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Home My WebLink About51063-Z TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit *: 61063 Data: 8/13/2024 Permission is hereby granted to Walsh, Jeremy 3460 Camp Mineola Rd _ Mattituck, NY 11952 To: Install new HVAC unit to existing accessory structure as applied for, with flood permit. Accessory PreCO as overflow sleeping quarters, pending. At premises located at: 200 Fay Ct, Mattituck SCTM # 473889 Sec/Block/Lot # 123.-5-12 Pursuant to application dated 6/21/2024 and approved by the Building Inspector_ To expire on 2112/2026. Fees: ACCESSORY $250.00 ELECTRIC $100.00 CO - ACCESSORY BUILDING $100.00 Flood Permit $150.00 Total: $600.00 ->;N- Building Inspector TOWN OF SOUTHOLD — BUILDING DEPARTMENT ' Town Hall Annex 54375 Main Road P. O. Box 1 179 Southold, NY 1 1971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 Gov 4 Date Received APPLICATION FOR BUILDING PERMIT El',�L-;��3 D) D I- e For Office Use Only _ + PERMIT NO. J Building 1"speczora `; �'- a Applications and forms must be filled out in their entirety. Incomplete TOWN;-# applications will not be accepted. Where the Applicant is not the owner,an Owner's Authorization form (Page 2)shall be completed. Date: C-j — I ec —ZO` OWNER(S) OF PROPERTY: Name:TARA AND JEREMY WALSH ScTM # 1000-123.-5-12 Project Address:200 FAY COURT MATTITUCK Phone #:347-834-2757 Erna i1:1EREMYWALSHLAW@GMAIL.COM Mailing Address:200 FAY COURT MATTITUCK 1 1952 CONTACT PERSON: Name:JEREMY WALSH Mailing Address:200 FAY COURT MATTITUCK 11952 Phone #:347-834-2757 Email:JEREMYWALSHLAW@GMAIL.COM DESIGN PROFESSIONAL INFORMATION: Name:AS ABOVE Mailing Address: Phone #: Email: CONTRACTOR INFORMATION: Name:AS ABOVE Mailing Address: Phone #: Email: DESCRIPTION OF PROPOSED CONSTRUCTION =New Structure [--]Addition DAlteration ORepair ODemolition Estimated cost of Project: E]Other $31 00.00 Will the lot be re-graded? DYes ®No Will excess fit[ be removed from premises? DYes ONo s PROPERTY INFORMATION Existing use of property:2 1 Q_ 1 intended use of property:2 1 0_0 Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? I]Yes ®No IF YES, PROVIDE A COPY. 8 Check Box After Reading: The owner/contractor/design professional is responsible for all drainage and storm water issues as provided by Chapter 236 of the Town Code. APPLICATION IS HEREBY MADE to the Building Department for the Issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold,Suffolk,County,New York and other applicable Laws,Ordinances or Regulations,for the construction of buildings, additions,alterations or for removal or demolition as herein described.The applicant agrees to comply with all applicable laws,ordinances,building code, housing code and regulations and to admit authorized inspectors on premises and in bullding(s)for necessary Inspections.False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the New York State Penal Law. Application Submitted By (print b).J E RE MY WALS H pAuthorized Agent Downer Signature of Applicant: Date: 06-1 9-2024 STATE OF NEW YORK) SS: COUNTY OF NASSAU J E RE MY WALS H being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)he is the OWNER (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his/h-er knowledge and belief; and that the work will be performed in the manner set forth in the application file there-- Sworn before me this 19 day of JUNE 2024 OF NEW YORK 4 t+lO A PUBLIC i (Where the applicant is not the owner) residing at +frllttt� do hereby authorize to apply on my behalf to the Town of Southold Building Department for approval as described herein. Owner's Signature Date Print Owner's Name 2 y TOWN C>F SOUTHDLD — BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold, NY 1 1 97 1-0959 Telephone (631) 765-1802 li ps:// w.s<3 Floodplain is PROPERTY INFORMATION: Flood Zone:AE FIRM Panel:09-25-2009 SCTM # 1000-05.00-012.01 Address:200 FAY COURT city:MATTITUCK NY zip: 1 1952 CONTACT PERSON: Name:JEREMY WALSH Phone #:347-834-2757 Mailing Address:200 FAY COURT MATTITUCK NY 1 1952 PROJECT DESCRIPTION: REPLACE WINDOW WITH PATIO DOOR AND REPLACE HEATING AND COOLING UNIT TO ACCESORY STRUCTURE SECTION A: STRUCTURAL DEVELOPMENT (CHECK ALL THAT APPLY) Type of Structure Type of Structural Activity 8 Residential (1 to 4 families) 0 New structure 0 Residential (more than 4 families) f] Demolition of existing structure 0 Combined use ® Replacement of existing structure O Non-residential 0 Relocation of existing structure 0 Elevated 0 Addition to existing structure 0 Flood proofed (attach certification) [--I Alteration to existing structure 0 Manufactured Home I-] Other: _ = Located on individual lot M Located in manufactured home park SECTION B: OTHER DEVELOPMENT (CHECK ALL THAT APPLY) 0 Clearing of trees, vegetation or debris = Mining O Grading Drilling ID Dredging = Connection to public utilities or services [--] Paving O Placement of fill material 0 Drainage improvement (including culvert work) 0 Roadway or bridge construction 0 Fence or wall construction f] Watercourse alteration (attach description) M Excavation (not related to a structured development) i] Other development not listed (specify): By signing below I agree to the terms and conditions of this permit and certify to the best of my knowledge the information contained in this application is true and accurate. I understand that no work may start until-a permit is issued.The permit may be revoked if any false statements are made herein. if revoked, all work must cease until permit is re-Issued. Development shall not be used or occupied until a Cert. of Compliance is issued. The permit will expire if no work is commenced within one year of issuance. Other permits may be required to fulfill regulatory requirements. Applicant gives consent to local authority-or"representative'to make reasonable inspections to verify compliance. Application Submitted By (print n :J E RE MY WALS H Signature of Applicant: Date:O6-1 9-2024 1000-123.00-45.00-011.000 LAM NOT OR PORKMY XWORIR DUNN 100.00 f N 85°12'00 E CURB 0.41N 0.11 r i o I Ilrepl m t hvac o 11for accesory mIstructure iLA i Stoop in fb new P ^ _patio slidng door �.. 11.0 d, P•� lbw U w ' ix, //A37 c i o o cQ 40,6 I r 100.00 o:B f S S 85012'00„ 0.29 1000-123.00-05.00-013.000 UND NOT OR FORIDMY ■R=F. IRUS &VH=IRM C�2 T4 � L- BSI OF aff eASOMvs Sam a of I CMO=IMR SEARMx *SURWOR IS NOT RIMNSM FOR UNIMMM mm OR _ � 13 PREPARED FOR: SCAM: 1"=20' DR►WN BY: D.P.L. JEREMY WALSH FILE No.: Q124-22 LISA MCQUUKN DATE: JULY 13, 2022 LAND SURVSYIIVG SURVEY OF DESCRIBED PROPERTY AREA: 10,000.00 Sq.Ft. EAST274 EAST MAIN STREET11730 AT MA CIt, TOWN OF SOUTHOLD, 0,2296 ACRES TK I631 N.Y. 605 SUFFOIX COUNTY, NEW YORg ZONED "R-40" RESIDENCE TEL: 631-277-3905 SLIM: 1000-123.00-05.00-012.000 ELEVATIONS IN NAVD88 DATUM FAY: Iands 7-3906 lisaMlongislandsurveyor.com Ms SMU 15 l MUM v .0—7 R M.— Y LO. (W W tax tM D=a MMM acre Rrcn. 1c € uMtVM AM sM=nernoea TO MUM o . 3460 CAMP OIA ROAD, MATMUCK