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HomeMy WebLinkAbout51235-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#: 51235 Date: 10/03/2024 Permission is hereby granted to: FI Lookout LLC 238 Curwen Rd Rosemont, PA 19010 To: alter unfinished attic to living space (to include new dormer addition) to existing single- family dwelling as applied for. Premises Located at: 1153 Treasure Pond Rd, Fishers Island, NY 06390 SCTM#8.-2-3.2 Pursuant to application dated 07/19/2024 and approved by the Building Inspector. To expire on 10/04/2026. Contractors: Required Inspections: Fees: Single Family Dwelling- Addition&Alteration $495.00 CO-RESIDENTIAL $100.00 Total S595.00 Building Inspector 44 TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone(631) 765-1802 Fax(631) 765-9502 hi s://'ww �&r. o titli oldto liii ,p Date Recelved BUILDINGAPPLICATION FOR I For Office Use Only PERMIT NO. Building Inspector: Applications and forms must be filled out in their entirety. Incomplete applications will not be accepted. Where the Applicant is not the owner,an Owner's Authorization form(Page 2)shall be completed. Date: June 17, 2024 OWNER(S)OF PROPERTY: Name: Carol Bradbeer SCTM#1000-008000200003002 Project Address: 1153 Treasure Pond Rd. Phone#: 610-316-3997 1Email:boymom4@verizon.net MailingAddress: 414 Old Lancaster Rd. Apt. 401 Haverford, PA. 19041 CONTACT PERSON: Name: Mailing Address: Phone#: Email: DESIGN PROFESSIONAL INFORMATION: Name: Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: Name: HP Broom Housewri ht Mailing Address: P.O. Box 70, 162 Fer Rd. Hadlyme, CT. 06439 Phone# '��i Email: 'ulie@h broom.cm DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition RAlteration ❑Repair ❑Demolition Estimated Cost of Project: ❑Other $_ Will the lot be re-graded? ❑Yes 1@No Will excess fill be removed from premises? ❑Yes ONO i PROPERTY INFORMATION Existing use of property: residential Intended use of property: Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? Dyes NNo IF YES, PROVIDE A COPY. ❑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 building(s)for necessary Inspections.False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210AS of the New York State Penal Law. Application Submitted B {., pp y(print name): Ik ��� ` � NAuthorized Agent ❑Owner M. .. Signature of Applicant: """�" Date: June 17, 2024 STATE OF . 9K)Ct1rNTNXVt.Gtw* SS: 616 Ly 14� COUNTY OF SWAW4 William A. Bartlett being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)heisthe Contractor- HP Broom Housewright (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/her knowledge and belief;and that the work will be performed in the manner set forth in the application file therewith. Sworn before me this day of 20 9 Notary Pu RYN S Lam. NOTARY Pusuc State of Connecticut T_ ER AUTHORIZATIONy Commission Expires (Where the applicant is not the owner) September 30r 2024 ,, Carol Bradbeer residing at 1153 Treasure Pond Rd. do hereby authorize William A. Bartlett to apply on my behalf to the Town of Southold Building Department for approval as described herein. 6/18/2024 Owner"s� g Signature Date Carol Bradbeer Print Owners Name 2 V RECEIPT C pY k SUFFOLK COUNTY GOVERNMENT DEPARTMENT OF LABOR, LICENSING, AND CONSUMER AFFAIRS 11agg at ACTING COMMISSIONER JENNIFER CABRERA P.O. BOX 6100, HAUPPAUGE, NY 11788 (631) 853-4600 Today Date: 10/26/2023 Application: H-1 3061-REN02 , License #: H-13061 Application Type: Home Improvement License Renewal Fee Allocation: Fee Item Description Fee Amount Amount Paid Amount Paid Total Balance Due License Renewal $400.00 $400.00 $400.00 $0.00 .Total. * . __--------_.,...... ....�_._.. ..... _....... .._ .__. $400.00 $400 00 $400.00 $0 00 Receipt No. 514129 Payment Method Ref, Number Amount Paid Payment Date Cashier ID Comments Check 25253 $400.00 10/26/2023 LSALVAG Total: .... ...... . . . ....,...__... . -_....$400......._..---- ---------- ... .. . ....... .......------ - ....,... ..... .. 00 Contact Info: HP BROOM HOUSEWRIGHT INC HARRY P BROOM PO BOX 70 162 FERRY RD HADLYME, CT 06439 Work Description: Suffolk County Dept. of Labor, Licensing&Consumer Affairs ` HOME IMPROVEMENT LICENSE Name �a.., HARRY P BROOP,I Business Name This certifies that tie HP BROOM HOUSf-WHIGH i INC hearer is duly licensed License Number H-13061 ty to cot,my of Suffolk Issued: 1 1'01•1986 � . 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