HomeMy WebLinkAbout51405-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#: 51405 Date: 11/21/2024
Permission is hereby granted to:
Russell L Gregg
PO BOX 1302
Southold, NY 11971
To:
Relocate accessory shed from off premise location as applied for. Shed must maintain minimum side
and rear yard setbacks of 10 feet.
Premises Located at:
65 Great Pond Way, Southold, NY 11971
SCTM#59.-9-10.6
Pursuant to application dated 10/01/2024 and approved by the Building Inspector.
To expire on 11/21/2026.
Contractors:
Required Inspections:
Fees:
Accessory-New Structure $225.00
CO Accessory Structure $100.00
Total $325.00
Building Inspector
t k � yy 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 httL)s. outl ol.dtuwl ,
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only L5,
G k..bV ,
L�
PERMIT NO. I `D Building Ins eec:r� CT j roy
Applications and forms must be filled out in their entirety. Incomplete
applications will not be accepted. Where the Applicant is not the owner,an RUITIDWG 1+W
Owner's Authorization form(Page 2)shall be completed. TOW`i 1F St ".7- 011 "
Date:
OWNER(S) OF PROPERTY:
Name: SCTM # 1000-
vss� `� � G� Q—
Project Address: (a'S 6C eAT T0LJ4 ha `�(� fV T �
Phone#: Lq 3l 1 -3(0345 Email: r S s 0-r i Mv Ale—'
Mailing Address: A --Say l3 02 SnJ-o Id /V 119 �H
CONTACT PERSON:
Name*
Mailing Address:
Phone#: Email
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone#: & 1 --'-4' --4357 Email: -YPamles ZbCA3sk.��Q
CONTRACTOR INFORMATION:
Name: 5 p rwt..e—
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project
Will the lot be re-graded? ❑Yes B''Vo Will excess fill be removed from premises? Eyes ❑No
1
PROPERTY INFORMATION
Existing use of property: Intended use of property:
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? ❑Yes ONO 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 HER 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 210.45 of the New York State Penal Law.
Application Submitted By(print name): ❑Authorized Agent ❑Owner
Signature of Appli nwt: Date:
STATE'OF NEW PORK) `
COUNTY OF'
SS-G l L G''r being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)he is the
(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; arid
that the work will be performed in the manner set forth in the application file therewith.
Sworn before me this
day of /),e�- 20 a 4 c
12 zj"
Notary P blic
MERE MEREWN,BuTTERS
Notary Public,State of New Yo*
�1�
No. 1�
PROPERTY OWNER AUTHORIZATION SufWk
(Where the applicant is not the owner)
I, �U rS e- I( �` '� vJJ residing at �f --T �G /,
do hereby authorize to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
Z_&/ z�
Owner's Signature Date
S f e-LL[._ L_ a
Print Owner's Name
2
JIM DEERKOSKI.PE
phone:(631)298-7116
- -...,_
FRONT ELEVATION RIGHT ELEVATION
SCALE:1/4"=1'-0" SCALE:1/4"=1'-0"
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LEFT ELEVATION REAR ELEVATION W p
SCALE:1/4"=1'-0" 10'-0' SCALE:1/4"=1'-0" CA Wx x
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CROSS SECTION A „ SCALE: SEE PLAN
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SCALE:1/4"=1'-0"
SHEET NO:
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FLOOR PLAN FOUNDATION PLAN o
SCALE:1/4"=1'-0" SCALE:1/4"=1'-0"
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OPEN SPACE �e
SURVEY OF PROPERTY
FO R
H.S. ;T a-SO-38 COMMUNITY DEVELOPMENT AGENCY
AREA =3;172sq ft. AT SOUTHOLD
TOWN OF SOUTHOLD
----.cER rIFIEO ro
SUFFOLK COUNTY , N.Y.
SOUTHOLD SAVINGS BANK 1000 - 59 - 09 - P/0 10
RUSSELL GREGG
TAMMY GREGG SCALE I/1 = 30 '
SC TIC INC. N 0 V. 22 , 1988
Sept. 1, 1989 (fond. /oc. )
Feb. 13, 1990 (final)
��O LAND SG
M1�LP
o
Y.S C. NO. 49618
ECON
(516) 765 a p�gW P.C. tit Fix
P. O. BOX mow- a
MAIN ROAD LOT NUMBERS REFER TO : "MINOR SUBDIVISION "
SOUTHOLD. N.Y. 11971 MADE FOR COMMUNITY DEVELOPMENT AGENCY.