HomeMy WebLinkAbout51413-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 SPECIFICATION'S
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 51413 Date: 11/25/2024
Permission is hereby granted to:
Paul Mullins
1515 Plum Island Ln
Orient, NY 11957
To:
legalize "as built"outdoorshoweras applied for.
Premises Located at:
1515 Plum Island Ln, Orient, NY 11957
SCTM# 15.-5-5
Pursuant to application dated 10/04/2024 and approved by the Building Inspector„
To expire on 11/25/2026.
Contractors:
Required Inspections:
Fees:
As Built Accessory Structure $250.00
CO Accessory $100.00
Total $350.00
uilding Inspector
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
IN
" Telephone (631)765-1802 Fax(631) 765-9502 htt s:Hwwv w.southoldtowag . ov
Date Received
APPLICATION FOR BUILDING PERMIT
E C E WL"
For Office Use Only 1 .
pp
PERMIT NO. a — Building lnspectors
Applications and forms must be filled out in their entirety. ¢�vi-,�r� Department
PP ety.Incomplete � -��,�„�,�� ,�;�w�a..uti:obd
applications will not be accepted. Where the Applicant is not the owner,an
Owner's Authorization form(Page 2)shall be completed.
Date:
OWNER(S)OF OPER' Y.-
Name: SCTM#1000-
ProjectAddress: rv\ r OgWnf
Phone#: K-I � sZ ' � Email: V
Mailing Address:
CONTACT PERSON:
Name: `
Mailing Address: 4,-��
Phone#: Email:
DESIGN PROFESSIONAL INFORMATION:
Name: A
Mailing Address:
Phone#: 7Email:
CONTRACTOR INFORMATION:
Name:
Mailing Address: 000 y
Phone#: - 2 Email:
"� a � � • s= �� I�IK� � L
DESCRIPTION OF PROPOSED CONSTRUCTION
❑Repair Dl)emolition Estimated Cost of Project:
D
DOthertructure Addition C�IAltr�ion
Will the lot be re-graded? ❑Yes NO Will excess fill be removed from premises? ❑Yes'YNo
14
11
PROPERTY INFORMATION
Existing use of property: Rl�� Intended use of property:
1��Icef,
Zone or use district in which premises is situated: Are there any covenantp and restrictions with respect to
st � this property? ❑Yes o 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
apter 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 By(print name): ,.. [.-- �V` �' ❑Authorized Agent ner
Signature of Applicant: Date:
CONNIE D.BUNCH `� l
STATE OF NEW YORK) Notary Public,State of New York
SS: No, OI BU6185050
COUNTY OF Qualified in Suffolk County
Commission Expires April 14,County
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;and
that the work will be performed in the manner set forth in the application file therewith.
Sworn before me this
1 day of O&A6 ,ZD /ti-�
Notary Public
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
I, residing at
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
LOT 117
MAP OF"ORIENT BY THE SEA" SEC.2
AT ORIENT POINT,
FILED O SO NO.3444 PLUM ISLAND LANE
TOWN OF SOUTHOTHOLD
SUFFOLK CO.,N.Y.
SCTM 1000-15-05 -05 -
"�-- S87°1530'E
LOT AREA: 20,722.13 SF - 145.06 sme I `
0.48 ACRES
GUARANTEES:
PAUL MULLINS
MARGUERITE MULLINS
HAMLET TITLE AGENCY,INC. "
SCTM LOT 04 SCTM LOT 5
SCTM LOT06 Z
•WELL 43.1
2STORYFRAME y
&VINYL RESIDENCE
NO.1515
gLA 44*V SA d?y7,Vg,7NlS 7.2 r`O. 4
PETER A.GROBEN JoY a
LAND SURVEYOR NY LIC.50869 0 w
P.O.BOX 704 RIDGE,NY 11961 r +
631.049.4750
o
PONART OOMTNNAI�fT � -� , � N
f.FLAB VAMPLASM CAP
DATE OF SURVEY:12 MAR 2023 9 I,Tj x S t
�o
THE OFFSETS OR AR ENSIGNS SHOWN FIFAONFROM WE PROPZRTEFORF MINNEES TO
THE S1TiUCTU TOMONFOR A SPECIFIC PURPOSE6 USE THEREFORE,EIIEC IO
NOTINfEN0E0 EOMNALaTR T THE PROR A Yl OTHER I TO 00lOE NNE ERECTION -
OFFEJCES,ADDRIONALSTHUCNRE90R ANY OTHER IAIPROVEMEN7:
UNAUTHORIZED ALTERATIONS ORAUUITIONS TOTHISSURVEYISA VIOLATION OF 51
SECTIONTm;SUBOWISON 2DOFTHENEW VORKSTATEEDLICATKINLAW.COPIES q-
OF THIS SURVEY MAP NOT BEARING THE LAND SURVEMITS IN SEAL OR -
EMBOSSED SEAL SHALL NOTBE CONSIDERED TO SEA VAUD TRUECOPY. - -- �5557774
$4 i89d FEMCE - - - -._
CEESURVE ISPREPAREDI AND ON SHALL BEHALFUN TO THE TO
ONFTNI WHOM V -
ERNMENVEYIS PRFPARLE AND ON THEIR BENAI TEOTHE 7IHECOMPANY GOV- N8B°57�0'W 145.00
ERNMENTAGENCY AND LENDING INSTRUTION LI87E0 HERE ON.CERTIFICATIONS
ARFNOT
NO RESPONSIBIUTYWASSUMEDBY THE UNDEIISIGNEDFORANYSURFACE,SUB- SCTM LOT 24.6
SURFACE,AERIAL EASEMENTS,SUBSURFACE UTILITIES AND/OR STRUCTURES
INOR OUT OF EASEMENTS IF M PROVIDED
SCTM 1000-15-05-05