HomeMy WebLinkAbout51438-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#: 51438 Date: 12/04/2024
Permission is hereby granted to:
Fredy M Castaneda
1480 Elijahs Ln
Mattituck, NY 11952
To:
construct alterations(finish basement)to existing single-family dwelling as applied for.
Premises Located at:
1480 Elijahs Ln, Mattituck, NY 11952
SCTM# 108.-3-5.12
Pursuant to application dated 10/11/2024 and approved by the Building Inspector.
To expire on 12/04/2026.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling- Alteration $845.00
CO-RESIDENTIAL $100.00
Total $945.00
Building Inspector
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 litt s://wwwy southoldtow�tn ,gore
Date Received
APPLICATION FOR BUILDING PERMIT "
a
For Office Use Only
4,
PERMIT NO. Building Inspector:
Applications and forms must be filled out in their entirety. Incomplete
applications%Vjll not be accepted. Where the Applicant is not the owner,an
Owner's Authorization form(Page 2)shall be completed.
Date: to .j
OWNER(S)OF PROPERTY:
Name: Fredy Castaneda SCTM# 1000-
Project Address: 1480 Elijahs Ln, Mattituck NY 11952
Phone#: 6315203020 Email: mirsitacastaneda@gmail.com
Mailing Address: 1480 Elijahs Ln, Mattituck NY 11952
CONTACT PERSON:
Name: Fredy Castaneda_
Mailing Address: 1480 Elijahs Ln, Mattituck NY 11952
Phone#: Email: mirsitacastaneda@gmail.com
DESIGN PROFESSIONAL INFORMATION:
Name: MhtZK SC Z
Mailing Address: 0 �� C" " Ci
Phone#: Email:MLkSo"?/G�
CONTRACTOR INFORMATION:
Name:
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition KAlteration ❑Repair ❑Demolition Estimated Cost of Project:
❑Other
Will the lot be re-graded? Dyes ENO Will excess fill be removed from premises? yes ❑No
. 1
I
PROPERTY INFORMATION
Existing use of property: N M . Intended use of property:
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
/ 2+0 this property? ❑YesKNNo IF YES, PROVIDE A COPY.
Check Box After Reading: The owner/contractor/design professional is responsible for all drainage and storm wafer ISsms as provided by
Chapter 236 of the Town Code.APPLICATION 15 HERESY MADE to the Building Uepartment#or the issuance of a aulldir*Permit pursuattt to the Building Zone
Ordinance of the Town,o'Southold,SAW,County,New York and other applieabte Laws,Ordinances or Regulations,for the construction of buildings,
additions,alterations orfor removal or demolition as herein described.The applicant agrees to comply with all appllcable laws,ordirrantes,building code,
housing code and regulations and to admit authorized inspectors on premisas and in building(s)for necessary Inspectlons..False statements made herein are
punishable as a Class A misdemeanor pursuant to Section 250,45 of the New York State Penal Law,
Application Submitted By(p int name): M n� authorized Agent Owner
Signature of Applicant: Date: [�
STATE OF NEW YORK)
ASS:
COUNTY OF `
Z— being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the
(Contractor,Agelit,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 �C-Foe r , 20
Nota` li
JULIANNE CAROLINE FEDELE
Notary Public.State of New York
N0.01FE0016050
QuaNffed in Suffolk Caur:y
-.,- - — -- My Commission Expires Nov „1, 2027
(Where the applicant is not the owner)
residing at �
do hereby authorize C/" ,2— ;F- to apply on
my behalf to a Town of Southold Buildil� Department for approval as described herein.
*r` ., ✓r
Own is Signature Date
Print Owner's Name
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