HomeMy WebLinkAbout51255-Z ��oFsoUTy° 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#: 51255 Date: 10/08/2024
Permission is hereby granted to:
Stella T Smith
1380 Hobart Rd
Southold, NY 11971
To:
demolish existing shed as applied for.
Premises Located at:
49100 Route 25,Southold, NY 11971
SCTM#70.-7-6
Pursuant to application dated 08/16/2024 and approved by the Building Inspector.
To expire on 10/09/2026.
Contractors:
Required Inspections:
Fees:
DEMOLITION $205.00
Total $205.00
Building Inspector
°�0 UfF01M�oG TOWN OF SOUTHOLD—BUILDING DEPARTMENT
e� y� Town Hall Annex 54375 Main Road P. O. Box 1179 Southold NY 11971-0959 .
Telephone 631 765-1802 Fax(631) 765-9502 hqs://www.southoldtownpy.izov '
APPLICATION FOR BUILDING PERMIT
For Office Use Only
PERMIT NO. 519,55 Building Inspector: G9�`r
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:
LIC
Date: I
OWNER(S)OF OPERTY: .
Name: ,P� 7FSCTM-!1000- "7/0 — -7_ (�
Project Address: (QO _ -(� -- - -- -. - _- )--Cti1--
Phone#: L Email:
---- - �_-- . a. -- - ----- ---- -
Mailing Address:
CONTACT PERSON:
Name:
----------
Mailing Address:
Phone#: Email:
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name:
fn -(- �510. ---- - - —---- ---—- - - - -- -- - ----
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair XDemolition P'� I Estimated Cost of Project:
❑Other slued $ Oco
------------------ ------ ---- - ---- ----- - --- - -- --- -- ---- ---- --- -
Will the lot be re-graded? ❑YesNo Will excess fill be removed from premises? ❑Yes No
PROPERTY INFORMATION
Existing use of property: C Intended use of property:
- -- -- - CGC 5- g107 - - ------- ----- >2.envvwt c4a�cek; s'F'v--
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
-� — this property? ❑Yes ❑No 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 210.45 of the New York State Penal Law.
olle
Application Submitted By(print n 5ZAUthorized Agent []Owner
Signature of Applicant: Date:
STATE OF NEW YORK)
SS.
COUNTY OF C) ^p
being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the AL
(Contractor,Agent,Corporate Officer,etc.)
of said owner or owners,and is duly authorized to perform or have performed the said work an 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 27'
of ETSYiA.PERKINS
Notary Public,State of New York
No.0 1 PE6130636
PROPERTY OWNER AUTHORIZATIONQualifled In Suffolk Cou
ply
(Where the applicant is not the own&�mmission Expires July 18, -)S--
V S
residing at
OAAl +()I l,� do hereby authorize pb'fy t C / 1 C6 to apply on
my behalf to the Tow of Southold Building Department for approval as described herein.
Owner's Signature Date
V Q�G Srwx
Print Owner's Name
2
SURVE:YE0 r0Q
H N R Y, S M I T H
AT co A
Sou-`HOLD OFy No.LS 2%W
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SFO SAND SVP� v
5UF-F-OLK CCUr4rY N- Y. � �•t
APP OVED AS NOTED '� m
VA B.P.# tS � cv
FEE S,D� BY. /
NOTIFY BUILDING DEPARTMENT AT-
6765-1802 8AM TO 4PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATIOItI
FOR POUREi
Sca(e- :40 ,— irr
2. ROUGH-FIR,�,��iI; L .. �
•o I.r,�_.._ i
3. INSULATION ` ,��'
4. FINAL-CONSTRUCTION i1fiUST W a / or `� � �� �
f7- v
BE COMPLETE FOR C.O. `` •- y
� �� ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW"
x Q -
` YORK STATE. NOT RESPONSIBLE FQA
OESIGN OR CONSTRUCTON ERROR, •� O `� $► 34'- >
�Qi S34 rA
COMPLY WITH ALL CODj OFr ��
NEW YORK STATE&TOWN CODES ' ^'
AS REQUIRED AN ., • se% �� `.. ..
D CONDITIONS OF
SOUTHOLD ZBA
SOUTH TOWN PLANNING BOARD �� q �•` �p .
SO , TOWN TRUSTEES � -c�� -,� 4- d'
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