HomeMy WebLinkAbout51562-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#: 51562 Date: 01/16/2025
Permission is hereby granted to:
William Isaacson
356 S Silver Pond Rd
Boca Raton, FL 33432
To:
legalize "as built"outdoor shower as applied for.
Premises Located at:
4030 Nassau Point Rd, Cutchogue, NY 11935
SCTM# 111.-8-20
Pursuant to application dated 11/15/2024 and approved by the Building Inspector.
To expire on 01/16/2027.
Contractors:
Required Inspections:
Fees:
As Built Addition/Alteration $500.00
CO-RESIDENTIAL $100.00
Total $600.00
Building Inspector
www J," TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P.O.Box 1179 Southold,NY 11971-0959
Telephone 631 765-1802 Fax 631 765-9502 htt? L/wN v.sg1gEi�olclto�N'tatt ov
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Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only �
J
PERMIT N0, D Building Inspector:
Applications and forms must be filled out in their entirety.Incomplete
applications will not be accepted. Where the Applicant is not the owner,an
Owner's Authorization form(Page 2)shall be completed.
Date:
OWNER(S)OF PROPE TY:
Name: `�� \\;a v.• �-.Scx c so a SCTM#1000- ((,1 sp0—OV .04—OaO•OOO
S LI U l wos
Project Addres
Phone#: E61- a$o1- (too Email: Y Jcr r , r e: l crw
Mailing Address: 1 3 ��
u .
CONTACT PERSON:
Name: (V10.A, Scher,-�z
Mailing Address: a$LA cif mG'� �o� C�� ��ro�u� `( 1��35
Phone#: �. 31y— '16 a Email oyv)l;Ne .
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address: aFS q g-S (Ylk, R o la
Phone#: (o 1 y y I Email: yµ
CONTRACTOR INFORMATION:
Name:
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑ evwr StrtV
❑Addition ❑Alteration ❑Repair ❑'Dem ition Estimated Cost of Project:
her '" d
Will the lot be re-graded ❑Ye s No Will excess fill be removed from premises ❑Yes ❑No
1
PROPERTY INFORMATION
Existing use of property: ,'N(kg Intended use of property: S �
Zone or use district in which premises is situated„ Are there any covenants and restrictions with respect to
this property? ElYesAvo 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 bullding(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): uthortzed Agent ['Owner
Signature of Applicar- Date:
. ® �
CONNIE D.BUNCH
STATE OF NEW YORK) Notary Public,State of New York
S W No.01BU6185050
COUNTY OF It- ) Qualified In Suffolk County
Commissi,)n Expires April 14,2�-
f - being duly sworn,deposes and says that(s)he is the applicant
Name of individual signing above named,
( nin g g contract) amed,
(S)he is the
(Contra or,Agent,16orporate 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 efore me this
�o � tt_nA•�O � IQ-)L l 41
I day of �� P 2GO
Notary Public
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
residingat 3510 S S; ,- rPG`..� �ac�
A `1 33y'�� do hereby authorize �i���» �LIJQ { Z to apply on
my behalf to the To n of hold Building Department for approval as described herein.
!. I�. a a.(
Owne_s Sign to a Date
i \\M C,, k. gym.,.
Print Owner's Name
2
REVISIONS:
SITE DATA
PROPERTY: 21,499 SF 0.494 ac
y ESTIMATED AREA OF -
.'.,^' .^ '!"°^'"^"a'�.•. ....•... ^4`: " ,._ � 'i ,��1, � D DISTURBANCE. 4.000 SF
:tea
" ~ ' NON CONFORMING LOT: R-40
EXISTING: AREA LOT COVERAGE:
HOUSE: 1,716 SF
DECK: 578 SF
yy PORCH: 200 SF
.,.�.--- .- ,�_-a / HOT TUB 63.2 SF
OUTDOOR SHOWER: 32.0 SF
i ;� •. ,r.
e7:, TOTAL: 2589.2 SF 12.1%
METES AND BOUNDS: SURVEYOR: SECCAFICO LAND SURVEYING, PC
SCTM: 1000-111-08-20
00 DATE SURVEYED: AUGUST 15,2024
ELEVATIONS REFRENCE: NAVD 1988
01
Da
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OUTDOOR SHOWER
0
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GA
o �� E N78 3620� 200 . 00
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S 78036 20 W 230oOO'
O
;ON - 16 DRAWN: MH/MS
\�o SCALE:
EXISTING SITE PLAN . . JOB#:
SCALE: V = 10'-0" W► 11/11/2024
s �' �, _ SHEET NUMBER:
M S-1