HomeMy WebLinkAbout51567-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#: 51567 Date: 01/16/2025
Permission is hereby granted to:
Elizabeth Swift
725 Park Ave
Hoboken, NJ 07030
To:
Construct additions and alterations to an accessory garage as applied for to include second story
storage and an outdoor sauna.
Premises Located at:
1690 N Bayview Rd, Southold, NY 11971
SCTM#70.-12-37
Pursuant to application dated 11/07/2024 and approved by the Building Inspector.
To expire on 01/16/2027.
Contractors:
Required Inspections:
Fees:
Accessory-Addition/Alteration $375.00
CO Accessory $100.00
Total $475.00
21
Building Inspector� �
tlbW"pC
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 littpsHwww.southoldtowiinv.gov
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
PERMIT N0. �
Building Inspector., NOV 7 2024 �
,.
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: — L4 -a c a s
OWNERS)OF PROPERTY:
Name: T>,Ay�� SW 1000-
ProjectAddress: ` GC\0 R.
Phone#: —1 l � —_�� S—aLIa3 Emai1: X SWI1i;+T K\K\
Mailing Address:
CONTACT:PERSON:
Name: A<og
Mailing Address;
Phone#: —�(.!�s—�as`1 Email:
DESIGN'PROFESSIONAL INFORMATION:
Name:
Mailing Address„
Phone#: Email:.
CONTRACTOR INFORMATION:'
Name: ,
Mailing Address:
Phone#: G3 !— 14 Email: K,C N�lam. P�
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition VAlteration ❑Repair ❑Demolition Estimated Cost of Project:
❑Other $ "
Will the lot be re-graded? ❑Yes 190 Will excess fill be removed from premises? ❑Yes k,0
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 END IF YES, PROVIDE A COPY.
❑ i 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 building;
addRions,alteratbro or for removal or demolition as herein described The applicant agrees to comply with all applicable laws,ordinances,building code,
housing code and regulations aid to admit authorized Inspectors on premises and In building(s)for necessary inspections.False statements made herein are
punishable as a Cass A misdemeanor pursuant to Section 210AS of the Now York State Penal Law.
,t
Application Submitted By(print name • v Authorized Agent
Signature of Applicant: Date:
CONNIE D.BUNCH
STATE OF NEW YORK) Notary Public,State of New York
No.01BU6185050
SS: Qualified In Suffolk County
COUNTY OF! CV) 04 ) Commission ExplreSApr11 14,2
k It duly sworn,depos s' a tthat s)he is the app ica t
(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 �—
t` day of Nov OR 6ec- 20 4
Notary Public
MARC S.WASSER
Notary PUblic,State of New York
Qualilicd in Nassau County
I No.01 WA6340938
` .:_ a My Commission Expires April 25,20
(Where the applicant is not the owner)
I, Ryl� 1 residing at bQ� !"° • LAO1EIP1 (ZD .
Ny do hereby authorize I Q a P41116� to apply on
my alf to the Tow Southold Building Department for approval as described her
Owner's Sig Date
1Zf
Print Owner's Name
2
Suffolk County Dept of
Labor,Licensing&Consumer.Affairs' -I
HOME IMPROVEMENT LICENSE
Name
� RONALD PONELLA
Business Name
� TITAN CONSTRUCTION MANAGEMENT {
This cart11es'thatttra SERVICES INC
bearer Is dryly licensed
by the County of Suffolk License Number HI-63813
Wagftz,T. "w' Issued: 06/19/2020
Commissioner Expires: 06/01/2026
i
Suffolk County Dept.of
Labor,Lieeneirig&Consumer Affairs
HOME IMPROVEMENT LICENSE
Name
RONALD PONELLA
Business Name
TITAN CONSTRUCTION MANAGEMENT
This certifies that the SERVICES INC
bearer is duly licensed a
by the County of suffolk License Number HI-63613
Issued: 06/19/2020
W "�T Expires: 06/01/2026
Commissioner