HomeMy WebLinkAbout51571-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#: 51571 Date: 01/17/2025
Permission is hereby granted to:
Daniel Jones
PO BOX 141
Southold, NY 11971
To:
demolish existing accessory shed as applied for,
Premises Located at:
925 Town Harbor Ln, Southold, NY 11971
SCTM# 61-4-11
Pursuant to application dated 01/17/2025 and approved by the Building Inspector„
To expire on 01/17/2027.
Contractors:
Required Inspections:
Fees:
DEMOLITION $285,00
Total -p
of __
L
Building Inspector
TOWN OF SOUTHOLD-BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold, NY 11971-0959
p ) ) ::://www.southoldtowuu
Telephone 631 765-1802 Fax 631 765-9502 iLttnL://www.southol—dt-o-w-n—n�y-&qv
Received
APPLICATION FOR BUILDING PERMIT
Ua
For Office Use Only «
PERMIT NO.
Building Inspector: `J" N
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 F'.(OP91RI TY
Name: " n � � V v r 1 e5 SCTM #1000- -
Project Address: n arbor" k)le
Phone#: `) Sl(, Email: )p Q L`L.CPS IM
Mailing Ad mess: J 'i �
CONTACT PERSON:
Name:
Mailing Address:
u m ail:
Phone# - `J� E
DESIGN kOFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name: bLW
t7
Mailing Address:
Phone#: b Email:
DESCRIPTION OF P"ROPI"SED CONSTRUCTION
❑New Structure ❑ ❑
❑Other "'�
Addition Alter Lion ❑Re pair Estimated emolition $ Cost of Project:
:�.
Will the lot be re-graded? Dyes FNo Will excess fill be removed from premises? s ❑No
1
PROPERTY INFORMATION
Existing use of property;non , ' Int 11 ended use of property: I cY)
Zone or use district in which re Ises Is situate
p ,, Are there any covenants and restrictions with respect to
this property? ❑Yes ilo IF YES, PROVIDE A COPY.
O'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 b Class A misdemeanor pursuant to Section 210.45 of the New York State Penal Law.
Application Submitted By(print name): 1 O6 \t 'Y"e5 ❑Authorized Agent ffowner
Signature of Applicant: ' , m Date: .`
CONNIE D. BUNCH I
Notary Public,State of New York
STATE OF NEW YORK) No.01BU6185050
Quallfled in Suffolk County
SS: COMMISSlon Expires April 14,2�
COUNTY OF
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
2 �.� ��
�ay of .,N .k. ' � x 20 Y'v�
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
` N, N 78 5 U + ..- """" FM 1!5192, OCT.21,1968 }
A9 .
SURVEY OF
DESCRIBED PROPERTY
O�� SITUATE
� SOU THOL D, TOWN OF SOUTHOLD
SUFFOLK CO.,N.Y.
di
SURVEYED FOR DANIEL ✓ONES
LUCILLE JONES
t
� cue TM 9 1000-063-04-II
A_
SURVEYED 25 AUGUST, 1995
Z "s SCALE: 1 = 40'
c Q w AREA r 0,753.128 SF
kal
� - C� 1.4636 Acres
_ 3g. 1 NOTES
irk\ N l ' �O1
� �z � lad � ''�
SP I THIS SURVEY WAS DEEDS:
TED FROM
Z T11E FOLLOWING DEEDS=
\0 L/BER 3502,page 209
0 LIBER 3438,page 548 GUARANTEED TO:
" E� OTw ° L/B£R 6101, page 5/5 - DANIEL JONES
f �c1 �� 'I LUCILLE ✓ONES
FIDELITY NATIONAL TITLE INS. CO.
0 l, t 2. i r /S ALSO BASED ON MAP OF TOWN THE GREATER NEW YORK SAVINGS BANK
N� .0 HARBOR TERRACE; ,SAID MAP FILED/N
S TOWN OF SOUTHOLD
THE COUNTY CLERKS OFFICE AS
MAP 5192, FILED OCTOBER 21, 1968
off
3_ THIS SURVEY WAS PREPARED USING SURVEYED BY
THE PREVIOUS STATED 1NR7RMATION STANLEY J. ISAKSEN,JR
AND PHYSICAL EVIDENCE FOUND ON P.O. BOX 294
THE PREMISES. NEW SLIFFOLK,N1Y.,11956
N �cpies of this survey map not bearing (S/6) 7�"4-,5'835
AS
the Land Surveyors embzssad s3ti shall
not be considered to be a valid true
.P -5 s11
NOTI0 COPY.
FEE Eg-'r"L art
FY BUILDING DE'6sAFgTMENT A COMVnavthsrized alteration nr addition to thf.
631-765-1802 8AM TO 4PM FOR THE OR` WITH &-�°°° CO � wmy is a violation of Section 7209 of
FOLLOWING INSPECTIONS: AS f NEW STATE � �� I �:: the Now-York State Education Law.
1. FOUNDATION-TWO REQUIRED
FOR FOR POURED CONCRETE 1 TOPS 78A
2. ROUGH-FRAMING&PLUMBING Guarantees wicated hen on shall run ICENSEC' LAN SURVEY
3. INSULATION 8 '�' TOWN PLANNING BOO only to the person for whom the wry N.Y.S. L1C NO. 49273
y
4. FINAL-CONSTRUCTION MUST TO' RUT 13 F ore
repd, and on his beholf to the
JOL
BE COMPLETE FOR C.O. tiff_ CM1300i Col,ent-al Agency,
ALL CONSTRUCTION SHALL MEET THE lending. InstK icrn, if listed hereon, and
REQUIREMENTS OF THE CODES OF NEW Sil1 OL ' P to the r-sinew of the lending insffteaion.
YORK STATE. NOT RESPONSIBLE FOR Guarantees are not transferable to
DESIGN OR CONSTRUCTON ERRORS additional Gatitutians or subsequent owrwNs 95R573