HomeMy WebLinkAbout51576-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#: 51576 Date: 01/21/2025
Permission is hereby granted to:
Michael Nemeth
115 Ernest St
Massapequa, NY 11758
To:
Construct a pavilion accessory to an existing single-family dwelling as applied for. Structure must
maintain minimum rear and side yard setbacks of 10 feet.
Premises Located at:
2900 Stillwater Ave, Cutchogue, NY 11935
SCTM# 136.-2-15
Pursuant to application dated 11/20/2024 and approved by the Building Inspector.
To expire on 01/21/2027.
Contractors:
Required Inspections:
Fees:
Accessory-New Structure $28S.00
CO Accessory Structure $100.00
Total $385.00
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 htt s://www southoldtgMM.n .Lynv.
Date-Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
PERMIT NO. Building lnspecton-... O 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 l t t3 "�07,virtrn rat
Owner's Authorization form(Page 2)shall be completed. aGiptd'
Date: 11/11/2024
OWNER(S)OF PROPERTY:
Name: Michael Nemeth SCTM#1000-136.-2-15
Project Address:2900 Stillwater Avenue, Cutchogue, NY 11935
Phone#:631-734-7923 (Agent) IEmail:creativeenvdesign@yahoo.com
Mailing Address:P.O. Box 160, Peconic, NY 11958
CONTACT PERSON:
Name:David Cichanowicz / Creative Environmental Design
Mailing Address: P.O. Box 160, Peconic, NY 11958
Phone#:631-734-7923 Email:creativeenvdesign@yahoo.com
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name:Creative Environmental Design
Mailing Address:P.O. Box 160, Peconic, NY 11958
Phone#:631-734-7923 Email:creativeenvdesign@yahoo.com
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project;
❑• other Pavillion 16x20 see attached plans $30,000
Will the lot be re-graded? ❑Yes iiJ No Will excess fill be removed from premises? ❑Yes WNo
1
PROPERTY INFORMATION
Existing use of property: Intended use of property:
C 4 J1f � t �0.
Zone or use district in which premises is situated: Are there any covenan�ttsff nd restrictions with respect to
this property? ❑Yes L1dNo IF YES, PROVIDE A COPY.
IV Check x After Reading: The owner/contractor/design professional is responsible for all drainage and storm water issues as provided by
Civapter 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.
t e : ; ENditch rnUa�l�� bCSi N IIQAuthorized Agent ❑Owner
Application Slubrrrltte n ) �` ,�
Signature of Applicant: , Date:
STATE OF NEW YORK)
SS:
COUNTY OF S u lij�aAV-, )
t1.7 t being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
(S)he is the o
113 (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
day of NCO exys e.C 20 ')YILA%l
DN
No Public
iEl�ilaY LO�ilil INOTARY PI.BLI�C,STAtRegi tion No.0Quaiifiedn�ufWhere the appyant is not OPERTY OWNER )Z )ON
Gr�rrrrrliWon Expires D0 ( the owner)
I, residing atI00 2A'NkWmNerAve, t e-
do hereby authorize to apply on
C, f to the Town uthold Building Department for approval as described herein.
�[3 202�wner's Signature Date
c�C� �� S 1 V 12LIiL
Print Owner's Name
2
�• ,n° Suffolk County Dept.of
Labor,Licensing&Consumer Affairs
HOME IMPROVEMENT LICENSE
Name
DAVID J CICHANOWICZ
Business Name
INDIAN NECK CORP DBA
This certifies that the
bearer is duly licensed License Number H-29895
by the County of suffolk Issued: 12/13/2001
Jefto'ifwCabYefa, Expires: 12/01/2025
Commissioner
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