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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 v ,o