HomeMy WebLinkAbout51640-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#: 51640 Date: 02/13/2025
Permission is hereby granted to:
1055 Soundview Rd LLC
200 E 61st St Apt 29ABC
New York, NY 10065
To:
legalize "as built"alterations to existing single-family dwelling as applied for. Additional certification
may be required.
Premises Located at:
1055 Sound View Rd, Orient, NY 11957
SCTM# 15.-3-13
Pursuant to application dated 04/23/2024 and approved by the Building Inspector,
To expire on 02/13/2027.
Contractors:
Required Inspections:
Fees:
As Built Alteration $675.00
CO-RESIDENTIAL $100.00
1hTotal $775.00
gilding Inspector
A -
%,— TOWN OF SOUTHOLD—BUILDING DEPARTMENT
n
g Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971 0959
Telephone (631) 765-1802 Fax (631) 765-9502 htt l�k%- Nkf southoldto nny= '
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only g
PERMIT NO. Building Ins stor _ _,
Applications and form must be, it ed out in their entirety.Incomplete
applicsitiorr will not be accepted. Where the Applicant Is not the owiner,an . _.
fees Auth6diwari e` shail be completed. .
Date: -
OWNER(S)OF PROPERTY:
] SCTM#Name: 1000- f 5
�/� I��t l
Project Address: — - r
10S S BSc)L)A t3t)1t; v 1.),,- le-r Fes''I_ y
Phore#. '
Email:
Mailing Address: 2_0C,
COITAL PERSON:
Name:J
Mailing Address: )Aiz 1 U U f-/Lc_( (5)NI r /fM4Vh-'1 - �h
Phone#: - IS75 CJH Ivl C Cllti`
- -
DESIGN PROFESSIONAL INFORMATION:
Name: -00/U _ 5- ib
Mailing Address:
Ph
Jwa
- :one#: Email
CC
CONTRACTOR INFORMATION:
Name:
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED C NSTRI;ICIION
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
Dther"al e ---
Willthe lot be re-graded? ❑Yes Po Will excess fill be removed from premises? ❑Yes ❑No
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 []No 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 Buflftg 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 aB applicable laws,ordinances,building code,
housing code and regulations and to admit authorized Inspectors on premises and In bulldktg(s)for necessary Inspections.false statements made herein are
punishable as a(lass A misdemeanor pursuant to Section 210AS of the New York State Penal Law.
Application Submitted B (print name):
.�/ g pp y(p_ ��c - eAuthorized Agent ❑Owner
Signature of ly`ppiicant: �� ���# � -��- Date: AV IL(L"2
STATE OF NEW YORK)
SS:
COUNTY OF
� � t being duly sworn, deposes and says that(s)he is the applicant
t-
(Name of individual signing contract) above named,
[5)he is the
(Contractor, gent,-orporate Officer,etc.)
of said owner or owners, and is duly authorized to p m 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
v
day of 20 �
Notary Public
RICHARD B. GROSS
PROPERTY OWNER AUTHORIZATION NOTgRY PUBLIC-STATE OF NEW YOR
No. 01 G R6271137
(Where the applicant is not the owner) Oualified in Nassau County
Certificate Filed in New York County
My Commission Expires 10-29-2024
residing at - q u j&
do hereby authorize r 'f4_TftLj �, j�!/� to apply on
my behalf to the S u d Building Department for approval as described her in.
_
c/o ly
Owner's Signature Date
G `(44s 14(m/0/ei
Print Owner's Name
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"MAP OF ORIENT-BY-THE SEA. SECTION ONE"
SITUATE AT ORIENT
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
FILED: NOVEMBER 21, 1957, FILE#2777
CERTIFIED TO: JONATHAN FOSTER
(jDCOPYMC4tT 2021 WARD BROOKS.ALL RIGHTS RESERVED.DUPLICATION OF THIS DOCUMENT IS A VIOLATION OF FEDERAL COPYRIGHT LAW.
THIS SURVEY HAS BEEN PREPARED IN ACCORDANCE WITH THE CODE OF PRACTICE ADOPTED BY THE NEW YORK STATE ASSOCIATION OF PROFESSIONAL LAND SURVEYORS.
CERTIFICATION SHALL RUN ONLY TO THE PERSON,THEIR INTEREST AND/OR ASSIGNS.
CERTIFICATIONS ARE NOT TRANSFERABLE..
THE EXISTENCE OF RIGHTS OF WAY,AND/OR EASEMENTS OF RECORD,IF ANY NOT SHOWN ARE NOT GUARANTEED. SCALE 1"=40-(8.5"X14")
ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209-2 OF THE NEW YORK STATE EDUCATION LAW. SCTM 1000-015.00-03.00-013.000 -
DO NOT SCALE FENCES.OFFSETS SUPERCEDE. SURVEYED:SEPTEMBER 30,20
LAND SURVEY LONG ISLAND.COM
WARD BROOKS LAND SURVEYOR
N AVENUE
11 OCEAN
BLUE POINT, NY. 11715 ��
631 576-7794 631 363-3179 �g
WARDBROOKSO@GMAIL.COM
FILE#11190