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HomeMy WebLinkAbout51688-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#: 51688 Date: 02/26/2025 Permission is hereby granted to: Domingo L Rodrigues 14 Titus Ave Carle Place, NY 11514 To: construct accessory structure as applied for. Premises Located at: 2350 Elijahs Ln, Mattituck, NY 11952 SCTM# 108.-3-5.16 Pursuant to application dated 01/14/2025 and approved by the Building Inspector.. To expire on 02/26/2027. Contractors: Required Inspections: Fees: Accessory-New Structure $530.00 CO Accessory $100.00 Total S630.00 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 littps,://www.soutliolcitownny.gov Date Received AP PLICATION FOR BUILDING I G PERMIT IEFor Office Use Only 2 PERMIT NO. � Building Inspector: r Applications and forms must be filled out in their entirety. Incompleteu11d11A Ou�olcly applications will not be accepted. Where the Applicant Is not the owner,an Owner's Authorization form(Page 2)shall be completed. Date: la/l/o24 Name: SCTM#1000- Mpg _ 3 D3rr1 i tl (ZOdlt c)25 0 Project Address: a_,50 fc.I=Al1's LANE MA".rV4 • My 11R52 Phone#: 5I G 3Jr i _ -� Email: QXfi b, 1 , cal Mailing Address: jL4 -Ti+cis ke Cane (Mace by I 1 i.q CORTWPERSOW" Name: Codonoes Mailing Address: i L4 -T&x5,J Aye (Irle P Iup- ICY 1 I 4,5-1 Phone M Email; �l 351 -0313 DESIGN PROFESSIONAL INFORMATION: Name: DAvic MA211INS (ARWIV" MAD Mailing Address: i8 M10TOWN l20 •e!at& PL&,F- • NV 11 514 Phone#: 631- 332 -3621 Email: dmQ AQx*IrEc-r,5 mADcam "CON,' , TO I,FQR A JONtr Name: QE�IN FAEt,co F[.AwI.Es3 ffA60n► INC. Mailing Address: p(),aov 1,09 Sm m+rouJN Ny • II184 Phone#: (03)_ 446 _ 9411 Email: pEU1N @ F�W�55 mAsoN �m DESCRIPTION OF PROPOSED CONSTRUCTION ©New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: []Other $ '20,000.00 Will the lot be re-graded? ❑Yes ®No Will excess fill be removed from premises? ❑Yes ®No 1 PROPERTY INFORMATION Existing use of property: SIAI6LE FAmwy Owe"" Intended use of property: 61,E F'AMuy owlswAML Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to R-w D this property? ❑Yes R]No IF YES, PROVIDE A COPY. l9 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 buliding{s)for necessary Inspections.False statements made herein are punishable as a Gass A misdemeanor pursuant to Section 210.45 of the New York State Penal Law. Application Submitted By(print n " �Uf`f�tfl(r S �oclric�c�e� ❑Authorized Agent RfOwner Signature of Applicant: 7 •1 Date: 1'21 1® Izq STATE OF NEW YORK) SS: COUNTY OF a"CAl ) 0 kO L 0 being duly sworn, deposes and says that(s)he is the applicant (Name of in idual signing c tract) above named, (S)he is the O LAI N E(L (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 20 Notary Pub iZBEL X r 1M.MARQUES Notary Public,State of New York PROPERTY OWNER AUTHORIZATION A!/A No.01MA6009473 (Where the applicant is not the owner) Qualified in Nassau County Commission Expires on June 29,20, 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 Town Nall Annex �„ °lug Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O. Box 1179 Southold, NY 1 1 971-0959 BUILDING III=PARTMNENT NOTICE OF UTILIZATION OF TRUSS TYPE CONSTRUCTION PRE-ENGINEERED WOOD CONSTRUCTION AND/OR TIMBER CONSTRUCTION Date: l� i....� ��..,.,.. ,.�.... ._.__........�._�..�... Owner: Location of Property . r o ' . L rary . --Mk , ,.M . _.. ..........� Please take notice that the (check applicable line): v _ New commercial or residential structure (A"65or1.b ,5W xR*6J Addition to existing commercial or residential structure Rehabilitation to an existing commercial or residential structure to be constructed or performed at the subject property reference above will utilize (check applicable line): WIT Truss type construction (TT) „ esr Pre-engineered wood construction (PW) Timber construction (TC) in the following location(s) (check applicable line). Floor framing, including girders and beams (F) Roof framing (R) Floor and roof framing (FR) Signature Name (person submitting this form): . _ Capacity (check applicable line): Owner �C Owner representative (AWu Iroci) TrussReg15.docx Effective 1/1/2015 s :'I /i///°r//iH! /i fr,�lriia,lr JY�rlfdrrgji4rr(r�(l f�d�J {./P,iWd� �i�"�r/.��/f-rjf��. it it ��w'•sl �� }... �I,.. 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