HomeMy WebLinkAbout51699-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#: 51699 Date: 03/03/2025
Permission is hereby granted to:
J Geddes Parsons
4 Palm Trl
Hobe Sound, FL 33455
To:
construct accessory shed as applied for.
Premises Located at:
515 Sterling St, Fishers Island, NY 06390
SCTM# 10.-9-3.1
Pursuant to application dated 01/21/2025 and approved by the Building Inspector,
To expire on 03/03/2027.
Contractors:
Required Inspections:
Fees:
Accessory-New Structure $186.75
CO Accessory $100.00
Total S286.75
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 Www r. outho) townn �ov
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APPLICATION FOR BUILDING PERMIT
For Office Use Only
PERMIT NO. Building Inspector: '
Applications and forms must be filled out in their entirety. Incomplete 0
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 PROPERTY:
Name: ,e ..�- SCTM#1000- p j p 131", 9 Wt 3
Project Address: ' �1 S183s U` 3?v
Phone#: Email:
Mailing Address: y
,tom 1*1 �V-� CTv� � L 33
CONTACT PERSON:
Name:
Mailin Address: 57
s "
Phone#: Email
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DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone#: & ly 0 Email:
CONTRACTOR INFORMATION:
Name: " �►�e,�.
Mailing Address:.SAS ~" o� 3v� �02 �csltie.•��s
Phone#: & 3! s 7Y�- 7�� Email: + , G,C w^IT A4j ns e , 60
DESCRIPTION OF PROPOSED CONSTRUCTION
❑NewStrocture ❑Ad ition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
U4MFler
Will the lot be re-graded? ❑Yes []No Will excess fill be removed from premises? Dyes ❑No
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_. ..... .....,.u. .... _ �_ m ..,..� m ®m _.
e ...�� PROPERTY INFORMATION
.. ...
0ting use of property: �� Intended use of property
_........................_ ... ... .._ ._ ....._w. �..m ..... �. e ......... m®,
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ionc or use district in which premises is situated Are there any covenants and restriction,with respect to
nn this property? CJYes � No IF YES, PROVIDE A COPY.
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❑ - iww The owner/contractor/design_ n professional is responsible for all drains and storm water issues s by d
.,��a�-,e ;���, esig p po Aa 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 bullding(s)for necessary Inspections.False statements made herein are
punishable as a Class A misdemeanor pursuant to Section 210.4S of the New York State Penal law.
Application Submitted By(print ame): f - &'jT1 L-W OAuthorized Agent ❑Owner
Signature of Applicant: Date: /1/Vl25'
STATE OF NEW YORK)
S .
COUNTY OF j
cotfT1 L-Lo being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the
C r
(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 C
that the work will be performed in the manner set forth in the application file therewith.
li Sworn before me his
day of 20Z-1'
9���Nbtary Public
(Where the applicant is not the owner)
I' T G64/1AC f"It"' is residing at
5.»r4 , fL 3I'l Sf do hereby authorize 't S CI n MA-C-Q1► A-1� apply on
my behalf to tilt ,+n of Southold Building Department for approval as described herein,
Owner's Signature pate
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Print Owner's Name
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STERLING STREET
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