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HomeMy WebLinkAbout51885-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#: 51885 Date: 04/30/2025 Permission is hereby granted to: David Cannizzaro 192-25 Underhill Ave Fresh Meadow, NY 11365 To: - install oil to gas boiler in existing building as applied for. Premises Located at: 53155 Route 25, Southold, NY 11971 SCTM# 61.4-7.1 Pursuant to application dated 03/25/2025 and approved by the Building Inspector. To expire on 04/30/2027. Contractors: Required Inspections: Fees: Single Family Dwelling- Alteration $250.00 CO-RESIDENTIAL $100.00 Total S350.00 wilding 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 fta:L/www.southoLdtqwnn . Date Received APPLICATION FOR BUILDING PERMIT Q For Office Use Only PERMIT NO. Building lnsp n MAR 2 5 2025 ication �Id rrr nti t "',filledout,tot ali e0 jr � Ire iarra lei Building apifbrb jdl�ib� �eif� M $ oew,a V 9 Department � aail ��P �d � Town of Southold Date: I 'w Of- 11=I., I " . �, . Name:j)4,V1; 0`,n„r A ! SCTM#1000- Project Address: 53 S S5 ;Zod e. ZSrJ ' di Phone#: 7�M" - gD �` -$ 5- Email: r-eNCk * e Ao MailingAddress: i0 P I N Name: rc l Cam d Mailing Address, /92` 25 v4d e,-Q Ave, 4d w,4 ! / Phone#: /7 - � 7-3 5-g �.�+�' i t� Email: (� �+ `pN( C1N1a11w.IN1=0R1 77 , E "aGN QFES�I. Name: Mailing Address: Phone#: Email: � I 10R111" iit ICI C Name: Mailing Address: Phone#: Email: Q44 O.F PROP..OSED CON! III;UCTION . ©New Structure ®Addltlo ❑ lteration 13Iepa it PDemolition Estimated Cost of Project: Other O 1( � ilk ° .C70 Will the lot be re-graded? E1Yes No Will excess fill be removed from premises? ❑Yes �lo 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 w dl » pQ1 t��MADE to the Bin Ckeperrta title fra e11 wi�nage end ter" as Tweed h APIW 2M of" E' " nal is rest storan wwe inglane Ordininaof the 7`ov MofSouthold, u�f N6Cuuntr, err''orkandad�hutwreppNW le,Ums,Chrdi►atwMa�esYwr u� IS M' � d ap tees trr' " epfa t antes, eode, " of a r�to OW o how toile end"n MUMth pk bird tla adr author ed Ana N on lire istt an i I forte �Y ini false N Oar d� � ►wed tgloe se marts�idi nt punklsl�ao�e ads a Class Ar►nisd+�q tra Se�I BSI of 0!*Ne*YdrkStaft Penal law., Application Submitted 'gyp t name): ❑Authorized Agent Kowner Signature of Appiica Date: STATE OF NEW YORK) SS: OEM OF " 1W--- P)/ Z 7-4400 being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (Xhe is the ' (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 ap Sworn before me this 25 day of March , 2025 Notary Public MERCEDES AUFIERO NOTARY PUBLIC,STATE OF NEW YORK PROPERTY OWNER AUTHORIZATION REGli Qualified In Na sau County 048 quallfled In Nassau County Commission Expires 05/18/2027 (Where the applicant is not the owner) 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