HomeMy WebLinkAbout51897-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#: 51897 Date: 05/06/2025
Permission is hereby granted to:
Joseph Cowley
630 Oriole Dr
Southold, NY 11971
To:
Install replacement windows in-kind to an existing single-family dwelling as applied for.
Premises Located at:
630 Oriole Dr, Southold, NY 11971
SCTM#55.-6-15.8
Pursuant to application dated 03/28/2025 and approved by the Building Inspector.
To expire on 05/06/2027.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling- Alteration $250.00
CO Single Family Dwelling-Addition /Alteration $100.00
Total $350.00
Building Inspector
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Sox 1179 Southold,NY 11971-0959
Telephone (631) 765-1802 Fax (631) 765-9502 htt s://www southoldtownti < ov
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
V 6B
PERMIT NO. � � Building traspector: I' ���R 2 8
Applica€ons and forms must be4illed out in their entirety.Incomplete Building Departmentappl4cations will.dot be accepted,Where the Applicant is not the owner,an Town of Southold
Ow'ner's Authorizatlon form(Page 2)shall be completed.
Date:
Name: 305f SCTM#1000-
Project Address: b;�o wc A , 9 C-,v
Phone#: �3 07 n3 Email:(�
Mailing Address:
Name:
Mailing Address: a p p.i AG b ('.J-ry
Phone#: f ° � ��D Email: P� r � " ��"`J+.Vp
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! IP '. / � �W /�G/ i ,I n,,
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Name:
Mailing Address:
Phone#: Email:
f
; '�' �„ n ��l�Na�ly"f� �, ,;:�1, ,✓.��'�'r�/fr„�r� rH %[r��J/7pl ri �%' r l`�/,1, ,c� "'o
Name:
Mailing Address:
Phone#t 7[
Email:
,�g� ❑Akteration ❑Re it ❑Demolition Estimated Cost of Project:
❑NN�Othertr�ucture ❑Ad�litiol �W� ^,a� Ida $
Will the lot be re-graded? ❑Yes o Will excess fill be removed from premises? ®YesNo
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 El 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 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.
Application Submitte 'y(print name w b'SL( ` \� ❑Auuthorized Agen wrier
Signature of Applicant: Date:
STATE OF NEW YORK)
SS:
COUNTY OF )
being duly sworn, deposes and says that(s)he is the applicant
(Name of in ivicluai signing cont ct)above named,
(S)he 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 application file therewith.
Sworn before me this
If
Q day of r�. , 20 o�Jr
ry Public
PROPERTY OWNER AUTHORIZATION,
NOT,;RY PtMLIC,STATE OF NEW YOR
(Where the applicant is not the owner) NO.01 DWf;3;!F�900
�'J,i'?IE N vl l"FOLK('0!.l^J'-Y
COMM �:3'ON E!IPI'R_S JUNE 30,206?
I residing at
do hereby authorize to apply on
my behalf to the Town of Southold Building Department for approval as de cribe herein.
11'Z,r-
Owner's Signature Date
oo/Vy
Print Owner's Name
2