HomeMy WebLinkAbout52087-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#: 52087 Date: 07/10/2025
Permission is hereby granted to:
Michael Hance
1020 Cox Neck Rd
Mattituck, NY 11952
To:
alter a screened porch to an unconditioned recreational room to an existing single-family dwelling as
applied for.
Premises Located at:
1020 Cox Neck Rd, Mattituck, NY 11952
SCTM# 111-14-6
Pursuant to application dated 05/20/2025 and approved by the Building Inspector.
To expire on 07/10/2027.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling- Alteration $341.00
CO-RESIDENTIAL $100.00
Total S441.00
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 htt"i //ww .sot tholdtoiYt��� �o
Date Received
APPLICA1 ION FOR BUILDING 1PERMrr
LS
r Office Use Only
PERMIT NO Building Inspector. ,,.
Applications and forms must be filled out in their entirety. Incomplete t
:
applications will not be accepted. Where the Applicant is not the owner,an
Owners Authorization form(Page 2)shall be completed.
Date:
OWNER(S)OF PROPERTY:
Name:Joann Hance SCTM# 1000-113-14-6
Project Address: 1020 Cox Neck Road Mattituck NY 11952
Phone#:516-434-0240 Email:j.hance1955@icloud.com
Mailing Address: 1020 Cox Neck Road Mattituck NY 11952
CONTACT PERSON:
Name:
Mailing Address:
Phone#: Email:
DESIGN PROFESSIONAL INFORMATION:
Name:Joseph Olivieri Architect P.C.
Mailing Address:39 Morris Avenue Patchogue NY 11772
Phone#:516-524-0873 Email:joeolivieriarchitect@outlook.com
CONTRACTOR INFORMATION:
Name: Devin Ratel - Spectrum Construction
Mailing Address:
Phone#:631-721-3863 Email:spectrumconstructioniongisland@gmail.com
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition *Alteration ❑Repair ❑Demolition Estimated Cost of Project:
❑Other $12,000
Will the lot be re-graded? ❑Yes *No Will excess fill be removed from premises? ❑Yes RNo
1
PROPERTY INFORMATION
..............
Existing use of property:single family residential intended use of property:Same
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
R-80 this property? E]Yes 10No IF YES, PROVIDE A COPY.
19 Checic Box After Reading.- The owner/contractor/design professional Is responsible for all drainage and storm water Issues as provided by
Chapter 236 of the Tom 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 210AS of the New York State Penal Law.
Application Submitted By(print name):Joseph Olivieri WAuthorized Agent ElOwner
Signature of Applicant: Date:
STATE OF NEW YORK)
SS:
COUNTY OF Suffolk
Joseph Olivieri being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the Agent / Design Professional
(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 Lo 20
Notary Public
teverw Cent
Notary Public,State of Now York
No.OICE6445671
PROF)ER"I"Y OWNER AUTHORIZATION Qualified In SuffolkC"Exp.12j27120,nAL
................................
(Where the applicant is not the owner)
I, Joann Hance residing at 1020 Cox Neck Road
do hereby authorize Joseph Olivieri to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
61
6" Owner's Signature Date
Joann Hance
Print Owner's Name
2
H.D. REFERENCE NO. R10-99-202
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FILE N0. T5917 SCALE: 1"=40' DATE: 9,113,199 ;t¥ N.Y.S. L IC. NO. 049287