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HomeMy WebLinkAbout52084-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#: 52084 Date: 07/09/2025 Permission is hereby granted to: Philip J Wasilausky 575 Goose Creek Ln Southold, NY 11971 To: construct accessory shed as applied for. Premises Located at: 105 Goose Creek Ln Ext, Southold, NY 11971 SCTM# 77.-3-25.1 Pursuant to application dated 03/08/2024 and approved by the Building Inspector. To expire on 07/09/2027. Contractors: Required Inspections: FOOTING/REBAR, FOUNDATION 1ST, FRAMING/STRAPPING , PLUMBING , ELECTRICAL- ROUGH, ELECTRICAL- FINAL, DRAINAGE, FINAL, Fees: Accessory-New Structure $245.00 CO Accessory $100.00 Total S345.00 illding Inspector TOWN OF SOUTHOLD—BUILDING DEPART 'LEN Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 1 ' -0959 Telephone (631) 765-1802 Fax (631) 765-9502 htt s://ww . uthol2025 Date RIPOng 15epartment APPLICATION FOR BUILDING PERMIT Town of Southold For Office Use Only M R PERMIT NO. L/ Building Inspector: a ji�//%f✓/l//l��%/%v�����/,.. �i/i/i/,/%rrrri/�,r��������/,��,r///ri�;�%0����/%�l✓/��/ r/�//��. /i Date: !„ ,,,. c„v�,/„fjT/%" i /,�, Name: Ph;1,jo �"� fi j3�,lo���A, L4,/&s;tauSi<el SUM # 1000- 77--0 3 2.Sf creme c e,(' ems'/ SQK�G,o(dJ .vy liR7/ Pro'ectAddress: S7.,J:- frvase Phone#: C,31 _ 2 -cf 06�f Email: y4k�. Cam Mailing Address: S-7_�— Ce-e e t,4� 4,rA,.+ eJ 164.c¢-11u[d l t`T;Pl Name: Mailing Address: J- �r ��Se C;-Qqz(< zalle-/ s L-c-F-4 olA ,v>/ %f9 '7/ Phone#: 63 ( — 2 G/— GC, Email: Pti,'/Q'� �.r/q S ��1LA_flfc �' ,ya.Gco _C of-" 4E51G(1f,Pf (�1 'Sf1Ml�lK 1MUII�I�iTrQI ,, Name: I�e a/'cera e,�cZ Ian � �►a Pi`r h -f' �S " f��• LOu iS .S C�Z✓CxY�Z Mailing Address: z c,c/ a // L Phone#: c/, c�g �[tL Email; C?RM/FO,(iMAI�IONs Name: /to �r✓►C cQ CO Mailing Address: �8� ��- � ,I.)� Phone#: 6 f- ? Email: /v�Sls�cQFG� - Cc 4-*1 r L? SCRIPTION,CIF F�RpPQ51ED;CONS7RUCiIpN,, ew Structure ❑Addition ❑Alteration ❑Demolition Estimated Cost of Project: ❑Repa' ❑Other L-f� 4- a V Will the lot be re-graded? ❑Yes ©< Will excess fill be removed from premises? ❑Yes Rl o 1 PROQERTY IN FORMATION Existing use of property: Intended use of property: Zone or use district in which premises is situated: Are there any covenaWo d restrictions with respect to this property? Dyes IF YES, PROVIDE A COPY. 0 Oheck BOX After Reading,:-The owner"/contractor/design professional is responsible for all drainage and storm water issues as provided by Chapter t%of the Town Code,APPLICATibN IS HEREBY MADE to the Building Department for the issuance of a`Building Permit pursuant to the Building Zone, ordinance of theTown of Southold,Suffolk,Caunty,New Yark and other applicable,La+ti's,Ordinances or Regulations,forthe construction,of buildings, additior►s,'alterations or for rem""oval,or;demolitian as(retain described The applicant agrees to comply'wlth all applicable"laws,"ordinances,building code, housing code and regulations and to,admit authbrized inspi�ctors on premises and in bw7ding(s)for necessary inspections.False statements made herein are punishable as a Class A misdemeanor pursuant to Section 21`A45 f the New York State Peeal Law. Application Submitted By(print name): t'h,`�,� L�I;�'(q¢���7 ❑Authorized Agent ner Signature of Applicant: eil 4 Date: � CONNIE O.� U C Notary Public,State of New York STATE OF NEW YORK) No.OIBU6185050 SS: Qualified in Suffolk County COUNTY OF Sk Commission Expires April 14,2-Mq �of�_) G being duly sworn, deposes and says thatU)he is the applicant (Name of individual signing contract) ab 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 daY of MCM 20 Notary Public PROPERTY OWNER AUTHORIZATION (Where the applicant is not the owner) 1, 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 b (0 ems."' X-. �bIYj 41 rQl �sN,l �SOd Qp as as 117OdOid rb, p° h 3snOH o Z .OI �� v Q ��. LA rn r JSW rnrn ° ro - d d -691 r� 1-35 's3�/b1S r Mr38�l� Cb Aj S 0 y O Q r r n r o iul iA-J, / Y /