HomeMy WebLinkAbout52140-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#: 52140 Date: 08/01/2025
Permission is hereby granted to:
Peter S Malloy
PO BOX 476
Orient, NY 119S7
To:
Construct a shed accessory to an existing single-family dwelling as applied for.Structure must
maintain a minimum side yard setback of 25 feet.
Premises Located at:
1670 King St, Orient, NY 11957
SCTM#26.-2-42.3
Pursuant to application dated 07/02/2025 and approved by the Building Inspector.
To expire on 08/01/2027.
Contractors:
Required Inspections:
Fees:
Accessory-New Structure $251.00
CO Accessory Structure $100.00
Total $351.00
14 IL
Building Inspector
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
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Telephone 631 765-1802 Fax 631 765-9502 htl)s: ww"v '.SoLIt"Io a town.I1 aoY
Date Received
EC APPLICATION FOR BUILDING PERMIT
For Office Use Only
PERMIT NO. 1 �/ Building Inspector L
202
Applications and forms must be filled out in their entirety.Incomplete
applications will not be accepted. Where the Applicant Is not the owner,an Building Department
Owners Authorization form(Page 2)shall be completed. Town of Southold
Date:July 2, 2025
OWNER(S)OF PROPERTY:
Name:Mary Perica SCTM#1000-026.00-02.00-042.003
Project Address:1670 King Street
Phone#:917-209-6633 =mafl:majorspondfarm @gmail.com
MailingAddress:PO Box 476 Orient, NY 11957
CONTACT PERSON:
Name:Mary Perica
Mailing Address:PO Box 476 Orient, NY 11957
Phone#:g17-209-6633 Email:majorspondfarm@gmail.com
DESIGN PROFESSIONAL INFORMATION:
Name:NYShed Co.
Mailing Address:885 Wickham Ave, Mattituck, NY 11952
Phone#: (631) 765-3090 Email:christianm.nyshedggmail.com
CONTRACTOR INFORMATION:
Name:No Contractor, shed being delivered
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
R'New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
❑Other $25,000
Will the lot be re-graded? ❑Yes RNo Will excess fill be removed from premises? ❑Yes ®No
1
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PROPERTY INFORMATION
Existing use of property:residential Intended use of property:residential
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
residential this property? ❑Yes MNo IF YES, PROVIDE A COPY.
❑ Clieck 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,Suffok 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 authorked Inspectors on premises and In building(s)for necessary Inspections.False statements made herein are
punishable as a Class A misdemeanor pursuant to Section 2I0AS of the New York state Penal Law.
Application Submitted By(print name):Mary Perica ❑Authorized Agent @Owner
Signature of Applicant: Date: 'zs
STATE OF NEW YORK)
SS:
COUNTY OF Suffolk )
( � being duly sworn,deposes and says that(s)he is the applicant
(Name of individual s fining contract)above named,
(S)he is the Q W N L K
(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 20 0-5 F
Notary Public
JONMMIMUM
l f f'''l mmf' OWNER f ry l.�......lll ll� ) �. NOTARY I i I , w,rc llc
(Where the applicant is not the owner) 101MU6429053
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#, 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
S.C.T.M.# DISTRICT 1000 SECTION 26 BLOCK 2 LOT 42.3
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/ AREA:271. 863 SQ.FT. OF 6.23 ACRES ELEVATION DATUM:
UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY
/ MAP NOT BEARING THE LAND SURVEYORS EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND LW HIS BEHALF TO THE TITLE COMPANY,GOVERNMENTAL AGENCY AND LENDING INSTITUTION
LISTED HEREON,AND TO THE ASSIGNEES OF THE LENDING INSTITUTION GUARANTEES ARE NOT TRANSFERABLE.
THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE
NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION OF FENCE$ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS. EASEMENTS
AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE TIME OF SURVEY
SURVEY OF: DESCRIBED PROPERTY CERTIFIED TO: PETER S. MALLOY,
GRAPHIC SCALE MAP OF: MARY PERICA;
s FILED: FIDELITY NATIONAL TITLE INSURANCE SERVICES, LLC;
SITUATED AT:ORIENT
TOWN OF:SOUTHOLD KENNETH M WOYCHUK LAND SURVEYING, PLLC
( IN FEET ) SUFFOLK COUNTY, NEW YORK Professional Land Surveying and Design
1 inch = 50 fG.. -- -- P.O. Box In Aquebogue, New York 11931
FILE 0 16-164 SCALE:I°=50' DATE:OCT. 2, 2DI6 PHONE(63L)296-1666 FAX(631)296-1669
N.Y.S. LISC.NO. 050882 m.mwwni w.....a.a ft—J.H--!CaomW Y.W."huk