HomeMy WebLinkAbout50463-Z SofF un4 TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y TOWN CLERK'S OFFICE
oy • o�� 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#: 50463 Date: 3/20/2024
Permission is hereby granted to:
Ford, Aaron
210 Fairview Rd
Palm Beach, FL 33480
To: construct interior alterations (interior demolition) to existing single-family dwelling as
applied for. Additional approvals/permits will be required.
At premises located at: o 1775 Pt Pleasant Rd, Mattituck
SCTM #473889
Sec/Block/Lot# 114.-1-6
Pursuant to application dated 2/16/2024 and approved by the Building Inspector.
To expire on 9/19/2025.
Fees:
SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $250.00
CO-ALTERATION TO DWELLING $100.00
Total: $350.00
Building Inspector
FIELD INSPECTION REPORT DATE COMMENTS
FOUNDATION (1ST)
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FOUNDATION (2ND)
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ROUGH FRAMING& y
PLUMBING
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INSULATION PER N.Y.
STATE ENERGY CODE
FINAL
ADDITIONAL• COMMENTS
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O�g�fFO(k�oG TOWN OF SOUTHOLD—BUILDING DEPARTMENT
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x Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone(631) 765-1802 Fax(631) 765-9502 https://www.southoldtownny.jzov
Date Received
APPLICATION FOR BUILDING PERMIT
IRI C EC W E
For Office Use Only
F E B 1 6 2024 LL
PERMIT NO. .1U Building Inspector:
Applications and forms must be filled out in their entirety.•Incomplete r7'lepa?tmmnt
`applications will not be accepted.'.Where the Applicant is not the owner,an Tov +� aaf c�c�ttioicl
Owner's Authorization form(Page'2)shall be completed.',,,
Date: IIT y
OWNERS)OF PROPERTY:. . '
Name: SCTM#1000-
.�
----
.Project Address: -- '
_ _ __
Phone#: _ Email:
Mailing Address-/.Ld
CONTACT PERSON:
Name:
Mailing Address:
Phone#: Email: i !
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORM ION.
Name:
Mailing Address:
Phone#: /—��V�/s c Email:_ � Ov
DESCRIPTION OF PROPOSED CONSTRUCTION
❑NNewStructure ❑Addition ❑Alteration ❑Retpair.❑Demolition Estimated Cost OfP�o,�'ect:
PIKher /) t-V o to NL S /j, l60 —
Will the lot be re-graded? ❑Yes EKO Will excess fill be removed from premises? ❑Yes o
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PROPERTY INFORMATION .
Existing use of property: Intended use of property: y
/� e
A
Zone or use district in which remises is situated: Are there any covenants aid restrictions with respect to
V — - this property? ❑Yes "o 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 hereimare
punishable as a Class A misdemeanor pursuant to Section 210.45 of the New York State Penal Law.
Application Submitted By(print na ): �� �L� ❑Authorized Agent 06wner
Signature of Applicant: Date: 16/2_
cj-
D.BUNCH
Notary Public,State of New York
STATE OF NEW YORK) No._01BU6165050
SS: QualifCommissioled In Suffolk n ExpIres April County
14,2 I COUNTY OF )
being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)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
day of r,�r LC 20-a$ �o CA
Notary Public
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
I, 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
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SITUATE SURVEYED
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P.O. BOX 294 1 scete 1 -w'
NEW SUFFOLK. N.Y. 11956 a4
MATTITUCK, TOWN OF SOUTHOLD 631-734-5835 SURVEY
GUARANTEED TO: SUFFOLK COUNTY, N.Y. a�
DIANE DECOSTE
FIDELITY NATIONAL TITLE INS: CO. 09.mw
SURVEYED FOR: DIANE DECOSTE LIE; NS�LAND SURVE R I A - I
�NYS Lic. No. 49273 07F0 �wG.No
LNunemaker, Amanda a,
From: ADF Fragola <adfventures@gmail.com>
Sent: Wednesday, March 20, 2024 10:51 AM
To: Nunemaker,Amanda
Subject: Ref: 1775 Point Pleasant Road Mattituck
1
Hello Amanda,
Request a permit to demo the following:
- Removal of sheetrock
- Insulation _
Plumbing
- Electrical
- HVAC
- Cabinets ,
- Appliances
- Bathroom
- Fixtures
Thank you,
Fred
ADF Ventures, LLC .
ADFVentures0e7mai/.com
W. 631-654-1771 F. 631-447-1775
ATTENTION:This email came from an external source. Do not open attachments or click on links from unknown senders
or unexpected emails.
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APPROVED AS NOTED e rm'4s re �rcl✓
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p
3By COMPLY WITH ALL CODES OF
M.p011FY8UILDING DEPARTMENT AT NEW YORK STATE&TOWN CODES
d3f•7SS-1802 SAM TO 4PM FOR THE AS
REQUIRED AND CONDITIONS OF
'FMOWING INSPECTIONS: M
OLD TOZBA
1. FOUNDATION-TWO REQUIRED PLANNING BOARD
FOR POURED CONCRETE TRUSTEES
P. ROUGH-FRAMING&PLUMBING
& INSULATION 4. FINAL-CONSTRUCTION MUSTBE COMPLETE FOR C.O. OCCUPANCY OR
ALL.CONSTRUCTION SHALL MEET THE
REQUIREMEN TSOF THECODESOFNEW USE IS UNLAWFUL
YORK STATE. NOT RESPONSIBLE FOR
MIGN OR CONSTRUCTON ERRORS WITHOUT CERTIFICA
OF OCCUPANCY
1
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