HomeMy WebLinkAbout52352-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
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#: 52352 Date: 10/14/2025
Permission is hereby granted to:
Cameron Dowe
975 Cedar Point Dr W
Southold, NY 11971
To:
construct alterations to an existing single-family dwelling as applied for with flood permit.
Premises Located at:
975 Cedar Point Dr W, Southold, NY 11971
SCTM#90.4-5
Pursuant to application dated 09/02/2025 and approved by the Building Inspector.
To expire on 10/14/2027.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling- Alteration $295.00
Flood Permit $150.00
CO- RESIDENTIAL $100.00
Total $545.00
Building Inspector
TOWN OF SOUTHOLD— BUILDING 6E1ARTIVTEI\T
.�q Towel Hill Annex 54375,Main RoadV. OP Box 1179 Seatold,NY 11971 0959
w
Telepba Jb11) y63-1d02 0(631)7¢5--1502 rat'.'D
,n Date Received
APPLICATION FOR $U11,0ING PERMIT
For office Use Only SEP
PERMIT NO. Building Inspectors �
f
',rOwif °
Applications and forms must be filled out in their entirety. Incomplete u
applications will not be accepted. Where the Applicant is not the owner,an
Owner's Authorization form(Page 2)shall be completed.
Date: ( L, +� ,
............_::A
OWNER(S) ROP'ERTY:
Name: N eA yx5TY-u-,ke ' �A iN12w' fa SCTM # 1000-
Project Address:
Phone#: Email. II' . ; �
Mailing Address: - l
CONTACT PERSON:
Name:
Mailing Address:
Phone#: 0 b Email; Q
DESIGN PROFESSIONAL INFORMATION: d
Name:
Mailing Address:
Phone#: - Email. w .
42
CONTRACTOR INFORMATION:
Name:
Mailing Address: ~-^ ~-
Phone#: " 3 �640 Email:
DESCRIPTION OF PROPOSED CONSTRl1CT10N
❑New Structure ❑Addition Alteration . epair -']Demolition Estimated Cost of Project:
❑Other $ �Q U
Will the lot be re-graded? ❑Yes E 1'I�o Will excess fill be removed from premises? ❑Yes 13111ro
1
PROPERTY INFORMATt N
Existing Usp Of property:re l InteA (eta u5eof property:
Zone Use district in whit i
�r sit Arelherp arty covenants and restrictions with respect to
thisprppertk? Dyes 1215o IF YES, PROVIDE A COPY.
171 ", The rM *n prafessional is responsible for all drainage and storm water Issues as provided by
Chapter 296 of the town Code. i PPLICAT10" f5 HWI ll+e Building Department for the Issuance of a Building Permit pursuant to theBuilding Zone
Ordinance of the frown of Southold,Suffolk,4=ounty,N" ;,t or,k and other applicable laws,Ordinances or Regulations,for the construction of buildings additions,alterations or for removal or dernc)4 tion as herein described.The,applicant agrees to comply with all applicable laws,Ordinances,building code,
housing code and regulations and to admit aaLA#horized inspectors on premises and in building(s)for necessary inspections.False statements made herein are
punishable as a class A misdemeanor pursua"tw to Section 210.45 of the New York State Penal Law,.
Application Submitted By(print name): 04 �� ST�2L�,@ f ❑Authorized Agent lFrOwner
Signature of Applicant: Date:
STATE OF NEW YORK)
S ://��
COUNTY OF S 4)% OIJ
M ti lifre,,
being duly sworn, deposes and says that(s)he is the applicant
(Name of i ividual signing contract) above named,
(S)he is the to
(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
................ 2�
day of �� ' t' -e/,q C_
o a ry bl i WENDY A.STAPM
hillfic,State of New M-
s ,u l )art,6,zo
(Where the applicant is not the owner)
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
� z8g
E C E
F " -
In cu rr_- / ,
Lot 137
Med Map a. 9C Subdivision a t f
FUed 1212011`927 Cedar Beach Park
Situated at
£ 1— BayView
of Southold
- Suffo aunt , New York
Am
$had bd I Iffiom I;Ii:,ixtI--"Iwr W-WAW 37.6 cr
� }#8Prop.Shed Dim
aar /tAmend 1rop
now. /stssAmetid P"p
Upland Lot Coverage(SF-) .� � A � Rev."/ZL Mu coverw ft Tor Itoft
1370i
Deck
a sleps7s e a
--__.
7:-4
. '
P3ed Zwo
vCt� 3M-5-
WOW
Ir GI& tea. f3.
T{ $ -a-
=` The
Dom £
- row nwe€
��
sir vysc
NOTES
1. All tnm are eerrlferous mato »a nchd. `
o 2. i psrl [a to Zone —40=
! e 3. La1 olza to 28.898 S.F.
MUNICIPAL LAND SURVEY, P.C.
0 ail 60 to SnVU LAM