HomeMy WebLinkAbout52416-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#: 52416 Date: 10/30/2025
Permission is hereby granted to;
Brian T McNamara
PO BOX 679
New Suffolk, NY 11956
To:
Install shed at existing single family dwelling as applied for.
Premises Located at:
230 Kouros Rd, New Suffolk, NY 11956
SCTM# 117.-6-16.6
Pursuant to application dated 09/25/2025 and approved by the Building Inspector..
To expire on 10/30/2027.
Contractors:
Required Inspections:
Fees:
Accessory-New Structure $233.00
CO Accessory Structure $100.00
Total S333.00
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 hqps://www southoldtownn . ov
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
E 0
PERMIT NO. Building Iripettcar; S E P 2 5 2025
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
Owner's Authorization form(Page 2)shall be completed. Town of Southold
Date: ��Is
�Oz-�
OWNER(S)OF PROPERTY:
Name: Lys M' SCTM# 1000- //7_ �.
Project Address: 230 K O U R OS %K 1, W EVJ JUF FD I f l q,�)
Phone#: 57(,,- --,39 Y, I
Email: 5 N\GN{Ot K k (10 ( g V w6 '(
Mailing Address: V,Q �p (o7q NEW SU FFO
CONTACT PERSON:
Name: 'OR 1 i43 M
Mailing Address: o
Phone#: S�(p — 39 ZVO Email: �RA t�GcYtQt C
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name:
Mailing Address:.
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
❑Other $ C'
Will the lot be re-graded? Dyes 1;9No Will excess fill be removed from premises? Dyes XNo
1
PROPERTY INFORMATION
Existing use of property: �S t �Tl Intended use of property: �'�qeSC
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
S®La4-f+0 L -1�, this property? ❑Yes 7[No 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 5outhcild,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 210.45 of the New York State Penal Law.
Application Submitted By(print name): PAL { m ,}944 ❑Authorized Agent Owner
Signature of Applicant: Date:
Date:
STATE OF NEW YORK)
SS:
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 120
Notary Public
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
q, 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
BEARINGS SHOWN HEREON ARE E
ON USER 12685 PAGE 057-
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(50' WIDE)
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2