HomeMy WebLinkAbout52449-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#: 52449 Date: 11/12/2025
Permission is hereby granted to:
Michael C Nardo
5 Willow Rd
New Hyde Park, NY 11040
To:
construct an accessory shed as applied for.
Premises Located at:
470 Moose Trail, Cutchogue, NY 11935
SCTM# 103.-4-12
Pursuant to application dated 10/03/2025 and approved by the Building Inspector.
To expire on 11/12/2027.
Contractors:
Required Inspections:
Fees:
Accessory-New Structure $221.00
CO Accessory $100.00
Total $321.00
utilding Inspector
,Fd7�
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold, NY 11971-0959
t�0 ��"�� Telephone (631) 765-1802 Fax (631) 765-9502 11t[ps://www.sogtholdto nn ,�yo'v
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
PERMIT NO. Building Inspector.
Applications and forms must be filled out in their entirety.Incomplete Building Department
applications will not be accepted. Where the Applicant is not the owner,an Town o oY stholdl
Owner's Authorization form(Page 2)shall be completed.
Date: 0 dober 3 20 is
OWNER(S)OF PROPERTY:
Name: MICµpFL AirtaDo FCT M #1000- t 3 4
Project Address: q7o Hoo36 101L—
Phone#: "" (, Z32 rgt/6 Email: Me -do @ oloo.CoM
Mailing Address: D fJOQSf-� 'TIZAL �,U oC.A)F 11,4 j l 4 5
CONTACT PERSON:
Name: MOP&,l- µK-oe)
Mailing Address: q1b H085f t o F5 a l i s
Phone#: Sl` 2.3Z VLAV Email: me-Ae,,rdo @ q�00 c-m
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name: AU 6 t,P/S t4 q 00V 4- 2 �0
Mailing Address: -72,q MIl)DLf�' CW" e0AX;> "tea ody ll4
Phone#: L 31 q 2q 124S, Email: I�r'cc� _., �Gli.u�ol s (20u4foaL c-eM
DESCRIPTION OF PROPOSED CONSTRUCTION
New Structure [--]Addition [--]Alteration ❑Repair ❑Demolition Estimated Cost of Project;
❑Other 13 Ooo
Will the lot be re-graded? ❑Yes' No Will excess fill be removed from premises? ❑Yes No
1
PROPERTY INFORMATION
Existing use of property: NP-90 AL RESIDC0C.C- Intended use of property: PG"oom- ws iof-ys
Zone or use district in which premises is situated. Are there any covenants and restrictions with respect to
(�-ND lv�N _GpN� iNG this property? ❑Yes VAo 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 herein are
punishable as a Class A misdemeanor pursuant to Section 210.45 of the New York State Penal Law.
Application Submitted By(priNIP"
): MIUfA �D ❑r-d� IVAo Authorized Agent 5z/owner
Signature of Applicant: C� Date: Ql r0S62— 3/ 7-oz,611
CONNIE D.BUNCH
STATE OF NEW YORK
) Notary Public,State of New York
SS: No.01 BUS1 BS050
COUNTY OF_ SI)0-'eO L ) Qualified in Suffolk County
commission Expires Aprll 14,
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 mm��,:.. ,y�. ,C.w� 20a 60n"�
11
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
Iv
*771
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