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HomeMy WebLinkAbout52500-Z TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD, NY BUILDING PERM111T (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 52500 Date: 12/01/2025 Permission is hereby granted to: Donna M Walters PO BOX 347 Cutchogue, NY 11935 To: construct exterior basement stairway to an existing single-family dwelling as applied for. Premises Located at: 10105 Oregon Rd, Cutchogue, NY 11935 SCTM# 83:2-19.4 Pursuant to application dated 10/21/2025 and approved by the Building Inspector. To expire on 12/01/2027. Contractors: Required Inspections: Fees: Single Family Dwelling- Alteration $250.00 CO-RESIDENTIAL $100.00 Total $350.00 Building Inspector TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 w Telephone(631) 765-1802 Fax(631) 765-9502 httjs1/www southoldtown Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only g PERMIT NO. Building Inspector: Applications and,forms must be filled out in their entirety.Incomplete - applications will not be accepted."Where the Applicant is not the owner,an Owner's Authorization form(Page 2)shall be completed. " Date: LA OWNER(S)OF PROPERTY: Name: 'Rack� � SCTM#1000- r� g� Ji Project Address: If (2f- o� I�G�, Ct �, 119 -3 Phone#: Email: �f Mailing Address: e CONTACT PERSON: Name: ^ r- Mailing Address: D 1G S © rC A0 ZC1 t5+ L►o ue 6v c3 S Phone#: (o�' 66-e Email: tMrrr' Co.r LtW' DESIGN PROFESSIONAL INFORMATION: Name: SC.."w �r 1r Z- 4' � ,v, .. Mailing Address: g*4 .5 - IhA 1, i _�0. Ccd Je- (� Phone#: �31 73y , 4// 9'S Email: .'+t CONTRACTOR INFORMATION: Names 1R! cl-- v-- ; Mailing Address: VJ y Phone#: ^ ' SR O Email: ��5 t l�E.a e+ Cc) Cr%t-eva DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition XAlteration ❑Repair ❑Demolition Estimated Cost of Project: ❑Other $ 9 60 Will the lot be re-graded? ❑Yes o Will excess fill be removed from premises? ❑Yes CKNO 1 PROPERTY INFORMATION Existing use of property: Gam,dC� i Intended use of property: "k7G5 C Ae cK,ck.\ Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? ❑Yes I%No IF YES, PROVIDE A COPY. 04,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,Btillidtrig 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 demoratiIan as herein described.The applicant agrees to comply with all applicable laws,ordinances,building code, "and o admit authorized inspectors on remises and in building(s)s for necessary inspections.False statements made herein are housing code and regulations a t o gl i ry hosP _..P g punishable as a Class A misdemeanor pursuant to Section 210.45 of the New York State Penal Law. Application Submitted By(print name): --:kac,he( ){rQZ, I� ❑Authorized Agent Owner Signature of Applicant: Date: ci I tv STATE OF NEW YORK) SS: COUNTYOF Svc\L ) ' ���� 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 Uo day of ' � 20 Notary Public CATHERINE MARGMET WAP -" PROPERTY OWNER AUTHORIZATION Notary Public-Scat* "York NO.OtVf $0 MO+if (Where the applicant is not the owner) Quail n Suffolk county My Jon Expires Jun 3,2029 e siding at �� � � � -1�t n, N !E�^ do hereby authorize to apply on my behalf to the Town of Southold Building cue ment for approva escribed herein. y ner"s Sign a Date' e Y—e-a?A . Pr' Owner's Name 2 F' j�2 m Q 2 j a U LZti LAW Lo .I . itn, T o a tic al O ¢F- AOuOOa 9pW2 NZ �r . sJ2 0 - � SOW A COWW Z p 'd c � UOZ W W zD � tiaOH W `o o I go �o�° � QZ Z3� W m q Ci a°Do o. O Z 2 x l Lu Lu Q I Q Lu Z Z 4Lu W ► Q) 1 ~ QO � �y m Co v. F' ):QQ QZC9 LV� N " S39043'40"E 261.80 � 0 22 n a3� j� J ae ti p e Q. Q 0 m z d' ►Lo-20 0 ~� Z �k 2 ~ W p E of O 3¢ j YU� W V S W iL =p2 J mOLu0 J ujQ L a. 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