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52605-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) Date: 01/12/2026 Permit#: 52605 Permission is hereby granted to: Kevin Rousell 6805 Alvahs Ln Cutchogue, NY 11935 To: lied for. Barn must Construct a pole barn accessory to an existing single-family dwellingas applied maintain minimum side and rear yard setbacks of 25 feet. Premises Located at: 6805 Alvahs Ln, Cutchogue, NY 11935 SCTM# 101:1-16.5 ed 11/19/2025 and approved by the Building Inspector. Pursu ant to application dat To expire on 01/12/2028. Contractors: Required Inspe�ion Fees: Accessory-New Structure $ $16565.00 1,2 .00 CO Accessory structure $100.00 Total � _ Building Inspector TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 ltt : /v,ww. otloldtowno . Date Received APPLICATION FOR BUILDING PERMIT .1 L. For Office Use Only I PERMIT N0. Building Inspector: e , Applications and forms must be filled out in their entirety. Incomplete applications will not be accepted. Where the Applicant is not the owner,an Owner's Authorization form(Page 2)shall be completed. Date: 1VOVeMb2Jr 'L�I�In , -XDQS OWNER(S)OF PROPERTY: Name: KlrSaen ` l<evi� RDusell SCTM # 1000- -1(0,S Project Address: (o$mS Alvahs Lzaf12 r Ct-l+C►-Na L)Le) tQ 119 35 Phone#:�(v3i�9toC-3 Email: kdr ' CON-\ Mailing Address: Sam aS p 'c:t CONTACT PERSON: Name: KI rr1- Mailing Address: Sarre �,S -prc ec+ Phone#: (b3q--)9loS-Qsz l" TEmail: Sarv\,e -)5 above DESIGN PROFESSIONAL INFORMATION Name: JI�►►�kl� 4�j�e1�C�1 : 5 Mailing Address: 6E�S�- Park r Pik :L-7S29 Phone#. (-117)445-(A$3 Email: Shirkpd2@Shirl--P:,-lebL,�iI(Ai(A3S. :o. CONTRACTOR INFORMATION: Name: Sarme 2S 1�25\�nr5S10Y ( Mailing Address: Phone#: \k '� Email: DESCRIPTION OF PROPOSED CONSTRUCTION ®New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: ❑Other $ Will the lot be re-graded? ❑Yes ®No Will excess fill be removed from premises? ❑Yes CKNo 1 Albert J. Krupski, Jr. °SUFF STOR IMMAT]ER SUPERVISOR 1\\4A�NA\,G]Elwl[]ENT SOUTHOLD TOWN HALL-P.O.Box 1179 u' 53095 Main Road-SOUTHOLD,NEW YORK 11971 Town n of So u th o l d C TER 236 - STORMWATER MANAGEMENT REFERRAL FORM ( APPLICANT INFORMATION TO BE COMPLETED BY THE APPLICANT ONLY FOR PROPERTIES ONE ACRE IN AREA OR LARGER. ) APPLICANT: (Property Owner, Design Professional, Agent, Contractor, Other) NAME:: � n ��� Date: M sot .L 4 w ads Contact Informatio �1ilo� �i� ll, Cb(Yl (E-Mail 8 Telephone Number) Property Address / Location of Construction Site: (QwS Nv"ahs L-2wN2 S.C.T.M. #: 1000 District Section Block Lot TO BE COMPLETED BY SOUTHOLD TOWN ENGINEERING DEPARTMENT ❑ - Area of Disturbance is less than I Acre. No S.P.D.E.S. Permit is Re uired 1 Project does Not Discharge to Waters of the State. No S.P.D.E.S. Permit is Re uired f ❑ - Area of Disturbance is Greater than 1 Acre& Storm-water Runoff Discharges Directly to Waters of the State of New York. THE APPLICANT MUST OBTAIN a S.P.D.E.S. Permit DIRECTLY From N.Y.S. D.E.C. Prior to Issuance of a Buildin Permit. ❑ - Area of Disturbance is Greater than 1 Acre& Storm-water Runoff Flows Through Southold Town's MS4 Systems to Waters of the State of New York. THE APPLICANT MUST OBTAIN a S.P.D.E.S. Permit throu h the Southold Town En ineerin De artnent Prior to Issuance of a Builqigg Permit. Reviewed B�. Date: FORM " SMCP-TOS December 2024 r �y s SURVEY OF LOT 3 THEST , MAP OF EAST COAST PROPERTIES FILE No. 9225 FILED MAY 27, 1992 SIT ATE CUTCHOGUE ® TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-101-01-16.5 " SCALE 1"=50' JUNE 10, 2025 di Q ,. . 0� W 0 — j r1 L .. O. AREA 94,713 sq. ft. 2,174 cc. x a F KEVIN ROUSELL ROUSELL Ik � FIRSTE 1 AMERICAN TITLE INSURANCE COMPANY 0, / vol. ., W01 IT By THE U"Imp- 'T °% " 9lY'�j •T��g urn '5 d�,�^ 4 00 1O SEPTIC SYSTEM TIE MEASUREMENTS A1,+,� � M ha � AZc Na 50487 .OHOUSE HOUSE " * ��ti CORNER A CORNER CORNER HOUSE Nathan Taft Corwin III COVER 31 17 © CORNER D uw. TE S SEPTIC TANK STA 'LEACHING POOL �OF"SURVEY NOT 1�NO Land Surveyor THE =V S Ste„ow COVER 1 39.6' 36.6' Era �NOT BE COVER 2 25' 32.6' u S Succaesor To: 1,tan�l r A n na S LS. LEACHING POOL LS. COVER 2 171' 150' TO AN Tide Surveys —SubdMalons — Site Plans — Coneducdon Layout pm � a - PHONE (631)727-2090 Fax (631)727-1727 THE EXISTU'OE OF WORT OF WAYS OFFICES LOGITED AT ANUNG ADDRESS PSdR EA9EAAENTS OF REOORO, IF 1566 Main Road P.O. Box 16 . NaT SNONYN ARE NOT O4dAliANTEEp, Jamesport New York 11947 Jamesport New York 11947