HomeMy WebLinkAbout52846-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
T� LD Sod o , NY
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT CAN THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 52846 Date: 04/08/2026
Permission is hereby granted to:
13710 Soundview Ave LLC
795 Cedar Dr
Southold, NY 11971
To:
Construct a detached garage accessory to a single-family dwelling as applied for.
Premises Located at:
13710 Soundview Ave,Southold, NY 11971
SCTM#54..3.5
Pursuant to application dated 03/23/2026 and approved by the Building inspector.
To expire on 04/07/2028.
Contractors:
Required Inspections:
Fees:
Accessory-New Structure $701.00
CO Accessory Structure $100.00
Total $801.00
4r 2L ...I ......
W llding Inspector
TOWN OF SOUTHOLD--BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. 0. Box 1179 Southold,NY 1 1 97 1-0959
,1 ,60V
Telephone (631) 765-1802 Fax(631) 765-9502 s- � �. � A j°o 1` y•:
Date Received
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PERMIT NO. Building Ipem.
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Applications and forms must be filled out in their entirety. Incomplete
applications will not be accepted. Where the Applicant is not the owner,an 1�1,, "LL71 All"I.
Owner's Authorization form(Page 2)shall be completed.
Gate:
OWNER(S)OF ROPERTY:
Name: �► SCTM#10C}U- .�, ''
V 1E ►� + ' +
WWWW WWWW11 i
Project Address: 10 0
1 70
Phone#• Z12 ..� .. " '' Email. �; V 90 �M►r
Mailing Address:
CONTACT PERSON:
Name: Zi
,,,
Mailing Address: �02 3
� u
Phone#: Email:
DESIGN PROFESSIONAL INFORMATION:
Name: 0�'`
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name:
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
*New Structure []Addition li Iteration D Repair ❑Demolition Estimated Cost of Project:
*OtherEll $ ........................................................
" "
Will the lot be re-graded? [-Yes No Will excess fill be removed from premises? I@Yes 0 No
1 �
PROPERTY INFORMATION
...............
Existing use of property: V4 CAW Intended use of property: SIA)6CE PAM geS
Zone or use district in which premises is situated,.,, Are there any covenants and restrictions with respect to
Athis property? FlYes No IF YES, PROVIDE A COPY.
2
Che6k l3ox After Rea difig', 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.
jC#C460/J Authorized Agent DOwner
Application Submitted By(print name),,,
Signature of Applicant: Date:
CONNIEI?93u,''CH
STATE OF NEW YORK) Notary Public,,State of New York
No.OIBU6185050
Qualified In S,'uffolk County
Commission Expires April 14,
COUNTY OF
...............
being duly sworn, deposes and says that(s)he is the applicant
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(Name of individual signing contract)above,named,
o
ir(S)he is the
0Officer,k4 to t orate c.)
rac` r,Ag6,
,,,CorIA
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
ay
of 20
................
Notary Public
PROPERTY OWNER Au'rHORIZATION
(Where the applicant is not the owner)
residing at ... `
avoioow�1� do hereby authorize
0- — to apply on
J lizzi
mytehalf to the Town of Southold Building Department for approval as described herein.
t�. G1I. ..............
IfKwner's Signature Date
r•J
Print Owner's Name
2
Albert J,, Krunski, Jr.
SUPERVISOR IMI A N A G I E 1\\11 I E N F
SOUTHOL�D►TOWN HALL-P.o.Box 1179
t�
• Southold
HOLD r�VV YORK 11971 l ���
o
53095 Main Road SCJ►UT
CHAPTER236 TO WATE .A DEMENT REFERRAL FORM
'IF ( APPLICANT
INFORMATION TO BE COMPLETED BY THE APPLICANT
ONLY FOR PROPERTIES ONE ACRE IN AREA OR LA.R GE R. )
APPLICANT'. (Property Owner, Design Professional, Agent, Contractor, Other)
A
1 a Z/2-10000/
NAMELY Date.
(Signature)
Contact Inf ormat ion: r owe. WA i 6 0 M
(E-Mail&Telephone Numbers
I
Propert Address / Location of Construction Site:
i i , r . .M. • 1000
1
pt
District
Section Block Lot
m
TO BE COMPLETED .BY SOUTHOLD TOWN ENGINEERING DEPARTMENT
[3 - Area of Disturbance is less than 1 Acre. No S.P.D.E.S. Permit is,Requird
Project does :Not Discharge to Waters of the State. No �"`. y .,E �. r
� Pei mft is e uj
Area of Disturbance is Greater than I Acre&Storm-water Runoff Discharges Directly
i
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 Perrnit.
[�
torm-water Runoff Flows Through Southold.Area of Disturbance is Greater than I Acre .� g
Town"s MS4 Systems to Waters of the State of New York. THE APPLICANT MUST OBTAIN
a S.P.D.E.S. Permit through the Sout,hidid Town Engineering, -e a t
Priorto Issuance of a Building Permit.
�?6
Reviewed By.
gate: �
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FORM * SMCP-TOS December 2024 �-
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