HomeMy WebLinkAbout52849-Z TOWN OF SOUTHOLD
` BUILDING DEPARTMENT
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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#: 52849 date: 04/08/2026
Permission is hereby granted to:
S McFadden
3047 Hollow Rd
Malvern, PA 19355
To:
Construct alterations to reconfigure an existing bathroom in an existing single-family dwelling to
include adding shower as applied for.
Premises Located at:
1955 Haywaters Rd, Cutchogue, NY 11935
SCTM# 111.4-1
Pursuant to application dated 03/25/2026 and approved by the Building inspector.
To expire on 04/07/2028.
Contractors:
Required inspections:
Fees:
Single Family Dwelling- Alteration $278.00
CO Single Family Dwelling-Addition /Alteration $100.00
Total 378.00
Building inspector
TOWN OF t iTTI� LI -�BUILDING DEPARTMENT
1I971-0959
A Town ball Annex 54375 Main Road P. ►. Box 1179 Southold,N
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Telephone (631) 7+65-1 02 Fax (631) 765 5 2 � �
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Date Received
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APPLICATION FOR BUILDING
For Office Use Only
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PERMIT NO
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Project Address
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❑New Structure 7Addition /TAI,te�ration DR,epair 0 Demolition Estimated Cost of Project:
❑other .
Will the lot be re-graded? ❑Yes 0 Well excess fell be removed from premises? ❑Yes No
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Existing use of property,,. Intended use of property:
Are there an covenants and restrictions with respect to
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this property? ❑Yes 1XNo IF YES, PROVIDE A COPY.
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A lication B (print : ❑Authorized Agent ❑Owner
pp Submitted Y name�
Signature of Applicant: Date:
STATE OF NEW YORK)
SS:
COUNTY OF - }
---� sworn, deposes and says that(s)he is the a licantbeing dulyswo
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(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
Notary Public
CATHERiNE MARGA.RET WARD
Notary Public-State of New York
PROPERTY OWNER A.UTH RIZATION No,01WA00380�41
Qualified in Suffolk County
(Where the applicant is not the owner)
My Commission Expires Jun 3, 2029
1, residing at
do hereby authorize to apply on
my beh the Town of outhoid Building Department for approval as described herein.
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Owr S Signature Date
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Print Owner's Name
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