HomeMy WebLinkAbout53010-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
SOUTHOLD., NY
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET CIF APPROVED .PLANS AND .SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 53010 Date: 05/21/2026
Permission is hereby granted to:
Margaret A Bowles
PO BOX 1267
Mattituck, NY 11952
To:
remove an existing deck and construct a screened deck addition to an existing single-family dwelling
as applied for.
Premises Located at:
425 Blossom Bend, Mattituck, NY 11952
SCTM# 115. 5-14
Pursuant to application dated 05/1=/2026 and approved by the Building Inspector.
To expire on 05/20/2028.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling- Addition &Alteration $418.00
CO-RESIDENTIAL $100.00
Total 51$, 00
Buy j6di'n'
g Inspector
A; Town mall Annex 4 Mai Road P. O. Box 117 t�o�d, 11 71-�►'.9 9
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A F L I CA T'l 0`04* Fvo"%R BU"IL""'W P MIT
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PERMIT NO.
Appkations and form must be fi*W out bt Owk a irety.lame
applications wiff not be accepted. Where the Appikant is mA the owmr..an
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Date:
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Name SCTM#100()� �
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MaHing Address:
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Mailing Address.
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DES"PROFE INFORMATION,
Name:
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Maifing Address
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Phone .
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DIESCRIPT,ION Of:PROPOSED lcmsmcrm�
D ew ru dur J ft�r Rq k e O#� s ed Project-.
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PROPERTY INFORMATION
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Existing use of property: �' '""` intended use pruperW.
Zone or use st , � G �is Si aM,restrictions withrespect to
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Signa r ce �r�.p Date:
c�tary�ubii��Mate of New York
No.01 BU8185050
STATE OF NEW YORK) Qualified In Suffolk Counter
Commission Expires April 141 2
COuNTY OF
left, being&Aj sue" , s arml says that s applicant,
t am of��a signing co nu above red,
is the AOC I
(Conwtractorl ,, c-)
of said owner or owners,and is duly authorized to performer or have performed the said work and to make and file this
ap i r" � �m a tre t the be l k �and�+ ;a
that the work be Performed the manner set fah ton the appikation Me therewith.
Sworn before me.this
41�n
day of AIL 1, .20
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w'+.'ws'....� ��� ��� �,���w�r r�,✓wmh�+na��,w ,�»s�w�yr"'u�w!�w�o�ww�iv�w rw�r��mr�u�r�n�w�mrtmm���m�r�aw,���;��w�
(Where the applicantis not the owner)
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residingat �r.
do hereby aut o6ze to applV on
ray behalf to the Town of Southc4d auihfing Department for approval as cfecdbed herein.
nees. 4--%%"e Mate
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girt Owrwps Name
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Albert J. KrE.pski, Jr.
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SUPERVISOR WIN M
A�.NA.GIEIMIIEN�F
SOUTHOLD TOWN HALL-P.0.Box 1179
53095 Main Road-SOUTHOLD,NEW YORK 11971 dt To wn o o u thold
CHAPTER 236 ST RMWATER MANAGEMENT REFERRAL FORM
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( APPLICANT INFORMATION TO BE COMPLETED BY THE APPLICANT
ONLY FOR PROPERTIES ONE ACRE IN AREA OR LARGER. )
A.PPLICAPPLICANT: Property Owner,, Design Professional,, Agent, Contractor, Other)
Date:
NAME: C Coco
(Print) CO) 4L
Contact Inforrnat ion:
(E-Mail&Telephone Number)
1,V
T
Property Address Locat ion of Construct ion Site:
eoop� S.C.E.M. # 1000
District
woo,
Section Block Lot
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IF, TO BE COMPLETED BY SOUTHOLD TOWN ENGINEERING DEPARTMENT
Area of Disturbance is less than I Acre. No S.P.D.E.S. Permit is Required I
I
Project does Not Discharge to Waters of the State. No S.P.D.E.S. Permit is Require,-ri .
Area of Disturbance is Greater than I 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 Buil,ld!u Permit.
E
-- Area of Disturbance is Greater than I 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 throe the Southold Town Engineering Dep rtment
Prior to Issuance of a Building Permit.
Reviewed By: Date:
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FORM # SMCP-TOS December 2024