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Home My WebLink About47773-Z FO �; TOWN OF SOUTHOLD aye BUILDING DEPARTMENT co TOWN CLERK'S OFFICE oy • o� 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#: 47773 Date: 5/2/2022 Permission is hereby granted to: Tast, Jill 620 Ostrander Ave Riverhead, NY 11901 To: install handicap ramp to existing single-family dwelling as applied for. At premises located at: V 0/�2555 Youngs Ave Unit 14C, Southold I SCTM #473889 � � �Q Sec/Block/Lot# 63.2-1-45 Pursuant to application dated 5/2/2022 and approved by the Building Inspector. To expire on 11/212023. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $200.00 CO-ALTERATION TO DWELLING $50.00 Total: $250.00 oh� Bui ding spector 0f 50UTyOlo - --- # . * TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 INSPECTION [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I ULATION/CAULKING [ ] FRAMING /STRAPPING [ FINALI`nn. [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: DATE INSPECTOR ho�aOF SOUTyO� f TOWN OF SOUTHOLD BUILDING DEPT. • �o °`ycouHtv��`' 631-765-1802 . INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [rSLATIOWCAULKING U FRAMING /STRAPPING [ NAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL R EEMARKS: 0 DATE yOy1/ INSPECTOR f ,YIELD INSPECTION REPORT DATE COMMENTS FOUNDATION (1ST) -J --------------------------------- FOUNDATION (2ND) [� z � o Ch �N (� H ROUGH FRAMING& It PLUMBING r INSULATION PER N.Y. STATE ENERGY CODE i r r FINAL ADDITIONAL COMMENTS � ro �o � z x r� 1G� �x d b y SufFoc,� TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 �y�o• °ao�� Telephone (631) 765-1802 Fax (631) 765-9502 hqs://www.southoldtownny.gov Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only PERMIT NO. Building Inspector: R AA(�' Ic MAY o 2 2022 BUILDING DENT: Applications'and forms must be-filled out in their entirety Incomplete TOWN OFSOUTHOLD applications Will not be accepted: Where the:Applicaht is not the"owner;an Owner's Authoriiatiori form(Page 2)shall be completed Date: aL- OWNER(S)OF PROPERTY: Name: 6__I?i' _.___ __ SCTM#1000-04 3, Q/, Project Address: 65- youlIJ 5 AUE- Phone#: Emai .Mailing Address _R5Fr— Uf�/U 5_AU5. O/l/1l. l l�_c...�-_50-U7H — CONTACT PERSON Name: _id ,� hf_._ls._ ___-------___............... ._. ._.__.____._____ Mailing AddressF Phone#: 63( - `7 a-, - Email DESIGN PROFESSIONAL INFORMATIONf Name: Mailing Address: Phone#: Email: CONTRACTOR.INFORMATION: Name: ' . Mailing Address: �..1\./.7.._�..�.1_�I_._.._..rl.-�'�,A��_..__.._.�G� �/042r_Phone#: Email: __._.. - _ _ _ L 6._ _ �_-- S _.8______._.._____..-_-- DESCRIPTION OF PROPOSED CONSTRUCTION El New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: Other l�/q C y rn 10LJ A lV 7' �� 11'��l� $�ri . 0 oe Will the lot be re-graded? 1:1Ye0d No Will excess fill be removed from premises? ❑Yes %No 1 sPROPERTY INFORMATION Existing use of property: M/T l C Intended use of property: A)61 Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? ❑Yes El No IF YES, PROVIDE A COPY. 1 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 Coder 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 appliceble.Laws,Ordinances oFRegulations;•foi the construction of buildings, additions,alterations or for removal or demolition as herein described The applicant agrees to comply wifh'all-applicable laws,ordinances,building code, housing code and'regulations and to admit authorized1rispectors on premises'and nrbuilding(s)-for necessary inspections.False statements made herein are punishable as a Class A misdemeanor pursuant to 5e'ction-216.45 of the New,York'State Penal Law Application Submitted By(print name): �1 C, TAS ❑Authorized Agent Owner Signature of Applicant: Date: - __. ___..._ _ .�� C.i_-_.- -_ �___._._._-_-__.__ _--___..________._____ .___--___ lr►.��._,_Via_._.___________. STATE OF NEW YORK) SS: COUNTY OF S(�fu�k ) C 65 T 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 d day of C(U 20 22- 2(o-t�,IYA Notary Public TRACEY L. DWYER PROPERTY OWNER AUTHORIZATION NOTARY PUBLIC,STATE OF NEW YORK NO.01 DW3306900 (Where the applicant IS not the Owner) QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,2NX I, residing at do hereby authorize to apply on my behalf to the Town of Southold Building Department for approval as described herein. Owner's Signature Date Print Owner's Name 2 ■ .>,.� ■ ■ � l it �� ■ ■ I I � I�•` � iI "r � - - _ S • : 11 ■ ■ ■ �. ► . � --err � _ _ � ' 1 -� i - -I - -- ��-��-�.�-!- � _ter,��-; ! ►_I � _I I I I - � ► �---�-I ► I I ,____I I ► ,�i L � - II_I I � I I I I I I I I _ _ I II I I l I I I I