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HomeMy WebLinkAbout53179-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) Permit#: 53179 Date: 08/05/2026 Permission is hereby granted to: Francis B Mccaffery PO BOX 245 Cutchogue, NY 11935 To: construct a sunroom addition to an existing single-family dwelling as applied for. Premises Located at: 4010 Bridge Ln, Cutchogue, NY 11935 SCTM#84.-5-8.1 Pursuant to application dated 07/20/2026 and approved by the Building Inspector. To expire on 08/04/2028. Contractors: Required Inspections:. Fees: Single Family Dwelling- Addition &Alteration $332.50 CO-RESIDENTIAL $100.00 LgiTotaj ' 432.50 nspector ���� r 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 htt :.:/l\-v,,�vw,soutlioldtovwni . Yo-\t Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only i PERMIT NO. Building Inspector: r JUG Applications and forms must be filled out in their entirety.incomplete applications will not be accepted. Where the Applicant Is not the owner,an Building ®Apartment Owner's Authorization form(Page 2)shall be completed. 1.a,ars of"oitViold Date: . OWI NIER(S):OF PROPERTY-. Name: . , c _ SCTM#1000- Physical Address: Phone#:" Email: Mailing Address: '/ G'1 CONTACT PERSON: Name: Mailin Addres g s: ILA I n.�4 i Phone#: As . . t Email: , DESIGN PROFESSIONAL INFORMATION: Name: ° Mailing Address: Phone#: U3 15 Le 0 - h5ksell CONTRACTOR INFORMATION: Name: �6AAL-kk 60S Mailing Address: S u Phone#: Email c�u� � DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure Qddition ❑Alteration ❑Repair ❑Demolition Estimated Cost o€Project: ❑Other $ �Z©G Will the lot be re-graded? ❑Yes ©No Will; xcess fill be removed from premises? ❑Yes YNo 1 PROPERTY INFORMATION Existing usjproperty: Intended use of roe s p p rtY� Zone aJ" cfsostrict in which premises is situated: Are there any covenants and restrictions with respect to this Property? ❑Yes �No IF YES,PROVIDE A COPY. ,j Chee=,Scr 14 After Reading: The r c ractor/desi n professional is responsible for all drainage wnd storm water Issues as r f apter Z36 +cyf/#"town code.APPUCA'noN i5 ff EREBY"i4t�'DE to the Building Deparivnent for the Issuance of a:Building Permit pursuant to the Buifdfn Provided by ordinance! cry t►�M"own of Southold,Suffolk,county,New York and other applicable laws,ordinances or Regulations,far the construction of buildings addltiorss, ,awttite`On$orforremoval ardemolition as herein descrfb�ed,The ap�pilcant a gone haausinB code►. a regulations and to admit authorized Inspectors on premises and In building(s)fornnecessary inspeth 411 iction�s.I Rise stateme�building code, pu0ish0bleM as a ass fY misdemeanor pursuant to Section :to.cl5 of the view Yortlk State Penal Law, made herein are gpp�Ication Submitted BY(print name): rf k✓er� f4' c- ❑�, � Authorized Agent AR Sig;natur�e of Applicant: tea - . Owner f Date: �6 a STATE OF NEW YORK) " SS: COUNTY DFSAEOi) _ ) (Name of individual signing contract)above named, being duly sworn, deposes and says that ls)he is the applicant (S)he is the W (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 ' application; that all statements contained in this application are true to the best of his/her knowledge and belief,e th andthat the work will be performed in the manner set forth in the application file therewith, Sworn before me this _day of 20�� ry Public EVE i.GATZ SC'ii WA,\4B0RN PROPERTY ER i Re �rHORI f d �W vt°f' lfi PUgistBLIC. a�,� r 6 fi fJf l {Where the applicant is not the owner) 6Jafrfied wn Suffolk 4:ouilty CST R)issiori Expires Dcc.24.,,20dl G I, f, residing at do hereby authorize � � r to apply on my behalf to the Town of Southold Building Department for approval as described herein. ener'sSignatur�C- 0 o Date w rIr c- k ., Print Owner's Name 2 aS Albert J. K - f ��5 � ST{0}1[ MWA�TIE] 3UMRVI8 n of Boutl�o MANAGEMENT t EM1ENT SOUTHOLD TOWN HALL-P.O.Box 1179 53095 Main Road-SOUTHOLD,NEW YORK 11971 Town ofSouthold CHAPTER 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: La. iS� - _ bate: IA („� G Contact Information: ega (E-Mad&Telephone Numbed Property Address / Location of Construction Site: S.C.T.M. #: 1000 District w a q Section Block Lot TO BE COMPLETED BY SO OLD'TOWN ENGINEERING DEPART"MENT uih id- — — — — — — _ — _ _ _ - - - - - - - Area of Disturbance is less than I Acre. No S.P.D.E.S.Permit is Re faired l Project does Not Discharge to Waters of the State. No S.P.D.E.S. Permit is Re uired! - 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 Building Permit. - Area of Disturbance is Greater than I Acre&Storm-water Runoff Flows Through Southold Tow6s MS4 Systems to Waters of the State of New York. THE APPLICANT MUST OBTAIN a S.P.D.E.S.Permit through the Southold Town En aneerin De artment Prior to Issuance of a Building Permit. Reviewed By: Date: FORM * SMU-TOS December 2424