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Home My WebLink About48337-Z TOWN OF SOUTHOLD BUILDING DEPARTMENT I'' TOWN CLERK'S OFFICE X191 r 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#: 48337 Date: 9/27/2022 Permission is hereby granted to; Herrmann, Nancy 3775 Pine Neck Rd Southold, NY 11971 To: construct interior alterations to existing single-family dwelling as applied for. At premises located at: 3775 Pine Neck Rd., Southold SCTM # 473889 Sec/Block/Lot# 70.-6-26 Pursuant to application dated 8/11/2022 and approved by the Building Inspector. To expire on 3/28/2024. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $235.20 CO-ALTERATION TO DWELLING $50.00 Total: $285.20 Buy Spector 4�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 1it1V ://wwr lout of taxa ao Date Received I IIS nI� 1,DINGI I 1111ISI 1°°IIIA f cc, �. Y- � 1'11 ,,,l 1dk For Office Use Only Fjf�-11 BUILD�NG DEPT PERMIT NO. 37 Building Inspector: T VJ'Orr S-4 Applications and forms must be filled out in their entirety.Incomplete applications will not be accepted. Where the Applicant Is not the owner,an Owners Authorization form(Page 2)shall be completed. Date:August 8th, 2022 OWNER(S)OF PROPERTY: Name:Ms. Anthy Antoniou & Ms. Nancy Herrmann SCTM#1000-70.-6-26 Project Address:3775 Pine Neck Road, Southold, NY 11971 Phone#:_ Email:anthy.antoniou@gmail.com Mailing Address:3775 Pine Neck Road, Southold, NY 11971 CONTACT PERSON: Name:Jake LaChapelle AIA Mailing Address:p.0. Box 1251 Mattituck, NY 11952 Phone#:(646) 251-5058Email:fake@lachapellearchitecture.com DESIGN PROFESSIONAL INFORMATION: Name:Jake LaChapelle AIA Mailing Address:p.0. Box 1251 Mattituck, NY 11952 Phone#:(646) 251-5058 ]�rnail:fake@lachapellearchitecture.com CONTRACTOR INFORMATION: Name:Steve Kaplan, Homework PCSK Inc. Mailing Address:90 Bridle Court, Cutchogue, NY 11935 Phone#:(347) 258-8642 Email:steven@homework.builders DESCRIPTION OF PROPOSED CONSTRUCTION [:]NewStructure ❑Addition ■Alteration ❑Repair ❑Demolition Estimated Cost of Project: ❑Other $12,000 Will the lot be re-graded? Dyes IN'NO Will excess fill be removed from premises? ❑Yes 8No 1 PROPERTY INFORMATION Existing use of property:single-family res. Intended use of property:Single-family res. Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to R40 Low Density Residential this property? ❑Yes ■No IF YES, PROVIDE A COPY. IIS Check Box After, IlReadiling: 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 Budding 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 budding(s)for necessary Inspections.False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210AS of the New York State Penal Law. Application Submitted By(print name):Jake LaChapelle ■iAuthorized Agent ❑Owner Signature of Applicant: Date:August 9th, 2022 STATE OF NEW YORK) SS: COUNTY OF Suffolk ) Jake LaChapelle being duly sworn, deposes and says that(s)he is the applicant (Name of in .,. , ning contract)above named, agent (S)he is e, (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 'tel o 0 day of Zt oiary Public (J" N 1'1ft I' EN 14" II I''t C I It 1 17 °°IIIf°'1111 N TFtAc E' i- + E �. .m . NOTARY PUBI_I(� .B Ia�1�OFI IBS YORK (Where the applicant is not the owner) c.0,j;vj 0690 OUAIw rV ED$N FFOLK COUNTY comioIsION B FIRE SII.NP:30, Anthy Antoniou residing at 3775 Pine Neck Road I, Southold, NY 11971 Jake LaChapelle do hereby authorize to apply on my behalf to the Town of Southold Building Department for approval as described herein. August 9th, 2022 Owner's Signature Date Anthy Antoniou Print Owner's Name 2