HomeMy WebLinkAbout51192-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
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#: 51192 Date: 09/17/2024
Permission is hereby granted to:
Peconic Land Trust
PO BOX 1776
Southampton, NY 11969
To:
Legalize an "as built" finished basement with egress window well and legalize "as built"
window replacements throughout the existing single-family dwelling as applied for.
Premises Located at:
10273 N Bayview Rd, Southold, NY 11971
SCTM#79.-5-20.12
Pursuant to application dated 02/21/2024 and approved by the Building Inspector.
To expire on 03/19/2026.
Contractors:
Required Inspections:
Fees:
As Built Addition/Alteration $740.00
CO-RESIDENTIAL $100.00
Total $840.00
Building Inspector
F A TOWN OF SOUTHOLD BUILDING DEPARTMENT
w Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
ti Telephone (631) 765-1802 Fax (631) 765-9502 hfts://www.souttioldtowniiv.izov
Date Received
APPLICATION FOR, BUILDING PERMIT
For Office Use Only E C
i
CA
PERMIT NO. 5 Buildin Ins ector:, fl
202.4
L. p �' II
Applications and forms must be filled out in their entirety.Incomplete
applications will not be accepted. Where the Applicant is not the owner,an
Owner's Authorization form(Page 2)shall be completed.
Date:1/4/2024
OWNER(S)OF PROPERTY:
Name:Peconic Land Trust SCTM#1000-79-5-20.12
Project Address:10273 N Bayview Rd, Southold, NY 11971
Phone#:631-283-3195 Ext. 143 Email:jwilson@peconiclandtrust.org
Mailing Address:296 Hampton Road, Southampton, NY 11968
CONTACT PERSON:
Name:Jacqueline Wilson
Mailing Address:296 Hampton Road, Southampton, NY 11968
Phone#:631-283-3195 Ext. 143 Email:jwilson@peconiciandtrust.org
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone M Email:
CONTRACTOR INFORMATION:
Name:Sid Beebe & Sons Builders Inc.
Mailing Address:24925 Main Road, Cutchogue, NY 11935
Phone#:631-478-1874 Email:sbeebebuilders@optonline.ne
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ®Alteration ❑Repair ❑Demolition Estimated Cost of Project:
❑Other Installation of an Egress Window $15,000
Will the lot be re-graded? ❑Yes BNo Will excess fill be removed from premises? ❑Yes RNo
1
PROPERTY INFORMATION
Existing use of property:Education & Aquaculture Intended use of property:Education & Aquaculture
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
R40 this property? ®Yes ONO IF YES, PROVIDE A COPY.
8 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 Code. 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 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 building(s)for necessary inspections.False statements made herein are
punishable as a Class A misdemeanor pursuant to Section 220.45 of the New York State Penal Law.
Application Submitted By(print name):Melanie TebbenS (Vice President) ❑Authorized Agent BOwner
Signature of Applicant; Date: ,q/r1,0 p[�
STATE OF NEW YORK)
SS:
COUNTY OF 'i�OFFcl4-t< )
71� P y1 S being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the J�`C-e- I 'J �-tiV.ct ( V7-1 T ��, ° o
(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
'day of ���O�,i av 20 a2 �a
Notary Public If
Kathleen Kennedy
Notary Public State of New York
PROPERTY OWNER AUTHORIZATION No. OIKE6047674
Qualified in Suffolk County
(Where the applicant is not the owner) Commission Expires 09/05/20. 6
q, 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
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EXISTING (2) EXISTING (2)
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ao FEBRUARY, 2024
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FOUNDATION PLAN Architect, P.C.
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