HomeMy WebLinkAbout51637-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#: 51637 Date: 02/12/2025
Permission is hereby granted to:
Nachiket Dabhi
1 Deerland Dr
East Quogue, NY 11942
To:
Legalize as-built deck repairs and boiler replacement at existing single family dwelling as applied for,
with flood permit.
Additional certification maybe required.
Premises Located at:
1575 Eugenes Rd, Cutchogue, NY 11935
SCTM#97.-2-20
Pursuant to application dated 12/17/2024 and approved by the Building Inspector.
To expire on 02/12/2027.
Contractors:
Required Inspections:
Fees:
As Built Alteration $1,085.00
CO-RESIDENTIAL $100.00
Flood Permit $150.00
To l $1,335.00
Building Inspector ^�
� � .. 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 out�hol towntl iLy
Date Received
APPLICATIONILO PIER I'
For Office Use Only
PERMIT NO. Building Inspector, ���.. � 2024 �
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:12.9.24
OWNER(S)OF PROPERTY:
Name:Nachi Dabhi SCTM# 1000-97.-2-20
Project Address:1575 Eugene's Rd. Cutchogue
Phone#:631-875-3354 Email:nachidabhi@gmail.com
Mailing Address:1 Deerland Drive, East Quogue
CONTACT PERSON:
Name:Joan Chambers
Mailing Address:PO Box 49 Southold NY
Phone#:631-294-4241 Emailloanchambers10@gmaii.com
DESIGN PROFESSIONAL INFORMATION:
Name:Lou Schwartz
Mailing Address:? Ridgewood St, Bay Shore, NY 11706
Phone#: 631 410-6838 Email:tiderunnereng@gmail.com
CONTRACTOR INFORMATION:
Name:owner
Mailing Address,
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration *Repair ❑Demolition N04 Estimated Cost of Project:
❑other Re air to existing 1st & 2nd floor wood framed deck §ol
Will the lot be re-graded? ❑Yes *No Will excess fill be removed from premises? ❑Yes FENo
1
PROPERTY INFORMATION
Existing use of property:single family residence Intended use of property:same
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
R-80 this property? ❑Yes *No IF YES, PROVIDE A COPY.
V Check Bee 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 buildingls)for necessary inspections.False statements made herein are
punishable as a Class A misdemeanor pursuant to Section 210.45 of the New York State Penal Law.
Application Submitted By(print name):Joan Chambers HAuthorized Agent ❑Owner
Signature of Applicant: Date:
CONNIE D.BUNCH
Notary Public,State of New York
STATE OF NEW YORK) No.01BU6185050
Qualified in Suffolk County
COUNTY OF SS:
COMMISslon Expires April 14,20416
)
Joan Chambers being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
(S)he is the Agent
(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
0±�ayof '1-'1-eCe4y-\b!A SZZ_j_
Notary Public
P RC i'I'tE II11T C I" IIII°"° I ION
(Where the appllC
ant is not the owner)
I,
Nachi Dabhi residing at 1575 Eugene' s Road, Cutchogue
NY, 11935 Joan Chambers
do hereby authorize to apply on
my behalf to the To outhold Building Department for approval as described herein.
12/11 /24
Owner's Signature Date
Nachi Dabhi
Print Owner's Name
2
SURVEY OF PROPERTY
SITUATED AT
CUTCHOGUE
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1000-97-02-20
SCALE 1"=30'
APRIL 10, 2024
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