HomeMy WebLinkAbout51844-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#: 51844 Date: 04/18/2025
Permission is hereby granted to:
Alison L Bloomer
4600 Old North Rd
Southold, NY 11971
To:
Legalize "as built" interior alterations to include a first-floor bathroom and finished basement to an
existing single-family dwelling as applied for. Additional certification may be required.
Premises Located at:
4600 Old North Rd, Southold, NY 11971
SCTM# 55.-2-6
Pursuant to application dated 03/12/2025 and approved by the Building Inspector.
To expire on 04/18/2027.
Contractors:
Required Inspections:
Fees:
As Built Addition/Alteration $1,222.00
CO Single Family Dwelling-Addition /Alteration $100.00
Total $1,322.00
�� Building Inspector �_���
t
TOWN OF SOUTHOLD -BUILDING DEPARTMENT
' Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone (631) 765-1802 Fax (631) 765-9502 Its:�t" r owmunWu �
Date Received
Allf�)PLICATION FOR BUILDING PERMIT
For Office Use Only
PERMIT NO. 5154 Building Inspector.Applications and forms must
ete
applications will e fill
not be accepted. Where the Applicant ed out in their l ish not the owner,an -Town oj Sout o�
owner's Authorization form(Page 2)shall be completed.
Date: fA&f C4 10 2026-
OWNER(S)OF PROPERTY:
Name:Alison Lew Bloomer sum# i000-
Project Address:4600 Old North Road Southold NY 11971
Phone#: Email:
917-873-7306 alisonlew7@gmail.com
Mailing Address:4600 Old North Road Southold NY 11971
CONTACT PERSON:
Name:Joan Chambers
Mailing Address: ov +ft S 0UT-t foL.0 M,� I (et, -7
Phone#: &31 — -0_4t anc ti0.mb rj 1 o (1,1 mat
DESIGN PROFESSIONAL INFORMATION:
Name: �_oU S ck.CJo+r4Z
Mailing Address: -7 f l p&uwoQP S tfU�t
Phone#: 4 31 — -4I o -- f683$ comtrRxv @ 01 may� - C D✓�'l.
CONTRACTOR INFORMATION:
Name: w U I C.,
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
ROther as-built $
Will the lot be re-graded? ❑Yes El No Will excess fill be removed from premises? ❑Yes ❑No
1
PROPERTY INFORMATION
Existing use of property:single family residential Intended use of property:Same
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
AC, this property? ❑Yes 19 No IF YES, PROVIDE A COPY.
R Check Cox After Fteadh1g. 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 210.45 of the New York State Penal Law.
Application Submitted By(print name): jq�klGthorized Agent ❑Owner
Signature of Applicant: Date: 3-12-.2 S
STATE OF NEW YORK)
SS:
COUNTY OF 'SU-%I I�
C iYi80z�- being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the 46-ewv-
(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
X day of M arc k 20-a5
tairy Public
NOTE,if `F"tgILI ,STATE OF NEW YORK
01 DW(g%V9I7
Ft'
ii F)E R IY OWNER ..AUTI Il112Aw 0 ""PI"F-IF"Ol 4;II-FOLK a.0tvq"1
(Where the applicant is not the owner) COM " ''ON F,,Fj , JI N 30,
Alison Lew Bloomer 4600 Old North Rd Southold NY 11971
i, residing at
do hereby authorize Joan Chambers to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
_ March 10, 2025
Owner's Signature Date
Alison Lew Bloomer
Print Owner's Name
2
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4600 OLD NORTH ROAD
(• FLOORPLAN' y
F
cr"i a FRONT STAIRS TO ENTRY
77006 �V
SMOKEICO2 DETECTOR
® SMOKE DETECTOR
41'
CEILING HEIGHT:B'
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f— WINDOW68x42" —► r WINDOW68x42' —► _ 4"
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1
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144" c o
75" ! 280" 150'
�--35" 60"—► }
t136" 76" �- -F—70"
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.� POCKET DOOR
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w012.5x12.5' .75'+ KITCHEN19.5s9' 108'#1
V 60" 232"
SLIDING DOOR ENTRY
WINDOW64x42" 70" + f— WINDOW70x34' —►
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TO BASEMENT,
DECK
BACK STAIRS TO DECK
F
s, 4600 OLD NORTH'ROAD f
77006 j BASEMENT '
�FESSIONP�" ii �
BASEBOARD HEAT RUNS
SHEETROCK WALLS+INSULATION
s SHEETROCK WALLS
• SMOKEICO2 DETECTOR
BASEMENT CEILING HEIGHT:T
DROP CEILING,EXCEPT IN UNFINSHED AREAS
NO INSSLATION BETW DROP CEILING AND FLOOR ABOVE
CEMENT FLOORS THROUGHOUT
DOOR HEIGHT:80"
EGRESS WINDOW 32x18"
w�
of 0
224"
UNFINISHED
O_ UNFINISHED
UTILITYROOM W BOILER/OILTANK
150"
UTILITY AREA
1
182"
68" 160"
64 i
W
/ N
( 298"
G
S UNFINISHED
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f
`F STORAGEROOM
s CLOSET 30" 6"
160" 4
4 1
134" 4
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166"
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Y 80" 68"
i
100"
EGRESS
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BILCO EXIT TO
BACKYARD
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f
4600 OLD NORTH ROAD-
r
77006 i BATHROOM#2
(added byprevious owners) ,-
9 1
1 g' SKYLIGHT.19a26"
1 1
POCKET
DOOR
24"
TILED SHOWER �{ 7" 28"
925"
a I i a
a L-P-5ILL
f
9 A
28"
{; 50.5"
23"
!J 9
jf
t s_—P—_ -------------- m- mm PEDESTAL SINK O 28"
r 41
22"$ f m
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= 18"
m 3
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a TOILET
19"
7-