HomeMy WebLinkAbout51884-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#: 51884 Date: 04/30/2025
Permission is hereby granted to:
Caracciolo Jr L 2022 QPRT
PO BOX 312
Laurel, NY 11948
To:
legalize "as built" interior alterations to existing single-family dwelling as applied for. Additional
certification will be required.
Premises Located at:
8070 Great Peconic Bay Blvd, Laurel, NY 11948
SCTM# 126.41-17
Pursuant to application dated 03/24/2025 and approved by the Building Inspector,
To expire on 04/30/2027.
Contractors:
Required Inspections:
Fees:
As Built Alteration $695.00
CO-RESIDENTIAL $100.00
Total $795.00
NIilding Inspector
,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 liqps://www.southoldtowjitjy.gov,
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
1/
PERMIT NO. a Building Inspector
A 2225
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 Department
Owner's Authorization form(Page!'2)shall be completed. Town of Southold
Date:03.24.25
OWNER(S)OF PROPERTY:
Name:Louis Caracciolo TSCTM#1000-126-11-17
Project Address:8070 Peconic Bay Blvd - Mattituck, NY 11952
Phone#:631.484.2097 Email:Iceastend@gmail.com
Mailing Address:
CONTACT PERSON:
Name:Zackery E. Nicholson, RA
Mailing Address:1250 Evergreen Drive - Cutchogue, NY 11935
Phone#:631.513.6589 Email:ZENicholson.Arch@gmail.com
DESIGN PROFESSIONAL INFORMATION:
Name:Zackery E. Nicholson, RA
Mailing Address: 1250 Evergreen Drive - Cutchogue, NY 11935
Phone#:631.513.6589 Email:ZENicholson.Arch@gmail.com
CONTRACTOR INFORMATION:
Name:
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project;
❑Other As Built Alterations N/A
Will the lot be re-graded? ❑Yes ' No Will excess fill be removed from premises? ❑Yes IONo
1
PROPERTY INfaRMATION
Existing use of property: (2) SINGLE FAMILY Intended use of property: UNCHANGED
DWELLINGS
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
R-40 this property? ❑Yes ❑No IF YES, PROVIDE A COPY.
❑ 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,ordioancas 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 bullAng(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):Zacke, ry E. Nicholson, RA WAuthorized Agent ❑owner
Signature of Applicant: �'" Date:
CONNIE D.BUNCH
STATE OF NEW YORK) Notary Publlr,State of New York
SS: No.01 BU6185050
Qualified In Suffolk County
COUNTY OF ) Commission Expires April 14,2 �.
being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the
(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
" y of OVA .20
Notary Public
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
I, 13 6a-r&Lt't'-o w residing at,
�do hereby authorize to apply on
my behalf to he Town of Southold Building Department for approval as described herein.
Owner's Signature Date
wu,
Print Owner's Name
2