HomeMy WebLinkAbout51892-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#: 51892 Date: 05/01/2025
Permission is hereby granted to:
James T Nicholls
105 W 13th St Apt 12F
New York, NY 10011
To:
Legalize an "as built"finished basement as applied for. Additional certification may be required,
Premises Located at:
39595 Route 25, Orient, NY 11957
SCTM# 15.-8-16
Pursuant to application dated 03/26/2025 and approved by the Building Inspector.
To expire on 05/01/2027.
Contractors:
Required Inspections:
Fees:
As Built Addition/Alteration $1,420.00
CO Single Family Dwelling-Addition /Alteration $100.00
Total S1,520.00
Building Inspector
TOWN OF SOUTHOLD —BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971 0959
41 Telephone (631) 765-1802 Fax (631) 765-9502 Lit ,Nv.so thoimllo, lii .,,
Date Received
For Office Use Only E C E D L' E
IT No. 5 Building Ins-ector.
PERM g P
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:3.21.25
OWNER(S)OF PROPERTY:
Name:James Nichols SCTM#1000-15.-8-16
Project Address:39595 Main Rd. Orient
Phone#:1-917-443 -1009 Email:jamesnicholls@hotmaii.com
Mailing Address: 105 W 13th Street, 12F, NY NY 10011
CONTACT PERSON:
Name:Joan Chambers
Mailing Address:PO Box 49 Southold NY 11971
Phone#:631-2944241 T—Email'joanchambersl O@gmaii.com
DESIGN PROFESSIONAL INFORMATION:
Name:Lou Schwartz
Mailing Address:? Ridgewood St, Bay Shore, NY 11706
Phone#031)410-6838 Email:tiderunnereng@gmail.com
CONTRACTOR INFORMATION:
Name:as built
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
0ther finished basement as built
Will the lot be re-graded? ❑Yes X 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
R-40 this property? ❑Yes ANo IF YES, PROVIDE A COPY.
Ili i'iiiecic Box After i l irig: 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):Joan Chambers ®Authorized Agent ❑Owner
Signature of Applicant: Date:
CONNIE D.BUNCH
Notary Public,State of New York
STATE OF NEW YORK) No.01BU6185050
SS: Qualified In Suffolk Countya
COUNTY OF ) Commission ExpiresAprll 14,2
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 Text
Aay of MaA- dn 20=,:X,5 "p 1 tv V
Notary Public
PROPER°°(°' NE tIT1111� I 1 1.1 1;,1 ,
(Where the applicant is not the owner)nnnn
James Nicholls 105 W 13th Street, 12F,NY NY 10011
I
residing at
do hereby authorize to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
3/21/25
Owner's Signature Date
James Nicholls
Print Owner's Name
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CEILING HEIGHT VARIES FROM 89" TO 95"
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-� ALL CONSTRUCTION SHALL MEET THE
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FINISHED BASEMENT NICHOLLS RESIDENCE
39595 MAIN RD.
1 /4" = 1'-0"
3.25.25 ORIENT
1000- 15.-8- 16