HomeMy WebLinkAbout51896-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#: 51896 Date: 05/06/2025
Permission is hereby granted to:
Penelope Christophorou
15 Cheever PI
Brooklyn, NY 11231
To:
Construct a detached garage accessory to an existing single-family dwelling as applied for.
Premises Located at:
2465 Wunneweta Rd, Cutchogue, NY 11935
SCTM# 111.-8-6.1
Pursuant to application dated 03/27/2025 and approved by the Building Inspector.
To expire on 05/06/2027.
Contractors:
Required Inspections:
Fees:
Accessory-New Structure $413.00
CO Accessory $100.00
Total $513.00
Building Inspector
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
z� Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone (631) 765-1802 Fax (631) 765-95021�tt �s:/lwww. tititti,iol towowtii .� o
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
PERMIT NO, �� Building Inspector:
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: 3Z�
OWNER(S)OF PROPERTY: aa�Yf A SCTM# 1000-
o ru Name; Ch QQ
Project Address: Zt�
Phone#: 9 -1-
_ Email; rY1pl�0.�ipxt' •GOM
91 3� 7
Mailing Address, 2L1(v5- WL k1ACWd&
w_ .._ ..,.. _ ...__.._�_ W .... �», ......... _.
CONTACT PERSON:
. .Name:...... �e Q1n Ca✓tIi LK-- ,r
Mailing Address: PD 877 JaUnQ'�u ('�"" N T I��y
Phone#: (�3�'3u4' 31�Iv Email: •�1 "�" 1 �"(iI'" "�"� YYLIU• �m
DESIGN PROFESSIONAL INFORMATION:
Name: C ies 111
Mailing Address:
J
Phone#: — Email:
5 � :...
CONTRACTOR INFORMATION:
Name:
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
New Estimated Cost of Project:
r ❑Demolition 1
�Oth S`'tr r� Alteration ❑Repai $
Will the lot be re-graded? ❑Yes ®No Will excess fill be removed from premises? ❑Yes .kNO
1
. m_ .,.._..
PROPERTY INFORMATION
Existingy
use of property: �� �f �� intended use�of pproperty.
Zone or use p this property? ❑Yesl�NO IF YES,PROVIDE district in which remises is situated: Are there any covenants and res ri+ctions wit espectto
��, fo E A COPY.
yn hei k Box After Read, Wig. The owner/contractor/design professional P-,responsible for all drainage and storm water issues as-provided by
T BY MADE to the Building Department for the Issuance of a Building Permit pursuant to the Building Zone
Chapter�31�of the Town Cod
e.APPL
ICATION IS HERE
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'bu7ding(s)for necessary inspections.False statements made herein are
New York State Penal Law.
pursuant. to Section 2I0A5 of the.. . __.� _.. �.m.....punishable as a Class A misdemeanor
Application Submitted By(print name): VAuthorized Agent ❑Owner
Signature of Applicant: Date: J/27 Z S—
CONNIE ID,BUNCH
Notary Public,State of New York
STATE OF NEW YORK) No.01BU6185050
SS: Qualif led in Suffolk County
COUNTY OF commisslon Expires April 14, ..+ .
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
ay of (► t 0� ......... ._::6 n ..
Notary Public
(Where the applicant is not the owner)
residing at ! .. vvv w .—
Megan Carrick to apply
do hereby authorize, on
my behalf to the To of Sout uilding Department for approval as described herein.
Date
Owner's I at e
Print Owner°. ame
2
Albert J. Kru ski, Jr. ST01K1\M[WA\,T]E1K
SUPERVISOR 1\\4A\,NA�G]El\\l[]ENT
SOUTHOLD TOWN HALL-P.O.Box 1179 53095 Main Road-SOUTHOLD,NEW YORK 11971 Town
oW n of Southold
CHAPTER 236 - STORMWATER MANAGEMENT REFERRAL FORM
( APPLICANT INFORMATION TO BE COMPLETED BY THE APPLICANT
ONLY FOR PROPERTIES ONE ACRE IN AREA OR LARGER. )
- - - - -- - - - — - - - - - - - - - - - - - — - - - - - — - - - - — -
APPLICANT: (Property Owner, Design Professional, gen Contractor, Other)
NAME:. P• v ., X_ Date:
(h aba 1
Contact Information: 'C � . ce "I
(E-Mad&Telephone Number) '�•
Property Address / Location of Construction Site:
►� � . .+ch . S.C.T.M. #: D00istr�0
ct
! lI
Section Block Lot
TO BE COMPLETED BY SOUTHOLD TOWN ENGINEERING DEPARTMENT
- - - — - - — - - - - - - - - - - — - — - - - - - - - - - — - - - - -
❑ - Area of Disturbance is less than 1 Acre. No S.P.D.E.S. Permit is Re wired 1
Project does Not Discharge to Waters of the State. No S.P.D.E.S. Permit is Re wired l
❑ - Area of Disturbance is Greater than 1 Acre & Storm-water Runoff Discharges Directly
to Waters of the State of New York. THE APPLICANT MUST OBTAIN a S.P.D.E.S. Permit
DIRECTLY From N.Y.S. D.E.C. Prior to Issuance of a Buildin Permit.
❑ - Area of Disturbance is Greater than 1 Acre & Storm-water Runoff Flows Through Southold
Town's MS4 Systems to Waters of the State of New York. THE APPLICANT MUST OBTAIN
a S.P.D.E.S. Permit throw h the Southold Town Eat iatt e¢'iat De artment
Prior to Issuance of a Building Permit.
Reviewed By: ' ""ww Date: ✓ U S
FORM * SMCP-TOS December 2024 ` C r V Pv