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Home My WebLink About51914-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#: 51914 Date: 05/12/2025 Permission is hereby granted to: Anna Bajlak 1995 Ruth Rd Mattituck, NY 119520917 To: Construct additions and alterations to an existing single-family dwelling as applied for. Premises Located at: 1995 Ruth Rd, Mattituck, NY 11952 SCTM# 106.-7-7 Pursuant to application dated 04/03/2025 and approved by the Building Inspector. To expire on 05/12/2027. Contractors: Required Inspections: Fees: Single Family Dwelling- Addition&Alteration $722.00 CO Single Family Dwelling-Addition /Alteration $100.00 Total $822.00 AR ) 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 litti)s://,,vNvw,sotitholldtowiiny.gov Date Received APPLICATION FOR BUILDING PERM'IT For Office Use Only . PERMIT NO. 1 Building Inspector. pegartment Applications and forms must be filled out in their entirety.Incomplete Bullding old applications will not be accepted. Where the Applicant is not the owner,an Town of Souk Owner's Authorization form(Page 2)shall be completed. Date:2025.04.02 OWNER(S)OF PROPERTY: Name:Mary & Ken McGorry SCTM #1000-106.-7-7 Project Address: 1995 Ruth Road, Mattituck, NY 11952 Phone#:(917) 359-6630 Email: _ Mailing Address:3 Orchard Farm Road, Port Washington, NY 11050 CONTACT PERSON: Name:Jake LaChapelle Mailing Address:P.O. Box 1251, Mattituck, NY 11952 Phone#:(646) 251-5058 Email:jake@lachapellearchitecture.com DESIGN PROFESSIONAL INFORMATION: Name:Jake LaChapelle AIA Mailing Address:P.O. Box 1251 Mattituck, NY 11952 Phone#:(646) 251-5058 Email:jake@lachapellearchitecture.com CONTRACTOR INFORMATION: Name:Mark Davis Builder Mailing Address:P.O. Box 1493, Mattituck, NY 11952 Phone#:(631) 767-0812 Email:Imcd1700@gmail.com DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition RAlteration ❑Repair ❑Demolition Estimated Cost of Project: ❑Other $1so,000 Will the lot be re-graded? Dyes BNo Will excess fill be removed from premises? ❑Yes WNo 1 PROPERTY INFORMATION Existing use of property:single-family res. Intended use of property:no change Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to R-40 this property? ❑Yes A No IF YES,PROVIDE A COPY. 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 210AS of the New York State Penal Law. Application Submitted By( me): ke LaChapelle @Authorized Agent 0 wner Signature of Applicant: Cate: STATE OF NEW YORK SS: COUNTY OF Suffolk Jake LaChapelle being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, Agent Nhe 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 day of 2D Not Wl MI HLA0HTE NOTARY PUBLIC,STATE OF NE'WW YO(K Registration No.O ISCS039767 Qualified in Suffolk o k bounty Commission Expires February 27.2 (Where the applicant is not the yawner) Mary McGorry residing at 3 Orchard Farm Road, I, , Port Washington, NY Jake LaChapelle g do hereby authorize, p to apply on 70w to the Town of uthoid Building Department for approval as d�cri d herein. er's Signature Date Mary McGorry 01 Print Owner's Name 2 o A� % 7— P, ton 0 CAI rV1, CP ro DATE: FEB. 13, 2025 JOB NO:2025-034 Survey for: CERTIFIED TO: KENNETH McGORRY KENN GO ETH McRRY MARY McGORRY FIRST AMER4C,ANaz--RTLF,INSURANCE MARY McGORRY COMPA0 , GROSSICOOKTRY,MORTGAGE L[ .ISAOA/A-nMA Lot 7, "Sunset Knolls, Section 2" At Mattituck X Town of Southold Suffolk County, New York S.C.T-M.: 1000-106.00-07.00-007.000 DAVID H. FOX, L4S. P.C. N.Y.S.L.S, #50234 FOX ND SURVEYING 30 64 SUNSET AVENUE WESTHAMPTON BEACH, N.Y. 11978 SCALE:1 30' (631) 288-0022 - NOTES: UNAUTHORIZED ALTERATION OR ADOLTION TOET-HIS SURVEY 7E S A VIOLATION OFSECTION 7209 OF THE N W PORK STA FOUCATION LAW. COPES OF TWS SUMVEY MAP NOT BEARING 1. AREA 21,866 S.F. THE LAND SURVEYOR'S iNKED SEAL OR EMBOSSED SEAL SMALL -NOT BE CONSIDERED TO BE A VALID TRUE COPY. 2. a= MONUMENT FOUND, A = STAKE FOUND. CER IriCATiO% IN7ICATED HEREON SMALL RUN ONLY TO THE 3. SUBDIVISION MAP "SUNSET KNOLLS, SECTION 2" PERSON FOR �HOM THE SURVEY 15 PREPARED AND ON HIS —x tw.PANY, FILED IN THE OFFICE OF THE CLERK OF SUFFOLK A N,D NISTZ7U AND TO T.4 ASS, �..E: LE�NOING NSTOUTION- �"V�PCAMOINS COUNTY ON APR. 9, 1970 AS FILE NO. 5448. ARS 7S TO A01011EON-L JNST.TU'IONS OWNIERSL DWG: 2025-034