HomeMy WebLinkAbout52001-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#: 52001 Date: 06/16/2025
Permission is hereby granted to:
Lawrence I Wall
7 Rockhill Ter
Larchmont, NY 10538
To:
legalize "as built" additions and alterations to a pre-existing single-family dwelling as applied for.
Additional certification may be required.
Premises Located at:
4075 Pequash Ave, Cutchogue, NY 11935
SCTIVI# 137.-2-19.3
Pursuant to application dated 05/06/2025 and approved by the Building Inspector.
To expire on 06/16/2027.
Contractors:
Required Inspections:
Fees:
As Built Addition/Alteration $722.00
CO-RESIDENTIAL $100.00
Total $822.00
Building Inspector
3ce.
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1 179 Southold,NY 1 1971-0959
� Telephone (631) 765-1802 Fax (631) 765-9502 IIp :°:`r�R + tpl.1 ' IIcb�u ;�
Date Received
APPLICATION FOR BUILDING PERMIT For Office Use Only ECEMSE �`)
PERMIT NO. :5J6ABuilding Ins ector., &---- I I M AY - 6 2
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:04/04/2025
OWNER(S)OF PROPERTY:
Name:Lawrence Irvin Wall I
A�M# 10:0o-137-2-19.3
Project Address:4075 Pequash Avenue, Cutchogue
Phone#:917-536-3351 Email:Lawrence.wall@TD.com
Mailing Address:7 Rockhill Terrace Larchmont, NY 10538
CONTACT PERSON:
Name:Lawrence Irvin Wall
Mailing Address:? Rockhill Terrace Larchmont, NY 10538
Phone#:917-536-3351 Email:Lawrence.wall@TD.com
DESIGN PROFESSIONAL INFORMATION:
Name:Esra Ozcan
Mailing Address:3 Locust Drive Sag Harbor, NY 11963
Phone#:631.833.4416 Email:esra@ozcanarch.com
CONTRACTOR INFORMATION:
Name:None
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
I
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
(]OtherPreviosly completed alteration to the existing building $
Will the lot be re-graded? El Yes ®No Will excess fill be removed from premises? ❑Yes ®No
I,
1
PROPERTY INFORMATION
Existing use of property:single family residence Intended use of property
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
R-1 this property? ❑Yes �No IF YES, PROVIDE A COPY.
ii 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,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 taws,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): Lawrence I. Wall ❑Authorized Agent BOWner
Signature of Applicant: Date:
STATE OF NEW YORK)
COUNTY OF Alt
�)
Lo Lor<nr 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
day of Mau 20
Lary Public
TPACEY L. DMIM
PROPERTY OWNER AUTHORIZATION NOTARY PUBLIC,STATE OFNEWYI,?Rl
NO.01 DWS306900
(Where the applicant is not the owner) 01J, LIFIEO IN SlOrFOLKCOU"
COM MSSION EXPIRES J NE 0,
I, residing at
do hereby authorize to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
Owner's Signature Date
Print Owner's Name
2
No. Date Issue Notes
1 08/01/2021 Existing Conditions
2 04/04/2025 Building Permit Application for
c re Conversion to
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Ownership and Use of Documents:
ZX6 RRS Location: Cutchogue,New York
-ASSUMED 1/2 PLYWOOD SHEATHING EXIST.RRS Construction Type Single-family These drawings and specifications
including the ideas and arrangements
ro,ect Type: Alteration
J-BUILDING PAPER Project SubType: None
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$ OGUE,NY 11935
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Report date: 04/04/25
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