HomeMy WebLinkAbout52036-Z 4 TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, NY
BUILDINiG 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#: 52036 Date: 06/26/2025
Permission is hereby granted to:
Alexandra Wagner
250 W 94th St Apt 11A
New York, NY 10025
To:
construct alterations(garage conversion to habitable space) to existing single-family dwelling as
applied for.
Premises Located at:
640 Chestnut Rd, Southold, NY 11971
SCTM# 59.-3-16.3
Pursuant to application dated 05/02/2025 and approved by the Building Inspector.
To expire on 06/26/2027.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling- Alteration $656.00
CO-RESIDENTIAL $100.00
Total S756.00
Building Inspector
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
p Telephone(631) 765-1802 Fax(631) 765-9502 ����. �.o_v
.rs,
Date Received
IF A
APPLICATION FOR BUILDING [� C E p E
For Office Use Only 2
2025
�j
PERMIT NO. `/ 63 l Building lns}aectior:
- L-
u61 4rtg Op ;# ent
Applications and forms must be filled out in their entirety. Incomplete Town of Southold
applications will not be accepted. Where the Applicant is not the owner,an
Owner's Authorization form(Page 2)shall be completed.
Date:
OWNER(S)OF PROPERTY:
Name: Alexandra Wagner SUM# 1000- 3 i
Project Address: 640 Chestnut Rd. Southold, NY 11971
Phone#: 9173539343 Em::�11:
Mailing Address: 640 Chestnut Rd. Southold, NY 11971
CONTACT PERSON:
Name: Edward Giarrizzo
Mailing Address: P.O. Box 66 Eastport,NY 11941
Phone#: 6312195726 Email: edgrenovationsny@gmail.com
DESIGN PROFESSIONAL INFORMATION:
Name: Richard Suter
Mailing Address: P.O Box 79 Cutchogue, NY 11935
Phone#: 5169711063 Email: suterandsuter@gmail.com
CONTRACTOR INFORMATION:
Name: EDG Renovations
Mailing Address: P.O. Box 66 Eastport, NY 11941
Phone#: 6312195726 Email: edgrenovationsny@gmail.com
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
El Other Garage Conversion
Will the lot be re-graded? ❑Yes ANo Will excess fill be removed from premises? ❑Yes *No
1
n ...,_ ,. .. .�.v ...w., -- PROPERTY INFORMATION
Existing use of prope r ty: --------- ........
Residential Intended use of property: Residential
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? m. Yes �8r�o 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 L46 of the Town Code. APPLICATION 1S HEREBY MADE to the Building Department for the Issuance of a Building Pernnft 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 appkant agrees to comply with all appacable laws,ordinances,building code,
housing code and regulations and to admit suftrired Inspectors on premises and in buiMing(s)for necessary inspections.False statements made herein,are
punishable as a Class A misdemeanor pursuant to Section ZIDAS of the New York State Penal Law.
O
VAutharized Agent [--]Owner
Application Submitted By print.naririe): �,�,��r� C9�`�� 1 ZZ
Signature of Applicant: CONNIVE D.RUNVe;
Notary Public. State of Niew"York
No.01 BU61 R5050
STATE OF NEW YORK) Qu9lifIGd In Suffolk County
SS: Cormrrl on]Expires APrI1 1
COUNTY OF ww Suffolk )
...... 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
�� w �� c
dayof r� . 20 ., ...o�.�.�..,....... . ......... m....,,
Notary Public
PROPERTY OWNER AUTHORISATION
(Where the applicant is not the owner)
I Alexandra Wagner residing at 640 Chestnut Rd Southold NY
11971 do hereby authorize Edward Giarrizzo to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
_ May 1, 2025
Owner s ASigna
' re Date
Alexandra Wagner
Print Owner's Name
2
y
CHESTNUT ROAD
..................... .6 OW*.................
3'
c WHEELER
Y
o
0) N 4T41'1Cr E MAW
L}U ro rasa '
wm
to
i
67.541.....
0
............... .....
.. Si
W
9
Z �
asa
no r
20
S 4T4l'IW W vn1AGE OF
�of
(rd@IPoRf
LOT 2 ON
"MINOR SUBDIVISION FOR RHR REALTY CO.'
SITUATE AT SOUTHOLD
TOWN OF SOUTHOLD
SUFFOLK COUNTY,NEW YORK
FILED:SEPTEMBER 13.1989.MAP#8811
CERTIFIED TO:ALEXANDRA WAGNER 7
FIDELITY NATIONAL TITLE INSURANCE COMPANY
JPMORGAN CHASE BANK,N.A.
4Vaar�awew�nsser�s+aa�nww�.ass�+rs a�r�asa�rew�w+sowra4ararruw. c .
Of
�suwss��wwsalwirrsu�mrwwr�zs^rusaasear �rr�rrr^rpszdsaw
,,�q/Ig11O1 M1iLN�lOLYIOtI�rltl�a1411lRMIl�MOIOIflMYpI ,.
noz esraa ar wns a/Mwr,woos eraslre�pasr ar iecaa/r�Msor�saisi�emsurwunem
NMK1�f�IM1�11O�1071yA�lIRY'AMAMOtAlg11V�701�ip11l1lM�ORtTA7��11G�10111AL �" „
gMf'�Nil�l`�CIr61l �M 1113�'1OIaICYIrC,
LAND SURVEY LONG ISLAND.COM
WARD BROOKS LAND SURVEYOR
11 OCEAN AVENUE C
BLUE POINT, NY. 11715
(631)576-7794 (631)363-3179
WARDBROOKSO a@GMAIL.COM
vs
-
• Ili,Ir
F eft 4"i"f6
y
�s
hr?t�S.� : I 4X
*r ,eta
1.
toPIA-
rf
,
- _-,
• �cfl
14
mm..
-
1
up r—aU/4rPt�lort:
wl iuw "e � G
lf
77 .
1 b: 'tom' aa __:_1` :I_<` IG "t� 'Q6 '._:... . ►�f�i�kriS't oNL::t V t� d"?f"`"n,�'�`
4 110
lei
��
�► m _ - '
r
41
v
�. - - -- $�t�U�?i f _ - 43—
1
i - �` t :-b===i•°NOx^I�-,'���sr�"ta'��:�1'+?r.. -__�Cii�l�d�' �i �" fi — �l�c�e43 a- - �'�itl7'j�� j-i�?�,fh� . �.4
,
��` ��`' -;. . �.t? �tit.
fitlh
zz
� ;�-- `� �C� 4 � -Y� -•(y���/��.+I�J(f� � .,- , ,. ,.� ,�, .� is � qw
� s 1 � i � � k r � � t f 4 F I; �_:'• ti 'c.{ iJ
i f �
IN
IN 1p
S tf \ �►I y �.''
f t 1
!
X
'� s '< r� ___ __ _ __ a _ - � aC:t•J .14'_:.:. Gt11�5 S�M'� f« ►1''�n
t
w
i
.. � - �-'G/•�{/• `+•^� (fit !.�'r'S�3 I�M__-F�_IeMrv6
! '' : 1 h ? F 2025
'15!�
,
L-04 p '
5 NTT,