HomeMy WebLinkAbout52067-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#: 52067 Date: 07/07/2025
Permission is hereby granted to:
Bransbourg G Revoc Trt
240 E 29 St
New York, NY 10016
To:
Construct alterations to an existing single-family dwelling as applied for.
Premises Located at:
2045 Lake Dr, Southold, NY 11971
SCTM# 59.-5-4
Pursuant to application dated 06/02/2025 and approved by the Building Inspector,
To expire on 07/07/2027.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling- Alteration $308.50
CO Single Family Dwelling-Addition /Alteration $100.00
Total S408.50
Building Inspector
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
�a
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold, NY 11971-0959
Telephone (631) 765-1802 Fax (631) 765-9502 litt �s:// w . outlio➢dtowiii ov
d�
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
E
PERMIT NO. Building Inspector.
Pr
� M. h� 2 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 SuIlding Dcameo
Owner's Authorization form(Page 2)shall be completed. Town;f 8crutbold
Date:05.23.25
OWNER(S)OF PROPERTY:
Name:Gilles Bransbourg SCTM#1000-59-5-4
Project Address:
- 71
� 2045 Lake Drive Southold NY 119 0 5 a e ,
Phone#: Email:gilles.bransbourg@gmail.com
Mailing Address:
CONTACT PERSON:
Name:Zackery E. Nicholson, RA
Mailing Address: 1250 Evergreen Drive - Cutchogue, NY 11935
Phone#:631.513.6589 Email:ZENicholson.Arch@gmail.com
DESIGN PROFESSIONAL INFORMATION:
Name:Zackery E. Nicholson, RA
Mailing Address: 1250 Evergreen Drive - Cutchogue, NY 11935
Phone#:631.513.6589 EMILZENicholson.Archggmail.com
i
CONTRACTOR INFORMATION:
Name:TBD
Mailing Address:
Phone#: Email„
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition RAlteration ❑Repair ❑Demolition Estimated Cost of Project:
❑Other $20,000
Will the lot be re-graded? ❑Yes ONo Will excess fill be removed from premises? ❑Yes ligNo
1
PROPERTY INFORMATION
Existing use of property:Single Family Dwelling Intended use of property:Singe Family Dwelling
Zone or use district in which premises is situated; Are there any covenants and restrictions with respect to
R-40 this property? OYes CNo 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 236 of the Town code. APPUCA-nON 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 housing code and regulations and to admit authorized Inspectors on premises and in building(s)for necessary Inspections False statements buildings,
additions,alterations or for removal or demolition as herein described.The applicant agrees to comply with all applicable laws,ordinances,building code,
Punishable as a Class A misdemeanor pursuant to Section 210.4S of the New York State Penal Law. made herein are
Application ication Submitted By(print name):Zackery E. Nicholson, RA
Authorized Agent ElOwner
Signature of Applicant:
Date: (ol 25' ,
STATE OF NEW YORK)
COUNTY OF
� being du s that duly sworn,deposes and says
(Name of individt al signing contract)above named, Y t(s)he is the applicant
(S)he is the
of said owner or (Contractoe
orporate Officer,etc.)
application;that7owners,
satements contained inuly thi toor have performed the said work and to make and file this
that the work will be performed in the manner)setfolrth in the applicaication are true tion fie therewith.the best of his/her knowledge and belief; and
Sworn before me this
,a�Zday of J
zo as
Lary Public
71acF" I" , C +Y
�) (Z ) NOTARY'PUBLIC,STATE,OF NEl�hl'YORK
�PErRTY
the arlpli arit is not the owner ��t, 1 NO.OlDw63%900
,L FIED IN UFFOLK COUNT y
COMIM SION EXPIRES J'UNE 30,
residin at 2045 Lake Drive
mm.
Southold, NY 11971 do hereby authorize Zacke�ry E• Nic
holson
.......... apply on
my behalf to the Town of Southold Building Department for approval as described herein_
rter`s S i n g ature
Date
Print Owner's Name
2
ZEN DESIGN
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BRANSBOURG
RESIDENCE
/ 2045 LAKE DFINE
sanrtow,NY17ID71
S.C.T.F9.Y 1000.59-5-4
SCA4t; 1/2�-1'-0'mB5'ail'dbpe�
DATE; 07.0$25
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EXISTING 2x10 FLOOR JOISTS @ 16"O.C.(UNCHANGED)
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PROP.BATHS PROP.SATH4
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SECOND FLOOR ! _T ZEN DESIGN
�— POST OFFICE BOX 88
CUfCHOGUE,NY 11935
�— PHONE:631.513.6589
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BRANSBOURG
EXISTING EXISTING q RESIDENCE
BEDROOM BEDROOM 2045 LAKE DRIVE
SOUTHOLD,NY 11971
WALL TYPE LEGEND _ S.C.T.M.N 1000—59—5—4
SCALE: 112'-V-0'
DATE: 05.23.25
x DRAWN BY: Z.E.N.
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NEW DOOR EXISTING DOOR
EXISTING/PROPOSED
--------------
DEthO WALL SECOND FLOOR PLAN
DEMO PLAN PROPOSED SECOND FLOOR PLAN
1 ecuE y.+iw
EXISTING STUD WALLS
i I NEW STUD WALLS A-10mi