HomeMy WebLinkAbout52202-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#: 52202 Date: 08/20/2025
Permission is hereby granted to:
Peconic Landing @Southold
1500 Brecknock Rd
Greenport, NY 11944
To:
Cottage#28/Oriole Lane-Construct alterations to an existing single-family dwelling as applied for.
Premises Located at:
1205 Route 25, Greenport, NY 11944
SCTM#35.4-25
Pursuant to application dated 06/30/2025 and approved by the Building Inspector.
To expire on 08/20/2027.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling- Alteration $612.00
CO Single Family Dwelling-Addition /Alteration $100.00
Total S712.00
(,JnD
Building Inspector
� TOWN OF SOUTFIOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone(631) 765-1802 Fax(631) 765-9502 ht!ps://www.soutlioldlownny.R-Qv
Date Received
APPLICATION FOR BUILDING PERMIT DEC E OVE
For Office Use Only JUN 3 0 2025 E
PERMIT NO. R()2- Building Inspectors
Applications and forms must be filled out in their entirety.incomplete Building Department
applications will not be accepted. Where the Applicant is not the owner,an Town of Southold
Owners Authorization form(Page 2)shall be completed.
Date:06.30.25
OWNER(S)OF PROPERTY:
Name:Reed &Jane Rubin SC TM#1000-35-01-25 ue,c"oni Lay)4 i `
Project Address:28 Oriole Ln - Greenport, NY 11944
Phone#:917.856.4189 Email:reedrubin@msn.com
Mailing Address:580 Park Ave, 710, New York, NY 10065
CONTACT PERSON:
Name:
Mailing Address:
Phone#: Email:
DESIGN PROFESSIONAL INFORMATION:
Name:Zackery E. Nicholson, RA
Mailing Address:1250 Evergreen Drive - Cutchogue, NY 11935
Phone#:631.513.6589 Email:ZENicholson.ARCH@gmail.com
CONTRACTOR INFORMATION:
Name:Michael Sirico
Mailing Address:1220 Pine Tree Rd - Cutchogue, NY 11935
Phone#:631.871.4403 Email:michaelsirico@optonline.net
DESCRIPTION OF PROPOSED CONSTRUCTION
• Estimated Cost of Project:
iti n Alteration ❑Re a it ❑Demolition
❑New Structure ❑Add o
P
❑Other
Will the lot be re-graded? ❑Yes W No Will excess fill be removed from premises? Ryes IR No
1
PROPERTY INFORMATION
Existing use of property:Single Family - Condo Intended use of property:Single Family - Condo
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
HD this property? Dyes ❑No 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. 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 210.45 of the New York State Penal Law.
Application Submitted By(p cint name):Zackery E. Nicholson, RA @Authorized Agent Downer
Signature of Applicant: '`I/ CONNIEQLjp.�Q1 A0.25
Notary Public,State of New York
No.01BU6185050
STATE OF NEW YORK) Qualified in Suffolk County
SS: Commission Expires April 14, 2
COUNTY OF )
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 ZD±
Notary Public
(Where the applicant is not the owner)
I,
Reed Rubin residing at 580 Park Ave, 7C, New York, NY 10065
,
do hereby authorize Zackery E. Nicholson to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
06.27.25
Owner's Signature Date
Reed Rubin
Print Owner's Name
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POST OFFICE BOX 88
CUTCHOGUE, NY 11935
- PHONE: 631.513.6589
These plans are copyrighted and are subject to copyright
protection as an"architectural work"under Sec.102 of the a
Copyright Act,17 U.S.O.as amended December 1990 and known
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as Architectural Works Copyright Protection Act of 1990.The
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design.Under such protection,unauthorized use of these plans,
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NO. ISSUE DATE
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These plans are copyrighted and are subject to copyright
f�~ protection as an"architectural work"under Sec.102 of the
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These plans are copyrighted and are subject to copyright
protection as an "architectural work"under Sec. 102 of the
Copyright Act,17 U.S.O.as amended December 1990 and known
as Architectural
protection includes but is not limited to the overall form as well
-! as the arrangement and composition of spaces and elements of
design.Under such protection,unauthorized use of these plans,
work or home represented,can legally result in the cessation of
construction or buildings being seized and/or monetary
compensation to ZEN DESIGN LLC.
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NO. ISSUE DATE
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+ 01 SCHEMATIC DESIGN 1 12.11.22
02 SCHEMATIC DESIGN it 03.23.25
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