HomeMy WebLinkAbout52224-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
UNTI L FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 52224 Date: 09/02/2025
Permission is hereby granted to:
ANVK NY Holdings LLC
68320 Main Rd
Greenport, NY 11944
To:
construct alterations (non-substantial)to an existing single-family dwelling as applied for with flood
permit.
Premises Located at:
2195 Albertson Ln, Greenport, NY 11944
SCTM# 52.-5-54
Pursuant to application dated 05/02/2025 and approved by the Building Inspector.
To expire on 09/02/2027.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling- Alteration $497.50
CO-RESIDENTIAL $100.00
Flood Permit $150.00
Total S747.SO
____ 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) 765-950211 1rwwVw
Date Received
PERMITAPPLICATION FOR BUILDING
..For Office Use Only
II
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PERMIT NO. Building Inspector---,.-.—.h
5
Applications and forms must be filled out in their entirety.Incomplete r.111 j,)
applications will not be accepted. Where the Applicant is not the owner,an I Y n Ma -
Owner's Authorization form(Page 2)shall be completed. A o �o � I'
Date:4.30.25
OWNER(S)OF PROPERTY:
Name:Deborah Rivera SCTM#s000- ..
Project Address:2195 Albertson Lane Southold
Phone#:1-917-254-1860 Email:drivera@thesuccessiongroup.com
Mailing Address:
CONTACT PERSON:
Name:Joan Chambers
MailingAddress:PO Box 49 Southold NY
Phone#:631-294-4241 :=Emjoanchambers10@gmail.com
DESIGN PROFESSIONAL INFORMATION:
Name:Lou Schwartz
Mailing Address:? Ridgewood St, Bay Shore, NY 11706
Phone#:(631) 410-6838 Email:tiderunnereng@gmail.com
CONTRACTOR INFORMATION:
Name:by owner
Mailing Address: C --IL O V>f1Ls-\-J I F .
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition RAlteration RRepair ❑Demolition Estimated Cost of Project:
❑Other $
Will the lot be re-graded? ❑Yes INo Will excess fill be removed from premises? ❑Yes WNo
1
PROPERTY INFORMATION
Existing use of property:S ingle family Intended use of property:same
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
R_80 this property? OYes*No IF YES, PROVIDE A COPY.
8 Check Box After Reading,
The owner/contractor/dedp professional Is responsible for all drainage and stoln 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,Suffa k,County,New York and other applicable Caws,Ordiminces or Reguiauons,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 bullci ft(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)-.Joan Chambers ®Authorized Agent ❑owner
Signature of Applicant: Date:
STATE OF NEW YORK) CONNIE D.BUNCH
SS. Notary IPublIA Mate of NeYv York
COUNTY OF ) No.OIBU6186050
Ouallfled in Suffolk+DountY
Joan Chambers OolrirnlaBlon SxplreB April 14,Z
being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
(S)heisthe Agent
(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
d-� Y
61 Notary Public
ROPH-try OWNER AUTHORIZATION
(Where the applicant is not the owner)
I, a-1 mit.L �-��.^� rb....- residing at .
do hereby authorize to apply on
my behalf to the Town of Southold Building Department for approval as described herein,
el
Owner's Signature Date
Print Owner's Name
2
TOWN OF SOUTHOLD—BUILDING DEPARTMENT P
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0
Telephone 631 765-1802 i ��'�� nt
t:
I[,,Ioodplain Development Permit Application'
PROPERTY INFORMATION- I Flood Zor_e:AE 6 FIRM Panel:36103C0159l-I SCTM#1000-54-r5-52
Address:2195 Albertson Lane
city:Southold zip:NY 11971
CONTACT PERSON: Name:Joan Chambers Phone#:631-294-4241
Mailing Address:PO Box 49 Southold NY 11971
PROJECT DESCRIPTION: Window replacement, arbor removed, ramp added.
SECTION A:STRUCTURAL DEVELOPMENT (CHECK ALLTHAT APPLY)
Type of Structure Type of Structural Activity
Residential(I to 4 families) ❑New structure
❑Residential(more than 4 families) ❑ Demolition of existing structure
❑ Combined use ❑ Replacement of existing structure
❑Non-residential ❑Relocation of existing structure
❑ Elevated ❑ Addition to existing structure
❑ Flood proofed(attach certification) ❑Alteration to existing structure
❑Manufactured Horne ® Other: window replacement
❑Located on individual lot
❑Located in manufactured home park
_ __...— . ...—,,, .----�... �.... ......_ ,,.
SECTION B: OTHER DEVELOPMENT(CHECK ALL THAT APPLY)
❑Clearing of trees,vegetation or debris ❑ Mining ❑ Grading ❑ Drilling ❑ Dredging
❑Connection to public utilities or services ❑ Paving ❑ Placement of fill material
❑ Drainage improvement(including culvert work) ❑ Roadway or bridge construction
❑ Fence or wall construction ❑Watercourse alteration(attach description)
❑ Excavation (not related to a structured development) ❑ Other development not listed (specify):
B signing below I agree to the terms and conditions of this permit and certify to t y g g he best of my knowledge the information contained
in this application is true and accurate.I understand that no work may start until a permit is issued.The permit may be revoked if any
false statements are made herein. If revoked,all work must cease,until permit is re-issued_Development shall not be used or occupied
until a Cert.of Compliance is issued.The permit will expire if no work is commenced within one year of issuance.Other permits may be
required to fulfill regulatory requirements.Applicant gives consent to local authority or representative to make reasonable inspections
to verify compliance.
Application Submitted By(print name):JOan Chambers
Signature of Applicant: Date:
Tiderunner Engineering & Design, P.C.
7 Ridgewood St
Bay Shore,NY 11706 (631)-839-482
August 21, 2025
Building Inspector
Town of Southold
53095 Main Road
Southold,NY 11751
Re: Construction Certification
Rivera Residence
2195 Albertson Lane, Southold,NY
To Whom It May Concern:
The work that was done to this house was far below the threshold required by FEMA for
the project to be labeled a substantial renovation. The work was the replacement of doors
and windows and the interior was painted. The definition of a substantial improvement is
that the cost of construction is equal to or greater than 50% of the market value of the
house only. Replacing windows and doors and an interior paint was not going to cost
over 50% of the current worth of the house.
If you have any questions please feel free to contact me.
10 Sincerely,scly4t
c�
W
Anchwartz, P.E.
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