HomeMy WebLinkAbout52234-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#: 52234 Date: 09/05/2025
Permission is hereby granted to:
Weathers Revocable Trust
2047 Arlington Ct
Houston,TX 77008
To:
Construct repairs of water damaged areas as applied for.
Additional certification will be needed for as-built alterations.
Premises Located at:
335 Oak St, Cutchogue, NY 11935
SCTM# 136.-1-25
Pursuant to application dated 08/01/2025 and approved by the Building Inspector,
To expire on 09/05/2027.
Contractors:
Required Inspections:
Fees:
CO Single Family Dwelling-Addition /Alteration $100.00
Single Family Dwelling- Alteration $295.00
Total S39S.00
Building Inspector
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone (631) 765-1802 Fax (631) 765-9502 11.j�t �� 1 + l lto1y°itu I-Y.2L�
Date Received
APPLICATION FOR BUILDINGPERMIT
� E C E 9 W E
For Office Use Only D
;03 9/
PERMIT NO. Building Inspector,
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: July 31, 2025
OWNER(S)OF PROPERTY:
Name: Weathers Revocable Trust scTM # s )00- 136-01-25
Project Address: 335 Oak Street , Cutchogue, NY, 11935
Phone#: 713-426-0958 or 713-202-3647 Email: (weathers@krimshaw.com
Mailing Address: 335 Oak Street, Cutchogue, NY, 11935
CONTACT PERSON:
Name: Lloyd Ray Weathers, Trustee
Mailing Address: 335 Oak Street, Cutchogue, NY, 11935
Phone#: 713-426-0958 Email: (weathers@krimshaw.com
DESIGN PROFESSIONAL INFORMATION:
Name: Mark Schwartz &Associates
Mailing Address: 28495 Main Road, Cutchogue, NY, 11935
Phone#: 631-734-4185 Email: lcsArc tegO opt-UN
CONTRACTOR INFORMATION:
Name:
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
NOther Repair of Mold and Water Damage $
Will the lot be re-graded? Dyes ®No Will excess fill be removed from premises? Dyes ®No
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PROPERTY INFORMATION
Existing use of property: Residential Intended use of property: Residential
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
R-40 this property? ❑Yes 1XNo IF YES, PROVIDE A COPY.
OCh Chec
k .)o f( IIr e'aiIln :. Theowner/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 210AS of the New York State Penal Law.
Application Submitted By(print na ek KlAuthorized Agent ❑Owner
Signature of Applicant: Vx- Date: � Z 5
CONNIE D.ZUNI
Notary Public,State of New York
STATE OF NEW PORK) No.01BU6185050
S Qualified in Suffolk County
" Commission Expires April 14, 20:��
COUNTY OF
✓ Z being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the 14CA
( ntractor,F8ent�,Qrate fficer,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 (it� 20�� `�� � n"� � I
Notary Public
(Where the applicant is not the owner)
I, Lloyd Ray Weathers residing at 335 Oak Street, Cutchogue, NY, 11935
do hereby authorize Mark Schwartz Architect to apply on
my behalf to the Town of SouthoN ilding Department for approval as described herein.
�a�, July 31 2025
Owner's Signa re Date
Lloyd Ray Weathers
Print Owner's Name
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