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Home My WebLink About52268-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#: 52268 Date: 09/17/2025 Permission is hereby granted to: Kathy A Ward 75 Madison Ave Garden City Park, NY 11040 To: Construct a garage accessory to a single-family dwelling as applied for. Must maintain setbacks of a minimum of 5 feet. Premises Located at: 2455 Sigsbee Rd, Laurel, NY 11948 SCTM# 144.-2-25 Pursuant to application dated 07/23/2025 and approved by the Building Inspector. To expire on 09/17/2027. Contractors: Required Inspections: Fees: Accessory-New Structure $305.00 CO Accessory Structure $100.00 Total $405.00 ALE Building Inspector rr^tss TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 � ITelephone (631) 765-1802 Fax(631) 765-9502 htt S://www.souttioldtownilv.Ltov ��xSW,4YJIMAVNo Date Received For Office Use Only 91' �� W. a PERMIT NO. J Building Inspector; Applications and forms must be filled out in their entirety.Incomplete Building 1)ena1r'fmr-%nt applications will not be accepted. Where the Applicant is not the owner,an Town Of:"acufhold Owners Authorization form(Page 2)shall be completed. Date:7/10/2025 OWNER(S)OF PROPERTY: Name: Kathy Ward SCTM#1000-144-2-25 Project Address:2455 Sigsbee Road, Mattituck NY 11952 Phone#:646-265-0681 :1EMElmkward07@yahoo.com Mailing Address:75 Madison Avenue, New Hyde Park NY 11040 CONTACT PERSON: Name:Joseph Nehrebecki, R.A. Mailing Address: 1927 Bergen Street, Bellmore NY 11710 Phone#:516-690-3741 Email:jnehrebecki@gmail.com DESIGN PROFESSIONAL INFORMATION: Name:Joseph Nehrebecki, R.A. Mailing Address: 1927 Bergen Street, Bellmore NY 11710 Phone#:516-690-3741 Email:jnehrebecki@gmail.com CONTRACTOR INFORMATION: Name:TBD Mailing Address: Phone#: Email: DESCRIPTION OF PROPOSED CONSTRUCTION MNew Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: ❑Other Construct Detached Garage $54,000 Will the lot be re-graded? Yes'❑No Will excess fill be removed from premises? MYes ❑No 1 PROPERTY INFORMATION Existing use of property:Vacant Intended use of property:Single Family Dwelling Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to R_40 this property? ❑Yes @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 bulldings, 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 name): / >' ®Authorized Agent ❑Owner Signature of Applicant: Date: A STATE OF NEW YORK) SS: COUNTY OF ) Joseph Nehrebecki, R.A. being duly sworn;deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (s)he is the 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 1( day of, Notary Public ALAN ROSENBERG PROTAIY PUBLIC, STATE OF NEW YORI< Fig ( ( QUALIFIED IN NASSAU COUNTY (Where the applicant is not the owner) NO.01 RO6198480 MY COMMISSION EXPIRES DEC.229 I, a+vL ( 0.Ir '� residing at -1.5 INA d l'Son tc— Joseph Nehrebecki R.A. do hereby authorize to apply on my behalf to the Town of Southold Building Department for approval as described herein. Owner's Signature Date H... Uji W .. Print ner's Name 2 Town Hall Annex `a Telephone(631)765-1802 54375 Main Road � Fax(631)765-9502 P.O. Box 1179 Southold, NY 11971-0959 ' BUILDING DEPARTMENT NOTICE OF UTILIZATION OF TRUSS TYPE CONSTRUCTION PRE-ENGINEERED WOOD CONSTRUCTION AND/OR TIMSER CONSTRUCTION Date: �b - Owne r• Location of Prop rty: Please tak lice that the (check applicable line): New commercial or residential structure Addition to existing commercial or residential structure Rehabilitation to an existing commercial or residential structure to be constructed or performed at the subject property reference above will utilize (check applicable line): Truss type construction (TT) Pre-engineered wood construction (PW) Timber construction (TC) in the following location(s) (check applicable line): Floor framing, including girders and beams (F) Roof framing (R) Floor and roof framing (FR) Signature: Name (person submitting this form): raw (P 9 ) Capacity(check applicable line): Owner Owner representative TrussReg15.docx Effective 1/1/2015 Building Department ApWicsition AUTHORIZATION (Where the Applicant is not the Owner) I, + \ residing at Jr 0 GIC� 1 S y (Print prop ,owner's name) (Mailing Address) vv H v cl % ec,V „ 01 do hereby authorize Joseph Nehrebecki, R.A. j t o(,r U (Agent) to apply on my behalf to the Southold Building Department. mw (Owner's Sign Lure) (Date) (Print Owner's Name) co r"io m m m < z y z Z Y Z N MH° Z O (J <— w CDID � /H M M/M L Q(D p mm M = m O ° /M =M M M S �� :. M Z 7 I C D m Q0 \, 3395 M JOO Zl m :L] \ D N vp in wn m � N m z (Z5 0 \ o� Ma sl wis 100P z ` L \ a� �� Y , V O Z \off w � �3dNOI 0d3d MONSXdl 091 Lr) rrl 0 N w N�p� 1 O Z m < r p p M Dm Z M o z � N N 00 (NJT N 00 Cn SURVEY SITE PLAN 0 N VV SITUATE AT clC MATTITUCK 1229 TOWN OF SOUTHOLD COUNTY OF SUFFOLK � LAND SURVEYING STATE OF NEW YORK FILED MAP: AMEND, MAP MATTITUCK PROPERTIES SURVEY PREPARED FOR AND CERTIFIED TO: 1099 FILED: JANUARY 12th, 1926 MAP NO: 801 KATHY ANN WARD BLOCK: --- TOWN OF SOUTHOLD MASSAPEQUA ♦ NEW YORK LOT(S): 55A GERARD D. LENZE L.S. PRESIDENT PHONE: (516)967-3028 TAX MAP ID: 1000-144.-2-25 NYS LICENSED LAND SURVEYOR EMAIL: LENZELANDSURVEYING@GMAIL.COM PROPERTY AREA= 0.29 ACRES/ 12,600 SQ. FEET LICENSE NO. 051099 S• UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY S A VIOLATION OF SECMNT 7209 OF THE NEW YORK STATE EDUCATION LAW}COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYORS SEAL SHALL NOT CONSIDERED TO BE A VAUD TRUE COPY' GUARANTEES CERnnCATIONS INDICATED HERON SHALL RUN ONLY TO THE PEASON FOR WHOM THE SURVEY 5 PREPARED,AND ON HIS BETIALF TO THE 9R€COMPANY,LENDING INSTITUTION,AND GOWENMENT AGENCY LISTED HEREON*GUARANTEES ARE NOT TRANSFERABLE TO ADDITIONAL INSRTIITIONS OR'e1a°�e. OWNERS•ENCROACHMENTS BELOW GRADE AND/OR SUBSURFACE FEATURES,IF ANY,Mr-LOCATED OR SHORN HEREON OFFSETS SHOWN ARE FOR INFORMATIONAL PURPOSE ONLY. THEY ARE NOT INTENDED TO ESTABUSH PROPERTY Son FOR THE ERECTION OF FENCES,STRUCTURES,OR ANY OTHER IMPROVEMENT♦SURVEY IS - TO ANY STATE OF FACTS WHICH AN UP-TO-DATE TITLE EXAMINATION MAY DISCLOSE•SURVEY PERFORMED IN ACCORDANCE WITH THE 'CODE OF PRACTICE FOR LAND SURVEYS -`A 1"O}iYP iTf 4 YM STAT A AT 0€ - L t' YY SRTi AS sah§T '#a'�-i�9'