HomeMy WebLinkAbout52369-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
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#: 52369 Date: 10/20/2025
Permission is hereby granted to:
Joseph W Sledge
3550 Enclave Bay Dr
Chattanooga, TN 37415
To:
Construct additions and alterations to an existing single-family dwelling as well as window and door
replacements and an outdoor shower as applied for.
Premises Located at:
100 East Ln, East Marion, NY 11939
SCTM#31.-15-11
Pursuant to application dated 08/29/2025 and approved by the Building Inspector.
To expire on 10/20/2027.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling- Addition&Alteration $640.00
CO Single Family Dwelling-Addition /Alteration $100.00
Total S740.00
Ji 6
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 ://www.solithQold tcpm my
Date Received
APPLICATION FOR BUILDING PERMIT
i O For Office Use Only
i
3�
PERMIT NO. 5 A Building Inspector--j—AZ7-
AUG 2 9 2025
II
Applications and forms must be filled out in their entirety.Incomplete
applications will not be accepted. Where the Applicant is not the owner,an 8111lc In De �
Owner's Authorization form(Page 2)shall be completed. f `1&.1 t
Date:
OWNER(S)OF PROPERTY:
Name: i ° �- SCTM#1000- ?7 S-
Project Address: ��5� Ecus - N)Prt n � . 3
Phone#: Z S 03 , 115(10 �' Email: d ��5 l �' Ce CGt - A
Mailing Address:
CONTACT PERSON:
Name: ML S zz
- - Ch
Mailing Address: v 2 4,q
Phone#: 5 6 S ( -7 Email: L lv/ to h c " do ,mil°
DESIGN PROFESSIONAL INFORMATION:
Name: A L, I I I juri LAC
Mailing Address:
LL -
Phone#: 6/ 3 j �� � �5 � Email: ehh e- 1s- �eri.
CONTRACTOR INFORMATION:
Name: 6 OC_ 1�0�
Mailing Address: ��
mail:
Phone#: Z'3 J 03 — 1 5-� 0.�
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New structure ❑AdditionAlteration ❑Repair ❑Demolition Estimated�ed Coast off Project:
CROther l -D
Will the lot be re-graded? ❑Yes XNo Will excess fill be removed from premises? ❑Yes [gNo
1
PROPERTY INFORMATION
Existing use of property: Intended use of property:
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
` (a-` this property" ❑Yes;<No IF YES, PROVIDE A COPY.
Of 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 Budding 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,bullding 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( nt name): , N !'�2( RO 5-A-Al O EIAuth rized Agent []Owner
Signature of Applicant: Date: Z 91Z-lC/I-f
STATE OF NEW YORK)
SS:
COUNTY OF
Y U\:SJ ,5 a being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the A
(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 then
Sworn before me this
day of ZD
N4SUFFOLK
TIMOTHY LEIT�CN
NOTARY COUNTYNEW Yd7FI
LI .1101 LE00 4 5?
PROPERTY OWNER AUTHORIZATION COMM,EXP,05/03/ 0=—
(Where the applicant is not the owner)
(CA9 C— residing at JS�� viclaI�`e�
' \ [� �16 — ���\��A� ttl apply on
-7 do hereby authorize,
my behalf to the Town of Southold Building Department for approval as described herein.
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Print Owner's Name
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DESCRIBED PROPERTY
SF DATE AT EAST MAARION
TOWN OF SOUTHOLD
SUFFOL K COUNTY,NEW YORK
CERTIFIED TO:JOSEPH WALTER SLEDGE
DONNA JONES SLEDGE
FIDELITY NATIONAL TITLE IMSURANCE
FIRST HORIZON MORTGAGE
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WARD BROOKS'LAND SURVEYOR
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BLUE POIAT, NY: 11715 s
(631) 5 6 779 (631) 363-3179
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