HomeMy WebLinkAbout52394-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#: 52394 Date: 10/23/2025
Permission is hereby granted to:
Nancy E Stroker
166 Duane St Unit 6A
New York, NY 10013
To:
install generator as applied for.
Premises Located at:
2355 Reeve Rd, Mattituck, NY 11952
SCTM# 100.4-43
Pursuant to application dated 09/19/2025 and approved by the Building Inspector.
To expire on 10/23/2027.
Contractors:
Required Inspections:
Fees:
GENERATOR $125.00
CO Accessory $100.00
Total S225.00
Building Inspector
t t TOWS OF SO[;THOLD—BUILDING DEPARTMENT
Town Hall _annex 54375 Main Road P. O. Box 1 179 Southold, DIY 1 1971 0959
Telephone (631) 765-1802 Fax (631) 765-9502 I�tt, a www. ot�l� ollew�t� . t
Date Received
APPLICATION FOR BUILDING PERMIT EP E
M
r y
:r..tt�..._ i_ e Only
I ' I
PERMIT NO� Building Inspector:- 2025
Applications and forms must be filled out in their entirety. Incomplete Building ep rf l tlt
applications will not be accepted. Where the Applicant is not the owner,an own of u,f n,l l
Owner's Authorization form(Page 2)shall be completed.
Date:09/15/25
OWNER(S)OF PROPERTY:
Name:Nancy Stroker SCTM # 1000-100-0 1-43
Project Address:50 Harbor View Avenue, Matittuck
Phone #:917-767-4619 Email:nestroker@gmail.com
Mailing Address:50 Harbor View Avenue, Mattituck
CONTACT PERSON:
Name:Brooke Epperson
Mailing Address:PO Box 152, Mattituck, NY 11952
Phone#:631 603 9092 Email:bepperson@amparchitect.com
DESIGN PROFESSIONAL INFORMATION:
Name:Anthony Portillo
Mailing Address:PO Box 152, Mattituck, N.Y. 11952
Phone#:631 603 9092 Email:aportillo@amparchitect.com
CONTRACTOR INFORMATION:
Name:
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
E-:1Ot her Prop ane powered Generator $,10,000
Will the lot be re-graded? ❑Yes *No Will excess fill be removed from premises? ❑Yes *No
1
PROPERTY INFORMATION
Existing use of property:Single Family Dwelling 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 Conforming this property? ❑Yes gNo IF YES,PROVIDE A COPY.
® 6:-'__ __. :. 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 Pasmit 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 Taws,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('prin naurnej:-&LA' ` �rQ MAuthorized Agent ❑Owner
Signature of Applicant: ... - Date: 09/15/25
STATE OF NEW YORK)
SS:
COUNTY OF Suffolk
Ibeing 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 �C.O�f'(YV��i ,20� �, r,
otary Public it
DARCEE AUFENANGER
NO"rARY PUBLIC,STATE OF NEW Y
Registration No. 01A0001964
(Where the applicant is not the owner) Qualified
Suffolk
County
ou
CommissionExpires 9 Z(
Nancy Stroker residing at 50 Harbor View Avenue
Mattituck do hereby authorize AMP Architecture to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
,,.. goy, 11.31 j
Owner's Signature Date
Nano , E S'Mo(u/
P int Owner's Name
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