HomeMy WebLinkAbout52429-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#: 52429 Date: 10/31/2025
Permission is hereby granted to:
53995 Rt 25 LLC
3 Greenacre Ct
Great Neck, NY 11021
To:
Construct repairs to existing plate glass windows on business building as applied for.
Premises Located at:
53995 Route 25, Southold, NY 11971
SCTM# 61.4-20
Pursuant to application dated 10/31/2025 and approved by the Building Inspector.
To expire on 10/31/2027.
Contractors:
Required Inspections:
DRAINAGE, FOOTING/REBAR, FOUNDATION 1ST, FOUNDATION 2ND, FRAMING/STRAPPING, PLUMBING ,
ELECTRICAL- ROUGH, FIRE RESISTANT PENETRATION , ELECTRICAL- FINAL, INSULATION , FIRE SAFETY
INSPECTION , FIRE RESISTANT CONSTRUCTION , FINAL,
Fees:
Commercial- Repairs $300.00
CO Commercial-Addition/Alteration $100.00
Total 400.00
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 httl)s:/Iwww.southoldtownU.gov
W;
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
PERMIT NO. Building Inspector.
�tl r '2
Applications and forms must be filled out in their entirety.Incomplete
applications will not be accepted. Where the Applicant Is not the owner,an ,� it u e 'en
Owner's Authorization form(Page 2)shall be completed.
Date:10.31.25
OWNER(S)OF PROPERTY:
Name: INt7FD(hUToJUSTrnItlKf�o scTM#s000-61-1-20
Project Address:53995 Main Rd. Southold
Phone* 1-n4e- 382- 5i 53 Email jrnirro@kensingion-cap.com
Mailing Address:
CONTACT PERSON:
Name:Joan Chambers
Mailing Address:PO Box 49 Southold NY 11971
Phone#:631-294-4241 Email:Joan chambers10@ gmail.com
DESIGN PROFESSIONAL INFORMATION:
Name:Loll Schwartz
Mailing Address:7 Ridgewood St, Bay Shore, NY 11706
Phone#:(631) 410-6838 TM:ail:tiderunnereng@gmail.com
CONTRACTOR INFORMATION:
Name:
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration WRepair ❑Demolition Estimated Cost of Project:
[]Other EMERGENCY REPAIR TO WINDOWS
Will the lot be re-graded? ❑Yes iiNo Will excess fill be removed from premises? ❑Yes @No
1
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PROPERTY INFORMATION
Existing use of property:Retail shop Intended use of property:no change
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
H B this property? ❑Yes A No IF YES, PROVIDE A COPY.
'rr Check Box After Reading: The owner/contractor/design professional is respons!We 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 name):Joan Chambers @Authorized Agent ❑Owner
Signature of Applicant: Date:
CONNIE D.BUNCH
Notary Public,State of New York
STATE OF NEW YORK) No.01BU6185050
OUalified In Suffolk Count
SS: Commission Expires April 14, 2YQ4
COUNTY OF
Joan Chambers 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
94:i� 2�4
qlgt_� EV-1 f� ,ay Of L) � 0
�" � Notary Public
PROPERTY O NIER AUTHORIZATION
(Where the applicant is not the owner)
I AJ M( residing at
do hereby authorize Joan Chambers to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
D1911srlly signed by Justin MIrro
DsO7 2025.10.31 11:10:13-04'00'
Owner's Signature Date
NofoMoto LLC, Justin Mirro
Print Owner's Name
2
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