HomeMy WebLinkAbout52457-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#: 52457 Date: 11/13/2025
Permission is hereby granted to:
Marilyn Weigold
650 Esplanade
Southold, NY 11971
To:
legalize "as built"generator as applied for.
Premises Located at:
650 Esplanade, Southold, NY 11971
SCTM#88.-6-13.50
Pursuant to application dated 10/06/2025 and approved by the Building Inspector.
To expire on 11/13/2027.
Contractors:
Required Inspections:
Fees:
As Built Generator $250.00
CO-RESIDENTIAL $100.00
Total $350.00
Building Inspector
R
094'
' 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 htt° �:�Jwwa�r.southo)dt�aw�n . o�
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
PERMIT NO. �a Building Inspector;
6 2025
Applications and forms must be filled out in their entirety. Incomplete
applications will not be accepted. Where the Applicant is not the owner,an 7�iliS� �� rinf
Owner's Authorization form(Page 2)shall be completed. aKer a c r f C-,outhald
Date: G
OWNER(S)OF PROPERTY:
Name: !/gar n SCTM #1000-
Project Address:
Phone#: ` �� , �74_. �s� Email:
Mailing Address:
CONTACT PERSON:
Name: `1"'" .d t r o
Mailing Address:�,no Jzv,,c1 //� Z-
Email: /ran ar.1 eta G
Z N-�
Phone#: �L-3f yi 2 Z f.mod ��2 �l
DESIGN PROFESSIONAL INFORMATION:
Name:.
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name:
Mailing Address:
Phone#: f/10 S y� `Zsor' Email: L� rtd1.
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑AAdition ❑Alteration Repair ❑Demolition Estimated Cost of Project:
bther � e $
Will the lot be re-graded? ❑Yes ❑No Will excess fill be removed from premises? ❑Yes ❑No
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
this property? Dyes ❑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 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 210.45 of the New York State Penal Law.
Application Submitted By(print name):Zf r is 4,-e �er�c. uthorized Agent ❑Owner
Signature of Applicant: ate:
CONNIE D.BUNCH
STATE OF NEW YORK) Notary Public,State of New York
SS: No.01 BU6185050
Qualified in Suffolk Count
COUNTY OF y'
COMMY IS ion Expires April 14
Z/" being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)he is the
If (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.
SwornJefore me this ,
day of .,. .' , 2 s
Notary Public
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
I, 111C� r; I/Ue� elf residing at �S� � f�/ a1✓s/ k•r�7rb/�
do hereby authorize r/S / uz' to apply on
my ha to the Town of So thold Building Department for approval as described herein.
.�: s-
Owner s Signature Date
Print Owner's Name
2
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SURVEY OF
I LOT o 6 1I p 8
ANGEL SHORES � -
SL) , FILE No.9129 FILED AUGUST 23,1995 _
"S8+ SITUATED AT
BAYVIEW _
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK r7
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S.C. TAX No. 1000-88-06-13.50 1� `
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AREA=40.120,12 sq.11. 2
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Land Surveyor
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A wg^N.3=11.1 m,.N"m.N."r,nDu°1 •"°r'"°""'�"°r°°'b""®' FIRST AMERICAN TITLE INSURANCE COMAPNY OF NEW YORK
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