HomeMy WebLinkAbout52486-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#: 52486 Date: 11/20/2025
Permission is hereby granted to:
Katherine J Knight
15 E 36th St Apt 3C
New York, NY 10016
To:
construct additions and alterations to an existing single-family dwelling as applied for.
Premises Located at:
27754 Route 25, Orient, NY 11957
SCTM# 18.-6-21.9
Pursuant to application dated 09/04/2025 and approved by the Building Inspector.
To expire on 11/20/2027.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling- Addition &Alteration $740.50
CO-RESIDENTIAL $100.00
Total $840.50
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 ht s:/J ww.so tholdtoivii.n . o
Date Received
APPLICATION
For Office Use Only E C W E
PERMIT NO. Building Inspector:
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
Owner's Authorization form(Page 2)shall be completed. :'i°iir' ''
1 �V ll e a i. , ..
Date: Sept. 4, 2025
OWNER(S)OF PROPERTY:
Name:Jennifer Knight SCTM#1000-18-6-21
Project Address:27754 Main Rd., Orient, NY 11957
Phone#:917-225-1382 1Email:kjenknight@gmail.com
Mailing Address:15E 36th St. Apt.3C, New York, NY, 10016
CONTACT PERSON:
Name:Elizabeth Thompson Architect
Mailing Address:P.O.BOx 464, Orient, NY 11957
I
Phone#:917-848-1541 Email:et@elizabeththompsonarchitect.com
DESIGN PROFESSIONAL INFORMATION:
Name:Elizabeth Thompson Architect
Mailing Address:P.0.Box 464, Orient, NY 11957
Phone#:917-848-1541 Email:et@elizabeththompsonarchitect.com
CONTRACTOR INFORMATION:
Name:Peter Torkelsen & Co.
Mailing Address:800 Summer Lane, Southold, NY 11971
Phone#:516-807-2265 JEMalL�peter.torkelsen@gmaii.com
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition WAlteration ❑Repair ❑Demolition Estimated Cost of Project:
❑Other $100K
Will the lot be re-graded? ❑Yes W No Will excess fill be removed from premises? ❑Yes 1 No
1
PROPERTY INFORMATION
Existing use of property:Single fam. dwelling Intended use of property:Single fam. dwelling
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? ❑Yes WNo IF YES,PROVIDE A COPY.
IR 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 bw'Iding(s)for necessary inspections.False statements made herein are
punishable as a Class A misdemeanor pursuant to Section 220.45 of the New York State Penal Law.
Application Submitted By(print name): 1i th Thompson IlAuthorized Agent ❑Owner
Signature of Applicant: Date: `�G
i
STATE OF NEW YORK)
SS:
COUNTY OF }
being duly sworn,deposes and says that(s)he is the applicant
(Name o indivi ual'signing contra )above named,
r
(S)he is the Zd A*"`�
(,C ntractor,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 m this,I, ..••- '' �g
day o
AM -M.SCHLACHTER Notary Public
)dOTARY PUBLIC,STATE OF NEWYOR
Registration No,OI SCS0139767
Ouaiified In Suffolk County
Commission Expires February 27,20 "Y ) IION
(Where the applicant is not the owner)
see attached residing at
do hereby authorize to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
Owner's Signature Date
Print Owner's Name
2
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