HomeMy WebLinkAbout52567-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#: 52567 Date: 12/22/2025
Permission is hereby granted to:
Thomas Deierlein
19 Westbury Rd
Garden City, NY 11530
To:
Construct additions and alterationsto a single-family dwelling as applied forto include converting the
existing garage into habitable space.
Premises Located at:
770 Chablis Path, Southold, NY 11971
SCTM#51.-3-3.10
Pursuant to application dated 10/30/2025 and approved by the Building Inspector.
To expire on 12/22/2027.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling- Addition&Alteration $545.00
CO Single Family Dwelling-Addition /Alteration $100.00
Total S645.00
Building Inspector
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
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"town Hall Annex 54375 Main Road P. O. Box 1179 Southold, NY 1 1 971-0959
1'ele hone (G3 1) 765-1802 fax 63 1 765-9502 aloe r � wtl,i„1
Date Received
PERMIT F
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For Office Use Only OCT
2 �025
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PERMIT NO. Building Cnstwctraw`-,.m
Building Department
Applications and forms must be filled out in their entirety. Incomplete 76wiy of Southold
applications will not be accepted. Where the Applicant is not the owner,an
Owner's Authorization form(Page 2)shall be completed.
Date:October 17, 2025
OWNER(S)OF PROPERTY:
Name:Nicholas granato SCTM#1000-
Project Address:770 chablls path southold ny 11971
Phone#:9179394933 Email:niCkgranato@gmaii.com
Mailing Address:2109 41 st street apt 3 astoria ny 11105
CONTACT PERSON:
Name:nieholas granato
Mailing Address:2109 41 st street apt 3 astoria ny 11105
Phone#:9179394933 Email:
DESIGN PROFESSIONAL INFORMATION:
Name:. � SC 6WIf �
Mailing Address: „„ j ,. '° °�9 fC d,,
Phone#: 73 4- d_ ? Email:ni
C �l r :ec .
CONTRACTOR INFORMATION:
Name:douglas w mcgahan
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition *- Alteration ❑Repair ❑Demolition Estimated Cost of Project:
❑Other $
Will the lot be re-graded? ❑YesANO Will excess fill be removed from premises? 1 11s 1-11No
1
PROPERTY INFORMATION
Existing use of property. 5 r /JG Intended use of property �^
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
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this property? ❑Yes KINo IF YES, PROVIDE A COPY.
�y Weck Box After ReadiIII"l, w 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
p 10.45 of the New York State Penal Law.
punishable as a lass A misdemeanor pursuant to Section 2 WM ww ..,„ µ�.....
Application Submitted BY(print ame): ' )(Authorized Agent ❑Owner
Signature of Applicant: Date: 3
C LEI BUNCH
Notary Public,State of New York
STATE OF NEW YORK) No.01BU6185050
SS: J f� � v Quallf led In Suffolk County
COUNTY OF..5. '"' " „ _,,,) Commission Expires April 14,2 bad
signing contract)awe named, "being duly sworn,deposes and says that(s)he is the applicant
(Name of individual
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(S)he is the ........... ......�..._�..._.....��,�__ - ...,
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( ntr ctor,A e t,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
' ' ay of 20
Notary Public
ITIi0FU
..._..,Where the a ... . ............ . ... ......�_ .....W..
( appli
cant' nt is not the owner)
C ell
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residing at_ _ �. . � � „. ." �� � .�"�_ . .(.�
_._.�._. .. ..w w.
..... .... ..._w. ..,. . .. __.__.._. ._ .__do hereby authorize to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
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Owner's Signature Date
Print Owner's Name
2