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Home My WebLink About1000-75.-6-6.1 Pa NL Q G c " WIL9LP FOR INTERNAL USE uNLY DEC 2 3 2025 SOUTHOLD TOWN S�-�E p LAM USE DETERMINATION • PLANNING BOARD - initial petorrninafion o� Date Sent*14_t � l _ Date: �� --'�S Project{Marne:;n In Project Address: 1�3& Zoning District:_ a -No.1000- Suffolk County Tax M P .e t' G� , bid i Requ m Permit Application suppo�ing documentation-a5 to (Note: Copy of B�uildin-g proposed use or uses should be submitted.) r In4 B / initial Determination as to whether use is permitted: Q 1nitual Determinatto n as to whether site planis requir d., 1" lei i; Signature of Building inspector planning Department (P.D.) Referral:, f Date of Comment- f �--�- p_D.Hate Received: Comments: -------------- Signature of Planning Dept. Staff Reviewer Fin-at Determination Date: Decision: �h, P of Ruilc{ino ingnPc=tnr �o�oyyFFOI too TOWN OF SOUTHOLD—BUILDING DEPARTMENT ,x Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 s afi Telephone(631) 765-1802 Fax (631) 765-9502 Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only 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 BoV,'ir*- r),nnn tment Owners Authorization form(Page 2)shall be completed. Date:11.03.25 OWNER(S)OF PROPERTY: Name:Samuel Singer SCTM# 1000-75-06-6.1 Project Address:44030 Main Road - Southold, NY 11971 Phone M 646.330.8658 Email:singers@mskcc.org Mailing Address:44030 Main Road - Southold, NY 11971 CONTACT PERSON: Name:Zackery E. Nicholson, RA Mailing Address:PO BOX 88 - Cutchogue, NY 11935 Phone M 631.513.6589 Email:ZENicholson.Arch@gmail.com DESIGN PROFESSIONAL INFORMATION: Name:Zackery E. Nicholson, RA Mailing Address:PO Box 88 - Cutchogue, NY 11935 Phone#:631.513.6589 Email:ZENicholson.Arch@gmail.com CONTRACTOR INFORMATION: Name: Mailing Address: Phone M Email: DESCRIPTION OF PROPOSED CONSTRUCTION dNew Structure ❑Addition ❑Alteration []Repair ❑Demolition Estimated Cost of Project: R Oth er Farm storage&Farm Labor Housing $TBD Will the lot be re-graded? ❑Yes 10No Will excess fill be removed from premises? ❑Yes *No 1 PROPERTY INFORMATION Existing use of property:Single Family Residence& Farmland Intended use of property:single Family Residence,Farmland a Farm Labor Housing Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to AC I this property? ❑Yes ❑No IF YES, PROVIDE A COPY. 8 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):Zackery E. Nicholson, RA BAuthorized Agent ❑Owner �--^ Date: I�.U�.2� Signature of Applicant: �' V STATE OF NEW YORK) SS: COUNTY OF ) being 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 . 20 Notary Public PROPERTY OWNER AUTHORIZATION (Where the applicant is not the owner) I Samuel Singer residing at 44030 Main Road - Southold, NY do hereby authorize Zackery E. Nicholson to apply on my behalf to of So old Building Department for approval as described herein. G 2 � Owner's Signature Date Sam Singer Print Owner's Name 2 ZACKERY E. NICHOLSON, RA ZENICHOLSON.ARCHOGMAIL.COM POST OFFICE BOX 88 CUTCHOGUE, NY 11935 PHONE: 631.513.6589 Town of Southold-Building Department November 3rd, 2025 53095 Main Road Page 1 of 1 PO Box 11971 Southold NY 11971 Re: Request for Expedited Review — 44030 Main Road Southold, NY 11971 To the Southold Town Building Department, I am writing to respectfully request an expedited review of the enclosed building permit application. The purpose of this submission is to obtain a Notice of Disapproval so that the application may be forwarded to the Southold Town Planning Board for further review. The project proposes the construction of a second "primary" residence on the property. Due to the size of the proposed building, it cannot be filed as an accessory structure with an apartment. As such, we are submitting it under the classification of farm labor housing. A Special Exception Permit application is being filed concurrently with the Zoning Board of Appeals, but we require the Notice of Disapproval from the Building Department to complete our Planning Board submission. The attached drawings represent the full scope of the proposed work. We understand that Planning Board review is the next step in the process, and we respectfully request your assistance in issuing the Notice of Disapproval as soon as possible to allow the project to proceed without delay. Thank you for your attention and prompt consideration. Sincerely, Zackery E. Nicholson, RA