HomeMy WebLinkAbout52543-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#: 52543 Date: 12/11/2025
Permission is hereby granted to:
Jessica LePore
10318th Ave
Brooklyn, NY 11215
To:
construct alterations to an existing single-family dwelling as applied for with flood permit.
Premises Located at:
6060 Main Bayview Rd, Southold, NY 11971
SCTM#78.-4-46.3
Pursuant to application dated 10/14/2025 and approved by the Building Inspector.
To expire on 12/11/2027.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling- Alteration $325.00
Flood Permit $150.00
O-RESIDENTIAL $100.00
Total S575.00
Building Inspector
n ,
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 ht1ps://www. outholdtownri '.go °
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only &u P
PERMIT NO. Building lns ector�
S
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. w a �
I
Date:2025.10.09
OWNER(S)OF PROPERTY:
II Name:Michael McGuire & Jessica Lepore scTM#Z000-78.E_46.3
Project Address:6060 Main Bayview Road, Southold, NY 11971
Phone#:(347) 410-2399 Email:mcguire2491 @gmail.com
Mailing Address: above
CONTACT PERSON:
Name: Jake LaChapelle AIA
Mailing Address: P.O. Box 1251, Mattituck, NY 11952
Phone#: (646) 251-5058 Email: jake@lachapellearchitecture.com
DESIGN PROFESSIONAL INFORMATION:
Name: Jake LaChapelle AIA
Mailing Address: P.O. Box 1251, Mattituck, NY 11952
Phone#: (646) 251-5058 Email: jake@lachapellearchitecture.com
CONTRACTOR INFORMATION:
Name: Frank Buonaiuto, North Fork Professional Services
Mailing Address:P.O. Box 1614, Mattituck, NY 11952
Phone#:(g 17) 217-6676 Email;
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition RAlteration ❑Repair ❑Demolition Estimated cost of Project:
❑Other $75,000
Will the lot be re-graded? ❑Yes RNo Will excess fill be removed from premises? ❑Yes IQNo
1
m Hi
PROPERTY INFORMATION
Existing use of property: single-family residential Intended use of property: no Change
9 Y
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
R-40 this property? ❑Yes RNo IF YES, PROVIDE A COPY.
01 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 ,Jake LaChapelle AIA I Authoriz d Agent Downer
1i e" Date: p 28Z 5
Signature of A ilµan y
STATE OF NEW YORK)
SS:
COUNTY OF CAjnf d I )
ZakA La C I being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the
(Contract r,�Agent, orporate Officer,etc.)
of said owner or owners,and is duly authorized to 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 bef
ore me this
day of oclolp ,20j X AL Unji A
R -4;Z�0" ( -
I-
0tary Public
NC TA6 y Ell
PUBLIC,STATE OF NEW y0RX
PROPERTY OP IIIR AUTHORIZATION N .owDW63 900
..mm ^ tf!-LIFIBD IN SUFFOL C C'OONTY
(Where the applicant is not the owner) O Si!140N E PI C JUNC 30,
Michael McGuire 6060 Main Bayview Road
I, residing at
Southold, NY 11971 do hereby authorize Jake LaChapelle to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
a4a69O2d-cbbb-4710-85ec-D`sit'piy71 signed ai' s 'SIT 1 0�07�2025
e3dccfd15caa bb40-a 3d=ta�r $
Date:2MA 0.09 22147 Q7-WW
Owner's Signature Date
Michael McGuire
Print Owner's Name
2