HomeMy WebLinkAbout52553-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#: 52553 Date: 12/16/2025
Permission is hereby granted to:
Alexander L Sutton
25500 Route 25
Orient, NY 11957
To:
Construct alterations to an existing dwelling as applied for to include the removal of a staircase.
Premises Located at:
25500 Route 25, Orient, NY 11957
SCTM# 18.-6-10
Pursuant to application dated 10/20/2025 and approved by the Building Inspector.
To expire on 12/16/2027.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling- Alteration $331.50
CO-RESIDENTIAL $100.00
Total S431.50
........... j2t 0
Building Inspector
TOWN OF SOU +OLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone(631) 765-1802 Fax(631) 765-9502
Date Received
For Office Use Only
Building Ins n
PERMIT NO.5� � g pecta .
Applications and forms must be filled out in their entirety.Incomplete 2, 0 2025
applications will not be accepted. Where the Applicant is not the owner,an
Owner's Authorization form(Page 2)shall be completed.
Date: 2
OWNERS)OF PROPERTY:
Nam ° t 1000-
Project Address:
Phone#: V5 210 Email: O
Mailing Address:
CONTACT PERSON:
Name:
Mailing Address:
Phone#:
DESIGN PROFESSIONAL INFORMATION:
Name: A
Mailing Address:
Phone#: ai
CONTRACTOR INFORMATION:
Name.
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
- Estimated'Cost of Project:
' ❑New Structure ❑Addition Iteration ❑Repair ❑D emolition J
❑Other -F 5"0i l(-G6 6-e-
Will the lot be re-graded? ❑Yes o Will excess fill be removed from premis 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? ❑Yes` o IF YES, PROVIDE A COPY.
The /contractor/design professional Is responsible for all drab//ge and storm water Issues as provided by
FChapter 236 of the Town Code. APPUCATION I5 HERMY MADE to the Building Department for the issuance of a Building Permit pursuant to the Buliding zone
Ordinance of the Town of Southold,Suffolk,County,New York and other applicable Laws,Ordlaances orRegulations,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 210AS of the New York State Penal Law.
Application Submui rit name): - ❑Authorized Agent Owner
o
Signature of Api7liat Date: l
STATE OF NEW YORK)
COUNTY OF
�r being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the ouuy
(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 - c
day of 111 it UUC/1( .20 OL� ..........a& &.Z
Notary Public
MADISON MESSINA
Notary Public,State of-New York
No.01 ME63Y0536
Qualified in Suffolk County
(Where the applicant is not the ownerjommission-5xpires February 05,20—D
„,°,re slding at
m�
`�do,hereby hereby authorize to apply on
my behalf to the Town of Southold Build ng department for approValps described herein.
Owner's Signature ate.
Print 00inei's Name
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