HomeMy WebLinkAbout52563-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#: 52563 Date: 12/18/2025
Permission is hereby granted to:
Georgia Constantine
1050 Inlet Dr
Mattituck, NY 11952
To:
Construct interior alterations to an existing single-family dwelling as applied for to include the
reconfiguration of the garage and a finished basement.
Premises Located at:
1050 Inlet Dr, Mattituck, NY 11952
SCTM#99.-2-15
Pursuant to application dated 10/29/2025 and approved by the Building Inspector.
To expire on 12/18/2027.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling- Alteration $741.00
CO Single Family Dwelling-Addition/Alteration $100.00
Total S941.00
Building Inspector
�'v"sro TOWN OF SOUTHOLD—BUILDING DEPARTMENT
a x 1179 Southold NY 11971 09 59
Town Hall Annex 54375 Main Road P. O. Bo
o
Telephone (631) 765-1802 Fax (631) 765-9502 lltt ://WWW. OLitholdtownil . eiv
Date Received
APPLICATION FOR BUILDING PERMIT P"V
For Office Use Only
PERMIT N0. Building Inspector: P E
Applications and forms must be filled out in their entirety.Incomplete i t
applications will not be accepted. Where the Applicant is not the owner,an i 11 IJ U R=
Owner's Authorization form(Page 2)shall be completed.
Date:10/27/25
OWNER(S)OF PROPERTY:
Name:Georgia Constantine SCTM#1000-99-2-15
Project Address:1050 Inlet Drive, Mattituck
Phone#:516-817-6766 IHII.:gc:mailbox2OO4@yahoo.com
Mailing Address:1050 Inlet Drive, Matittuck
CONTACT PERSON:
Name:Brooke Epperson
Mailing Address:PO Box 152, Mattituck, NY 11952
Phone#:631 603 9092 Email:bepperson@amparchitect.com
DESIGN PROFESSIONAL INFORMATION:
Name:Anthony Portillo
Mailing Address:PO Box 152, Mattituck, N.Y. 11952
Phone#:631 603 9092 Email:aportillo@amparchitect.com
CONTRACTOR INFORMATION:
Name:
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition RAlteration ❑Repair ❑Demolition Estimated Cost of Project:
❑Other $20,000
Will the lot be re-graded? ❑Yes ®No Will excess fill be removed from premises? ❑Yes RNo
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PROPERTY INFORMATION
Existing use of property:Single Family Residential Intended use of property:Single Family Residential
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
R-40 Non-Conforming thisproperty? ❑YesBNo IF YES, PROVIDE A COPY.
R Check BoxAfter 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(pr` t-n nee): ►�a/>� 1(i( 4"�('Q' BAuthorized Agent ❑Owner
Signature of Applicant: Date:
10 �S-7[V5
STATE OF NEW YORK)
SS:
COUNTY OF(::�L; Cp��L )
- being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signini 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
17 dayof
r
20��
._ tablic
DARCEE AUFENANGER
PROPERTY ,�„ I NOTARY PUBLIC,STATE OF NEW YORK
Registration Pilo.01A00019644
(Where the applicant is not the owner) Qualified in Suffolk County
Commission Expires 4.,Tj, ark 9 2028
,, Georgia Constantine residing at 1050 Inlet Dr., Mattituck
NY 11952 do hereby authorize AMP Architecture to apply on
my b aIf to the=epartment for approval as described herein.
10/24/25
Owner's Signature Date
Georgia Constantine
Print Owner's Name
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