HomeMy WebLinkAbout52569-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#: 52569
Permission is hereby granted to: Date: 12/22/2025
Vleve LLC
58 East Gate
Manhasset, NY 11030
To:
Convert a portion of an existing single-family dwelling into an accessory apartment as applied for,.
Premises Located at:
47420 Route 25, Southold, NY 11971
SCTM#69.-6-9.4
Pursuant to application dated 11/05/2025 and approved by the Building Inspector..
To expire on 22/22/2027.
Contractors:
Required Inspections:
Fees:
Accessory Apartment in Dwelling
Co single Family Dwelling-Addition/Alteration $32550
$140.00
Total ..Q.
ouil'ding Inspector
OFF80� °�:a 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 litt.S://www, outlioldt�ow , o
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use only
't
j
,,
r%tniviiT iJD. w
� 1� Building Inspector. V ^5g
i
~F
r
Applications �d forms must accepted.
be filled r Incomplete
applications w llnot be acreped Where the ApPlicant Is not the
owner,an
Owner's Authorization form(Page 2)shall be completed.
u ,
Date:10.4.25
OWNER(S)OF PROPERTY:
Name: . V .�V L-LC slD =CTMsoon-69-6-9.4
Project Address:
47410 Route 25 Southold
Phone#:(516) 779-2084 Email:tbaktidy@gmail.com
Mailing Address:4632 Third Ave. Bronx, NY 10458
CONTACT PERSON:
Name:Joan Chambers
Mailing Address: PO Box 49 Southold NY 11971
Phone#:631-294-4241 Email:joanchambers10@gmail.com
i
DESIGN PROFESSIONAL INFORMATION:
Name:Lou Schwartz
Mailing Address:7 Ridgewood St, Bay Shore, NY 11706
Phone#:(631) 410-6838 Email:tiderunnereng@gmail.com
CONTRACTOR INFORMATION:
Name:existing
Mailing Address:
Phone#: ::TEmail:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
El Other addition to be apartment
Will the lot be re-graded? ❑Yes INo Will excess fill be removed from premises? [:]Yes; No
IX
PROPERTY INFORMATION
Existing use of property:residence Intended use of property:residence W/ apartment
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
r_80 this property? ❑Yes *No IF YES, PROVIDE A COPY.
IN 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 constmcdon 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 budding(s)for necessary Inspections.False statements made herein are
punishable as a Gass A misdemeanor pursuant to Section 210.45 of the New York State Penal Law.
Application Submitted By(print name):Joan Chambers 19,Authorized Agent ❑Owner
Signature of Applicant: Date: 11 -S -a s
STATE OF NEW YORK)
SS:
COUNTY OF 5u�-601 l� )
Joan Chambers being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the Agent
(Contract Agent orporate 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
2WEday of NOVA 20
otary Pu Ilc
TRACEY L DWYE13
PROPERTY OWNER AUTHORIZATION NOT"RYPI BLI ,STATEOF NEW YORK
W.01 OW6306900
(Where the applicant is not the owner) 0�.I„�L*IED IN SUFFOLK COUNTY
COM MISSION EXPI ir-- JUNE 30 2p�a(p
I, Steve Baktidy residing at 38 Barkers Point Road, Port Washington
NY, 11050 do hereby authorize Joan Chambers to apply on
my behalf to the To of Southold Building Department for approval as described herein.
November 4, 2025
CiWner's Signature Date
Steve Baktidy
Print Owner's Name
2
• ,.. OffFOLK CO HEALTH own.APPROVAL
_ H.S. NO.
pw
o' ti N 1
NIM
qr-.25 I TIME WATER SUPPLY AND SEWAr3E DISPOSAL rram.
' .•- ''v -' _ SYtTEMS FOR THIS RESIDENCE , WILL VJ
t� CONFORM TO TE STANDARDS OF FOLD co. DEPT. OF HEALTHSFR
SURVEE THE
t
• v FG
1
,. � - -..._ -...._..... � ,• APPLICANT
. • " " ! i w » ,.. . . . - SUFFOL UNTY DEPT. OF HEALTH
...,� ..... - .. K CO
-'"' ,• '•- �` SERVICES - FOR APPROVAL OF
` ; w .
CONSTRUCTION ONLY
C
DATE
11» � A H.S. REF«N •. 852010-9
a•... I1 .. APPROVED:
T,�oM '
} 5WTJ40i-f) NY-
1 '" SUFFOLK CO TAX MAP DESIGNATION.
s
< I DIST. SECT. BLOCK PCL-
i ,. Q.2
z 'T�ip1A►.�,��.'x'. i d71,a�.
UFFqLK
tUFFOIK COUNTY HEALTH DEPARTMENT .: - =
CA
-- DEED: L. P.
�•..
` y ' ,
a j � ��
,.... T L P
L , SINGLE,� tLY L .1 ONLY � �,, ��,� i""
r '" x
• ��
• H.D. F. NC;. � ,.
� LGAt�9
I
DAT » �
THE Loo NAGE DISPOSAL HAVE R INSPECTEDEN A Y FA � F ,sHDS � � � � �
AND aft
D
TOM
BE
ir
y 95
S51 t Section
»
_
«. IT �, • 1
Lmi
, LICENSED LAND SIN t,ra "
GREENPORT NEW YORK