HomeMy WebLinkAbout52592-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#: 52592 Date: 01/05/2026
Permission is hereby granted to:
Robert P Bunn Jr
100 Greenway E
Orient, NY 11957
To:
Construct alterations to an existing single-family dwelling to include in-kind door replacements as
applied for.
Premises Located at:
100 Greenway E, orient, NY 11957
SCTM# 15.-2-21
Pursuant to application dated 11/13/2025 and approved by the Building Inspector.
To expire on 01/05/2028.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling- Alteration $250.00
CO Single Family Dwelling-Addition/Alteration $100.00
Total $350.00
ilding Inspector
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Date Received
APF LICAT UON FOR BUILDING PERMIT
For office Use Only
PERMIT NO.
ra Building Inspector: 2
q.c ox
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 7-)shall be completed.
Date:11/7/2025
OWNER(S) OF PROPERTY:
Name: SCTM# 1000- 115 , I�L.
Project Address: 100 Greenway E
Email: packardbunn'gmail.corn
Phone#.
5 16 650 3351
M ai 11,;1 g Ad d re ss-P,10 0 G ree n way, E
...........
CONTACT PERSON:
Name: Robert Bunn
M a i I i ng Ad d re ss:1,0 0 G re e n,way E
E in a*11: Icom
Plione#''.516 6,50 3351 packardbunti@gma*1
DESIGN PROFESSIONAL INFORMATION:
Name*.
Mailing Address:
Pho�ne#,.,, Email.
CONTMCTOR INFORMA TJON*
Names Renle,wal by Andersen
Mailin�Address:2029 New Hwy Farmingdale NY 11735
TEmail:cvalente('aw")rbal on g island-Com
Phone#.631' 81,43 1713 ext 2255
DESCRIPTION OF PROPOSED CONSTRUCTION
El New I Structure ElAddition E]Alteration DRepair nDemolition Estimated Cost of Project:
20therDirect Replacement 2 Doors $220165
W-i il the lot be re-graded? E]Yes,2% Will excess fill be removed from premises? E]Yes F!!!Wo
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„ r PROPERTY
Existing use of property::
Intended use of property:
Zone or use district in which premises.mises is situated: Are there any covenants and restrictions with respect to
this property? Ryes ONo IF YES, PROVIDE A COPY.
The owner/contractor/design professional is,responsible for all drainage and storm water issues as provided by
o
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,
demolition as herein described. applicant agrees to comply with all applicable laws,ordinances,building code,
additions,alterations or for removal or
4 are
housing code and regulations and to admit authorized inspectors onpremises and in buildings for necessary inspections.False statements made herein
--—------
punishable as a Class A misdemeanor pursuant to Section 210.45 of the New York State Penal law.
. El Authorized Agent El Owner
Application Submitted By(print name). -�I� ��"`'-�,. � �
NA
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te:
Signature ofApplicant' :
1�
�``` ar ubiiC
Y a of New York
STATE OF NEW YO o. U � �85t�5o
RK} 'lualifled In Suffolk Coun�
S ommission Expires April 14
COUNTY OF_
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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 sta
tements 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 "
o-
16"1
1-_:11'*" )day
t ofJy 110--e. 0,20-3�
Notary Public
PROPERTY
AUTHORIZATION
,
(Where the applicant is not the owner)
1 residing at
do hereby authorize
to apply 1
pY on
�
my behalf to the Town of Southold BuildingDepartment for approval as described herein.
Owner's Signature Date
Print Owner's Name
2