HomeMy WebLinkAbout52652-Z TOWN OF SOUTHOLD
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SOUTHOLD, NY
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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#: 52652 Date: 02/05/2026
Permission is hereby granted to:
Mark Munson
4 Cedar Ct
Laurel, NY 11948
To:
Construct interior alterations at existing single family dwelling as applied for.
Premises Located at:
650 Brigantine Dr, Southold, NY 11971
SCTM# 79.-4-35
Pursuant to application dated 12/12/202S and approved by the Building Inspector.
To expire on 02/05/2028.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling- Alteration $438.50
CO Single Family Dwelling-Addition /Alteration $100.00
Total 538.54
Building Inspector
TOWN OF SOUTHOLD--BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. 0. Box 1179 Southold, NY 1 1971-0959
r Telephone (631) 76 5-1 02 Fax (631) 765-9502 htt ' w VW'.SOLI l Idt,!2AD M
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Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only f
PERMIT NO. Building Inspector: � �
5�
Applications and forms must be filled out in their entirety.Incomplete
applications will not be accepted. Where the Applicant I not the owner,an
Owner's Authorization form(Page 2)shall be completed.
Date:12/12/25
OWNER(S)of PROPERTY:
Name:Susan Munson SCTM#1000-79-4-35
Project Address:650 Brigantine Ave Southold NY 11971
Phone#:570-296-50 2 Email: usanfromcb@yahoo.com
Mailing Address:650 Brigantine Ave Southold NY 11971
CONTACT PARSON:
Name:AMP Architecture
Mailing Address:PO Box 152, Mattituck
Phone#:031 503 9092 Email:bepperson@amparchitect.com
DESIGN PROFESSIONAL INFORMATION:
Name:AMP Architecture, Anthony Portillo
Mailing Address:PO Box 152, Mattituck
Phone#:631 503 9092 email:doppici@amparchitect.com
CONTRACTOR INFORMATION:
Name:
Mailing Address.: x
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition *Alteration ❑Repair 7 Demolition Estimated Cost of Project:
C�lOther convertingrec.roam to bedroom 0
Will the lot be re-graded? FYes ` No Will excess fill be removed from premises? ❑Yes iRNo
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