HomeMy WebLinkAbout52695-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#: 52695 Date: 03/02/2026
Permission is hereby granted to:
Crystal R Bolling
360 Cottage Way
Mattituck, NY 11952
To:
finish basement of an existing single-family dwelling as applied for.
Premises Located at:
360 Cottage Way, Mattituck, NY 11952
SCTM# 122:2-23.22
Pursuant to application dated 12/29/2025 and approved by the Building Inspector.
To expire on 03/01/2028.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling- Alteration $482.50
CO-RESIDENTIAL $100.00
Total $582.50
_",IIIigilding Inspector
Tom OF SOUT oLil--BUILDING DEPAR'I'`1V TENT
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Town Hall Annex 54375 Mama.load P. CJ. Box 1179 Southold NY 11971-0959
Telephone(631) 765-1802 Fax(631) 7659502 � � �� .souto dto�.
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Date Received
APPLICATION FOR BUILDING PERMIT -Wft '0M
D
For Office Use OnlyDEC 2 9 2025
5
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PERMIT NO.,, Building Inspector
Ultdln
Applications and farms must be filled out in their entirety.Incomplete Town Southold
applications will not be accepted. Where the Applicant is not the owner,an
f� Ar � rtn form(Page 2)shall be completed. :.
Date:1/11/26
OWNER(S)OF PROPERTY:
Name: Crystal Bolling SCTM#1000- 122-2-23.22
Project Address: 360 Cottage Way, Mattituck
Phone#: 631-743-1034 Email:
Mailing Address: same as above
CONTACT"'PERSON:
Name: Chris Meyer
Mailing Address: Southold, NY
Phone#: 631-745-1958 Email.
DESIGN PROFESSIONAL INFORMATION:
Name: Nick Mazzaferro, PE.
Mailing Address: -Ireenport, NY
Phone#: 516-457-5596 Email: nickmazaferro@verizon.net
CONTRACTOR INFORMATION:
Name: TBD
Mailing Address:
Phone#: Email:
DESCRIPTION of PROPOSED CONSTRUCTION
❑New Structure C]Addition RAlteration D Repair ❑Demolition Estimated Cost of Project:
❑other partially finish basement $50,000
Will the lot be re-graded? ❑Yes ❑No Will excess fill be removed from premises? ❑Yes []No
1
POOPE INFORMAIMON
tingle► Intended property s family residence
r ill family residence nce
Zone or use district in which premises is situated. Are there any covenants and restrictions with respect to
�AHD this property? DYE W o IF YES,RROVIM A ' _
pOw&box After ft*&W, P t
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Appikation Submitted By(prirvt narne): Chris Meyer 111"hcwIxed Agent Clown r
: Da4
r
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CONNIE D.BUNCH
ATE OF NEW R Notary Public,State of New`ors ,
i No.01 BU 1 050
Qualified In Suffolk County
COUNTY
R
commission Expires April 14, 2
Chris Meyer being duly sworn deposes and says that(s he is the applicant
Name of indMdual signing ingcontract)above named,
(S)he is th
agente
(Contractor,Agent,.Corporate Officer:etc.)
of said owner or owners and "Is duly authofized to perform or have performed the sai4 work and to make and file this
a pprli catlo►w that all statements contained In this applikation 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
tin
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f
�
Notary Public
'ELQUmlit,Datus' '
KILKA%ffA,'QA`,2, A1, &M
(Where the applicant is not theowner)
Crystal
Bolling
Cottage Way, a t tuck, NY
1, residing at
"do hereby authonze r
m�u�mimi uiuiw iu i. �iW w r yore`' �I
my behalf to the Town of Southold Building Department for appmva l as described herein.
1/11/2026
Date
Crystal Bol
Print Owner's Name
2