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Home My WebLink About52704-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#: 52704 Date: 03/03/2026 Permission is hereby granted to: Ralph M Palmiotto PO BOX 988 Mattituck,, NY 119S2 To: Convert an existing second floor balcony into conditioned storage space as applied for. Premises Located at: 1250 Marlene Ln,, Laurel,, NY 11948 SCTM# 144.-2-38 Pursuant to application dated 01/09/2026 and approved by the Building Inspector. To expire on 03/02/2028. Contractors: Required Inspections: Fees: Single Family Dwelling- Addition&Alteration $431.50 CO Single Family Dwelling-Addition /Alteration $100.00 Total S532.S0 Building Inspector ,10-f A BUILDING DEPARTMENT TOWN OF SOUTHOLD -0959 Town Hall Annex 54375 Main Road P. 0. Box 1179 Southold,NY 11971 wN '"HWWW'SOU Telephone (631) 765-1802 Fax (631) 765-9502 h1tps. Lhol�dto�wn�.t -�� 3", ............ Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only L pector: PERMIT NO. r7,0 , P,1 X If, Building Ins ........ ............... 9 20 P6 t be filled out in their entirety.Incomplete Applications and forms mus applications will not be accepted. Where the Applicant Is not the owner,an Owner's Authorization form(Page 2)shall be completed. Date:2026.01.07 'WON" OWNER(S)OF PROPERTY: ................ Name:Carol & Ralph Palmiotto SCTM# 1000-144.-2-38 Project Address: 1250 Marlene Lane, Mattituck, NY 11952 ..................... Phone#:(631) 298-9435 Emaill:carol@cbrp.us Mailing Address: above CONTACT PERSON: Name: Jake LaChapelle AIA Nl h MW W"i MailingAddress: P.O. Box 1251 Mattituck, NY 11952 Phone#: (646) 251-5058 Email: jake@lachapellearchitecture.com DESIGN PROFESSIONAL INFORMATION: Name: Jake LaChapelle AIA MailingAddress: P.O. BOX1251, MattituCk, NY 11952 Phone#: (646) 251-5058 Email: jake@lachapellearchitecture-com CONTRACTOR INFORMATION: Name: Frank Buonaiuto, North Fork Professional Services Will Mailing Address:P.O. Box 1614, Mattituck, NY 11952 Phone#:(917) 217-6676 Email:frank@nofops.com DESCRIPTION OF PROPOSED CONSTRUCTION EINewStructure F-lAddition iOAlteration F-lRepair nDemolition Estimated cost of Project: F-lother Will'"th e I im ot be re-graded? E:]Yes IRNo Will excess fill be removed from premises? E]Yes RNo —----- ......... PROPERTY INFORMATION Existing use of property: single.-family residential Intended use of property: no change Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to R-40 this property? FlYes RiNo, IF YES, PROVIDE A COPY. v U water Issues as provided by Check Ba�x�,Aft, r Reading,: The owner/contractor/design professional is responsible for all drainage and storm Chapter Z36 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,,Suffolko Countyo 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. '',,Jake LaChapelle AIA R,,Author1*tzed,Agent [3 Owner Application Submitted By(pr na ,pr Date,; Signature of Applicant: -***�ONNIE D.BUNCH Notary Public,State of New York No.01 BU6185050 STATE OF NEW YORK) Qualified In Suffolk County SS: CoMmission Expires April 14, COUNTY OF 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 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 _T 2Qc= ,_,4�bd,ay of Notary Public PROPERTY OWNERAUTHORIZATION (Where the applicant is not the owner) 1250 Marlene Lane, Mattituck, Garol Palmiotto residing at MOW~ NY 11952 do hereby authorize Jake LaChapelle to apply on my behalf to the Town of Southold Building Department for approval as clescribr d herein. ...... .....MAW"* Date Owner's Signature 7 Carol Palmiotto Print Owner"s Name 2 ... .......... SURVEY OF PROPERTY A T MA TTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY N.Y. 1000-144-02-38 SCALE- V--30f DECEMBER 06, 2025 A* t4 13L a=MONUMENT AREA=21,7W SO. FT LOT NUWERS REFER TO 7HE MAP OF*MAT17nJCK PARK PROPER IX RLED IN 7HE SUF�W COUNTY CLERK$OFRCE AS MAP NO.801. N.y.S, LIC. NO. 051132-01 zRnn T 007770NS ANY AL7ERAIION OR AD01770M To THIS SURVEY IS A WOLA77ON PECONIC FLOOD CER OF SEC770N 72OW INENEW YORK SIA7r EDUCA77ON LAW Phonw(6JI) 989-9174 EXCEPT AS PER SEC77CW 7209-SUBMWSION 2.ALL CERllnCA770Af$ Email' peconicks@gmOil-com HEREON ARE VAUD FOR INIS AIAP AND COPYES 7HV?C0F ONLY IF P.0. BOX 128 SAID MAP OR COPIES JWAR 7HE IMPRESSED SE4 OF INE SURVEYOR RIVERHEAD N.Y 11901 25-037 ... -ARS HEREON. JWO5F WGNATURE APPLE