HomeMy WebLinkAbout52713-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#: 52713 Date: 03/04/2026
Permission is hereby granted to:
Shaw D L& L S Family Trust
30 E 21st St Apt 5B
New York, NY 10010
To:
Install replacement windows to an existing single-family dwelling as applied for as per Historic
Preservation Commission approval.
Premises Located at:
220 Skippers Ln, Orient, NY 11957
SCTM#25.4-21
Pursuant to application dated 03/04/2026 and approved by the Building Inspector.
To expire on 03/03/2028.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling- Alteration $250.00
CO-RESIDENTIAL $100.00
Total S350.00
�14& —
Building Inspector
TOWN OF SOUTHOLD —BUILDING DEPARTMENT
�'s Town Hall Annex 54375 Main Road P. O_ Box 1179old, 1971-0959
Southol NY 1
Telephone (631) 765 1802 Fax (631) 765 950 httl1_ .�� n �. 11t1d! tc111a 'm: t
Date Received
APPLICATION FOR Bl
1I
For Office Use Only
PERMIT NO. 5a 1 13� Building Inspector:__,.,,
Applications and forms must be filled out in their entirety. Incomplete
applications will not be accepted. Where the Applicant Is not the owner,an
6ivner's Authorization form(Page 2)shall be completed.
Date:
blame. SCTM# 000- M. ..
Project Address: 22 p C p ,� La � } f'N
Phone#: 2 cS Email i s s7 ry-)
Mailing Address:
CO 4TACT PERSON:
Name:
Mailing Address: (e, 0 u �c�X C� i�l�l1�- )'/
Phone#: � Email:� c � �( rCP� t �
. �
DESIGN PROFESSIONAL INFORMATION;
Name:
Mailing Address:
Phone#: Email:
��I' T° 1 ,� R IN 'IV "TION�
Name: A— V/ CAo1
Mailing Address: �?2 �J�/
Phone#:: 1 1— 13 _.... Email: I r,K:+ru C: glrm dC(
F* 1, ON Olµ PROPOSEDCONSTRUCTION
1New Structure ❑Addition Alteration XRepair ❑Demolition Estimated Cost of Project:
❑Other -f Z1 r) '" " y° $�
Will the lot be re-graded? ❑Yes [XNo Will excess fill be removed from premises? []Yes ❑No
1
PROPERTY INFORMATION
Existing use of property: Intended use of property: a0l,G I y-, k l)-yy)e
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? Dyes ❑No IF YES, PROVIDE A COPY.
❑ Check Box Af#er,Realding: The owner/contractor/design,professional is responsible for all drainage and storm water issues as provided bar
� ;7 6of lre:Town Cede.-l4PpVcA7ngN IS HEREBY MADE to thelluilding Department for the Issuance of a Building Permit pursuant to the Building Zone
�fi �of the town;of Southold,Suffolk,,County,New York and other applicable Laws,ordinances or Regulations,for the construction ofbulldings,
g��g lteratioias"orfor removal ordejn olition as herein described.The applicant agrees to comply with all applicable laws,ordinances,buifdirt code,
� am!regulatkms arul.to admit aythorized inspectors on premises and in building(s)for necessary inspections.False statements made herein are
punlshable,s *Gass A1,misdemeanw pursuant to section 2io.4s of the New York State Penal Law.
Application Submitted By(print name) � t
�_2S;fy( L ❑Authorized Agent []Owner
Signature of Applicant:
pplicant: Date:
CONNIE D.BUNCH
STATE OF NEW YORK) f Notary Public,State of New York
SS: No.OI BU6188050
Qualified In Suffolk County
COUNTY OF Qa
commission Expires April 14,2__
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
day of IJ� r_(�MLAI �
,k , 20 .
Notary Public
PROPERTYR AUTHORIZATION
(Where the applicant is not the owner)
I, residing at
do hereby authorize to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
Owner's Signature Date
Print Owner's Name
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1-765-180 8AM TO 4PM FOR THE
FOLLOWING INSPECTIONS: m C7 "' m a
FOUNDATION-TWO REQUIRED
FOR POURED CONCRETE
ROUGH-FRAMING&PLUMBING r n „ q� �p
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INSULATION t °i a. m °' m
FINAL-CONSTRUCTION MUST % I + M '�°
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ALL CONSTRUCTION SHALL MEIETTHE
REQUIREMENTS OF THE CODES OF NEW n `$ ID
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YORK STATE. NOT RESPONSIBLE FOR _
DESIGN OR ION ERRORS x °,' m
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From: lucy stille lucystille@gmail com
Subject:
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December 5,2025 at J: AM 1
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To: lucystille lucystille@grnail.com
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Date: December 5,2025 at 9:47 AMA
To: lucy stille Iucystille@gmail.com
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David Mammina,Chairperson
r Town Hall Annex
Anne Surchin,Vice Chair 54375 Main Road,NYS Route 25
Allan Wexler ' �► PO Box 1179
Marina de Conciliis xk Southold,NY 11971
Jeri Woodhouse ` Telephone: (631)765-1809
Daryl Ketcham �* Email: kimf@southoldtownny.gov
Ahmad Sardar-Afkhami " . ,,AT
Kim E. Fuentes, Coordinator
Town of Southold Historic Preservation Commission
Certificate of Appropriateness
�<< q February 26, 2026
RESOLUTION #02.26.2026.1
RE: 220 Skippers Lane, Orient, NY. SCTM# 1000-25-1-21
Owner: SHAW DL & LS TRUST - LUCY STILLE
RESOLUTION:
WHEREAS, 220 Skippers Lane, Orient, NY, is on the Town of Southold Registry of Historic
Landmarks; and
WHEREAS, as set forth in Section 170-6 of the Town Law (Landmarks Preservation Code) of the
Town of Southold, all proposals for material change/alteration must be reviewed and
granted a Certificate of Appropriateness by the Southold Town Historic Preservation
Commission prior to the issuance of a Building Permit; and
WHEREAS, the applicant submitted a proposal on February 9, 2026, for approval to replace two
windows in an existing single family residence; and
WHEREAS,the applicant, Lucy Stille appeared before the Commission at a Work Session on February
26, 2026 to describe the proposed improvements to the single family residence as
illustrated in photographs submitted to the Commission; and
WHEREAS, the proposed improvements consist of two (2) Anderson 400 Series Windows as
illustrated in the submitted manufacturer's specifications; and
WHEREAS, the Commission has determined that pursuant to Chapter 170-4(E)(2) of the Southold
Town Code, the Commission has the authority to determine that some proposals do not
rise to the level of requiring a public hearing, as the proposal is de minimis in nature; and
WHEREAS, the Commission has determined that the subject application for the Certificate of
Appropriateness is de minimis in nature, and therefore does not require a Public Hearing;
and
Certificate of Appropriateness, Res.902.26.2026.1
HPC, Lucy Stille—SCTM No. 1000-25-1-21
Page 2
WHEREAS, the applicant shall submit to the Commissioners photographs of the finished
improvements upon completion; and
WHEREAS, the Commissioners may conduct a site inspection of subject premises once improvements
are completed.
NOW THEREFORE BE IT RESOLVED,that the Southold Town Historic Preservation Commission
detenni.nes that proposed improvements to the single family residence to replace two (2)
Anderson 400 Series Windows (in kind) meets the criteria for recommendation under
Section 170-8 (A) of the Southold Town Code; and
BE IT FURTHER RESOLVED,that the Commission approves the request for a Certificate of
Appropriateness, subject to approvals by all involved agencies; and
BE IT FURTHER RESOLVED, that any deviation from the approved plans referenced above may
require further review from the Commission.
Motion made by: Commissioner Wexler
Motion seconded by: Commissioner Surchin
VOTES: AYES: Commissioners Surchin, Wexler, De Conciliis, Woodhouse, Ketcham, Sardar-
Afkhami (6-0)
RESULT: Passed
Please note that any deviation from the approved plans as referenced may require further
review from the commission.
Signed: _. .,
Kim E. Fuentes
Coordinator for the Historic Preservation Commission
Date: March 2,2026
Resolution No. 02.26.2026.1
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
SOUTHOLD,N.Y.
NOTICE OF DISAPPROVAL
DATE: January 28, 2026
TO: Shaw D L &L S Family Trust
30 E 21st St Apt 5B
New York,NY, 10010
Please take notice that your application dated December 5, 2025:
For permit to: Install replacement windows to an exi tin si.n'�le-lan�il dwellin� a't:
Location of property: 220 Sk.i ens Lane Orient NY
County Tax Map No. 1000 - Section 25 Block 1 Lot 21
Is returned herewith and disapproved on the following grounds:
The fro osed construction on the 12.632 sq. ft. lot in the R-40 District ]nnitted pursuant
to Section 170 of the Southold Town Code and is subiect to Historic Preservation Commission
ApSLov 1.
Zhori:re 01
gnature
Note to Applicant: Any change or deviation to the above referenced application may
require further review by the Southold Town Building Department.
CC: file,Historic Preservation Commission
From: Alfredo Galdamez infoagwconstruction@gmail.com Q /tIi/�
Subject: Re:Your license °�lPt
Date: December 4,2025 at 1:26 PM
To: lucy stille lucystille@gmail.com
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On Thu, Dec 4,2025 at 9:48AM lucy stille dur,)re iillw + ea:a&gL)I i>wrote:
1 already have your certificate of liability but 9 also need a copy of your license for the application to the building department,
Thanks.
! ? mnk you,
ARredo
Arc a CERTIFICATE OF LIABILITY INSURANCE DATE(MM DDIYYYY)
11t17/2025
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT': If the certificate holder Is an ADDITIONAL INSURED„the potloy(les)must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED,subject to the terms and conditions of the Polley,certain policies may require an endorsement. A statement on
this cartiflcate does not confer rlg!�s to the certificate holder In Iisu'of such endorseme s.
Kirk Associates LTD PHONE t 1 727 7' tiOt
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18 First Street .�� ,....w.__UCER Eric
� t�,maaicsn nRllonal c.^odrw 631 727 794
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..... .........INaORER(9,),AFFORDING,COVERAGE ...... ...... ........HAW4
Riverhead _M.M.M.......,,,wu NY 11901 INSURER.A.;_FARM FAMILY CASUALTY INSURANCE 13803
NNSGeEaa INSURERS. UNITED FARM FAMILY COMPANY 29963.......
AGW CONSTRUCTION INC 1RS.u,,,RER c ............ _,..._ ..........
1675 Tuckers Ln RaauaEseD...... ....... _..,,,,.. .............w...
Southold NY 11971 IM URER F.
COVERAGES CERTIFICATE NUMBER. REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TfPOPuaSURA...... .. ....... �_..._. _....,......
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NCL 0 pL.1,;CY N1'XdCk q....q q LIMfr3
X OMMERCLGENERALUABILITY X 31O3L/61A 03/2212025 O 22)2026 EACHOCCURRENCE F 1000000
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A ., C,.� UI CLAIMS-MADE �X OCCUR 1OOf000
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From: Alfredo Galdamez infoagwconstruction@gmail.com [$ �O '4 �SStC
Subject: Re:Proposal
Date: November 17,2025 at 12:24PMPAf�
To: lucy stifle lucysblle@gmail.com yti i
On Mon,Nov 17,2025 at 9:38 AM Alfredo Galdamez<in oa wctc g dl" cr' r' wrote:
This is my home improvement license number HI-63057
On Mon, Nov 17,2025 at 9:29 AM lucy stills<iuc tallrtr9an'a' wrote: �l
Thank you.I also need your license for the Bldg dept application
On Mon,Nov 17,2025 at 9:28 AM Alfredo Galdamez<in_oagA,a,,)nsrt omail.ccrn>wrote:
Hi Lucy„
i will send you a certificate of insurance when i receive it.The details for the windows will be verified in the field by the window saes
guy before they get ordered.
" Operation Location
1(}13 2 Left None Assigned
Ro size-31 11 "x 34112" Unit Size 31""x 34
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PSC 2 8"tt2"10',Unmt..400 series Casement.pnswtlation Flange,white Exterior Frame Wtute Extenor Sa aztet Pine,
wi�te Paimed interior Frame.t 4 Hillge�kv&wash e,Dural Pane Low-E4 Standard Series Argon FmiC F l f�vkYed Ligl
' Gpa� d C1siiV�etSpace Faac�tibrnal olding,sWh e,Whae.F mfer s Gripe
(FClL)?Warie<2 Ftmgho aitet aFaad Fgtae4 q.wgttt Patten.Whyte. it Screen,
Bar.V8°`t'arille Sara"Traditional Trim,tetra Profile i ss
Aluminum
Wrapping.4 9I16'Interior Extension Jamb Pine i white-Painted Standard Compiete Unit Extension Jambs,Factory Applied
Hardware:PSC Traditional Folding White PN:1361560
Pp 9 white
Insect Screen 1.400 Series Casement PSC 31 x„3a Full Semen �M Area(Sq.Ftj
Factor SHGC ENERGY STAR Clear O nln !Unit 4 width 29,1480
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All 0.29 0.29 NO Al ..... 21.2980..........__...14&Q.�,.._..4W.3111..-.._.__....�.w.�_.�................._.._�.,_..�...
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From: lucy stille lucystille@gmail.com
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'Trapping:4 9116"Interior Extension Jamb Dine/White-sainted Standard Complete Unit Extension Jambs, Factory Applied
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Unit# U-Factor SHGC ENERGY STAR Clear Operting/Unit# Width Height Area(Sq. Ft}
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