HomeMy WebLinkAbout52733-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#: 52733 Date: 03/10/2026
Permission is hereby granted to:
12585 Sound LLC
1647 E Jericho Tpke
Huntington, NY 11743
To:
Install window replacements in kind to an existing single-family dwelling as applied for.
Premises Located at:
12585 Sound Ave, Mattituck, NY 11952
SCTM# 141:3-38.1
Pursuant to application dated 20/17/2025 and approved by the Building Inspector„
To expire on 03/09/2028.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling- Alteration $250.00
CO Single Family Dwelling-Addition /Alteration $100.00
Total S350.00
Building Inspector
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
' Telephone (631) 765-1802 Fax (631) 765-9502 1ttL �+ vr. o ,tholdtcto ,
Date Received
APPLICATION FOR BUILDING PERMIT
J a
For Office Use Only
PERMIT NO. r - Building lnspec,ton_w�1 °-
Applications and forms must be filled out in their entirety.Incomplete 1 nn
applications will not be accepted. Where the Applicant is not the owner,an
Owner's Authorization form(Page 2)shall be completed.
Date:
OWNER(S)OF PROPERTY:
Name: 12585 Sound LLC SCTM#1000-141.00-03.00-038.001
Project Address: 12585 Sound Avenue
Phone#:516-659-9646 :JErnall:droesch@florencecorp.com
Mailing Address: 1647 E Jericho Turnpike, Huntington NY 11743
CONTACT PERSON:
Name:Patricia C. Moore
Mailing Address:51020 Main Road, Southold
Phone#:631-765-4330 Email:pcmoore@mooreattys.com
DESIGN PROFESSIONAL INFORMATION:
Name: VrcL(
Mailing Address: L( . S}-t�
Phone#: (4-"- �&l 1Z Email:
CONTRACTOR INFORMATION:
Name:
Mailing Address: ��0 p e>..K I qo—( c
Phone#: Email: - r1rwc,,DC(Wa-4_
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ,❑Alteration epair Derpolition Estimated Cost of Project:
❑Othe —5
Will the lot be re-graded? ❑Yes LINO Will excess fill be removed from premises? ❑Yes ONO
1
PROPERTY INFORMATION
Existing use of property: Intended use of property:
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? ❑Yes ONO IF YES, PROVIDE A COPY.
❑ Check Box After Reading: The owner/contractor/design professional is responsible for all drainage and storm water issues as provided by
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,
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.
Application Submitted BY(print name .Patricia C. Moore BAuthorized Agent ❑Owner
Signature of Applicant: Date:
STATE OF NEW YORK)
SS:
COUNTY OF Suffolk )
Patricia C. Moore
being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the Attorney - Authorized Agent
(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
n day of cd 20
Notary Public
MADISON MESSINA
Notary Public,State of New York
PROPERTY IER AUTHORIZATION No.01 ME6370536
(Where the applicant is not the owner) Qualified in Suffolk County
Commission Expires February 05,ZO
12585 Sound LLC residing at 1647 E Jericho Turnpike, Huntington
NY 11743 do hereby authorize Patricia C. Moore to apply on
my behalf to the Town of Southold Building Department for approval as described herein..
Owner's Signature C Date
ALA 4 i 275-S575o,rd Lt C
Print Owner's Name
2