HomeMy WebLinkAbout52889-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#: 52889 Date: 04/20/2026
Permission is hereby granted to:
Milo BD LLC
110 Riverside Dr Apt 12B
New York, NY 10024
To:
legalize "as built"alterations to an existing single-family dwelling as applied for. Additional
certification may be required.
Premises Located at:
1465 Harbor Ln, Cutchogue, NY 11935
SCTM# 103.-2-1.1
Pursuant to application dated 03/16/2026 and approved by the Building Inspector.
To expire on 04/19/2028.
Contractors:
Required Inspections:
Fees:
As Built Alteration $1,379.50
CO-RESIDENTIAL $100.00
Total $1,479.50
Building Inspector
Docusign Envelope ID:88433CAA-OC8E-8324-83C5-A34171 D61 EF9
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
svt 040
Date Received
APPLICATION FOR BUILDI�NG PERMIT
For Office Use Only
PERMIT NO._ 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
Owner's Authorization form(Page 2)shall be completed.
Date:3/10/26
OWNER(S)OF PROPERTY:
Name:JED FINN sCTM#1000-103-02-1.1
Project Address:1465 HARBOR LANE CUTCHOGUE NY 11935
Phone#: 9177507724 Email:jed.finn@gmaii.com
Mailing Address: 110 Riverside Drive apt 12B, NY, NY 10024
CONTACT PERSON:
Name:
Mailing Address:
Phone#: Email:
DESIGN PROFESSIONAL INFORMATION:
Name:KATHERINE SAMUELS
Mailing Address:25235 MAIN ROAD CUTCHOGUE NY 11935
Phone#:631-734-6405 Email:KATE@SAMUELS AND STEELMAN.COM
CONTRACTOR INFORMATION:
Name:SCOTT EDGETT
Mailing Address:PO Box 1407 SOUTHOLD NY 11971
Phone#:631-298-7900 1Email:scoff@nfwoodworks.com
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition RAlteration ❑Repair ❑Demolition Estimated Cost of Project:
Other 200,000
Will the lot be re-graded? ❑Yes WNo Will excess fill be removed from premises? ❑Yes WNo
1
Docusign Envelope ID:88433CAA-0CBE-8324-83C5-A34171 D61 EF9
PROPERTY INFORMATION
Existing use of property:RESIDENTIAL Intended use of property:RESIDENTIAL
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? Dyes WNo IF YES, PROVIDE A COPY.
❑Check x 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. APPUCATION 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): S l/l� t4uthorized Agent ❑Owner
Signature of Applicant: Date:
CONNIB D.BUNCH
Notary Public,State of New York,
STATE OF NEW YORK) No.0 1 BU6186050
SS: Qualified In Suffolk County �w µ
COUNTY OF ) Commission Expires April 14„2_1
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
"y of�� 0 --
Notary Public
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
Jed Finn 110 Riverside Drive apt 12B
I, .residing at
Kate Samuels
dui hereby authorize to apply on
my behalf to the Tow hold Building Department for approval as described herein.
3/10/2026
Owner's Signature Date
Jed Finn
Print Owner's Name
2