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Home My WebLink About52873-Z TOWN OF SOUTHOLD "I 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#: 52873 Date: 04/17/2026 Permission is hereby granted to: Debra Tellekamp 40 Aberdeen Rd Smithtown, NY 11787 To: construct alterations to an existing single-family dwelling as applied for. Premises Located at: 275 parsons Blvd, East Marion, NY 11939 SCTM# 37.-2-3 Pursuant to application dated 03/13/2026 and approved by the Building Inspector. To expire on 04/16/2028. Contractors: Required Inspections: Fees: Single Family Dwelling- Alteration $397.00 CO-RESIDENTIAL $100.00 Total S497.00 wing Inspector TOWN C�F C)U �TH LD--BUILDING DEPARTMENT I Town Hall Annex 54375 Main Read P. 0. Box 1179 Southold,NY 11971-0959 tf Telephone(631) 76 5-1802 Fax (631)765-9502 ` � r n H, ldto i, Ir °l f l Cate Deceived APPLICATION IM1011, BUILDING PERMIT n p ul WwMa"uW' LA a ,For,Office Use Only i 5e A R �„ PERMIT NO. Building Inspector:-, � ... . ..... Applications and farms 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:0 -11-2026 OWNER(5)OF PROPERTY: Name: Debra Tellekamp sc-rm#1000_3 7,_2- , Project Address. 275 Parsons Blvd. East Marlon i Phone#:6 1_942-3234 Email:d bra lusltanoenterf rlses.com ............ Mailing Address:40 AberdeenRd. Smithtown, NY 11787 CONTACT PERSON: Name:Debra Tellekamp Mailing Address040 Aberdeen Rd. Smithtown, ICY 11787 Phone#: 1-942- 2 4 Email:debra@lusitanoenterpr'ises.com DESIGN PROFESSIONAL INFORMATION: Name: Daniella Ravn, R.A. r Mailing Address. 1171 Cold Country Road -- suite 8 Plainview, NY 11803 Phone#:631-885-1 41 Email:daniella@newhabitatarch.com � CONTRACTOR INFORMATION: Name: Rene Construction NY 1MMINIM M mwm im - - 1 1-I'll-- ","I'll Mailing Address:191 ROBINWOOD DRIVE WEST SHIRLEY NY 11967 83 348 701 Reneconstructlon80@gmall.com DESCRIMON OF PROPOSED CONSTRUMON M New Structure ❑Addition RAlteration 17 Repair Cl Dernolition Estimated Cost of Project: ❑other $32,000 Will the lot be re-graded? Clues ii No Will excess fill be removed from premises? ❑Yes No .............. PROPERTY INFORMATION Existing use of property.single family resideence Intendeduseofproperty:Single family residence i NONE 101011 00 0,Mono Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? F7lYes*,No IF YES, PROVIDE A COPY. 'R-40 es as provided by Check Box Aftler The owner/contractor/design professional Is responsible for all drainage and storm water Issu Chapter 236 of the Town Code. APPLICATION I'S 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,Now York and other applicable Laws,Ord Inonces or Regulations,for tho construction of bulldlnp, additions,alterations or for removal or demolition as herein described.The applicant agrees to comply with afl applicable tows,ordinances,building code) housing code and regulations and to admit authorized Inspectors on promises and In buliding(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): DAuthorized Agent Owner zo Date: '10" Signature of Applican, de STATE OF NEW YORK) SS: COUNTY OF being duly sworn,deposes and says that she is the applicant (Name of Individual signing contract)Wbee named, (S)he is the \7-\ (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 app lication;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. oovl Sworn before me this 1�- 20 JWSEPHNE aALDXSWE ry Public 'It y0f*11,10ta,fy Pobbc,SU t*j,0�18=52,3w (),�jaWled in Suff,*C;oonty 0 Ex OWN E R AUTHO R I ZAT (Where the applicant is not the owner) 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 2 6 3 62 61 6 S31*01'30.0*E 6'STOK.FE. 6' STOK.FE. 100.00' *mw mom�101111111 mp: FE.0.WS FE.0.5'N 74 73 ui IS75 CONC. 72 WD. DECK, FE.O.4S ID S1X, WAtX G \— WD, 61 K. F-- ST,pS,. 5v.5 124 GATE 5.8' ZA.C. 3i C.E. FE, 2,1'N FE. 0.4'S J-7 4' PIK, FE. I�24 4,11PIK 44.1"' 11.7' 1 STY. FR.#275 (GAR.) C6 12.03 26.5' ... ku 44S PLNT. w.w, WD. PORCH WX WD. sps. BIRK. WW C4: WELLO CALCI, R'- 20,220 EA 1 4 0 ApNx ANN- UNAUTHORIZED ALTERATION OR ADDITION TO A SURVEY W BEARING A LICENSED LAND SURVEYOR'S SEAL IS A VIOLATION OF SECTION 7209,SUBDIVISION 2,OF THE NEW YORK STATE EDUCATION LAW. 02025 CERTIFIED TO: SURVEY OF LOTS 73 & 74 MAP OF "GARDNERS BAY ES TA TES, SEC. 2 SITUATE AT EAST MARION dal II TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK SCALE 1`--20 OCTOBER 21, 2025 EASEMENTS AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THETIME OF THE SUM. GUAIWiTEES INDICATED HEREON SHALL ONLY RUN TO THE PERSON(S)FOR WHOM THE SUM IS PREPARED,AND AMERICAN ENGINEERING ON HIS BEHALF TO THE TITLE COMPANY,GOVERNMENTAL AGENCY AND LENDING INSTITUTIONS LISTED,AND TO THE ASSIGNEES OF THE LENDING INSTITUTION.GUARANTEES ARE NOT TRANSFERRABLE,TO ADDITIONAL INSTITUTIONS OR AVA & LAND SURVEYING P.C.' SUBSEQUENT OWNERS. THE OFFSET DIMENSIONS SHOWN HEREON FROM STRUCTURES TO THE PROPERTY LINES ARE FOR A SPECIFIC PURPOSE AND ARE NOT INTENDED 70 GUIDE THE ERECTION OF FENCES,RETAINING WALLS,POOLS,PATIOS, 1171 old country road-ste.6 PLAN71NG AREAS,BUILDING ADDITIONS OR ANY OTHER CONSTRUCTION, Plainview,ny 11803 R,/1317§113'1 76�-275-PA,RSONS.DWG tel:5 16.454.7500 JOB NO. 13 176 MAP NO. 275 fax:5 16.822.2743 TAI' REVISIONS: FILED 0912JI1927 www.aelandsurveying.com S.C.T.M. DIST. 1000 SEC. 37 BLK. 2 LOT 3 STEPHEN E. RAVN, P.E., L.S. (LS. NO. 496J64)