HomeMy WebLinkAbout52941-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#: 52941 Date: 05/04/2026
Permission is hereby granted to:
CAST I n c
PO BOX 1566
Southold, NY 11971
To:
Legalize three (3) HVAC units as applied for.
Premises Located at:
53930 Route 2% Southold, NY 11971
SCTM#61.4-19.1
Pursuant to application dated 04/24/2026 and approved by the Building Inspector.
To expire on 05/03/2028.
Contractors:
Required Inspections:
Fees:
As Built HVAc $600.00
CO Accessory $100.00
Total $700.00
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8uifafnglInspector
T'+ T t "Z' OLD--BUILDING DEPARTMENT
Town roll Annex 54375 Main Road P. 0. Box 1179 Southold,NY 11971-0959
Telephone (631) 7 5-�1 02 Fax (631) '7 5-95 2 � t�- s� , �� .s,ou liol , ]',,I,� �o
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
PERMIT NO,, Building Inspector.
Applications and forms must be filled out in their entirety.Incomplete V JP
applications will not be accepted. Where the Applicant is not the owner,any
Owner's Authorization form(Page 2)shall be completed.
Date:April 24, 2025
OWNER(S)OF PROPERTY.
Name:Erica Steindl SCTM#1000- Lo
-- --
Project Address: 39 0 Main Road, Southold, NY1 1971
Phone#.631-477-1717 Email:o, toindl castnorthfork.org
Mailing Address:PO Box 1566, Southold, NY 11971
CONTACT PERSON:
Name:Cora Fitzgerald
Mailing Address:PO Box 1566
Phone#:631-477-1717 Email:cfitzgerald@castnofthfork.org
DESIGN PROFESSIONAL INFORMATION
Name:N/A
Mailing Address:
Phone#: Email,.:
CONTRACTOR INFORMATION:
Name:N/A
................... ------
Mailing Address-:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure DArd.ition FlAlt+eration CJ Repair ❑Demolition Estimated Cost of Project:
g_Art n $12,708 See Attached
Will the lot be re-graded? Ell �1 No ill excess fill be rernov d from premises? -]Yes ®No
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? F]Yes F1No IF YES, PROVIDE A COPY.
F1 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 Sectio 6 210.45 of the New York State Penal Law.
Application Submitted By(print name):Cora Fitzgerald RAut,horizecl Agent Oowner
Signature of Applicant Date.
CONNIE D.BUNCH
STATE OF NEW YORK) Notary Public,State of New York
SS: No.0IBU6185050
COUNTY OF Qualified In Suffolk County
Commisslon ExplresAprll 14,
laf(11 being duly sworn, deposes and says that(s)he is the applicant
(Name of indivi l i,gning 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
C-6
ay of —120 Notary Public
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
Erica- Steindl residing at 5393o Malin Fed, Southold, NY 11971
,do hereby authorize Cora Fitzgerald to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
161;62
Owner's Signature ate
Erica Ste i n d I
Print Owner's Name
2
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