HomeMy WebLinkAbout53080-Z r TOWN OF SOUTHOLD
0
BUILDING DEPARTMENT
THOLD NY
SOU ,
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#: 53080 Date: 06/23/2026
Permission is hereby granted to:
Melvin Parker
215 E 68th St Apt 10-0
New York, NY 10065
To:
Construct a deck addition to an existing single-family dwelling as applied for to replace the existing
rear deck. Floodplain development permit is required.
Premises Located at:
905 Bay Haven Ln, Southold, NY 11971
SCTM#88.-4-34
Pursuant to application dated 06/03/2026 and approved by the Building Inspector.
To expire on 06/22/2028.
Contractors:
Rewi red inspect'io s
FOOTING/REBAR, FRAMING/STRAPPING, DRAINAGE, FINAL,
Fees:
Single Family Dwelling- Addition&Alteration $395.50
CO Single Family Dwelling-Addition /Alteration $100.00
Flood Permit $150.00
Total 645.SO
-A. i
Building Inspector
"f
TO
WN WN of SOUTHOLD—BUILDING DEPARTMENT
} Town Hats Annex 54375 Main Road P. 0. Box 1179 Southold,STY 11971-0959
d Telephone(631) 765-1802 Fax (631) 765-9502 rt r
Date Received
APPLICATION FOR BUILDING PERMIT
Liff",
For Office Use Onlyv7%I
D5C)
Building
�11
PERM IT NO.
Applications and forms must be filled out in their entirety. Incomplete
applications will not be accepted. where the Applicant is not the owner,anrt
Owner's Authorization form(Page 2 shall be completed.
Date: May 28, 2025
OWNER(S)OF PROPERTY: -------
Name: Melvin Parker SCTM# 1000-
Project Address: 905 Bay Haven Lane, Southold, NY 11971
Phone#:917-596-5105 Email:
Mailing Address: 215 East 58th Street, 10-0, New York, NY 10065
CONTACT PERSON:
Name: Melvin Parker
Mailing Address: 215 East 88th Street, 10-0, New York, NY 10065
Phone#:917-695-6105 Email: mel@melparkerbooks.com
DESIGN PROFESSIONAL INFORMATION:
Name. !,a,OJ
Mailing Addre
ss:Sr
,OAJ
Phone#: Email:
CONTRACTOR INFORMATION:
Name: , �6
r o
��
Mailing Address: 13 "�
i
�,, ! AJ
Phone#: ' ,,.. Email:
o D
efiyF:
DESCRIPTION OF PROPOSED CONSTRUCTION
Cl
New t. u�tre ❑Addition Alteration El Repair ❑Demolition Estimated Cost of Project:
ClE New Stuture OAddition
i
C oth er
fat be re- raded? DYes o will excess fill be removed from premises? MYes DKO
Will the g
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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-lYes [� IF YES., PROVIDE A COPY. ......
lkCh eck Box Aft et,R ea d eft g The e ow,,Aer/tionty,act�or/d,es:ign Profess lonal is responsible for all drainage and storm,water issues as proMed
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 cod*and regulations and to admit authorized inspectors on promises 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.
arker
Application Submitted By%( `Int DAuthorized Agent Nowner
2...o2Z
Signature of Applicant: Date:
STATE OF NEWYORK)
COUNTY OF
being duly sworn, deposes and says that(s)he is the applicant
11%00'
(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 per-formed 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 fi t er with.
Sworn before me this
day of ............I
Notary Public
ENZA M.CUSENZA
Notary Public.State of New York
Registration No.01CU6183779
PROPER 1"Y OWNIER AUTHORIZA IF101Y Qualified in New York County
MN Commission Expires 012412028
(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 Data
Print Owner's Name
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