HomeMy WebLinkAbout53092-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#: 53092 Date: 06/26/2026
Permission is hereby granted to:
Breezy Shores Comnty Inc
PO BOX 925
Mattituck, NY 11952
To:
demolish an existing dwelling(#29) due to fire damage as applied for perTrustees approval.
Premises Located at:
65490 Route 25, Greenport, NY 11944
SCTM#53.-5-12.6
Pursuant to application dated 06/22/2026 and approved by the Building Inspector.
To expire on 06/25/2028.
Contractors:
Required Inspections:
Fees:
DEMOLITION $10069,00,
Total 1069.00
Building Inspector
to
TOWN OF SOU'xHOLD--BUILDING DEPARTMENT
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Town Hall Annex 54375 Main Road P. 0. Box 1179 Southold, NY 11971-0959
Tole hone �31) 7 5-1802 Fax (631) 765-9502 htt s:/lvcr�c w s i , n o)A . . ov
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Date Received
APPLICATION FOR BUILDING
PERMIT
For Office Use only
Q
PERMIT NO Building Inspector. ��d 12 2, 20'P
Applications and forms must be filled out in their entirety.Incomplete . . n
applications will not be accepted. There the Applicant is not the owner,an n
Owner's Authorization foam(Page 2)shall be completed.
Date. .5-UAU E_
OWNER(S)OF PROPERTY:
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Name. ` " f" �m
i
Project Address: �` C'� 2-v r.It/ pU JAJ
Phone#: _ Email:M/&,Z6 A R F��} 1A (61fl
. . 1070 1
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M allln Addr �1 C
CONTACT PERSON:
w Names /� ��.'�.� '� 9F' ) �I�Ylr%w�
Mailing Address:
�C
Phone#:� � _ Email: ,,''1A��,�..k �� � �R y +�%� � (6
DESIGN PROFESSIONAL INFORMATION:
Name*
Mailing Address:
Phone#: Email::
CONTRACTOR INFORMATION:
N a m e: C L ', 1J hl y' - Jv N
r.,-
A
Mailing Address . , RbAJ KOK)� A,
Phone#: - "�( Email: �'w"`• }� D �.�� R R)V E>
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DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Struc ture ❑Addition ❑Alteration ❑repair XDemolition Estimated Cost of Project:
2(
Other re-graded? 7Yes V-)
INIII the lot be r -
No Will excess fill be removed from premises? ❑Yes ANo
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PROPERTY INFORMATION
Existing use of property: 'INC)j P, FA/Kjt kAArt- intended use of property: s)vr, 6 Pr AAq c
Zone or use district in which premises is situated.- Are there any covenants and restrictions with respect to
..
this property? Yes XNo IF YES, PROVIDE A COPY.
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—eCheck Box After Reading: The own er/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 p i, t name): F)64�r�,� /<Er Aj (z Z/Authorized Agent FlOwner
Signature of Applicant: Date: ,r �.� ,�,
CON, E D.BUNCH
Notary Public,State of New York
STATE OF NEW YORK) No.OIBU6185060
SS: Qualified in Suffolk County
Commission Expires April 14,2
COUNTY OF Commii Ei D�ks-ll
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
7 � ... '
a' of
20
y
Notary Public
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
De fZ Rd
I residing at
J 111 161t�8
do hereby authorize i c iq a- v try'�eK to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
Q CQ 6
erps Signature Date
C' Pr e,V1
Print Owner's Name
2
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Town Hall Annex
Glenn Goldsmith,President 54375 Route 25
A Nicholas KxuPski,Vice President P.O. Box 1179
Eric Sepenoski Southold, New York 11971
:biz Gillool Telephone 1 7 -1 9
Joseph Finora Fax 1 76 -6 41
BOARD OF TOWN TRUSTEE
TOWN OF SOUTHOLD
Permit No.: 10973A
Date of receipt of Application: June 9, 2026
Applicant: Margaret Heidenry
C T M#: 10 0 0-53-5-12.6
Prot Locati ! Route 25, Breezy Shores Cottage #29, Greenport
, c
Dateof Resolution/ l nice: June 10, 2026
Date of Expiration: June 10, 2029
Reviewed by: Board of Trustees
Project Description: remove debris from dwelling destroyed by fire.
Findings: h project meets all there uireme�nts for issuance of an
Administrative r it set forth, in Chapter 275 .f the Southold Town Code. The
�
issuance
of an Administrative Permit allows for the operations as indicated on the
i plan, prepared b Margaret Heidenry, received on June 9, 202+6, and
site p Y 9
stamped approvedon June 10, 2026.
Special Conditions: None.
Inspections: Final Inspection.
If the proposed activities do not meet the requirements for issuance
Adm
inistrative Permit set forth in Chapter 275 of theSouthold Tolwn Code, a
Wetland Permit will be required.
This is not a determination from any other agency.
AW
Ayoo�
Glenn Goldsmith, President
Board of Trustees
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