HomeMy WebLinkAbout53096-Z TOWN OF SOUTHOLD
II 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 WORD AUTHORIZED)
Permit#: 53096 Date: 06/29/2026
Permission is hereby granted to:
James A Richter
705 Front St
Greenport, NY 11944
To:
Construct porch repairs to an existing single-family dwelling as applied for.
Premises Located at:
75750 Route 25, Greenport, NY 119"
SCTIVI#48.4-11
Pursuant to application dated 06/11/2026 and approved by the Building Inspector.
To expire on 06/28/2028.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling- Addition&Alteration $330.50
CO Single Family Dwelling-Addition/Alteration $100.00
Total 430.50
Building Inspector
tt
TOWN OF SCE C-TT'HOLD--BUILDING
DEPARTMENT
nee. 5� 7 �
Town. Hall An 5 N,,'�a'n Road P. 0. Box 1179 S outhold
Telephone (631) 765-1 02 �'�, (631)
� 1197I-0959
x ? 502 ht ?
APPLICATION FOR BUILF:31ING
PERMITDate Received
,»
For Office Use Only
PERMIT NO. 53PA,le. Building InsP ec-t
....... N1 2()26
Applications and forms must be,filled out in their enrl ire. Incomplete
Pli a i n viil not he acre ted ''Where the Apprl Ca is not the owner,an
Owner's Authorizationform(Page 2)shall be com et .
n
i
Date:
OWNfER(S)OF PRO,P,ERTY. I IN
Name: Aiv e6 A*
SCTM#1000-
Project Address:
10 5 F Ro�Jr Rao)
Pone#: 69 31 V 7 Ct Email:
Mailing Address:
CONTACT PERSON:
NamesSA
Mailing Address
Phone#: Email:
DESIGN PROFESSIONAL INFORMATION:
Name: "A ,
Mailing Address,-
Phone#: Ernail
CONTRACTOR INFORMATION:
Name:
err
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
ONew Structure ❑Addition CfAlteration,Repair
❑Demolition Estimated Cost of Project:
olect.
Other
------------
Will the lot be re-graded? ❑Yes No Will excess fill be removed from premises? ❑Yes 1KNo
--------------
v�ffi�a°
pI OPER`I I INFORMATION
Intended use of property:
f p o
use roperty:
Existing
. • which remises is situate Are there.any
covenants and restrictions with reslb
e or use district In w p � Yes No IF YES, PROVIDE A C
Zone this property.
for all drainage and storm water issues as provi
d I n : The owner/contractor/design professiionaN is responsible of a Building Permit pursuant to the
[l Check fox After tea � � construction of buildings,
Code. APPLICATION IS HEREBY MADE to the Building Department for the
o Regulations,for the
Chapter 23fi of the Town Co New York and other applicable Laws,Ordinances
Ordinance
of�the Town of Southold,Suffolk,County, 'cant a sees to comp
additions, ly with all applicable laws,ordinances,building code,
ition as herein
alterations or for removal or demol described.The applicant building(s)lding(s)for necessary inspections.False statements made herein are
g
housin code and regulations and to admit authorized inspectors of he N
punishable as a Class A m ew York`State Penal Law.
isderr3eanor pursuant to Section 2lQ•4S
-,OR 4
" -rf Aj--6,
� owner
A M� [Authorized Agent ,
Applica
tion Submitted By nt narne):
Date:
Signature of Applicant*, CONNIE D.BUNCH
gState of New York
� ovary p'ubllc,
No.01 BU6185050
Vv YORK Quill#led in Suffolk County
STATE OF NE }
SS: Commission Expires April 14, 2�&
COUNTY OF
being duly sworn deposes and says that (s)he is the applicant
----------
Name of Individual signing contract)above named,
g g
S he is the to officer, etc.)
} o,
r
a
� or
t
C
Contractor,Agen , p
performed the said work and to make and file this
is dui authorized to perform or have per/ a and belief; and
of said owner or owners, and tion are true to the best of his/her knowledg
•that all statements contained In this application
h in the application file therewith.
k will be pP
that the work Performed in the manner set fort
Sworn before me this
j
.—day 2 a
of ��� NotaryPublic
P ROPERTY OWNERAT
(Wherep�the applicant is not the owner)
los
Kf,,,5 Al residing at F
l
to apply0n
do hereby authorize
nt for a royal as described herein.my r if
to the T n Southold Building Departme lap
—'f—2-G
Date ae
Owner's Signature
nF
Print owner's Name
2