HomeMy WebLinkAbout53116-Z TOWN OF SOUTHOLD
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BUILDING DEPARTMENT
SOUTHOLD, NY
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BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH NS,ETOF APPROVED PLANS, AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 53116 Date: 07/09/2026
Permission is hereby,granted to:
Erin Occhiogrosso
150 Mayflower Rd
Mattituck, NY 11952
To:
construct interior alterations and to legalize an "as built"finished basement to an existing single-
family dwelling as applied for. Additional certification may be required.
Premises Located at:
150 Mayflower Rd, Mattituck, NY 11952
CTM# 107.-8-31
Pursuant to application dated 06/01/2026 and approved by the Building Inspector
To expire on 07/08/2028.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling- Alteration $427.63
As Built Alteration $767.00
CO-RESIDENTIAL $100.00
Total S1,294.63
Building Inspector
F 0� TOWN OF SOUTHOLD BUILDING DEPARTMENT
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n Town Hall Annex 54375 Main Road P. 0. .Box 1179 Southold,NY 11971-0959
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Telephone (631) 765-1802 Fax (631) 765-9502 h.tt "� o � ,�l t 0
Date Received
APPLICATION FOR B PERMIT
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For Office Use Only
PERMIT NO. Building Inspector:
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Applications and forms must be filled out in their entirety.Incomplete
applications will not be accepted. Where the Applicant is not the owner,an
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Owne 's Authorization form(Page 2)shall be completed.
Date:611126
OWNER OF PROPERTY:
Name: Erin Occhiogrosso SCTM # 1000-107-08-31
Project Address. 150 Mayflower Road, Mattituck, NY 11952
Phone#:631-488-r1341 Email:erinhalladaYa gmail.com
Mailing Address: 150 Mayflower Road, Mattituck
CONTACT PERSON:
Name:Brooke Epperson
Mailing Address: PO Box 152, Mattituck, NY 11952
Phone#:631 603 9092 Email:hopperson@amparchitect.com
DESIGN PROFESSIONAL INFORMATION:
Name:Anthony Portillo
Mailing Address: pp Box 152, Mattituck, N.Y. 11952
Phone#.631 603 9092 Email:aportillo@amparchitect.com
CONTRACTOR INFORMATION:
Name:
Mailing Address:
Phone#: Email.
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition Alteration ❑Repair ❑Demolition Estimated Cost of Project:
❑other convert attached garage into living space $,15.000
Will the lot be re-graded? [❑Yes @R No Will excess fill be removed from premises? ❑Yes iRNo
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p"FoP" FtT INFORMATION
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Existing use of property:ShVLPF j JW Fp. Intended use of property:;' h9F "j Wtl� l
Zone or use district in which premises is situatedA Are there any covenants and restrictions with respect to
this property? ❑Yes ■No IF YES, PROVIDE A COPY.
PRO
Check Box After • The owner/contractor/'design professional is responsible for all drainage and storm water issues as provided by
Chapter 236 of the Town Cade. APPUCATION IS HEREBY MADE to the Building Department for the issuance of 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 bulldings,
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 st«�mer�ts made herein are
punishable as a Class A misdemeanor pursuant to Section 210.4S of the New York State penal Law.
AM Y h Ict ■
Application Submitted By('prl,t,a,r aime): � � �� ■Authorized Agent ❑Owner e
ure of Applicant:
Date:
Signat
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STATE OF NEW YORK)
SS:
COUNTY OFu }
c being dui sworn, deposes and says that(s)he is the applicant
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(Name of individual signing contract) above named,
(S)he is the
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(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
.� day ofZL .......... --- -------
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TIF'FANI J BE REZNY
Notary Public-State.of New York
No.01 BE6284112
Qualified in Suffolk County
PROPERTY OWNER AUTHORIZATION my commission Expires 06/17/2029
(Where the applicant is not the owner)
tour Cti��C
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
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Print owner's Name
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