HomeMy WebLinkAbout53119-Z TOWN of SOUTHOLD
BUILDING DEPARTMENT
� SOUTHOLD, NY
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT CAN THE PREMISES
WITH ONE ,SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION O►F THE WORK AUTHORIZED)
Permit#: 53119 Gate: 07/14/2026
Permission is hereby granted to:
53995 Rt 25 LLC
3 Greenacre Ct
Great Neck, NY 11021
To:
Construct alterations to the first floor of an existing commercial building as applied for to relocate the
side entrance and add an ADA compliant bathroom as applied for.
Premises Located at:
53995 Route 25,Southold, NY 11971
SCTM#61.4-20
Pursuant to application dated 04/17/2026 and approved by the Building Inspector.
To expire on 07/13/2028.
Contractors:
Required Inspection..
DRAINAGE, FOOTING/REBAR, FOUNDATION 1ST,FOUNDATION 2ND, FRAMING/STRAPPING, PLUMBING.,
ELECTRICAL- ROUGH,, FIRE RESISTANT PENETRATION, ELECTRICAL-FINAL, INSULATION, FIRE SAFETY
INSPECTION , FIRE RESISTANT CONSTRUCTION, FINAL,
Fees:
Commercial-Addition&Alteration $350.00
CO Commercial-Addition/Alteration $100.00
Total $450.00
Building Inspector
F C� JTH(�Ll� --BUILDING DEPARTMENT'TOWN O
r � Town Hall Annex 54375 Main Road P. 0. Box 1179 Southold NY 1 1 97 1-0959
Telephone (631) 765-1802 Fax (631) 765--9502�11�1. s�. �wx�vs�ouft� dfo Y
nµ I
Date Received
Ll�-- L!) I
:,a
kPPLIC ►TIONF - RBUILDINGPERM-IT
m `
r Office Use Only N 2026
For y � � .�. �
,
l
�J
PERMIT NO. Building Inspector:
Applications and forms mint be filled out in their entirety. Incomplete
applications will not be accepted. where the Applicant is not the owner,an
Owner's Authorization farm(Page 2)shall be completed.
Date:6.1 2.26
OWNER(S)OF PROPERTY:
Narne:Justin Mirro 53995 Rte. 25 LLC SCTM# 1000-61-1-20
Project Address:53995 Main Rd. Southold
_� mmmmmmmmmmm�mmmmmmmmmmmmmmmmmmmmmm mm mmmm mm
Phone#:1-646-382-5153 Email:jmirro@kensington-cap.com
Mailing Address:
CONTACT PERSON:
Name:Joan Chambers
Mailing Address:pO Box 49 ,Southold NY 11971
Phone#:831-294-4241 Email:`oanchambersl O@gmaii.com
�
DESIGN PROFESSIONAL INFORMATION:
Name:Lou Schwartz
Mailing Address:7 Ridgewood St. Bay Shore NY 11706
Phone#:631-41 a-6838 Emailliderunneren9Q9 rnail.com
CONTRACTOR INFORMATION:
Name:
--------------
Mailing Address:
Phone#: Ennal i
k,
DESCRIPTION of PROPOSED CONSTRUCTION
❑New Structure ❑Addition RAlteration D Repair ❑Demolition Estimated Cost of Project:
7Other
ADA Bathroom @ shops on first floor. Repairs to entry doors.
Will the lot be re-graded? C]YesRNo will excess fill be removed from premises? DYes A No
1
PROPERTY INFORMATION
Existing use of Property:Retail mixed Intended use of property:same
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
H B this property? E]Yes No IF YES, PROVIDE A COPY.
------------------- ............
CIIIII'�Iieck Box Aft���- Readingo. The owner/contractor/design professional is responsible for all drainage and storm water issues as pravided by
Chapter 236 of the Town Code. APPILICATION 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 210AS of the New York State Penal Law.
Applicaflon Submitted By(print name):J oan ���"1 a m bers MAuthorized Agent ❑Owner
Ok**"y"id by
Signature of Applicant: net%.9 IS M1925-04vw Date:
CONNIE D.BUNCH
STATE OF NEWYORK) Notary Public,State of New York
No.01 BU6185050
SS: Qualified in Suffolk County
Commission Expires April 14,2WY
COUNTY OF
Joan Chambers being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the Agent
(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 &
0) M tv%111P �&p
day of 20 14 1,17 Notary Public
E
PROPRTY OWNER AUTIAORIZATION
..uuuuuu u..uu.................. I .......................................... .........................................
(Where the applicant is not the owner)
4 Justin Marro
residing at
—do hereby authorizeJoan Chambers to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
Dikq�ltoft�sotaJ by b3-
Da1c,20,26 03.19 1 19A 5-W'W
Owner's Signature Date
Print Owner's Name
2
..............