HomeMy WebLinkAbout53124-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#: 53124 Date: 07/15/2026
Permission is hereby granted to:
Jonathan Ellinghaus
620 Pelham Rd Apt 2A
New Rochelle, NY 11805
To:
construct repairs(waterdamage from broken pipe)to an existing single-family dwelling as applied for.
Premises Located at:
840 Little Neck Rd, Cutchogue, NY 11935
SCTM#97.-7-26.6
Pursuant to application dated 06/24/2026 and approved by the Building Inspector.
To expire on 07/14/2028.
Contractors:
Required Inspections:
Fees•
Single Family Dwelling- Alteration $250.00
CO-RESIDENTIAL $100.00
Total $350.00
ilding Inspector
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TOWN OF SOUTHOLD-BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold, NY 11971-0959
Telephone (631) 765-1802 Fax (631) 765-9502 htt s:,/' r w.southo dto�vnn . � .
x
Date Received
APPLICATION FOR BUILDING PERMIT
x
Office Use Only R
PERMIT N0. Building Inspector;57�
4
Applications and forms must be filled out in their entirety.Incomplete
applications will not be accepted. Where the Applicant is not the owner,an 'Irr pnt t1�1 n
tl n.aw
Owner's Authorization form(Page 2)shall be completed. Town Of ootho,ld
OWNER(S)OF PROPERTY:
Name: O i \ l� SCTM#1000- .,
Project Address;
Phone#: ►'1 Email: 1 �I11 �GIUs �' QED Vd 64W
Mailing Address: (,
CONTACT PERSON:
Name: D -e% 17�
Mailing Address: C(�
r
Phone#: 1111s, Email: i A . M
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name: A-U
Mailing Address: /r �
Phone#: �p f �� 1p �� Email:ro D / yon
DESCRIPTION OF PROPOSED CONSTRUCTION
El New S� P " Demolition E` ate�ost of Project:
t uctt�re ❑Addition ❑Alterati r� R air ❑
Will the lot be re-graded? []Yes o Will excess fill be removed from premises? ❑Yes o
1
PROPERTY INFORMATION
Existing use of property: Intended use of propert t T r�
......_........... ....._....
Zone or use district in which premises is sit ated: Are there any covenants and dstrictinns with respect to
this property? ❑Yes &Ao IF YES, PROVIDE A COPY.
'Check BOX After Reading: The owner/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(print name): ❑Authorized Agent f r
PP P g
GU ��i � hau5
Signature of Applicant: J MUNIE D. BUNCH
Notary Public,State of New York
No.01BU6185050
STATE OF NEW YORK) ✓ ^ uaatiiff d in,Suffolk County
SS: Commission E'XpiresAprll 14,2
COUNTY OF^ )
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
ofday of ���-Q Z00 �� Ct 0)
Notary Public
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
I, ... ............_........__......... .......... residing at...... ........ .. .......... ... ..M ...._
.do hereby authorize ... to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
.....
...._ ......._. . .....
Owner's Signature Date
Print Owner's Name
2
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Young & Young, Land Surveyors
400 Oatrander Avenue, Riverhead, New York 11901
��uttg 516-727-2303 1
Ate Iv Young. P-9 &&Ss IYGR=t a4)
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3 4p o NOTES:
o prep 1. ■- MONUMENT FOUND
i O 2. SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF
SUFFOLK COUNTY ON NOV. 3% 1973 AS FILE NO. 6048.
'lIE7L
"# SURVEY FOR:
RICHARD B. SMITH & DONNA M. SMITH
v 7 LOT NO. 6, "LITTLE NECK PROPERTIES"
m °t At: EAST CUTCHOGUE Town of: SOUTHOLD °
1 Suffolk County, New York
Suff. Co. Tax Map: 1000 97 7 26.6
rDIdrkl ebcr FLO
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CERTIFIED PJCHARD SMITH DON x
DONNA M.. SMITH
BRIDGEHAMPTON NATIONAL BANK °
COMMONWEALTH LAND TITLE INSURANCE COMPANY JJ
(L-237704) a
fifl
DATE :SEPT. 23, 1997 •ti-
SCALE .1"= Y
JOB NO .97-0633 ON
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SHEET NO..1 OF 1 ji
'970633Ov 411