HomeMy WebLinkAbout52997-Z ��ofso�Tyo 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#: 52997 Date: 05/20/2026
Permission is hereby granted to:
Mary Anne Kelley
14 Wilda Ln
Waldwick, NJ 07463
To:
demolish an existing cottage as applied for per Trustees approvals.
Premises Located at:
1775 Naugles Dr, Mattituck, NY 11952
SCTM#99.-4-19
Pursuant to application dated 05/20/2026 and approved by the Building Inspector.
To expire on 05/19/2028.
Contractors:
Required Inspections:
Fees:
DEMOLITION $292.20
Total S292.20
----------------------------
Building Inspector
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4�g�FfO(t�o TOWN OF SOUTHOLD—BUILDING DEPARTMENT
y z Town Hall Annex 54375 Main Road P. O. Box 1179 Southold, NY 11971-0959
�y�o• �ao�� Telephone (631) 765-1802 Fax (631) 765-9502 https://www.southoldtownny.gov
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Date Received
APPLICATION FOR BUILDING PERMIT
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For Office Use Only
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PERMIT NO. Building Inspector:
Applications and forms must be filled.out in their entirety. Incomplete
applications will not be accepted. Where the Alpplicant is,not the owner 'in �Gtv peP�r
Owner's Authorization foram(Page 2)shall be completed:
Date: May 19 2 0 2 Co
"OWNER(S)OF PROPERTY:,
Name: Mar nn e. e e ��TM#.1000- 14,-73 FS g9 -97- H 1 ''
Project Address:
P 1.hone#: 2-o 1 - d p g - 0�31 1 A Email: T-F �e I2\ 6(o i co
Mailing Address: I q VV ( l a a Lan e VV a1 A W i .
C6NTACT'PERSON: '
Name:
Mailing Address: 14 w ( a Lanei Wod ui ( . 0-7 (o
Phone#: �dJQ Email: Z l \ (Mai Co Wl
.DESIGN PROFESSIONAL INFORMATION:,
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name: V U LL Coo e_r
Mailing Address:
2 2. 0 0 .. recuk-Wa.ip RJ Ma. . . 11-152
Phone#: 3 I - 02 7.�-- lD Z-1 5- Email:
'DESCRIPTION OF PROPOSED,CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair emolition E stimated Cost of Project:
❑Other $
Will the lot be re-graded? ❑Yes% No Will excess fill be removed from premises? ❑Yes XNo
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„ PROPERTY INFORMATION
Existing use of property: in 30- 5_1AM r bun ntended use of property: re-M Ve_ &OderoaSS(YtIC
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? ❑Yes)INo 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 Buokling;P,ermit pursuant to.the Building Zone
Ordinance of the Town ofSouthold,5uffdi' 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,inspector_s on premises arid in;building(s)for necessary inspections..False statements made herein are,
punishable as a Class Armisdemeanor,pursuant to Section 210.45;of the New York State,Penal Lain
Application Submitted By(print name): []Authorized Agent ❑Owner
Signature of Applicant: J U Date:
CONNIE D.BU7HZ
Notary Public,State of New York
STATE OF NEW YORK) No.01BU6185050
SS: oual(fled in Suffolk County
COUNTY OF ) Commission Expires April 14,2P-Vt 0
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
ao d y of M 20
Notary Public
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
� I
I, MQrghnx )�e&v residing at N Wilda Lo , Walit Ide, /VJ_ D°7163
do hereby authorize to apply on
my behalf to the Town of Southold Building Department for approval as described herein'
Owners Signature Date
Print Owner's Name
2
Glenn Goldsmith,President a S®(/J� Town Hall Annex
Nicholas Krupski,Vice President ®� ��Q 54375 Route 25
P.O. Box 1179
Eric Sepenoski Southold,New York 11971
Liz Gillooly ces Telephone (631) 765-1892
Joseph Finora �n w` �@ Fax(631) 765-6641
COUNT�,�
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Permit No.: 10965A
Date of Receipt of Application: May 1, 2026
Applicant: Maryanne Kelley & Dianne McKenna
SCTM#: 1000-99-4-19
Project Location: 1775 Naugles Drive, Mattituck
Date of Resolution/Issuance: May 13, 2026
Date of Expiration: May 13, 2029
Reviewed by: Board of Trustees
Project Description: Remove imploded bungalow.
Findings: The project meets all the requirements for issuance of an
Administrative Permit set forth in Chapter 275 of the Southold Town Code. The
issuance of an Administrative Permit allows for the operations as indicated on the
site plan prepared by Maryanne Kelley, received on May 1, 2026, and stamped
approved on May 13, 2026.
Special Conditions: None.
Inspections: Final Inspection.
If the proposed activities do not meet the requirements for issuance of an
Administrative Permit set forth in Chapter 275 of the Southold Town Code, a
Wetland Permit will be required.
This is not a determination from any other agency.
Glenn Goldsmith, President
Board of Trustees
11 E
5/13/2026
MARYANN MCKENNA-KELLEY Service To:
14 WILDA LA 1775 NAUGLES DR
WALDWICK,NJ 07463 MATTITUCK,NY 11952
Customer Project#:900000239058
Dear MARYANN MCKENNA-KELLEY:
This is to advise you that the PSEG-LI electric facilities at the above referenced location have
been disconnected and removed off the building structure that is located on the property.
Please note that there may still be PSEG LI facilities located within the property boundaries
and that NYS law(NYCRR Part 753)requires all contractors to call for a utility locate(NY
811)prior to performing any ground excavation or regrade activity. The call to the 811 Call
Center must be done at least 2 business days prior to the start of the work and confirmation of
utility marks having been identified must be received from all the facility owners prior to any
site work.
You must also contact National Grid at 631-348-6150 to procure a letter of demolition
associated with natural gas service,whether or not your home or business uses natural gas.
If you have any questions regarding the above,please contact Building&Renovation Services
at 1-844-341-6378 or via email at BRSLI@PSEG.com.
Very truly yours,
Katherine Gianelli
�-"0.
Building&Renovation Services
PSEG-LI
MaryAnne Kelley
14 Wilda Lane Waldwick , NJ 07463
5118/2026
Building Inspector
Town of Southold Building Department
53095 Main Road
P.O. Box 1179
Southold, NY 11971
RE: Certification of No Gas Utility I Demolition Permit Application
Property Address: 1775 Naugles Drive, Mattituck, NY 11952)
SCTIVI #: 473889-99-4-19
Dear Building Inspector,
Please accept this letter as formal notification and certification regarding the upcoming
demolition of the bungalow located at the above-referenced property (1775 Naugles
Drive).
hereby certify that there is currently no propane gas supplied by an attached storage
tank, nor is there any other type of natural, municipal, or bottled gas attached to or
servicing the structure scheduled for demolition. There are no active gas utilities present
on the premises.
Should you require any further information or an on-site inspection to verify the status of
the utilities, please do not hesitate to contact me at 201-888-2391
Thank you for your time and assistance in processing this demolition permit.
Sincerely,
MaryAnne Kelley
Property Owner y
FIELD INSPECTION REPORT DATE COMMENTS
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TOWN OF SOUTHOLD—BUILDING DEPARTMENT
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y x Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone (631) 765-1802 Fax (631) 765-9502 https://www.southoldtownnygov
BUILDING PERMIT APPLICATION INSTRUCTIONS& CHECKLIST
• Applications and forms must be filled out in their entirety. Incomplete applications will not be
accepted.
• The work covered by this application, including land clearing/site work, may not be commenced before
issuance of a building permit.
• No building shall be occupied or used in whole or in part for any purpose whatsoever until the Building
Inspector issues a Certificate of Occupancy.
• Every building permit shall expire if the work authorized has not commenced within twelve (12)
months after the date of issuance or has not been completed within eighteen (18) months from such
date. If no zoning amendments or other regulations affecting the property have been enacted in the
interim, the Building Inspector may authorize, in writing, the extension of the permit for an additional
6 months. Thereafter, a new permit shall be required.
ALL APPLICATIONS MUST BE SUBMITTED WITH THE FOLLOWING MATERIALS:
❑ Building Permit Application: Complete, signed and notarized.
❑A survey/site plan, drawn to scale at original size, showing the location of lot and of buildings on
premises, relationship to adjoining premises or public streets or areas and waterways.
[]Four (4) sets of plans bearing the signature and original seal of a NYS licensed professional engineer
or architect illustrating compliance with the Building Codes of New York State.
❑Contractor's proof of insurance and Suffolk County license:
• Certificate of Workers' Compensation Insurance (C105.2 or U26.3) AND a Certificate of
Disability Benefits Compensation Insurance (DB120.1)
• Certificate of Liability Insurance
"Note: Final Fees will be calculated by the Building Department using the fee schedule. Fees will be
collected after the permit is written"
ADDITIONAL DOCUMENTATION MAY BE REQUIRED AS IDENTIFIED BELOW:
❑Suffolk County Department of Health Services Approval (original copy)
❑Approval of the Zoning Board of Appeals, Planning Board, and/or Historic Preservation Commission
(if applicable)
❑Electrical Permit Application (FILED SEPERATELY): Electrician must have an active license with Suffolk
County
❑Flood Plain Development Permit Application (if applicable)
❑Southold Town Trustees Permits may be required: If any work will be done within 100' of a tidal or
fresh water wetland.
❑NYS D.E.C. Permits may be required: If any work will be done within 300' of a tidal wetland or 100' of
a fresh water wetland
❑1 copy of ComCheck/ ResCheck (if applicable)
❑1 copy of Manual J, Manual D and Manual S (if applicable)
❑Utilization of truss/pre-engineered wood/timber construction form (if applicable)
❑Single and separate title search (if applicable)
❑Curb cut permit (NYS or Suffolk County form 239F) (if applicable)
❑Original signed Owners Authorization: if applicant is other than owner.
3
4�OgUfFO(��oG TOWN OF SOUTHOLD—BUILDING DEPARTMENT
y�
T Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone (631) 765-1802 Fax (631) 765-9502 https•//www.southoldtownny.gov
INSPECTION & CERTIFICATE OF OCCUPANCY INFORMATION
It is the responsibility of the applicant, owner, or contractor to request inspections from the Building
Department. Construction must be completed and certificate of occupancy must be obtained within eighteen
(18) months, or the permit may need to be renewed. Building permits shall be visibly displayed at the work
site and shall remain visible until the authorized work has been completed.
Work shall remain accessible and exposed until inspected and accepted by the Building Inspector.The permit
holder shall notify the Building Inspector when any element of work described below is ready for inspection.
The following elements of the construction process shall be inspected, where applicable:
• Footing reinforcement or pier excavation prior to pour;
• Footing keyway with foundation wall reinforcement;
• Foundation before backfill;
• Foundation damp proofing;
• Framing, tie down/strapping and plumbing;
• Underground plumbing;
• Perimeter insulation;
• Rough electric;
• Insulation and caulking;
• Solid fuel-burning heating appliances, chimneys, flues or gas vents;
• Energy Code compliance; and
• A final inspection after all work authorized by the building permit has been completed.
After all necessary inspections are completed additional documents,,including but not limited to the following,
may be required:
• Suffolk County Health Department Approval—original copy
• Plumbers Affidavit
• Miscellaneous Certifications as requested by Plans Examiners or Inspectors
The Certificate of Occupancy will be issued after all of the required documents are"submitted to this office. No
building may be used or occupied in whole or in part, until a Certificate of Occupancy shall have been issued
by the Building Inspector.
The owner/contractor/design professional is responsible for all drainage and storm water issues as provided
by Chapter 236 of the Town Code. The person responsible for this site must call in for all inspections listed
above.
Contact the Town of Southold Building Department at (631) 765-1802 to schedule your inspections. Please
have your building permit number ready.
4
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A R _ Southold Town � THE WATER SUPPLY, HELLS DRYHELLS AND CESSPOOL
Board of Trustees l LOCATIONS SHOWN ARE FROM FIELD OBSERVATIONS
t�AR D G I AND OR DATA OBTAINED FROM OTHERS
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FILE#222-93 SCALE:1"=40' DATE:JULY 25. 2022 N-Y.S LISC.NO. 050882 PHONE(631)288-1588 FAX(631)298-1588
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