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Home My WebLink About53178-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#: 53178 Date: 08/05/2026 Permission is hereby granted to: Tracy Peck 2206 Brookside Ave Wantagh, NY 11793 To: install a generator as applied for. Premises Located at: 1305 Sigsbee Rd, Laurel, NY 11948 SCTM# 144.-2-6 Pursuant to application dated 07/20/2026 and approved by the Building Inspector. To expire on 08/04/2028. Contractors: Required Inspections: Fees: GENERATOR $125.00 CO-RESIDENTIAL $100.00 Total $225.00 —4iding Inspector _ s° TOWN OF SOUTHOLD — BUILDING DEPARTMENT M� Town Hall Annex 54375 Main Road P. O. Box 1179 Southold NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 kt��as://www .gugl cltowtata or' Date Received APPLICATION FOR BUILDING PERMIT E C E 0 U, I For Office Use Only PERMIT N0. Building Inspectors,,_,,,_,_ Building e rfinent Applications and forms must be filled out in their entirety. Incomplete Town Of SoUthold applications will not be accepted. Where the Applicant is not the owner,an Owner's Authorization form(Page 2)shall be completed. Date: 4a—Z(10(10 OWNER(S)OF PROPERTY: Name: b k --L 11`` SCTM# 1000- illt�_N_®'Z_{� _�}Q�p_ � Project Address: I `�b��- t-C q 7 Phone Email: �.�; c eal Mailing Address: I2jp�j SwGs-b�.. �A (c�+��vL�, 1 CONTACT PERSON: Cal Name: Mailing Address: Ny' �d`l a1'Z Phone#: DESIGN PROFESSIONAL INFORMATION: Name: Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: Name: Mailing Address: I LA2 Phone#: - j21Q_13�E7O Email: �� +nwC Wcr�l Cavv1 DESCRIPTION OF PROPOSED CONSTRUCTION ❑N w Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: 5YOther .,"q..r Will the lot be re-graded? Dyes XO Will excess fill be removed from premises? Dyes L;<o 1 PROPERTY INFORMATION Existing use of property: Intended use of property: Zane or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? ❑Yeso IF YES, PROVIDE A COPY, 0 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): �t3 (}h authorized Agent C10wner Pp i `�`� Signature of Applicant: _ Date: 12 EA-2— STATE OF NEW YORK) COUNTY OF, S. being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)he is the fxA+("" - f— (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 dC l/ day of 20 Notary Public SABRINA M BORN Notary Public, State of New York No 01BOS317038 Qualified in Suffc.ik County PROPERTY OWNER AUTHORIATION commission Expires Dec. 22,20 (Where the applicant is not the owner) I _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 Print Owner's Name 2 o h TITLE SURVEY NOTES: I LOT 80 4'n-F r.ed aI 8 C Orloff L Engineering- to a ear y Nap 6aafng G +icers.l land - y seo s -- do - r 7 DS. subdivision 2,a the New Yo St .at_Ed c ti.n va. Only boundary..,.'+Y�CGS bearing an afiginGC e:Yi1}Oe'>2tl or inked - .,� seal and signature G Genuine true and correct copies Of the a; s 7"s origin.: wo c and Opinion. N 69`22'00" E 140.00 1I' ,I 1 2. ?hs . s p ,n a eda. e xth e current existing d d Co a Practicefor Lcnd -. y adopted y h NewY.r Statz Assa c.. a- Professional Lad S yo s I.c - d 6'W000 ENCE 0.1'S mee e U as:.a y StOndora - rid y.dap ea b ABTA and - I NSPS C rt-ca ion hereon s C: ea to persons. ,or whom the �,_ S0 b u.?'8 9 6'RdtS'^,.`c�i'CE O.TS r ' , vti goremboundam ntal.y mop is gamy,add f ache lording -nsltt Eenpantedt an i.e this,^±ap. The certificGbans hereon.are at tic-nsferob:`z, 395. 14.2 73.6 Ic 3. The location of underground improvements or On....chmame BELGIAN BLK CURB 261 I are not always known and often must be estimated. m Underground improvements or encroachments are not covered o y o by this certificate. j GRAVEL DRIVEWAY I � �iiL _ 4. A title report and other"Record Documents"as defined in the II ai I I FRAME &SHINGLE crdcfd Detail Reguirsments to AL3Ajti5P5 Lend U.G.GAS SERVICE LOT j9 7 e Surveys, has not been provided for use in preparing this 3� m� BELGIAN ELK CURB survey. Easements and ceverants of record affecting the !!�! GAR PEAK 27.11 w O property may not be shown.I o = 5. ELEVATIONS ARE IN NAVD 1988 DATUM. IJ3.91 13.3 LL � w 111 -EGRESS W.W. _ �a a I ' GATE 6 0„ 3� 73 M�.2GM i f 13.3 Dte LL THIS SURVEY IS CERTIFIED TO THE :14:,5 W o BEST OF MY PROFESSIONAL ABILITY ONLY TO: cn DAVID CORBET RIaGE EL 3J.53 a O TRACY CORBETT I u, 00 35.6 -- 5.2' HOUSE No. 1305 3.3' I 57.9' 00 o ONE STORY&BASEMENT o O1 [V� � FRAME RESIDENCE .I 3 a o ( (V o `^ 4 BLUESTONE ( �: z PATIO SURVEY I OVERHEAD WIRES I �� ` I° 3 i yy I OF A.G.UNIT LOTS 78 AND 79 I� �) GATE AS SHOWN ON THE AMENDED MAP OF 126 5'_P A_ 41 MATTITUCK PARK PROPERTIES 1-1 10 7'N k FILED: JANUARY 12, 1926 FILE No. 801 U AI FND CONC ION < ! 0.16'N SITUATE MATTITUCK 3 I FRAME 0.04'WS 69'22'00' W 140.00 SHEDTOWN OF SOUTHOLD, SUFFOLK CO., N.Y. W 3.2'S S.C.T.M. No. 1000-144.00-02.00-006.000 ~ �( SCALE: 1" = 20' 0.-k;_ SURVEYED At FOUNDATION LOCATED: JULY 11, 2021 LOT 77 � >✓ LOCATE MODIFIED FOUNDATION AUGUST 9, 2021 t I� FINAL AS BUILT SURVEY FEBRUARY 14, 2023 CV ADDED PROPOSED WATER SERVICE RELOCATION: AUGUST 24, 2023 y SET LATH ON SOUTHERLY PROPERTY ONE: SEPTE?dBER 28, 2023 t i AS—BUILT WATER SERVICE: NOVEM8 R 3. 2023 REVISED GAS SERVICE & ADO DRYWELL JANUARY 16, 2024 Prepared by: ' D'AMARO ENGINEERING AND SURVEYING, P.C. 20 MARIPOSA LANE TEL: (631) 878-7808 ,`5-. MANORVILLE, NY 11949 JDAMARO®OPTONLINE.NET