HomeMy WebLinkAbout53183-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#: 53183 Date: 08/07/2026
Permission is hereby granted to:
Richard J McBride
10625 Oregon Rd
Cutchague, NY 11935
To:
Legalize "as built"garage addition to a pre-existing structure as applied for.Additional certification
may be required.
Premises Located at:
10725 Oregon Rd, Cutchogue, NY 11935
SCTM#81-2-16.1
Pursuant to application dated 06/23/2026 and approved by the Building Inspector.
To expire on 08/06/2028.
Contractors:
Required Inspections:
Fees:
As Built Addition/Alteration $1,161.00
CO Accessory $100.00
Total S1,261.00
Building Inspector
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 Iittt)s //'www.sotitl�iol townn . „rev
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use only
PERMIT NO. Building inspector;—J� J N 2 3 202
Applications and forms must be filled out in their entirety. Incomplete V1,111rf1n 'DrippIrtmen
applications will not be accepted. Where the Applicant Is not the owner,an �, d ,y : i7id
Owner's Authorization form(Page 2)shall be completed.
Date: .p
OWNERS OF P[01PIERTY. t
Name: i �A SCTM#1000-
Project A dress: ? G i O'��� ►' C i
Phone#: Email:
Mailing Address:
CONTACT PERSON:
Name: +
Mailing Add ess: 0, lo< Z0 04 - . 114.3
Phone#: ?�! 7i� Email:
DESIGN PROFESSIONAL INFORMATION:
Name: od"T i ,1. A- ,
Mailing A dress: +�,' QX
Phone#: (j?1{ .- '�? r Email: � T FCT, Cd•'t-j
CONTRACTOR INFORMATION:
Name:
Mailing Address:
Phone#: TEmail:
DESCRIPTION OF PROPOSED CONSTRUCTION
CAN w Structure ❑Addition ❑Alteration ❑Repair MDemolition Estimated Cost of Project:
Other - $
Will the lot be re-graded? E]Yes No Will excess fill be removed from premises? OYes 2<0
1
PROPERTY INFORMATION
Existing use of property: Intended use of property:
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? ❑Yes 0 No IF YES, PROVIDE A COPY.
Rf 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 bullding(s)for necessary Inspections.False statements made herein are
punishable as a Class A misdemeanor pursuant to Section 220AS of the New York State Penal Law.
Application Submitted By(print name): 16 Author zed A nt 00,wner
Signature of Applicant: Crate:
CONNIE D.SUNCH
STATE OF NEW YORK) Notary Public,State of Now York
SS: No,01i U6186050
COUNTY OF ) Quali"fled in auffolk.County
CoT mission Expires April 14l 2''
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
da of 20,1L Notary Public
PROPERTY OWNER, AUTHORIZA"nON
(Where the applicant is not the owner)
7j—• G rI e residing at ) 0 W S 0 rc cN a ft,j �A6 Zue,
ew 9 3T do hereby authorize ,rd 46 arc�►yi ee-fto apply on
my behalf to the Town of Southold Building Department for approval as described herein.
Owner's Signature Date
I1�,d 7. i►1e r,d e
Print Owner's Name
2
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StiBTCI3 PLAN OF ' DF FAMILY
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SOU t`_OTD
TOWN OF SOUTN'JiC I
\ UFFOLK COUNTY, NE YORK
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Nathan Taft Corwin III
Land Surveyor