HomeMy WebLinkAbout53092-Z of so ly° TOWN OF SOUTHOLD
BUILDING DEPARTMENT
SOUTHOLD, NY
o��00UN'ry,
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#: 53092 Date: 06/26/2026
Permission is hereby granted to:
Breezy Shores Comnty Inc
PO BOX 925
Mattituck, NY 11952
To:
demolish an existing dwelling(#29) due to fire damage as applied for per Trustees approval.
Premises Located at:
65490 Route 25, Greenport, NY 11944
SCTIVI#53.-5-12.6
Pursuant to application dated 06/22/2026 and approved by the Building Inspector.
To expire on 06/25/2028.
Contractors:
Required Inspections:
Fees:
DEMOLITION $1,069.00
�i Total S1,069.00
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Building Inspector
FIELD INSPECTION REPORT I DATE COMMENTS
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FOUNDATION (1ST) Q
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FOUNDATION (2ND)
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PLUMBING
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INSULATION PER N.Y. y 6�
STATE ENERGY CODE
FINAL
ADDITIONAL COMMENTS
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oos' FO���o� TOWN OF SOUTHOLD—BUILDING DEPARTMENT
s� 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
For Office Use Only U
9
PERMIT NO. Building Inspector: J U N 2 2 2026
Applications and forms must be filled out in their entirety. Incomplete , 13ti91d'sng Department
applications will not be accepted. Where the Applicant is not the owner,an Town of Southold
Owner's Authorization form•(Page 2)shall be completed.
Date: -TUA/E
OWNER(S)OF PROPERTY:
Name: 1`1 A R6 P zf -- 14'"PV(� SCTM # 1000-
Project Address: a S'AG F` 0 jq-- Al
Phone#: C // X 7 Or, Emai1:/✓ ,AZC)A R 0, F)bOkj CA Pt, Ca
Mailing Address: ) "76 gRpN y' I l,L E Rk APB B g3
CONTACT PERSON:
Name:
Mailing Address: d7C ZOJJ fIUICLE �p, ld 9 J5 AJJ /U 6 g
Phone#: 9 I �� �, 9 S . Email:MiAkAAR 0; HE IA RI @ C)/444/C . (0
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name: CLF F-Nv1I -oAlNBCN SAL . SF-Rvtcr` CO ?—
Mailing Address: AlKo/,,x /-, v
Phone#: (�3) 7 - �`(`f� Email: j L I N DN IA L CGFAKRiV F 2. �S
DESCRIPTION OF PROPOSED.CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair MDemolition Estimated Cost of Project:
.bother FF PE5%J f�F—l+•bv L o 0
Will the lot be re-graded? ❑Yes ANo Will excess fill be removed from premises? ❑Yes ANo
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PROPERTY INFORMATION
Existing use of property: f lNC)IP FA"[,` &w< Intended use of property:
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
p %0 this property? Dyes R(No 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 demoli4ion as herein;described:The applicant.agrees to complywith all applicable laws,ordinances,building'code,
housing code and regulations and to admit authorized inspectors on premises and in,buildin'g(s)for necessary inspections.False statements made herein are
punishable as,a Class A misdemeanor pursuant to Section'210:4S of"the New York'State Penal Law.
Application Submitted By p i t name): R�C}}P.RJ� /��EAJ E OAuthorized Agent ❑Owner
Signature of Applicant: Date:
CON E D.BUNCH
Notary Public,State of New York
STATE OF NEW YORK) No.01BU6185050
SS: Qualified In Suffolk County
COUNTY OF ) Commission Expires April 14,2m�
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
c day of �l .� 20 c� n�� &,,
Notary Public
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
I, Ikfj APle4 oehR residing at I Sa p a-40 (Loh/✓iIle g0 8g3
Q I5eohf yr e-/ /1'( 16108
do hereby authorize t klA 9- b K92 K e,-< to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
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O ner's Signature J Date
M a P, H P
Print Owner's Name
2
Glenn Goldsmith,President QF SOVr Town Hall Annex
�� Ol 54375 Route 25
Nicholas Krupski,Vice President O P.O. Box 1179
Eric Sepenoski 1 Southold,New York 11971
Liz Gillooly G Q Telephone(631) 765-1892
Joseph Finora Fax(631) 765-6641
C4UNT{,�
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Permit No.: 10973A
Date of Receipt of Application: June 9, 2026
Applicant: Margaret Heidenry
S CTM#: 1000-53-5-12.6
Project Location: 66490 Route 25, Breezy Shores Cottage#29, Greenport
Date of Resolution/Issuance: June 10, 2026
Date of Expiration: June 10, 2029
Reviewed by: Board of Trustees
Project Description: Remove debris from dwelling destroyed by fire.
Findings: The project meets all the requirements for issuance of an
Administrative Permit set forth ih 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 Margaret Heidenry, received on June 9, 2026, and
stamped approved on June 10, 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.
Y+
Glenn Goldsmith President
Board of Trustees
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