HomeMy WebLinkAbout46244-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD NY
,P
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#: 46244 Date: 5/13/2021
Permission is hereby granted to:
1795 Elij hs Ln
_..... ..... _......_ _............_..........._____ ..._____
Mattituck. NY 11952
To` construct accessoryin-ground swimming g g pool as applied for.
At premises located at:
1..?96 El jahs Ln., Mattituck.�.� �...�_�..................
----
CT # 473889
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_ ................................__._.... _.........�.�......�.�.�.�.�.�.�..........�...
Sec/Block/Lot# 108.4-7.10
Pursuant to application dated 4/27/2021 and approved by the Building Inspector.
To expire on 11/12/2022.
Fees:
SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00
CO - SWIMMING POOL $50.00
Total: $300.00
!uilding Inspector
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
P Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone (631) 765-1802 Fax (631) 765-9502t!,p ://www (,,)u;til Idtw�u��
Date Received
APPLICATION FOR BUILDING
For
Office Use Only
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PERMIT NO. Building lnspector: ° M.19 "102"
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Phone#: Email,
Mailing Address: "
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n []Alteration ❑Repair ❑Demolition Estimated Cost of Project:
❑NOte�weStructure �ddit � ..
Will the lot be re-graded? ❑Yes ETTO Will excess fill be removed from premises? ❑Yes Leo
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Existing use of property: f � Intended use of property: �� .
Zone or use district in which premises is situated: Are there any covenants and restricti ns with respect to
this property? ❑Yes PVo IF YES, PROVIDE A COPY.
Check Box After Reading: h ? rldesn�� w�� �� w trisssp °" by
Chapter 6 a
th!parn �rd #ppi4 fold 6 MAEiE tit CNS uiidTn pawnor EuiHn permit pursuant to the Building Zone
ordinante,of the on,ror Ow construclidn of k Wldin s,
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Application Submitted By(pri na e): W tiFCAZICPOOLCAIKEITMCXuthorized Agent DOwner
Signature of Applicant:)( Date: /D ZaZ
STATE OF NEW YORK)
SS:
COUNTY OF
�I'CKS being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the t—PA '
(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
day of 20
Notary Public
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
residing at < �
do hereby authorize C to apply on
my behalf to a Town of Southold Building Department for approval as described herein.
. ___'j
gnature Date
Print Owner's Name
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71 �� 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK
ALDEN W.YOUNG HOWARD W.YOUNG"
PROFKOBICTNAL ENGINEER AND LAND SURVEYOR
LAND SURVEYOR.N.Y.B.LIC.NO.121945 N.Y.G.Lie.NO.4211999
SURVEY FOR:
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TO THE TITLE COMPANY'GOVERNMENTAL
AGENCY AND LENDING INSTITUTION LISTED Ely
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