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HomeMy WebLinkAbout46873-Z got,*'-_, TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE 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#: 46873 Date: 9/24/2021 Permission is hereby granted to: Sterling, Shaun 2645 Elijahs Ln Mattituck, NY 11952 To: construct accessory in-ground swimming Pool as applied for. Swimming pool must be entirely located behind deck addition of single-family dwelling in the required rear yard. At premises located at: 2645 Elijahs Ln, Mattituck SCTM # 473889 Sec/Block/Lot# 108.-4-7.15 Pursuant to application dated 9/16/2021 and approved by the Building Inspector. To expire on 312612023. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO- SWIMMING POOL $50.00 Total: $300.00 i wilding 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 htt-ns: k wso :r_oldto ,,-,,.2o-, Date Received -- APPLICATION BUILDING - For Office Use Onlyel _- I PERMIT NO. x Building Inspector:_- Applications and forms must be filled out in their entirety. Incomplete applications will not be accepted. Where the Applicant is not the owner,an Owner's Authorization form(Page 2)shall be completed. Date: 3 • 1 OWNER(S)OF PROPERTY: \ " Name: SCTM # 1000- Project Address: Vq< Phone#: 1 065 11� Email: 31 Mailing Address: _} CONTACT PERSON: Name: F 3 Mailing Address: !TEmail: � -= g . Phone#; - _-� � _ �IK; DESIGN PROFESSIONAL INFORMATION: Name: Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: Name: I Mailing Address: j - £ Phone#: �� t Email: 3 DESCRIPTION OF PROPOSED CONSTRUCTION 1 F ANew Structure ❑Additions lAlteration ❑Repair ❑Demolition Estimited Cost of Project: ❑Other � 3 I Will the lot be re-graded? ❑Yes o Will excess fill be removed from premises? Xyes ❑No 1 PROPERTY INFORMATION Existing use of property: n = Intended use ofproperty: .1 t�e51 J1 t Gl - $ V,�,,j A C, Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to i this property? ❑Yes NNo IF YES, PROVIDE A COPY. 0eck Box AT-terRead'no: The owner/contractor/design professional is responsible for all drainage and storm water _ provided by pter 236 of the Town Code. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit Pu -to the Building Zone Ordinance of the Town of Southold,Suffolk,County,New York and other applicable Laws,Ordinances or Regulations,for the co `;of buildings, additions,alterations or for removal or demolition as herein described.The applicant agrees to comply with all applicable laws,o ��_ building code, housing code and regulations and to admit authorized inspectors on premises and in building(s)for necessary inspections.False - ' 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 e). ` f�)[ uthorized � k C(A r-t Agent ❑Owner Signature of Applicant: Date: - STATE OF NEW YORK) SS: COUNTY OF _ ) i7jesbeing duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, She is the (Contractor, Agent, Corporake 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 ' 6. ALEXUS A BIRKMIER Notary Public-State of New York Sworn before me this NO.01516415618 Qualified in Suffolk County My Commission Expires Mar 22, 2025 �0 day of Sf p�(Y-'"2t", , 201Q _ Notary Public PIERTV OWN— AUTHOR-7ATION (Where the applicant is not the owner) i o residing at `� , g a I �: L do hereby authorize 1 01 411-- u er to apply on my behalf to th T n old Building Department for approval as described here. € Ci W,L,c) i Owner's Signature ( Date l � AL 114 Print Owner's Name 2 Sp ,. �UF"FOL}{ COJNzx li�,l.LIH DLFARI'b'�NT w '. , i' ;ha JL•vJsgd JIgnostll'atld vatar Supply t °+£ tAvllitio. for tbID 19cu.lom.havv boon tnspoctOd by this dc�artment �r4 Soundto be i Chi of of o 4 s� i ;t+ tp is NIP s� _ ��, �+ it - •. `� r3 `t �'3' ,+� t•I • , .. _ � � 1t'§ k7 tamull i3 •', '' r" ¥` ��`�. � � '�' 7 ` `11 �> �AS:Y361tltv,y7c, 6� yO�P�G a ,73 i97C hFA, �3 1874075 �N0EA,hYI;nL�, A(YtRNI?A�7NEWYt'i}�X t)NGL)Y ��- YOUNO, *WHr.FR Ano tttrH.Y,wuc• 1111 � Vtle�i �q o ••LxA, stC s J- ir• �Iw ,,., .t+:t ,e+,r.it�,4 INLAND HOMVNC." � + _�Nt4R .,�o.•,a LOT NO,ILtJ L1Jr57'7t5 L {y G. .3- I►11 g . 1' .'.r,.t• vet ,tt p/,+1r� ,' Y i$ HOL °} 5ot�r D L l o�(Q�5 �� R4, woos, ax VWQ Wks • e NN of .fgag aw cal w� ajowd Am Aim t. y ryt �,or- *WJ h-t r ' pom4. 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