HomeMy WebLinkAbout47067-Z TOWN OF SOUTHOLD
`u 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#: 47067 Date: 11!112021
Permission is hereby granted to:
Nikolis,Constantine
24021 Maryland Rd
Douglaston, NY 11362
To: construct accessoryin-ground swimming g g pool as applied for.
At premises located at:
380 The Greenway, East Marion
SCTM#473889
Sec/Block/Lot#30.-2-47
Pursuant to application dated _10121/2021 and approved by the Building Inspector.
To expire on 513/2023.
Fees:
SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $250.00
CO-SWIMMING POOL $50.00
Total: $300.00
i =t
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 t %,2 � out� ldto #� o,
Date Received
APPLICATION FOR
BU11 I
For Office Use Only
PERMIT NO. 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 TOIVIVIN Or Ou' ar L
Owner's Authorization form(Page 2)shall be completed.
t
Date: I
OWNER(s)O pitopE
Name t _
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Project Address:-iE -
Phone#: _ Email: Jd r
Mailing Address: ' Rte ;
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CONTACT PERSON:
Name:
Mailing Address: = 4-)4—� t �
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Phone#:1 1 %, .� _ Email: .; z _,
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DESIGN PROFESSIONAL INFORMATION:
Name: li 3 t (
Mailing Address: _ '
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Phone#: � � - �� ' ' � Email:
CONTRACTOR INFORMATION:
Name:
'
Mailing Address:
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Phone# ' l l t'/ Email;
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑A,ddition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
Otherl - r $
g,
Will the to be re graded? Yes❑No Will excess fill be removed from premises? Yes ❑No
TV 1—Y iri /22-Aa, ' I
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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? Y s❑No IF YES,PROVIDE A COPY.
11 Check e d`c; The owner/contractor/design professional is n?5 - Rif e for aq drainage and storm avatar issues as provided by
Chapter 236 of the Town trade.APPLICATION IS HEREBY MADE to the Building Dep nt for the issuance of a and
Permit pursuant to the Building Zane
Ordinance of the Town of Southold.Suffolk,County,New York and other applicable Laws,Ordinances or Regulations,for the ednstruction of bulidings,
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.
I
Application Submitted By(printame): //Zo ,uthorized Aenttwner
Ij
Signature of Applicant:
Date: �� ��
t �
STATE OF NEW YORK)
SS:
COUNTY OF )i
V J being duly sworn,deposes and says that(s)he is the applicant
Namee of individual signing contract)above named,
(S)he is the '
(Contractor,,,p orporate Officer,etc.)
of said owner or owners,and is duly authorized tp
W. jvaye performed the said work and to make and file this
application;that all statements contained in tfzt �* l ae to the best of his/her knowledge and belief;and
that the work will be performed in the manner setifodwisnWippkation file therewith.
coiNTY _
ASworn before me this comNAVIA t,
day of 2
It.tI ilk," Notary Public
PROK-IRTY OWNERAU-HORI-A-ION
(Where the applicant is not the owner)
I, 0'4md-k)hnQ_P kJ 16ing at
do hereby authorize to apply
on
my behalf to the Town of Southold i3t�ding Department for approval as des ribed herein.
� �
1�
Owner's Signature Date
Print Owner's Name
2
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TOWN OF SOUTHOLD MAP N 23'23'25"W 77.00' LINE
SUFFOLK COUNTY,NEW YORK N(F F.F.KING
FILED:JUNE 11,1975,MAP No.6266
CERTIFIED TO:FIRST AMERICAN TITLE INSURANCE COMPANY
LYONS MORTGAGE SERVICES,INC.
CONSTANTINE P.NIKOLIS AND YVONNE NIKOLIS
MADISON AVENUE ABSTRACT INC.
QC. Rk3 2020WARDRRO &ALLRIGHTSRESERVED.DUPLICATIONOFTHISDOCUMENTISAMOLATIWJOFFEDERALCOPYRIGHTLAW.
THIS SURVEY HRS SEEN PREPARED IN ACCORDANCE WITH YHE CODE OF PRACTICE ADOPTED BYTHE NEYt VOW(STATEP590CIATION OF PROFESSIONAL LAND SURVEYORS.
CERTIFICATION SHALL RUN ONLY TOTHE PERSON.THOR INTEREST ANOlOR ASSIGNS.
OT TRAHSFERFBEE SCALE 1"=40'
THE EXISTENCE:E
OF WAY,ANDKJR EASEMENTS OF RECORD,IF ANY NOT 9HOYtN ARE NOTGUARANTEED. SCTM 1000-030.00-02.00-0$7.000
ANY ALTERATION OR AODITIONTOTHISSURVEYISAVTSLATION OF SECTIWd12D&20FTHENEWYORKSTATEEDUGATION LAMt. SURVEYED.AUGUST 7,2020
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LANDSURVEYLONG 1SLAND.COM
WARD BROOKS LAND SURVEYOR
11 OCEAN AVENUE
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BLUE POINT, NY. 11715
(631)576-7794 (631)363-3179
WARDBROOKSO@GMAIL.COM }sI}=
FILE#10931