HomeMy WebLinkAbout47378-Z 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#: 47378 Date: 1/25/2022
Permission is hereby granted to:
Caravanos, Jack
137 E 36th St Apt 10A
New York, NY 10016
To: construct accessory in-ground swimming pool as applied for.
At premises located at:
3700 Stars Rd., East Marion
SCTM #473889
Sec/Block/Lot# 22.-2-16
Pursuant to application dated 1/10/2022 and approved by the Building Inspector.
To expire on 7/27/2023.
Fees:
SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00
CO- SWIMMING POOL $50.00
Total: $300.00
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dire_ hpector
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 hitI/ -w soutldtom�fn ov
-
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only - _
ID)
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 1ILDING
TOWN
OF So THOLD
Owner's Authorization form(Page 2)shall be completed.
Date:
OWNER(S)OF PROPERTY:
Barrie: SCTM#1000-22-02-16' Email:jackcaravanos@gmail.com
Project Address:3700 Stars Road, East Marion, NY 11939
Phone#: 646-275-2828 - - - -
i
Mailing Address: 3700 Stars Road,East Marion,NY 11939
1 O�TA�'PERSON•
Name: Jack Caravanos
I
Mailiri Address: 3700 Stars Road, East Marion, New York, 11939
iEmail: jackcaravanos@ mail.com 1
Phone#: 646-275-2828 1 g ,
i
III AN
I
Name: G t Ci'titt k
Malin Addre s• PO Box 9, Cutcho ue NY 11935
P one Chituk@O torline.net
#£ 631-734-7665 Email:I g p i
Chituk Pools (Gene Chituk
PO Box 9, Cutchogue, NY 11935
i Phone#: 631-734-7665 Email: gchituk@optonline.net
CONSTRUCTIONDESCPJPZI8N OF PROPOSED 1
CNNew Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
❑0ther In-ground pool installation $ 32,000
Will the lot be re-graded? ❑Yes 91 No Will excess fill be removed from premises? ❑Yes (NNo ,
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 ONO 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 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 an 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.
Application Submitted By(print name): i j< t�,� ( lq luo _S' ❑Authorized Agent 171 Owner
Signature of Applicant: f - Date• _
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f
STATE OF NEW YORK)
SS:
COUNTY OF )
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
day of,T, yA-e, ' 204 4-
Notary Public
CAROLINE M MACARTHUR
NOTARY PUBLIC-STATE OF NEW YORK
PROPER—VWNER AU-11-1110RIZATION No.01 MA6384635
(Where the applicant is not the owner) Qualified In Suffolk County
My Commission Expires 12-17-2022
i, residing at
do hereby authorize to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
Owner's Signature Date
Print Owner's Name
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