HomeMy WebLinkAbout47478-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 #: 47478 Date: 2/23/2022
Permission is hereby granted to:
Gorman, William
PO ................._...,...._.�........._....__.................www.............__........ __ __W.__........._ww......................._............. .......
BOX 1447
..._._.......__.___________ .... ....._______ _..
M....... .......uck NY 11952
atti t.............. ..............................._.,,_.v.v.
To: construct accessory in-ground swimming pool as applied for.
At premises located at:
45805Rom Southold.w_..._.w.................................................._..._
SCTM # 473889
Sec/Block/Lot# 75.-2-14
Pursuant to application dated 11,18/2022 and approved by the Building Inspector.
To expire on 8/25/2023.
Fees:
SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00
CO - SWIMMING POOL $50.00
Total: wwwwww_,........$300.00
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TOWN 4F SOUTHOLD—BUILDING DEPARTMEN"l'
��', Tower Hall Annex 54375 Main Road P. 0. Bax 1179 Southold,NY 11971-W59
l Telephone (631 765-1802 Fax (631) 765-9502
,rrfl`ulJ r
Date Received
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For Office Use Only � i_ � r
PERMIT NO. _ Building�n ct r�.
.. ........
Applications and farms must be filled out in their entirety.Incomplete 11
applications will not be accepted. Where the Applicant is not the owner.an
Owner's Authorlxation form(Page 2)shall be completed.
Date:1.14.22
OWNER(S)OF PROPERTV-
Name:Bill Gorman SC-rM# 1000-75-02-14
Project Address-45805 Main Rd. Southold -�
Phone#:631-445-1461 _...... ... ....... .w-_..-_.-..-........... Email:newenglandbarns@aol.com
aol.com -mm
Mailing Address:PO ox 1447 Mattituck —_.
CONTACT PERSON:
Name:Jaan Chambers , _.���, .�.,,..�,__..,...�_.�_ ,�. ....- ..._�w.-...-�__.. �...�.M..�_.. .....-�...,�.-.�.-..�µ-. .µ.�.............,_....... ......
Mailing Address:P0 Box 49 Southold NY 11971 -� --�
Phone#:631-294-4241 Emailloanchambers I O@gmail.com
..................
DESIGN PROFESSIONAL INFORMATION,
. -...,...._.......
Name:Jefrey Sands
.. ....,...
Mailing Address:East QUOgue, New York.
Phone#=631-375-5997 Email:Infojsa-ny.com
..... ... _ ...._ __....._www .. . .. _...... w.w _.._..... .....w ww
CONTRACTOR INFORMATION:
. ._ .....�..�.�.�µ�-......_............—..b-.�. ....................
Name.PatrlCk Pools Inc
. .................._..............................._.............. µ .... ....... ...............
Mailing Address:PO Box 3024 East Qu ue Y 11942
. ......................... -.......... .www .__... ... _ __ .._. ._,,... ,, � ____ _-...— _-........._..-...........__...... - ........ ........
Phone#:631-903-7665 Email:
_. .__...M.M. .._...._._.__...................n_w _.................................... ................._..................
..
DESCRIPTION of PROPOSED CONSTRUCTION
-.New Structure QAddition ❑Alteration ElRepair ❑Demolition Estimated Cost of Project:
Me Othern-ground swimming pool&enclosure
...,, _........_..............._w ....._M........._. _ ... ... ..._ �ww_. ._..
Will the lot be re-graded? ❑Yes 814107.... M _ ._. - . _._._. .... ............... wµ.--,---------
Will excess fill be removed from premises? Yes 0No w_
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PROPCRTY INFORMATION
Existing use f property: Residence Intended use of re _ ,., ,.._�. �...�,_.�..........,��,µ_,�
Zone or use district In which premises is situated: Are there any covenants and restrictions with respect t
AC this property? CJyes .-No IF YES, PROVIDE A COPY.
Check Box After Reading: 'rhe r/cruonr m° skpkwn pr f k n ul r .for all drainage and^ antra water issues_.sa ... .mm ..,...
chapter z3fi of the'rom code., APPLICATION IS HEREBY Widing Departmentfor the issuance 0 a Bu!Wkq Pemit 1xvsuant to the Building Zane
OrMnance of do'r~of southoM,SuffWk,county, Yowka avid odwr appkable Laws,Mdinanm. or ReguPAwws,for the consfuwu kora of krrm nfr
addMons,alterations or for remavW or akwrrruwrkfflon as herein desedbed.The applicant agrees to comply w9,kn all applicable laws,ordhwances,building coda:,
hm. krn code and reguWons and to adrrakn audwrized lope prownkses and In b ukkakkrn )for wiecemry Inspectiorn.False itMements made herein are
mbdevneanor pursuantdon MAIS of the York State Penal Law.
plpikati rr Submitted By(print name): ri ChambersSlAuthorlized Agent 0Owner
Signature f Applicant: " ..� N . ,m,,...� Date:
TATE OF NEW YORK)
)
COUNTY OF . .µ . .w._.....
.. Chambers being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the
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k°ntr�kctr�n F Agent,, krp0r�t�Officer,etc,)
of
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of said owner 0r owners,and is duly authorized to erf fl"rn or have performed the said work and to make and file this
pylic ti n;that all statements contained in this application are true to the best of his/her knowledge rid belief®and
that the work will be performed in the manner set forth in the application file therewith.
Sworn before me this
...
_. day ._. . .,�. 2
a Publi
Ffa nCEY f.. i IEE i
®"GARY PUBLIC,STATE OF NEW YORK
NO.01 DW6306900
I10 ERS IINH 1 U' H�^�R a 101N () Lff1 „ EXPIRES Lwk4TY
� � r � � � �LI� uIRV L4 IN SUFFOLK
here the applicant is not the owner] COMMISSION `� k'`3%202,-3,
ll Gorman 5”
I,.B...�� 3 Main Rd
_..........._w w_. . __ .. .._residing at ._�__.... ......_...._._.. ...... ....._w��.._........................
._................_..... �.
Southold
��.�.do hereby authorizeJoan
a.._..._,,,....��._. ... ,,,,,,,...�................._....._ ..,..,.......���t�r�n�apply on
my behalf to the`V wrn of Southold ld Buildin p rtme nt for approval as described h r irn.
2
022
Owner's Signature Date
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--------------
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#: 47478 Date: 2/23/2022
Permission is hereby granted to:
Gorman, William IT
PO BOX 1447
Mattituck, NY 11952
To: construct accessory in-ground swimming pool as applied for.
At premises located at:
45805 Route 25, Southold
SCTM # 473889
Sec/Block/Lot# 75.-2-14
Pursuant to application dated 1/18/2022 and approved by the Building Inspector.
To expire on 8/25/2023.
Fees:
SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00
CO- SWIMMING POOL $50.00
Total: $300.00
L" Lneifor
u coo . TOWN OF SOUT O —BUILDING DEPARTMENT
k4 �;
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
� Telephone (631) 765-1802 Fax(631) 765-9502
I
Date Received
APPLICIVrION ! IOR BUILDINGIIT
For Office Use only
I )
17,
g D
PERMIT NO. Buildin Isetr;
JAN
Applications and forms must be filled out in their entirety.Incompletea ""
applications will not be accepted- Where the V:�'�I�'. I �� Dl::,-",p u.
PP P Applicant is not the owner,an ➢e���°� � SOU`�I#CA...D
Owner's Authorization form(Page 2)shall be completed.
Date:1.14.22
CYWNER(Si)OF PROPERTYName: ill Gorman scrM#IOM-75-02-14
Project Address:45805 Main Rd. Southold
Phone#:631 5-1461 Email:neNenglandbarns@aol.com j
Mailing Address:PO BOX 1447 Mattituck
CONTACT :
Name:Joan Chambers
Mailing Address:PO ox 49 Southold NY 11971
Phone#:631-294-4241 =Email:joanchambersl0@gmail.com
DESIGN PROFESSIONAL INFORMATION:
Name:Jeffrey Sands
MailingAddress:East Quogue, New York.
Phone#:631-375-5997 jEmail=lnfo@jsa-ny.com
CONTRACTOR INFORMATION:
Name:Patrick Pools Inc
Mailing Address:PO Bax 3024 East Quogue NY 11942
Phone#:631-903-7665 Email:
DESCRIPTION D CONSTRUCTION
'New Structure E lAddition E lAlteration DRepair ❑Demolition Estimated Cost of Project:
2 Other in-ground swimming pool&enclosure $
Will the lot be re-graded? ❑Yes @No Will excess fill be removed from premises? 9Yes ®No
1
PROPERTY, INFORMATION
Existing use of property; Residence Intended use Of prop
Zone or use district In which premises is situated: Are there any covenants and restrictions with respect to
this property? CJYes o IF Y , PROVIDE A COPY.
19 Check Box After Reading: i w wawamtiw.w x' gam i is responsible for afldirahWemd stormwater issues fur fi d by
Chapter z36 of the Town code. APPUCATION is 1-9-REBY MADEwm iw r mmt fort issuance of a BuUding Permft ptnuam to the Building Zone
Ordburme of ft Town of ScuthoW,Saw Cmany,Now York and other appNeable laws,w iwrn or Regulatkms6 for the constnxtion ef i
addfflom,akeratiorws or for iremoval or dernolMon w,herein 9w.dw The aimimii nt agees to complyall applicable laws,ordinances,building e,
houskq rode and reguladm and to admit atahorized kapectm on premises and in imwwiidiini for necemary Inspections. i made herein are
punkhabk as a Cm A mbdmicanoruur ar to Section 220ASe Nm Poria State ftnal law.
Application Submitted By(print In r ) JoanChambers uthori d Agent 00wner
Signature Applicant: 04k- Date. 1
01
f,
..i. F F NEW YORK)
COUNTY OF... ..� -........_._�)
Joan Chamibers
being duly sworn®deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the g ...
(Co ntr ctra(
c,)
of said Owner car owners,and is duly authorized to Kin"tai or have h�said work end to rvn �performed t .......__.......vv_Wv._�v..
and file this
application;that all statements contained in this application are tlru to the best of his/her knowledge rmd belief;and
that the work.will be p rforrnd in the m nn r set forth in the application file therewith
Sworn before me this
a
yrr ZO
_ .�...._�,�__.._ ° Jnr lubiir;
y
fCEY L. fER
NOTARY PUBLI ,STATE OF NEW YORK
NO.01 DW6306900
PIROPERTY OWNER li II �l�llI'i �letI��u � LxiU2
Y
COMMISSION PIR a JUNE 02 r
(Where the applicant is not the owner
l
I,
Bill ""� r sldM t , i
. ... .......... .... .............. _._..
Southold
�mdo Thereby authorizeJoan to apply on
my behalf to the Town Of Southold Building Department for approval as described herein,
_ r
_. _.__... 2022
............_......_..........
_
Owners Signature Date
Print Owner's bairns _
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D SURVEY OF PROPERTY
GOVFeaa�E SITUATE
�SOgl014 . ,_�N �� SOUTHOLD
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1000-75-02-14
SCALE 1"=30'
00. o FEBRUARY 11, 2008
9 ? NOVEMBER 18,2008 ADDED PROP.ADDITION
MAY 25,2010 ADDED PROPOSED PARKING SPACES
APRIL 3,2018 ADD PROPOSED ADDITIONS
JUNE 22,2018 ADD STORMWATER NOTES
NOVEMBER 17,2018 AS-BUILT SURVEY FOR ADDITION
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Nathan Taft Corwin III
Land Surveyor
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