HomeMy WebLinkAbout48379-Z TOWN OF SOUTHOLD
r BUILDING DEPARTMENT
f� TOWN CLERK'S OFFICE
bx 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 #: 48379 Date: 10/6/2022
Permission is hereby granted to:
Ward, Charles
351 E 84th St#13B
New York NY 10028
To: construct accessory in-ground swimming pool as applied for. Pool equipment must be
located in the rear yard with a minimum setback of 10 feet from lot lines
At premises located at:
3555 Duck Pond Rd., Cutcho ue
SCTM #473889
Sec/Block/Lot# 83.-1-13
Pursuant to application dated 8/26/2022 and approved by the Building Inspector.
To expire on 4/6/2024.
Fees:
SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00
CO- SWIMMING POOL $50.00
Total: $300.00
Building Inspector
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
t
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
" Telephone (631) 765-1802 Fax (631) 765-9502 htt)s;// vvv. a t lrit w �a " Dov
Date Received
APPLICATION FOR BUILDING PERMIT
tied ��
For Office Use Only
PERMIT NO. Building Inspector: IV
BLIVV ii`sV6`IG):SN-.N
Applications and forms must be filled out in their entirety. Incomplete g),,0','0F S(,):i:V n '�
applications will not be accepted. Where the Applicant is not the owner,an
Owner's Authorization form(Page 2)shall be completed.
Date:
OWNER(S) F PROP T'Nt
Name SCTM#1000- /
Project Address: Dar-
Phone#: �N Email: r
Mailing Address:
CONTACT PERSON:
Name: ' /'I,A
Ej�, . .... -&S! ITT72.5i
Mailing Address:
Phone#: 4e7Email:
DESIGN PROFESSIONAL INFORMATION:
�me:l U4
Mailing Address
Phone#: tn`�) - - Email:
CONTRACTOR INFORMATION:
Name:W2L&I
Mailing Address: �.
Phone# lEmail: ek-D' coo,,
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Co of j
.....her �. ...�
Will the lot be re-graded? ❑Ye No Will excess fill be removed from premises? Yes ❑No
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 o IF YES, PROTIDE A COPY..
❑ Check Box After Reading: The owner/contractor/design professional is responsible for all drainage d 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 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.
Application SubmittedB Tint name)Cka�� JW J ❑IAuth rized gent wrier
Signature of Applicant Date: 7
�� 11111 y�p
14
STATE OF NEW YORK)
S$: "P11� 011\41623165
x r1,1ri.11�11a IN
COUNTYOF ) ,SxUN-
I K NTY
COMM R �
9,( Vdk)L aVA
b jAda y rrr 8f 'oses and says that (s)he is the applicant
(Name of individual signing contract) above named, �'`/* O�iIq%4\, ;\\1
(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
abay
Notary Public
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
I, ' S residing at .
Y _
r do hereby authorize - . apply on
'10 ri y,,
my behalf to the Town of Southold Building Department for approval as des rifled h rte. "1"1auAMr6E®'N7 e0
SUFFOLKCdUNTYa
L/. C O M "
4 „
ner s
Signature date `��9 ual_
Print Owner's Name
2
GOT NUMBERS REFER TO i1MAP of VISTA BLUFF"F'L£D
1N INE SUFFOLK COUNTY CLERK'S OFF7CE ON MARCH
N 15, 1968 AS FILE Na 5060.
SCDFIS Ret.#M RIO-04-0084 SURVEY OF PROPERTY
AT CUTCHOGUE
TOWN OF SOUT OLD
SUFFOLK COUNTY, X Y
1000-83-01-13
SCALE 1--30'
JANUARY 14 2004
MAY 11, 2004(R:O.K)
NOMEMRER'22: 2004(RCW90N5)
JANUARY 12,2005(REASKAYS)
AUMST 1a 2!X05(RCW&ONS)
.%WARY e: 2006(r"OA170N LOCARON)
OCTOBER 11,2WO(fWAL)
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•—REBAR
A-STAKE s S C NO: 49618
ANY ALTERARON OR ADOMON TD TMS SCWVEY 1S A WMAADN ' L`CON
OF SECTWN 7209OF THF NEW YORK STAT MCAWN LAM, (630 765-1797
EXCEPT AS PER SECTKON 7204-StASW- f Z ALL CiRN)CAflQMS ,.o. BOX
HEREON ARE VALO EOR TMS MAP AAV COPES TtCWCF 014LYi 1'230 TRA' �] fes/'}
SATO MAP OR COPIES REAR 1HE XPRESSED SEAL.OF M St MEYOR savmaca, /Y.x 11971 if3—tJll4
NNOSE SIGN YWE APPEARS HEREON.