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Home My WebLink About48470-Z TOWN OF SOUTHOLD � r BUILDING DEPARTMENT TOWN CLERKS 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#: 48470 Date: 11/10/2022 Permission is hereby granted to: Lope Shawn 365 Rachaels Rd Mattituck, NY 11952 To: legalize "as built" hot tub as applied for. At premises located at: 365 Rachaels Rd. Mattituck SCTM # 473889 Sec/Block/Lot# 108.-4-7.45 Pursuant to application dated 9/12/2022 and approved by the Building Inspector.. To expire on 5/11/2024. Fees: AS BUILT- SWIMMING POOL $500.00 CERTIFICATE OF OCCUPANCY $50.00 Total: $550.00 BIgane+ctor ora TOWN OF SOUTHOLD— BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1 179 Southold, NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 https!/xvw w Southoldto«-nib !Zov„ Date Received APPLICATION FOR BUILDING PERMIT For Office Use only PERMIT N0. - IT Building Inspector: IT Applications and forms must be filled out in their entirety. Inc pp y. ompleteJ11 i applications will not be accepted. Where the Applicant is not the owner,an WYILDR NG imlE1"-1`.' Owner's Authorization form(Page 2)shall be completed. 'TOWN C;A ':CMM�1. i0?� t1 Date. OWNER(S) OF PROPERTY: Name �r SCTM # 1000- I C) _ — 7. If5 Project Address _....__.. ..G NY ._M'So'L Phone# � Cmal.l n..__�6CJY�b(o/✓� J�,e�e�. Cam-( __ . . Mailing Address: �(os OR d fl o�44,-4uc-x N /9sa CONTACT PERSON: Name: ._. Mailing Address: 3Lv_v` ac/t.Y. . . . Phone# DESIGN PROFESSIONAL INFOR ATION':. Name: Mailing Address: Phone#: � WEmail: W�..... _ �. CONTRACTOR INFORMATION: Name: .__�(.e.J�3-P�� Utl, ./�IC�Y/�-�-- Mailing Address: _ma . DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: 1_kother„ „ 2146 _.. _., $ h _ o y re-graded? E]Yes �No Will excess fill be removed from remises. ❑Yes []No Will the lot be re-g ? premises? PROPERTY INFORMATION Existing use of property: Intended use of property: t d4�,6(,ii Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? ❑Yes UNo IF YES, PROVIDE A COPY. Chapter 236 of Town Code ding: The owner contractor desi n professional is responsible for all �s aspr_� Reading: / / g p p drainage and storm water issues as provided by p a CATION 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 A punishable as a Class A misdemeanor pursuant to Section 210.45 of the New York State Penal Law. Application Submitted By(print name):X I✓ L�D� � ❑Authorized Agent Ld'Owner Signature of Applicant: k' Date: g ZZs I Z02L STATE OF NEW YORK) SS: f,GGrJIK COUNTY OF �_ _Z-0 .... being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, mm (S)he is the.m..m�.m./�. .:W .m..�.� _._. .�.v�......�....�_.._W..m_ ....__.._. . (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 -Fr d4 IT day of. zo ZZ . ..,. __. ... _ w... c .w...W Notary E L. DWYER NOTARY PUBLIC,STATE OF NEW YORK NO.01 DW6306900 QUALIFIED IN SUFFOLK COUNTY PROPERTY OWNER AUTHORIZATION COMMISSION EXPIRESJUNE:30,2DIb (Where the applicant is not the owner) residing at __w....._ ..... W ., . _ ...do hereby authorize apply on my behalf to the Town of Southold Building Department for approval as described herein,. Owner's Signature Date ..._-.Print Owner's Name__..._....___........�__......�.� 1..Copyrgh12018,Alphonse Pesce Jr„Co.,Inc.Land Surveying,AN Rights Reserved. 2.Unauthorized afteradon or addlNon to a survey map beading a licensed land surveyors seal is a violation of section 7209,subdlvlslon 2,of the New York Slate Education Law, 3.Only boundary survey maps with the surveyors embossed seal are genuine true and correct copies of the surveyors original work and cronlon, 4.Certifications on this boundary survey map signify that the map was prepared In accordance with the current existing Code of Practice for Land Surveys adopted by the New York State Association of Professional Land Surveyors,Inc,The certiNcatlon Is limited to persons for whom the boundary survey map Is prepared,to the title company,to the governmental agency,and to the lending Instilutlon listed on this boundary survey map. 5,The ceNticallons herein are not bansfemble. 6..The location of underground Improvements or encroachments are not always known and often must be estimated.11 any underground Improvements or encroachments exist or are shown,the improvements or encroachmenLs are not covered by this certIllmia. 7,The offsets or dimensions shown from the foundation to the property fines are for specific purpose and use and therefore are not intended to guide the erection of fences,retaining walls,pods,planting areas, addition to structures and any other construction. D RACHALLS " KOA �KkACKKRK, �ROAD)) ^a8 N 1,,4'l$,2134:Kfi. 18�K7.�.K10" tS p t` �n V) N Vu 22. hn t fra arcapv, ' a 7atnnn A; ��. aYq�e toRo 22.9' ^� � dirj„rq fkd7; 25.6' lop CAI 04 K tl>M cap t�itlCrC �° C N�44 rr Alf FAL * O GARAGE R2 R,a GARAGE I.": gp¢yr'iIJ "rq N u7 O N r N N L07 AREA=J2,58!S0.FL CP 0.75 ACRES ' o �9Gy^'kl'�PpCS S80-27'5 I"W NOTES: 50.61' -Non-vvisible easements,recorded or MAIN ROAD anreGoNedare not 6hown. -Underground foundations or tis\ (N.Y.S ,... ••2 2qrs6arpkn+re ead' m aew uapp�4lamwn. SURVEY FOR LOCATION: 7 365 RACHAELS ROAD �1 IIIiBP PSfP, Jr. °, TOWN OF MATTITUCK COUNTY OF SUFFOLK,STATE OF NEW YORK rufrssinnul RanD !§ururyor i LOT 4 ON"MAP OF NORTH FORK HOUSING ALLIANCE INC." Filed:NOVEMBER 6,1995 N.Y,S,Llc.No.0463651 tT" DIST.:1000 SEC.:108 BLOCK:04 LOT:007.045 ALE SURVEY DATE:MARCH 23,2016 JOB:18-1000 5 CIRCLED OK,NEW Y LANE ,r HOLBROK,NEW YORK 11741 "�=40' 718-486-5408 631-585-5317 I Iwqi F04 BUILDING DEPARTMENT- Electrical Inspector 41 4�� w TOWN OF SOUTHOLD Town Hall Annex - 54375 Main Road - PO Box 1179 ,5 Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 ro errsoutholdtownn ov seand southoldtownn ov, APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (,iii information Required) Date: Company Name: Electrician's Name: License No.: Elec. email: Elec. Phone No: ❑1 request an email copy of Certificate of Compliance Elec. Address.: JOB SITE INFORMATION (All Information Required) Name: 54VI-7 Address: leoL A41a44.A /Y9sL �/�f 4,a,.._L 1. �'r ll9sL Cross Street: _ ...-�..._-.. ...... -..�^�___._ _..��.mm. Phone No.: (o'j _fo Bldg.Permit #: email: Tax Map District: 1000 Section: 0Block: Lot: w BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): [6f--r,b Square Footage: Circle All That Apply: Is job ready for inspection?: YESL_J NO Rough In Final Do you need a Temp Certificate?: YES NO Issued On Temp Information: (All information required) Service Size[11 Ph 3 Ph Size: A # Meters_ Old Meter# ,,,,, _ , ❑New Service❑Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground❑Overhead # Underground Laterals 1 2 H Frame Pole Work done on Service? Y ON Additional Information: . PAYMENT DUE WITH APPLICATION