HomeMy WebLinkAbout48624-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#: 48624 Date: 12/19/2022
Permission is hereby granted to:
SDB Family Trust
C/O Premier Trust - co trustee
4465 S Jones Blvd
Las Vega NV 89103
To: Remove existing pool and construct new in ground gunite pool in current location, at
existing single family dwelling as applied for.
Must maintain minimum 15 foot setback to side / rear property lines for pool and
equipment.
Separate permits are required for any deck work.
At premises located at:
555 Eagle Nest Ct, Laurel
SCTM # 473889
Sec/Block/Lot# 127.-9-8
Pursuant to application dated ,10/20/2022 and approved by the Building Inspector.
To expire on 6/19/2024.
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
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
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Telephone 631 765=1802 Fax 631 765-9502]1 ://' °. + u1'�1�allOtnii , 0
Date Received
APPLICATION
For Office Use Only
PERMIT No. J o2 '' Building Inspector;
c,..r
Applications and forms must be filled out in their entirety. Incomplete
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)OF PROPERTY:
Name: SCTM#1000-
Project Address: �,
Phone#: Email: 5 e I�V►'l ah ►�W1Q V1 e�eYLVI i
71
Mailing Address: � ,._.-
CONTACT PERSON:
Name: Jennifer Del Vaglio
Mailing Address: PO Box 369 Peconic, NY 11958
Phone#:631-734-7600 1 1Email:cj@eastendpoolking.com
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone#: Email;
CONTRACTOR INFORMATION:
Name: Eastern End Pools, DBA East End Pool King
Mailing Address: PO Box 369 Peconic, NY 11958
Phone#: 631-734-7600 Email:cj@eastendpoolking.com
DESCRIPTION OF PROPOSED CONSTRUCTION
Structure Addition_ ❑AIteration� OR--pair �� oll :�__�
Estimated Cast of Project:
❑Othe
Will the lot be re-graded? ❑Yes ®No Will excess fill be removed from premises? ( Yes ❑No
1
PROPERTY INFORMATION
Existing use of property: Single Family Dwelling Intended use of property: Single Family Dwelling
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
Residential _ this property? ;,Yes EJ No IF YES, PROVIDE A COPY.
9�2—
N Check Box After IReadir1g: 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 on premises and in buildingis)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(print name):Jennifer Del Vaglio IWAuthorized Agent ❑Owner
Signature ofAppli — Date:
STATE OF NEW YORK)
SS:
COUNTY OF )
3C) coa being duly sworn, deposes and says that(s)he is the applicant
(Name of indi+v dual signing cori4act)i above named,
(S)he is the f , _,
(Contractor,Ajent,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, � , 0
Notary Public
PROPEFITY OWNER AM,,, Rift TI IIS
(Where the applicant is not the owner)
I, ✓G residing at
�Ij *L gA,6,veio
do hereby authoriz t & &ij � to apply on
my b f'to the Town a Southold�WIding Department for approval as described herein.
1�11°Il v
2
Owner's Signature Date
Print Owner's Name
2
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