HomeMy WebLinkAbout48753-Z ,. t 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#: 48753 Date: 1/19/2023
Permission is hereby granted to:
Chausow, Robert
875 West End Ave Apt 12E
New York, NY 10025
To: construct accessory in-ground swimming pool as applied for.
At premises located at:
495 Linnet St, Greenport
SCTM # 473889
Sec/Block/Lot# 48.-2-39
Pursuant to application dated 12/8/2022 and approved by the Building Inspector.
To expire on 7/20/2024.
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
Telephone (631) 765-1802 Fax (631) 765-9502 littps://W).NTWSOL[tl101dt�owiiiiy.gov
Date Received
APPLICATION FOR IL I CaE IIS`
ECHNE
r Office Use Only
DEC o 8, 2022
PERMIT NO. Building knspector. a,/
Applications aril forms,must be filled out in their entirety. Incomplete ��
appircat�ons will not be accepted. Where the Applicant is not the owner,an
Owner's' thorizatloo form(Page 2)shall be completed.
Date: (2. 2-2—
Name:
ZName. SCTM# 1000- Irk Z -30j
Project Address: I-IC1 Get' L- ti S--� old- 13
Phone#: L s Email:
Mailing Address: `7 �ii1y1Q;� 5+i (j��►�`� M
Coto*P"E/9 lI :
Name: . r
Mailing Address:
Phone# '7(�� 5j7�5 �(Io'� Email:
DESIGWIPROFE5SIONAL INFORMATION:
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR°IN FORMATION:
Name:
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑NewStru ture ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
Other $
Will the lot be re-graded? ❑Yes AO Will excess fill be removed from premises? Wes El No
1
PROPERTY INFORMATION
Existing use of property: S�h �� �� Intended use of property: SIti� `� � k,-
rse district in which premises is situated: Are there any covenants and restrictions with respect to
Zone or u _ _ this property? ❑Yes�No IF YES, PROVIDE A COPY.
Chet/ 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 a#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,
hoysing 60ide and regulations and to admit authorized inspectors on premise's and in building(s)for necessary inspections.False statements,made herein are
pur►isha6i,as a Class A misdemeanor pursuant to Section 210.45 of the NewYork State Penal Law.
Application Submitted By(print name): -BlI tor\ MAuthorized Agent ❑Owner
Signature of Applicant: � ,� Date:
7
�"/ CONNIE D.BUNCH
STATE OF NEW YORK) Notary Public,State of New York
SS: No.01 BU6185050
Qualified in Suffolk County
COUNTY OF ) Commission Expires April 14,2 �
C.rn being duly sworn, deposes and says that(s)he is the applicant
(Name of i dividual signing contract) above named,
(S)he is the A -�
(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 , 20 a� X71 ✓�-P C �
Notary Public
PROPERTY OWNERAUTHORIZATION
(Where the applicant is not the owner)
I, Sews i residing at f) L't r,,,t 5 .} ae- .-�
do hereby authorize 1'M 6a to apply on
my beh If, rr the T wn of uthg Building Department for approval as described herein.
r' ' 12 Z
wner's ign cure , Date
Print Owner's Name
2
495 aka 708 Linnet St - Proposed Pool (Lot Coverage)
Dwelling Coverage 21.8' x 44.8' 976.64 sq ft
Lot Size 5632.00 sq ft
Proposed Pool Size 10' x 15' 150.00 sq ft
Total Lot coverage 1126.64 sq ft
Total Lot coverage Percentage 20.0%
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