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Home My WebLink About48803-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#: 48803 Date: 1/25/2023 Permission is hereby granted to: Reds Adventures LLC 250 David Ct Calverton NY 11933 To: Construct in ground swimming pool at existing single family dwelling as applied for. At premises located at: 5495 Bridge Ln, Cutcho ue SCTM # 473889 Sec/Block/Lot# 84.-1-6.15 Pursuant to application dated 11/30/2022 and approved by the Building Inspector. To expire on 7/26/2024. 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 ht[ ://www. otatlioldlowni Date Received APPLICATION For Office Use Only V PERMIT NO. U�()�) Building Inspector: R NOV 3 0 202 2 [D Applications and forms must be filled out in their entirety.Incomplete SWIV4'Lw--Pr applications will not be accepted. Where the Applicant is not the owner,an I Owner's Authorization form(Page 2)shall be completed. Date:11/28/2022 OWNER(S)OF PROPERTY: Name:Jay Waxenberg O O kK) aWNR-rZ SCTM#1000-84-1-6.15 Project Address:5495 Bridge Lane Cutchogue, NY 11935 Phone#:914-261-9456 Email:jwaxenberg@gmail.com Mailing Address: 3 y.S [Si- - /d r 4 /v y /00 / CONTACT PERSON: Name:Jonathan Paetzel, RLA Mailing Address:POBOX478 Mattituck, NY 11952 Phone#:631-209-2410 Extension 2# Email:jonathan@mplastudio.com DESIGN PROFESSIONAL INFORMATION: Name:Jonathan Paetzel, RLA - Marshall Paetzel Landscape Architecture, PC MailingAddress:PO Box 478 Mattituck, NY 11952 Phone#:631-209-2410 Extension 2# Email:jonathan@mplastudio.com CONTRACTOR INFORMATION: Name:TBD Mailing Address: Phone#: Email: DESCRIPTION OF PROPOSED CONSTRUCTION h•New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: D Other Swimming Pool with built in spa $75,000 Will the lot be re-graded? ❑Yes ENo Will excess fill be removed from premises? ❑Yes WNo 1 PROPERTY INFORMATION Existing use of property:Residence Intended use of property:Residence Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to AC this property? ❑Yes BNo IF YES, PROVIDE A COPY. �I heck Boy 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 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 Submitted By(print name):Jay Waxenberg ❑Authorized Agent N■Owner Signature of Applicant: Date: 11/29/2022 STATE OF NEW YORK) SS: COUNTY OF .SAY W Ax V2(—�- being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the W (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 Z qday of �O�t?��YV�OQif` 20 O TIFFANY A 8055 Notary Public-State of New York NO.01006409478 Qualified in Suffolk County I)RCHIER W Y^ II � NE l,i 1° My Commission Expires Sep 28, 2024 AL)"'I m�� .� �m (Where the applicant is not the owner) I, residing at do hereby authorize to apply on my behalf to the Town of Southold Building Department for approval as described herein. Owner's Signature Date Print Owner's Name 2 STOIKIM[WA\T]EIK Scott A. Russell f, SUPERVISORI��1[A�l�A\,G�]EMUEN T SOUTHOLD TOWN HALL-P.O.Box 1179 " Southold 53095 Main Road-SOUTHOLD,NEW YORK 11971 ., Town A)n YV of w� CHAPTER 236 - STORMWATER MANAGEMENT REFERRAL FORM _ .. ( APPLICANT INFORMATION E COMPLETED BY THE APPLICANT ONLY FOR PROPERTIES ONE AC OR LARGER. ) J� RE IN ..... _ �. ...� _._ _., . . T ..._ <<' APPLICANT: (Property OWl"Iel' lesign Professional,-- gent, Contractor, Other) r NAME: _) 0 r�4 Date: '' �- ' P '��2 f� .......--:.w IT . �� . `' lr Contact Infos tion: a0 Property Address / Location of Construction Site: ri S.C.T.M. #: 1000 District y G 1 m 61V _.......__ Section Block Lot ! ...�. �.�. .. ....w f 3� .. .. TO BE COMPLETED BY SOUTHOLD TOWN ENGINEE r r RING DEPARTMENT �i 1 r Area of Disturbance is less than I Acre. No S.P.D.E.S. Pern�it is Re wired f , Project does Not Discharge to Waters of the State. No S.P.D.E.S. Permit is Re_ aired I - Area of Disturbance is Greater than 1 Acre & Storm-water Runoff Discharges Directly to Waters of the DIRECTLY From State of New York. DEC Prior THE APPLICAN'l" MUST OBTAIN a S.P.D.E.S. Permit I to Issuance of a Buildin Permit. , - Area of Disturbance is Greater than I Acre& Storm-water Runoff Flows Through Southold Town's MS4 Systems to Waters of the State of New York. THE APPLICANT MUST OBTAIN a S.P.D.E.S. Permit through the Southold Town Engineering Department f1 i Prior to Issuance of a Building Permit. Reviewed By: � ....... .... �. � Date i � ... FORM # rMC P-Tnq 0rtnhar 901 Q L2, z FS 93- i2P, 91. '75, 0 "1 2 --eQ-p to ,,ti6tiL M.0e.0mot s Z ci 4- 10 co 0 All 3 OZ,O&Vt,N t;