HomeMy WebLinkAbout48841-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
�u 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 #: 48841 Date: 2/1/2023
Permission is hereby granted to:
Feldman Francis
PO BOX 1167
Cutcho ue NY 11935
To: Install in ground swimming pool at existing single family dwelling as applied for.
Maintain minimum 10 foot setback from property lines to pool and equipment.
At premises located at:
2395 Ha aters Rd Cutcho ue
SCTM # 473889
Sec/Block/Lot# 111.-7-7
Pursuant to application dated 1/10/2023 and approved by the Building Inspector.
To expire on 8/2/2024.
Fees:
SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00
CO- SWIMMING POOL $50.00
Total: $300.00
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Building Inspector
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O.Box 1179 Southold,NY 11971-0959
pr yy r
y' Telephone(631) 765-1802 Fax(631) 765-9502 hti s://www.souLhjdtownno
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
PERMIT NO. Building Inspector-
JAN 1 0 2023
Applications and forms must be filled out in their entirety.Incomplete LD
applications will not be accepted. Where the Applicant is not the owner,an BUILDING DEPT.
Owner's Authorization form(Page 2)shall be completed.
TOWN OFSOUTHOLD
Date:
OWNER(S)OF PROPERTY:
Name:Shirley Feldman SCTM#1000-111-00-07-00-007-000
Physical Address:2395 Haywaters Road, Cutchogue NY 11935
Phone M Email:
Mailing Address:
CONTACT PERSON:
Name:Constantine Rigas
Mailing Address:22260 Main Road, Orient NY 11957
Phone#:917-509-8751 Email:c@rigasco.com
DESIGN PROFESSIONAL INFORMATION:
Name:Joseph Fischetti, P.E.
Mailing Address: 1725 Hobart Road, Southold NY 11971
Phone#:631-765-2954 Email:Joseph@fischetti.com
CONTRACTOR INFORMATION:
Name:Constantine Rigas
Mailing Address:22260 Main Road, Orient NY 11957
Phone#:917-509-8751 Email:c@rigasco.com
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
®Other Inground Pool50,000
Will the lot be re-graded? ❑Yes RNo Will excess fill be removed from premises? RYes ❑No
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PROPERTY INFORMATION
Existing use of property:Single Family Intended use of property:Single Family With pool
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? Dyes *No IF YES, PROVIDE A COPY.
Check 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 of the Town of Southold,Suffolk,County,New York and other applicable Laws,Ordinances or Regulations,for the construction of buildings,
additions,alterations or far 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 n mmle): (2CXAC�%rk IRAuthorized Agent El Owner
Signature of Applicant: Date:
STATE OF NEW YORK)
SS:
COUNTY OF
I ,
,, being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)a ove named,
(S)he is the t" � �. �"
ontract r,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 020
Notary Public
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(See Wseparate"ownerµauthorization)
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