HomeMy WebLinkAbout48921-Z � r TOWN OF SOUTHOLD
BUILDING DEPARTMENT
r TOWN CLERK'S OFFICE
SOUTHOLD, NY
419
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 #: 48921 Date: 2/16/2023
Permission is hereby granted to:
Esteves HIdg Cor
80 Sunset Ave
Selden NY 11784
To: Install in ground swimming pool to existing single family dwelling as applied for.
Must maintain a minimum setback of 10 feet from property lines to pool and pool
equipment.
At premises located at:
105 Ripple Water Ln, Southold
SCTM # 473889
Sec/Block/Lot# 76.-1-15.4
Pursuant to application dated 2/3/2023 and approved by the Building Inspector.
To expire on 8/17/2024.
Fees:
SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00
CO- SWIMMING POOL $50.00
Total: $300.00
Building Inspector
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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 littrmrw��o>»itjdt(�)wntl:V,�lov
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APPLICATIONI II
For Office Use Only
PERMIT NO. / Building Inspecton—
FF Inspector-
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Applications and forms must be filled out in their entirety. Incomplete
applications will not be accepted. Where the Applicant is not the owner,an BURDW
Owner's Authorization form(Page 2)shall be completed.
Date:
OWNERS)O P RTY:
i I �� SCTM#�000--7� ..
Name: Man wr
Project Address: 1 � I�+ 5S-D "
Email:
Phone#: 2 -- 1t'
Mailing Address: eLo
CONTACT PERSON:
Name:
Mailing Address:
Phone#:
Email
(moi ' -
DESIGN PROFESSIONAL INFORMATION:
Name:(" �J ............
h
MallinAddress:
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Phone#: .� � ��. mai ��,
CONTRACTOR INFORMATION:
Name: "� �
is
Mailing Address:
a
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Proojer
O
ED ther
Will the lot be re-graded? El Ye INo Will excess fill be removed from premises? Yes
1
PROPERTY INFORMATION
Existing use of property: Intended use of property:
Zone or use district in which premises is situated: Are there any covena is and restrictions with respect to
this property? ❑Yes IF YES, PROVIDE A COPY,
t'ec' Box After Reading: The owner/contractor/design professional is responsible for all drainage and storm water issues as provided by
,ptAr 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
�?rdlnatwce 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 jprio n e)t thorned Agent Downer
Signature of Applicant: Date:
STATE OF NEW YORK)
SS:
COUNTY OF
being duly sworn, deposes and says that (s)he is the applicant
(Name of indivi al signing contract) above named,
(S)he is the
(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 applicati jorpj�rue to the best of his/her knowledge and belief; and
that the work will be performed in the manner set f qh' iMAIi.,eLk bion file therewith.
Sworn before me this
1�"' x
day of �
a t, .
NLary Public
III11
IIT PIE; " NEAUTI-10RIZATIGN
(Where the applicant is not the owner)
euresiding at 65'
�_.., Lane-
LI—Inn� do herebyauthorize to apply on
my behal o the Town of South ld Building Department for approval as described herein.
Owner's Signature a v Date
16 o L) ✓cam
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Print Owners Name 7 , . o = �
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