HomeMy WebLinkAbout49022-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
k 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 #: 49022 Date: 3/13/2023
Permission is hereby granted to:
Ed ett, Daniel
225 Willow St
Cutcho ue, NY 11935
To: construct accessory in-ground swimming pool as applied for. Pool equipment must
have a minimum setback of 10 feet from rear and side yard lot lines.
At premises located at:
225 Willow St, Cutcho ue
SCTM #473889
Sec/Block/Lot# 103.-7-8
Pursuant to application dated 3/2/2023 and approved by the Building Inspector.
To expire on 9/11/2024.
Fees:
SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00
CO - SWIMMING POOL $50.00
Total: $300.00
Building Inspector
YWPAld
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 https:/Ywww,southoldtownny.gov
4MP Gif� dP
Date Received
PERMITAPPLICATION FOR BUILDING
For Office Use Only
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PERMIT NO. Building 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
Owner's Authorization form(Page 2)shall be completed. i
T0'VVN0F'S(AJP-UL1)
Date:
OWNER(S)OF PROPERTY:
Name. 1:SCEM #
:1:000-
Project Address: kj tj 11O W
Phone#: , Email:
Mailing Address:. 15 LA) I" A-44-cli t9/,A veg
CONTACT PERSON:
Name:
Mailing Address. t
Phone#: Email:
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address: lu Ja Aile,) LZ
1
Phone#: Email: '
CONTRACTOR INFORMATION:
Name: ✓
Oaf-
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
ther $
Will the lot be re-graded? ❑Yes o Will excess fill be removed from premises? Dyes
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PROPERTY INFORMATION
Existing use of property: Intended use of property:
Zone or use district in which premises is situated: Are there any covenan and restrictions with respect to
this property? ❑Yes o IF YES, PROVIDE A COPY.
heck Box After Reading: The owner/contractor/design professional is responsible for all drainage and storm water issues as provided kap
'h ter 256 of the Town Code, APPLICATION IS HEREBY I'r✓IADE to the Building Department for the issuance of a Building Permit pursuant to the Btaild(ng 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( ' name): te
onlzed Agent El Owner
Signature of Applicant: Iia /
11
STATE OF NEW YORK)
SS:
COUNTY OF
being duly sworn, deposes and says that(s)he is the applicant
(Name of indivl 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 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 thiso-ab
day of aLch -M�Q
N tiarY Public
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PROPERTY UTI,,, IU "n I r�o.I�Ir r z�rss�:
OUAI IHED IN
(Where the applicant is not the owner) SUFFOLK coComm li Ty.
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residing at ''r, O -\N —,N;``
RIIIIIIIIwt Via,
do hereby authorize � ,;,,- to apply on
my behalf to the Town of Southold Building Department for approval as described herein,
3Owner's Signature Date
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Print Owner's Nam
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WILLOW STREET
SURVEY OF PROPERTY
AT CUT+C OGUE
TOWN OF SOUTHOLD
stcmr?ards fw fills mve)&= ®stab%lwd by
the I-LA.l,.s. and approved aodopte:: SUFFOLK COUNTY, N.Y.
'For ukh use by The Now York state Land 1000 — 103'
3 _ 07 -' 08
rife Auoemfmn.
SCALE I" _ 30'
_ SEPT. 17, 1985
MAR . 18 , 198R
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CERTIFIED TO ;
CHICAGO TITLE INSURANCE
`
Y.S. x.10. NO 49618 COMPANY OF NEW YORX
SOUTHOLD SAVINGS BANK
PECO a ENGiNEERS, rP C. OET€R FERRJGAN
(519 . 6 'VIRGINIA FERRIC AN
54655 MA OAD TITLE NO. 8808 0945 73
SOUTHOL D , N _ Y . 119 71
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