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Home My WebLink About49136-Z r . TOWN OF SOUTHOLD BUILDING DEPARTMENT p TOWN CLERK'S OFFICE SOUTHOLD, NY 4,1�*,0-01 " 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#: 49136 Date: 4/18/2023 Permission is hereby granted to: Rutkin, Marlene 6 Henwawk Rd ................... .-. .- __ ............................. . . Great Neck, NY 11024 To: Construct an in-ground swimming pool to an existing single family dwelling as applied for per Trustees and DEC approvals. Pool and pool equipment must maintain a minimum primary front yard setback of 40 feet and a minimum secondary front yard setback of 25 feet. At premises located at: 800 Lakeside Dr, Southold SCTM_m# 473889 Sec/Block/Lot# 90.-3-6 Pursuant to application dated 3/16/2023 and approved by the Building Inspector. To expire on 1w0/17/2024.� 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 4. Telephone (631) 765-1802 Fax (631) 765-9502 littps://www.southoldtowiitiy.g2 Date Received APPLICATION FOR BUILDING PERMIT L (� For Office Use Only PERMIT NO. I J Building InspectorJAI:& E � � n, MAR I b NO " Applications and forms must be filled out in their entirety. Incomplete applicationswill not be accepted. Where the Applicant is not the owner,an ? iltI � t Owner's Authorization form(Page 2)shall be completed. onournqow Date: OWNER(S) OF PROPERTY: Name:Marlene J Rutkin scTM#io00-90-3-6 Project Address:800 Lakeside Drive North,Southold Phone#:516-721-3748 (Bruce) IEmail. Mailing Address:6 Henhawk Rd Great Neck NY 11024 CONTACT PERSON: Name:lslandia Pools L.T.D. (John J Wysoczanski) Mailing Address:108 Fishel ave Riverhead NY 11901 Phone#:631-727-6312 Email:john@islandiapools.com DESIGN PROFESSIONAL INFORMATION: Name: Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: Name:lslandia Pools L.T.D (John J Wysoczanski) Mailing Address:108 Fishel Ave Riverhead NY 11901 Phone#:631-767-2280 Email:john@islandiapools.com DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: DOtherSwiming pool $135,445.00 Will the lot be re-graded? RYes El No Will excess fill be removed from premises? AYes 1:1 No 1 PROPERTY INFORMATION Existing use of property: Intended use of property:SWlmming Pool Zone or use district in which premises is situated; Are there any covenants and restrictions with respect to this property? i*Yes ONO 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 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 B na );John J Wysoczanski RAuthorized Agent Downer Signature of Applica � Date: �w STATE OF NEW YORK) SS: COUNTY OF John J Wysoczanski being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)he is the Contractor (Contractor,Agent, Corporate Officer,etc.) of said owner or owners, and is duly authorized to perform or have performed the s i wo and to make and file this application;that all statements contained in this application are true to the best of h'' h r k owledge and belief; and that the work will be performed in the manner set forth in the application file there i Sworl�efore me this day of //i"f`ub� 1203 tar Public PROPERTY OWNER AUTHORIZATION J�M (Where the applicant is not the owner) 1, 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 PROPERTY INFORMATION Existing use of property: Intended use of property:SWl1'T ming Pool Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? ®Yes ONO IF YES,PROVIDE A COPY. IR 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 15 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,Ordlnences 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 authorhed inspectors on premises and to buildings)for necessary Inspections.False statements made herein are punishable as a Class A misdemeanor pur;uant to Section 210.45 of the New York State Penal Law. Application Submitted Bna ):John 1 W)SOC7anski WAuthorized Agent ❑Owner Signature of Applica Date: STATE OF NEW YORK) SS: COUNTY OF ) John J WysoczanSkl being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the Contractor (Contractor,Agent,Corporate Officer,etc.) of said owner or owners,and is duly authorized to perform or have performed the s° i wo and to make and file this application;that all statements contained in this application are true to the best of h h k owledge and belief;and that the work will be performed In the manner set forth in the application file there Swo r efore me this Z day of ° 2023 .� to 71 Public „I D' 'ID FREEBORN r )IIG,Strata c"""'wyolit I PROPERTY OWNER AUTHORIZATION { Q1FR,137!" ' a d(r,C- C� (Where the applicant is not the owner) 3. Expir Ue;G u5,202" a , N( Qvl X00 residing at La-lees /'ate Dv N • I, .o clops, W soCz aoskL' /1-P 71do hereby authorize to apply on my behalf to the Town of Southold Building Department for approval as described herein. " Owner's Signature Date Y t Name Print Owner's Na r 2 ( t I