HomeMy WebLinkAbout50978-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
71 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#: 50978 Date: 7/24/2024
Permission is hereby granted to.
Israel, Isaac
889 Harrison Ave FI 2
Riverhead, NY 11901
To: construct swimming pool addition to existing single-family dwelling as applied for. Pool
equipment must have a minimum setback of 15' from the side yard lot line.
At premises located at:
75920 Route 25, Green port
SCTM # 473889
Sec/Block/Lot# 48.-1-13
Pursuant to application dated 3/15/2024 and approved by the Building Inspector..
To expire on 1/23/2026.
Fees:
SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $522.00
SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $300.00
CO -ADDITION TO DWELLING $100.00
Total: $922.00
Building Inspector
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TOWN OF SOUTHOLD—BUILDING DEPARTMENT I
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone(631)765-1802 Fax (631) 765-9502 hip,s;l/www, OtitholdtormULov
Date Received
APPLICATION FOR BUILDING PERMIT
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Fir Office Use Only K
PERMIT NO. Building Inspector � �
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Date:8-25-23
Project Address 621 Front Street ,�-
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Phone# G631 9Q2 ,5294 Email Herbe
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Mailing Address:8 Harrison AVM, �1�� tloor, jiverhead BABY 11901
Name Jackie Glass
Mailing Address BOX 21 amptgn N 1
Phone# 51 f77 93927 Email Jacltilegll
Name
Mailing Address:.
Phone#: Email:
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Name G Ill PQI
Mailing AddressP.O 48 �cuharnptarl 11
Phon 11 e# '6312�1 Email G`UJ.1 O
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�1 yr �rN:* 7� w
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
❑Other Swimming pool 40000
Will the lot be re-graded? WYes El No Will excess fill be removed from premises? ❑Yes ONO
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Existing use of property Intended use of property
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? ❑Yes ❑No IF YES, PROVIDE A COPY.
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Application Submitted By(pr name): 8
Authorized Agent ❑Owner
Signature of Applicant: Date:___ � ,
..............
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STATE OF NEW YORK)
COUNTY OF )
/ e-1-/1 &�[,�` (' w, being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is they c�
(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 F wledge and belief;and
that the work will be performed in the manner set forth in the application file therewith.
BARBARA H. TANDY
Sworn before me this Notary Public, State Of Mew York
No, 01 TA6086001
�, Qualified In Suffolk Ooun �,� �a,7
day of V�rcl ► 20 Cor° mission Expires
Notary Public
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
residing at
do hereby authorize (f- C21 65f to apply on
my behalf tot Southold Department for approval as described herein.
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Owner's Signa a Date
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Print Owner's Name
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