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HomeMy WebLinkAbout51304-Z TOWN OF SOUTHOLD BUILDING DEPARTMENT 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#: 51304 Date: 10/22/2024 Permission is hereby granted to: Kirkland DA Revoc Trt 2275 Deep Hole Dr Mattituck, NY 11952 To: Construct an inground swimming pool accessory to an existing single-family dwelling as applied for. Pool and pool equipment must maintain a minimum side and rearyard setback of 5 feet. Premises Located at: 2275 Deep Hole Dr, Mattituck, NY 11952 SCTM# 115.-14-14 Pursuant to application dated 09/03/2024 and approved by the Building Inspector„ To expire on 10/22/2026. Contractors: Required Inspections: FOOTING/REBAR, ELECTRICAL- ROUGH, ELECTRICAL- FINAL, DRAINAGE, FINAL, Fees: SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $300.00 CO Swimming Pool $100.00 Total $400.00 ........... ju Building Inspector 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 litt s:HwNvNv, o tholdtownriL o o- Date Received APPLICATION FOR BUILDING PERMIT I 9 .11 avol i For Office Use Only PERMIT NO. Building Inspector;—JA�& �U � �� ' Applications and forms must be filled out in their entirety. Incomplete T011DIt applications will not be accepted. Where the Applicant is not the owner,an SO UT1101 Owner's Authorization form(Page 2)shall be completed. " Date: q OWNER(S)OF PROPERTY: Name: SCTM #1000- Project Address: Q2 IC`a r\,Jc Phone#: y� Email: Mailing Address: CONTACT PERSON: Name: KQLwCA Mailing Address: 5ql ke- Phone# _ "1 -' � Email: S t\ , DESIGN PROFESSIONAL INFORMATION: Name: Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: Name: S Mailing Address: a S O U Phone#: . Email: Wncf DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: Other" '�C $ Will the lot be re-graded? I9Yes El No Will excess fill be removed from premises? ❑Yes ly0 1 PROPERTY INFORMATION Existing use of property: I �'� � '" r>Le Intended use of property: i Qqr, (,Z� 7 Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to K_ 40 this property? ❑YesOo IF YES, PROVIDE A COPY. heck Box After Reding: 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 By Lbrint name): 6t�n a Authorized Agent ❑Owner Signature of Applicant: Date: q)31 3kq STATE OF NEW YORK) SS: COUNTY OF ) vg�k,irl)Lc& 'AR, being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)he is the 4 �Itontractor,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 , 20 Notary Public VICTORIA A FERREMI E Public^'State of New York110 moN OIFE6430360OPERTY OWNER alified in Suffolk County Wherthe a I ant Is notthe u n C " IIImission Expires Mar 14, 2026 •� ��. ( pp owner) I, 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 Building a artmgent Aj2gliegtion AUTHORIZATION (Where the Applicant is not the Owner) I, q ._._.residing at 0j Ur (Print property owner's name) (Mailing A. ess) do hereby authorizeKa4ri'm-Me-maric, (Agent) to apply on my behalf to the Southold Building Department. Q-0 0(0 ner's Signa ire (Date) (Print Owner's Name) JUN wvn�i OFFICE OF lo/ E 28 �g LOT TOWN OF SOUTHoi S�OCKw SfOCIfME FENCE ROW OF ARBORVITAE II IIQ 0 r�/ j //�3� ��, n'''� r r /Ff Iti / /0 21, r r t t li" Jl, CE 1/2 fST60y FRAME r AGE Gl�K e "AM " 14 4 /�r ++rx �r If M c„ j J uVVVVI 7 t, m ^rp1' // n " / r , �j,