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HomeMy WebLinkAbout51475-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#: 51475 Date: 12/13/2024 Permission is hereby granted to; Richard N Kalich 605 Saltaire Way Mattituck, NY 11952 To: construct accessory in-ground swimming pool as applied for. Premises Located at: 605 Saltaire Way, Mattituck, NY 11952 SCTM# 100.4-19 Pursuant to application dated 10/21/2024 and approved by the Building Inspector. To expire on 12/13/2026. Contractors: Required Inspections: Fees: SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $300.00 CO Swimming Pool $100.00 41 Total S400.00 Iding 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 lint)s:HwwN .soutioldtowtin, Y v Date Received APPLICATION FOR BUILDING PERMIT MII For Office Use Only � I IIyIyI I/ PERMIT NO, Building Inspector. Applications and forms must be filled out in their entirety. Incompletei �u ny r � t applications will not be accepted. Where the Applicant is not the owner,an roVV Owner's Authorization form(Page 2)shall be completed. Date: OWNER(S)OF PROPERTY: Name: SCTM # 1000- Project Address: Phone ' �, Email: Mailing Address: CONTA PERSOI'�. Name: OWN Mailing Address: 1;5A Phone#t Email. .,) DESIGN OFE0IONAL INFORMATION: Name: f s LaPwioo, Mailing Address: �kffi r)s— Phoin #031 Email: CONTRACTOR INFORMATION- Name : Mailing Address: Phone#: Email: DESCRIPTION OF PROPOSED CONSTRUCTION pair ❑Demolition ' Estim crs��Pe ❑New Struct I� $ ;Other tion ❑Re ure ❑A dition ❑Alters Will the lot lbe re-graded? ❑Yes No Will cessfill be removed from premi�es I 1 PROPERTY INFORMATION 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? ❑Ye o IF YES, PROVIDE A COPY. Check Box After Reading: The owner/contractor/design professional is responsible for all d' Inae and storm water issues as provided by C tear 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 Orden ce 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 210.4S of the New York State Penal Law. Application Submitted By( i name : 1)4 utlori2ed Agent El Owner Signature of Applicant: Date: Ao121 1� STATE OF NEW YORK) SS: COUNTY OFP-4Q AJ A I k:ZkZ&�) being duly sworn, deposes and says that(s)he is the applicant (11ame of individ a 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 applicatio rel i q to the best of his,/her knowledge and belief; and that the work will be performed in the manner set fort,�I : k , 'I + Lin file therewith.. : 0.0111 152 1657"; � t Sworn before me this QUALIFIED 1� .. ;s Fol K COu1�1Ty day of ,2 ": tt-29. . vs + Not ry Public �Ip ti�, PROPERTY OWNER AUTHORIZATION (Where the applicant is not the owner) 1, Ma fQ residing at do hereby authorizeA Ytap ply on z1111111I j my b�e�alf to the Town of Southold Building De, la1�m 944ftz"proval as described herein. .col A ZK :1o.01 M 162 3165 7 O 'er's ignature oUALIFIED M Date SUFFOI. COUNTY Comm. o . � G 11-26 Prin. Owner s Name �'�"��� . �'r'�'+Illl i I I14111ti"���� 2 ..Awwnom ACTMIMOR Au0W00% Mnow" �O�latllt 4 A r10M14DM Of 7w OF at mw Tm Sun Com of 40 HOB 1 aq qa o Vxrrrt rB`oom WA ot �IIAIAND� d MOWN fiW(ailr ZIM7 10 AR Po*m pm 1h"AR sum �� �� .1+WAMM w140 CM iB"4W 1010 r► � 'Of-��tAo 711i L10W0a. �} � ft%b%Are c0 Da^oxWmw C*"as4rc OWN, tA, 4 t s ,M " �1- � 14 " yea fie'" 1 SURVEY TOR THOMAS A. ER a DEBRA N. FLAD R LOT 22 49SALTAiRE ESTATES` , e MATTITUCK r TOWN OF SOUTHOLD SUFF. CO., N.Y. ' ' NOTE i YOUR ^4 L SUFFOLX C4UNlYTAX MAP w. T ,Wti N3,1987 a u/A�MMD 3 4 ODIHUEG MAP-nt.L"0 IN T'H OFFX R NO.4 ,