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Home My WebLink About51479-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#: 51479 Date: 12/16/2024 Permission is hereby granted to: Rosmarin AP Revoc Trt 31 Annandale Dr Chappaqua, NY 10514 To: Construct an inground swimming pool accessory to an existing single-family dwelling as applied for perTrustees approval. Pool and pool equipment must maintain minimum side and rear yard setbacks of 10 feet. Premises Located at: 640 Lloyds Ln, Mattituck, NY 11952 SCTM#99.-3-4.1 Pursuant to application dated 10/21/2024 and approved by the Building Inspector. To expire on 12/16/2026. Contractors: Required Inspections: Fees: SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $300.00 CO Swimming Pool $100.00 Total $400.00 Building Inspector 4, TOWN OF SOUTHOLD—BUILDING DEPARTMENT if Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 u Telephone(631) 765-1802 Fax(631)765-9502 https-://wwwsoutholdtgmppy.gov Date Received f APPLICATION IG For Office Use Only � ' 4 PERMrr NO. c l Building Inspector-, i, °N " "O 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. Date:October 21 st, 2024 OWNER(S)OF PROPERTY: Name:Rev.Trust ofAbby P.Rosmadn, Abby Rosrnarin and David Ross Tr stew SCTM#1000-99-3-4.1 Project Address:640 Lloyds Lane, Mattituck, NY 11952 Phone#:631-734-7923 (Agent) lEmail:Creativeenvdesign@yahoo.com Mailing Address:P.O. Box 160 PeconiC, NY 11958 CONTACT PERSON: Name: David Clchanowlcz/Creative Environmental Dealgn MailingAddress:P.O. Box 160, Peconic, NY 11958 Phone#:631-734-7923 Email:creativeenvdesign@yahoo.com DESIGN PROFESSIONAL INFORMATION: Name: Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: Name:Creative Environmental Design Mailing Address P O. Box 160, Peconic, NY 11958 Phone#:631-734-7923 Email:creativeenvdesign@yahoo.com DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure [--]Addition ❑Alteration ❑Repair ❑Demolition Esti ted Cost of Project: ❑OtherPool $ Will the lot be re-graded? ❑Yes to No Will excess fill be removed from premises? ❑Yes,,No 1 PROPERTY INFORMATION Existing use of property:Residential Intended use of property:Residential 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. it 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,bullding code, housing code end 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. David CichanowlezlCreative Environmentai Design Application Submitted By(print name): Authorized Agent ❑Owner Signature of Applicant: Date: d f [ lag STATE OF NEW YORK) SS: COUNTY OF David Cichanowicz being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the Ag ent (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 this _day of (Y� cf .20 FENNY LOUISE M FFETONE Notary PAWir NOTARY PUBLIC,STATE OF NEW YORK Registration No. 01 MA6402379 Qualified in Suffolk County 3ROPERTY OWNER ) ( ( fission Expires December 30t6,2027 (Where the applicant is not the owner) I, residing at Abby Rosmarin 640 LLoyds Lane, Mattituck, NY 11952 David Cichanowicz/Creative Environmental Design do hereby authorize to apply on my behalf tQ the Town of Southold Building Department for approval as described herein. /dzZ Owners Signature 6ate Abby Rosmari n Print Owner's Name 2 F t fi a', „b ,.... „� p N I 1' BOARD OF SOUTHOLD TOWN TRUSTEES , SOUTHOLD NEW YORK PERMIT NO.10645 DATE: SEPTEMBER I .20Z4 >, a k ISSUED TO: REVOCABLE TRUST'OF ABBY P. ROSMARIN DATED OCTOBER 19 tt.2020. coo ABBY P. ROSMARI� & DAVID M. ROSS AS TRUSTEES PROPERTY ADDItl+1 SS: 640 LLOYDS LANE MA"1 rITUCI SCTM# 1000-99-3-4.1 AUTHORIZATION Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on Member 18.2024. r and in consideration of application fee in the sum of$1,250.00 paid by REVOCABLE TRUST OF ABBY P. ' CTOBER 191"' 2020.c/o ABBY P.ROrrOSh4RIN 1 IE O . R1N&I)AV1D 1vt.ROSE TRUSTEES and subject to the Terms and Conditions as stated in the Resolution,the Southold Town Board of o Trustees authorizes and permits the following: w a J� Wetland Permit to remove existing pool and construct a new 16'x36' in-ground pool; b G y °wf ""y remove existing pool patio and construct a 1,570sq.ft, patio surround with steps; , connect drainage to drywell; install 4' high pool enclosure fencing with gates; existing black cherry tree to be removed and replaced with a 3" caliper oak tree; and remove 'U steps on east side of patio; with the condition that the drywell be moved to the easternr ; side of the property; and silt fence and hay bales installed prior to construction; all as depicted on the site plan prepared by Creative Environmental Design, received on 4w" ' September 20, 2024, and stamped approved on September 27,2024. IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, fand these presents to be subscribed by a majority of the said Board as of the day and year written above. fl pry A _. 53 r° i .r ,, f a"f, Suffolk County Dept.of Labor,Licensing&Consumer Affairs HOME IMPROVEMENT LICENSE Name DAVID J CICHANOWICZ Business Name " INDIAN NECK CORP DBA This certifies that the bearer is duly licensed License Number H-29895 by the County of suffolk lsgsued: 12/13/2001 J94'L �CbYelra, Expires: 1 210112 02 5 Commissioner 5 Y N r