HomeMy WebLinkAbout51529-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#: 51529 Date: 01/08/2025
Permission is hereby granted to:
Thomas J Deierlein
19 Westbury Rd
Garden City, NY 11530
To:
construct swimming pool with spa addition to an existing single-family dwelling as applied for. All
construction activity must be outside of 100'from the wetland boundary delineation.
Premises Located at:
2515 Calves Neck Rd, Southold, NY 11971
SCTM# 70.4-45.5
Pursuant to application dated 11/12/2024 and approved by the Building Inspector.
To expire on 01/08/2027.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling- Addition&Alteration $833.00
SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $300.00
CO-RESIDENTIAL $100.00
Total 1 233.00
ing I 11 nspector
� tt 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 InI .2YO
Date Received
APPLICATION FOR BUILDING PERMIT
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F Office Use Only d
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PERMIT NO. Building Inspector.
Applications and forms must be filled out in their entirety.Incomplete ,,w
applications will not be accepted. Where the Applicant is not the owner,an
Owner's Authorization form(Page 2)shall be completed.
Date:10/10/2024
OWNER(S)OF PROPERTY:
Name:Thomas J. Deierlein SCTM#1000-70-4-45.5
Project Address: 2515 Calves Neck Road„ Southold, NY 11971
Phone#:g172875961 Email:tomdeierlein@gmail.com
Mailing Address: 19 Westbury Road, Garden City, NY 11530
CONTACT PERSON:
Name:Jonathan Paetzel
Mailing Address:PO BOX 478, Mattituck, NY 11952
Phone#:6312092410 Email:jonathan@mplastudio.com
DESIGN PROFESSIONAL INFORMATION:
Name: Jonathan Paetzel
Mailing Address:PO BOX 478, Mattituck, NY 11952
Phone#:6312092410 Email:jonathan@mplastudio.com
CONTRACTOR INFORMATION:
Name:TBD
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ®Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
❑Other $200,000
Will the lot be re-graded? ❑Yes R 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
R-40 this property? ❑Yes WNo IF YES, PROVIDE A COPY.
8 Check Box After Reading: The owner/contractor/design professional Is responsible for all drainage and storm water issues as provided by
Chapter 136 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.
`' fc� �"❑Authorized ent ne�r
Application Submitted By(print name): 1 �
A
Signature of Applicant: ,r� Date:
STATE OF NEW YORK)
SS:
COUNTY OF
2EI 42, being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the 6 Qj/v''
(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
II--
day of ICA- , 20LJ
Notary Public
MARIA PRIKAS GANLEY
ROPE OWNER �I �I T H �^It IW I Notary Public-State of New York
_. NO.01 PR5003206
(Where the applicant is not the owner) Qualified in Suffolk County
My Commission Expires Oct 19, 7076
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
L. 2
Sco
tt A. Russell
SUPERVISOR A4 ANAcGr]ENIENT
SOUTHOLD TOWN HALL-P.O.Box 1179
53095 Main Road-SOUI'HOLD,NEW YORK 11971 Town of Southold
CHAPTER 236 - STORMWATER MANAGEMENT REFERRAL FORM
( APPLICANT INFORMATION TO BE CO MPLETED BY THE APPLICANT
ONLY FOR PROPERTIES ONE ACRE [N AREA OR LARGER. )
I �
"K APPLICANT: (Property Owner, Design Professional, Agent, Contractor, Other)
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Date: UZ i./
NAME:
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Contact Informa lon: ..
IE-Niail8 Ielepil iViunheil
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Pro ert Address / Location of Construction Site:
S.C.T.M, : 1000
w Dhtrrct
.... __ _
......_. .._... T ......._ Section Block Lot
TO BE COMPLETED BY SOUTHOLD TOWN ENGINEERING DEPARTMENT
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Area of Disturbance is less than l Acre. No S,P.D.E.S. Permit is Required !
® - Project does Not Discharge to Waters of the State. No S.P.D.E.S. Permit is Required !
- Area of Disturbance is Greater than I Acre & Storm-water Runoff Discharges Directly
to Waters of the State of New York. THE APPLICANT MUST OBTAIN a S.P..D.E.S. Permit
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DIRECTLY From N.Y.S. D.E.C, Prior to Issuance of a Building Permit.
,Area of Disturbance is Greater than I Acre & Stoi-m-,varPr Runoff Flows Through Southold
Town's MS4 Systems to Waters of the State of Nei\ York. THE APPLICANT MUST OBTAIN
a S.P.D E.S., Permit throw I.y the Southold Town Engineeruz De artment
Pa•rial- to Issuance of a BuildigL Permit.
Reviewed By:
G Date: II t Z 7
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