HomeMy WebLinkAbout51811-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#: 51811 Date: 04/07/2025
Permission is hereby granted to:
Popover LLC
306 Carter St
New Canaan, CT 06840
To:
construct accessory in-ground swimming pool as applied for,
Premises Located at:
4 Sterling St, Fishers Island, NY 06390
SCTM# 10.-9-7
Pursuant to application dated 02/26/2025 and approved by the Building Inspector.
To expire on 04/07/2027.
Contractors:
Required Inspections:
Fees:
SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $300.00
CO Swimming Pool $100.00
Total $400.00
gilding 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
R�... ��,,a
Date Received
BUILDINGAPPLICATION FOR
For Office Use Only E C E Y LI E
Building
PERMIT NO. g Inspector: 2 F E 8 2 6 2025
Applications and forms mu
st be filled out in their entirety.incomplete
lete
not the owner,
applications will not be accepted. Where the Applicant i's an Building Department
Owner's Authorization form(Page 2)shall be completed. Town of Southold
Date. a
OWNER(S)OF PROPERTY:
Name: SCTM#1000-
&1\ t + . 6U �A n- S \o - G� -1
Project Address: ��ritJ 1 i" 1, t) 3
Phone#: L i!buU1\ Email: +^k Yt 0 u�"vL
Mailing Address: 3b1v CAtJ,A�A,J Q(c 101 Lk
CONTACT PERSON:
Name: 'y� ^
Mailing Address: 3o�P � �( GQAATJ [;(g 1040
Phone#: 6,1-1 L . Email: lc W I/WV% dC Ol�k. t 16M
DESIGN PROFESSIONAL INFORMATION: n
Name: CtZ 4.i "w
Mailing Address: 1G� le • —)?\31 r� " t1 W l (053 L
Phone#: Email:
CONTRACTOR INFORMATION:
Name: C W
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
Other
$ 5
Will the lot be re-graded?IK
Yes El No Will excess fill be removed from premises? ❑Yes No
1
PROPERTY INFORMATION
Existing use of props y: Inte ded use o property:
Zone or use district in which premises is situated: Are there any covenan and restrictions with respect to
this property? ❑Yes KNo IF YES, PROVIDE A COPY.
I —
teck 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 appBcable 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 210AS of the New York State Penal Law.
Application Submitted f gTint name): VAAV"-� �J .L 1(A. Owner ent
Signature of Applicant: �— Date:
STATE OF NE�HFAfiK)1Clsvev+.e-r�'`u'`
SS:
COUNTY OF d,)
erg /l� being duly sworn,deposes and says that(s)he is the applicant
(Name of individual 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 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
J day of __ 20215
Notary Public
lZA
") °' V ca es rjn F*:res Sept.3�, u 5
(Where the applicant is not the 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