HomeMy WebLinkAbout52048-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#: 52048 Date: 06/30/2025
Permission is hereby granted to:
Anna Bajlak
1995 Ruth Rd
Mattituck, NY 119520917
To:
Construct in ground swimming pool at existing single family dwelling as applied for,
Maintain minimum 10 foot setback to side and rear property lines as required.
Premises Located at:
1995 Ruth Rd, Mattituck, NY 11952
SCTM# 106.-7-7
Pursuant to application dated 05/28/2025 and approved by the Building Inspector,.
To expire on 06/30/2027.
Contractors:
Required Inspections:
Fees:
CO Swimming Pool $100.00
SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $300.00
400.00
...__. Building Inspector
�r' TOWN OF SOUTHOLD—BUILDING DEPARTMENT
o,
O. Box 1179 Southold NY 1197 1-0959
To
wn Hall Annex 54375 Ma
in Road P. ,
Telephone (631) 765-1802 Fax (631) 765-9502 bg //wwrsoutholdto nn
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
l
PERMIT NO. +� Building Inspector
AppIkatkwtsand forms must be filled aut in their entirety irtaompiete Uo1i i�a D to ral
appllcations wlf,1 riot be acxepted Wherethe/IP�1caM,Ls nat`t1rc owr>rer,an To �� of O LP th(A d
ir ,!
Owners Autfi°orizs fon>i(Pag+a`">chall be compte>Ded
0
Date:
OWN S F PROPERTY'
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Name: f-�C o� " SCTM#1000- /6& - 7, (jv _ 7. D00
Project Address: f 99 2 M� � cK AA�
Phone#: 9/7-359 636 Email:fth I"egvrr A7 iclu�. camel
Mailing Address:
CONTACT PERSON:
Name: � � �; K
Mailing Address:c-70, 3vk 9 3s
Phone#: &3/_ tf&Y `/Eels Email:gCh;4uKc-3oyonl t n< -ne_�
QES1RaN,PROF�SSIQNAI.INFORMATION:
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name: ��c hc�S
L k,�
Mailin Addres :�1 .U. � 1 r
N !' // 5 3 S
Phone#: 631^ 23el-7&&S Email:gch--�oKa)Oi' -vn I>rae.rn'O-k
DESCRWTM OF PROPOSOtONSRUCnON
El New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
Pother &,oj ►) TbJ WU. UO
Will the lot be re-graded? ,dyes ❑No Will excess fill be removed from premises? es ONO
1
PROPERTY INFORMATION
+, r-r- ��— Intended use of pro �rt
Existing use of property: G Y ""q
p this property? PROVIDE restrictions
respect to
Zone or use district in which remises is situated: Are there an
p p E A COPY,
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 Budding Department for the issuance of a Building Permit pursuant to the sullding Zone
Ordinance of the Town of Southold,Suffolk,County,Now 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 authorked inspectors on premises and In buildings)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{ int name): QiAuthorized Agent [Downer
Signature of Applicant: �O I BUNCH Date: �/2 g/Z S—
�ry publlc, Tate of New York
No.01 BU6185050
C2
STATE OF NEW YORK) ualifled in Suffolk County
SS: ComrnI slon Expires April 14,2
COUNTY OF
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
p
Y of 20c)S
-° Notary Public
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
,Q � µ
residing at
q
do hereby authorize 64,vle- 6% I40k, OO Is to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
O er's Signature Date
Prim Owner's Name
2
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DATE: FEB. 13, 2025
JO8 NO:2025-034
Survey for:
CERTIFIED TO:
KENNETH MCGORRY KENNETH McGORRY &
MART McGCOMPAAMERI RY � �
FIRST AMEN T1 - INSURANCEMARY
GROSS-.. r-WO TGAI E I I C SAOA ATII�dA �, a�
Lot 7, Sumet Knolls, Section
At
t` .
Matt-ituck
-` Town of
Southold
Suffolk County, New York
S.C_T.M.: 1000-106.00-07.00—007.000
DAMD H. FOX.°I_:S. P.C. N.Y.S.L.S. ;50234
FOX L4JVD SURVEYING u '�
I
64 SUNSET AVENUE
WESTHAMPTON BEACH, N.Y. 11978 SCALE:1"=30'
(631) 288-0022
NOTES:
UNAUTHORIZED ALTERAI.ON OR ADDITION TO TH=S SL:R'V;Y
IS A VTOLA—iON --CS-CTIOV 7209 05 THE NEW YORX STATE
E7JC�TIO.N LAW. cOP.�S THI$ SVR`JEY MAP NOT 9::.iINc. 1. AREA = 21,866 S.F.
THE LA147 SURVEYOR'S (INKED SEAL OR EKEOS'SEO SEAL
SHA_L NOT BE COIISDERED TO @E A VALID TRUE COPY. 2. = MONUMENT FOUND, 1 = STAKE FOUND.
CR>> r? � �� zl s ,3 , si�acuu rati ka ap sw�sF r xNtui� sEC.ncu� a'
USTCO FILED IN THE OFFICE OF THE CLERK OF SUFFOLK