HomeMy WebLinkAbout52246-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
ow 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#: 52246 Date: 09/09/2025
Permission is hereby granted to:
Byron Elmendorf
1570 Bray Ave
Laurel, NY 11948
To:
install an accessory hot tub as applied for.
Premises Located at:
1570 Bray Ave, Laurel, NY 11948
SCTM# 126.-7-26.1 -
Pursuant to application dated 07/29/2025 and approved by the Building Inspector.
To expire on 09/09/2027.
Contractors:
Required Inspections:
FOOTING/REBAR, ELECTRICAL- ROUGH, ELECTRICAL- FINAL, DRAINAGE, FINAL,
Fees:
SWIMMING POOLS-ABOVE-GROUND WITH REQUIRED FENCING $300.00
CO Accessory $100.00
Total S400.00
Building Inspector
�,�rauaam J
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 h1t is://\Mw.soqtho1dtoA"iny,g.0V
Date Received
APPLICATION FOR BUILDING PERMIT
"r L5 For Office Use Only
4
PERMIT NO. Building Inspector: JUL 2 202
Applications and forms must be filled out in their entirety. Incomplete
applications will not be accepted. Where the Applicant is not the owner,an Building Department
Owner's Authorization form(Page 2)shall be completed. Town of Southold
Date: 7/28/2025
OWNER(S)OF PROPERTY:
Name: Byron Elmendorf and Miranda Capriotti SCTM #1000- 126.00, 007.00, 026.001
Project Address: 1570 Bray Ave Laurel NY 11948
Phone#:530 386 7673 Email: byronelmendorf@gmaii.com
Mailing Address: Byron Elmendorf 1570 Bray Ave Laurel NY 11948
CONTACT PERSON:
Name: Byron Elmendorf
Mailing Address: 1570 Bray Ave Laurel NY 11948
Phone#: 530 386 7673 Email: byronelmendorf@gmaii.com
DESIGN PROFESSIONAL INFORMATION:
Name: NA
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name: NA
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure RAddition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
DOther Hot Tub Install $ $1000
Will the lot be re-graded? ❑Yes ®No Will excess fill be removed from premises? ❑Yes ®No
1
PROPERTY INFORMATION
Existing use of property: Residential, family occupied I Intended use of property: Residential, family occupied
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
R-40 this property? ❑Yes ❑No IF YES, PROVIDE A COPY.
Check Box After Reading: The owner/contractor/design professional is responsible for all drainage and storm water issues as provided by
Chapter Z36 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,Suffollt,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.
Application Submitted By(print name): piq CL.Qt&Nj-?VF1r ❑Authorized Agent ❑Owner
Signature of Applicant: Date: —+69 p�5
STATE OF NEW YO''RK)
COUNTY OF�"`� 1 I L )
C7 fam - 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
oe
dY of 20 d
14Notary Public
NOTARY PUBLIC ATE OF NEWYORK
ROU0fie inSon uf 01Sk� ty PROPERTY OWNER AUTHORIZATION
Commission Expires FebrLARry 27, 0X4Wflere 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
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REVISED: DECEMBER 5, 2019 4 p SYSTEM � MATTITUCK
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SURFED: APRIC Q, 2019 , '691� TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
ROBERT A. SMITH,
S. H. W. and S., LAND � ,,
AREA = SCALE: S.F. (0-344 ACRE)
SQUIRES, HO ENBACHER & SMITH
SCALE: 1" = 20'
LAND SURVEYING — LAND PLANNING ENGINEERING
SOUTHAMPTON — NEW YORK
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