HomeMy WebLinkAbout52343-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
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#: 52343 Date: 10/10/2025
Permission is hereby granted to:
Michael Poulos
150 Java St Apt 513
Brooklyn, NY 11222
To:
construct accessory in-ground swimming pool as applied for.
Premises Located at:
200 Ihar Ln, Cutchogue, NY 11935
SCTM#83.-4-15
Pursuant to application dated 08/29/2025 and approved by the Building Inspector:
To expire on 10/10/2027.
Contractors:
Required Inspections:
Fees:
SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $300.00
CO Swimming Pool $100.00
Total $400.00
lding Inspector
6 M'y
r to TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town
P Y 11971-0959
Tele h ne1 631) 7651802MFax 6317655-9502(� 79:5 1 �t) 0(dl n . 0
a tit vet
APPLICATION FOR BUILDING PERMIT
Q y�
r Office Use Only
S�3V
PERMIT NO, Building Inspector.,_,,
nspector.. , en
�ttlllln ' 'e''Parf
Town of Southold
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:
OWNER(S)OF PROPERTY:
Name:
SCTM#1000-
I y ( i
Project Address: L080 - t'on d I -& � (ylo l-CL �\
Phone#:�4 l L3 U1 7I L Email:
� d
Mailing Address:
CONTACT PERSON:
Name:
EVIC
Mailing Address:
m Phone#: Email:
. .. �� �
DESIGN PROFESSIONAL INFORMATION:
Name: 11C>`CrZ)VV Mailing Address: "'A Nv uj�-
Phone#: Is lP 0 Z- Email: 'Al'noo-o J CJ�
CONTRACTOR INFORMATION
Name: _ i'�l V
Mailing Address: ' r
Phone#: �/�� 51N�,4�33J33
X 1 -"�3 Email: rn� li/1d ��cis , CA(Yl
DESCRIPTION OF PROPOSED CONSTRUCTION
-eNew Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
LRO
❑Other �O
Will the lot be re-graded? ❑Yes PKo Will excess fill be removed from premises? es ❑No
inSijolk f
1 m 'VU UA&
PROPERTY INFORMATION
Existinguse ofproperty: Intended use of property: vu I Li.i fi c.�-�l (q o
I � � �
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? ❑YeseNO IF YES, PROVIDE A COPY.
Check R After Re i lit : The owner/tontrartor/,oesign professipnol is responsible for all drainase and storm water Issuesas provided by
Chapter 2t fi of the Town Code, APPUCA'rloN is HEREBY MAd to jheeuiHolng,Department for theissuante bf a sulidiirut permit pursuan t tsr the liyilding done
00inanue try the Town of Southold,Suffolk,Countyr,New�Yorkarid othar applithble Lrs,ordinates or Regulations, r the cb sinuttion of bolidi ,
additions,aiteratio is;or folr removal or'demoiition as herein dascrtbed."The apptican't,agr°ees to comply,w th allapplicable laws,ordinances,buliding node,
hduslr%,code and regulations and to admit auttiorized inspectors on premises end in building )for necessaru inspections.false statements made herein are
punkheble as a class A misdemeanor pursuant to Sattion 210.45 of the iIew York State`penal Law-
Application Submitted By(print name): I v'I 0-Authorized Agent wner
Signature of Applicant: Date:
STATE OF NEW YORK)
COUNTY OF
\ being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing cant ct)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
day of t,c,o ,20
Notary Publi
Arlene D, ,)ino
Notary Public ew York State PROPER ry OWNER AUIH-ORIZATION
Suffolk County (i F _' (Where the applicant is not the owner)
Commission E, ires /06/ 4
I, � residing at
�- to apply on
do hereby authorize
my behalf to the Town o outhold Building Department for approval as described herein.
5
Owne s Si nature Date
c
Print Owner's Name
2
284
LOT AREA-40L 365 SQ.FT. 9 8-34 1
98-523
LOT NUMBER 14
50'— VACANT
S29�E. 150.00'
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DUCK POND ROAD
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9-29-1998 FINAL SURVEY
6-23-1998 FOUNDATION LOCATION
5-15-1998 REvlsED DWELLING
1-26-199a PROPOSED DWELLING -
IHE OFF21TS (K DTMANSIONRI ,w 4uAtr,A1+ aEs IHLgg0.A1WO JOB NO. 97-269 FILE ND. WOODBINE MANOR
SHOWN HEREON FROM THE Ilrgr�.q IMIN'4NLY T'qR THE SURVEYED FOR
STRUCTURES TO THE PROPERTY POR NTpWm THIE RIJNM M
.INu ARE FOR A SPEOFIC PUR- FARED .AND ON HIS RkHA9.P W
.M AM USE AM THBREPORE TrE TdS4E C'O"+*vo!Rlai, LOT NO. 15
.'M NOT T To GUIDE TI$ TAL AreEN.Y AND i MAP OF WOODBINE MANOR
inCRON OF FMCES, RETAINING TUTION LISTED tiERE"7Ny AND TO
WALL$, POD, PA100S, PTItNTIkq�G'� THE ASSGNEES OF TamT LEFgO@NCr'. a
♦REM, AVOTTION TO R9bILDINOS 6dJCbT gTLiTCW.FJeO"S"EA'RC1 NJDET'ISrAN
xANYIHHI SITUATEDAT CUTCHOGUE
TNSTX rMU"a P OR q Aro"10"
d NAUTNOwlto AA'1'REAT)ON Calk awpam�
AR9nR N jr* Tm SURM Is A TOWN OF SOU THOLD - SUFFOLK COUNTY N.Y.
AWT04 Of 19c" 'rm OM G"JPRS CF T1rkr SCrEVE"r MAP NOT
HR P$w YORIT WA* uANb SUgWYOR's SCALE I" - 50' DATE 7-23-1997
AWE: ET660SW SEAL
f - To @ FILED MAP NO. 8239 DATE 12-t5-1986
GUARANTEED ON y TAX MAP NO. 1000-83-4-15 (REF.ONLY)DISK 176.
C
p ,"I HAROLD F. TRANCHON JR. P.C.
x LAND SURVEYOR
of- 1T45 D
Rr 1866 WADING RIVER-MANOR RD. WADING RIVER,
L Nb NEW YORK, 1 1 y92
Y. LIC. NO. 1D48992 516-929-4695
HAROLD F. TRANCHON JR. PENN. LIC. NO. 91115-E
Michele + Mike °
i, Pasquale it
i 680 Duck Pond Rd i
Cutchogue, NY 11935
pr i l
Moab' -usei'
i!
Corner ErMry W/
Beach Along Shallow
wr B �
End Wall
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iwo'oitrr"stt
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Benches 20 x 40 Rectangle
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