HomeMy WebLinkAbout52392-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#: 52392 Date: 10/23/2025
Permission is hereby granted to:
Papadopoulos TN Rev Trt
4175 Ole Jule Ln
Mattituck, NY 11952
To:
construct an accessory in-ground swimming pool as applied for.
Premises Located at:
4175 Ole Jule Ln, Mattituck, NY 11952
SCTM# 122.-5-13.3
Pursuant to application dated 09/16/2025 and approved by the Building Inspector.
To expire on 10/23/2027.
Contractors:
Required Inspections:
Fees:
SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $300.00
CO Swimming Pool $100.00
Total $400.00
Building Inspector���
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone(631)765-1802 Fax (631) 765-9502 htt �s://ww r.sootholdtonM _ orr
7,011
Date Received
APPLICATION FOR BUILDING PERMIT
E C E � Id E
For Office Use Only '
PERMIT NO.+ Building Inspector. E P 1 6 2025
ApplkatfonS 00 fOMS must be,Plied aut irk their entirety:Incomplete 0u61s1"sng e rt� t
applkatians Wil not be actWed Where tM'A' 0M ant Is not the owner an T own of o atl t�f;i
owners"utltorirtatlo�'forn(Page 2)shall be completed.
Date:
OWN PERTY*
Name: E 6e.�C+ d o��oS SCTM#1000-
Project Address: 17S D/ vle— 1/hs�
Phone#: Ca'/G-��//— 3Co�o Cj Email . Pd'PA _."P0 or►n� Gvr,�
Mailing Address:,//�SA#4/ n/y 1/9_62,
04M'ACTfMON: ,
Name:
Mailing Address:--?p ^—C20 X Gti�,cj /Af
Phone#: Email:qc2.kI a-wkm_) I;me , ne—
IDESIG�1 PROFESSIONAL INF lll�TlON. ` ,
Name:
Mailing Address:
Phone#: Email:
CON rRAcroR INFORMATION:
Name:
Mailing Address: U � ed
��x
Phone#: (931 - 7391 -26&_5 EmaiI.- _9 �a7� onl� ne . ne
DESMPr"O,N OF PROPUSED fANSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair ❑0emoiition Estimated Cost of Project:
Other r e far
Will the lot be re-graded? j 6es [I No Will excess fill be removed from premises? Ntles ❑No
1.
PROPERTY INFORMATION
/% �, yam. �l s '�n� /%
Existing use of property: Intended use of property:
1 Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? ❑Yes kNo IF YES, PROVIDE A COPY.
Check Aox,Aft t,E inR',' / . / l i$"spon"afWan l by
ctoptor 23 tat , ,AP
ordinance of the Tom ofSoullmld,Suffolk.County,New York and other tom Or I "ti"oa ill of
addidons,alterations or for rammml or demilld n as hereln douffttILVto appllcant agrees to'compl wIth dopokatih JeWs,u wry.ma*`code,
housing code end ro and to admfe sudmted inspedws on premises and In a)fou6sespaty Inspections.False statements made herein we
punishable as a class pursuant to Section 21CAS of Oa New York State Penal law.
Application Submitted By(pr` t name): j5c,x' ,, JUAuthorized Agent ❑Owner
Signature of Applicant Date: r'
g PP � &
CONNIE D.BUNCH
STATE OF NEW YORK) Notary Public,State of New York
5S: No.01 BU6185050
Qualified in Suffolk County
COUNTY OF ) Commission Expires April 14,2_C�
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 setforth in the application file therewith.
Sworn before me this
� �" d,ay of 20 films I
Notary Public
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
I, 'v002� residing at cT
c-A /✓% 1(f s jdo hereby authorize f 1�Q / - to apply on
my behalf t Town of Southold Building Department for approval as described herein.
Owner's Signature Date
00
Print Owner's Name
2
DIST: 1000 5EOT ON:,,122 BLOCK: 5 TAX LOT: 13.31 15UPVffYNO. 17-17920
TITLE NO. RA29 12-F5
THE OFFSETS OR DIMENSIONS SHOWN HEREON.
FROM THE PROPERTY LINES TO THE 5TRUCTURE5.
I ARE FOR A SPECIFIC PURPOSE AND USE:
THEREFORE THEY ARE NOT INTENDED TO
MONUMENT THE PROPERTY UNES OR TO GUIDE THE
L J L LA r j ERECTION HE FE ADDITIONAL STRUCTURES
C j OR ANY OTHER IMPROVEMENT
EMENT
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MAP OP PROPERTY ISLAND WIDE LAND SURVEYORS
SITUATEAT� I K PROFESSIONAL LAND*CITY 5URVEYOR5
1I I T V �� \ 199 LAFAYETTE DRIVE,5Y055ET, N.Y. 1 1791
PHONE: I-86s-808-5800 FAX: 5 1 6-49s-1792
TOWN OF SOUTf TOLD RECORDS OF WALTER I.BROWN,GU5TAVE A.ROULLIER
5UFFOLK COUNTY, N.Y. rF ROBERT A.HAYNE5
UNAUTHORIZED ALTERATION OR ADDITION
TO TH15 SURVEY15 A VIOLATION OF
SECTION 7209 OF THE NEW YORK STATE 5URVEYED : SEPTEMBER 27, 2017
UCTlON LAW. AMENDED : OCTOBER 3, 20I 7 -
GO OF THi5 5URvEY MAP NOT BEARING t
THE EMBOAND SSED
URVEYOALL INKED SEAL CO SI GUARANTEED TO :- F
EMBOSSED SEAL SHALL NOTBE CONSIDERED
TO BE A VAUD TRUE COPY. ELIZABETH E. MACEDONIO * THEODORE N. PAPADOPOULOS
GUARANTEES OR CERTIFICATIONS INDICATED FIRST AMER/CAN TITLE INSURANCE CO.
HEREON SHALL RUN ONLY TO THE PER50N
FOR WHOM THE SURVEY 15 PREPARED, AND THE BRIDGEHAMPTON NATIONAL BANK, lT5 SUCCESSORS _
ON HI5 BEHALF TO THE TITLE COMPANY,
GOVERNMENTAL AGENCY AND LENDING AN010R ASSIGNS
IN5TITUTION LISTED HEREON, AND TO THE RIDGE ABSTRACT CORP.
ASSIGNEES OFTHE LENDING INSTITUTION.
GUARANTEES OR CERTIFICATIONS ARE NOT LOT NUMBERS: -
TRANSFERABLE TO ADDITIONAL INSTITUTIONS
OR SUBSEQUENT OWNERS.
DRAFTED BY R.C.OCTOBER 2, 2017 IIAND
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