HomeMy WebLinkAbout52445-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#: 52445 Date: 11/10/2025
Permission is hereby granted to:
NoFo Prop Ventures LLC
PO BOX 791
Cutchogue, NY 11935
To:
construct an accessory in-ground swimming pool as applied for.
Premises Located at:
5345 Skunk Ln, Cutchogue, NY 11935
SCTM# 138.-2-6
Pursuant to application dated 10/02/2025 and approved by the Building Inspector.
To expire on 11/10/2027.
Contractors:
Required Inspections:
Fees:
SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $300.00
CO Swimming Pool $100.00
Total $400.00
tiling Inspector
t 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 litt,ps://www.southoldtownU.Loy
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
i
PERMIT NO. L50 Building Inspector:
Applications and forms must be filled out in their entirety.Incomplete
applications will not be accepted. Where the Applicants not the owner,an Mini n �t: t
Owner's Authorization form(Page 2)shall be completed. TfoW0
Date: 40
OWNER(S)OF PROPERTY:
Name: Dana Locatell SCTM#1000- �g _ ,.
Project Address:5345 Skunk Lane, Cutchogue, NY 11935
Phone#:(631) 734-7923 (Agent) Email:creativeenvdesign@yahoo.com
Mailing Address:P.O. Box#160
CONTACT PERSON:
Name:David Cichanowicz - Creative Environmental Design
Mailing Address:P.O. Box#160, Peconic, NY 11958
Phone#:(631)-734-7923 Email:creativeenvdesign@yahoo.com
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name:Creative Environmental Design
Mailing Address: P.O. Box #160, Peconic, NY 11958
Phone#:(631) 734-7923 Email:creativeenvdesign@yahoo.com
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
OOther In ground vinyl pool $100,00.00
Will the lot be re-graded? ❑Yes ®No Will excess fill be removed from premises? ®Yes ❑No
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PROPERTY INFORMATION
Existing use of property:Residential Intended use of property:Residential
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? ❑Yes ®No IF YES, PROVIDE A COPY.
Iiii 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 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,Ordinancetor Regulations,for the constructlon of buildings,
additions,alterations or for removal or demolition as herein described.The applicant agrees to comply with all applicable laws,ordinances,bulldipg 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.
David Cichanowicz/Creative Environmental Design
Application Submitted Tint name): BAuthorized Agent ❑Owner
Signature of Applicant: Date: t 1
STATE OF NEW YORK)
SS
COUNTY OF Suffolk
David Cichanowicz
being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the
Agent
(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
Nb day of ®Ct�le� 20_2�L
Notary Puf II
PEN-W Lot)ISi_
NOTARY PUBLIC.STATE OF �YORK
ti�tion No.01MA640M7 hOPERTY OWNER AUTHORIZATION
Qualiw-in Suffolk aunty
Commission F iplf D m 3M here the applicant is not the owner)
Dana Locatell residing at 5345 Skunk Lane
I, .
Cutchogue, ICY 11935 David Cichanowicz/Creative Environmental Design
do hereby authorize to apply on
my beha f to the Town of Southold Building Department for approval as described herein.
k4k2�Ll-, : - 10/01/2025
ner's Signature Date
Dana Locatell
Print Owner's Name
2