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HomeMy WebLinkAbout52508-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#: 52508 Date: 12/03/2025 Permission is hereby granted to: Nelson TD Ventures LLC 74 Vanderbilt Ave Brooklyn, NY 11201 To: Construct an inground swimming pool accessory to an existing dwelling as applied for.. Premises Located at: 945 New Suffolk Ave, Mattituck, NY 11952 SCTM# 114.41-23 Pursuant to application dated 10/23/2025 and approved by the Building Inspector,. To expire on 12/03/2027. Contractors: Required Inspections: Fees: SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $300.00 CO Swimming Pool $;00.00 Total 4 0 Building Inspector TOWN OF SOUTHOLD- BUILDING DEPARTMENT "own Nall Annex 54375 Main [toad P. 0. Bc`c 1179 Southold. NY 11971-0959 �V Telephone(631) 765-1802 Fax(631.)765-95Q2 Oate 7ehmd APPLICATION FOR BUILDING PERMIT For office Use only L lJ L IJ 11 L n PERMIT NO. d Building Applications and brms must be ffied out In their entieety,Incomplete 0,11 1"ot Oe A P wt the owner,an z t ownws xdhi ll� '( 2i OilM d"0' s p Date: Name: � �_ SCTM � 40I70- Project Address: Phone#: ` -� Email: j - u r C � Mailing Address: Iq VAN, W-Ra 1 o 6 Name: Mailing Address: �� 1-ram u A ; t�3 l 1 5 0 Phone# 3 9 a a�} � o� � Email: Name: _ �o S� �, r` G C Mailing Address: P,o Z8Cly- 61 b SOL.AA"tA � l�e,w `�o�k-, Phone#: `31 76S- a9SAJ Email: ,,.;►N V,� C� owi%q,. . kiLA a' a /7 w, Name: Mailing address: ?a, fisay� lc-c r A e A- P l t l 51 I bone#: Ia'A Email: A u,:i Co^sip\ n 11J�Mi ON �- ONewStructure ©Addition DAltera€ion CsRepair ®Demolition Estimated Cost of Project: bother Sa,:• +a Will the lot be re-graded? ©Yes.®lea Will excess fill be removed from premises? PYes [3N,o 1 PROPERTY INFORMAMON Existing use of property: intended use of property: Zone or use district in which premises is situated. Are there any covenants and restrictions with respect to this property? OYes ONo IF YES, PROVIDE A COPY, &�heck MW After Reading; TMr rf pWosswwl Is forte &W~wow Wm 06 pMvWd by : flQ#IltMteWft APIRWAIM4,11MINYIwIIAMWdn Mfrrr** 011'S, ** Ora 04 ".114 Ymn of ISwOoK,5 'n W,Vim"cork 04COW qVbt**'UWS,,OAMUMOS 00040100,far 00+ �1 of balmr4p, arm MWM or AWAM&11W a0pkaft ogmftto=M*Wftb 44 oiapftbbbvx, r Is cm and k+bu (s)Aw y V �tsr airI I,1r�Iau rbu' I`ftI�nwr Yvttc fe lNwr Ir,a Om X Application Submitted 8Y(print name): [Muthorized Agent 130wner Signewre of Applicant. C Date* /o f a))3'j rirvat, L; VLa�� w J CONNIE D.BUNCH ` Notary Public,State of New York STATE OF NEWYORK) `a-v'r`-'-aC No.01131.16185050 SS: Qualified In Suffolk County CUB COUNTY OF Commission Expires April 14, 2 '-g3�A hW �- 4 a a�5 _ A 04, i A being duly sworn; deps�5es and lytsat(s)he is the api licard (Name of individual signing contra above named, (S)he is the } of card owner or owners, and.is Contractor, Agent, Corporate Officer, etc.) dirty authorized to perform or have performed the said worm and to make and file this application;that all staternems 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 et forth in th e application on file e there it h. Sworn before me this X �clayof 2Q °c ` p Notary Public OTHLEEN PROPERTY OWNER E AUTHORIZATION St At�`� r W), 10TfO0°ts6,s (Where the applicant is not the owner) �t� ��,�see k c arMy mission 6plrrs Ape''16,2026 I, LAt t L - residing at �S N L sod Fa Jam.K- do hereby authorize h8m LI 1 to apply on MY to the Town of Southold Building Department for approval as described herein, Ow rsvlgnattke Date V 1� Print Owner's Name 2 , e I ffi4a�: ;ti r� ,�;� k� ][�l��l[\�vA\�C']E]EZ Albert J. Krupski, Jr. n. r_.; SUPERVISOR \4[ .A\G]EM]ENT SOUTHOLD TOWN HALL-P.O.Box 1179 Pow"; of Southold 53095 Main Road-SOUTHOLD,NEW YORK 11971 CHAPTER 236 - STORMWATER MANAGEMENT REFERRAL FORM ( APPLICANT INFORMATION TO BE COMPLETED BY THE APPLICANT ONLY FOR PROPERTIES ONE ACRE IN AREA OR LARGER. ) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - APPLICANT: (Property Owner, Design Professional, Agent, Contractor, Other) NAME: Date:.�.._. ��+ � �� � Q �� mo I _ _. ..._ Contact Information: C ' m1a -...- (E.Mail&Telephone Number) Pro erty Address / Location of Construction Site: S.C.T.M. #. 000 .........�....._..�. _ District Section Block Lot TO BE COMPLETED BY SOUTHOLD TOWN ENGINEERING DEPARTMENT - Area of Disturbance is less than 1 Acre. No S.P.D.E.S. Permit is Required! Project does Not Discharge to Waters of the State. No S.P.D.E.S. Permit is Required Area of Disturbance is Greater than 1 Acre & Storm-water Runoff Discharges Directly to Waters of the State of New York. THE APPLICANT MUST OBTAIN a S.P.D.E.S. Permit DIRECTLY From N.Y.S. D.E.C'. Prior l.o Issuance of a Buildin Permit. - Area of Disturbance is Greater than 1 Acre&Storm-water Runoff Flows Through Southold Town's MS4 Systems to Waters of the State of New York. THE APPLICANT MUST OBTAIN a S.P.D.E.S. Permit through the Southold Town En ineEin De artment Prior to lssuance of a Building Permit r Date: D_�.. ..�... Reviewed By: —. Ved It) FORMSMCP-TOS December 2024 fl e C �� /