HomeMy WebLinkAbout52651-Z TOWN of SOUTHOLD
BUILDING DEPARTMENT
1 0 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#: 52651 Date: 02/05/2026
Permission is hereby granted to
McKeon Family Trt
755 Moores Ln N
Greenport, NY 11944
To:
Construct in ground swimming pool at existing single family dwelling as applied for.
Premises Located at:
755 Moores Ln N, Greenport, NY 11944
SCTM#33.-2-35
Pursuant to application dated 12/11/2025 and approved by the Building Inspector.
To expire on 02/05/2028.
Contractors:
Required Inspections:
Fees:
SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $300.00
CO Swimming Pool $100.00
Total e 400.00
Building Inspector
TOWN OF SOUT:HOL.D--BUIL.DING DEPARTMENT
4 5 1Vlain Road P. CJ. Box 1179 Southold NY 11971-0959
Town Hall Annex 5375 7 ,
` Telephone (631) 765-1802 Fax (631) 765-9502 ht s://www.southoldtownny.gv
RP
Date Received
APPLICATION FOR BUILDING PERMIT
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For Office Use Only
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PERMIT NO. Building � �
Building Inspector. ` � � , w ?
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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.
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Date:
OWNER(S) OF PROP
• SCTM# 1000-
Name: (12fi
Project Address: I....... Lay) . ...........................................
(qfl I E,
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Phone
Email.
Mailing Address:
CONTACT PERSON:
Na me:
Address.. 1�qq_l oeo
Mailing
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Phone# -- + Email: L'i tivvli
[DESIGN PROFESSIONAL INFORMATION:
Name: M- 1—-----------
Mailing Address:
Phone#: Email:
....... ............
CONTRACTOR INFORMATION.
Name
Mailing Address:
a
Phone#:
(�43 `7IbL
Email:
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[DESCRIPTION OF PROPOSED CONSTRUCTION
p ' mollt n Estima� ed Cost of P�0
New Structure Addition Alt � ti�ori Re a I �
ether
Will the lot be re-graded? C�Yes No Will e ,eni, a oved from premises? s ❑No
PROPERTY INFORMATION
...............
Existing use of property: Intended use of property:
7-
Zone or use district in which premises is situated: Are there any covena, is and restrictions with respect to
this property? DYes IF YES, PROVIDE A COPY.
heck,Box After Read1*11g.* The owner/contractor/design professional is responsible for all Wnage 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,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 210.4S of the New York State Penal Law.
(,Joe
Application Submitted B y 4 name): U, rized Agent El Owner
Signature of Applicant: Date; J 1
STATE OF NEW YORK)
SS:
COUNTY OF
being duly sworn, deposes and says that (s)he is the applicant
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(Name of indivi 61 signing contract)above named,
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(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
applicatiow that all statements contained in this appli.5�VoauArjg true,to the best of his/her knowledge and belief; and
that the work will be performed in the manner se �n IN cation file therewith.
IKor
11 1 f3
Sworn before me this 6�?357
0 A I F I E'D I N
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00
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lio, c0imp"I—day of 1%*—-----
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Notary Public
All
N
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
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.............
Joe
jo residing at
.........................................
e y LS to apply on
do hereby authorize
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my behalf to the Town ofSouth, d Building Department for approval as described herein.
g Date
Owner's J�
s""nature
yl�rk
Print Owner's Name
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