HomeMy WebLinkAbout52679-Z TOWN OF SOUTHOLD
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BUILDING DEPARTMENT
SOUTHOLD, NY
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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#: 52679 Date: 02/17/2026
Permission is hereby granted to:
13710 Soundview Ave LLC
795 Cedar Dr
Southold, NY 11971
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Construct a new single-family dwelling with unfinished basement and a deck and pool addition as
applied for per SCHD approval. Pool equipment must maintain side and rear yard setbacks of a
minimum of 25feet.
Premises Located at:
13710 Soundview Ave,, Southold, NY 11971
SCTM# 54.-3-5
Pursuant to application dated 12/23/2025 and approved by the Building Inspector.
To expire on 02/17/2028.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling-NEW $4,866.50
SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $300.00
CO Single Family Dwelling-New $100.00
Total S5.266.50
Building Inspector
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TOWN off' SOUTH OLD--BUILDING DEPARTMENT
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Town Hall Annex 54375 Main Road P. 0. Box 1179 Southold Y 11971-0959
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Telephone (631) 7+ 5-1 02 Fax (631) 7 5-9502 :LNv
Date Received
,., ,.P'PL,l CATION FOR IBU[LDING PIERIMIT
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PERMIT NC} Building Inspector: ,u
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Applications and forms must be filled out in their entirety.Incomplete
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applications will not be accepted. where the Applicant is not the owner,an
Owner's Authorization farm(Page 2)shall be completed.
Date:
OWNER(S)OF PROPERTY:
Name:David Kiesgen ! SCTM#1000- ..---- ...-.
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Project Address:
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Phone#:212 8516752 Email:kiesgendave@gmaii.com
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Mailing Address: 7,95' ip ke
CONTACT PERSON:
Name:
same as above
Mailing Address:
Phone#: Email:
DESIGN PROFESSIONAL INFORMATION:
Name:Mark Schwartz:
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Mailing Address:PO Box 933 Cutchgoue 11935
' Phone#: 734Email:mark@mksarchitect.com 4185 mark@mksarchltect.com
CONTRACTOR INFORMATION:
Name: ��,,'/+' ''�"-- ► �d�' �l�r i ..-~
Mailing Address: , -4
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Phone#: a C Z. 5`15'3"1 Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
ig New Structure ❑Addition DAlteration M Repair 0 Demolition Estimated Cb t of Pro ject:
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❑other
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'U1l�ll excess fill removed from premises? Yes C]No
V1l�ll the lot be re-graded? C1es o ce be rem ed p
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PROPERTY INFORMATION
FExisting use of property:vacant Intendeduseofproperty:Single Fam Res
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? FlYes RNo IF YES,. PROVIDE A COPY.
IN 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,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.
David Kiesgen
Application Submitted By(print name): DAuthorized Agent @Owner
Signature of Applicant: Date: t7# 6 Z 0 7L,
CONNIE D.BUNCH
Notary Public,State of New York
STATE OF NEW YORK) n No.OIBU6185050
ss: Qualified In Suffolk County
Commission Expires April 14,2dD56
COUNTY OF Suffolk
David Kiesgen being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is,the Owner
(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 bjt '46re me this
—d ayof.igum Zzk- 202C /V eaqAA 6
Notary Pubiil��
PROPERTY OWNERAUTHORIZXTION
(Where the applicant is not the owner)
IJ# residing at
do hereby authorize to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
Owner's Signature Date
Print Owner's Name
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New Constructiom P. 0. Box 38, Oakdale NY 11769-0901
31218-1148
December 8, 2025
Dave Kiesgen
13710 Soundview Avenue LLC
795 cedar Drive
Southold, NY 11971
Location: 13710 Soundview Avenue Southold
SCTM#: 1000054000300005000
BP# 2000683419j DAVID & INGA KIE'SGEN
Notification #: 300132656
Dear Customer:
We have received your request for information regarding availability of public water
service to the above captioned property.
The nearest water main is located on Soundview Ave. In order to serve your clients
property, a water main extension of approximately 615 feet would be required. please
note an easement may be required.
Please contact the undersigned if you wish to proceed with the project or if you have any
questions at(631) 563-0251 or by email at � i r r. atte @,s *, i c
Sincerely,
PAWPA AWtea
Jennifer Matteo
Supervisor
3M:cs
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]F]E11k
A ert J. Krups 1, J r.
SUPERVISOR
EM IENIF
SOUTHOLD TOWN HALL-P.0.Box 1179
Town of Sauthold
53095 Main Road-SOUTHOLD..NEW YORK 11971
CHAPTER 236 STO `ER MANAGEMENT RE FE FORM
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( APPLICANT INFORMATION TO BE COMPLETED BY THE APPLICANT
ONLY FOR PROPERTIES ONE ACRE IN AREA OR LARGER. )
APPLICANT.- (Property Owner, Desi gn Professional, A gent, Contractor, Other)
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Date.NAME
(Signature)
Contact Informat ion- K .
(E-Mail&Telephone Number)
Property Address I Location of Construction Site:
: � � ��-�i S.C.T.I'` . 1000
District
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Section Block Lot
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TO BE COMPLETED BY SOUTHOLD TOWN ENGINEERING DEPARTMENT
0 - Area of Disturbance is less than I Acre. No S.P.D.E.S. Permit is Reguired !
Project does Not Discharge to Waters of the State. No S.P.D.E.S. Pqrm it is-Required!
0 - Area of Disturbance is Greater than I 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 to Issuance of a Building Permit.
Area of Disturbance is Greater than I 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 throe the Southold Town E1,n2ineeri,gS Department
Prior to Issuance of a Buildincr Permit,
Reviewed By: /411aiV) Date- �?6
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FORM SMCP-TOS December 2024
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