HomeMy WebLinkAbout52696-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
SOUTHOLD, NY
Y
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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#: 52696 Date: 03/02/2026
Permission is hereby granted to:
Katharine Mesquita
24 Stuart PI
Manhasset, NY 11030
To:
construct accessory in-ground swimming pool as applied for.,
Premises Located at:
305 old Shipyard Ln, Southold, NY 11971
SCTM# 64.-5-4
Pursuant to application dated 01/05/2026 and approved by the Building inspector.
To expire on 03/01/2028.
Contractors:
Required Inspections:
Fees
SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $300.00
CO Swimming Pool $100.00
Total S400.00
Building Inspector
MIN
� TOWN OF SOUTHOLD--BUILDING DEPARTMENT
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�� b Town Hall Annex 54375 Main Road P. 0. Boy 1179 Southold 11971-0959
y Telephone (631) 76 -1 0 �Fax (631) 765-9502 t ": � a .S �l� w . wv
Date Received
APPLICATION FOR BUILDING PERMIT
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For Office Use Only
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PERMIT NO, r Building inspector:
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Appli�ca ions and forms must be filled out in their entirety.Incomplete �
applications will not he accepted. Where the Applicant is not the owner#an
owner Authorization form(Page �shall he completed. °
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Date:
OWNER(S)OF PROPERTY*
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N a m e.,: S CTM# 1000"
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Project Address:
Phone°#: Email: `
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Mailing Address: .. kov�t
CONTACT PERSONK
Name: ,� n ,, / x + -, PoL 1 — 4 aAJ
MaiIingAddress. ' 1 l / I I 7 s,
Phone# - — Email. Poo) Fec-h*
DESIGN PROFESSIONAL INFORMATION:
M y/�
Name':
ailing Add ress: '�...�� ,,-�,0 __7
ne#: \q (P* 10-0
Email*
CONTRACTOR INFORMATION:
Name: 'P 0 0) c-,-h L)
Mailing Address:
..,..Phone#:
Email: Poo i
DESCRIPTION of PROPOSED CONSTRUCTION
-0 New Structure ❑Addition F Alteration 7 Repair F-I Demolition Estimated Cost of Project:
[Zot h e r SImo °
Will the lot be re-graded? ❑'Yes F l No Will excess fill be removed from premises? ❑'Yes ❑No
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PROPERTY INFORMATION
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? ❑Yes 46o IF YES,PROVIDE A COPY.
�ch+e+ck Box After Reading: ni fnai is respaon for all drainage and smarm water imm as provkled by
Chapter 236 of the Town Code.APPLICATION 5 HEREBY MADE to the BuIlOV-Dep►artment for the ante of a Building Permit pursuant to the Binding Zane
Onfirance of the Toean of SmIkk
County,Ner Yoh ow o6a Ca b1i ILam„ftfinan=or Bt ° kwu�for than ammitriethm of bulhftgs,
or for n or es# +eln ?hr appowA IVe Is t4 aoo ►aft ad Lam ordbumaceit,buftft cod ,
housing cede and Mons and to admit authorized on pre nim sand in building(s)for necessary i ons.False statements made herein are
punistmWe as a Chm A mbden eanor pursuant to Sectfon 210AS of the New York State Penal Lane.
i
Appiication Submitted By(print name); dAuthorized Agent ❑owner
5anatur+e of Ap nt: � � Date:
1
�11NA �C��H1
STATE of PiEw YoR NSW Y'0'
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SS. Qu;qjifiend In oco�unt,y
w.........41�111a,
COUNTY of . �,k-
commiss,,o �x� Ires
I�.. sworn deposes ands s that s he is the applicant
bung duly � � ) PP
(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 set forth in the application file therewith.
Sworn before me thisy,
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ay of 2
m ary,Public
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PROP
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(Where the applicant is not the owner)
Pdl
I, residing at
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Ao hereby authorize ` to apply on
I my b alf to the Town of Southold Building Department for approval as described lerein
owner's Signature Date
E
Print owner's Name
2
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