HomeMy WebLinkAbout52705-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#: 52705 Date: 03/03/2026
Permission is hereby granted to:
4760 Blue Horizons Rity LLC
C/O Mario Fusaro,
Northport, NY 11768
To:
construct an accessory in-ground swimming pool as applied for perTrustees Non-Jurisdiction letter.
Premises Located at:
4760 Blue Horizon Bluffs,, Peconic,, NY 11958
SCTM# 74.4-35.55
Pursuant to application dated 12/01/2025 and approved by the Building Inspector.
To expire on 03/02/2028.
Contractors:
Required Inspections:
4
Fees,
SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $300.00
CO Swimming Pool $100.00
Total S400.00
omeo
Building Inspector
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Town Hall Annex 54375 Main Road P. 0.Box 1179 Southold,NY 11971-0959
tow, L
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Telephone(631) 765-1802 Fax (631) 765-9502
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Date Received
APPLICATION FOR BUILDING PERMIT
0
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L LL J
For Office Use Only
PERMIT NO. Buildin Inspector,-.,,
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Applications and forms must be filled out in their entirety. Incomplete
341
applications will not be accepted. Where the Applicant*is not the owner,an
t
ownees Authorization form(Page 2)shall be completed.
Date.-
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OWNER(S)OF PROPERTY-*
SCTM#1000-
Name:
Project Address: q 7.J 41 6) (3 0 r 17-0 r, ee ceq� q,>
Phone#: 6 3 1 9,16 0 Email: ie;o�-a'rr
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Mailing Address: IN
0 1 ''1 ................
CONTACT PERSON:
..........
Name:
a r a- r(9
Mailing Address: C&..r_ Iif cut.,r /V Y4
Phone#: 0 3sr/ Email: CI-M,
DESIGN PROFESSIONAL INFORMATION-,
Name:
a j,- Pa-
Mailing Address: 0, t4 P,0 i-, -7
Phone#: 63 /-.Wl �74-1 Email: r�-y
(01 r
CONTRACTOR INFORMATION.
Name:
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
-;,NewStructure nAddition 0AI'teration ORepair F-IDerlition Estimated Cost of Project:
W 4 4 A 4 n $
,Notitierl— 471.1- 10,0-01 V
U" j
Will the lot be re-graded? 1AYes EJ No Will excess fill be removed from premises? FlYes IgNo
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PROPERTY INFORMATION
Existing use of property: —7�;ended use of property:
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
P- q 0 this property? E]Yes ANo IF YES,PROVIDE A COPY.
[3 Check Box After Reading: ne,mmer/wnwmor/&,sip pratessionW b responsible,for all dmInage and storm waw Issues as provided by
Chapter 236 of the Town Code.APPLICA11010 IS HEREEty mADE to the'suildins Department for the 4swate of a Building Permlt purstw*to the sulding Zone
ordbwca of theTown of SouflWd.Suffolk Countv,NewYork andatherappilimble taws,oranantes ariteguladons,forthecewkstruction ofbu11dbW,,,
additlom alterations or for removal or demolition as herein described.The appllaw4 agrees to con*y wfth aU applicabie Iauis,ordinances,building code..
housing code ant!ftufatons,and to admit mAhorlzed inspectors on pien fSesk and In building(s)*W inspections.False statements nuWe herein are
punishable as a Class A misdemeartor pursuant to Section 21US of the New York Stft Penal Law.
ptlSa.,rO OAuthorized Agent 2"ner
Application Submitted By(print name): ax 10
Signature of Applicant:
�, ,-v, Date:
CONNIE D.BUN
H'
Notary Public,State of New York
STATE OF NEWYORK) No.01 BU61 85050
Qualified In Suffolk County
SS:
Commission Expires Aprfl' 141�-tQy
COUNTY OF
being duly sworn, deposes and says that(s)he is the applicant
(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 this
5+4:1 Z) 11 " ��S"It �
!la of 20_s��T,
Notary Public
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
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
2
J,
1sU FQ
1\\4WA\x,]F1E1K'
ps r
Albert J.'- Kru --ki ' i 11
401
SUPERVISOR , I I
"I W � z ' ' �AANA\G]EhAIEI\�F
SOUTHOLD TOWN 14ALL-P.0.-Box 1179 � %b V ''
53095 Main Road-SOUTHOLD,NEW YORK 11971 T111 Town 6f Southold
CHAPTER 236 STORMWAT"'ER MANAGEMENT REFERR AL 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)
Date:
NAME: 6t r 10 a
(Signature)
Contact Information:
(E-Mail&Telephone Number) 431- --------
Property Address Location of Construction Site:
1000
S.C.T.M.
District
/V
Section Block Lot
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 Required I
d -
A I
Project does Not Discharge to Waters of the State. No S.P.D.E.S. Permit is Required :
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 B
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
Prior to Issuance of a Building Permit
Ze
Reviewed B Date.
FORM I SMCP-TOS December 2024
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Town Hall Annex
Glenn Goldsmith, President -4375 Route 25
A, Nicholas Krupski,Vice President P.O. Box 1179
Southoldl New York 11971
Eric Sepenoski
Liz Gillooly Telephone (631) 765-1892
E lizabeth Peeples Fax(631) 765-6641
BOARD OF TOWN TRUSTEES
TOWNT OF SOUTHOLD
November 5, 2025
Mario J. Fusaro
12 Gilder Court
Northport, NY 11768
RE: 4760 BLUE HORIZONS REALTY, LLC
4760 BLUE HORIZONS BLUFF., PECONIC
SCTM#1000-74-1-35.55
Dear Mr. Fusaro:
The Southold Town Board of'Trustees reviewed thesurvey Prepared by T-Wm Forks Land
Surveying, last dated October 8, 2025, and determined that,the proposed construction of a
I rea under,Chapter 275
im and wi J
dwelt"' s 'mming poo-1 is �out ofthe 100 foot Wetland Juris6cfional a
of the Town Wetland Code and Chapter 11,1 off,the Town Code.
This area along Long Island Sound experiences significant erosion of both top and bottom of
bluff, It is advisable to keep construction activity as far away from top of bluff as possible and
reduce any ground disturbance.
Please be advised, however, that no construcfion, sedimentation, or disturbance of any kind
may take placesie,award of,the tidal andfor freshwater wetlands jurisdictional boundary, or within
100' landward from the edge of vegetated wetlands, without further authorization from the
Southold Town Board of Trustees pursuant to Chapter 275 and/or Chapter 111 of the Town
Code.
It is your responsibility to ensure that allf necessary precautions are taken to prevent any
sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal
Wetlands jurisdiction and Coastal Erosion Hazard Area, which may result from your project.
Such precautions may include maintaining adequate work area between the tidal wetland
jurisdictional boundary and the coastal erosion hazard area and your project or erecting a
temporary fence, barrier, or hay bale berm.
This determination is not a determination from any other agency.
SincereAy.
401