HomeMy WebLinkAbout52818-Z TOWN OF SOUTHOLD
~° BUILDING DEPARTMENT
SOUTHOLD., NY
`t�pGilC�"
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITHONE SET OF APPROVED PLANS ANC SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 52818 Date: 03/31/2026
Permission is hereby granted to:
Tomer Blechman
320 Carlton Ave
Brooklyn, NY 11205
To:
construct an accessory outdoor shower as applied for. Must maintain a minimum 10'side yard
setback.
Premises Located at:
1740 Inlet Pond Rd, Greenport, NY 11944
SCTM#33.-3-19J
Pursuant to application dated 03/05/2026 and approved by the Building Inspector.
To expire on 03/30/2028.
Contractors:
Required Inspections:
Fees:
Accessory-New Structure $125.00
CO Accessory $100.00
Total S225.00
u3lding Inspector
Authentisign ID•.24B40572-31OC-F111-A69A-000D3A4FF82A
TOWN OF O►UTHOLD--BUILDING DEPARTMENT
� Town Hall Anne.54375 Main Road P. 0. Boy 1179 Southold,NY 11971-0959
1 Telephone (631) 7 5-1802 F'a .(f 31) 7f 5-9502
Date Received
APPLICATIONFOR BUILDING PERMIT
T'
mNi
A
For Office Use Only
PERMIT NO.
rffff Building Inspector.,
I N m
n i
.0
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 farm(Page 2)shall be completed.
Date:2117/2026
OWNER(S)OF PROPERTY:
name:Toner Blechman SCTM# 1000-33.-'' -19.7
Project Address:1740 Inlet Pond Rd, Greenport IVY
. .Email:
P tomer@missadanye.com
adanyc.com Phone 880-0789
Mailing Address.320 Carlton Ave, Brooklyn IVY 1120
CONTACT PERSON:
Name:Sara Matthews
Mailing Address:230 ,South Ln, East Marian NY 11939
Phone#: 201 602-8�8�4� Email:sara nneadpropertygroup.com
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address.
Phone#: Email.
CONTRACTOR INFORMATION:
Name:Jeffrey Mead
Mailing1
Address:'' '� 0 South �n Marlon IVY 1 9
Phone#:(978) 201-9282 Email:ieff m e ad p ro p e rtyg ro u p.co m
DESCRIPTION OF PROPOSED CONSTRUCTION
New Structure ❑Addition nAlteration ❑Repair Fl Demolition Estimated Cost of Project:
Fe Other Outdoor shower with changing area $16,500
Will the lot be re-graded? ❑Yes RNo Will excess fill be removed from premises? MYes RNo
1
Authentisigri ID:24840572-31OC-F1l1-A69A-00OD3A4FF82A
PROPERTY INFORMATION
Existing use of property:Single Family Intended use of property:Single Fam ily
mwmmmmmm�"I
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
R40 - non conforming this property? ❑Yes No IF YES, PROVIDE A COPY. -------
El C h e c k B o x Aft e r R e a d I n g: The owner/contra ctor/design professional is res ponsible for all d ra I nage 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 210.45 of the New York State Penal Law.
Application Submitted By(print named M atth ews @Authorized Agent El Owner
Digitally signed by Sara Matthews
Signature of Applicant: Sara Matthews 2026,,,02 17 13:23:23-05'00' Date: 2/17/26
STATE OF NEWYORK)
SS:
COUNTY OF
Sara Matthews being duly sworn,deposes and says that (s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the Agent .......
(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 beflef;qpd�,
A& AM- 10
that the work will be performed in the manner set forth in the application file therewith.' ,_
C480LINE M MACA"' U"R
,Not,ary Publ" -State Of t40,*York
NO,01AA6 35
3846
Sworn before me this Suffolk CoU Oy
my comml5,,sjon,Expires,Dec,17 ',02!6
611—day of tRa1vt1L 202
Notary Public
PROPER11TY OWNER,A UTHORIZATION
(Where the applicant is not the owner)
Tamer Blechman residing at 320 Carlton Ave, Brooklyn I"'' Y 11205
Sara Ma tt h ews
do hereby authorize 1,to apply on
my behalf to the Town of Southold Building Department for approval as described herein,
Authent
iter- 2/17/26
Owner's Signature Date
Tamer B lech ma n
Print Owner's Name
MISS N_ 1111111�,o
SURVEYERTI
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