HomeMy WebLinkAbout52871-Z TOWN OF SOUTHOLD
'° <a BUILDING DEPARTMENT
4 SOUTHOLD., NY
�o �o
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#: 52871 Date: 04/15/2026
Permission is hereby granted to:
Angel B Chimbo
105 Oakview Hwy Trlr 20
East Hampton, NY 11937
To:
construct an accessory in-ground swimming pool as applied for.
Premises Located at:
565 Barley Ln, Southold, NY 11971
SCTM# 59.-4-5.10
Pursuant to application dated 04/03/2026 and approved by the Building Inspector.
To expire on 04/14/2028.
Contractors:
Required Inspections:
Fees:
SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $300.00
CO Swimming Pool $100.00
Total S400..00
Building Inspector
r / a
U TOWN OF SOUTHOLD_BUILDING DEPARTMENT
f�
N "own Hall Annex 543 75 Main Road P. 0. Box 1179 Southold, NY 11971-0959
Telephone (631) 765-1802 Fax (631) 765-9502 h t .',Hwww,,so i .h ldtow u I. o
marMM. 5 .
I'
Date Received
APPLICATION FOR B PERMIT
w
i u p
rrp'WW,
.„ a
d pp u 4.� dr
a
For Office
Use Only
.,w u....
PERMIT No. Bu i lding IuweD :
Applications and forms mint be filled out in their entirety.Incomplete
applications will not be accepted. When the Applicant is not the owner,an "
Owner's Authorization form(Page 2):shall be completed.
Date:411126
OWNER(S)of PROPERTY:
Name:An el Bergara SCTM# 1000-59-04-5.1
�
Project Address:565 Barley Lana, Southold
Phone#:631-404-9031 Email:a bconstructionsery
9 @9mail.com
Mailing Address:,565 Barley Lane, .Southold
CONTACT PERSON:
Name:Brooke Epperson
Mailing Address:FCC) Box 152, Mattituck, NY 11952
Phone#:631 603 9092 Email:bepperson@amparchitect.com
DESIGN PROFESSIONAL INFORMATION:
Name:Anthony Portilio
Mailing Address: PO Box 152, Mattituck, N.Y. 11952
Phone#:631 603 9092 Email:aportillo@amparchitect.com
CONTRACTOR INFORMATION:
Name:
Mailing Address:
Phone#* Email-,
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
0 other Accessory inground pool 80,000
Will the lot be re-graded? F]Yes RNo Will excess fill be removed from premises? IRYes ❑No
1
.........................
PROPERTY INFORMATION
Existing use of property: ILI Intended use of property:
S� sin
Zone or use district in which premises is situated-. Are there any covenants and restrictions with respect to
this property? r-]Yes Ax No IF YES,, PROVIDE A COPY.
Check Box After Readi*ng*, The owner/contractor/design professional Is responsible for all drainage and storm water issues as provided by
Chapter 236 of the Town Code. APPUCATION 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,buiWing 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.
Application Submitted By(print name): -,ZAuthorized Agent ElOwner
Signature of Applicant: Date* V1031Z6
STATE OF NEW YORK)
SS:
COUNTY OF 1 FF06 K
Ak) 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
?, day of
20
Notary Public
CHRISTOPI-15R B BON DA RC'HLIK
PROPERTY OWNER AUTHORIZATION WTARYPUBLIC 5TA7`F0FNFXk'Y0RX
Registration No M BC03R944
C(pul A
(Where the applicant is not the owner) Qualified in Suffolk ,
M�Commisiion Expires
residing at Cos
.7
pply vo,&o do hereby authorize to a on
--kQ2
my behalf to the Town of Southold Building Department for approval as described herein.
Owner's ignaturce Date
Print Ow4er's Name
2
----------
........................................- -------------------
1•t w n
" _ (� w ram* a u.
6 x0a..d _ ! Q- f voi o 0 .1
(D -4 in 02
dh(133 I.,d`a o 110d Xuoyzuy a j I I;o E);!q 0 J V d I Y _
w o
O wMaw
o rs
m
Mw"k� 0 S1N3,....�WINOD ....."„�........31V...8' w,,,.........I�., ""Yj 6.to ..�,.R.."".,�,,,,,�....;:,".,. .., ........................... ....... ....w.....................
�. ,....,.. a ,,,
, Uy
Ill
d i /
r- u
1r
tR O
111
LL
G 6 / „ 4 art ❑
N W j H 0 1 i7' 2 do r
T f /, j Q CS 0uj
a a
zo z
- IL
ui w o B_9 rC'. 0 F
i N p J y w
)l O d k z tD Lg41 z
r
i
+ t�vv
0r..',.R U� �; p 4 a F q LL 11r q w �o ,
F
w n.V�9 6w.7 t,/)0�. 1 �;Q p ;�; 0 d .,� a q p'�U�' <IL
kY
�M1II iNl p
U x x F
..... .....
0 �
m _ U
v
,
N� 0
to .T'V.u
�y 1 34 j °q o
yza m�yui
q
7mN
a
a,,. �'a��q�y u p p•ar
NO
54�U '`}
N� ,"}�ua,l �ONp� aa�a oN�
4 43 V
(91IONV Ql3lzV
'IV73fLL'1!Y?I21�Jb' 3 M
Ifi
..........� ....,.. .......�.Y...w�,..»r.,,..,...w..,...,�...�...,....�........., .,....,.......`..,.,�...,.......,..
I' Js
11 _ _ w
P U 4Q '
9 ... P
� d
tu
a
y s
r
q O O
e
a .. EDq �
�............ ......"f._..e.,..., K ry w 0
Qa�tl�
.. ...�.............. ........„
f ................
•�a � ..Q .J., �{ r,�gym' �"s�� �
Fa 1 f F
00
it
s�
tu
V ���� III °��rv�,��e�,m°' ��, J n •�,�t � `��., � .L
d
h,
ro�
, µw
W14{�
n
as s�z .. ». ... ——,.,..,.,..«-., ———————
M„046c.Q9 a
ul Wd Q
a31vM�ner a N ° ~ —�
m [L
uj pLu
K
a �4
G07:1 =4N:13",'�!4G)