HomeMy WebLinkAbout52972-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#: 52972 Date: 05/13/2026
Permission is hereby granted to:
Yedloutschnig RJ Rev Trt
1800 SE St Lucie Blvd 5-108
Stuart, FL 34996
To:
install a hot tub as applied for.
Premises Located at:
440 Jernick Ln, Southold, NY 11971
SCTM# 70.-3-18
Pursuant to application dated 05/01/2026 and approved by the Building Inspector.
To expire on 05/12/2028.
Contractors:
Required Inspections:
FOOTING/REBAR, ELECTRICAL- ROUGH, ELECTRICAL-FINAL, DRAINAGE, FINAL,
Fees:
SWIMMING POOLS-ABOVE-GROUND WITH REQUIRED FENCING $300.00
CO Swimming Pool $100.00
Total $400.00
�r
Buildingpe Insctor � �
�° � TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone (631) 765-1802 Fax (631) 765-95021, t . ://www.soutliol(qI) yi . g
Date ReceWed
APPLICATION FOR BUILDING PERMIT
Far Office Use Only
S;I
PERMITNO.. Building Inspecton. ......w _ WNIAY
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 form(Page 2)shall be completed.
Date:
OWNER(S) OF PROPERTY:
Name„ N -- � �� SCTM #1000- '1c)
Project Address: � t4<11 Mi
Phone#: Email:
Mailing Ad dress:
CONTACT PERSON:
Name:
Mailing Address:
Phone#: LON " IV)o _mm.... _._,..... Email: ►
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name: ".�` E ( .�.,�. �� �.� ......_..
na
Mailing Address: em nQq
Phone#: _-7 Email: "
�1 -7 39
DESCRIPTION OF PROPOSED CONSTRUCTION
w Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
Other $ i°� O'o
Will the lot be re-graded? ❑Yes VN1D Will excess fill be removed from prem" es? ❑Yes ❑No
1
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Existinguse fproperty: Intended use of property: Single Fam--ii ' Wq in
g
. . . ..__Single,famll w »
Zone or use district in which premises is situated: Are there any c enants and restrictions with respect to N�&
Ro this property? Yes❑No IF YES,PROVIDE A COPY.
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Application Submitted By(print name): Jennifer Del Vag I io MAuthorized Agent I]Owner
Signature of Applicant: Date: 3/9/26
STATE OF NEW YORK) QP ll��n C-
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Jennifer Del Vaglio being duly sworn,deposes and saeftk)be&Aepipplicant
(Name of individual signing contract)above named, Notary Public,State of New.York
No.01BU6185050
(S)he is the agent/contractor Qualified In Suffolk County
(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
t
0` tday of YAA CkN 20g��p
Notary Public
PROPERTY OWNER AUTHOR19AT O
(Where the applicant is not the owner)
I, Nicholas Telesmanic residing at 440 Jernick Lane, Southold, NY
Jennifer Del Vaglio and/or East End Pool King
do hereby authorize to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
��U�� �; 3 —
Owner's Signature Date
Nicholas Telesmanic
Print Owner's Name
2
JERNICK LANE
N 65°98'00"E 120.03'
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'MAP OF HARVEST HOME ESTATES, SECTION O E'
SITUATE AT SOUTHOLD
TOWN OF SOUTHOLD
SUFFOLK COUNTY,NEW YORK
FILED:JULY is, 1969,MAP#5337
CERTIFIED TO:NICHOLAS TELESIMANIC
SANDRA TELESMANIC
FIDELITY NATIONAL TITLE INSURANCE
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LAND SURVEY LONG ISLAND.COMI OF
WARD BROOKS LAND SURVEYOR WAMM
11 OCEAN AVENUE
BLUE POINT, NY. 11715 r
(631) 576-7794 (631) 363-3179
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UIREMENTS
ELECTRICAL REQ ,
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� BY:
NOTI BUILDING DEPAI TMENTAT
MI.765-1802 8AM TO 4PM FOR THE OCCUPANCY OR
FOLLOWING INSPECTIONS:
I. FOUNDATION-TWO REQUIRED USE IS UNLAWFUL
FOR POURED CONCRETEVVITHOUT 2. ROUGH-FRAMING&PLUMBING -
3. INSULATION "
CCUPANCY
4. FINAL-CONSTRUCTION MUST � � �
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTON ERRORS
RETAIN STORM WATER RUNOFF
COMPLC IT�i ALL EIS PURSUANT TO CHAPTER 236
NEW YORK S'T TE TOWN CODES OF THE TOWN CODE.
AS REQUIRED AND POND�`TIONS OF
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Height 36" titrBrW: CLS Clarity
DO NOT SCALE DRAWING Dw8y, Easley Date, 1113/25
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DO NOT DIVE.
42