HomeMy WebLinkAbout53021-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y 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#: 53021 Date: 05/26/2026
Permission is hereby granted to:
Leanne M Barry
1145 Donna Dr
Mattituck, NY 11952
To:
Construct a hot tub accessory to an existing single-family dwelling as applied for.
Premises Located at:
1145 Donna Dr, Mattituck, NY 11952
SCTM# 115.46-11
Pursuant to application dated 05/18/2026 and approved by the Building inspector.,
To expire on OS/25/2028.
Contractors.
Required Inspections:
FOOTING/REBAR, ELECTRICAL-ROUGH, ELECTRICAL-FINAL, DRAINAGE, FINAL,
Fees:
Other $300.00
CO Accessory $100.00
Total $400.00
Building Inspector
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex. 54375 Main Road P. 0. Boy. 1179 Southold NY 11971-0959
1 7+65-1 fJ2 "ax (631) 5- 2 ��� � Telephone(63 76 954� '� t � s- w �s u,tl�,�l, o � ��m
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61
Date Received
APPLICATION FOR BUILDING PERMIT
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For Office Use Only02 u`,
PERMIT NO, Building Inspector;
i v t w 9r MrrJ
Applications and forms must be filled out in their entirety. Incomplete
applications Will not be accepted. Where the Appllicarnt is not the fawner,an °a w
Owner's Authorization form(Page 2)shall be completed,
Date:
OWNER(S)OF PROPERTY:
Name. MW5
hst
CTC1/I # 1oC}0►-�
Project Address: A y
Phone#: .- �.319V — ?Y? -, EmaiI: 0 "`Shy��' `ol Z we
Mailing Address: SOM e 0
pro 'e
CONTACT PERSON: �
Name:
Mailing Address: 45OLM
Phone# .. Email: cok
DESIGN PROFESSIONAL INFORMATION
Name.- VL
Mailing Address
Phone#: Email,
CONTRACTOR INFORMATION
Name:
Mailing Address,:
Phone#: Email
DESCRIPTION OF PROPOSED CONSTRUCTION
New Structure OAddition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:.
00ther .
Will the lot be re-graded? C]Yes $[No Will excess fill be removed from premises? )QYes F�No
1
...............
.........................
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PROPERTY INFORMATION
Intended use of property:
Existing use of property: Int
Z one or use district in which premi ses is situated:� Are there any covenants and restrictions with respect to
this property? F-]Yes ❑nNo IF YES, PROVIDE A COPY.
Che ck,Box After Rea d'l'ng*: The,ow,,,ner,/'contr,�,,,ctor/design,professional is responsibli'e,for a lldra,inage and storm,water issues a,s,'provided,by,
udding Permit porsulant to the,evilding,Zone
cha pter,236 of the Town Code. APPLICATI'ON 15 HEREBY MADE to,the Sull4ing Department for the issuance ofe 0 tructtion of building"s,
Ord,i naince of the Town of sout hold Suffolk,,Cau'nty,New Yo,rk.an4 other applicable �,Ordinances or Regulations,for the,cons,
ition as herein described.The applIcant agrees to,compfy with licable laws,ordinantest building code,,,
alla P
additions,afteratilons or for rernoval or, ernoi False statements rn,040 hen are
housing,tode and regulations and to admit a,uthoriied inspectots, on premiso,and in building'(s)for necessarf inspe drIon
purtishable as aGass A rnlisdemeanor pursuant too SectJ00,210.45 of the New'yoirk,Stato Penal Law.
'le X
Application Submitted By(print name). a ElAuthorlized Agent Owner
Signature of Applicant: Va Date:
CONNIE D.BUNCH
STATE OF NEW YORK) Notary Public,State of New York
No.01BU6185050
SS: Qualified In Suffolk County,
COUNTY OF Commission Expires April 14,2�0�
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
C
4)
-day of 20 CJ 10
Notary Public
PROPERTY OWNERAUTHORIZATION
(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
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F BUILDING DEPARTMENT- Electrical Inspector
`
TOWN C)P S OUTHOLD
T o
Town Hall Annex - 54375 Main Road - PO Box 1179
Southold, New York 1197`1 095
9
' M Telephone (631) 765-1302
4
APPLICATION FOR ELECTRICAL INSPECTION
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ELECYRICIAN INFORMATION (Au Information Required)
Date".1Pow,
Company Names C.
Electrician's Name: �Sa ...
License No..
TfW*76—MEElec. email: bVQJ(55c;,�,t)CC � �. � C�o+�
y
Elec. Phone No: 16 31� 65'3-
I(o?,t 1 request an email copy of Certificate of Compliance
Elec. Address.. P.O. $ox (3t0l_ a�0&0�21&tlaJy
JOB SITE INFORMATION (All information Required)
Name: ftlwskalt &, v4ry es 1W4e
Address: Do kpt 'V
�.
Cross Street: S v e.
Phone No.: 311 - Tyll
Bldg.Permit#: 31, 0 ,;Z email: 5fdW,ir,eta
fax Mae Di
strict: 1000 Section: Vf.6D Block: I G s 00 Lot:01 G000
BRIEF I i INc UDE. S UARE FOOTAC� (Please Pr' t clearly):
�CI'lla r�l �'"u 44V% Gars
P
LSquare Footage-.:,,,J,
i rc I e A!,I Thlat Apply:
Is job read for inspection?: YES ' NO Rough In ! Final
Y p 0
Cho you need a Temp Certificate?: YES NO issued On
Temp Information: (All information required)
Service SizeEl
1 Ph 3 Ph Size: A # Meters Old Meter#
New S e rviceM Fire Reconnect Flood Reconnect MService Reconnect Ounder round Eloverh ead
-
# Underground Laterals 1 H Frame MM&ONJPole Work done on Service? YLl
Additional Information:
PAYMENT DUE WITH APPLICATION
NEW SUFFOLK AVENUE SURVEY OF
0 LOT 63
Lri
OD
MA P OF
0
LOT 0 DEEP HOLE CREEK ESTATES
d
0- S87*1 9'20"E 182.00 0 LOT AT MATTITUCK
FILE No. 4256, FILED JANUARY 28, 1965
0 0�4 FE 10. S1 TUA TE
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METES AND BOUNDS SURVEYING
NOTE. LOCATIONS AND EXISTENCE OF ANY
W UTITIES ANDOR URE
53 PROBST DRIVE READ ILYSUBSURFACE VISIBLE,LI /
ARE NOT CERTISTRUCTMED. THES NOT
SHIRLEY, NY 11967 CERTIRCATIONS HEREON ARE NOT TRANSFERABLE.
PHONE: (516)-972-5812
E-MAIL:- METESANDBOUNDSSURVEYINGOGMAIL.COM THIS SURVEY IS SUBJECT M MY EASEMENT OF RECORD AND ANY OTHER
PERTINENT FACTS WHICH A TITLE SEARCH MIGHT DISCLOSE
DISTRICT:1000 LOT:01 1.000 BLOCK:16.00 SECTION:115.00 'UNAUTHORIZED ALTERATION OR AMMON TO A SURVEY MAP BEARING A
LICENSED LAND SURVEYOR'S SEAL IS A VIOLATION OF AR71CLE 134.
MAP/FILE NO.: 4256 SECTION 7209.SUBDIVISION Z OF THE NEW YORK STATE EDIUCATION LAW`
'Copies from the original of this wxvvy map not marked with an orfglnoi
of tho land auveyW*TnW sod or his embooved"al shaft not be
considered a volld tue oopy* *Certiffeabon indicated hereon stwft*4t
oft A" so In*=rdoncs wM he eArting Code if Procilce,
MAP OF: "MAP OF DEEP HOLE CREEK ESTATES AT MATTITUCK" W Land l;u;Z%=W by tho New York S t tate AsoocialJon of
Praftsional Lonod Survoyars. Sohl osrUffootions sholl nm only to
pervort for wttom the survey to prepared.and on his beholf to the Ift
TITLE NO.: 40647FI-S company.governmental aqw4y and landing kwObAlon. Certflootlons we
not tromforoMe to additional brollixtUorm or subseqwent ownenx-*
MAP FILED DATE: JANUARY 28, 1965
COUNTY TAX MAP ID: 1000-11500-1600-011000
SITUATED AT: MATTITUCK, TOWN OF SOUTHOLD
SUBDIVISION MAP Roy LOT#S-. 63
E
SEAN AL MAR SHALL AND LEANRE MRIE BARRY'
JUDICIAL TITLE INSURANCE COMPANY, TITLE NO. 140647FI-S
U-0 COPYRIGHT`2020 RALPH HEII,
FIDELITYRZT15NXL TITLE INSURANCE COMPANY METES AND BOUNDS SURVEYING,INC.
US AA FEDERAL SAVINGS BANK AND=OR IJOB NO.: 20-1531
ITIE SECRETARY OF THE DEPARTMENT OF VETERANS AFFAIRS, ISAOAIDATE: OCTOBER 9,20201