HomeMy WebLinkAbout53027-Z ��oFsa�,T�o 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#: 53027 Date: 05/27/2026
Permission is hereby granted to:
Erin Occhiogrosso
150 Mayflower Rd
Mattituck, NY 11952
To:
legalize an"as built" hot tub as applied for.
Premises Located at:
150 Mayflower Rd, Mattituck, NY 11952
SCTM# 107:$-31
Pursuant to application dated 05/21/2026 and approved by the Building Inspector.
To expire on 05/26/2028.
Contractors:
Required Inspections:
FOOTING/REBAR, ELECTRICAL- ROUGH, ELECTRICAL-FINAL, DRAINAGE, FINAL,
Fees:
As Built Pool/Hot Tub $600.00
CO Swimming Pool $100.00
Total $700.00
Building Inspector
4
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Tern:Hall Annex 54375 Main Road P. 0. Box 1179 Southold, NY 11971-0959
31 7+65-1802 "ax 631 765-95112 t -//w, w�ou�tho� d�t� w p v
Telephone }
Date Received
APPLICATION
FOR BUILDING PERMIT
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For Office Use Only
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PERMIT NO. Building Inspectors w�i,
MAY 1 202
Applications and forms must be filled out in their entirety.Incomplete
applications will not be accepted. Where the,Applicant is not the fawner,an
Owner's Authorization form(Page 2)shall be completed,
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Date
OWNER(S)OF PROPERTY: f SCTM # 1000-
Names � PV ,--
Project Address � � � �� �� tL
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Phone#: Email.
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Mailing Address:: a
CONTACT PERSON
Name:
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Mailing Address:
Phone#: Email:
DESIGN PROFESSIONAL INFORMATION
Na
me: �
Mailing Address,
Phone#: Email:
CONTRACTOR INFORMATION:
Name:
Mailing Address:
Phone#: Email:-
DESCRIPTION OF PROPOSED CONSTRUCTION
XNew Struotu ition, ElAfteration EIRepair ❑Demolition Estimated Cost of Project:
00ther $
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Will the lot be re--graded? ❑Yes EJ No Will excess fill be removed from premises? ❑Yes ❑No
1
.......... -------
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PROPERTY INFORMATION
Existing use of property: Intended use of property:
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? E]Yes FNo IF YES, PROVIDE A COPY.
El Check,Sox-After Reading* owner/contrador/lei gn profestjon'a I iskrespbrisiblofor all alai and$Aorm water issues ot'providod4y
Chapter-2,30 of th#,,`ToWn,Cq BY MADE,to,the Buff4ing Department for the,issuaoce,of a Building,Permit pursuant to,the HuRdIng Zone,
e,-, ,,P'Pt WAT'ON 11S HERE I I 1 11 ''r ,ion of,holldt"'195,
ordinance of the Towo of Southold,Uff'olk",County,New York and'other applitable�La ws,Ordinances or Regula)Ions for the co nstruct
ad,difions alterations,or for removal or demdIftion asf here':,in describod.,The appli,calInt agrees,to comply With all aohpllcable laws,,ordinances,bluilding code)
ry Inspections.Fais,e statern ents,made herein are
,
housing co4e,andregula,flons aid to,admit authorized Insoerctors,an premises an'd In,build ing(s)for necem
New sr Mate Penal Low.
caner
Application Submitted By(print name),. occb V I& ElAuthorized Agent
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Signature of Applicant CONNIE D.BUNcH Date:
Notary Public,State of New York
No.01 BU,6185050
STATE OF NEWYORK) Qualified In Suffolk County
commission Expires April 14, 2,—
CO U NTY 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 N,
day of' 20-a
U 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
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BUILDING DEPARTMENT- Electrical Inspector
TOWN of SOUTHOLD
Town I--+lall Annex - 54375 Main Road - PO Box 1179
,Southold, New York 11971-0959
��r Telephone (631) 765-1802
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APPLICATION FOR ELECTRICAL. INSPECTION
Information Required) ,
ELECTRICIAN INFORIVIATION (All � � Date:
Company Name:
IRWIN
Electrician's Name: BAL
License : 3 --tAeElec. email: Vt
Elec. Phone
❑ request
Na: �� � � I an email copy f Certificate of Compliance
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A ress.:
Elec. dd �
JOB SITE INFORMATION (All Information required)
Name.
Address
Cross Street: Ile
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Phone No..
7
:
B I d9.P e r m i t#. � � email. ���� � �
Tax Map District: 1000 Section: Block: 6dot
BRIEF DESCRIP
TION OF OIL -�INCLUDE SQUARE FOOTA E (Please Print dearly}:1
Square Footage:,Li
Circle All That Apply:
p� Y
?: NO [:]Rough In Final
is fob ready for inspection. . YES _
Do you need a Temp Certificate?: YES NO Issued On
Y p
F'TempInformation: Al into p ion uired)
Service Size 1 PhE:1
3 h S # Meters
Old Meter#
. ego �nect i�c Reconnect under round Floverhead
ew Service Fire Reconnect Fl ❑
# Underg
round Laterals 12 H Frame Pole Work done on Service? Y N
_...W110,11,
Additional Information:
PAYMENT DUE W'ITH APPLICATION
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