HomeMy WebLinkAbout53029-Z �o��af�pUT�o`D TOWN OF SOUTHOLD
BUILDING DEPARTMENT
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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#: 53029 Date: 05/28/2026
Permission is hereby granted to:
Emma Oakley
5845 N Bayview Rd
Southold, NY 11971
To:
construct an accessory in-ground swimming pool as applied for.
Premises Located at:
5845 N Bayview Rd, Southold, NY 11971
SCTM#79:3-43
Pursuant to application dated 05/21/2026 and approved by the Building Inspector.
To expire on 05/27/2028.
Contractors:
Required Inspections:
Fees:
SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $300.00
CO Swimming Pool $100.00
Total S400.00
`Ilufl" ing Inspector
TOWN OF SOUTH OLD--BUILDING DEPARTMENT
Town Hall Annex 543 75 Main load P. 0. Box 1179 Southold,NY 11971 0959
Telephone (631) 765-1802 Fax (631) 765-9502 �� . �
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Date Received
APPLICATION FOR BUILDING PERMIT
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For Office Use Only1
W„„ 1 2011"1"
PERMIT No. Ildin lspetion
Applications and forms must be filled out in their entirety. incomplete
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applications Will not be accepted. Where the Applicant is not the owner,an
Owner's Authorization farm(Page 2)shall be completed.
Gate: ,5 2.
. .....................
OWNER(S)of PROPERTY:
N a m e: � � � 0 SCTM # �000-
Project Address: 99 LIS i eW
N 0 71
Phone#: -- _ ,,0 ,S4 7 q f/�
Mailing Address: "715 .. ,
CONTACT PERSON:
Name: CrA rf4ffiffihhhhhhh
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Mailing Address: ,
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Phone#: 6 31 �- (.. ! E m a i I.- Ze 0 ok,+ ` qlmaif , com
DESIGN PROFESSIONAL INFORMATION:
Name: I WMV)
Mailing Address, �
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Phone#: 9- '1 Email: 6,�
CONTRACTOR INFORMATION:
Name: y'" c ►
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Mailing Address: q71 �e N
Phase#: �,=�,� -� qoz—iob Email: � 0,,0
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DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Additi n ❑Alteration ❑Repair ❑Demolition Estimated Cast of Project:
®other $
J...............
..........
Will the lot be re-graded? ❑Yes No Will excess fill be removed from premises? RYes [-]No
1
PROPERTY INFORMATION
Existing use of property: Intended use of property:
Od
..............
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? ❑Yes IRNo IF YES., PROVIDE A COPY.
Check Box After Reading** The owner/contractor/design professional is responsible for all drainage 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 name) ElAuthorized Agent ®Owner
Signature of Applicant: NIE D. BUNCH Date: 2-G
Notary Public,State of New York
STATE OF NEW YORK) No.01 BU6185050
SS.. Qualified In Suffolk County
COUNTYOF Commission Expires April 14,2DIS111
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
a y of 120
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
JOSHUA R. WICKS P-L.S 45UPIEY I Q:� PPOPfPTY
SURVEYED BY-I R.W. DRAWN BY.D.T.O. JOB NO..JRW23-oi76 �ot 2�-Map of
P.O. BOX 593 Bayview Woods Estates
Center Moriches, N.Y. 11934
Joab,,uag,,Wicka0g,tnM,,I.com Map No,5520
GftAPHIC SCALE
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EMMA OAKLEY
EMINENT ABSTRACT INC,
WESTC(?R SAND TITLE INSURANCE Ca,�,PANY
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cv 21,608.50 S.F.
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