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Home My WebLink About53034-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#: 53034 Date: 05/29/2026 Permission is hereby granted to: Miro Florence Trust PO BOX 619 Mattituck, NY 11952 To: construct an accessory in-ground swimming pool as applied for. Premises Located at: 495 Knollwood Ln, Mattituck, NY 11952 SCTM# 107.-6-9 Pursuant to application dated 04/30/2026 and approved by the Building Inspector. To expire an 05/28/2028. Contractors: Required Inspections: Fees: SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $300.00 CO Swimming Pool $100.00 Total S400.00 ing Inspector F ' fin TOWN OF SClIJ'Y` IOLD_BUILDING DEPAR'TM�NT "gip 54375 Main Road P. 0. Box 1179 Southold, NY 1 1971-0959 Town Hall Annex � Telephone 631 765-1502 Fax (631) 765-9502w . to Date Received APPLICATION FOR BUILDING PERMIT L= II14 r,office Use Only n PERMIT NO Building Inspector. .... ._� .... � � --------- Applications and forms must be filled out in their entirety. Incomplete applications will not be accepted. Where the Applicant is not the owner,an ' ownerls Authorization form(Page 2)shall be completed. w Date: .'/!b �'� I OWNER(S) of PROPERTY: Name. " '"' s ` scTM # laaa- y 1ry 'I lq SOL Project Address. � ►,DLA M ' Phone#: 3c� S��o Email: :S66 • P►r 4P.- YA'FW01 63r Mailing Address: 1213 MI aD CAW641rori CONTACT PERSON Name: Mailing Address:1213 fti I QD 6Awf4toN ` NY 1103 i7 Phone#: � 313�0 5if 5 C3 E m a i l:. s . P0949- YAFW.�� CO DESIGN PROFESSIONAL INFORMATION: Name: DPOJ10 I A9nfi5 Mailing Address: IS ff),OTW NaD N" Pwk- my #-nVy Phone#, Emai1: 0M e, A#.0 i11EC;r f1I's &XCV , CONTRACTOR INFORMATION: Name: -sza Q, Mailing Address: Ua MI aD CAWE94rori ' NY ' lrq.S,3 Email:i Ema : - Pry MOWPhone#. �,►31 •inn�- 5 J 5C3 Ie. �� .cOen DESCRIPTION OF PROPOSED CONSTRUCTION h ��I""w,'"" FAlteration ❑Re air R Demolition Estimated Cost of Project: ❑New Structure p El Other 1NIi1 the sat be re-graded? C�Yes �'lNo will excess fill be removed from premises? Dyes RNo ? 1 ........... PROPERTY INFORMATION Existing use of property: SIA)b&p. rAMILoy ��„5 intended use of property: Swi,&a. FAmuy ��'"`.'' Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? E]YesANo IF YES, PROVIDE A COPY. §6 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 11 punishable as a Class A misdemeanor pursuant to Section 210.45 of the New York State Penal Law. I e): ► ElAuthorized Agent ACOwner Application Submitted By(print narr Signature of Applicant: Date: C 0 NIE D.BUNCH STATE OF NEW YORK) Notary Public,State of New York No.01BU6185050 SS: oualified in Suffolk County COUNTY OF Col ,Lesion Expires April 14, 2 Ge _00601 being duly sworn, deposes and says that (s)he is the applicant 'Ed (Name of individual signing contract) above named, (S)he is the (Contractor, Agent, Corporate Officer, etc.) s 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 Ap 20 «< (h Notary Public AIIA 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 UNAUTHORIZED ALTERATION OR ADDITION GUARANTEES INDICATED HEREON SHALL RUN THE EXISTENCE OF RIGHTS OF WAY TO THIS SURVEY IS A VIOLATION OF ONLY TO THE PERSON FOR WHOM THE SURVEY ANDIOR EASEMENTS OF RECORD IF SECTION 7209 OF THE NEW YORK STATE IS PREPARED, AND ON HIS BEHALF TO THE ANY NOT SHOWN ARE NOT GURANTEED. EDUCATION LAW. TITLE COMPANY, GOVERNMENTAL.AGENCY AND COPIES OF THIS SURVEY MAP NOT BEARING LENDING INSTITUTION LISTED HEREON, AND ELEVATIONS REFER TO NAVD 1988 DATUM. TO THE ASS#GNEES OF THE LENDING INSTI— THE LAND SURVEYOR'S INKED SEAL OR ��TUTION. GUARANTEES ARE NOT TRANSFERABLE, EMBOSSED SEAL SHALL. NOT BE CONSIDERED 1 Premises known as: TO BE A VALID TRUE COPY. # 495 Knollwood Lane, Mattituck 1511 01 , 7Yb a 5I„M I .. ; 1), " 1. 1 K �i►"' a p J N,,As a a „, w %9A , a Ijn 7 � co t7 "fro o rr Nk 0� m . o . w ;h211 L� ,�.,,,,ryry m Cj L wmw� �V•ry � � AV1P1� NJ h .A1 Topographic Area- 49,656 M. Survey of Described Property situate at IA�E SEff.2025 DRAWING&JOB NO.25-1035 Mattituck Town of Southold Michael W. .1V.tintoy L.S.P.C. Suffolk County, New York LICENSED PROFESSIONAL LAND SURVEYOR District 1000 Section 107 Block 6 Lot 9 NEW YORK STATE LICENSE NUMBER 050871 87 Woodview Lane Scale 1"= 49' Surveyed September 23, 2025 Ce.ntereac.h, N.Y. 11720 GRAPHIC SCALE PHONE/FAX: (631) 580--1202 40 20 40 so Aso CELLULAR; (631) 766--9714 EMAIL: mikemintolspoggMall.com IN FEET ) 1 inch. = 40 ft.