HomeMy WebLinkAbout53198-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#: 53198 Date: 08/13/2026
Permission is hereby granted to:
Sean Evans
3538 Peconic Bay Blvd
Laurel, NY 11948
To:
construct an accessory in-ground swimming pool as applied for.
Premises Located at:
1125 Greton Ct, Mattituck, NY 11952
SCTM# 107.-3-2.1
Pursuant to application dated 07/27/2026 and approved by the Building Inspector.
To expire on 08/12/2028.
Contractors:
Required Inspections:
Fees:
SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $300.00
CO Swimming Pool $100.00
Total $400.00
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Building Inspector
f° �� 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) 765-9502 htttps:/,`www.sOLltholdto�vnngov_
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
� C E0VE
PERMITNO. �"� Building Inspector.,,,,_
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Applications and forms must be filled out in their entirety.Incomplete
applications will not be accepted. Where the Applicant is not the owner,an Building Depmrtment
Owner's Authorization form(Page 2)shall be completed. Town Of SOLTthokid
Date:
OWNER(S)OF PROPERTY: e
Name: 5e0.r\ 'llp"v(3,cts I
SCTM#1000- '1 - 03 - Q,\
Project Address:1\FS &c c_korlVJ�c�'�� Asa
Phone#: 6-5k 3\G sot o Email:E-`��•�SSGo•c�.US�'c @G�oa.�.COW-1
Mailing Address:1�0
CONTACT PERSON:
Name:
Mailing Address: P. O
Phone#: SCE\O Email: � �� US�FL�CTWa��� C.o
DESIGN PROFESSIONAL INFORMATION:
Name: J G-Me S �C'.2_C"OF� • a
Mailing Address:
Phone#: 63 LA 1 *6 5 S ov-,
CONTRACTOR INFORMATION:
Name: -:"• ri Zak oSY�.
Mailing Address: �>b Zc� ,-- \A
Phone#: �,2� ,, Email
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
)40ther + _ n $ A G1
Will the lot be re-graded? ❑Yes io Will excess fill be removed from premises? XYes ❑No
1
.......
PROPERTY INFORMATION
'n use ofproperty: Intended use of property:
Existing 1�G�i�_en�ctG-�
Zone or use district in which premises is situated; Are there any covenants and restrictions with respect to
7,-\-\d this property? F�Yes)<No 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
MADE to th
e Building Department for the issuance of a Building Permit pursuant to the Building Zone
36 of the Town Code
. APPLICATION IS HEREBY g P
Chapter 2
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 ( t name): G Cl v G_a t ❑Authorized Agent ICwner
Signature of Applicant: CONNIE D. BUNCH Date: S,\.A ""5\ p2.0 Ra :'
Notary Public,State of New York
No.01 BU6185050
STATE OF NEW YORK
Qualified In Suffolk County �,
SS: Commission Expires April 14,2
COUNTY OF �c.��...�,�.)
�V grn S being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
(S)he is the W 2
(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
2�day of _ � \ 20
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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