HomeMy WebLinkAbout53219-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#: 53219 pate: 08/24/2026
Permission is hereby granted to:
Browne K&F Fmly Irry Trt
1350 Marratooka Rd
Mattituck, NY 11952
To:
legalize an "as built"above-ground swimming pool as applied for. The pool must have a minimum
side yard setback of 15 feet.
Premises Located at:
1350 Marratooka Rd, Mattituck, NY 11952
SCTM# 123.4-3.4
Pursuant to application dated 08/10/2026 and approved by the Building Inspector.
To expire on 08/23/2028.
Contractors:
Required Inspections:
Fees:
As Built Pool/Hot Tub $600.00
CO Swimming Pool $100.00
Total $700.00
Building Inspector
1
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold, NY 1 1 97 1-0959
.w Telephone (631) 765-1802 Fax (631) 765-9502 11t�F -��vww. o��tl�oldtov� 'A�t. o
Date Received
APPLICATION FOR BUILDING PERMIT I
For Office Use Only
PERMIT NO, ��0211— Building Inspector.—. ._.-.......
Applications and forms must be filled out in their entirety.Incomplete Building DepartmentTown of Southold
applications will not be accepted. Where the Applicant is not the owner,an
Owner's Authorization form(Page 2)shall be completed.
Date: ` 1(7,
OWNER(S)OF PROPERTY:
Name: SCTM#1000-
Project Address:
Phone#: I "' (0 ! � Email: ire
Mailing Address: a
CONTACT PERSON:
Name. C,
al7
Mailing Address: 3 g)
Phone#: S ' Email; yawl
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name,, v.` k
Mailing Addr ss: 60 AlJd& ! -J- ,
Phone#: 60 -' R90 — 71: 3 Email: go
DESCRIPTION OF PROPOSED CONSTRUCTION
20ther
ew Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
t! r JAt 6
Will the lot be re-graded? ❑Yes . NO Will excess fill be removed from premises? es ❑No
1
I
PROPERTY INFORMATION
Existing use of property: '�/`�'�'92
Intended use of property:
p P ert yi3c�
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? OYes 5 Klo IF YES, PROVIDE A COPY.
Check Box,A,fter,+.Re9dingt 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.raise statements made herein are
punishable as a Class A misdemeanor pursuant to Section 220.45 of the New York State Penal Law.
Application Submitted By(print name): / � J-5 R o 'U/V ❑Authorized Agent [gOwner
Signature of Applicant: � " Date:
STATE OF NEW YORK)
SS:
COUNTY OF y LL— )
a 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
_ day of AUA . 20 _
C/ d4 Notary Public
CHRISTOPHER B BONDARCHUK
PROPERTY OWNER AUTHORIZATION NOTARY"PUBLIC STATE OF VFW YORK
(Where the applicant is not the owner) Registration No 0IBC03R444
Qualified in SulTolk iitr t�
MN Commission Expires
IR 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 10CE D V E
may` . TOWN OF SOUTHOLD
w Town Hall Annex - 54375 Main Road B III 9R)
�'6
Southold, New York 11971-0959 '
Telephone (631) 765-1802 UP ing Dna
t
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFO :.
MATION (All Information Required) Date
Company Name: 0 4
Electrician's Name:
License No.: ffd#2 3 Elec. email: v
Elec. Phone No: 516 - i�3 73 ❑I request aK email cop of Certificate of Compliance
Elec. Address.: 5C' 0, , a
JOB SITE INFORMATION (All Information Required)
Name: �eylrl AIV40176
Address: ll�
Cross Street:
Phone No.: ( b6a
Bldg.Permit#: email: 7S'
Tax Map District: 1000 Section: Jam Block: 3 Lot:
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
Square Footage:
Circle All That Apply:
Is job ready for inspection?: YES ZINO 0 Rough In F] Final
Do you need a Temp Certificate?: YES 0 NO Issued On
Temp Information: (All information required)
Service Size l Ph[]3 Ph Size: A # Meters Old Meter#
R New Service❑Fire ReconnectOFlood Reconnect Mservice ReconnectOUnderground QOverhead
# Underground Laterals 1 D2 M H Frame Pale Work done on Service? Ll Y N
Additional Information:
PAYMENT DUE WITH APPLICATION
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