HomeMy WebLinkAbout53271-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#: 53271 Date: 09/14/2026
Permission is hereby granted to:
Roger Chudzik
625 Corey Creek Ln
Southold, NY 11971
To:
legalize an "as built" pool fence enclosure as applied for.
Premises Located at:
625 Corey Creek Ln, Southold, NY 11971
SCTM# 78.-4-25
Pursuant to application dated 08/26/2026 and approved by the Building Inspector.
To expire on 09/13/2028.
Contractors:
Required Inspections:
Fees:
As Built Accessory Structure $250.00
CO Swimming Pool $100.00
,, Total $350.00
iiiilding Inspector
r TOWN OF SOUTHOLD—BUILDINO DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold, NY 11971-0959
' Telephone (631) 765-1802 Fax (631) 765-9502 h!tps.//www. orixhcalelto x l
Date Received
APPLICATION FOR BUILDING PERMIT
m � IE0WE
For Office Use Only AUG PPERMIT NO. w Building Inspectorc,,�w_„ "o
Applications and forms must be filled out in their entirety.Incomplete ,u"t1ing er-,w tment
applications will not be accepted. Where the Applicant is not the owner,an Town of Scwthol
Owner's Authorization form(Page 2)shall be completed.
Date: & ' r b
C1WI �ft( 011~P OPCRTI(:
Name: G SCTM#1000-
", .
Project Address:
Phone#: Enn il: CI 4 i �, cvY►'�
Mailing Address: 4;2,' ceyrll X C' 0V—J 71C;�- "
CONTACT PERSON:
Name: �'
Mailing Address:[ ASf
Phone#: � ���` .� . Email.
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone#: Email:
O TR COI ld 1 TION.
Name: 7t IZd�
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition 01 / Estimated Cost of Project:
$4Other 0= t f�Ir;i� NC=IN ter>,'� Jo�v1,s�=cv'P
Ir
Will the lot be re-graded? ❑Yes�KVo Will excess fill be removed from premises? ❑Yes MNo
1
PROPERTY INFORMATION
Existing use of property: d L Intended use of property: � L
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? Dyes gNo 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 Cade. 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,Suffok 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 Vass A misdemeanor pursuant to Section 210.45 of the New York State Penal Law.
Application Submitted By(print nam): �� ' � C�v��� ❑ AgentAuthorized Agent Owner
ell-Signature of Applicant: Date:
STATE OF NEW YORK)
SS:
COUNTY OF S'UjW01 V )
(Name
ww. .,�._w ....wwwwwww
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 1.1 U T 20 i?
ary Public 0
/ 1:13 + '0£3Nn r53hlldx3 NUISSPNYYQ3
fvOTr�RY PlJSi IC,5TA�O�"JF NEW YORK ALNnoo x10d�nS Ni d31.�wno
N0.01DW6306900 PROPERTY OWNER AUTHORIZATION 00690e9MC40'ON
OU5LIFIED IN SIJ FOLK COUNTY (Where the applicant is not the owner) NHOAMEIN JO 3.1VIS Onend AUMN
COMWdSSION EXPIRES JUNE30, P D d3AMa I A33dt:11
residing at
do hereby authorize ��wwwwwww .__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
1J
I J,
S.C.T.M, NO. DISTRICT: 1000 SECTION:78 BLOCK: 4 LOT(S):25 '
i
0.9''1J
236.02' STK,
LOT20 Z
1 i.8
cTIWIRc FENCE i l
6'STOCKADE FENCE NT/G'PC t
83021'30"E ec � PGO.
ND N
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TK
0.0.T 1 D o
7'S
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4-VINYL FENCE t
0
1 '
t"��1�fr GATE 17% .��
z
\\ � � LAND N/F OF
DRAiTV {
2'A ` to be removed 0 POOL STEVEN
Z 2i s EOP.
I NORKELUN
GEo 11.0E
G}� _ CRAVE - I
rg r35 a G 27.0E $
gyp„ y _S.`w f
m P. AY 0 PROPOSED l c
UP.77{ v O GAS �v�� s � IIIS UN � �_ 1� BLDG.
m `v�`.i19. z w
1 O l
tT} WELL will ! 4p m
OCCUPANCY3N
m v-
GEAL �STK,
p J v INN 6'STOCKADE FENCE 223.10
p� J v
N
REBAR 111 a.l.v Al4RVID A
aA s 85°03'40"w 6.PLOT 22
THE WATER SUPPLY, AELLS DRYKELLS AND CESSPOOL . ) BY.
LOCA BONS SHOY,9V ARE FROM f7ELO OBSERVA77ONS \ LOT COVERAGE MPLY W ALL CODE C4
AND OR DATA OBTAINED FROM OTHERS NOTIFY BUILDING DEPARTMENT AT NEW YORKSTATE&T0, , OD
''AR°^'DnTUM
\ MAX.ALLOWABLE 4673 S.F.or 20% 631-765-1802 8AM T04PM FOR THE AS REQUIREDAND (}`VDFw
AREA:23,365.33 SQ.FT. or 0.54 ACRES , DWELLING W/DECK: 3096 S.F. FOLLOWING INSPECTIONS: !'
UNAUTHORIZED AL TERA ON OR ADDITION TO THIS SURVEY IS A NOLATON OF SECTION 7209 OF THE NEW"OR"
STATE EDUCATION LA W. COPIES OF THHS SURVEY 1 H
NAP NOT BEARING T LAND SURVEttMS EMBOSSED SEAL SHAL1 NOT BE CONSIDERED TO BE A VALID T7UE COPY. GUARANTEES tNOLCATEO HEREON SHALL RUN SWIMMING POOL: 927 S.F. . FOUNDATION-TWO REQUIRED
HE
ONLY 70 THE PERSON FOR 9HOM THE SURVEY HS PREPARED AND ON HIS BEHALF TO THE 77E COMPANY,GOVERNMENTAL AGENCY AND LENDING INSTTUTON SHED: N/A(96 S.F.)TO BE REMOVED FOR POURED CONCRETE `'TPit. 4T
OSIED HEREON,AND TO THE ASSIGNEES OF THE LENDING INSTIU7T[#i,GUARANTEES ARE NOT TRAN9'ERABLE. 'EF &THE
OFFSETS OR DHMENSIONS SHORN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE PROP.BLDG: 648 S.F. 2. ROUGH FRAMING&PLUM,51, C, _ �
NOT NTENCED TO MONUMENT THE PROPERTY LINES OR TO GLIDE THE ERECTION OF FENCES ADDH7TONAL STRUCTURES OR AND OTHER IMPROVEMENTS EASEMENTS i! -- �
ANDIOR SUBSURFACE STRU.'IURES RECORDED OR UNRECORDED ARE NOT GYIARANTEEO UNLESS WiSiCALLY ENDENT ON TH£PREMISES AT THE TIME OF SURVEY 3. FINAL
a
ROGERcHuozlK; TOTAL 4671 S.F.or 20°/D Y OE
4. FfNAL-CONSTRUCTION MUST Pa �.P
SURVEY OF:LOT 21 or y CERTIFIED TO: BE COMPLETE FOR G.O. r u .Dpn
Sk
NAP OF:COREY CREEK ESTATES ALL CONSTRUCTION SHALL MEET THE
REQUIRED+9ENTSOF THE CODES OFNEAf �
FLED:AUG. 15, 1967 - -
SITUATED AT:BAYVIEW - YORK STATE. NC,T RESPONSIBLE FOR
Tom OF.SOUTHOLD _ _ DESIGN OR C '4S;PI TON ERRORS
SUFFOLK COUNTY, NEW YORK _ v KENNETH M wOYCHLN LAND SL0S'1sYING, PLLC UPDATE 04-25-26
`" '= ,�. Profeeaional Land Surveying d Design REVISED 01-20-26
P.O.Box 153 Aquebogue,New York 11931
FlLE N224-38 SCALE:1"=20' DATE:MAR. 29. 2024 sons{esgz9e-Lees ru{eeL)zee-Leas UPDATE & ADD PROPOSED BLDG & LOT COVERAGE 12-15-25
N.Y.S LTSC.NO.050882