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Home My WebLink About53252-Z TOWN OF SOUTHOLD BUILDING DEPARTMENT a 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#: 53252 Date: 09/08/2026 Permission is hereby granted to: Lucy Cat 2 LLC 350 Moffitt Blvd Ste 2 Islip, NY 11751 To: construct an accessory in-ground swimming pool as applied for. Premises Located at: 500 Summer Ln, Southold, NY 11971 SCTM# 78.-9-21 Pursuant to application dated 08/20/2026 and approved by the Building Inspector. To expire on 09/07/2028. Contractors: Required Inspections: Fees: SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $300.00 CO Swimming Pool $100.00 Total 400.00 ing Inspector 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 httt,)s://www.southoldtoMgi!W4gy :sj @* �ol Date Received BUILDINGAPPLICATION FOR For Office Use Only � <7 PERMIT NO, Building Inspectorr _ AUG 2 0 2( 5 Applications and forms must be filled out in their entirety.Incomplete �t�?lilnpa : ant applications will not be accepted. Where the Applicant is not the owner,an � ��r�(}r�i,s Owner's Authorization form(Page 2)shall be completed. Ljw" 'l Sri Date: OWNER(S)OF PROPERTY: Name: i(c.a �� 4 "' SCTM#1000-.5ec4lar Iq 13ILx!, I L0T , Project Address: Sv Phone#: 51 b) Q 1 03 —qs 1 cj Email: ��re.COM Mailing Address: 5W $vVAMef 409\,- 50UWXVX0U NY CONTACT PERSON: Name: N'1Co1e, COO p2�(' Mailing Address: Phone#:( 516 ) 9�03 — q51 6 Email: Ni 4icq) �q,gTe- CoA& DESIGN PROFESSIONAL INFORMATION: Name Mailing Address: Phone#: Tim CONTRACTOR INFORMATION: Name: Mailing Address: 161 VJG�-t ve. M.e, %� 1 1 -+G 3 Phone#: C 631.E 4Tr> —�fV1'!) I Email: "Ubo Pdb �IM\0 J `co'('1 DESCRIPTION OF PROPOSED CONSTRUCTION ❑ w Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: 90ther Ty\S "►,11O-kWvN Op- RyZ16 V Y\% �NV6� tCOI Will the lot be re-graded? ❑Yes No Will excess fill be removed from premises? des ❑No 1 PROPERTY INfORMATION Existing use of property: Intended use of property: Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? EYes DNo IF YES, PROVIDE A COPY. Check_. .__ ,. ..�_...�,��.._.._ ..��_.....w.. .�.�_�.._� �.,,._.�,...._.m�.. �... _�_.�__._.._. . Box After heading fatntr r rtati4ptprrfforrianaiirraaaPowtaOale d pram by of the T e, APPL"TW MN IS HEREBY MADIEMforth*bsumve , of a to qBu e ordkonce of Ow To"of , k I i yp rk a' blWsWN�i Lava, nsmoJ Regulations,forpcofatructhm off MRdinqpips,, at for removel of domoUtfoin as herein dour%W.The @Wkwd agreas to cornpiv with sl appkable Wvm ordinawAs,boUding code, to admtt authookeaf kdpwtors an pmrnlm and In d )for nocemry k4pedlorm Fain statements made herein am puMsha le at a Cfats A m4dlemoartor purwarn to Section 210.45 of the New York State PwW Law. Application Submitted BY(print name): 1Authorized Agent ent ❑Owner Signature of Applicant: pate: STATE OF NEW YORK) SS: COUNTY OF ) 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 day of , 20 9& Notary Public SiOBRAIV M. CO ViWAY NOTARY PUBLIC,STATE OF NEW YO K PROPERTY OWNER AU O1 (ZA�`�� Registration No. 01C0,640 59� (Where the applicant is not the owner Qualified in Suffolk County Commission Expires March 1 ,20,?81 ! �_. w .. 11738 t „Nicole Co° r_.. .... _.._ .. residing at 6 KimberlyAve Farmin villa, NYw..._.�.� ., .,,._.. do hereby authorize Harbor Swimming Pool&Patio to apply on my behalf to the To n of Southold Building Department for approval as described herein. � Owner's Signature _..�.�. Date Nicole Coo er Print Owner's Name 2 SITE DATA Site Tax Map No.: Zone: 1000-078.00-09.00-021.000 R40 2 •,'a1 Site Area: Use: 10,928.925F Single Family Residence REFERENCES E Based on Proposed Plot Plan By: TEHN DESIGN GROUP LLC e 8 1257 UDALL ROAD,BAY SHORE,NEW YORK (631)242-3184 o y a DATED:6/25/2025 a=s S 24'52'20"W 100.00, z` k ----- } GENERAL NOTES 1. ALL WORK SHALL BE COMPLETED IN STRICT ACCORDANCE WITH Rv THE APPROVED POOL CONSTRUCTION PLANS PREPARED BY MASON BERGERSON,P.E.THE CONTRACTOR SHALL COMPLY WITH ALL - v PROPOSED DETAILS, NOTES, AND SPECIFICATIONS CONTAINED THEREIN, SHEDI o' 14'X 24' INCLUDING BUT NOT LIMITED TO TEMPORARY AND PERMANENT +, IN-GROUND PF.4, BARRIER REQUIREMENTS AND ALL APPLICABLE SAFETY PROVISIONS. �'_ BJ, SWIMMING 2. THIS PLAN IS BASED ON A SURVEY PREPARED BY OTHERS.THE c`u POOL M 40'� �2.0' DESIGN PROFESSIONAL ASSUMES NO RESPONSIBILITY FOR THE PROPOSED FENCING X 3 '�-�' E ACCURACY OF THE SURVEY DATA,ALL DIMENSIONS AND EXISTING �5E ;COMPLIANT WITH PROP. X CONDITIONS ARE 5UBJECTTO FIELD VERIFICATION. PERMANENT _ GARAGE 3. PROPERLY LINES SHOWN HEREON ARE BASED THE REFERENCED SURVEY.NO NEW PROPERTY LINE DETERMINATION HAS BEEN BARRIER R328.4.2 19.3' 15' MADE. REQUIREMENTS "' q, ALL PROPOSED IMPROVEMENTS ARE DESIGNED TO COMPLY WITH e L gyp.) APPLICABLE ZONING REGULATIONS OF THE TOWN OF OYSTER BAY. IT 15 THE CONTRACTOR'S RESPONSIBILITY TO VERIFY COMPLIANCE T i _ STOOP X PRIORTO CONSTRUCTION. 5. ALL WORK SHALL BE PERFORMED IN ACCORDANCE WITH PERMITS ISSUED BY THE TOWN OF SOUTHOLD AND ANY OTHER AGENCIES 50.`, } HA VINGIURISDIC{ION. _ ;--� (� 6. CONTRACTOR SHALL VERIFY THE LOCATIONS OF UNDERGROUND PROPOSED SELF CLOSING 3 UTILITIES PRIOR TO ANY EXCAVATION- _ 8,LATCHING GATE 7. ALL GRADING SHALL BE DIRECTED AWAY FROM STRUCTURES.NO INCREASE IN RUNOFF ONTO ADJACENT PROPERTIES IS PERMITTED. g- PROPOSED TWO Y E. POOL EQUIPMENT SHALL BE LOCATED AS SHOWN AND COMPLY se, W PROPOSED STORY DWELLING 3 WITHALLAPPLICABLESETBACKAND NOISE REGULATIONS - POOL RDOL SHALL BE ENCLOSED WITH A CODE-COMPLIANT BARRIER IN ACCO a F O EQUIPMENT ',,.. O REQUIRDEMENTS.ANCE or APPLICABLE BUILDING CODES AND LOCAL m ALL ELECTRICAL WORK SHALL COMPLY WITH THE NATIONAL =e ELECTRICAL CODE AND LOCAL REQUIREMENTS.BONDING AND 0_ � c� i 33.9, v aEa = 7 w IRT I` GROUNDING SHALL BE PROVIDED AS REQUIRED. o„A T ' 7 11. NO PORTION OTTER POOLSHALL BE LOCATED BENEATH OVERHEAD ELECTRICAL CONDUCTORS.A SEPARATE CERTIFICATION MAY BE 'H (n 314' 120 c«, 1 Z REQUIRED VERIFYING COMPLIANCE WITH CLEARANCE s - REQUIREMENTS. 12.NO STRUCTURES OR IMPROVEMENTS SHALL BE PLACED WITHIN WALKWAY ANY EXISTING EASEMENTS UNLESS APPROVES BY THE AUTHORITY o HAVINGJURISDICTION. �S E \ 13.CONTRACTOR SHALLVERIFY ALL EXISTING CONDITIONS IN THE FIELD _ PROPOSED PRIOR TO CONSTRUCTION AND REPORT ANY DISCREPANCIES TO COVERED PORCH THE DESIGNER. =G Co THE CONTRACTOR IS RESPONSIBLE FOR SAFEGUARDING ADJACENT PROPERTIES,STRUCTURES,AND UTILITIES DURING CONSTRUCTION. y� .tL PROPOSED PLOT PLAN FOR: ND HARBOR SWIMMING POOL A PATIO -a o 194 MORRIS AVE,UNIT4 `222} Harbor o, HOLTSVILLE,NY 11]42 v�a �Q 383.22 L i _ i _ _ _ °' b PH.631-980766q 500 SUMMER LANE 's s E- NE SOUTHOLD,NY 11971 A N 25'05'30"E 100.00' r TOWN OF SOUTHOLD A, 4�BERGF p a➢ cU PREPARED BY: = 4 C3 g Mason Bergerson,PE sage SUMMER LANE _ ti 28O4lohiRoeSmthAve,Metl{ottl,NYl@63 Phone John Rce S60 Em Medford, NY 1 63 com Lu -m DRAWING SCALE m FILE NO:. HP26-12 PLOT PLAN E a 20 10 5 0 20 ��' DATE: 08/13/2026 PP "E @ 0 4A� ��03V P\, REVISIONS: �F e y m- 1 inch= 20 feet ESS10 € - SEAL