HomeMy WebLinkAbout53260-Z , u 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#: 53260 Date: 09/10/2026
Permission is hereby granted to:
Francis Raia
28 Eagle Ln
Tappan, NY 10983
To:
Construct a hot tub accessory to an existing single-family dwelling as applied for. Hot tub must be in
rear yard.
Premises Located at:
1815 Arrowhead Ln, Peconic, NY 11958
SCTM#98.-3-13.1
Pursuant to application dated 08/21/2026 and approved by the Building Inspector.
To expire on 09/09/2028.
Contractors:
Required Inspections:
FOOTING/REBAR, ELECTRICAL- ROUGH, ELECTRICAL- FINAL, DRAINAGE, FINAL,
Fees:
Hci-'TUb Accessory-New Structure $300.00
CO Accessory $100.00
Total $400.00
7k Ii)
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) 765-95021 s //w\y v. QutholdtoN�LjLi ,''• �"
Date Received
APPLICATIONI IPERMIT
For office Use Only
PERMIT N0. G� �� � Building Inspector: AUG
Applications and forms must be filled out in their entirety. Incomplete
rlent
applications will not be accepted. Where the Applicant is not the owner,anBuildingof outh ld
Owner's Authorization form(Page 2)shall be completed.
Date:
OWNER(S)OF PROPERTY:
Name: Qck k a
SCTM#1000-
Project Address: t
i
Phone#: Email:
r Ira
Mailing Address: 6(-Y�ok
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CONTACT PERSON:
Name:
Q
Mailing Address: S y)0y-v 1 j 11q49
Phone#: S ( ` Email•
i- 9�& win �,,�P-Qkndt V'V
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name: 01-S 'r-,. •- -'
c .
Mailing Address.w ( -
Phone#: C0 _Itp Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ORepair DDemolition Estimated Cos of Project:
Cpther � , fi $ t
Will the lot be re-graded? E]Yes o Will excess fill be removed from premises? es ONO
1
PROPERTY INFORMATION
Existing use of property: m Intended use of property: �� ►�mm�rl
Zone or use district in which premise is situated: Are there any covenants and restrictions with respect to
this property? ❑Yes IL IF YES, PROVIDE A COPY.
Ieci Box After Reading: The owner/contractor/design professional Is responsible for all drainage and storm water Issues as provided by
apter 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 buliding(s)for necessary Inspections.False statements made herein are
punishable as a Class A misdemeanor pursuant to Section 210.4S of the New York State Penal Law.
Application Submitted By rint name): �alr�rl ICY1C'.I�C,�➢Y"l (�. �`IAuthorized Agent ❑Owner
Signature of Applicant: Date: 6' 1 , �}
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
(Contras or,Agent,C porate Officer,etc.)
of said owner or owners,and is duly authorized to 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
Al �
6S�day of U4 �,20so:�a= 11
otary Public
TRACEwY"L. DWYE R
PRO.n. PE� .. . IYERAUTliORIZA,'IoION NOTA1#Y PUBLIC,STATE OF NkW YORK
(Where the applicant is not the owner) NO.Otl)v60690o
OUALIFIED IN SUFFOLK.COUNTY
COMMISSION EXPIRESJUNvIE SDI,ZOP
I, 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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