HomeMy WebLinkAbout53279-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#: 53279 Date: 09/16/2026
Permission is hereby granted to:
Adam Lacku
56 Devon Rd
Rockville Centre, NY 11570
To:
construct an accessory in-ground swimming pool as applied for. Pool and pool equipment shall have a
minimum side yard setback of 15 feet.
Premises Located at:
4045 Route 25, Greenport, NY 11944
SCTM# 35.-2-9.4
Pursuant to application dated 08/27/2026 and approved by the Building Inspector.
To expire on 09/15/2028.
Contractors:
Required Inspections:
Fees:
SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $300.00
CO imming Pool $100.00
Total $400.00
Building 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 httos://www.sotitlioldtowniiy.gov
Date Received
APPLICATION FOR BUILDING PERMIT
77Z)For Office Use Only
PERMIT NO. Building Inspector; r�,(U G 2 7
Applications and forms must be filled out in their entirety.Incomplete
applications will not be accepted. Where the Applicant is not the owner,an Buildin e'parfrrtent
Owner's Authorization form(Page 2)shall be completed. Tcrwa, of Southold
Date:August 20, 2026
OWNERS)OF PROPERTY:
Name: Adam Lacku SCTM #1000-35.-2-9.4
Project Address: 4045 Route 48, Greenport, NY
Phone#:347-585-0894 1Email:alacku@gmaiI.com
Mailing Address: 4045 Route 48, Greenport, NY
CONTACT PERSON:
Name: Jennifer Del Vaglio
Mailing Address: PO box 369 Peconic NY 11935
Phone#:631-734-7600 Email:jennifer@eastendpoolking.com
DESIGN PROFESSIONAL INFORMATION:
Name:Same as above
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name: East End Pool King LLC
Mailing Address: PO Box 369 Peconic, NY 11935
Phone#:631-734-7600 Email:cj@eastendpoolking.com
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition DAlteration ❑Repair ❑Demolition Estimated Cost of Project:
❑Other Vinyl swimming pool 20x4O $ 66,000
Will the lot be re-graded? ®Yes El No Will excess fill be removed from premises? RYes ONo
1
PROPERTY INFORMATION
Existing use of property: Single family dwelling Intended use of property: single family dwelling
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
R-80 this property? OYes F'No I YES, PROVIDE A COPY.
WN
R Check Box After Reading: The owner/contractor/design professional is responsible for all drainage and storm water issues as pro led 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.False statements made herein are
punishable as a Class A misdemeanor pursuant to Section 210AS of the New York State Penal Law,
Application Submitted By(print name): Jennifer Del Vag l i o -Authorized Agent ❑Owner
Signature of Applicant -- Date:
CONNIE D.BUNCH
STATE OF NEW YORK) Notary Public,State of New York
No.01BU6185050
SS: Qualified In Suffolk County I
COUNTY OF ) Commission Expires April 14,2Q4b
East End Pool King/ Jennifer Del Vaglio
being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
(S)he is the Agent/Contractor
(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
�Q
day of 20 �� C-f—z�rY1 ��fl
Notary Public
PROPERTYNEB AUTHORIZATION
(Where the applicant is not the owner)
Adam Lacku residing at 4045 Route 48, Greenport, NY
.
East End Pool King and/or Jennifer Del Vaglio
do hereby authorize to apply on
my behalf t Town f Southold Building Department for approval as described herein.
d� 8/20/26
cAvner's Signature Date
Adam Lacku
Print Owner's Name
2
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