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HomeMy WebLinkAbout47357-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
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#: 47357 Date: 1/19/2022
Permission is hereby granted to:
Rose, Dina
355 Windjammer Dr
Southold, NY 11971
To: install new AC unit as applied for.
At premises located at:
355 Windjammer Dr, Southold
SCTM # 473889
Sec/Block/Lot# 79.4-40
Pursuant to application dated 12/29/2021 and approved by the Building Inspector.
To expire on 7/21/2023.
Fees:
SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $200.00
CO-ALTERATION TO DWELLING $50.00
Total: $250.00
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ding 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 ha � . otaho'-to y� _.-ov
Date Received
APPLICATION FOR BUIL _ E IT
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r For Office Use Only
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PERMIT NO. Building Inspector-
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Applications and forms must be filled out in their entirety. Incomplete BUILDING;
applications will not be accepted. Where the Applicant is not the owner,an TOWN of OU��oL
Owner's Authorization form(Page 2)shall be completed.
Date: 1 ),- t)_q 0_ \
OWNER(S)OF PROPERTY: i
Name: �ij1 � SCTM# 1000-
Project Address: )
Phone#: G• 73 Email:
Pi�F1 ��S�ar�1
Mailing Address:
l'�l r,6 rz.r.1r�-t r X 'S�41-Yta_-A cl N) ` 1
CONTACT PERSON:
Name:
Mailing Address: � lC
Phone#: (03i - Email:
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name: ctlt� _xo&1N
Mailing Address: '1 - c .� )
Phone#: 3i 7 SS<S Email: rd, A�shvc,C c+��t�`) rL
DESCRIPTION OF PROPOSED CONSTRUCTION
El New Str e c tion Li k —i_ epair ❑Demolition Estimated Cost of Project:
$ ...� H I
Other �"` �, £� �-� �---� �-. � O�
z
Will the lot be er���-0 -,Ra Will excess fill be removed from premises? ❑Yes �o
1
PROPERTY INFORMATION
Existing use of property: Intended use of property:
-----------CA -L- &41 1
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? ElYes &Xo IF YES, PROVIDE A COPY,
G;rtheck 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 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 210.45 of the New York State Penal Law.
Application Submitted By(print nwe): ElAuthorized Agent 2-0.1*Wner
Signature of Applicant: Date: 0.7 /,,1
STATE OF NEW YORK) CONNIE D.BUNCH
Notary Public,State of New York
SS: No.0IBU6185050
COUNTY OF Qualified in Suffolk County
Commission Expires April 14, 2-W3
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
4
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rylj A
ay of-hcl!�,r It-o' 20 -'9-�11
Notary Public
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
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
O � BUILDING DEPARTMENT- Electrical Inspector
} TOWN OF SOUTHOLD
Town Hall Annex - 54375 Main Road - PO Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX (631) 765-9502
ren�sout�oldto � ov sea�d�southoldtownny goy
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date:
Company Name: G ,- - --
Electrician's Name: C C
License No.: m - 44-
(.62� Elec. email
Elec. Phone No: ❑I request an email copy of Certificate of Compliance
Elec. Address.:
JOB SITE INFORMATION (All Information Required)
Name:
Address:
Cross Street:
Phone No.: la
Bldg.Permit#: email: A
t
c'-LJ
Tax Map District: 000 Section: '73 Block: Lot: /-/o
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
Square Footage: -
Circle All That Apply:
Is job ready for inspection?: YES ❑ NO DRoughln Final
Do you need a Temp Certificate?: ❑ YES NO Issued On
-
Temp Information: (All information required)
Service SizeF-11Ph E]3 Ph Size: A # Meters Old Meter#
❑New Service[–]Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground[]Overhead
# Underground Laterals 1 H Frame El Pole Work done on Service? Y MN
Additional Information:
PAYMENT DUE WITH APPLICATION
SSe �s
Grattan's Heatlng&Cooling Estimate
322 Terry Ct
Southold, NY 11971 US
(631)745-5555
gra an hva mail. m
tt s c@g co
3.Mk�:srz-ca'.�t.'a�is�,,-„�''�aE.;c:�3k„r,.
Dina Rose
k 355 Wind Jammer Lane
Southold,NY 11971
895 17J11l2021
.,��;�wu,�w �' �. �,' � a ^+`�".�:�+':>�k....<zr atx��"� '�`��`,".L *�. ����.a�_..,x��.c .✓n12� 4 „s�E xs.�” �
Installation f t I 0.00` 0.00
Remove and discard existing 3.5 ton R=22 AC system and replace with a new I i i
heat pump-system.Installation inciudes,removal of old R-22 refrigerantto
E.P.A.standards, a new Rheem 4 ton heat pump compressor model#
e
1 RP1448AJ1NA located outside of residence in existing location on a new pre i
F cast pad,a new Rheem air handier model#RH1 T4821 STANJA located in
existing location in basement,reconnecting refrigerant piping,condensate y
drain,line voltage'wiring,controls for low voltage wiring to stage heat pump as i ; k
first stage heat and hydronic water coil as auxiliary heating,all supply and x
t return duct work transitions, manual balancing dampers to adjust air flow '
between first and second floors,environmentally friendly R-41 OA refrigerant
and start up and testing of new heat pump system. {
Investment Prim 1 .7,400.00 7,400.00 i
$7400.00 Seven Thousand Four Hundred Dollars {
Warranty 1 ` 0.00 0.00'
10 year manufacturers factory warranty on all Rheem parts during normal s
business hours i r
Deposit 1 r 0.00; 0.00
50%upon signed contract 50%upon start up and completion c
z ?
Not included 1 ,� 0.00; 0.0011
: Permits by homeowner„r t
TOTAL $70400.00
Accepted By Accepted Date