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HomeMy WebLinkAbout47681-Z o�SufFni,��oTOWN OF SOUTHOLD �a BUILDING DEPARTMENT C* x TOWN CLERK'S OFFICE SOUTHOLD, NY e 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#: 47681 Date: 4/15/2022 Permission is hereby granted to: Nasary, Veronica 2905 Arbor Ln Mattituck, NY 11952 To: Legalize as-built (installed) AC unit at existing single family dwelling as applied for. Additional certification may be required. At premises located at: '`� 2905 Arbor Ln, Mattitucky �r ►'� �f'rp r SCTM #473889 Sec/Block/Lot# 113.-7-25 Pursuant to application dated 3/15/2022 and approved by the Building Inspector. To expire on 10/15/2023. Fees: AS BUILT-ACCESSORY $400.00 CO-RESIDENTIAL $50.00 Total: $450.00 Building Inspector �aOP SOUTh� Lt TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 -INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. ( ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ LECTRICAL (FINAL) [ ] CODE VIOLATION ] PRE C/O [ ] RENTAL REMARKS: ou DATE NSPECTOR i hO��OE SOUI,�o� fff wlwwy # TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN ATIOWCAULKING [ ] FRAMING /STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: No L& A DATE '� INSPECTOR FIELD INSPECTION REPORT DATE COMMENTS b FOUNDATION (1ST) y -------------------------------- FOUNDATION (2ND) z 0 ROUGH FRAMING& PLUMBING y INSULATION PER N.Y. y STATE ENERGY CODE FINAL - O � G� N COMMENTS � C. i L i CO _ G Z �rn k ( O z x d r� b f3 F�a�SUFfot r�oGy�,` TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold, NY 11971-0959 'y • of Telephone (631) 765-1802 Fax (631) 765-9502 hgps://www.southoldtownny.gov ,F Date Received APPLICATION FOR BUILDING PERMIT RMAR E C For Office Use Only I'' DD PERMIT NO. Building Inspector: I BUILDING DEPT. :Application"stand forrns,rnWtbd lled out:in the,ir.,entirety:ancom`plete,: TOWN OF SOUTHOLD applications wilt not belaccepted: lNh'ere,ttie=Applicant is.not'tti'e:owner;r'an •t Owner's AutF orization.form(Page 2)shall,bd completed: , Date: OWNERS)OF'PROPERTY: Name: �O SCTM#1000- 113_ a _ 5— Project Address: Z [K AI JAZ Phone#: ? _ Emai Mailing Address: OS z CONTACT PERSON:, Name: Mailing Address: d 7� Phone#: �6 8 0 7 Email 055 OAI DESIGN PROFESSIONAL.INFO.RMATIONc Name: Mailing Address: Phone#: Email- �� .CO NT kACTO R'I N FO R MATI O N; Name: N Mailing Address: Phone#: Email: :,.z.:.. : ..,.. 'DESCRIPTION=OF PROPOSED CONSTRUCTION -wj­ •'s"= ❑New Structure ❑Addition XAlteration ❑Repair El Demolition Estimated Cost of Project: ;WOther 0? O G �L $ Will the lot be re-graded? ❑Yes;9No Will excess fill be removed from premises? ❑Yes ONO PROPERTY INFORMATION Existing use of property: Intended use of property• ffW Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? ❑Yes XNo IF YES, PROVIDE A COPY. �$Check'Box.Afte f�Re.ad ingc .The owner/contractor/des ign'',professional,is responsible;for all drainage and;sform water Issue's as provided by Chapter,236•of the;Town Cocle_. LICATION'.lS,HEREBy MADE'to the Building Department for,the issuance of a Building•.Permit pursuant to the Building Zone Ordinerice;of the T1.own of Southold,Suffolk,County;New York_and other.applicable Laws,Ordinances or Regulations;.for the construction of buildings, additions,alterations;_`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 iinspectorsron premises and'in buildings)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 name): 1//C1_14,,4L 4. eIH4 cel a" [WAuthorized Agent []Owner Signature of Applicant: G G, Date: STATE OF NEW YORK) SS: COUNTY OF l615!!F6 ) "IC-Alli-Al— .4. being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)he is the /.f 6 45N (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 `1 day of 20-.---Z— DAVID J.JANNILIZZI Notary Public NOTARY PUBLIC,STATE OF NEW YORK Registration No.02JA60a2585 Qualified in Suffolk County RERTY OWNER AUTHORIZATION Commission Expires February 13, (Where the applicant is not the owner) I, VAE02/t I04 VY45'ARY residing at 2'90.57,4 P,�O& IAiye Aj9. ;!yC/T-Y /195''—do hereby authorize f'//e'A/e�t� d�/mss to apply on myalf to the Town of Southold Building Department for approval as described herein. be YU —a )m Owner's Signature Date Ism 4WI C�qA M,r4" Print Owner's Name 2 SUIrF01� BUILDING DEPARTMENT- Electrical Inspector Q t' .��v. TOWN OF SOUTHOLD R Town Hall Annex 54375 Mai R, }" - n Road - PO Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 " �� � � ``• ro err soufihoidto o wnny.gov - sea nd(7a�southoldtownnL aov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: Company Name: k Electrician's Name: License No.: ` 2-_31 Elec. email: j In s• J/-/, Elec. Phone No: QDI request an email copy of Certificate of/Compliance Elec. Address.: JOB SITE INFORMATION (All Information Required) Name: ,f, Address: v� '�� S~ C %� r � ,r!�„ �u4 Cross Street: r fes. Phone No.: j (� C 7 2- Bldg.Permit -Bldg.Permit#: ,�/, email: ti f Tax Map District: 1000 Section.: Block: ' Lot: BRIEF DESCRIPTION OF [WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): aJA 14[5, e-) Jvj Circle All That Apply: Square Footage: Is job ready for inspection?.- ® YES ONO ❑Rough In1771 Final Do you need a Temp Certificate?: YES [0 NO Issued On Temp Informs ion: (All information required) Service S F� i Ph[3 Ph Size: A # Meters Old Meter# ®New Service ' e ReconnectOFlood Recon ect[]Service Reconnect QUn erground DOverhead # Underground Laterals 1 2 H Frame ole Work done on Service? Y N Additional Information: : - PAYMENT DUE WITH APP CATION � '© .�-� I 1 go s*2,L II PERMIT# Address: Switches Outlets i GFI's I Surface Sconces 1 / H H's UC Lts Fans Fridge HW Exhaust Oven Dryer Smokes DW Service Carbon Micro Generator Combo - - Coo top Transfer AC H Mini i Special: Comments: I I i �SUFFaTOWN OF SOUTHOLD ��o may BUILDING DEPARTMENT y TOWN CLERK'S OFFICE o • 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#: 47681 Date: 4/15/2022 Permission is hereby granted to: Nasary, Veronica 2905 Arbor Ln Mattituck, NY 11952 To: Legalize as-built (installed) AC unit at existing single family dwelling as applied for. Additional certification may be required. At premises located at: 2905 Arbor Ln, Mattituck SCTM #473889 Sec/Block/Lot# 113.-7-25 Pursuant to application dated 3/15/2022 and approved by the Building Inspector. To expire on 10/15/2023. Fees: AS BUILT-ACCESSORY $400.00 CO-RESIDENTIAL $50.00 Total: $450.00 J 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 hM2s://www.southoldtownny.g Date Received APPLICATION FOR BUILDING PERMIT IILE--� For Office Use Only PERMIT N.. Building Inspector: MARI J� G App'.1(catiQns and forms must be fille'd.but in their' BUIL DIN .entirety.Incomplete. TOWN OF SDEPT OUTHOLD applitationsmiji not be accepted:.wh��re�ib-�:AOplicant.isnot the.owner,'an Owner's Aut-ho"ifiation f6r"m-`(Phke 2)shall be conipl6ted. Date: oozz OWNERS)OF PROPERTY: Name: SCTM#1000- VAZ�?� ? 7 2 Project Address: 26 - ,�4ArrzmcKK IVY -119 Phone#: 19199 Emai &AM6V Z86Y,M- Mailing Address: 114 A125 &0gZ7XZ:JZQ< A/-.V CONTACT PERSON: Name: Mailing Address: p 0, Agog //O:Z S-b( -71 Phone#: 19 0 -7 Email 115EVZOA1, *--"!Z-� DESIGN PROFESSIONAL'-INFORMATION: Name: t F—A t' Mailing Address: 1�pg Y Phone#: 7 74 -7-3 Email YAW 8 CONTRACT-OR INFORMATION: Name: )VIA Mailing Address: Phone#: Email: DESCRIPTION OF PROPOSED CONSTRUCTION E]New Structure ElAddition XAlteration El Repair DIDemolition Estimated Cost of Project: $ Will the lot be re-graded? E]Yes XNo Will excess fill be removed from premises? DYes P-No I PROPERTY INFORMATION Existing use of property: ® Intended use of property- ZPA-_ Z94 rN �3' / W, Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? []Yes EKNo IF YES, PROVIDE A COPY. JZ CheClc 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.theTown of.Southold,Suffolk,;County,'New York.and other applicable Laws,Ordinances or Regulations,for the construction of buildings, additions,eiterations,or for removal or demolition as herein described.The applicant agrees to comply with all applicable laws,ordinances,building code, housing•code and.reguiations 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. .I Application Submitted By(print name): /,/[`�y114,4[ Afl�i4 cle ('Authorized Agent ❑Owner Signature of Applicant: 'f� - /f ,, �,s flU'� �� r�t� Date: ��' °'`� ���.--C STATE OF NEW YORK) SS: COUNTY OF 1'00��L./G ) 4/CA1.�,61 4 / Zq /Z— being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)he is the 4,&5N (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. i y� Sworn before me this `I day of zoo DAVID J.J;iqN'€ ,7 I Notary Public L Y PU3LtC,STATE+O±_NEW YORKegis af!-n hdo.U2Jaii0t5 585 Quaiilied in osiaoik Counission Expires F=ebruary 43, �'` PERTY OWNER AUTHORIZATION (Where the applicant is not the owner) I ►, VE/?2&1P,� A195'ARY residing at01 `A1*_1C;_, rs A`� ere do hereby�Y Y authorize /%l(_'�/.� kIH4 C& to apply on my be alf to the Town of Southold Building Department for approval as described herein. Owner's Signature Date _A C4 ,Ls4 C4" Print Owner's Name I 2 I I BUILDING DEPARTMENT- Electrical Inspector ZZ, TOWN OF SOUTHOLD " ° ` ' Town Hall Annex - 54375 Main Road - PO Box 1179 r ?' 2Z Southold, New York 11971-0959 01 ` .r'. Telephone (631) 765-1802 - FAX (631) 765-9502 Y rogerrp_southoldtownnv aov sea nd(a7southoldtownnv aov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: :S�-_- Z Company Name: C g. Ic i �- Electrician's Name: d 67--V\4'- ICA License No.: L?Z-107 z Elec. email: Elec. Phone No: C; . Z� (a_ L-Z_ �]I request an email copy of Certificate o Compliance Elec. Address.: ?. b, 9 D:X- SQ uz) ti, b JOB SITE INFORMATION (All Information Required) Name: Address: X2`/'0 A� Cross Street: r Phone No.: �5 (� 7-2 . p� Bldg.Permit#: ,�// email: ti Tax Map District: 1000 Section: Block: Lot: BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): A _ ,/-V Circle All That Apply: Square Footage: Is job ready for inspection?: ® YES ❑ NO [:]Rough In FAFinal Do you need a Temp Certificate?: ] YES 7 NO Issued On Temp Informai ion: (All information required) ServiceS' e]1 Ph 03 Ph Size: A # Meters Old Meter# ®New Service0 ' e Reconnect[]Flood Recon ectOService ReconnectQUn erground❑Overhead # Underground Laterals 1 2 H Frame ole Work done on Service? Y N Additional Information: YMENT DUE WITH APP CATION `t'G o 1d�3 � 1$v APPROVED AS NOTED OCCUPANCY pRUSE 1$ UNLAWFU DATE: �,�"a2 B.P.# W�TF�pU L FEE.4 BY: T CERTIFICATE NOTIFY BUILDING DEPARTMENT AT OF OCCUPANCY '�S '802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS:-,-- FOUNDATION NSPECTIONS: _ . FOUNDATION TWO REQUIRED rOR POURED CONCRETE ' '3OUGH - FRAMING & PLUMBING s. sNSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE , COMPLY WITH ALL CODES pl_ . REQUIREMENTS OF THE CODES OF NEW 'NEW YORK STATE & TOWN COD YORK STATE. NOT RESPONSIBLE FOR AS REQUIRE . ES DESIGN OR ,CONSTRUCTION ERRORS. AND CONDITIONS OF SOUTHOID TOWN ZBA SOROLD TOMPLANNINC BOARD SOUNOLD TOWN TRUSTEES N.Y,S.DEC Additional Certification May Be Required. *Skm MIT `,,` ter,:;.'--._,_ ••-�C�--:-= :� I • �naenY.dHn �=' �.����tlAYWARD ig Y S �— •� r Aute skfAm` p:( Y' dd l' Ik 4 `F � �.AF J t - t � ¢M • .k. Ar Y f ro 7 MF.. w R L � 1 6! DATE 4!2009 MOO.N0. 4TTX6048C1000AA VOLTS 230 SERIAL NO. 918318H 1 F PH 1 HZ 60 .; h MINIMUM CIRCUIT AMPACITY 28.0 AMPS Mme' OVERCURRENT PROTECTIVE DEVICE USA CANADA - MIN FUSE I BREAKER(HACR) 40 40 MAX FRSE I BREAKER(HACRj 45 45 HFC — 410A 7 LBS. 08 OZ OR 3.40 kg(SI) C1l.c.11 0-1.rrt SPInc tl SFION OF- TRANEU.S.INC, �f� �CENTRALC05LINC *AoufAm-1 ROFl1wAMDkNEMt1VNi'.NOARC AIR CONDIT"TOOA USE Ep r, TYLER,TX 75107 ASSEMBLED IN USA OOTD COM R.MOT, 21.2 RLA 230 t 96 MRA D Q.MOT. 1.00 ELA 200/230 V 115 M.E.A.ND. 392—04E—IVIEID, 02Y DESIGN PS;-HIGH 480 LOW 480 z i ARI Standnrd # ENERGY STAR 210(240 UAC CERTIHCATICOMPLETE ON APPUIES 010 k 4 ,j Ml a : l t®tl`t'07R1u411 IAI.I NU WHE IS.160 WITH An STEM ... I R Sl=RVI CALL � Vit.