HomeMy WebLinkAbout48285-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 #: 48285 Date: 9/13/2022
Permission is hereby granted to:
Foggy Bottoms LLC
466 Mountain Ave
Sonoma, CA 95476
To. legalize "as built" AC unit as applied for.
At premises located at:
810 Waterview Dr, Southold
SCTM #473889
Sec/Block/Lot# 78.-7-29
Pursuant to application dated 8/4/2022 and approved by the Building Inspector.
To expire on 3/14/2024.
Fees:
AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $400.00
CO-ALTERATION TO DWELLING $50.00
Total: $450.00
Building Inspector
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
N� Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone (631) 765-1802 Fax(631) 765-9502 littps://www.so,utlioldtownny.-gov.
Date Received
APPLICATION FOR BUILDINGPERMIT
C) D
For Office Use Only q,
A U 2022 D
PERMIT NO. �8 Building Inspector-
Applications and forms must be filled out in their entirety.Incomplete Wlf' DEVI,,'.
applications will not be accepted. Where the Applicant is not the owner,an
TOSVN OF SOT IOf.
Owner's Authorization form(Page 2)shall be completed.
Date:07/22/22
OWNER(S)OF PROPERTY:
Name:Foggy Bottoms LLC scTM#so00-
Project Address:810 Waterview Dr, Southold, NY 11971
Phone#:9737608855 Email:jarredroth@gmail.com
Mailing Address:466 Mountain Ave
CONTACT PERSON:
Name:Virginia Grieco
Mailing Address:2 Oak St, Wading River, NY 11792
Phone#:6314330049 Email:
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone#: Email:.
CONTRACTOR INFORMATION:
Name:
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
Inspection for royal of Rental Permit p � e
❑New Structure ❑Addition ❑Alteration ❑Re air ❑Demolitio Estimated Cost of Project:
[i]Other P PP 5
Will the lot be re-graded? ❑Yes ❑No Will excess fill be removed from premises? ❑Yes []No
1
PROPERTY INFORMATION
Existing use of property: Personal Home Intended use of property: Rental/Personal
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? ❑Yes ONO IF YES, PROVIDE A COPY.
W Check 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 15 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 name):Foggy Bottoms LLS ❑Authorized Agent BOWner
Signature of Applicant: Date: 07/22/22
STATE OF NEW YORK)
SS:
COUNTY OF Suffolk )
Foggy Bottoms LLC bean duly sworn deposesoses and says that(s he i
the applicant
(Name of individual signing contract)above named,
(S)he is theJarred Roth
(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
da N 20ii �Cfta'1
Notary P blic
KAREN M GIAMMv
PRUP ��;RT Ir 14711 . 1 117 '���) ���II Notary Public-State of New
�...... No.01 G 16191277
(Where the applicant is not the owner) Qualified in Suffolk
MY Commiealon Exp: 08/11/2024
I, S residing at Lucl— t,.[-- 12
do hereby authorize 0l13 to apply on
my b h If to the Town a Southold Building Department for approval as described herein.
�r
Own is Signature l3ate
U -
Print ner's Name
2
f I INO DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
w uvn a I Annex- 54375 Main Road - PO Box 1179
w � 1
Southold, New York 11971-0959
�,� �� � � lephone (631) 765-1802 - FAX (631) 765-9502
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date: 07/22/22
Company Name;
Electrician's Name: Jim Orlowski (HVAC)
License No.: Elec. email:<jcplumbing1969@gmail.com>
Elec. Phone No: 6319268597 ❑1 request an email copy of Certificate of Compliance
Elec. Address.:
JOB SITE INFORMATION (All Information Required)
Name: Foggy Bottoms LLC (Jarred Roth)
Address: 810 Watereview Dr.
Cross Street: Main Byniew Rd.
Phone No.: 9737608855
Bldg.Permit#: email:jarredroth@gmail.com
Tax Map District: 1000 Section:078.00 Block: 07.00 Lot:029.00
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
Inspection of exterior AC Unit and approval to allow for Rental Permit.
Square Footage: TAppx, 1400
Circle All That Apply:
Is job ready for inspection?: R] YES NO ❑Rough In Final
Do you need a Temp Certificate?: E' YES NO Issued On
Temp Information: (All information required)
Service Size1 Ph 03 Ph Size: A # Meters Old Meter#
F-1 New Service❑Fire Reconnect❑Flood Reconnect[]Service Reconnect❑Underground[]Overhead
# Underground Laterals 1 2 H Frame Pole Work done on Service? Y N
Additional Information:
PAlfilllilENT DUE WITH APPLICATION
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RHEEM AIR CONDITIONER
MODEL NO. RAMC-036JAZ
SERIAL NO. 6974 M4604 11234 MFD 11/2004
VOLTS 208/230OUTDOOR U$E
COMPRESSOR R.L.A. 16/16 PHASE I HERTZ 60
OUTDOOR FAN MOTOR F.L.A. 1.5 HP(WATTS)L.R.1/3' 88
MIN. SUPPLY CIRCUIT AMPACITY
MAX. FUSE OR CKT. BRK. SIZE* 22/22 AMP
MIN FUSE OR CKT. BRK. SIZE* 35/35 AMP
DESIGN PRESSURE HIGH,. 30/30 AMP
DESIGN PRESSURE LOW 2068 KPA/300 PSIG
OUTDOOR UNITS FACTORY CHARGE 1034 KPAZ. PSIG
O
TOTAL SYSTEM CHARGE 2637G/93 OZ. R22
SEE INSTRUCTIONS INSIDE ACCESS PANEL OZ. R22
RHEEM AIR CONDITIONING DIVISION
FORT SMITH, ARKANSAS
MADE
IN THE
USA
*HACR TYPE BREAKER FOR U.S.A.
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Andersen 33.625 in . x 40. 375 in. 400
Series Double Hung White Interior Wood
Windows
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