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Home My WebLink About48751-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#: 48751 Date: 1/18/2023 Permission is hereby granted to: Lilikakis, Demetrius 7911 Colonial Rd Brooklyn, NY 11209 To. Legalize as-installed wall mount mini split AC units at existing single family dwelling as applied for. Additional certification may be required. At premises located at: 1445 Green Hill Ln, Greenport SCTM # 473889 Sec/Block/Lot# 33.-2-25 Pursuant to application dated 12/8/2022 and approved by the Building Inspector.. To expire on 7/19/2024. Fees: AS BUILT-ACCESSORY $400.00 CO-RESIDENTIAL $50.00 Total: $450.00 Building Inspector r � r, TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 �j Telephone (631) 765-1802 Fax (631) 765-9502 http Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only PERMIT N0. l Building Inaspector:, DEC 0 7 2022 Applications and forms must be filled out in their entirety. IncompleteSUI'LDINOWK applications will not be accepted. Where the Applicant is not the owner,an TOWNCIFSOUTH&D Owner's Authorization form(Page 2)shall be completed. Date: .217 ,,' V,9--3 OWNER(S)OF PROPERTY: Name: �e/yI ��ilJ1 ��ls SCTM# 1000- _ S� Project Address: ` �/Q4,a ,0 Phone#: — �� — S I� 77 Email: Mailing Address: 7gll 13'At1VV/ 'IV V za CONTACT PERSON: Name: �� d a ✓ Mailing Address: Phone#: q1 —33 —.mac 77 Email: DESIGN PROFESSIONAL INFORMATION: Name: tet' Mailing Address Phone#: Email: CONTRACTOR INFORMATION: Name: Mailing Address; Phone#: Email: DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: Will the lot be re-graded? ❑Yes ❑No Will excess fill be removed from premises? ❑Yes ❑No 1 ri PROPERTY INFORMATION Existing use of property: Intended use of property: 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. ❑ 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 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 name): El Authorized Agent ❑Owner Signature of Applicant: Date: 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 (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 day of , 20 Notary Public AUTHORIZATIONPROPERTY OWNER (Where the applicant is not the owner) 1, residing at do hereby authorize to apply on my behalf to the Town of Sqythol.0,Building Department for approval as described herein. 7 � z Owner's Signature 6ate 0--2 CONNIE D.BUNCH Notary Public,State of New York No. 01 BU6185050 Print Owner's Name Qualified in Suffolk County Co mission Expires April 14,2)C9V 2 w" 4 L ,. � f DEC 0 7 2022 L NG DEPARTMENT- Electrical Inspector �`" �?� II�� TOWN OF SOUTHOLD Hall Annex - 54375 Main Road - PO Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 ra err so tl c ldf r�vnn ov seand southoldtownn . ov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: Company Name: ' Electrician's Name: License No.: Elec. email: Elec. Phone No: 91-7KOI q-)_7� ❑I request an email copy of Certificate of Compliance Elec. Address.: JOB SITE INFORMATION (All Information Required) Name: f,.j,e e*1�0 zf_ �4 1 Address: /Y 1 � ` Lir F Cross Street: Phone No.: /7 —3 —5q' 7 7 Bldg.Permit#: email: Tax Map District: 1000 Section: Block: 33. -,2 a S Lot:. BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly);. Av,r Square Foota e: 77 Circle All That Apply: Is job ready for inspection?: EfYES Q NO 0 Rough In HFinal Do you need a Temp Certificate?: 11 YES ©AO Issued On Temp Information: (All information required) Service Size 1-11 Ph 3 Ph Size: A # Meters _ Old Meter# ❑New service[-]Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground❑Overhead # Underground Laterals 1 D2 0 H Frame Pole Work done on Service? Y EIN Additional Information: PAYMENT DUE WITH APPLICATION