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Home My WebLink About49191-Z " wr TOWN OF SOUTHOLD ' BUILDING DEPARTMENT 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 #: 49191 Date: 5/2/2023 Permission is hereby granted to: 1470 Jackson St LLC 68 Jane St#2E ...............................__........_____ .... New York, NY 10014 To: Construct an accessory generator to a single family dwelling as applied for per manufacturer specifications. Requires a minimum 15 foot setback. At premises located at: 1470 Jackson St, New Suffolk SCTM#47w3889 Sec/Block/Lot# 117.-10-11 Pursuant to application dated 3/30/2023 . and approved by the Building Inspector, To expire on 10/31/2024. Fees: ACCESSORY $100.00 CO-RESIDENTIAL $50.00 ELECTRIC $85.00 Total: _..... ...................._....................$235............. 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 tittl,,ps.'e"\Nrw,,N;,s(,LitlioldtowiuV.gov Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only " ° PERMIT N0. Building Inspector: JX& CIA;'1111131% C"'ER), Applications and forms must be filled out in their entirety. Incomplete �'0- 01� ' applications will not be accepted. Where the Applicant is not the owner,an Owner's Authorization form(Page 2)shall be completed. Date:03/03/2023 OWNER(S)OF PROPERTY: Name: 1470 Jackson Street LLC (David &Jessica Levi) SCTM#1000-117- 10-11 Project Address:1470 Jackson Street, Mattituck NY 11956 Phone#:708-275-9465 11 Email:davidelevi@gmail.com Mailing Address:68 Jane Street, Apt 2E, New York NY 10014 CONTACT PERSON: Name:Fred Seifert Mailing Address: 11780 Old Sound Ave, P.O. Box 1407, Mattituck NY 11952 Phone#:631-831-7507 Email:seifertbuilders@gmail.com DESIGN PROFESSIONAL INFORMATION: Name:Lori Beppu at BMA Architects Mailing Address:P.O. Box 3007 Bridgehampton, NY 11932 Phone#:631-537-7277 Email:lori@bmaarchitects.com CONTRACTOR INFORMATION: Name:Fred Seifert Mailing Address: 11780 Old Sound Ave, P.O. Box 1407 Mattituck NY 11952 Phone#:631-831-7507 Email:seifertbuilders@gmail.com DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: ❑Other G? $ Will the lot be re-graded? ❑Yes El No Will excess fill be removed from premises? ❑Yes ❑No 1 it 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 ❑No 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 SubmltteY(pri t name): V" �,.� Skid f` ❑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 PROPERTY OWNER Y!1, 1 R( III (Where the applicant Is not the ow.._._. ner) I, 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 " ( BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD 7Town Hall Annex- 54375 Main Road - PO Box 1179 m y Southold, New York 11971-0959 W,. Telephone (631) 765-1802 - FAX (631) 765-9502 rogerr@southoldtownny.gov seand @,southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: - -� Company Name: is S L'/C C- -r-w(� L L G Electrician's Name: License No.: 3 9 L: Elec. email: ,n fZ V, co m Elec. Phone No: I,.dco-q,64,5 I request an email copy of Certificate of Compliance Elec. Address.: d? _ .k Aj� C�+5 1 )tv0/- "N JOB SITE INFORMATION (All Information Required) Name: Fred Seifert /L/70 LLC Address: 1470 Jackson Street -lq2 1A, I Cross Street: e�J /Z--J" Phone No.: 631-831-7507 Bldg.Permit# LAq ILII email: seifertbuilders@gmail.com Tax Map District: 1000 Section: 117 Block: 10 Lot: 11 BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Square Footage: Circle All That Apply: Is job ready for inspection?: YES NO Rough In F] Final Do you need a Temp Certificate?: YES F-1 NO Issued On Temp Information: (All information required) Service Size 1 Ph 03 Ph Size: A # Meters Old Meter# ❑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, PAYMENT DUE WITH APPLICATION