HomeMy WebLinkAbout49591-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
` TOWN CLERK'S OFFICE
SOUTHOLD, NY
.0
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#: 49591 Date: 8/16/2023
Permission is hereby granted to:
Hillcrest House LLC
. .......
71 Laight St Unit 1 B
....._ . .. _. ....................- ...
New York, NY 10013
To: Install a 38 kW generator to an existing single family dwelling as applied for per
manufacturers specifications.
At premises located at:
450 Hillcrest Dr, Orient
SCTM # 473889
Sec/Block/Lot# 13.-2-8.30
Pursuant to application dated _mm,6/27/2023 and approved by the Building Inspector.
To expire on 2/14/2025.
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
'kh , Telephone(631) 765-1802 Fax (631) 765-9502 l,ittlos://Wxvw. titholdtoNvnny.gov
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only p
1 Y
PERMIT NO. q S 1 Building Inspector- �� JUN '7 r 02
Applications and forms must be filled out in their entirety.Incomplete
applications will not be accepted. Where the Applicant is not the owner,an
Owner's Authorization form(Page 2)shall be completed.
Date:
OWNER(S)OF PROPERTY: Wit
Name: T SCTM#1000
Project Address:
Phone# IEmail:
Mailing Address:
CONTACT PERSON:
Name: �
Mailing Address: r3
Phone#:
Email
r
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address, -;
# - ! t bol
Phone#: Email: i
CONTRACTOR INFORMATION:
Name: � Jo w
Mailing Address:
Phone#: � �.�- L) �..�. ..
Email= u,
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
Will the lot be re-graded? Dyes UdO Will excess fill be removed from premises? ❑Yes o
1
r=xibLuig use UI property: I 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.
1p,deck Box After Reading: The owner/contractor/design professional is responsible for all drainage and storm mater issues as provided by
Chapter 236 of the Town code.. APPLICA`noN 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 coda,
housingcode and regulations and to admit authorized Ins
g pectora on premises and In building(s)for necessary Inspections.false statements made herein are
punishable as a C im A misdemeanor pursuant to Section 210AS of the New York State Penal law.
t ,
Application Submitted Byurint name): ❑Authorized Agent 1�ewner
Signature of Applicant: p
ate: �''
STATE OF NEW YORK) CONNIE D.BUNCH
SS: Notary Public,State of New York
COUNTY OF ) 1�4r1.01 B1.101 505
Qualified in Suffolk County
Commission Expires April 14,2-cily
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
-t�ay of •J Li�-� 21 � "�
Notary Public
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
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
flf� 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
Y . ' rogerr0southoldtowninygov - seand �sou tholdtownny.gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date:
Company Name: s
Electrician's Name: o I'3 6 U 40-1-u t.
License No.: W-- C Elec. email: dtb q Ca- Cs�.t
Elec. Phone No: -L 16, DffI request an email copy of Certificate of Compliance
Elec. Address.:
JOB SITE INFORMATION (All Information Required)
Name: f'►�JL C .� �' IL-C- ZL C-
Address:
Cross Street:
Phone No.:
Bldg.Permit#.
email:
Tax Map District: 1000 Section: Block: Lot:
BRIIE�,F I ESCRIP'TION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
�.. J' +�..... > �.;._..,' ...,;w -.. -,,, r.. h �., 6 �,
„ .
9
� ..I7.._ Square Foote:
Circle AII That Apply:
Is job ready for inspection?: YES [XNO DRoughin ❑ Final
Do you need a Temp Certificate?: LJ YESM NO issued On
Temp Information: (All information required)
Service Size1 PhF-�3 Ph Size: A # Meters Old Meter#
❑New Service❑Fire Reconnect[—]Flood Reconnect❑Service Reconnect❑Underground❑Overhead
Underground Laterals[]l H Frame Pole Work done on Service? Dy N
Additional Information:
I
PAYMENT DUE Wl'TH APPLICATION
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�t�rsatlati7�a 4ss,,dk. DO/12J2022
Oamrn'issian r xpires: Ciiii0M2074