HomeMy WebLinkAbout49610-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#: 49610Date: 8/22/2023
Permission is hereby granted to:
1050 West Cove Rd LLC
2215 Pine Tree Rd
Cutchogue, NY 11935 __
To: Install an accessory generator to an existing single-family dwelling as applied for. Must
maintain sideyard setback of 20 feet.
At premises located at:
1050 W Cove Rd Cutchogue
�..... ......y _ ............. ........____.. ......................__ .. ........................................................
SCTM #473889
Sec/Block/Lot# 111.-5-1
Pursuant to application dated 7/13/2023 and approved by the Building Inspector,
To expire on 2/20/2025.
Fees:
ACCESSORY $100.00
CERTIFICATE OF OCCUPANCY $50.00
ELECTRIC $85.00
Total: $235 .00
m............. � ....... ....... _. ................................
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 htt s://www sout-Ii-OlcltoW�a11a o
Date Received
APPLICATION
E
y
For Office Use Only r
„JAIL.., � e:� "���
PERMIT NO. 49
I L0 I O Building Inspector,. 2� -
Applications and forms must be filled out in their entirety. Incomplete '1; UII, TNG°I EP •W
applications will not be accepted. Where the Applicant is not the owner,an t ftp °µ:rye
Owner's Authorization form(Page 2)shall be completed.
Date: 7///
OWNERS)OF PIS PERTY":
Name: DS'� Uln- T 20 V6- RM,0, �-L�' SCTM# 1000-
Project Address: ""d� '� (247-e_ 0 g��
Phone#: aG Email: .
Mailing Address: CY
CONTACT PERSON:
Name: jot 12 6�_CL 10
Q �-�✓�
Mailing Address: AI 410 e4'77d ft06U!f
Phone#: �� ° 1 � 97 4.E Email:l�EI�P(E�
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address: � y
M R
i
Phone#• 6,31, ?, '�v Email: %t��,
,,.� ~- , " ,�� f�/ / lo ,
CONTRACTOR INFORMATION:
Name: I[)S "
Mailing Address: x 3t 0 A 35—
Phone#: ll 3 .- r?3# .,._ ,S_R Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
then "� /;2p $
❑New Structure ❑Addition ❑Alteration ❑Re air ❑Demolition Estimated Cost of Project:
Will the lot be re-graded? ❑Yes o Will excess fill be removed from premises? ❑Yes o
1
PROPERTY INFORMATION
Existing use of property: j���j f,o,,�:AJL -- Intended use of property: z�s ®,6: /Lt L4
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
k—1�D this property? ❑Yes 'o IF YES, PROVIDE A COPY.
heck 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): L= am G �y�� � d,1jr2 ❑Authorized Agent +wlwrner
Signature of Applicant: ' Date:
CONNIE D.BUNCH
STATE OF NEW YORK) Notary Public,State of New York
No.01BU6185050
SS: Qualified in Suffolk County
COUNTY OF SUFF02-I'{ ) Commission Expires April 14,2(a)y
Cu C/U� A being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
(S)he is the wy,--R
(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
- &�LCA
. '—'
dayof � � 0 �
Notary Public
ROPER"r °( Ill"°II°WIIUZ rII I
(Where the applicant isnot the owner)
q, 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
, fLp o BUILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
Town Hall Annex - 54375 Main Road - PO Box 1179
CO
Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX (631) 765-9502
.° ro err southoldtownn ov - seand @southoldto,wnny.goy
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date:
Company Name: T a
Electrician's Name:
License No.; Elec. email:
Elec. Phone No: ❑1 request an email copy of Certificate of Compliance
Elec. Address.
JOB SITE INFORMATION (All Information Required)
Name: C9 !✓ L
Address: /� w
Cross Street:
Phone No.: `
email:
BIdg.Permit #: w n
Tax Map District: 1000 Section: I Block: 15 Lot: b
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
�ro-0
Square Footage:
Circle All That Apply:
Is job ready for inspection?: YES [E NO Rough In ❑ Final
Do you need a Temp Certificate?: YES PWO Issued On
Temp Information: (All information required)
Service Size1 PhD 3 Ph Size: I A # Meters Old Meter#
❑New Service❑Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground❑Overhead
# Underground Lateralso-1 2 H Frame Pole Work done on Service? Y N
Additional Information:
PAYMENT DUE WITH APPLICATION