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HomeMy WebLinkAbout49690-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#: 49690 Date: 9/14/2023 Permission is hereby granted to: Ramsey, Gre o 1160 Oakwood Dr Southold, NY 11971 To: install generator as applied for. At premises located at: 1160 Oakwood Dr, Southold SCTM # 473889 Sec/Block/Lot# 70.-12-29 Pursuant to application dated 8/16/2023 and approved by the Building Inspector. To expire on 3/15/2025. Fees: ACCESSORY $100.00 ELECTRIC $85.00 CERTIFICATE OF OCCUPANCY $50.00 Total: $235.00 (L Building Inspector Y TOWN OF 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 :8www. outholdtowttrt .gov Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only i PERMIT NO. Building Inspector: AUG 1 6 20 23 Applications and forms must be filled out in their entirety.Incomplete applications will not be accepted. Where the Applicant is not the owner,an BU11DING DEPT. Owner's Authorization form(Page 2)shall be completed. ' F` 1; Date: UO 4('0' Z �J OWNER(S)OF PROPERTY: �tJ Name: 6 7 ,5�61 Or--I :5 QA-M�C-Y SCTM # 1000- Project Address: , dywoug Phone#: � . 1._ 6/+ Email: Mailing Address: tel/- CONTACT PERSON: Name: Mailing Address: Phone#: Email: DESIGN PROFESSIONAL INFORMATION: Name: Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: Name: Mailing Address: Phone#: Email: DESCRIPTION OF PROPOSED CONSTRUCTION w Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: Other $. Will the lot be re-graded? ❑Yes No Will excess fill be removed from premises? ❑Yes ❑No 1 h ' PROPERTY INFORMATION ;r Existing use of property: YJ ) � ] Intended use of property: 1;�"�n� Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? ❑Yes No IF YES, PROVIDE A COPY. ❑ Check Box After Reading: The owner/contractor/design professional Is responsible for all drainage and storm water Issues as provided by Chapter 236 of the town Code APPLICATION IS HEREBY MADE to the Building Department for the Issuance of a Building Permit pursuant to the Building Zone, Or�danee a �` 800th �. �fk,C Ile iyoirk and def, :pl cabte i s rdtrN,apn�air 4 fal to w for, e r strws of iu11SMirllts, I „ ad dN tlt�trs,siI eat on$oror *mr oval of, imotltlon as re lit describe_ N "I'I� applicant a rees to icor#,,P'ly', af(�pp��a�ab(e ra sp or�lrr6 es,bulga(lgi c rde, 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 Ne*'York State Penal Law. Application Submitted By(print name): �, 4 'I�lC-17 ❑Authorized Agent ❑Owner Signature of Applicant: YI''i, �' � Date: CONNIE D. BUNCH Notary Public,State of New York STATE OF NEW YORK) No. 01BU6185050 ss: Qualifiedin Suffolk County COUNTY OF °I' ) Commission Expires April 14, 2--Plif being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)he is the �ty (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 � 1 � �]t-y � Y 20 G� Notary Public PROPERTY OWNER AUTHORIZATION (Where the applicant is not the owner) 1, residing at do herebyauthorize 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 J OL BUILDING DEPARTMENT- Electrical Inspector �, Fft1l�- TOWN OF SOUTHOLD Town Halt Annex - 54375 Main Road - PO Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 ar ° ro err southoldtownn ov -- seand southoldtownr� ov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date (� Company Name: I Electrician's Name: License No.: Elec. email: Elec. Phone No: q OI re uest an email copy of Certificate of Compliance Elec. Address., . JOB SITE INFORMATION (All Information Required) Name: 6a) e v KAY 5_ i 5 Address: © IV- Cross Street: 134 \/l Phone No.: c° — �" b Permit#: �� email: y2LtA S I Bldg. IW' /gpL- r ... Tax Map District: 100 action: Block: 12 Lot: BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly); la✓ C j ei,' S _5 61 Square Footage: Circle All That Apply: Is job ready for inspection?: 0 YES NO 0 Rough In D Final Do you need a Temp Certificate?: YES O NO Issued On Temp Information: (All information required) n Service Size 1 PhE]3 Ph Size A # Meters 1� W Old Meter# O New Service0 Fire ReconnectO Flood Reconnect OService Reconnect OUnderground[-]Overhead # Underground Laterals 1 D2 H FramePole Work done on Service? Y N 6wm4 L1Additional Information: PAYMENT DISE WITH APPLICATION WWE6NE TIERNEY THOMAS TIERNEY 6 P To32 rP" r LOT 22 q uar d tq r,T ww°� NEVd TRFES,TVP� *� I ,^ o ma+ N/O/F EVELYN L BERGEN TRUST r'" :TWraT'gt DWYTS 4Faq �',Tq Mau p9 6k M „,.° i u�`"�wy"' WW 24.]4 WAW c 14 A 01 i, j �rx m"'4 'r" � °✓ "� 413 LOT 21 �✓" Mr n tl, x r" r, LOT 20 ZONA :` .04 lab AREA=41,581 SQ. FT �,✓ ��E" �b+�yy TO TIE LINE ��•�O r oU EK CgE SUM SECT Tq,RX I WT.29 m nT ps a rA wn Pfd a owV m"Pawn Ry Prrr.#w a RN YYK P r T MODEL 0058711 SERIAL 8038303 VOLTS 120 / 240 AMPS 83 . 3 / CONTROLLER OH66HO �' P / N 1 PH , 60Hz , RPM 3600 RAINPROOF ENCLOSURE FITTED CLASS H INSULATION RATED AMBIENT TEMP - 25 C FOR STANDBY SERVICE NEUTRAL FLO AT MAX LOAD UNBALANCE 50% MFG LOC : GEN WW GENERAC POWER SYSTEMS , INC WHITEWATER , WIS . 53190 U . S . A . COUNTRY OF ORIGIN USA n11