The URL can be used to link to this page

Home My WebLink About49969-Z TOWN OF SOUTHOLD rt BUILDING DEPARTMENT a TOWN CLERK'S OFFICE pW 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#: 49969 Date: 10/30/2023 Permission is hereby granted to: Ana nostakos P N Rev IV Trt 41-19 248th St Little Neck, NY 11363 To: legalize "as built' HVAC system as applied for. At premises located at: 900 Donna Dr Mattituck SCTM # 473889 Sec/Block/Lot# 115.-15-18 Pursuant to application dated 10/19/2023 and approved by the Building Inspector„ To expire on 4/30/2025. Fees: AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $500.00 ELECTRIC $200.00 CERTIFICATE OF OCCUPANCY $100.00 Total: $800.00 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 htt s://www.southoldtownny.go Date Received APPLICATION FOR BUILDING PERMIT L=EH1; For Office Use Only PERMIT NO. Building Inspector: o r,l 9 2 ,appTication,s and form ms ust Pe filled out'in their entirety.Incomplete applications will not/,be accepted. Where the ApphcanIf K not,the owner,,an 'Owner's authorization forri�(Page 2)shall'be completed. 7' r " Date: OWMER(S)OF PROPERTY: Name: i/FNQ-� G o S J A L� SCTM # 1000- Project Address: Phone#: L/ 6 2-7-3: 703 Email: / Gov--(' Mailing Address: yl_ LFg - SJ /V ((3 b' 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 ❑ Structure ❑Addi i n ❑Alteration ❑Repair ❑Demolition- Estimated Cost of Project: Other S to $ Will the lot be re-graded? ❑Yes ❑No Will excess fill be removed from premises? ❑Yes ❑No 1 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 Submitted By(print name): ❑Authorized Agent El 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 A R ►�� l � v�0 lcidayof � , 20 ` Notary Public e tAj PROPERTY OWNER AUTHORIZATION (Where the applicant is not the owner) I residing at —/ ,z�=lµ do hereby authorize to apply on my behalf to the Town of Southold Building Department for approval as described herein. caner' ignature Date CONNIE D.BUNCH Notary Public,State of New York �� 11J�(; tUJ� Stq k � No. 01BU6185050 Print Owner's Name Qualified in Suffolk County Commission Expires April 14, 2 _W 2 BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD sK Town Hall Annex - 54375 Main Road - PO Box 1179 Southold, New York 11971-0959 P Telephone (631) 765-1802 - FAX (631) 765-9502 ro err southoldtownn ov 7 seand southoldtownn , civ APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFO'R MATION (All Information Required) Date: J6 11 -11-1-3 Company Name: v Electrician's Name: License No.: Elec. email: Elec. Phone No: ❑I request an email copy of Certificate of Compliance Elec. Address.: JOB SITE INFORMATION (All Information Required) Name: 8Z,) L) S co S Address: O ��, ti - j � C s z Cross Street: « Phone No.: t 0 - Bldg.Permit#: email: Tax Map District: 1000 Section: Block: Lot: BRIEF DESCRIPTIO OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):, Square Foota e: Circle All That Apply: Is job ready for inspection?: YES NO []Rough In Final Do you need a Temp Certificate?: YES NO Issued On Temp Information: (All information required) Service Size Ill PhE]3 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 MITSUBISHI ELECTRIC SPLIT-TYPE AIR CONDITIONERS - N®®®R UNIT =� MSZ-GL18NA ` ------------ OPERATING:INSTRUCTIONS Fof user • To use this unit correctly and safely; be sure to read these operating in- ' J structions before'use. { MANUAL DE-INSTRUCCIO_NES Pai a'los'clientes Para utilizar;esta unidad de forma.correcta y segur'a, lea previamente ' ' lfiol estas instrucciorie`s de.funcionamierito. NOTICE D'UTILIZATION A Caftenn tiodes clients Pour avoFrangais ir la;certitude d: dtiliser'cet appareil correcteme6t et e'n toute securite, veuillez lire cette:notice"d"instructions avant de mettre le clima- ; .tiseur-sous-tension. y' _ Fr A i •f, yy - _ •4 9 .rY - p� 2` 3 J - ' .,1 k - 9i .. (� - .-:4`R+.;•- '.;s$A.w'� .sAq.,1 _ :�Y ?IPF �,�I�J �.A, '�� __ .r`Y �;ytDn+a-i-^JF:f.�-�` •,+rte:.};,. �..�",t 1 silk .ti$x'4 4` ;� v :, .. - . .'' r .�t.�d .fit 4�tik:•;. �'�3'"r}-'?:.' �-. jj �' � r4,'� - .. .. - . .. -. - ::fi•,1e}�:.�: �r + "'>:°`;,.,.. .-'� :�;x�'-b'.,5,,�,� .. , 'eta ::p' r v � W� t MITSUBISHI ELECTRIC SPLIT-TYPE AIR CONDITIONERS @fN®®®R UNOT MSZ-GL18NA r 1 i OPERATING INSTRUCTIONS Fob user To use this unit correctly and safely, be sure to read these operating in- structions before use. MANUAL•MINSTRUCCIONES Para los'clientes Espalfiol Para utilizar.esta::unidad,;de forma-correcta y segura, lea previamente bstas instrucciones"de`funcionamiento:� NOTICE D'UTiLISATiON.:' -- A I'attentiori des clients" Franigais Pour.avoir la''certitude d'utiliser cet appareil correctement of en toute srscurite,veuiiiez lire cette`notice d'instructions avant de mettre le clima- tiseur sous-tension. - e A- 10 i •4,. r L,. 1 s - _ d •s MITSUBISHI (ELECTRIC SPLIT-TYPE AIR CONDITIONERS INDOOR UNI� MSZ-GL18NA _ a- OPERATING INSTRUCTIONS For:user To use this unit correctly and safely, be sure to read these operating in- ' structions before use. MANUAL DE:IIVSTRUCCIONES .'" '; Para los:clientes_; • Para.utilizar esta:unidad,de-forma:cofrecta y segura, lea previamente spaflol estas'instrucciones de funcionamiento: NOTICE.D:'IITILISATION: :: A('attention des-client§ "Pour aVoir,,la certitude.d`utiliser cef a,ppareil correctement of en'toute Frangais so6irit"-veuillez lire cette,notice d'instructions avant de mettre le clima- - tiseursous•terision. . :'0.::`'i'., _ _�' - -4.' '•�;.,;, } �. s 7' - , t 4.• i e d vT.Vy 7F`i.:01 . :'.y+•s-?iii�.,�-..,• �� " •`� •FFI�I'} _ .q� ,,. :,,yt'. .a:�.4? sem• U�F1'=::Lam, rte d, �. .,A". .s •... Vis' `�w-_ .. . .'fi� � MITSUBISHI « if.' .''r ELECTRIC SPLIT-TYPE AIR CONDITIONERS 0N®®®R UNIT OPERATING INSTRUCTIONS For.user To use this unit correctly and safely, be sure to read these operating in- ' structions before.use. _ - - ,Para los clientes, _ MANUAL DE INSTRUCCIONES � - •.!Para.`utilizar•esta:tinidad.de..forrha correcta y segura, lea previamente ' estas.insfiucciones'd"e funcionarniento.' NOTICE D'UTILISATION, • A('attention des clients Pour'adoir la:certitude d'utiliser cet-appareil correctement et en toute s0curite;vedillez-lire cette notice d'instructions avant de mettre le clima- tiseur sous tension.. _I,R '! :If 1Y - i' _ Qi - qq ' I ?rc.�=:_, ;,+tom•`- �,�,=,,, s., �'', • , PP i f'`'` � - `'E''°�SM . _. � .. _ f.•'`,:.pn •'i+i;ti4"�^.i?"-.�n'�>'��` ''t"-�F'S �Fy; `" ;��-�,�:'�?_' ',�':,._• x=,�-: - ... � - yam`