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Home My WebLink About50571-Z TOWN OF SOUTHOLD � � BUILDING DEPARTMENT 03 TOWN CLERK'S OFFICE " SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLAINS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 50571 Date: 4/22/2024 Permission is hereby granted to:. JOTAS Corp 25500 Main Rd Orient, NY 11957 To: install generator in rear of building as applied for. At premises located at: 1000 Village Ln, Orient SCTM # 473889 Sec/Block/Lot# 25.-1-18 Pursuant to application dated 2/26/2024 and approved by the Building Inspector, To expire on 10/22/2025. Fees: ACCESSORY $125.00 ELECTRIC $100.00 CERTIFICATE OF OCCUPANCY $100.00 Total: $325.00 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 ) It; s: /w . tl�k�calaltavn,�� .� Date Received APPLICATION FOR BUILDING PERMIT W E For Office Use Only PERMIT NO, Building Inspectorrd , Applications and forms must be filled out in their entirety.Incomplete applications will not be accepted. Where the Applicant is not the owner,an CLL!!y ;, l<< .w: r.- •-.�. Owner's Authorization form(Page 2)shall be completed. f ,<•;y r ti?-i, ° Date: 2 2 OWNER(S)OF PROPERTY: Name: �� SCTM#1000- g`61 Project Address: Phone#: .Q a2— 02 a^ Q 6 k3 2, Email: •� Sea2� re/v a `� 1 Mailing Address: CONTACT PERSON: Name: cc vL Mailing Address: a11 Phone#: a 2 ^ C) �'— Email: DESIGN PROFESSIONAL INFORMATION: Name: Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: Name: ak. L Mailing Address: Q L--k1 > p Phone#: � � ._ '' �� Email:<_ ' � (�� Gl�� t DESCRIPTION OF PROPOSED CONSTRUCTION `" ❑New Structure ❑Addition ❑Afteration ❑Repair ❑Demolition Estimated Cost of Project: ❑Other . .� $ Will the lot be re-graded? ❑Yes El No Will excess fill be removed from premises? Dyes ONO 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 [;�fio 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 na ❑Authorized Agent Owner Signature of Applicant: 6' — Date: C9. a �. CONNIE D.BUNCH STATE OF NEW YORK) Notary Public,State of New York No.01 BU6186050 SS: Qualified in Suffolk County COUNTY OF ) Commission Expires April 14,2 ba y 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 ,� �/1 i, tl, L . � Y of Z n .. Notary Public Where the applicant is not the owner) I dcF`L residing at W W� do hereby authorize to apply on my behalf t n of Southold Building Department for approval as described herein. Owner's Signature Date Print Owner's Name 2 brvn , u �IspeC� o^. rBUILDING D TI r I �E C E L N 7 2(X 0Z TOWN OF OUFDLD r Town Hall Annex- 54375 Main Road - PO Box 1179 Ei Southold New York 11971-095 1'°" , " ' r t ' J1110Telephone (631) 765-1802 - FAX(631) 7 ��2' rr southold o nn ov seand@southoldtowpp,y.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: Company Name: Custom Lighting of Suffolk Inc Electrician's Name: Benjamin Doroski License No.: 38893-ME Elec. email:CLOS5170@gmail.com Elec. Phone No: 631-298-4588 ED I request an email copy of Certificate of Compliance Elec. Address.: PO Box 1698 Mattituck NY 11952 JOB SITE INFORMATION (All Information Required) Na ne,, ",C)f 2 Address: N I Cross Street: Phone No.: Bldg.Permit#: email: C1 Tax Map District: 1000 Section: Block: Lot: BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Square Footage: Irrl:ie All That Apply..... Is job ready for inspection?: YES ®NO —]Rough In [a Final Do you need a Temp Certificate?: ElYES�NO Issued On Temp Information: (All information required) Service Size❑1 Ph❑3 Ph Size: A # Meters Old Meter# ❑New Service❑Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground❑Overhead # Underground Laterals LJ 1 n2 n H Frame JJ Pole Work done on Service? Y N Additional Information: I'A ENT DUE'N IT PP'LICATION I 0 r ) a _ {Jf1`- I..y..r T� ryI ` N 25 5910 E 85.00, 1 RkpAAYIa>aY aaua�e, FtEN f rvi n rd1 ,.� Im. bJ W Fw CY T„'p V tJa m CONc w (!D h7 77 C'k ...4 mow'. ......1.�.. Cr1 "la 4M F,CK ry 2. A 5:. Iyy f r.... Po OOf) 4 W x 1 N a r B s „c c' ...Y . i o � 17 z .r I % cY as � „. ,j X. N An9 C-1 ^J P N Ca p � I Iry 6B MV✓ nY 0 r JrO+ r w o WALK 8. uB „ �sara�. cum A ALANE) STREET �_. I � 0 'i 1 � �r ill III i I f II I I i