HomeMy WebLinkAbout50740-Z ° TOWN OF SOUTHOLD
BUILDING DEPARTMENT
'A� TOWN CLERK'S OFFICE
SOUTHOLD, NY
4*0
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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#: 50740 Date: 5/23/2024
Permission is hereby granted to:
Allecia, Sandra......... _w.
300 Harbor Rd
Orient, NY 11957
To: legalize "as built" accessible lift as applied for. Additional certification may be required.
At premises located at:
300 Harbor Rd, Orient ......w. _ _. .............. _..........
SCTM #
Sec/Block/Lot# 27.-4-5
Pursuant to application dated 4/15/2024 and approved by the Building Inspector.
To expire on 11/22/2025.
Fees:
AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $500.00
CO-RESIDENTIAL $100.00
Total: ..........
$600.00
Building Inspector
TOWN OF SO.UTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Sou" Id,NY 11971-0959
'telephone 631 765-18w Fax 631 765-9502 ihIgILIicL� Li ,
Dateilatceopt(I
APPLICATION 1`011 BUILDING 1"
Fnr Office Use Only ��9f4
PERMIT NO. Building lnspect,or:
Applications and forms must be filled out in their entirety.Incomplete
applications will not he accented. Where the Applicant is not the owner,an �
Owners Authorization form(Page 2)shall be completed.
Date:
O_'tinfNER($)OF PROPERTY ,..�1.............__. _................._..... .-....�.www..._-�. �.. �� �.,.._..�. �j�.�..��...-��_
Name: raA F A 11 f C i a SCTM#1000............ ........ wwww
Dr^je::t.^.adress: 300 Jjacbor _ioa 4ri (1k N T 11,9 1
Phone#: ��] �1D a - 2 07 Z Email-
Mailing Address:U
rnlkITAf T eeoeL1ILI:
..v.4
r+... r�..... �.
Name: 1t�C4 a.,
Mailing Address: 3pb llarbbr A- i"" nl ro
Phone Email:
DESIGN PROFESSIONAL INFORMATION:
Name:
�•
Mailing Address:
Phone#: Email
CONTRACTOR INFORMATION:
Name: NCO Lewel cctssibi
Mailing Address: 3o I J i A Morts Rua ct �Neq ?av-Y- N 1l J Z Q
Phone#: 3 t✓ ?J2g_ l� 5 Email: s,�a X�. V L�CCQ,C6 `lUtt'1:1[�
DESCRIPTION-OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition Alteration ❑Repair ❑Demolition Estimated Cost of Project:
0nther
Will the lot be re-graded? ❑Yes No ;Hill excess fill be removed from premises? ,` Yes ❑No
1
PROPERTY INFORMATION
Existing use of properly: � 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.
7�fCheOBox After Reading, i ne owner%wntractorjdesign professional is responsroie For a3 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,
SuvYuu„'3.a,a�'clauu„-3 G7'FvT rs;T,Grel VT YE,TIY...Gn a3 ,un„u�cau"�iar�d.i�E oyri„wlia ugTcE3 to wT,M,j"io,u1 a,a`yNiiwuie Ie ,L,uiP,n:lir3,ui51�'iui'i1G CGuc,
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 r.Isdemeanor pursuant to Section 210.45 of the New Y^'t State P-C- !!'x.
&E mthorized A gent ❑Owner
Application Submitted By(print name g
Signature of Applicant: — Date: /2 z
STATE OF NEW YORK)
COUNTY OF 144:-A V, )
A-JQ L 0��J being duly sworn,deposes and says that(s)hp is the annlirant
(i,:uiiie."if iridl 1;.4U•%I signing�.^.ritrurt)ub:.ve ri8,i,.A
{S)he.is the C-c n-��-q
(Contractor,Agent,Corporate Officer,etc.)
of said owner or owners,and is duly authorized to perform or have pe!iorrneu the said work-and to nnane and file thIS
application;that aii statements contained in this application are true to the best of his/her knowledge and beiief; and
that the work will be performed in the manner set forth in the application file therewith.
Sworn before me this er'�
,w
day of 9,1l 20Z,
Notary
p�lw� °" Lli�l"1�V1GIOIA
iVC�T�lR'6 r�l iI;�IC,S fXIE III NSW`x* R
Registration No.01G16187694
pR P I��ilE AUTHORIZATION HORI TIO Qualified in Suffolk County
...,, ........ . .. ...� _.0 ,.� Commission Expires 05/27/
(Where the applicant is not the owner) . °°' '
1, ��'!Jl ,�'/9 �LC��I�I residing at �Q 4 R,egO/2 46. OleEl1J 7
do hereby authorize !� C'LSS11 l�apply on
my be a to the TCkn outhold Building Department for approval as described herein.
03 "
Owner's Signature Date
-9,gu e,4 A.4-CetA-
Print 0—,W nei's Na^.e
2
BUiLDiNG DEPART iAEN T-cleci ricai inspector
TOWN OF SOUTHOLD
Town Hall Annex- 54375 Main Road - PO Box i i 79
� �� Southold, New York 11971-0959
r.l .- . tan -7ac -4 onn r n v inn 1) �//�r nrnn
I tnty11u11C kuo 1) r uU-1 OU4 - rrin �V.7 1) /VU-7:JVL
�,fr arnesh souttoldtow� n . ov s^�and soutloldtownn ov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTR[CIAN INFORMATION (All Information Required) Date:
Company Name:
Electrician's Name:
License No.: Elec. email-
Elec. Phone No: E3 1 request an email copy of Certificate of Compliance
Elec. Address.:
IAQ `ITC II`ICAORAATIAI,1 i r____ �
•/VY SN T E N F V11\11•11/1 r KVN �Pd! Il llucraiation r uquovu)
Name:
Address: C �"bV, 11� A orre q it 9T
Cross Street: N&Vro W
Phone NO.: h
Bida_Permit#: email:
Tax Map District: 1000 Section: Block: Lot:
BRIEF DESCRIPTION OF WORD, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
-Square Footage.-
Circle All That Apply:
Is job ready for inspection?: El YES E]NO E]Rough In El Final
Do you need a Temp Certificate?: R YES E NO Issued On
Ternp Information: (All information required)
Service Size 1 Ph 73 Ph Size:,.,, _., ,A #Meters,,,.-,,,. _.... Old Meter# _.
n New ServicenFire ReconnectnFlood ReconnectnService ReconnectnUnderground Doverhead
# Underground Laterals 1 172 H Frame 0 Pole Work done on Service? Y MN
Additional hnfvr n ration:
PAYMENT DUE WITH APPLI �ATiONi
i
Suffolk County Department of Consumer Affairs
VETERANS MEMORIAL HIGHWAY * HAUPPAUGE,NEW YORK 11788
DATE ISSUED: 2/15/2012 No. 49723-H
SUFFOLK COUNTY
Home Improvement Contractor License
This is to certify that ARAM E MIURA
doing business as
NEXT LEVEL ACCESSIBILITY INC
having furnished the requirements set forth in accordance with and subject to the provisions of applicable laws,rules
and regulations of the County of Suffolk,State of New York is hereby licensed to conduct business as a HOME
IMPROVEMENT CONTRACTOR,in the County of Suffolk.
1
License Category
NOT VALID WITHOUT Additional Businesses Other
DEPARTMENTAL SEAL
AND A CURRENT
CONSUMER AFFAIRS
ID CARD
Director
} owNERs FRANK & $,4NDRA AREA= 13,642 SO. FT (to tie line
ALLECIA
300 HARBOR LANE SURVEY OF PROPERTY
ORIENT, N.Y. 11957 AT ORIENT
TOWN OF SO UTHOLD
`, SUFFOLK COUNTY, N.Y
1000-27-04-05
a�0 �� �10 SCALE: 1 2 20'
MAY 13, 2Qt3
ZONE
ULY 24,2013 (STONOE. ARMOR& C.EH.L)
00.
STONE ARMOR - BOULDERS - 700'bs-1000 IbS
PLACED AT TOE OF 13ULKNEAI�r�r 'Q. o
\ Z E
$k4'�"yQ
1
{ 4fi IJ .r
ZONE AE
(EL 6) f
�� Pa
\ F
�J �01 0
0 ZONE VE d4aOF lie
1 2 COASTAL EROSION HAZARD LINE FROM COASTAL
? EROSION HAZARD AREA MAP PHOTO 5 NO. 49-628-83 1`�
FLOOD ZONE FROM FIRM RATE MAP MAP NUMBER
36103CO068H SEPTEMBER 25, 2009 1_
sr.
t A g `
g kT
-f-= Yfc 77 FLA• LANDWARD£D OF 7DAL WETLANDS AS DELINEATED
a�l 8Y-SJ FOLK E1� ON+id-£N:AL CtlNSUf TtNG, INC, ON APRtL t9, 20t3. -'
fd0. 49618
ANY AL BRA rCkV R AD-NEW
TO THIS SURVEY is A JOLA NON FCOV/C c., :=YOBS P.C.
OF SEC77ON '209OF THE NEW ORx STAT, EDUCA77ON LAW 631 7
EXCEPT AS PER S C770t= 72O9—SuSBtvjSjON 2. AIL C1PRRCA77ONS ( ) 65-5020 FAX (631) 765-1797
H£REON APE VALI,FOR 7H1S MAP AND COPIES THEREOF ONLY IF P.O. BOX 909
SAID MAP OR COPES SEAR Tr1£/MPRESSED S,LAL OF THE SURVEYOR 1230 TRA�IEZER STREET r�
WYOS£SIGNATURE APPEARS HEREON. SOUTHOLD, N.Y 11971 1 J—1 v0
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Dealer Name
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Dealer Phone
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46019
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SPLIT-TYPE AIR CONDITIONERS
INDOOR UNIT
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MSZ-GL12NA MSZ-GL15NA
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OPERATING INSTRUCTIONS ;Fq�user
• To use this unit',corectlytiand safely, be sure to read these operating in- •
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._'�,,}MANUALADE;IN8TRUCCIQNES,`�� r�°} �Para�lo"s,-clienfes:
•st?ara autiiiiar esta urndad;de forma,correcta y segura, lea previamente . .
a, "esfassiristruceiores d'e funcionamiento;''
. �'"y� ''•y � %.5L�• 'A-1''attenfion•:des':cfients•
`y;NOTICE,D'UTILISATIQN<:''+ ;' a;,:.F-n-
,,:.;,;,Pour':�ayoirla'cErtitudediutilise��cet;;app�reil correctemen.t et en toute Frangais
curite;;veuillez,lite cette;rtotice d'iristructions avant de mettre le climati-
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