HomeMy WebLinkAbout50727-Z TOWN OF SOUTHOLD
b � ti BUILDING DEPARTMENT
1 r 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#: 50727 Date: 5/22/2024
Permission is hereby granted to:
Millard, Amo
435E 57th St A t 4C
New York, NY 10022
To: legalize "as built" mini split unit in existing artist studio of an accessory building as
applied for.
At premises located at:
495 Maple Ln, Orient
SCTM # 473889
Sec/Block/Lot# 17.-2-3.1
Pursuant to application dated 2/22/2024 and approved by the Building Inspector.
To expire on 11/21/2025.
Fees:
AS BUILT-ACCESSORY $250.00
ELECTRIC $200.00
CERTIFICATE OF OCCUPANCY $100.00
Total: $550.00
Building Inspector
TOWN OF SOUTHOL —BUILDING DEPARTMENT
Town Fall Annex 54375 Main Road P. ®. Box 1179 Southold,NY l 1971-0959
Telephone(631)765-1802 Fax (631) 765-9502
Oate Received
For Office Use Only
.W p
024
PERMIT NO. Building Inspector:
Applications and forms must be filled out in their entirety.Incomplete � -,; °;C'Aftait",d
applications will not be accepted. Where the Applicant is not the owner,an
Owner's Authorization form(Page 2)shall be completed.
Date: --�,
OWNER(S)OF PROPERTY:
Name: Vb t 04 _ wAax rA SCTM#1000- 3, 1
Project Address:
Phone#: Email: 0" N X qv e 0, COYA
Mailing Address:
CONTACT PERSON:
Name: () LO -Ir
Mailing Address:
Phone#: Email:
DESIGN PROFESSIONAL INFORMATION:
Name: •'�I
Mailing address:
Phone#:: „� _L (o Email:
CONTRACTOR INFORMATION:
Name: "� 1
Mailing Address:
Phone#: Email
DESCRIPTION OF PROPOSED CONSTRUCTION
they A1t gtio ❑I e air �D I lo'tio Estimated Cost of Project:
CI New St Ure AddItlOrl (1. moo' CID
WIII the lot be re-graded? ❑Yeslo Will excess fill be removed from premises? ❑Yes ANO
i
PROPERTV INFORMATION
Existing use of property. mm Intended use of property:
Zone or use district in which pre ses is situated; ,art-there any covena is and restrictions with respect to
this property: OYes o Ili YES, PROVIDE A COK
The oviner/contractor/design professional is responsible for all drainage and storm water issues as prr idd d by
)Chapter 236 of the Town Cade. APPUCAAON is HEREBY MADE to the nuildirg Department for the issuance of a Building Permit pursuant to the.sutl!di'ng none
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 VAth all applicable laws,ordinances,buliding 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 lint name): ❑Authorized Agent )wnet
Signature of Applicant C�, 'a. }' date: � X;�
.TATF CIF NFln/ynRK)
COUNTYOF ... -4,6 1 f� )
Amu 4 r f 1 being duly sworn, deposes and ( PP
he is the at th says s) applicant
(Dame of, dividual signing contract)above named,
(S)he is the 6V
(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 ,'AA
day of `G r a Q.r 20�
x
N any P lic P'.SIA ""ti
�""�
' ?11 $Co
l N ;t
COMM
I,s"gin t
(Where the applicant is not the owner)
1, 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
1 BUILDING DEPARTMENT-Electrical Inspector
TOWN OF SOUTHOLD
Town Hall Annex- 54375 Main Road - PO Box 1179
' - Southold, New York 11971-0959
IP' rti war " Telephone (631) 765-1802 - FAX (631) 765-9502
ro err iatholdtown,fly,g_gv,,—.seand@southoldtownny.gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (Alt information Required) Date.--- 2—
Company Name: L�
Name:
License No.: email:
Address:
Phone No.:
JOB SITE INFORMATION (All Information Required)
Name: V 1f4
Address: 1 I� ll�i5
Cross Street:
Phone No.: ^LNI --
Bidg.Permit#: email:
Tax Map District: 1000 Section: a Block: Lot: 3:
BRIEF DESCRIPTION OF WORK(Please Print Clearly)
Circle All That Apply:
Is job ready for inspection?: YES NO Rough In final
Do you need a Temp Certificate?: YES O 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 Reconnected-Underground -Overhead
#Underground Laterals 1 2 H Frame Pole Work done on Service? Y N
Additional Information°
PAYMENT DUE WITH APPLICATION
Request for Inspection FormAs
SURVEY OF PROPERTY
AT ORIENT
z TOWN OF SOUTH'OL.D
SUFFOLK COUNTY, N.Y.
1000-17-M-3.1
SCALK 11=40'
AUGUST 2^Z 20M
dlJNE 22, 2004 (foundolion k+ta/MW
" C SPL,rff IF
"'
cc
NDRA & GEORGE H, ROIA6W
N/O/r LONG BEACH OOWONERS
OLD CQ4ErANY r
25'MONT d WAY y w' .. '"��-- - -^ y Wt
�r.'
—.�+�+�w. --`:ar.�n�..,e„,,.w—e ►^,oc;.�.��tlCIAR" q� �� w,� �� ��
—'" — ".-w„"` ^.--
a
do
Sys
y 1f
,._.._.._.,. sy ." .-'r .`.r"
`Q
rN,52
,r
"rd rh
♦0
9fNAK
R.
EDY N/O/P HAROW L KgTiyLEE7y :
�r
PAIR'7LON
. . Q7,PC 0 O H -
P
py
ti JOL 2 8 am
M�tN 1gOAD 25) � 0
ELEVATIONS REFERENCED TO AN ASSUMED DATUM.
- MONUMENT
a1M= PPE
f ;M Y& LIC.. NO 49618
ANY AL 7ERAI OR A� TO SURVEY IS A W OLA 17ON C , P.C
AREA=89,140 SC Or SEA 1 °NEVI' TMlr UWArAW IAhY Apt (E ,1 765-1797
�1'AS M SEMW 72�S MaV,Z AU =TWCA71ONS + "
HrAFM ARE VAUO FOR 7W MAP A COPS WMW ONLY IF Gk`RDX 9C19
SAW MAP OR G�"S " IHE JWNESM SEAL OF'Wr SUpPW)VR I MA STREET
/ SMAR Sou .r. 11977 03-,22J�
��� III ll/ lI 111 / // ���
" -�'- ,yrryrrrryrrr�liiliil%i%ll/il!l/l%%�/I //�/ /�j/ /� /I /
io! V�,o
02"
• +yr lyrrN ylrlWW,
lI 11 �%/ j% %%� /%� /i ii „�•�'_"`
//
+f; y++lllllll/rlllllllll I/ll /l/ I /
- 1f�ffS++,Sn Nlirii illiiiiiiiii�il//lliiiii/�l%i��%%�%�i%%i/%�/Li.�'-_—•-_�...�
-
SfS jijfifiiii+l+l ryirrii%i�:i::iii irrrrrrrr r r
rll�l aa'�
J ..........
moo,
�,-.'rye► w ,.. - -
rp
.a
rrr
'A•�''`,ry s';-�� • �'...�_+1.. fin
Ems,, ' /1,1--•� .�, ^. :,
�� fir•;...
{SF��,� rs. �A y' T L�.. ! +T �r ¢.'.. i �`�'"��,.' f+; ""f .V ��• y�. �Y /j ej.
*�? � aim.. ••>/�kt�. '�' ~ '�X ="t •` �s. r rr.,
,
ti
"
.{
saw ■
IR CONDITIONER
E jjfjjtjry Small HP
4
ROSH36AXQ
SERIAL No. HVQ 0 O 1 0 2 8
SOURCE 208/230 V 60Hz 1-PH COOL HEAT
ARC) BTU/HR 33000 34000
CAPACITY18.0 18.8
TOTAL AMPS.
17.3 18.1
COMPRESSOR AMPS. 0.4
OUTDOOR FAN MOTOR AMPS. 0.4
M CIRCUIT AM
MINIMUM PACITY 23.3 A30 A
MAX. CKT. BKR. us
REFRIGERANT R410A FACTORY CHARGED 4 Ib 10 Oz ____------
IDE 450 PS19 Intertek
DESIGN PRESSURE HIGHSIDE 240 PSi9- 91987
LOW ETL LISTED
R(U)�WH36AXJ CONFORMS TO
UL STD. �995
APPLICABLE INDOOR UNIT : CERTIFIED TO
CSA STD.
C22.2 NO. 236
Rheem Sales Company, Inc.
MADE IN THAILAND
hiFR YEAR 2022