HomeMy WebLinkAbout50879-Z .rtI 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 #: 50879 Date: 6/27/2024
Permission is hereby granted to:
Kupari LLC
282 Washin tc„toon Ave
Brooklyn, NY 11205wwwuuuu
To: Legalize an existing generator accessory to an existing single-family dwelling as
applied for.
At premises located at:
115 Rock/ Point Rd., East Marion 4 _ ....._ __..................._....._..._......
...... .. a..
SCTM # 473889
Sec/Block/Lot# 21.-1-30.3
Pursuant to application dated 5/7/2024 and approved by the Building Inspector.
To expire on _m1„2/2712025.
Fees:
ACCESSORY $250.00
CERTIFICATE OF OCCUPANCY $100.00
ELECTRIC $200.00
Total: $550.00
Building Inspector
Mr TOWN OF SOUTHOLD—BUILDING DEPARTMENT
i Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
+r► �' Telephone (631) 765-1802 Fax (631) 765-9502 htt s://w w,southoldtownnygoy
Date Received
APPLICATION FOR BUILDING PERMIT
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For Office Use Only
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PERMIT NO. � Building Inspector: MAY 7 2024
Applications and forms must be filled out in their entirety.Incomplete
applications will not be accepted. Where the Applicant is not the owner,an w; .
Owner's Authorization form(Page 2)shall be completed.
Date: 5--7 -�Lf
OWNER(S)OF PROPERTY:
Name; I 0( - u W6-tFV r% SCTM # l000- 2-1 — o ( 3,a
Project Address: I p SLY D � r �'�2 L 41,J r
Phone#: Email:
Mailing Address:
CONTACT PERSON:
Name r
Mailing Address: D dx
Phone#: 6 3 ( ' T 6 %Y Email:
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name:
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
Estimated Cost of Project:
❑NeweStructure ❑Addi "on ❑Alteration ❑Repair ❑Demo �lition
Will the lot be re-graded? ❑Ye t Will excess fill be removed from premises? ❑Yeses
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.
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Application Submitted By(pri name): J40 l EVAuthorized 4gent El Owner
Signature of Applicant: Date:
CONNIE D.BUNCH
Notary Public,State of New York
STATE OF NEW YORK) No.01SU6185060
SS: Qualified in Suffolk County
COUNTY OF
Commission Expires April 14,x�1S
LIO � l
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
r day of , 20c�
Notary Public
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
), IVV 0c _ N �- "It_ f! residing at f J PA WY I 0/ �Q,
'
4Olj A JAQ do hereby authorize �6�e-
Z to apply on
my be to the Town of Southold Building Department for approval as described herein.
Owner's Signature D 'te
Print Owner's Name
2
BUILDING DEPARTMENT- Electrical Inspector
" TOWN OF SOUTHOLD
Town Hall Annex - 54375 Main Road - PO Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX (631) 765-9502
r " arnesh southoldtewnn ov seand southoldtownn ov
1111 :.ol
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (Au Information Required) Date:
Company Name: Al- R
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) r
Name. /f.
(Kue/)'A 1
),
Address: "-- ko&g- hd / .
Cross Street:
Phone No.:
Bldg.Permit#: 50 a 9 email:
Tax IMap District: 1000 Section: a Block: I Lot: 30.3
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
Square Footage.
Circle All That Apply:
Is job ready for inspection?: KYES [?, Rough In Final
Do you need a Temp Certificate?: El YES Issued On
Temp Information: (All information required)
Service SizeEl1 Ph 03 Ph Size: A # Meters Old Meter#
❑New Service❑Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground❑Overhead
Underground Laterals D 1 2 LJ H Frame Pole Work done on Service? Y N
Additional Information:
PAYMENT DUE WITH.. APPLICATION
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