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Home My WebLink About51311-Z 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#: 51311 Date: 10/23/2024 Permission is hereby granted to: Hinter Wm J Irry Trust PO BOX 1607 Mattituck, NY 11952 To: Legalize an "as built" HVAC system installed at an existing single-family dwelling as applied for per manufacturers specifications. Premises Located at: 600 Rosewood Dr, Mattituck, NY 11952 SCTM# 113.-2-18 Pursuant to application dated 09/10/2024 and approved by the Building Inspector. To expire on 10/23/2026. Contractors: Required Inspections: ELECTRICAL- ROUGH, PLUMBING, ELECTRICAL- FINAL, FINAL, Fees: As Built HVAC $500.00 CO-RESIDENTIAL $100.00 ELECTRIC -Residential $200.00 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 4it1 :J' ,'wwsouthojdtownny.gqy Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only C U E PERMIT NO. / Building Inspector. Applications and forms must be filled out in their entirety. Incomplete fit 1 0 applications will not be accepted. Where the Applicant is not the owner,an E10ding Department Owner's Authorization form(Page 2)shall be completed. Date: OVMER(S),OF PROPERTY: Name:hinter Wm J Irry Trust ScrM# 1000- Project Address:600 Rosewood Drive, Mattituck NY Phone#:631-987-9482 Email:janeflinter6@gmail.com Mailing Address: Same CONTACT PERSON: Name:Jane Flinter Mailing Address:600 Rosewood Drive Phone# 631-987-9482 Email: DESIGN PROFESSIONAL INFORMATION: Name:Does not apply Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: Name:Does not apply Mailing Address: Phone#: Email. DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: ❑' OtherHVAC $$10, 500 Will the lot be re-graded? ❑Yes WNo Will excess fill be removed from premises? ❑Yes El 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 l0 No IF YES, PROVIDE A COPY. I Check Box After Reading: Theowner/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(pr` arne)�:jane Hinter eAuthorized Agent ❑Owner Signature of Applicant: Date: STATE OF NEW YORK) CONNIE D. BUNCH Notary Public,State of New York SS: No.01 BU6185050 COUNTY OF ) Qualified in Suffolk County Commission Expires April 14, 2"M 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 day of� �4� ZB . .. .........L Notary Public PROPERTY OWNER AUTHORIZATION (� ..._.the applicant is not th� .....�.�_..� Where a owner) I, 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 2 ,mrw" ff BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD Town Hall Annex - 54375 Main Road - PO Box 1179 a u Southold, New York 11971-0959 " '"` Telephone (631) 765-1802 - FAX (631) 765-9502 " ro errt Ssoutholdtownny.gov — seand outholdtownn . 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 ✓❑I request an email copy of Certificate of Compliance Elec. Address.: PO Box 1698 Mattituck NY 11952 JOB SITE INFORMATION (All Information Required) Name: Jane Flinter Address: 600 Rosewood Drive Mattituck NY 11952 Cross Street: Cox Neck Rd Phone No.: 631-987-9482 Bldg.Permit#: S l 3 I I email: Tax Map District: 1000 Section: I I3 Block: a Lot: BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Electrical Wiring of HVAC with Condenser Square Footage: Circle All That Apply: Is job ready for inspection?: YES [] NO Rough In Final Do you need a Temp Certificate?: YES Z 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 2 H Frame Pole Work done on Service? Y MN Additional Information: PAYMENT DUE WITH APPLICATION NoW OR R7RME R LY sLEDZIE SKI S.16616,30..E 43.42 73.00 f.c.0.8 S. n r 00 � t AD D�c k N I$'Cap z 1.3OX n m o I 11/2 soy. 0 i^8 V fr,, dwell,"' d m aPo� stira �4ab�ra� N-4— N7'— cc-k r R LI.C10.8 S. 4 N.22'56'S0"W 116.00 M'"Ga' 'mo"VL#' „ T'h6 eX1StenCe o right of+Nays and or ease . Irfents `� f record,If any,not shown are hot Uarahteed #N## erNNffi#td IQ#P NAANkENdAr#'?NA# t4UR9d7h#ar#6R NW#YIC4rA'R#A Nd#RRgr+Y "#aNr.WN wN#R#rNr FR4,?pd4 #rr sA+at Rgp7# TO nro "AWN, «IOI`$ Ntl.�A'�M1�9 , "FILI" Ntl:N'0 I� fi9T. roRVC#tYR#E #A NVA# d°'R5}R'#R#1P # #AAA#GNV4 9MIN, UA4'Vk.'M O N'# nRC NfrA r.'Arr#..A#w, auR." RdMR#ea„ n#Rr xr#N His 'W#AaN AW3w -S•`tl Y9C! Et1 I"W I "�NIILLIAM J. Wr ,JAi4E N.'FLINTtR ,Y4AVPde t4NaCA•#'VWAEAC#4R#, #bM« t1t4P 9 !!F r �` N�NAd "Nq #NdNNC� pro,A #i4b A'LANN�1N AaNkr I#hRrAN#fN PNiISAM^ i s , , R#cNrAaM AAP jN#race. 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