HomeMy WebLinkAbout51381-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#: 51381 Date: 11/14/2024
Permission is hereby granted to:
Andrew R Garcia
245 Silver Colt Rd
Cutchogue, NY 11935
To:
Construct a hot tub accessory to an existing single-family dwelling as applied for per manufacturers
specifications.
Premises Located at:
245 Silver Colt Rd, Cutchogue, NY 11935
SCTM#95.-4-18.2
Pursuant to application dated 09/27/2024 and approved by the Building Inspector.
To expire on 11/14/2026.
Contractors:
Required Inspections:
Fees:.
Accessory-New Structure $300.00
CO Accessory $100.00
Total $400.00
jz 1)
Building Inspector
a
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 https://wwwsoutho1dtownnvgov
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
PERMIT NO. Building Inspector:
Applications and forms must be filled out in their entirety.Incomplete
applications will not be accepted. Where the Applicant is not the owner,an I i ti
Owner's Authorization form(Page 2)shall be completed.
Date: pq I a�
OWNERS)OF PROPERTY:
Name: �� IKM#-1000-A A ZI 2—
Project Address: a `LV C ;L..T Ra %-TC-NoGV 1 ccx's
Phone#: j�1_ $�a_ 6g.� Email:
Mailing Address: LISTS
� l-lX�'f�oeJ
CONTACT PERSON:
Name: ND A
Mailing Address: L-ocSW-,J
Phone#: 611- 6,81 Email: &�QQCV1 12A) C2 CA&4 L CO)A
DESIGN PROFESSIONAL INFORMATION:
Name: �J f A
Mailing Address:
Phone#. Email:.
w II �A?
Name . .wSA
G N)'s LEGVRLC-
Mailing Address: To .25Px 130 V A.(4t 0-s ,77", N 11
Phone#: ( Email: t, Nscl.FC-M,c. Q cNr►L.�
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
E90ther Neil Tu $Q'Say•o a
Will the lot be re-graded? ❑Yes KNo Will excess fill be removed from premises? ❑Yes t'No
1
PROPERTY INFORMATION
Existing use of property: Intended use of property:
Zone or use district in which premises is situated;.. Are there any covenants and restrictions with respect to
this property? ❑Yes 1�51\lo IF YES, PROVIDE A COPY.
5housingcode
After Reading: The owner/contractor/design professional Is responsible for all drainage and storm water issues as provided by
the Town Code. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone
he Town of Southold,Suffolk,County,New York and other applicable Laws,Ordinances or Regulations,for the construction of buildings,
rations or for removal or demolition as herein described.The applicant agrees to comply with all applicable laws,ordinances,building code,
nd regulations and to admit authorized inspectors on premises and in building(s)for necessary Inspections.False statements made herein are
punishable as a Class A misdemeanor pursuant to Section 210.45 of the New York State Penal law.
Application Submitted By(print name): Q>v�� A0.G4 ❑Authorized Agent 0/owner
Signature of Applicant: Date: Qq f QIaJA
STATE OF NEW YORK)
SS:
C NTY 0 .�
being duly sworn, deposes and says that(s)he is the applicant
(Name of indiv$'ual 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 rn �this
n
02 l day of 20
Nota Public
PROPERTY OWNER AUTHORIZATION NOTAW PUBLIC,STATE OFNEWIIQRK
6258145
(Where the applicant is not the owner EDIOIBLFFOLK
) QUALIFIED IN SUFFOL.K COUNTY
COMMISSION EXPIRES 31 M
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
. % ttt BUILDING DEPARTMENT- Electrical Inspector
ell
o TOWN OF SOUTHOLD
Town Hall Annex - 54375 Main Road - PO Box 1179
Southold, New York 11971-0959
AII Telephone (631) 765-1802 - FAX (631) 765-9502
iamesh southoldtownn ov — sea nd sout oldtownn . ov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (Au Information Required) Date: OqO, j H
Company Name: t
Electrician's Name:
License No.: C�! _j. �S�Elec. email: - Jec
Elec. Phone No: t- ❑I request an email copy of Certificate of Compliance
Elec. Address.: - 022e, ffv
JOB SITE INFORMATION (All Information Required)
Name: L (Fo r
Address:
Cross Street: a
Phone No.: C231-
BIdg.Permit #: 13
email„
Tax Map District: 1000 Section: G Block: Lot: Is. 2
BRIEF DESCRIPTION OF ""uu'ORI , INCLUDE SOARS F OTAO E (Please Pint Clearl ):
Square Footage:
Circle All That Apply:
Is job ready for inspection?: YES 17-1 NO Rough In J5
Final
Do you need a Temp Certificate?: El YES ! 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 1 n2 H Frame Pole Work done on Service? Y N
Additional Information:
PAYMENT DUE WITH APPLICATION
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