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HomeMy WebLinkAbout51477-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#: 51477 Date: 12/13/2024 Permission is hereby granted to: 240Strat LLC PO BOX 311 Greenport, NY 11944 To: legalize "as built" HVAC as applied for. Premises Located at: 240 Stratmors Rd, East Marion, NY 11939 SCTM# 21.4-10 Pursuant to application dated 10/22/2024 and approved by the Building Inspector.. To expire on 12/13/2026. Contractors: Required Inspections: Fees: As Built Alteration $500.00 ELECTRIC -Residential $200.00 CO-RESIDENTIAL $100.00 Total S800.00 ilding Inspector of fat t , TOWN OF SOUTHOLD—BUILDING DEPARTMENT ' Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 -4 4 . Telephone (631) 765-1802 Fax (631) 765-9502 htt s:/www.southoldtownn . ov . LralAPPLICATION FOR BUILDING PERMIT $ For Office Use Only .I PERMIT NO.� � Building Inspector �5 ." Applications and forms must be filled out in their entirety.Incomplete " applications will not be accepted. Where the Applicant Is not the owner,an Owner's Authorization form(Page 2)shall be completed. Date: © Z� OWNER(S)OF PROPERTY: Name: -t)-� 2A O o-- G SCTM#1000- Project Address: ZL,1a \ ° ;. .tmm l C ��13 Phone#: 6 i� ?��_ '(zq Email: \ dw � @� Mailing Address: bCB CONTACT PERSON: Name: k- , l �Nc; Mailing Address: T'k cv,� t�� Phone#: EmaiN DESIGN PROFESSIONAL INFORMATION: Name: Mailing Address: Phone#: Email CONTRACTOR INFORMATION: Name: Mailing Address: Phone#:. Email: DESCRIPTION OF PROPOSED CONSTRUCTION ❑Ne w Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: ;gQt,her Will the lot be re-graded? ❑Yes El No Will excess fill be removed from premises? ]es ONo 1 PROPERTY INFORMATION Existing use of property: JO Intended use of property: 4— Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to l D n this property? ❑Yes Vo 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. Application Submitted By(print name): LA C—L)Ph- 17�). Q�-JGjiiF—L-c ❑Authorized Agent v/owner Signature of Applicant: �� a Date:�.`..-, I of STATE OF NEW YORK) SS: COUNTY OF ), dr being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing coat t)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 YL-- 024_ 9& VX. l0 Notary Public RITA M. ROONEY [NOTARY PUBLIC,STATE OF NE]14,244 PROPERTY OWNER AUTHORIZATION NO. 01 R04961551 UALIFIED IN SUFFOLK C (Where the applicant is not the owner) COMMIISSION EXPIRES APR 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 � t F BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD Town Hall Annex - 54375 Main Road - PO Box 1179 Southold, New York 11971-0959 lip Telephone (631) 765-1802 - FAX (631) 765-9502 s - seand southoldtownn ov mash southoldtownnov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date.- Company Name: 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) ou)n�VZ— I N Name: 2 Address: ' Cross Street: 'R Phone No.: (012 Bldg.Permit#: j email" Tax Map District: 1000 Section: J-10 Block: a Lot: h BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): h'-V 14C Square Foolta e: Circle All That Apply: Is job ready for inspection?: YES F� NO Rough In Final Do you need a Temp Certificate?: r-1 YES aNO Issued On Temp Information: (All information required) Service Size1 Ph 3 Ph Size: A # Meters Old Meter# El New Service❑Fire Reconnect[—]Flood Reconnect❑Service Reconnect❑Underground❑Overhead # Undefgrou�nd Laterals M 1 2 H Frame D Pole Work done on Service? Y FIN Additional Information: PAYMENT DUE WITH APPLICATION F cy Y N. 7-9 cal Cf L� ^66.+7 t �,, a altaration or addition 4,r Y_ ^� t =y= rt is a violation of VCe of trio Ncw Vv t 0,�.., �� �?tl'tlfi rrlw.,,Frin� Q M seal shalt not be con fdmod t e valid true copy. �`1 Q men indicated hereon 91ER run tatha teevulomthesm-m p C' , c "endcmhishdhai€ tU, = rr 1rL?;.. / `!; t i lt, co overrnmental agomq ant? 0 4 in listed hereon end �� ��`�� �,� � 0 to assignees of the lending instl- to t don.Guarantees are not transferable �tr ra additional institutions or subsequent rr 1 owners. p kID �� ��/fr��'L�v'� ���';�-shirr �rj :>'i'='s:." �!-1,�,'y:-t.'•�,, ,r.-- ;- //���.� ,�-';.��f—�.���..�� � ,�s l/���'�i:� ��-rt r r c�'��. r%r•�/_ ,f":>.,_ s:.�r'.;�r-'�=v_ fir ,�Y ,r � � �jJ`� f Y / .• tie.... �S /',4;'?� /�Asr�. .._i i`1�,.,.�. � ��:-`�6"'.•ff� �j� -A�`- Lr''',•::.a'X l/t.._:� ... Y',r