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HomeMy WebLinkAbout51632-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#: 51632 Date: 02/12/2025 Permission is hereby granted to: Albina Sawicki 5535 Old North Rd Southold, NY 11971 To: legalize "as built" hot waterheater,ACand replacement windows to existing single-family dwelling as applied for. Premises Located at: 5535 Old North Rd, Southold, NY 11971 SCTM#51.-3-6.2 Pursuant to application dated 12/17/2024 and approved by the Building Inspector. To expire on 02/12/2027. Contractors: Required Inspections: Fees: As Built Alteration $500.00 CO-RESIDENTIAL $100.00 Total $600.00 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 Date Received APPUCA1 ION FOR BUR.DING PERMIT For Office Use Only DEC 17 �'-'024 PERMIT NO._ Building Inspector..., ..... n _ Applications and forms must be filled out in their entirety.Incomplete the Applicant is not the owner,an will not be accepted. Where applicationsP PP . Owner's Authorization form(Page 2)shall be completed. Date: OWNER(S)OF PROPERTY: Name:Walter Sawicki as Executor scrM#1000-51-3-6.2 Project Address:5535 Old North Rd, Southold, NY 11971 Phone#:612-414-3100 Email:waltersawicki@comcast.net Mailing Address: CONTACT PERSON: Name:Tom Scalia Mailing Address:PO Box 598, Southold, NY 11971 Phone#:631-786-6920 Email:tscalia@albertsonrealty.com DESIGN PROFESSIONAL INFORMATION: Name: Mailing Address: Phone#: Email„ CONTRACTOR INFORMATION: Name: Mailing Address: Phone#: Email: DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: (]Other HVAC-Central Air Conditioning installed Will the lot be re-graded? ❑Yes FgNo Will excess fill be removed from premises? ❑Yes RNo 1 a M1 ii: 11 )'1'iW ) 114 PROPERTY INFORMATION Existing use of property:Res Intended use of property:Res Zone or use district in which premises is situated: Are there any covens _.. � covenants and restrictions with respeectct t tooK � ,... AC this property? ❑Yes BNo IF YES,PROVIDE A COPY. Q 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 MANE 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 construch"of buRdlnp, additions,alterations or for removal or demolkion as herein described.The applicant agrees to comply with all applicable laws,ordinances,bulking code, housing code and regulations and to admit authorlted inspectors on premises and In buildingls)for necessary Inspections.False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.4S of the New York State Penal Law. Application Submitted 7:�;qNo. INAutharized Agent ❑Owner Signature of Applicant: N'NIE D.BUNCH Date:blic,State of New York 01 BU6185050 STATE OF NEW YORK) Qualified in Suffolk County SS: Commission Expires April 14.2 COUNTY0F being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing d Wing contract)above named, (S)he is the Contractor, Agent,Corporate ( , ,g p 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 1 day of C.6" 20a.�[ [VIP Notary Public (Where the applicant is not the owner) I, Walter Sawicki residing at do hereby authorize Tom Scalia to apply on my behalf to the Town of Southold Building Department for approval as described herein.. Owner's Signature Date Walter Sawicki Print Owners Name 2 BUILDING DEPARTMENT-Electrical Inspector TOWN OF SOUTHOLD Town Hall Annex-54375 Main Road - PO Box 1179 Sou thold, Ne w York 11971-0959 %vi 6M Telephone (631) 765-1802- FAX (631) 765 9502 t aLmesh &15,00hcfl t wnn 2y - s sand ii��Il�okj� OWIIII �.a)v L _ ._m._.�mm� ... APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date:. Company Name: Electrician's Name. License No.; Elec. email: Elec. Phone No: ❑1 request an email copy of Certificate of Compliance Elec. Address.: JOB SITE INFORMATION (All Information Required) Name: Walter Sawicki as Executor Address: 5535 Old North Rd,Southold, NY 11971 Cross Street: Route 48 Phone No.: 612-414-3100 BIdg.Permit#: I email:waltersawicki@comcast.net Tax Mae District: 1000 Section:51 Block: 3 Lot:6.2 BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Inspection of installed AC System kT Go Square Footage: Circle All That Apply: Is job ready for inspection?: © YES NO ❑Rough In ❑f Final Do you need a Temp Certificate? ❑ YES NO Issued On Temp Information: (All information required) Service Size[11 Ph❑3 Ph Size: A #Meters Old Meter# ❑New Service❑Fire Reconnect[]Flood Reconnect❑Service Reconnect❑Underground❑Overhead Underground Laterals D 1 02 H Frame 0 Pole Work done on Service? 17-1 Y N Additional Information: RAYMENT QUE WITH &E61CATION