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HomeMy WebLinkAbout51729-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 O�F APPROVED PLANS AND SPECIFICATION'S UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 51729 Date: 03/12/2025 Permission is hereby granted to: Moeller Family Trust 21 Camelot Ln Setauket, NY 11733 To: legalize "as built"central air conditioning as applied for. Premises Located at: 1155 Aquaview Ave, East Marion, NY 11939 SCTM# 21.-2-15 Pursuant to application dated 02/05/2025 and approved by the Building Inspector. To expire on 03/12/2027. Contractors: Required Inspections: Fees: As Built Alteration $500.00 ELECTRIC -Residential $200.00 CO-RESIDENTIAL $100.00 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 htt ://wwwv. uthgidtownn '. ors, Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only /A In D PERMIT NO. Building Inspector: 12 025 FEB Applications,and forms must be filled out in their entirety.Incomplete Building Department applicatib will not be accepted. Where the Applicant Is not the owner,an 9 P Owner's Authorization form(Page 2)shall be completed. Town of Southold Date: OWNER(S)OF PROPERTY: Name: L� P,5i 4/ SCTM # 1000- I �. Project Address: ' Phone#: , Email enl Mailing Address l2F�5 � r�� X �ir � ��-�✓ FT����'t CONTACT PERSON: Name: PAN Marling a2 Address: ,. Phone Email:, ,�,te / l° rye DEP0N ROF 0"IONAL INFORMATION: Name: <�>1 --7 S - © `7 Mailing Address: Phone#: Email:. CONTRACTOR INFORMATION Name: Mailing Address: 'd l Phone#: Email: DESCRIPTION OF PROPOSED.CONSTRUICTION ❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Co� a Prci ct: ❑Other ig $ A14rff, ll the lot be re-graded? ❑Yes EWo Will excess fill be removed from premises? ❑Yes o 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 210AS of the New York State Penal Law. Application Submitted B rin a e . - L 7 � N ❑Authorized Agent Werner pP Y(p I/bC,� � �/ � Signature of Applicant: / Date: STATE OF NEW YORK) SS: COUNTYOF f� �,) being duly sworn, deposes and says that (s)he is the applicant (Name of individual signin contract) above named, (S)he is the 000,CL (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 ���fr r , zo; JK- ")t R41-� No a Public Y�'J .:CY L. 0 ' I R NOTARY PULzUC,STATE OF NEW YORK NO.01 DW63046900 PROPERTY OWNER AUTHORIZATION 'YAI'FIF0 ra 81 l=Fa_KCOUNTY (Where the applicant is not the owner) COMiv VIUON EXFRES JUNE-.30,2_ q, 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 APPROVED AS NOTED DA a B.P.# FEE BY: . NOTIFY BUILDING DEPARTMENT AT 631-765-1802 8AM TO 4PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION-TANO REO lI iFO FOR POURED, Cjl�er.R F 2. ROUGH- FRAIv;IKG& PL J;73i', ,fa 3. INSULATION 4. FINAL-CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTON ERRORS r S REQUIFlED AND CONDM I S 0 1 SOUTHO t LD � NN 80, w , DEC ti S ' C U OI (JSE IS UNLAWFUL WITHOUI CE � mT-1 FICA, . 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