HomeMy WebLinkAbout51778-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#: 51778 Date: 03/25/2025
Permission is hereby granted to:
Elise A Calabrese
15405 Route 25
Mattituck, NY 11952
To:
legalize "as built"central air conditioning to an existing single-family dwelling as applied for.
Premises Located at:
15405 Route 25, Mattituck, NY 11952
SCTM# 114.-6-3
Pursuant to application dated 02/18/2025 and approved by the Building Inspector.
To expire on 03/25/2027.
Contractors:
Required Inspections:
Fees:
As Built Alteration $500.00
ELECTRIC -Residential $200.00
CO-RESIDENTIAL $100.00
Total S800.00
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 :Hwww. outholdto�wnn ,gt)v
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only EC E IVE
P ERMIT NO. �` Building Inspector: L, I I .,
i
Applications and forms must be filled out in their entirety. Incomplete
applications will not be accepted. Where the Applicant is not the owner,an Building Department
Owner's Authorization form(Page 2)shall be completed. Town of Southold
Date:
OWNER(S)OF PROPERTY:
Name: �, 0. SCTM# 1000- t l -q
J M
Project Address: Q'IKL Rd� MoAd ct' 5,
7
Phone#: l 3 7" _ �' . L) Email: eC ( (gSo2� w1C t ° C
Mailing Address: SA ML�- AS 49 O V A
CONTACT PERSON:
Name: C+ S[ l 1 Ve.Ir
Mailing Address: t YYo IAA, IM+ C., , , ( 52..
Phone#: S1 [0 38 '!{ _ q a (5Z5 Email: C oyl+ke- a CLO eCvrl
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:pp
Name: � k� S f\' (i/(!!-r
Mailing Address: 56 So � r. a CTI'�-mot
Phone#: �1 (a 3 g� - a 5 Email: - ov 4e- 6F- _Ch a0 -c VyA
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
❑Other G 1t+ $
Will the lot be re-graded? ❑Yes 54No Will excess fill be removed from premises? ❑Yes ®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? Eyes ®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 210.45 of the New York State Penal Law.
Application Submitted By(print name): ❑Authorized Agent 20wner
Signature of Applicant: a Date: �L
STATE OF NEW YORK)
SS:
COUNTY OF )
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
-
diy of 1r,j,6_r a 20 .'
Notary Public
NNNiFM I MUDD
PROPERTY OWNER AUTHORIZATION N fAf PUBUC�i�� ho.01h�On OF 2M
(Where the applicant is not the owner) oudWinSuftlkCourd►
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
" � ffuqq BUILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
Town Hall Annex- 54375 Main Road - PO Box 1179
" Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX (631) 765-9502
iamesh@southoldtownny.gov- seand southoldtownn ov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date: 9,o,
v
Company Name: JLd.i l o r� Eh t � .o
f4eieWs Name: Anikond
License No.: Elec. email: J,)rn r o .s E G±c H VA C�
Elec. Phone No: 01 request an email copy of Certificate of Compliance
Elec. Address.:
JOB SITE INFORMATION (All Information Required)
Name: ,
Address.
Cross Street: 1
Phone No.*
Bldg.Permit#: S email:
Tax Map District: 1000 Section: / Block: ✓o Lot: 3
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE Please Print Clearly):Y):
�G vL✓l � I � S E C R a �n�r of e t`c t"e n c C A I FI t'f Dwi d l�Y l�( f R TZ b o q
AJJ-
4. � �Iaje�Ser A4*-k614 �26bATi � � 1-1 SGEfZaamour"��.r< riSeS (S
%b I CSS e.led-, I'cal e-v)er,3 ° 4-o cno I S care Footage:
Circle All That Apply:
Is job ready for inspection?: 0 YES E] NO D Rough In Final
Do you need a Temp Certificate?: El YES ® NO Issued On
Temp Information: (All information required)
Service SizeF-11 Ph"3 Ph Size: A # Meters Old Meter#
❑New Service❑Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground❑Overhead
# Underground Laterals 1 2 F1 H Frame Pole Work done on Service? Y N
Additional Information:
PAYMENT DUE WITH APPLICATION
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RNEEM SALES COMPANY. INC.
Acondicionador de Aire Central
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