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Home My WebLink About51900-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#: 51900 Date: 05/07/2025 Permission is hereby granted to: John T Gardner PO BOX 727 Cutchogue, NY 11935 To: install EV charger in accessory garage as applied for. Protection from vehicular impact must be installed. Premises Located at: 4115 Stillwater Ave, Cutchogue, NY 11935 SCTM# 137.4-9 Pursuant to application dated 03/28/2025 and approved by the Building Inspector. To expire on 05/07/2027. Contractors: Required Inspections: Fees: EV Charger $125.00 ELECTRIC -Residential $100.00 CO-RESIDENTIAL $100.00 Total $325.00 Building Inspector � TOWN OF SOUTHOLD—BUILDING DEPARTMENT � a4 Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone(631)765-1802 Fax(631) 765-9502 I ttns://www.sioutii,o,.Idtowiiiiv.gov Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only MAR 2 8 2025 g PERMIT NO. � w Building Inspector- :. "A 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: March 17, 2025 OWNER(S)OF PROPERTY: Name: Erin Gardner SCTM#1000- Project Address: 4115 Stillwater Ave, Cutchogue, NY 11935 Phone#: 917-754-6065 Email: erin.gardner@astrazenca.com Mailing Address: 4115 Stillwater Ave, Cutchogue, NY 11935 CONTACT PERSON: Name. Absolute Electrical Contracting and Des ign n Mailing Address: 1200 Shames Dr, Unit A, Westbury, NY 115901 Phone#: 516-586-3050 Email: information@absolutec-d.com DESIGN PROFESSIONAL INFORMATION: Name: Absolute Electrical Contracting and Design Mailing Address: 1200 Shames Dr, Unit A, Westbury, NY 115901 Phone#: 516-586-3050 Email: information@absolutec-d.com CONTRACTOR INFORMATION: Name: Mailing Address: Phone#: Email: DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition MAlteration ❑Repair ❑Demolition Estimated Cost of Project: Mother Char a oint EV Char er installation and 300a OH se $7. 325.00 Will the lot be re-graded? ❑Yes 9 No Will excess fill be removed from premises? ❑Yes ❑■No i 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 IENo IF YES,PROVIDE A COPY. 0 Check Box After Reacting: 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,Suffbk 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 220.45 of the New York State Penal Law. Dominic Chizzoniti Application Submitted 13 (print name): NAuthorized Agent ❑Owner Signature of Applicant: Date: 3/17/2024 STATE OF NEW YORK) SS: COUNTY OF Nassau ) Dominic Chizzoniti being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, Master Electrician (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 `^ 20oZ5 Notary Public Jillian Rose Brunner Notary Public,State of New Yor PROPERTY OWNER AUTHORIZATION Reg. Nei. 01BROO24633 Qualified in Nassau County Where the applicant is not the owner) Commission Expires May 13, 2C Erin Gardner residing at 4115 Stillwater Ave I Cutchogue Absolute Electrical Contracting and Design do hereby authorize, to apply on my behalf to the can of South, Building Department for approval as described herein. 3/18/2025 Owner's Signature Date Erin Gardner Print Owner's Name 2 off ' BUILDING DEPARTMENT-Electrical Inspector gar TOWN OF SOUTHOLD p' Town Hall Annex- 54375 Main Road - PO Box 1179 Southold, New York 11971-0959 ° . Telephone (631) 765-1802 - FAX (631) 765-9502 � :�� aroesh southoldtownn . orseand southoldtownn . ov � , APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (Ail Information Required) Date: 3/17/2025 Company Name: Absolute Electrical Contracting and Design Electrician's Name: Dominic Chizzoniti License No.: ME-62784 Elec. email:information@absolutec-d-com Elec. Phone No: 516-586-3050 01 request an email copy of Certificate of Compliance Elec. Address.: 1200 Shames Dr, Unit A, Westbury, NY 11590 ,JOB SITE INFORMATION (All Information Required) Name: Erin Gardner Address: 4115 Stillwater Ave, Cutchogue, NY 11935 Cross Street: NY-25 Phone No.: 917-754-6065 Bldg.Permit#: email: Tax Ma District: 1000 Section: Block: Lot: BRIEF DESCRIPTION OF WORD, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Chargepoint EV Charger installation and 300a OH service upgrade Square Footage: Circle All That App'Iy. Is job ready for inspection?: YES 0 NO _ Rough In 0 Final Do you need a Temp Certificate?: YES❑✓ NO Issued On Temp Information: (All information required) Service SizeF�1 Ph[-]3 Ph Size: A #Meters Old Meter# ❑New Service❑Fire Reconnect[]Flood Reconnect❑Service Reconnect❑Underground❑Overhead #Underground Laterals 1 2 0 H Frame Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION w.� � �EAE le 7-1 FLOOD zq%r Ur Z ~' r'1 bd �, � r uNo " }" a N N1.0 � 6 o IS.cc tr) � C N m ZEti CL IQ vn. b +� �co 2 , co Z M ! 4 a O Li M �}�• r �w✓ Suffolk County Dept of Labor,Licensing&Consumer Affairs MASTER ELECTRICAL LICENSE Name DOMINIC CHIZZONITI Business Name ABSOLUTE ELECTRICAL This certifies that the CONTRACTING&DESIGN LLC bearer is duty licensed — by the Cowry of suff k License Number ME-62784 Issued: 01/21/2020 Commissioner Expires. 01/01/2026 This license is the property of Suffolk County Department of Labor,Ucensing&Consumer Affairs. Posmsion of fiats Icanse does not guarantee its validity. Additional Swinesa Name License Category