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Home My WebLink About51902-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#: 51902 Date: 05/07/2025 Permission is hereby granted to: Paul Kesicki 1210 Ashamomaque Ave Southold, NY 11971 To: install EV charger on exterior wall of single-family dwelling as applied for. Protection from vehicular impact must be installed. Premises Located at: 1210 Arshamomaque Ave, Southold, NY 11971 SCTM#66.-2-28 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 S325.00 13ua ding 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 li,ttps://www.,,;outtioldtownn _ ov Date Received APPLICATION, FOR BUILDING PERMIT For Office Use Only E C E OWE IDI PERMIT NO. Building Inspector. --j-/ MAR 2 8 )rv� 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:03/14/2025 OWNER(S)OF PROPERTY: Name:Paul Kesicki SUM#1000- Project Address:1210 Arshamomaque Ave, Southold, NY 11971 Phone#:631-492-0507 1Email:KESICKIPAUL@GMAIL.COM Mailing Address:1210 Arshamomaque Ave, Southold, NY 11971 CONTACT PERSON: Name:John Felbinger Mailing Address:20 Clark St East Rockaway, NY 11518 Phone#:516-887-4876 Email:jackjr@jffelectdc.com DESIGN PROFESSIONAL INFORMATION: Name:N/A Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: Name:John Felbinger Mailing Address:20 Clark St East Rockaway, NY 11518 Phone#:516-887-+4876 Email:jackjr@jffelectdc.com DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: 0 Other EV Charging Station 3920 Will the lot be re-graded? ❑Yes IiiNo Will excess fill be removed from premises? ❑Yes RNo 1 I PROPERTY INFORMATION Existing use of property:Residential Intended use of property:Residential/Single Family 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. IN Checks BOX After Reading: The owner/contractor/design professional is responsible for all drainage and storm water issues as provided by Chapter er 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 By(p 'nt name):50�1(\ �Q,��D:� � Authorized Agent ❑Owner Signature of Applicant: Date: 1 ( i( STATE OF NEW YORK) SS: COUNTY OF being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing co 'tract)above named, (S)he is the C (\ (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 clay of !r 'at't�iyl 20 LKAX-t -1 A 91 Notary Public YNTHIA LABIA Notary Public,Slate OI Newu York No.OI LA6l 1011 OUalified in Nassau COuntyjAxlq— PROPERTY OWNER ��:AUTHORIZ ' IOC ommission xpiresA1 ust . (Where the applicant is not the owner) I, `cs.:n 1 1 1=S� residing at + ( -nof4� "Sc, A-A i V do hereby authorize - TC= to apply on my behalf o tcuvn of d old Building Department for approval as described herein. Own g er s Signature r e Date Print Owner's Name 2 pft ' BUILDING DEPARTMENT-Electrical Inspector xrd 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 $'$ jamesh@southoldtownny.gov— seand southoldtownrl . ov APPLICATION FOR ELECTRICAL INSPECT10N ELECTRICIAN INFORMATION (Ail Information Required) Date: 03/14/2025 Company Name: JFF Electric, Inc. Electrician's Name: John Felbinger License No.: ME49343 Elec. email:jack@jffelectric.com Elec. Phone No: 516-887-4876 [D I request an email copy of Certificate of Compliance Elec. Address.: 20 Clark Street, East Rockaway, NY 11518 .SOB SITE INFORMATION (All Information Required) Name: Paul Kesicki Address: 1210 Arshamomaque Ave, Southold, NY 11971 Cross Street: Phone No.: 631-492-0507 Bldg.Permit#: email: KESICKIPAUL@GMAIL.COM Tax Map District: 1000 Section: Block: Lot: BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly). Install dedicated 100-amp 240v circuit for electric vehicle charging station protected by 100-amp circuit breaker&disconnect.Charger will be mounted on exterior wall of house. square Footage: 24w0 Circle All That Apply: Is job ready for inspection?: ElY€S Z✓ NO [—]Rough In Final Do you need a Temp Certificate?: YES R]NO Issued On Temp Information: (AII information required) Service Size❑1 Ph '3 Ph Size: A #Meters Old Meter# ❑New Service[]Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground averhead #Underground Laterals LJ 1 H Frame 0,Pole Work done on Service? Y N Additional Information: N/A PAYMENT DIRE WITH APPLICATION ti Su Is cum ", Labor,Liewming&CO"sul`/Y uirst MASTER ELECTRICAL LICENSE " Name JOHN FELBINCM Businmm Name This c"ries thatthe JFF ELECTRIC INC beambyOv o ormdr,& Lkense r ME-19343 Issued- la%l/lg% Ros"it,VMS,, Eatp M: 1WO 2025 COMN " r r a� Dk-eLLINS-PURLII.HATER DHELUNl,9=PUBLIC WATER } .�Y N 26°14'00" W 111.25' FY LINE ` � W ! 6UBJEGT Y .� *,w z r - -- ri►«...r.xw�..m..w. P ! qr IPM TMw.POf.C�1.11.eMb.IR• fawsaug�iceP ��Nry//� 0 (({ P .4 ae396wri r� PATIO w�Fsp Ne rtb� � - jjf -OiY pS.#t TOTAE iOT -- X .ki# �a.raa w aascar ""T 9-OTORT 7iTORY WOOD P - B€ki F WOOD PRAM®MOM W FRAMm ADDITION PROPOSW ADDITION P (4 BROOM) sip. TIAe@B1T a:14.' �.�� ,,,. -�- , ----N - _, �.. _ _. _ a�#,I:cess.aeR a •. —_ RAF ! ' t ' - .s� I TAW W 4° 4 U e ae WmArw we - ....+w� g absrr.o i:. -' #�a7nA� _ wn.rRrr#mx - tu ya..cwrr.ww. -. a.+c r � .a w,mss�- I gym► eT. ..� rw�lnm r.r rrr e+"w rw,.e N" > 8 - ( t � . 'sI $ � � i`o°'+►a°4 r "Y.I'l _ ! ,b.�Y Yrr..'�ii. .` �� louo�►rl ` �Lj s o N ati;err ww.r."aYnr S ' ' � ti I '_` PROPOSPD SEPTIC SYSTEM DETAIL 2FIR -- --- .I.rr. KESIC ,Z �� RESIDE . w =OLK COUNTY HEALTH DEPARTMENT APPROVAL .a l210 ARSHAM AR5HAMOMAWE AVENUE Mar Pp0P08! SITE SPA