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Home My WebLink About51957-Z � c 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#: 51957 Date: 05/29/2025 Permission is hereby granted to: Richard Perl 214 Barnstable Dr Wyckoff, NJ 07481 To: Install accessory standby generator at existing single family dwelling as applied for,with Trustees #10728 and flood permit. *Generator installation must be compliant with FEMA flood zone AE6 Premises Located at: 2880 Minnehaha Blvd,Southold, NY 11971 SCTM#87.-3-43 Pursuant to application dated 04/23/2025 and approved by the Building Inspector. To expire on 05/29/2027. Contractors: Required Inspections: Fees: GENERATOR $125.00 CO Accessory $100.00 ELECTRIC-Residential $100.00 Flood Permit $150.00 Total $475.00 Building Inspector h 1 s Fro 6 � TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 :f Telephone (631) 765-1802 Fax (631) 765-9502 htt s:Hww,w.southold:townny.gov N_ Date Received APPLICATION FOR BUILDING PERMIT For Office Use On ly PERMIT NO. Buildingln°rsPaco:r: APR 2 2 2025 Applications aid forms must'be filled out in their.entirety. Incompiete applications will be accepted. Where the Applicant is not tlae owner,an Town of au o!!.d Owner's Authorization form(Page 2)shall be completed.' Date: L L-1-/ L-L OWNER(S)OF PROPERTY: Name: �«i-� SCTM# 1000- 3 Project Address: A �'rl ki h C�" tZ a ��v L Phone#: U 3 % S -5 j(v b Email: e r- e tyl $ y Mailing Address: '�2/ b7 i CONTACT,PERSON: / / Name: ly � 1 Q 6 bq- r-c- Mailing Address: '00 �L)of, Lt-k Phone#: 6 03 ( b -1 ( Email: i 7 L.0 LL��J rad S G 0— )/ DESIGN PROFESS IONALINFORMATION: Name: Mailing Address: Phone#: Email: ,CONTRACTOR INFORMATION:7 „ Name: 1; (c?_ j1 Mailing Address: Q � Z L `��Z.0 c� t LL-e 1 % Phone#: // Email: DESCRIPTION OF PROPOSED CONSTRUCTION ' []New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estl lated Cos. of Project: Other R P.I,V —116. Will the lot be re-graded? ❑Yes ❑No Will excess fill be removed from premises? ❑Yes ❑No 1 PROPERTY INFORMATION Existing use of property: S�' � �•a- , 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"216.45 of tine New York State Penal Law, Application Submitted By(print name): � " 1 /9 / ❑Authorized Agent ❑Owner Signature of Applicant: L/ �� Date: u�c CONNIE D.BUNCH STATE OF NEW YORK Notary Public,State of New York SS: No.01 BU6185050, Qualified in Suffolk County �5 c, COUNTY OF, Commission Expires April 14, 2 ! 4j a-Y-4 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 , ��r day of ,� , ZD�� Notary Public PROPERTY OWNER AUTHORIZATION (Where the applicant is not the owner) 1, 4 � �� residing at 96d, do hereby authorize �I� ✓ ' to apply on my behalf to the T n of thold Building Department for approval as described herein. � Z Z 1 Owner's S gnature Date Print Owner's Name 2 Town Hall Annex , Telephone(631)765-1802 54375 Main Road ax(631)7 .5 P.O.Box 1179 ro er.richert ibwn.so�lo «n .us Southold,NY 11971-0959 "" S E BUILDING DEPARTMENT TOWN OF SO 'THOLD APPLICATION FOR ELECTRICAL INSPECTIO_—A"t 13` REQUESTED BY: /9L/�l� o Date: Company Name: Narne: � License No.: _ /y) C Address: Ll I Phone I 31 - 65�- 17 / `- JOBSITE INFORMATION: (*Indicates required information) *Name: Eel) lUZ . P C—P,L X *Address: r L ,57 d x *Cross Street: EC L~E A'L)F7 X *Phone No.: Permit No.: YC Tax Map District: , 1000 Section: Block: Lot: *BRIEF DESCRIPTION OF WORK (Please Print Clearly) N�CeJ ��IE? (Please Circle All That Apply) Is job ready for inspection: YE / NO Rough In CELnal *Do you need a Temp Certificate: YES NO Temp Information (If needed) *Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other *New Service: Re-connect Underground Number of Meters Change of Service Overhead Additional Information: PAYMENT DUE WITH APPLICATION .82=Request forinspection Form ' TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold, NY 11971-0959 Telephone (631) 765-1802 h!Vs://www.sgighgldtgMMny4gy Floodplain Development Permit Application PROPERTY INFORMATION: . Flood Zone: FIRM Panel„ SCTM#1000- �r Address: City: Sj✓ ti j Zip: a 5 'CONTACT PERSON: Name: Mailing Address: PROJE,CT;DESCRIRTION, S ��'� �j��c�)`c) SECTION A;STRUCTURAL DEVELOPMENT '(CHECK ALL THAT, Tpe"of 5tructufe Type of Structural Activity Residential (1 to 4 families) ❑ New structure ❑ Residential (more than 4 families) ❑ Demolition of existing structure ❑ Combined use ❑ Replacement of existing structure ❑ Non-residential ❑ Relocation of existing structure ❑ Elevated ❑ Addition to existing structure ❑ Flood proofed(attach certification) ❑ Alteration to existing structure ❑ Manufactured Home Other: e r e l+" ❑ Located on individual lot ❑ Located in manufactured home park SECTION B: OTHER;DRVELOPMENT(CHECK ALLTHATAPPLY) ❑ Clearing of trees, vegetation or debris ❑ Mining ❑ Grading ❑ Drilling ❑ Dredging ❑ Connection to public utilities or services ❑ Paving ❑ Placement of fill material ❑ Drainage improvement(including culvert work) ❑ Roadway or bridge construction ❑ Fence or wall construction ❑ Watercourse alteration (attach description) ❑ Excavation (not related to a structured development) ❑ Other development not listed (specify): i l ef`" 1'" e eto;the s ntl canditr n of thr er r"'and,Rertrfy to pe befit f rf yt'o,w1 1 e t ,rfrformatresn c ra#fin d B K„ R rr f0�l/,� �,r '��,g/� t R /, r rr / a „ .; ber . a ur t o d: s n t f i,1 rA ,a; rr ,, ),, l i , r „r /,, r it Sol / r .f i.... r ./ ✓... r/oiiiiii ./ ,i / /.. //o�..... 1.// //,,, i r / / / .//1///i/ f/1 o , , ,,/ r ,, / / i,% %/,r ,Ui /r r,/i, /,//// i / c,,, ( l �91 r ( h r rrr If;evo /dlf work Fnr�sa„ (r ��r � � r, lsrl D/ l� tfsla� orrd >cup( d untr( �rt Crirrf�s(i rice r issGed"°The pecrnat 3 i11° zpire'if no WarlCiS cisrrimen edrwrth)n c�Fre dear o,rssuaffcc;:at h r,p�rttiits may Lie required to fulfil t gulaxc ry;re urr ,►r orrts.'App(i"cant gives/`consent ta)ocal autho'ity ar"repr s r tatltie to make easona le inspections t�jtie�T#,y compilanr�. Application Submitted By(print name): Signature of Applicant: µ., �Signature a� Z$� NOTE FSK FLOW MIES PL4M 1W SE410M SOO HOON AM BAW SYMBOLLEGEND PM FEMA MW ON WER IMW PAM OM J f4 41 TAI 1000!A 01 C4 ocr Aq/ 'y 'a 1� I III 64 Q p, El Q) X, TAr LOr 48 ........... Nr AV 4 GA'f h VA nx fB, 13 S88*691100"w rAr LOT 44.1 OPEVYIEE 4 VENUE ABANDO.V.rD (38, GRAPHIC SCALE LorAREA 2 ALL ELEVATIONS REFER TO NAVD88'DATUM IN FEET 1 inch = 30 fL SURVEY OF PROPERTY %JL;AL1C"* E 2880 MINN&"WULWARD,SOUTHOW, Now York 11971 00 l SITUATE and surveying SOUTHOLD. TOWN OF SOUTHOLD mjs1ondsurvey.com P:631-957-2400 SUFFOLK COUNTY, NEW YORK 1 South Bay Avenue, Islip, NY 11751 DP-:MC CREW.:JP - SCALE: 1'= 30' r TAX MAP NO. DATE- SURVEYED:07/01/2022 1 JOB N..S22-23651 1000-007',1 -03,00-0410 010 4—14. '4