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Home My WebLink About52005-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#: 52005 Date: 06/17/2025 Permission is hereby granted to: Dimitry Baron 220-35 77th Ave Oakland Gardens, NY 11364 To: legalize "as built" central air conditioning as applied for. Premises Located at: 2780 Great Peconic Bay Blvd, Laurel, NY 11948 SCTM# 128.-6-23 Pursuant to application dated 05/09/2025 and approved by the Building Inspector. To expire on 06/17/2027. Contractors: Required Inspections: Fees: As Built HVAC $500.00 ELECTRIC -Residential $200.00 CO-RESIDENTIAL $100.00 Total S800.00 -.-. ding Inspector rx TOWN OF SOUTHOLD—BUILDING DEPARTMENT s Town Hall Annex 54375 Main Road P. O. Box 1179 Southold, NY 11971-0959 r Telephone (631) 765-1802 Fax (631) 765-9502 gov Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only E C E {� PERMIT NO., Building Inspector: M 0- Applications and forms must be filled out in their;entirety.,Incomplete applications will not'be accepted. Where the Applicant is not the owner,an Ba 6ltEln Department ent Owner's'Authorizati6n�form(Page�2)shall be completed. Tow n of Southoldi Date: OWNER(S)OF PROPERTY: Name: l-t ( 0 -O ill SCTM #1000- Project Address: Z T 0� PeC xo tt; C u j v1 [.tNc re-I Al,, l � Y Phone#: 0( �J 6® Email: eq-(-oa ale kor we GoWj Mailing Address: -` -o - `� 4-L/& e �� ad" Aly CONTACT PERSON: Name: Mailing Address: ��- 0' - al we- Phone#: Email: OESI11iN PROFESSIONAL'INFORMATION: Name: Mailing Address: Phone#: Email: COkii*TOR INFORMATION: Name: Mailing Address:.. Phone#: Email: DESCRIPTION OF PROPOSED CONSTRUCTION p I De olitio Estimated Cost of Project: ❑New Structure ❑Addition ❑Alteration ❑Re ai `Other l� i� cylZ"S I � ( G .................. ........... Will the lot be re-graded? ❑Yes;No Will excess fill be removed from premises? ❑Yes [:]No 1 PROPERTY INFORMATION Existinguse of pro ert e � Intended use of property: ( e dj ;,(�wCe p p Y La �� h . Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? ❑Yes ONO IF YES, PROVIDE A COPY. ec Box After Reading: The owner/contractor/design profession & iblefrrrall drairttrg or storm water issues as provided by t8:11 24 ,of the Town Code. APPLICATION IS HEREBY MADE to the Building Mtpar el fpr.1 Is wance 01a 4i1k1(R pent p4lsSuarpt to t ^wilding zone Ordinance of the Town of Southold,Suffolk,County,New York and other applittlbte ,Out�Iineu�Irrea r�r RgufatortiF�far kt ,,ccrrnstruciiorr of tyti)IdingS, additions,alterations or for removal ordemolition'as herein described.The applicant agrees to comply with'all applicable laws,ordinances,bupding 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 210.4S of the New York State Penal Law. Application Submitted By rint name).3)Ml o roil ❑Authorized Agent Owner Signature of Applicant: Date: (�� / Lv Zf NCH [[[ STATE OF NEW YORK) Notary Public,State of New York No.0 1 BU6185050 SS: Qualified in Suffolk County COUNTY OF ) Commission Expires April 14,2L_a� 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 d y of - � , 2f� Notary Public PROPERTY OWNER AUTHORIZATION (Where the applicant is not the owner) (, 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 S.C.T.M. NO. DISTRICT: 1000 SECTION:128 BLOCK: 6 LOT(S):23 15 LAND NIF OF ALISON ROSS w„ a^ �„� saw raw LAND NIF OF MELISSAHOBLEY LAND NIF OF \ AMY LEBLOND �N —101a 4 THE WATER SUPPLY, WELL$ DRYKELLS AND CESSPOOL LOCATIONS SHOWN ARE FROM FIELD OBSERVA77ONS AND OR DATA OBTAINED FROM OTHERS. AREA:19190.78 Sq. Feet or 0.44 ACRES ELEVA7701V DATUM: UNAUTHOR12ED AL7ERA770N OR ADD17701V TO THIS SURVEY IS A WOLA770N OF SEC77ON 7209 OF THE NEW YORK STATE EDUCA77ON LAW. COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYORS EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE 77XE COMPANY, GOVERNMENTAL AGENCY AND LENDING INS77TU77ON LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INS777U770N, GUARANTEES ARE NOT TRANSFERABLE. THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE EREC77ON OF FENCES, ADD17701VAL STRUCTURES OR AND OTHER IMPROVEMENTS EASEMENTS ANDIOR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT DN THE PREMISES AT THE 77ME OF SURVEY SURVEY OF.DESCRIBED PROPERTYj NE CERTIFIED TO:W. TODD JEFFCOAT; MAP OP M DESIRES VISCEOLIA• FILED: ,W SPANO ABSTRACT SERVICE CORP. SP1647—S'. " FIRST AMERICAN TITLE INSURANCE COMPANY; SITUATED AT.LAUREL UTHOLD SUFFOLKOCOUNTY, NEW YORK ' ' Professional Hazy 153 eb eNevYork11931ry1A1 C S 6u FILE 9225-91 SCALE:1"=40' DATE:APRIL 24, 2025 N.Y.S. LISC. N0. DSlP682 PHONE(581)298-1558 FAX(031) 2ee-1585 BUILDING DEPARTMENT- Electrical Inspector 4 « eqnr TOWN OF SOUTHOLD Town Hall Annex- 54375 Main Road - PO Box 1179 4 Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 jamesh@southoldtownny.gov seand seutholdtownn . ov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: Company Name: Electrician's Name: License No.: Elec. email: Elec. Phone No: ❑1 request an email copy of Certificate of Compliance Elec. Address.: JOB SITE INFORMATION (All Information Required) Name: ei o Address: IL-4 0 e c-ok.c- 6e ,f ,:,k eta &tre, Cross Street: , Phone No.: Bldg.Permit#: email: Tax Map District: 1000 Section: Block: Lot: BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): a S LL11, ' Ci S uawr"e Footage: Circle All That Apply: Is job ready for inspection?: YES NO Rough In Final Do you need a Temp Certificate?: YES R NO Issued On Temp Information: (All information required) Service Size Ell Ph 03 Ph Size: A # Meters Old Meter# ❑New Service[]Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground❑Overhead # Underground Laterals 1 2 H Frame D Pole Work done on Service? Y N Additional Information:. PAYMENT DUE WITH APPLICATION 1 4 ��665 A 1� XR DATE MFR 5I2017 Np. 4TTflS036H 1000NA V01TS 211 230 PM 1 Hi 60 SEWAI MC. 171827F6SF 15.0 AM?5 INIMLM C6ACUIT NAIALETY USA CANADA OVEPNT PROTECTIVE DEVICE SD gist I 96 All FUSE lAEAlER IRA 13 02,OR 2.16 kglsll HFC -410A 4 10"_7'i C.Mo ICll�ll y .6 i.uv..-.... - 1M .NFA iIMGRNC COOLING TRAME ECOIPMEMI N = AXUSIXE650i1NGFR.NOLI MMC _ 1lty9g]X IYIEA,TX 75701 Af1E1111FO M UNA 75 lAA GOOMtsm ml 14H ,4 zue DL V 1/S H1 C Iwl. 0 7 FLA 20Ef290 v CE510.X RI-NqX dk LPA'IEI F.ID.DLR �� InNI>IIPtMIb11W In Soul»nI and Sou1Nw>a1 MII► _ ,�aa`�.1 C_ERTIFIED� ', lN��Ii11�N1111 C�9 kve,.n R^° IN, ma iN �� x' F- i �� _ -�_ �.-.___ -Tom+.-� __ �:. -`' ':�► .� ._�_`, j