HomeMy WebLinkAbout52013-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#: 52013 Date: 06/18/2025
Permission is hereby granted to:
Anek Holdings LLC
7345 Soundview Ave
Southold, NY 11971
To:
legalize "as built"central air conditioning to an existing building as applied for.
Premises Located at:
1235 Youngs Ave, Southold, NY 11971
SCTM#60.-2-4
Pursuant to application dated 05/15/2025 and approved by the Building Inspector.:
To expire on 06/18/2027.
Contractors:
Required Inspections:
Fees:
As Built Alteration $500.00
ELECTRIC -Residential $200.00
CO-RESIDENTIAL $100.00
Total $800.00
__- Building Inspector
r
FFe n
G 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 s:1/www. outho1dtq vnny.gov
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
PERMIT NO. 5 3 Building Inspector; Y 5
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: I ®��
OWNER(S)OF PROPERTY:
Name: Ane
,k Ho[ ILl LL SCTM# 1000-
Project Address: 55 XeukwoAve, /V y rl Y'7r
Email: '
Phone#: �3i ' �� 7 43 � :z��',�c ��`I��'�, I� � � .
Mailing Address: S';Dt/YI
CONTACT PERSON:
Name: 74 V)Y)a Vim' Z L-"-) L-�S IGQ,
Mailing Address: SOS
Phone#: 6 (0 7 —/ ? J Email: song L°
DESIGN PROFESSIONILINFORMATION:
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name: Lam,
Mailing Address:
1 .,
Phone#: x4 �. '? ry i Email: W I_TZO w Q I I'LOrr \/IZ4 oo.
DESCRIPTION OF PROPOSED CONSTRUCTION
[]New Structure ❑Addition ❑Alteration epair ❑Demolition Estimated Cost of Project:
❑Other $
Will the lot be re-graded? ❑YesWo Will excess fill be removed from premises? ❑Yes ONO
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? ❑Yes 2No 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 210AS of the New York State Penal Law.
Application Submitted By(print name): AA/NA- 1/(o2 LC lc'S(/�!-r ❑Authorized Agent ❑Owner
T
Signature of Applicant � �w Date:
CONNIE D.BUNCH /
STATE OF NEW YORK) Notary Public,State of New York
SS: No.01 BU6185050
COUNTY OF Qualified in Suffolk County
Commission Expires April 14, 2-0_0
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 {4^/
day of , 20
Notary Public
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
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
� ,Uf folk ., 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
k ,
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (Au information Required) Date:. _f/
Company Name: t �"r'e c�¢rt C /h
Electrician's Name: k k
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:
E L l rV6S IBC
Address: ? `
Cross Street:
Phone No.:
Bldg.Permit#: email:
Tax Map District: 1000 Section Block: Lot;
BRIEF DESCRIPTIN OF W R_K, INCLUDE SQUARE FOOTAGE (.Please Print Clearly):.
Square Footage:
Circle All That Apply:
Is job ready for inspection?: YES NO 0 Rough In Final
Do you need a Temp Certificate?: YES NO Issued On
Temp Information: (All information required)
Service SizeEl1 Ph F-13 Ph Size: A # Meters Old Meter#
❑New Service❑Fire Reconnect[—]Flood Reconnect❑Service Reconnect❑Underground Eloverhead
Underground Laterals 1 2 H Frame Pole Work done on Service? Y N
Additional Information
PAYMENT CLUE WITH APPLICATION
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