HomeMy WebLinkAbout52042-Z a 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#: 52042 Date: 06/26/2025
Permission is hereby granted to:
Deanna Alpert
5050 Pequash Ave
Cutchogue, NY 11935
To:
legalize "as built"generator as applied for.
Premises Located at:
5050 Pequash Ave, Cutchogue, NY 11935
SCTM# 110.-3-25
Pursuant to application dated 05/22/2025 and approved by the Building Inspector.
To expire on 06/26/2027.
Contractors:
Required Inspections:
Fees:
As Built Generator $250.00
ELECTRIC -Residential $200.00
CO-RESIDENTIAL $100.00
Total S550.00
Building Inspector
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
u Telephone (631) 765-1802 Fax(631) 765-9502 tact :// ww.southoldtowiin . ors
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
Building Inspector.NO. f�)� p,..
ncortr let
s led d �rf their a!n re t � :
a�f�c�tla� wl� f►�tba f e}� �1"� 11 r A#o fha� e, n, Br5iNing Department
ti�ivrs r` I�uthplisa Rr� P ^ sr�i f( , ap1 >ec� Town of SoaprhoN
Date:May 20, 2025
;art %�" PRO
Name:Deanna Alpert SCTM#1000-110-00-03-00-025-000
Project Address: 5050 Pequash Avenue, Cutchogue, NY 11935
Phone#:(631) 800-9930 Email.oneoldvolce@gmall.com
Mailing Address: 5050 Pequash Avenue, Cutchogue, NY 11935
CONTACT PERSON ,
Name:Deanna Alpert
Mailing Address: 5050 Pequash Avenue, Cutchogue, NY 11935
Phone#:(631) 800-9930 Email:oneoldvoice@gmail.com
��DESJGI�I�F�OFESSIONAI INFORMATION:- =`
ti
Name:N/A
Mailing Address:
Phone#: Email:
COI1fT'RACTOR IIVFORMATIOM �"
Name:N/A
Mailing Address:
Phone#: Email:
gESCRIPTIdIV'OF PROPOSED CONSTRUCTION:
❑New Structure ❑Addition ❑Alteration ❑ReP air ❑Demolition Estimated Cost of Project:
■Other"As Is"..--generator $
Will the lot be re-graded? ❑Yes El No 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 ❑No IF YES, PROVIDE A COPY.
OECi(BGX After Reading The oumer/cc� tractor/des"IF rofcssldml Is rosponslble for atl drat a a�ld storm water Issues ash / d by
cha er 236 of the Ygwil Code APP',aUCATION 45 HE1{E9Y IYIIADT to Building deparSmenf for the lss}�ahce cif flu�dng PeSrn pursuant tl ui�yflna Zo„rye
l)rdjnance of the Town of Southold,Suffol)c,County,New l/ork and other appl#cjf�#e lafMs, npndEs or l#eu ns r thr sga�str�6 rlr176s� /
ad/ `s alteratlo s or ►emova#or demo#Itf+n a he d crlbfd The e�{ptFfkant �to comply With al�appl bk laws,erdLunces�t(u LtB code,
' I� ) necesdaty L4¢pectfarss
housM�wdEarrd n�ulatlorr�and fo adm�t aytfrorlfed Irrspeda�a�fp�fj+ist;E��in bul s�oI
r /i � / r�, oirii ,,,,,,� /r /„, //,„✓//, /ir r r am/ r r r/6 r r/0%r r
p[lrfls(iau�e as a(`bass A mtstlemeanor pursuant to Section 210AS of the New Yark S`�ate�ena I.aw '
else statdmerttz mace#rentln arc
Application Submitted By(print name):Deanna Alpert ❑Authorized Agent NOwner
Signature of Applicant: Date:
CONNIE D. BUNCH
Notary Public,State of New York
STATE OF NEW YORK) No.01 BU6185050
SS: Qualified in Suffolk County
COUNTY OF )
Commission Expires April 14, 2
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.
me this
Swornore �-� 20
day of �L
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
P�, BUILDING DEPARTMENT-Electrical Inspector
�VOl TOWN OF SOUTHOLD
Town Hall Annex- 54375 Main Road - PO Box 1179
Southold New York 11971-0959
Telephone (631) 765-1802
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date:
Company Name:
Electrician's Name:.
License No.: Elec. email:
Elec. Phone No: ❑I request an email copy of Certificate of Compliance
Elec. Address.:
JOB SITE INFORMATION (All Information Required)
Name: Deanna Alpert
Address: 5050 P uash Avenue, Cutch2que, NY 11935
Cross Street: Southern Cross Road
Phone No.: (631) 300-9930
Bldg.Permit#: 62Memail
Tax Map District: 1 1000 Section:110 Block:3 Lot:25
BRIEF DESCRIPTION OF WVORC, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
Need CO for"as is"-gnerator that was installed.
Square Footage:
Circle All That Apply:
Is job ready for inspection?: Z YES®NO Rough In Final
Do you need a Temp Certificate?: YES NO Issued On
Temp Information: (All information required)
Service Size❑1 Ph 3 Ph Size: A #Meters Old Meter#
❑New Service❑Fire Reconnect[-]Flood Reconnect❑Service Reconnect❑Underground(Overhead
#Und'erground! Laterals 1 n2 H Frame Pole Work done on Service? Y N
Additional Information:
PAYMENT DUE WITH APPLICATION
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