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Home My WebLink About52054-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#: 52054 Date: 07/01/2025 Permission is hereby granted to: Orient Fire District 23300 Route 25 Orient, NY 11957 To: Modify existing wireless location to install T-Mobile service to include replacing antennas and related components as well as replacement ground equipment on the existing fenced compound on the concrete pad per Planning approval.Additional certification may be required. Premises Located at: 23300 Route 25, Orient, NY 11957 SCTM# 18.-5-13.8 Pursuant to application dated 04/14/2025 and approved by the Building Inspector. To expire on 07/01/2027. Contractors: Required Inspections: Fees: WIRELESS COMMUNICATIONS -MODIFICATIONS $500.00 CO Commercial $100.00 Electrical-Commercial $150.00 Total S750.00 Building 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 i ttl)s://w%N'W.southoldtown.ny.gov Date Received APPLICATION FOR BUILDING PERMIT �' For Office Use Onlyppq�pp'� 1 `��,,) PERMIT NO. 5dOS L� Building Inspector: M Applications and forms must be filled out in their entirety.Incomplete applications will not be accepted. Where the Applicant is not the owner,an Owner's Authorization form(Page 2)shall be completed. Date: OWNER(S)OF PROPERTY: Name:Orient Fire District scTM#s000-18-5-13.8 Project Address:23300 Route 25,Orient Phone#:631-323-2445 Email:OrientFD@optonline.net Mailing Address:23300 Rt 25 Orient CONTACT PERSON: Name:Marie Russo Mailing Address:225 Kingston Dr, Ridge, NY 11961 Phone#:516-810-1117 I!mail:mrusso@highlanderinc.com DESIGN PROFESSIONAL INFORMATION: Name:Scott A Wirgau Mailing Address:1 Fenton Main-St300, Cary, NC 27511 Phone#:919-468-0112 Email:christopher.sandor@americantower.com CONTRACTOR INFORMATION: Name:Comcell Construction Corp Mailing Address:1373 Lincoln Ave, Holbrook, NY 11741 Phone#:631654-5915 1Email:MikeA@com-cell.com DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ®Alteration ❑Repair ❑Demolition Estimated Cost of Project: [--]Other $ 25,000.00 Will the lot be re-graded? Dyes RNo Will excess fill be removed from premises? Dyes ®'No 1 PROPERTY INFORMATION Existing use of property:Utility/telecom Intended use of property:Utility/telecom Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to institutional this property? []Yes 8'NO IF YES, PROVIDE A COPY. N 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 210.45 of the New York State Penal Law. Application Submitted 6Y(print name):Marie Russo ®Authorized Agent []Owner Signature of Applicant: Date: STATE OF NEW YORK) SS: COUNTY OF Suffolk ) Marie Russo being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the Agent for T-Mobile (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 af�plication file therewith. Sworn before me this day of A � 202S, Notary Public GABRIELLE CORSETTI OTA4RY PUBLIC STATE OF NEW YORK QUALIFIED IN SUFFOLK COLT TY o f T o EJ'THORIZATION LIC,#5050248 COMM.EXP,Oct P� 0:k� (Where the applicant is not the owner) C - residing at MA I,) �J ORTIr-r /V do hereby authorize Marie Russo Agent for T-Mobile to apply on my be' If to the Town of Southold Building Department for approval as described herein. Owner's Signatu Ue Date Print Owner's Name 2 of FO BUILDING DEPARTMENT- Electrical Inspector o" wa TOWN OF SOUTHOLD AZZ Town Hall Annex- 54375 Main Road - PO Box 1179 w � Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 " a . ov— seand southoldtownn ov " � 'amesh �southoidtownn APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: April 1, 2025 Company Name: Highlander Consultants Inc. Electrician's Name: To Be Determined License No.: Elec. email:mrusso@highlanderinc.com Elec. Phone No: I request an email copy of Certificate of Compliance Elec. Address.:. JOB SITE INFORMATION (All Information Required) Name: Orient Fire District/T-Mobile Address: 23300 Route 25, Orient/ 155 Carleton Ave, E. Islip, NY 11730 Cross Street: Phone No.: 6313232445 BIdg.Permit#: 5 4 email: mrusso@highlanderinc.com Tax Map District: 1000 Section:18 Block: 5 Lot: 13.8 BRIEF (DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): upgrade to existing telecommunications facility 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 y p Issued On Temp Information: (All information required) Service Size 1:11 Ph 3 Ph Size: A # Meters Old Meter# ❑New Service❑Fire Reconnect[]Flood Reconnect❑Service Reconnect❑Underground[—]Overhead #Underground Laterals 1 2 H Frame Pole Work done on Service? Y N Additional Information- PAYMENT DUE WITH APPLICATION 5-3 AP 1 4 025 S0UTH0LD TOWN G BOARD Highlander Consultants, Inc. PLANIN April 1, 2025 Town of Southold PO Box 1179 Southold, NY 11971 Attention: Building Department Re:Application for building permit Applicant:T-Mobile Northeast LLC(LI13883 Orient FD) Premises:Orient FD Cell tower 23300 Rt 25,Orient SCT M#: 1000-18-5-13.8 Dear Sir/Madam. Enclosed herewith you will find the following in regard to the application for a building permit for T- Mobiles upgrade to its existing telecommunications facility at the above-named site: 1. Application for building permit 2. Filing fee check in the amount of$375.00(Accessory:$125; Electrical:$150; COO commercial $100) 3. Certificates of Workers Compensation Insurance, Disability Insurance and Liability Insurance for general contractor, Comcell Construction Corp. 4. Four(4)sets of signed and sealed construction drawings for T-Mobile Please advise when building permit is ready. Thank you for your courtesy and cooperation in this matter. Very truly yours, J", M �l 155 Carleton Avenue, East Islip,New York 11730 Telephone: 516-810-1117 Email: mrusso@highlanderinc.com