HomeMy WebLinkAbout52077-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#: 52077 Date: 07/09/2025
Permission is hereby granted to:
Richard E Braunstein
34 Belmont Dr W
Roslyn Heights, NY 11577
To:
install generator as applied for. Provide protection from vehicle impact.
Premises Located at:
1885 Pt Pleasant Rd, Mattituck, NY 11952
SCTM# 114.4-7.2
Pursuant to application dated 04/30/2025 and approved by the Building Inspector.
To expire on 07/09/2027.
Contractors:
Required Inspections:
Fees:
GENERATOR $125.00
CO-RESIDENTIAL $100.00
ELECTRIC -Residential $100.00
Total S325.00
�� wilding 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 litti)s://www.,otitiioldtownjiv,.epv
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only 6
i
6
S T
PERMIT NO. BuildingInsprector; �,�'� 2025. „.
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. 'lw "� �
Date: - d-s-;�5
OWNER(S)OF PROPERTY:
Name:Richard Braunstein SCrM#1000-114-1-7.2
Project Address:1885 Point Pleasant Rd Mattituck, NY 11952
Phone#:917-359-3762 Email:richardbraunstein@gmail.com
Mailing Address:
CONTACT PERSON:
Name:Jesse Gaffga
Mailing Address:3350 Grand Ave Mattituck, NY 11952
Phone#:631-375-2737 Email:jga ga@ j echss.corn
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
-Name:,j-Tech
Mailing Address:3350 Grand Ave Mattituck NY 11952
Phone#:631-375- � "37 I - 11 11 1 1 1 Ema!I J94 ff9 @JteChSS.COm
DESCRIPTION OF PROPOSED CONSTRUCTION
[]New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
!]Other48KW stand by Generator $25000.
Will the lot be re-graded? ❑Yes R No Will excess fill be removed from premises? ❑Yes @No
1
PROPERTY INFORMA71ON
Existing use of property:Slilgle Family _ Intended use of property:Single Family
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.
M 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 Regulations6 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 buildingis)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 iprint name):Jesse Gaffga MAuthorized Agent ❑Owner
Signature of Applicant: Date: Z%_
STATE OF NEW YORK)
SS:
COUNTY OF
Jesse Gaffga being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the Contractor
(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
day of
Notary Public %LRRY
_-
VIC
Notary Public- State of Ne 'York
PROPERTY OWNERAUTHORIZATION No. 01 BE6070081
(Where the applicant is not the owner) Qualified in Suffolk Cou i,ty
Commission Expires "°
Richard Braunstein residing at 1885 Point Pleasant Rd
Mattituck, NY 11952 do hereby authorize Jesse Gaffga to apply on
my f to the en o S hold Building I artment for approval as described herein.
x" 04/17,
Owner's Signatu Date
Richard Braunstein
Print Owner's Name
2
BUILDING DEPARTMENT-Electrical Inspector
TOWN OF SOUTHOLD
" Town Hall Annex-54375 Main Road - PO Box 1179
Southold, New York 11971-0959
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Telephone (631) 765-1802- FAX(631) 765-9502
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APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (Au Information Required) Date: - .
Company Name: �t " ..
Electrician's Name: QN k'-v 0
License No.: Elec. email:
Elec. Phone No: -*Z CA ) `li( ❑I request an email copy of Certificate of Compliance
Elec. Address.: QtEe- Lit Lava
JOB SITE INFORMATION (All Information Required)
Name: Richard Braunstein
Address: 1885 Point Pleasant Rd Mattituck, NY 11952
Cross Street: Westphalia Ave
Phone No.: 917-359-3762
Bldg.Permit#: Ez I email:richardbraunstein@gmail.com
Tax Mae District: 1000 Section:114 Block: 1 Lot:7.2
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
Install 48KW Generac Generator
S uare Footage:
Circle All That Apply:
Is job ready for inspection?: ❑ YES NO []Rough In ❑ Final
Do you need a Temp Certificate?: YES NO Issued On
Temp Information: (All information required)
Service SizeD Ph 3 Ph Size: A #Meters Old Meter#
❑New Service❑Fire Reconnect[]Flood Reconnect❑Service Reconnect[:]Underground Iaverhead
#Underground Laterals 0 1 H Frame Pole Work done on Service? Y N
Additional Informabon:
PAYMENT'DUE WITH APPLICATION
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ROSLYN HEIGHTS, NY 11577 AAT40
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