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HomeMy WebLinkAbout52580-Z TOWN OF SOUTHOLD BUILDING DEPARTMENT 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#: 52580 Date: 12/29/2025 Permission is hereby granted to: Jason Crane 4925 S Harbor Rd Southold, NY 11971 To: Install a generator accessory to a single-family dwelling as applied for per manufacturers specifications. Maintain side and rearyard setbacks at a minimum of 10feet. Premises Located at: 4925 S Harbor Rd, Southold, NY 11971 SCTM#87.4-12 Pursuant to application dated 11/07/2025 and approved by the Building Inspector. To expire on 12/29/2027. Contractors: Required Inspections: Fees: GENERATOR $125.00 CO Accessory $100.00 Total $225.00 Building Inspector TOWN OF SOUTHOLD--BUILDING DEPARTMENT of Town Hall Annex 54375 Main Road P. 0. Box 1179 Southold, NY 11971-095 9 quay Telephone 631 765-102 Fax 631 765-9502 htt . LL �4 �s,, o dt0 � . p ran rc Date Received i APPLICATION FOR BUILDING PERMIT For Office Use Only PERMIT N0 :� Applications and forms mint be filled out in their entirety.Incomplete y �� � N�« µ'. applications will not be accepted. Where the Applicant is not the owner,an Owner's Authorization farm(Page 2)shall be completed'. Date:16 ; ; � OWNERS of PROPERTY: Name* r. SCTM # c�.,. P ro ject Ad d ress j q m Phone#:(6` Mailing Address: c >04e7 CONTACT PERSON: Names 4�E*H f J e0,9+f m Mailing Address: r'� � e� Phone#: °j'"""� Email: DESIGN PROFESSIONAL.INFORMATION: Name: Mailing Address: ,r==. Phone#: ° c CONTRACTOR INFORMATION ,r Nam e: �[ t �� C, 0,0�� /.Z IdL/ Mailing Address. ,Qr c .. c0 Phone#:&-" Email , ��-- :3 DESCRIPTIoN OF PROPOSED CONSTRUCTION New Structure QAddition EAlteration ❑Repair ❑Dernolition Estimated Cost of Project: S;?6therl, � Will the lot be re-graded? ©Yes o Will excess fill be removed from premises? ❑Yes ........... 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? E]Yes ❑No IF YES, PROVIDE A COPY. El 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 appficable 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 By(print name): uthorized Agent El Owner Signature of Applican Date: STATE OF NEW YORK) SS: COUNTY OF �'�` t�:lit C4 Co being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)he is the (Contra:c", r, Agent,. 111110 rporate Officer, etc.) of said owner or owners, and is duly,authorized or have performed the said work and to make and file this t or 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 tin —day of 20 (:)4otary Public DVNE13 PROPERTY OWNER AUTHORIZATION N0rj_,%Ry PUPVC,STATE OF NEW YORK "'0-U1,QW63Ctq0o (Where the applicant is not the owner) 4 1.1-,"r"'E:o J'F'J,S)lJ,�":F0L,K COUNTY colmmf",S.'Orj JUINE.30,24" 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 ------------------- » BUILDING DEPARTMENT- Electrical Inspector t ' v TOWN of SOUTHOLD ., Town Hall Annex-- 5375 fain Road - PCB Box 1179 Ze Southold New'York 1 1 971-9959 Telephone (631) 765-1892 e . APPLICATION FOR 'LE TR A , INSPECTION .......... ELECTRICIAN INFORMATION (All Information enquired) Date: � Company Narne: /00 7A Electrician's Name: 11111111111141c:2 License No.■ Elec email. � - I request an email copy of Certificate of Compliance ...................... Elec. Phone No. . Z.;5` Elec. Address.. c JOB SITE INFORMATION (All Information Required) Name: .... so tj gyp.. t,i ............ Address: 11 Cross Street: Phone o.: �',. , &0.- 1 Bld .Permit#: email: � Tax Map District: 1000 Section: Block: Lot: BRIEF DESCRIPTION OF WORK,, I C U E �S U R,E FOOTAGE (Please Print Clearly):' u -- S re Footage. Circle All That Apw Is job read for inspection?: 'YESqfe0Ne'09 Rough In Final Y p Do you need a Temp Certificate?: 'YES wo Issued Can Temp Information: (All information required) Service Size Ph Ph Size: 2,..�Qcq # Meters Old Meter# r t; Flood ReconnectF�Service Reconnect nderground F]Overhead New Serv�ce�Fire Recor� c ❑ Underground Laterals H Frame Pole Work done on Service? Y N Additional Information: PAYMENT.DUE WITH APPLICATION Ll ty ----'-= U Y L RENSSELAER G.7LRRY,Jr, ^