HomeMy WebLinkAbout52663-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#: 52663 Date: 02/11/2026
Permission is hereby granted to:
Brophy Family Trt
9525 SW Lodestone Dr
Beaverton, OR 97007
To:
Legalize an "as built" HVAC split system to an existing single-family dwelling as applied for per
manufactures specification. Floodplain development permit is required.
Premises Located at:
75 Second St, New Suffolk, NY 11956
SCTM# 117.-10-20.7
Pursuant to application dated 12/22/2025 and approved by the Building Inspector.
To expire on 02/11/2028.
Contractors:
Required Inspections:
Fees:
As Built HVAC $500.00
CO Single Family Dwelling-Addition /Alteration $100.00
Flood Permit $150.00
Total $750.00
i
Building Inspector
ry ry. TOWN F SOUTHOLD--BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. 0. :Box 1179 Southold,NY11971-0959
u Telephone (631) 765-1802 Fax (631) 765-9502 11"'t W.soutboldtos "
" u
WIN N ONION Is
Date Received
APPLICATION FOR BU
L �V L,
For Office Use Only
5 PERMIT N0. d, Building Inspector. `�..s�
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:l2 f l8 j25
OWNER(S) OF PROPERTY:
Name:Theresa Brophy -------
SCTM#l000-117.-10-20.7
Project Address:75 2nd Street, New Suffolk, NY 11956
Phone#:253-377-1700 Email:tbrophy@rjkconstruction.biz
Mailing Address:9525 SW Lodestone Drive, Beaverton,OR 97007
CONTACT PERSON:
Name:Krista Janes
Mailing Address:3685 Elijahs Lane, Mattituc"k, NY 11952
Phone#:631-335-8175 Email:mil[stonepropertyservices@gmail.com
O DESIGN PROFESSIONAL INFOR
MATION:
N:
Name:n/a
Mailing Address,
Phone#: Email:
CONTRACTOR INFORMATION:
Name:n/a
MW
Mailing Address:
Phone#: Email.-
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition C]Alterativn [:]Repair ❑Demolition Estimated Cost of Project:
WOther Air conditioning as-built $n/a
Will the lot be re-graded? C]Yes *No Will excess fill be removed from premises? ClYes C]No
1
PROPERTY INFORMATION
Existing use of property:residential intended use of property:residential
Zone or use district in which premises is situated: I Are there any covenants and restrictions with respect to
R-40 this property? F-lYes rm-lNo IF YES, PROVIDE A COPY.
N issue o, I ci�iiiieck,1111�1111ox Afte�r Reading.- The owner/contractor/desisn professional Is responsible for all drainage and to wate r s as pr v ded 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.
Krista Jones
Application Submitted By(print name): NAuthorized Agent 0Owner
Signature of Applicant: '`��..
CONNIE D.BUNCH Date:
Notary Public,State of New York
STATE OF NEW YORK) No.01 BUS 1 85050
SS: Qualified In Suffolk County C)#C-�
COU NTY 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.
Sworn before me this
A -"�)-' f day w
..........
Notary Public
PROPE11TY OWNER AUTHORIZATION
(Where the applicant is not the owner)
Theresa Brophy I residing at 75 2nd Street, New Suffolk, NY 11956
do hereby authorize Krista Jones to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
IN
Dec 19,2025
Owner's Signature Date
Theresa Brophy
Print Owner's Name
2
37-
-A
Application-for-AC Permit- tr t
Final Audit Report 2025-12-19
Created: 2025-12-18
By: Krista Jones(millstonepropertyservices@gmail.com)
Status: Signed
Transaction ID: CBJCHBCAABAAGLRfOTNasCFmiaw9OGr3URi-Lrp7vG_e
"Application-for-AC Permit-75 2nd Street" History
n Document created by Krista Jones(milistonepropertyservices@gmail.com)
2025-12-18-10:58:33 PM GMT
``+ Document emailed to Theresa Brophy(tbrophy@rjkconstruction.biz)for signature
2025-12-18-10:59:16 PM GMT
Email viewed by Theresa Brophy(tbrophy@rjkconstruction.biz)
2025-12-18-11:07:45 PM GMT
-,'rQ Document e-signed by Theresa Brophy (tbrophy@rjkconstruction.biz)
Signature Date:2025-12-19-5:09:02 PM GMT-Time Source:server
Agreement completed.
2025-12-19-5:09:02 PM GMT
Adobe Acrobat Sign
NOTES: SNOWFALL FROM DECEMBER 14, 2025 MAY CAUSE SOME FEATURES TO NOT BE DEPICTED ON THIS SURVEY.
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NEW SUFFOLK, TOWN OF SOUTHOLD — — OVERHEAD WIRES
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TAX No. 1000-11700-1000-020007 TREE
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DECEMBER 16, 2025 AERIAL LAND SURVEYING, D.P.C. Nmm ux.�mcNs AND EgSRNNCB OF ANY suswwAm
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75 2"d Street, New Suffolk
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SAIMMUM CIRCUIT ApIPACITY'. 18.0-. AMPS
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�`� MAX FUSE BREAKER(UACR) - 30 30,
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UNIT SUPPLY �nAi� 1 i 6D h11N.VOLTAGE VVOAi<.PL
APPROVED FOR HACR BR'rAKERS OR US.FUSE INS I ALLA
MAX,FUSE 25._AMps 4IJN CIRCUIT AMPACITY 22.1
FAN MOTOR 243_._''' 'r f
COMPRESSOR 12 11,7 SCCR 5 kA
REFRIGERANT R410A_ `
i FACTORY CHARGED 6_LBS,. 13 OZ
IFTHE LIQUID LNE EXCEEDS 96.6 PT PLUS 1 06 OZ.' U
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Zone #2: Office.
• One (1) Mitsubishi, model #MSZ-GS12NA, 12,000 BTU, ductless high efficiency fully
modulating wall mounted fan coil unit to be installed in the Office, exact location to be
determined.
Zone #2: Bedroom #1.
• One (1) Mitsubishi, model #MSZ-GS06NA, 6,000 BTU, ductless high efficiency fully
modulating wall mounted fan coil unit to be installed in the Bedroom #1, exact location to
be determined.
Zone #3: Bedroom #2.
• One (1) Mitsubishi, model #MSZ-GS06NA, 6,000 BTU, ductless high efficiency fully
modulating wall mounted fan coil unit to be installed in the Bedroom #2, exact location to
be determined.
Heat pump:
• One (1) Mitsubishi, model #MXZ-3C24NA, 24,000 BTU, multi-port Variable Refrigerant
Flow high efficiency outdoor heat pump condensing unit to be installed at the residence
exterior, exact location to be determined. Unit shall be set on a precast slab.