HomeMy WebLinkAbout52899-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#: 52899 Date: 04/21/2026
Permission is hereby granted to:
Beth H Anderson
PO BOX 1197
Quogue, NY 11959
To:
install an EV charger in an existing accessory garage as applied for. Protection from vehicle impact
will be required.
Premises Located at:
1345 Founders Path, Southold, NY 11971
SCTM# 64.-4-18
Pursuant to application dated 04/10/2026 and approved by the Building Inspector.
To expire on 04/20/2028.
Contractors:
Required Inspections:
Fees:
EV Charger $125.00
CO Accessory $100.00
Total S225.00
����� Building Inspector
� ta�t TOWN OF SOUTHOLD—BUILDING DEPARTMENT
� Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
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Telephone (631) 765-1802 Fax (631) 765-9502 litter//NK!K �!. otjtltoldtQw ii -qv
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
PERMIT NO. -/ , Building Inspector.
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: -1 nd Q-rso SCTM#100i
Project Address: 41 Jr. Fo L&h d e,r5 F-HI 50 CJ I CQ
Phone#:G ) 3e.15 Email: "8HA /098G- Mail
Mailing Address:To i3o i ) aj q 5 cf
CONTACT PERSON:
Name: 'K r
Mailing Address: C�C,�
Phone#: coo I 3 � Email: � /d 7 G Mali Co
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name:
Mailing Address:12Cf� �I 0 �71 GY)CJ(2t Ny 1 1 0
Phone#631 G(b3 11 Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition �timat d Cost of Pro ct:
❑ h Other ar-
Will the lot be re-graded? ❑Yes�No Will excess fill be removed from premises? ❑Yes No
1
TITLE N0. 72 S-Or032 8k S
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Unauthorized alteration or addition to this survey Is a violaHo of
.9 section 7209 of the New York State Education Law.
Copies of this survey mop not bearing the land surveyor's liked
seal or embossed seal shcll not be considered to be a valid capy
.� Guarantees or corti:ica'.: _ , ', rJ iie con An!I run only to the
person for whom the rv,vc, i• -r•-„r—1,and •^n I is behalf to the
title company, governmentol ovncy and J,&nding institution li ,,d
hereon,and to the assignees of the lending institution. Guaran loss
or certifications are not transferable to odditional [j)ptilutionj or
subsequent owners.
SURVEY FOR REFERENCE r
EUGENE F MURPHY SUBDIVISION MAP OF FOUNDERS ESTATES
AT SOUTHOLI? MAP NO 534, FILED MAY 10,I927
TOWN OF SOUTHOLD GUARAIMED TO,
SUFFOLK COUNTY) N.Y. CHICAGO TITLE INSURANCE COMPANY
SOUTHOLD SAVINGS BANK
SCALE : Ise= SO` EUGENE F. MURPHY
APRIL 10,1972
LAND SURVEYOR
t
cUIk4 + BUILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD- Town Hall Annex - 54375 Main Road -
PO Box 1179
ca
Southold, New York 11971-0959
* c� Telephone (631) 765-1802
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (Ail information quired) Date:
Company Name: f
Electrician's Name: i<r
License No.: Y57— yylC Elec. email: I'
Elec. Phone No: ❑I request an email copy of C rtificate of Compliance
Elec. Address./2(76 -,Z� = L! f-
JOB SITE INFORMATION (All Information Required)
Name: 0� - Lde-n5o
Address: Ems,,
Cross Street:
Phone No.: Mi
Bldg.Permit#: email:
Tax Map District: 1000 Section: Block: Lot:
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
(/"5f CLkk CE lZ Ck cxv-q le-4 --
Square Foota e:
Circle All That Apply:
Is job ready for inspection?: YES BNO []Rough In Final
Do you need a Temp Certificate?: F-1 YESE�JNO Issued On
Temp Information: (All information required)
Service Size Ill Ph F-13 Ph Size: A # Meters Old Meter#
❑New Service❑Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground❑Overhead
# Underground Laterals M 1 02 0 H Frame n Pole Work done on Service? Y ON
Additional Information:
PAYMENT DUE WITH APPLICATION
APB ASNOTED
GA � � B.P.#
FEE BY.
NOTIFY BUILDING DEPARTMENT AT COMPLYIT ALL CODES
631-765-1802 8AM TO 4PM FOR THE NEW YORK STATE
,,.OWN CODES FOLLOWING INSPECTIONS: S E k E N C DF1 IONS OF
1. FOUNDATION-TWO REQUIRED
FOR POURED CONCRETE nD Z8A
2. ROUGH-FRAMING&PLUMBING � � � �� � �,
3. INSULATION
4. FINAL-CONSTRUCTION MUST SO � ,�OW�q 5iUST S
BE COMPLETE FOR C.O. N Y „
ALL CONSTRUCTION SHALL MEET THE $ ,i L RIP
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTON ERRORS
OCCUPANCY OR
USE IS UNLAWFUL ELECTR- ICAL
INSPECnON IRE
WITHOUT CERTIFICATE
OF OCCUPANCY
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