HomeMy WebLinkAbout52981-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#: 52981 Date: 05/15/2026
Permission is hereby granted to:
Virginia Principi
PO BOX 1248
Southold, NY 11971
To:
legalize "as built" central air conditioning to an existing single-family dwelling as applied for,,
Premises Located at:
10947 N Bayview Rd, Southold, NY 11971
SCTM# 79.-5-20.11
Pursuant to application dated 05/08/2026 and approved by the Building Inspector.
To expire on 05/14/2028.
Contractors:
Required Inspections@,
Fees,
As Built HVAC $500.00
CO-RESIDENTIAL $100.00
I Total 600.00
ing Inspector
I
TO OFC�XJTHCJLD— BUILDING DEPARTMENT
` ad P. O. Box 1179 Southold NY 11971-0959
Town Hall Annex 54375 Main Road ,
Telephone (631) 765-1802 Fax (631) 7�5-9502 hit "M/ .soutl 1, t wnn . av,,
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
PERMIT NO, !"01 Building Inspector.
Applications and forms must be filled out in-their entirety.Incomplete
applications will not be accepted. 'There the Applicant Is not the owner,are
Owner's Authorization farm(Page 2)shall be com feted.
Date:
OWNER(S)of PROPERTY:
Name: SCTM # 1000- '-- �-
1 C WA*)I_0<Z_A4 Al ,
Project A,ddxg;k Opp"
Phone#c It Email: 01L o 6 ............................................ ......s�
Mailing Address: 0 ICA?Ap,kf'
CONTACT PERSON:
Names
A;
Mailing Address:
Phone#: Email
DESIGN PROFESSIONAL INFORMATION:
Na me: A
Mailing Address.-
Phone# Email:
CONTRACTOR INFORMATION:
Name:
Wi%intAddress.
Phone#: Email:
DESCRIPTION of PROPOSED CONSTRUCTION
C-INew Structure ❑Addition F-]Alteration ❑Repair ❑Demolition Estimated Cost of Project:
Other $
Will excess fill be removed from remises? ❑Yes ❑No
Will the lot be re-graded? ❑Yes o p
1
F- 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
ZIA this property? Oyes F�No IF YES, PROVIDE A COPY.
D 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,
ho
using Ing code and regulations and to admit authorized Inspectors on premises and in building(s)for necessary Inspections.False statements made herein are
ou'p punishable as a Class A misdemeanor pursuant to Section 210.45 of the New York State Penal Law.
A pplication Submitted By ElAuthorized Agent ElOwner
rint D;
Signature of Applicant: Date:
I INNIE D.BUNCH
of r Public,State of New York
STATE OF NEWYORK) No.01 BU6185050
Qualified In Suffolk County
SS: Commission Expires April 14,2
COUNTY OF
being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
N 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
day of 20
Notary Public
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
pq C 0 residing at
0
,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
...........
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DATE 0212001
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MOD. NO. TTX060D100AO VOLTS 208/230
SERIAL NO. Z073WM41 F PH 1 Hz 60 �-
MINIMUM CIRCUIT AMPACITY 38.0 AMPS
OVERCURRENT PROTECTIVE DEVICE USA CANADA
MIN FUSE / BREAKER (HACK) 60 60
MAX FUSE / BREAKER (HACK) 60 60
HCFC — 22 8 LBS. 11 OZ. OR 3.94 Kg(si)
BAYFCCV 092A REQUIRED INDOORS FOR RATED PERFORMANCE
THE TRANE COMPANY /�. OUTDOOR t1SE
YLER, TX 75711 -9010 ASSEMBLED IN USA C "'L.
COMPR. MOT. 29.0 RLA 208/230 v 169 L A
O.D. MOT, 1 .90 FLA 200/230 v 114 11P
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