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Home My WebLink About53003-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#: 53003 Date: 05/20/2026 Permission is hereby granted to: Patricia A Aylward 14 Millstone Ln Cutchogue., NY 11935 To,: install central air conditioningto an existing single-family dwelling as applied for with flood permit. All equipment shall be installed at elevation 9.5'or higher. Premises Located at: 25 Beachwood Rdl Cutchogue, NY 11935 SCTM# 116.-4-30 Pursuant to application dated 05/20/2026 and approved by the Building inspector. To expire on 05/19/2028. Contractors: Required Inspections: ELECTRICAL- ROUGH PLUMBING ELECTRICAL- FINAL, FINAL, Fees: HVAC $250.00 Flood Permit $150-00 CO RESIDENTIAL $100.00 Total $500.00 Building Inspector ...................... *pl' BUILDING DEPARTMENT TOWN OF SOUTHOLD Town Hall Annex 54375 Main Road P. 0. Box 1179 Southold,NY 11971-0959 //WWW -ov Telephone (631) 765-1802 Fax (631) 765-9502 htto's'' ,,so,ti,thol,d��to��wii-tiy,, -------------------------- Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only PERMIT NO. Building Inspector: V n' ....................................................... ...........----- 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,q)OF PROPERTY: 7 11 Nam SCTM# 1000- Project Addres, 6 1(" S�x I t� Phone#: Ernaik&,, Mailing Address: Yt C4,�c-I�D& c� el "'O'n n'�Ieiit CONTACT PERSON: Name: two-Ad c, A,0 q t4',e A( 1( Mailing Address. Em a Yi ': Phone#: +,&'tq C"(I J DESIGN PROFESSIONAL INFORMATION: Name. A(A Mailing Address:, Phone#: Email, ................ CONTRACTOR INFORMATION: Name: Kob Mailing Address 0 7 )tale,, Phone#: (02 1 Email ("I— (? d' 0 ......................... DESCRIPTION OF PROPOSED CONSTRUCTION st ONew Str cturp RAddition Jteration F-IRepair, DDemolition E ated Cost of ecto ........... F-1 Ot h 0 L�'-eAtA, Will the lot be re-graded? E]Yes) No Will excess fill be removed from premises? []Yes KNO NIPPON------------ ......................... PROPERTY INFORMATION A. f1% Existina use of property: Intended use of property: e - e,SA ADb -�S— Zone or use district in which premises is situated: Are there any covenants Ond restrictions with respect to —R '.. 4 0 this property? nYes*o IF YES, PROVIDE A COPY. (Check Box After Reading: The owner/contractor/design professional Is responsWe'for all drainage and storm water issues as provided by apter 236 of the Town Code. APPUCATION IS HEREBY MADE to the Building Department ftrthel' Issuance of a BuRding Permit pursuant to the Wid1hg 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 codeand regulations and to admit authorized Inspectors on premises and in buildiing(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. -xwApplication Submitte� "I,y,(p,,int name): It)o..,A ElAuthorized Agent ner Signature of App1ica,11111111 A, Date: STATE OF NEW YORK) S at& /�j COUNTY OF6 )R 4t- Ct Q I Wa�'d 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 '01 02- a y of Mj 6 y 2 0 Notary PubV CMISTINE FLYNN PROPERTY OWNER AUTHORIZATION NOTARY PUBLIC OF NEW YORK NO.OIFL4967625 (Where the applicant is not the owner) QUALIFIED IN SUFFOLK COUNTY' MY COMMISSION EXPIRES JUNE 4 2..gA residing at I 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 ............... 000I xi w A SAOC414 04 61 POO L F --------------- WWE Val 400 J, INFO MKIlarr WA WA KS MAf�4 NUW Tt WNE F19 ' 4V P4*I Pj TO �AJIW14 KO 914 04 ro W P10 KC H 14 1 'roorilm To KI;NIA I N - I Q W low ro N&W VJTPOVK 4HI 14, HAr414 C6 P IPFwNeo P ;0,4 w Ap&p) N944 STAI Mr P rO eVCAArOHrl6P PW- K4; w 6b'l 6 zn' 15 A4. ........................ utt IVA :ZON v At Vm 40 80111111 low A& wATM ot BUILDING DEPARTMENT-Electrical Inspector q, 43 29, TOWN OF SOUTHOLD Town Hall Annex- 54375 Main Road - PO Box 1179 Od Southold, New York 11971-0959 .4 Telephone (631) 765-1802 APPL!CATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (AX information Required) Date: I '0Z :i rft C o m p a n y N a rn e: S,4 �c kl,' LL C— .......... ElectriclaWs Name: License No.: M Elec. email: TS E L OT A4 Elec. Phone No 11L E]I request an email copy of Certificate of Compliance IN MR" 0 Elec. Address.: 41 Lotx>6, ...................... JOB SITE INFORMATION (All information Required) Name.- Va cecc i4-�4'' IujilAcl J' ...................... ua Address: 7t C, Ply....... Cross Street: ................... Phone No.: ;5 / .............. Bldg.Permit#: Tax Map, District: 1000 Se"' ction. Block: Lot* LIP, IN................. BRIE'F D,,ESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Priint Clearly): co,\Atc'� t0z-1et+r('C' ft'c- kiow.'Ton AC Cont� e*n.5evr- Cc�o(\et4- 0 j10 e& VeL4 T t C. t-&V, 60c> Otu SP 1i S ------ 110 uare Footage. t=mq . -3 N. _0 Gi'rcle All Thatkp-pily# Is job ready for inspection?: E] YES,' NO [],Rough In Final Do you need a Ternp Certificate?: .9f YES El NO Issued On ............... ............. .................. Temp Information: (All information required) ------------ Service Slze[]�l Ph[:]'3 Ph Size: A # Meters Old Meter# E]New ServiceEl Fire Reconnect[]Flood Reconnect E]Service Reconnect E:]Underg round[]Overhead L J, '=2 , Unda, ground Laterals I J I H Frame Pole Work done on Service? ----Nato y Additional Information. PAYMENT DUE WITH!APPLICATION