HomeMy WebLinkAbout53099-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#: 53099 Date: 06/30/2026
Permission is hereby granted to:
Foy Revoc Trt
215 Marina Ln
East Marion, IVY 11939
To:
replace an existing AC system as applied for.
Premises Located at:
215 Marina Ln, East Marion, IVY 11939
SCTM# 35.-8-5.9
Pursuant to application dated 06/12/2026 and approved by the Building Inspector.
To expire on 06/29/2028.
Contractors:
Required Inspections:
ELECTRICAL- ROUGH, PLUMBING , ELECTRICAL- FINAL, FINAL,
Fees:
HVAC $250.00
CO-RESIDENTIAL $100.00
Total 350.00
Building Inspector
o �
°° TOWN OF SOUTHOLD--BUILDING DEPARTMENT
Town Hall Anne.54375 Main Road P. 0. Box 1179 Southold,o d,NY 11971-095 9
Telephone 631 765-18 2 Fax +631 765-9502 ht s,,,"" sot :o t . 0,
Date Received
APPLICATi6N FOR B PERMIT
For Office Use Only
qqPERMIT NO. Building Inspectors
2026
Applications and forms must be filled out in their entirety.Incomplete
"applications will not be accepted. Where the Applicant"Is not the owner,an partrnent
owner's' ►uthorization form(Page 2 m shall be co let d. � � s v old
'TcopvnOT
Date
OW ER{ ) F PROPERTY*
Name• �, SCTM # 1000 too
-
Project Address: Z 1 l( ,[� , Cg) aok ww bn i3q, oqlq
Phone#: - Email:;W-royIN-e ��avloo. Cwofy)
RW I
--------------
Mailing Address:
j CONTACT PERSON
Name:
Mailing Address:
Phone#: Email:
DESIGN PROFESSIONAL A►L INFORMATION*
A►TION:
Name:
Mailing Address:,
Phone#: Email:
ONTR CTCIR I NFOR FORMATION:
Name:
Mailing Address: (( ,
V �qq 1\40
Phone#: (J) %IJL+ Email: '"-iM 4, -V 'I , I
oil
DESCRIPTION OF,PROPOSED CONSTRUCTION
❑New Structure F�Addition ❑Alteration ❑Repair F]Demolition Estimated Cost of Project:
C]0ther $
Will the lot be re-grade ? F]Yes ❑No Will excess fill be removed from premises? ❑Yes ❑No
1
PRO ERTY 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? DYes E]No IF YES, PROVIDE A COPY.
,[:)Check Box After Reaql*ng'. The owner/contractor/desig"n professional is responsibl'afo'r"'all"drai6ag*',and sthan+�ra"t'-O'rlstuesas'provide d by
Chapter'236 of the Town Code.APPLICATION IS HEREBY MADE,to the Building Department forthe Issuance,of,a'BuIldlIngi Pertnit,,"pursuant.to the,Building Zone
`Oons,�,fo buildin gs,
ordinance oft e Town of Southold.,Suffolko Countyp Ne w York and other applicable'Laws,,Ordinances pr,R0g4,1a 0,1hwcanitru on
I I''i�iiisi/,�,6tdi'nances��bulWIng code,,
additions.,alterations or for removal or demolition as herein'described.The applicant agrees to,;oMo,""'wilt
inihts'Madi herein are
housing code and regulations and to admit authorized,Inspectors on premises and,In'buildin'g(s),f6i,necessary, W I /
p ons.11 I istate
punishable as a Class A misdemeanor pursuant to Section 210.45 of,the New York State Penii law.,
25Authorized Agent ElOwner
Application Submitted By(pri amie)
Signature of Applicant: Date:
STATE OF NEW YORK)
SS:
COUNTY OF S(A' ` "
N v 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 olfhIs/her knowledge and belief;and
�h
that the work will be performed in the manner set forth in the applicatio t, — J. R'SSLOO,
rwi tiry Stift of New Y0*
No.01 RA6254580
Sworn before me this Oualified,in I County
Commisi Exores Jam 17, 20
7V'day of . .............. 20
Notary Public
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
I �1'� ��`� resic ing atJ ,
Zb E kCk/(10V1 t*q 1AGt"bq
,do hereby authorize I ��r V61 to apply o n
A
Zm my 'half to the Town of Southold Building Department for approval as described herein.
my al,to
Owner's Signatu re Date
Print Owner's Name
2
............
Young & Young, Land Eurveyors
400 Ostrander AvcnW. s Ow ark
t"
my t-
A Eden W Young,P_,0.,&L.S.(1908-1934)
Huwczrd r Ycr Land Surveyor r
Thomw C.1fatperf,Profaesmanat EnDneer
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fin
CP
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- -_
4y NOTE
- �� AREA—30+000 SO.FT.
oil l 8 0�MAP'SUFILIIT ESTATES,SECTION 5'FILM 1N THE
¢` OFFICE OF THE CLERK OF SUrFOLK COUNTY ON NOV_22.1993 AS
MAP NO.9426
131
Ile- Mg
t
_ SURVEYOR'S CER11F1CATION
+ WE HEREBY CERTT"TO By SMAR REALTY, bj 0
riDELITY NATIONAL TITLE INSURANCE t
COMPANY&MASPETH IFEDERAL SAVINGS&
LOAN ASSOCIATION THAT THIS SURVEY WASTREpARED `
mik"CE _
SURVEYS ADOPTM BY THE NEW YOW STA
PROFESSIONAL LAND SURVEYMS. E
o
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s
, A
16- HC7WARD W.YOUNG, T. L-S&NO,
01
V
- -
SURVEY FOR Mj
LOT 5 "SUMMIT ESTATES, SECTION 1"
At Erik Marian, Town of Southold
Suffolk County, New York
County flax Map msin�i 1000 smiF.35 etod, 8 iat 5-9
r
FINAL SURVEY NOV.27.2D 1',..�. �
UNDER CONSTRUCTION AUG,15,2
FOUNDATION LOCAT10N MAY IM,2001
ADDED CERTIFICA71ONS AM 17.19" �s �
MAP PREPARED FEB,2,1999� 3 &a
SCALE I'a 44T
FS
p=Wa+wrrST Sn R•00W}T MW a t arr cc x� it 3 suu�MAD JOB NO.99_{1tt4?
DWC.99 004?_tlnol
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� BUILDING DEPARTMENT- Electrical Inspector
TOWN of SOUTHOLD
XTown lull Annex - 54375 Main Road - PCB Box 1179
g
Southold New York 11971-0959
' Telephone 5 1 755-18 2 - FAX 531 755-9502
I Uttonon . V fan � thoid oV
APPLICATION FOR ELECTRICAL INSPECTION
--------------------
ELECTRICIAN IN ORMATION (All information Required) Date:
Company Name. ' . CX Cyr 0 C,
Electrician's Name: , `
License No.. Elec. email,,
.... ................
Elec. Phone No: El I request an email copy of Certificate of Compliance
Elec. Address.:
JOB SITE INFORMATION (All Informat' n Required)
Name: Veto AtCfk 4bk
Address:
y
Cross Street:
Phone No.:
Bld .Permit#.
r m
Tax Map, District: 1000 Section: Block: Lot:
----------------------BRIEF DESCRIPTION OF WORK, INCLUDE S 11 QUARE FOOTAGE (Please Print Clearly):
CJ Lkit 4q -
............
Square Footage:
C"Ircle All That Apply.
Is job ready for inspection?: YES NO Rough In Final
Do you need a Temp Certificate?: YES NO Issued On
Temp Information: (All information required)
Service Sizie 1 Ph Ph Size: A # Meters Old Meted
• nnect Flood Re onnect Service Reconnect[:]UndergroundDoverhead
0
New ServiceQ Fire Reco ❑
lJnder ground Laterals 1 ;2 H Frame Pole Work done on Service? Y N
Now
Additional Infbrmat n:
PAYMENT DUSE WITH APPLICATION
I