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HomeMy WebLinkAbout53122-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#: 53122 Date: 07/14/2026 Permission is hereby granted to: Anita Martignetti 95 Howland Rd Westport, MA 02790 To: legalize "as built"central air conditioning as applied for. Premises Located at: 910 New Suffolk Ave, Mattituck, NY 11952 SCTM# 114.-12-8 Pursuant to application dated 06/24/2026 and approved by the Building Inspector. To expire on 07/13/2028. Contractors: Required Inspections: Fees: As Built HVAC $500.00 CO RESIDENTIAL $100.00 Total $600.00 a I .,-` -- Building Inspector i i " TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone(631) 765-1802 Fax(631) 765-9502 https://www.s2,utholdtoMLnnE.gov Date Received PERMITAPPLICATION FOR BUILDING For office Use Only 4, XP PERMIT N0. � Building Inspactor: Building Dement Applications and forms must be filled out in their entirety. Incomplete cars of fro bold 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: SCTM#1000- ��y ©�" /Z. ap `-C)OF. 00 Project Address: a MI / PV Phone#: C Email: v Mailing Address: CONTACT PERSON: ...Name: � fT��� � � -21 Mailing Address: ' All Phone#: 3 Email: a r DESIGN PROFESSIONAL INFORMATION: Name: Mailing Address: IP Phone#: Email: CONTRACTOR INFORMATION: Name: Mailing Address: ' Phone#: Email: DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑ dition ❑Alteratio El r Demolition Estimated Cost of Project: her $ Will the lot be re-graded? ❑Yes o Will excess fill be removed from premises? ❑Yes C4<o 1 1 i PROPERTY INFORMATION Existing use of property: Intended use of property: Zone or use district in which premises is situated: Are there any covenants a restrictions with respect to this property? ❑Yes o IF YES, PROVIDE A COPY. heck 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, 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. Application Submitted nt name): //) uthori2ed'Agent ❑Owner Signature of Applic nt: v Elate: 1 ,0 STATE OF NEW YORK) SS: COUNTY OF ) being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, f)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 ., ,2D Notary Public PROPERTY OWNEIR Aug NI I11Z',ATlll -A, 31 9' (Where the applicant is not the owner) I, hm�v � . residing at V IV do hereby authorize ��v o z2--1 to apply on my behalf to the WTownof Sou"_dBg Department for approval as descri ed rein. Owner's Signature Date RA#qrffi(�rim Print Owner's Name 2 off BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD Town Hall Annex- 54375 Main Road - PO Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1802 APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: Company Name: Electrician's Name: License No.: Elec. email: Elec. Phone No: ❑I request an email copy of Certificate of Compliance Elec. Address.: JOB SITE INFORMATION (All Information Required) Name: Z Address: / (� Cross Street: Phone No.: "- Bldg.Permit#: / ' email: I Vd,.e Tax Map District: 1000 Section: Block: , Lot: BRIEF DESCRIPTION OF WORK, INCLLJDE QIJARE FOOTAGE ( se Print Clearly): Sgaare Footage: Circle All That Apply: Is job ready for inspection?: YES [—] NO [—]Rough In Final Do you need a Temp Certificate?: 11 YES O Issued On Temp Information: (All information required) Service Size 1 Ph[]3 Ph Size: A # Meters Old Meter# ❑New Service❑Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground❑Overhead Underground Laterals 1 R2 H Frame Pole Work done on Service? Y F�N Additional Information: PAYMENT DUE WITH APPLICATION f STREET ADDRESS: 910 NEW SUFFDLK AVENUE NEor SUFFOLS AVENUE N 88'29'00' E 60,00' .. w+xk ._ 49s 2 58' R or crDARS 44 STDam PJe � ! Its owswee 1 k �uav� ^C��m. owe aelrr 6��, �<a• a°I 22 STY. FR HSE''8 fv_ to 2I m,45 Cl) FE r 1 STY` r D, zi de w.. SURVEY OF PROPERTY a AT M4MTUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YO ' " 1000-114-12-08 SCAM: 1'=30' 1 JAN. 29, 2002 oEnc 0' p`E8„ 1, 2002 i prop. aril,'lon 1 M is.s' OCT 3, 2006U G 0'E m � CM y. FSHED - X*x i �7 wr W 0 0 v i 3 0 0 0 2 N v v 0 0 ti s . AREA=20,579 S.F. ° DR a4724 ACRES N=MDNUMENT � +�k� N� 9 8 l= FrT7{E' C�7�h91�G...S R4 Y S„ ANY ALTERATION ADDITIOI TV THIS S RVEY IS A VIOLATI6"+ (631) 765 1797 OF SECTIM 7209 OF THE NEW Y�C STATE EDUCATION LAW. r� EXCEPT AS PER SECTION 7209-SUODIVISIDN 2. ALL CERTIFICATIONS P. O. BOX 909 MEIN ARE VALID FOR THIS NAP AND COPIES THEREOF DNN.Y IF 1230 TRAVELER SAID SI LIE�ARS7�E1 SSED SEAL iNE SURVEYOR SOUTHOLD, N.Y. v 103