HomeMy WebLinkAbout53269-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#: 53269 Date: 09/14/2026
Permission is hereby granted to:
Kevin J O'Shea
55 Brown St
Greenport, NY 11944
To:
legalize "as built"central air conditioning to an existing single-family dwelling as applied for.
Premises Located at:
55 Brown St, Greenport, NY 11944
SCTM#48.-3-29
Pursuant to application dated 08/25/2026 and approved by the Building Inspector.
To expire on 09/13/2028.
Contractors:
Required Inspections:
Fees:
CO-RESIDENTIAL $100.00
As Built HVAC $500.00
Total $600.00
ing Inspector
err TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town� Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959' Tele hone 631 765-1802 Fax 631 765-9502 ht!ps://www.southoldtownny.go
Date Received
APPLICATION FOR BUILDING PERMIT
i .
For Office Use Only
p
PERMIT NO. Building Inspector. ✓ UG 2
C. g
Applications and forms must be filled out in their entirety. Incomplete
applications will not be accepted. Where the Applicant is not the owner,an SuMlin Department
Owner's Authorization form(Page 2)shall be completed. T W91 oa oulhold
Date:
OWNERS)OF PROPERTY:
1000- ��� l/V '0?, 00 -�
Project Address: J ! (IWWA) sy— D !!V&4L Ay
Phone#: CP3 1 1 Email:
Mailing Address: C a J Au Ej Ild joy, 1 2
CONTACT PERSON: �^
Name:. 4u !' .Jt+NA)y GS
Mailing Address: ►V Cv`
Phone#; I ". Email:
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name:
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑N w
Structure (-JAddition El Alteration FR air O'Demolition Estimated Cost of Project:
then 13W1, A $
Will the lot be re-graded? ❑Yes 2<o Will excess fill be removed from premises? ❑Yes o
1
PROPERTY INFORMATION
Existing use of property: Intended use of property:
Zone or use district in which premises is situated: Are there any covenants�d restrictions with respect to
this property? ❑Yes IJNo IF YES, PROVIDE A COPY.
11 eClf 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 Subry)jU d'0Y-''(pri t ame): "Iy i �� ,fb l_24thorizedAgent1 Downer
`~
Signature Applican � Date:
STATE OF NEW YORK)
SS:
COUNTY OF SaJPPA'-� )
tJ WIIIV
being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the 'O�A_fi_j r (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 /1
of L� 20 !-(o
y / ,
Notary Public
ERIKJOSEPH MCKENNA
N otwy Public,StMe of Now No.0 8 SM5 19 Yak
(Where the applicant is not the owner) Qualified In Suffolk County
- mission Expires February 6,9D
I, residing at
do hereby authorize 1 to apply on
my be'alf to the Town of So Id Building Department for approval as described herein.
`6wni—erNs Signature Date
Print Owner's Name
2
BUILDING DEPARTMENT- Electrical Inspector
�"q,9
TOWN OF SOUTHOLD
Town Hall Annex - 54375 Main Road - PO Box 1179
Southold, New York 11971-0959
c 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: l�
Address: .� eLh.) 15;/
Cross Street: 17
Phone No.:
Bldg.Permit#: email:
Tax Map District: 1000 Section:G L/ ® Block: u 3,6 0 Lot: 0 2 7,- O
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
AS `AL) ( (, 7
Square Footage:
Circle All That Apply:
Is job ready for inspection?: [ YESFJNO r Rough In Final
Do you need a Temp Certificate?: YES NO Issued On
Temp Information: (All information required)
Service Size1 Phi Ph Size: A # Meters Old Meter#
❑New Service❑Fire ReconnectElFlood Reconnect❑Service Reconnect❑Underground QOverhead
# Underground Laterals 1 M2 H Frame D Pale Work done on Service? Y N
Additional Information:
PAYMENT DUE WITH APPLICATION
3r54
SURVEY 3 F
LOT 4 MAP OF
{ S 82-44'30 E y T
tF GREENPORT DRIVING PARK
f
4 FILE No. 369 FILED DECEMBER f, 1909 Ij
105.52'
SITUATED AT
w -zy °"N.Efl.<�. GREENPQRT
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
CONCFpAlOE @ 3 S.C. TAX No. 1000-48-03-29
t JJ! cexc._� N SCALE 1"=20'
DECEMBER 11. 0051FOUNDAATION LOCATION 1
Lr) N AREA - 6,082 0.140 c. ff.
io �
" CD tr)
ryj (n
7 CERTIFIED TO.,
N 82-44'30" , - - t SCHEMBRI DEVELOPMENT CORPORATION
-- �. COMMONWEALTH LAND TITLE INSURANCE COMPANY 9;
J 1 10.74' � !
}F EXE OF PAr.p W
BROWN STREET
I
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u+vEr s A.+ww.m.oo
52T[N TM4 OF THE tEx nX%STATE
f3UCATtM Ux.
Nathan Taft Corwin III
-, 08EAVNNxEWp. Land Surveyor
111 E �rvR TeK sett
992 Roanoke Avenue
TK-TME"E ,:OF wn Riverhead, New York 11901
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lac taSEVFtiiS OF xECORD.6'
xoT sxaxx Arse xuT evunersccu. PHONE & FAX (631)369-5473
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