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Home My WebLink About53285-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#: 53285 Date: 09/17/2026 Permission is hereby granted to: Steven B Wick PO BOX 985 Cutchogue, NY 11935 To: Install an HVAC mini split system to an existing single-family dwelling as applied for per manufacturers specifications. Premises Located at: 1541 Stillwater Ave, Cutchogue, NY 11935 SCTM# 103.-1-19.7 Pursuant to application dated 09/01/2026 and approved by the Building Inspector, To expire on 09/16/2028. Contractors: Required Inspections: ELECTRICAL- ROUGH, PLUMBING, ELECTRICAL-FINAL, FINAL, Fees: Single Family Dwelling- Alteration $250.00 CO-RESIDENTIAL $100.00 Total $350.00 �� Building Inspector�� i �o 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 his //www. t1tholdtawnnvPov. Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only PERMIT NO. 53 a`-'"' Building Inspector° _ J&- 11 r�is�� 1 fJC��,1fj' Applications and forms must be filled out in their entirety. Incomplete applications will not be accepted. Where the Applicant is not the owner,an Difclsn Oepartmertt Owner's Authorization form(Page 2)shall be completed. Town of SouthoM Date: 4t) taa OWNERS)OF ROPERTY: } �V N a me; Syr j j SCTM # 1000- �?J i Project Address: Phone#: Email: Cw Mailing Add ss: CONTACT PERSON: Name:g Address: Mailing �� '� ✓' �� '� - rum N Phone#: - , Email: a l DESIGN PROFESSIONAL INFORMATION: Name: Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: Name: Mailing Address: Phone#: Email; DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ❑Alteration ❑Repair []Demolition , Estimated Cost of Project []Other /' ` ; C Z' "�►� $ Will the lot be re-graded? ❑Yes 6No Will excess fill be removed from premises? ❑Yes .?Wo I 1 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 this property? Dyes D No IF YES, PROVIDE A COPY. El 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, 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 By int name): ( Vtc,4 ElAuthorized Agent Owner Signature of Applicant: Date: STATE OF NEW YORK) S . COUNTY OF Ck 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 �dayof 20p -"-Z' I ary Public TRACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK PROPERTY OWNER AUTHORIZATION NO.01 DW6306900 (Where the applicant is not the owner) QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES.JUNE 30,2AI0 residing at 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 �yFtt .w 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: ,(-j I License No.: ,, Elec. email: Elec. Phone No: request an email copy of ertificate of liance Elec. Address.: C� N JOB SITE INFORMAT N (All Information Required) Name: t Address: .� + . v Cross Street: Phone No.: Bldg.Permit#: email: Tax Map District: 1000 Section• Block: Lot: BRIEF DESCRI/PTI N OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clea ly): c/4 6a� .'' A ? , F Square Footage: .... Circle All That Apply: Is job ready for inspection?: ES F-I NO 0 Rough In F] Final Do you need a Temp Certificate?: YES El NO Issued On Temp Information: (All information required) Service Size1 Ph 3 Ph Size: A # Meters Old Meter# ❑New Service Fire Reconnect El Flood Reconnect❑Service Reconnect❑Underground DOverhead # Underground Laterals 1 M2 M H Frame n Pale Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION r Rn//i, f 1%,ffJJJJi % i/6 G �fJ f I.,k --~I APPROVED AS NOTED COMELY WITH ALL CODES OF —�>'�— a B.P.# �J 3 a�5 Y RK STATE & TOWN ;ODE DATA„ AS QU' R D AND CONDITIONSOF FE�_ 0- BY jtJ9 SOUTHOLD TOWN ZBA NOTIFY BUILDING DEPARTMENT AT SOUTHOLD TOWN PLANNING BOARD 631-765-1802 8AM TO 4PM FOR THE SOUTHOLD TOWN TRUSTEES FOLLOWING INSPECTIONS: DEC FOUNDATION-TWO REQUIRED SOU THOLD FOR POURED CONCRETE UTHOLD HPC ROUGH-FRAMING&PLUMBING SCHD INSULATION FINAL-CONSTRUCTION MUST EI<-ECTIRIC L BE COMPLETE FOR C.O. INSPECTION REQUIRED ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS Additional Certification May e Required.