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HomeMy WebLinkAbout51023-Z TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, NY " qr 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#: 51023 Date: 8/1/2024 Permission is hereby granted to: Goerler Jr Ronald 3175 Cox Ln PO BOX 629 Cutcho ue, NY 119350629 To: Install roof mount solar to existing accessory garage (back garage) as applied for. Disconnects must be located on the exterior, labeled, and readily accessible. At premises located at: 3175 Cox Ln, Cutcho ue SCTM # 473889 Sec/Block/Lot# 96.-3-4.5 Pursuant to application dated 6/18/2024 and approved by the Building Inspector. To expire on 1/31/2026. Fees: SOLAR PANELS $100.00 ELECTRIC $125.00 CO-RESIDENTIAL $100.00 Total: $325.00 Building Inspector 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 lrti s:iJ �,W . o��.to Ion nn . o Date Receive APPLICATION FOR BUILDING PERMIT For Office Use Only JUN 1 0 �OL� PERMIT NO. 510CP-3 Building Inspector, ' � .. 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: 6/7/2024 OWNER(S)OF PROPERTY: Name: Ronald Goerler SCTM# 1000- Project Address: 3175 Cox Ln Cutchogue, NY 11935 Phone#: (631) 839-8329 Email: jamesportwines@gmail.com Mailing Address: 3175 Cox Ln Cutchogue, NY 11935 CONTACT PERSON: Name:Tyler Moston Mailing Address: 275 Marcus Blvd, Hauppauge NY 11788 Phone#: 631-203-1019 Email: permitting@surfcleanenergy.com DESIGN PROFESSIONAL INFORMATION: Name: Tom Petersen Mailing Address: 6 Country Ln Howell New Jersey 07731 Phone#: 732-730-1763 Email. petersen8@optonline.net CONTRACTOR INFORMATION: Name:Surf Clean Energy Mailing Address: 275 Marcus Blvd, Hauppauge NY 11788 Phone#: 631-203-1019 Email: permitting@surfcleanenergy.com DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ❑Alteration ❑Re, air ❑Demolition Estimated Cost of Project: VOther Roof mounted solar panels , $26,200 Will the lot be re-graded? ❑Yes No Will excess fill be removed from premises? ❑Yes DAo 1 PROPERTY INFORMATION Existing use of property: Single Family Residential Intended use of property: Single Family Residential Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to 1000-0 []Yes � this property? Yes No IF YES, PROVIDE A CONY. 11 ❑ 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 bulding(s)for necessary Inspections.False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210AS of the New York State Penal Law. Application Submitted By(print name): Tyler Moston ®Authorized Agent ❑Owner Signature of Applicant: Date: 6/7/2024 STATE OF NEW YORK) SS: COUNTY OF Suffolk Tyler Moston being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)he is the Contractor (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 of WW PORK 7th .' day of June 2024 Notary Pu "�" PROPER Y OWNER AUTHORIZATION (Where the applicant is not the owner) I, Ronald Goerler residing at 3175 Cox Ln Cutchogue, NY 11935 I' do hereby authorize Tyler Moston to apply on my behalf to the Town of Southold Building Department for approval as described herein, 6/7/2024 Owner's Signature Date Ronald Goerler Print Owner's Name 2 Of FO � BUILDING DEPARTMENT- Electrical Inspector h" i 111� 4 TOWN OF SOUTHOLD r' Town Hall Annex- 54375 Main Road - PO Box 1179 � Southold, New York 11971-0959 v Telephone (631) 765-1802 - FAX (631) 765-9502 � . ` ' a s xitsan.r ° jainesh southoldtownn . ov - seand southoldtownn . ov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: 6/7/2024 Company Name: V and V Electrical Contracting Electrician's Name: Vincent Polizzi License No.: ME-43825 Elec. email: vp1959@optonline.net Elec. Phone No: +19176821974 I request an email copy of Certificate of Compliance Elec. Address.:. JOB SITE INFORMATION (All Information Required) Name: Ronald Goerler Address: 3175 Cox Ln Cutchogue, NY 11935 Cross Street: Phone No.: 6318398329 Bldg.Permit #: email: jamesportwines@gmail.com Tax Map District: 1000 Section: 96 Block: 3 Lot: 4.005 BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Interconnection of roof mounted solar panels Square Footage: 647 Circle All That Apply: Is job ready for inspection?: YES 0 NO Rough In Final Do you need a Temp Certificate?: YES © NO Issued On Temp Information: (All information required) Service Size91 Ph3 Ph Size: A # Meters 1' Old Meter# SzNew Service❑Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground❑Overhead # Underground Laterals 1 n2 n H Frame Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION