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Home My WebLink About51483-Z TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE 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#: 51483 Date: 12/17/2024 Permission is hereby granted to: 420 Old Farm Rd LLC 24 W 130th St New York, NY 10037 To: install roof-mounted solar panels and (3)energy storage systems in the attached garage of the existing single-family dwelling as applied for. Premises Located at: 420 Old Farm Rd, Orient, NY 11957 SCTM#25.-5-8 Pursuant to application dated 10/08/2024 and approved by the Building Inspector. To expire on 12/17/2026. Contractors: Required Inspections: Fees: SOLAR PANELS $100.00 ELECTRIC -Residential $125.00 CO-RESIDENTIAL $100.00 4 Total $325.00 ��Wg Inspector TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold, NY 11971-0959 ` r Telephone(631) 765-1802 Fax (631) 765-9502 httL) ,//ww,,r.sotitholdtowtiji ow' Date Received APPLICA n0N FDR BUILI)INGPERMIT For Office Use Only y PERMIT N0. Building Inspector: Applications and forms must be filled out in their entirety.IncompleteJJ' e VL applications will not be accepted. Where the Applicant is not the owner,andJn ^wt wr .tour: Owner's Authorization form(Page 2)shall be completed. Date: OWNER(S)OF PROPERTY: Name: L42 0 C I 1 f- w g l • L LC =C7M1000- 0ZT. ()0 _ 05. Qc) (l ." Project Address: 4 a` ( 01- tEm , tic) C lt' Phone#: cr - I ° Q I- - 1 st y1nd' YYa t • CCU Mailing Address: ' "" .. r CONTACT PERSON: Name: Mailing Address: ' � (.� .4 I A v f 12-0 h L . l ► �l c� Phone#: Email: 3i 5q � o III rdr , (VU � X .hhQ DESIGN PROFESSIONAL INFORMATION: ,m Name: I V � tyl � Mailing Address: im atop It ` � i� Phone#:V4L0. U-Z Email:_ � - Cr � G1 f� II � S►� c� s i � -Com CONTRACTOR INFORMATION: Name:• I_ In Mailing Ad res al - av 1 Phone#: U31 - Email: DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ❑Alteration ❑Rewair El Demolition Estima d Cost of Project: Other J 16, UOU Will the lot be re-graded? ❑Yes 1WNo Will excess fill be removed from premises? ❑Yes CYNo 1 PROPERTY INFORMATION Existing use of property:V af+ Intended use of property:Sj te fa I vf�cuq 1P Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? ❑Yes VNo IF YES, PROVIDE A COPY. 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. I Application Submitted By(print name): i-II'Y1C� 'ly �fpl.lSr� E Authorized Agent ❑Owner Signature of Applicant: �— Date: STATE OF NEW YORK) SS: COUNTY OF Timoil being duly sworn, deposes and says that(s)he is the applicant (Name of individ al 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 � /�� - 24`� da of l �� Nota is ry SANDRA M ELISSA D ISTEFAN 0 CU NOTARY PUBLIC-STATE OF NEW YO 110I) RTY OWNER (III LI ri iQIUZA F101y No.01 D 16391205 (Where the applicant is not the owner) Qualified in Suffolk County My Commission Expires 04-29-2027 I� r107V" residing at 0 C WV aV.01 do hereby authorize to apply on MY ehalf to the Town of Southold Building Department for approval as described herein. 101 ►12 Owner's Signature owey I'u^ �W4n Date uC_ Print Owner's Name 2 Building lie ortment Application AUTHORIZATION (Where the Applicant is not the Owner) Lars westvirld as 1,. _ C residing at (Print property owner's name) LI.L (Mailing Address) ram" � do hereby authorize IfLA V agent) to apply on my behalf to the Southold Building Department. <LaM (L&A'4�d (Owner's Signature) (Date) ►2S Ws 1" ►n/ (Print Owner's Name) A CERTIFICATE OF LIABILITY INSURANCE DA�2/04202 ) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endomement(s). PRODUCER NAME: Danielle POIOnCzyk Brown&Brown Metro,LLC PHONE (856)552-6330 �Nd d (856)840-8484 10 Lake Center Drive A¢'NES& Danielle.Polonczyk@bbrown.com Suite 310 INSURER(S)AFFORDING COVERAGE NAIC A Marlton NJ 08053 INSURER A: Southwest Marine and General Insurance Company INSURED INSURER B: Merchants National Insurance Company Hytech Solar Inc INSURER C: New Jersey Manufacturers Insurance Company 12122 6 Washington Avenue INSURER D: INSURER E: Bayshore NY 11706 INSURER F: COVERAGES CERTIFICATE NUMBER: 23-24 MASTER REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER JgM2RNYYYL JMMLDDIYYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE �OCCUR '...�PREWSES Ear tmence. $ 100,000,,",. MED EXP(AnX one person) $ 5,000 A PK202300015171 12/11/2023 12/11/2024 PERSONAL BADVINJURY $ 2,000,000 GE.gL AGGREGATE.LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY t J JECT ❑LOC PRODUCTS-COMP/OP AGG $ 4,000,000 OTHER. $ AUTOMOBILE LIABILITY C MBNNEO pWLEIJM➢ $ Ea awdsnl ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS $... HIRED NON-OWNED PROPERTY . AUTOS ONLY AUTOS ONLY Perawdenl $ UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 2,000,000 B EXCESS LIAB CLAIMS-MADE EXL0003762 12/11/2023 12/11/2024 AGGREGATE $ 2,000,000 DED I I RETENTION$ $ WORKERS COMPENSATION X STPTtJTE ERH (FFICEM NnNNyRIPARAND BILITY NE EDXECLW76VE E.L,EACHAECIID EMPLOYEE YIN $ 100 000 C ANY OFFIOEIOPMETERExO%NER)E7 N NIA W42088-5-23 12/11/2023 12/11/2024 NT I$ 100,000 IDEI ya SkO'RdesIPTIO taeN unOFeCer OPERATIONS below E.L DISEASE-POLICY LIMIT $ 500,000 '..DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached IF more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of Southold ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 1179 AUTHORIZED REPRESENTATIVE Southold NY 11971 f ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 26(2016103) The ACORD name and logo are registered marks of ACORD A DocuSign Envelope ID:45DC4140-1512-4865-A055-FAF17C798225 YZ Workers' CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured 631-595-5500 Hytech Solar Inc. 6 Washington Avenue Bayshore,NY 11706 1c.NYS Unemployment Insurance Employer Registration Number of Insured Work Location of Insured(Only required if coverage is specifically limited to 1 d.Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.,a Wrap-Up Policy) Number 81-2376682 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) New Jersey Manufacturers Insurance Company Town of Southold 3b.Policy Number of Entity Listed in Box"l a" W PO Box 1179 42088-5-23 Southold, NY 11971 3c.Policy effective period 12/11/2023 to 12/11/2024 3d.The Proprietor,Partners or Executive Officers are Qx included.(Only check box if all partners/officers included) all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box"3"insures the business referenced above in box 1 a"for workers' compensation under the New York State Workers'Compensation Law.(To use this form,New York(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2". The insurance carrier must notify the above certificate holder and the Workers' Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail.)Otherwise,this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent,or until the policy expiration date listed in box"3c",whichever is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note:Upon cancellation of the workers'compensation policy indicated on this form,if the business continues to be named on a permit, license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Workers'Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury, I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Danielle Poloncz k (Print name of authorized representative or licensed agent of insurance carrier) 0"uSigruod by: Approved by: F' VAVj& 12/4/2023 18A680 20 . turn) (Date) Title: Broker Agent/ Insurance Producer Telephone Number of authorized representative or licensed agent of insurance carrier: 856-552-3010 Please Note:Only insurance carriers and their licensed agents are authorized to issue Form C-105.2.Insurance brokers are NOT authorized to issue it. C-105.2 (9-17) www.wcb.ny.gov Suffolk County Dept.of Labor,Licensing&Consumer Affairs TONE IMPROVEMENT LICENSE Name TIMOTHY H HOUSTON Business Name 'his cerifies:hat the )earer is duly licensed hYTECH SOLAR INC Dy the County of suffolk License Number:H-58891 Rosalie Drago Issued: 03/12/2019 Comrn;ssiorer Expires: 03/01/2025 i ,?", i fay DESIGN PROFESSIONAL'S CERTIFICATE OF COM LANCE, To: Town of Southold Building Department Subject: Solar Panels at residence of:420 Old Farm Rd LLC 420_ L Project Scope: Installation of Solar Panels on Existing Pitched Roof Application Number: N/A [' Naresh K. Mahangu on behalf of the owner(s)of premises Known as 420 Old Farm Rd, Orient, NY, 11957 submit the attached plans for your review and issuance of Building Permit for the project referenced above. Please note the following conclusion regarding framing structure, roof loading, and proposed site location of installation: Existing roof framing: Conventional framing 2"x 10"at 64" o.c.with 21'-6" (horizontal rafter projection). This existing structure is defiantly capable to support all of the loads that are indicated below for solar photovoltaic installation project. I, Naresh K. Mahangu , License No.089068, certify that I am a Professional Engineer, duly licensed to practice in the State of New York and that I have inspected and analyzed the roof structure at the above-mentioned address and have determined the structure and the panel attachments to be adequate to support the new additional load imposed by the proposed solar panel system. The proposed system complies with the 140-mph wind design load as 2020 New York State Residential Building Codes and the 2017 National Electric Code(NEC)NFPA 70,and the ASCE 7-10 when installed in accordance with the manufacturer's instructions and standards. TABLE R301.2(1)CLIMATE AND GEOGRAPHICAL DESIGN CRITERIA GROUND WIND WIND WEATHERING FROST TERMITE DECAY WINTER ICE FLOOD SNOW ZONE CATEGORY LINE DESIGN SHIELD 'HAZARDS LOAD DEPT TEMP. REQUIRED. 30 140 B SEVERE 3 MODERATE SLIGHT TO 11 YES NO FEET TO HEAVY MODERATE DESIGN LOADING R301.4 AND R301.5 AND R301.6 NET DESIGN WIND PRESSURE-ASCE 7-05 ATTIC W/O ATTIC W/ ROOF NO ROOF W/ RAFTERS HAVING RAFTERS HAVING ROOF 0 TO 7 DEGREES[-33.01 STORAGE STORAGE CEILING CATHEDRAL SLOPES GREATER SLOPES GREATER ROOF>7TO27 DEGREES[-56.21 LOAD CEILING THAN 3/12 WITH NO THAN 3/12 WITH FINISH CEILING FINISH CEILING ROOF>27 TO45 DEGREES[-30.4 ATTACHED ATTACHED p ps p LL- 10 sf LL-10 f LL=20psf LL=20psf U180 U240 DL=10psf IDL=20psf IDL= 10psf I DL= 15psf i , 41 Very Truly yours, 09/16/2024 Naresh K. Mahangu Signe 0 Date New York State License No. 089068 S&P SOLAR KESIGNI ��,