HomeMy WebLinkAbout51797-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#: 51797 Date: 04/01/2025
Permission is hereby granted to:
Kathleen E Walas
60 W 57th St Apt 10-B
New York, NY 10019
To:
install roof-mounted solar panels and energy storage system (outdoors)to existing single-family
dwelling as applied for with flood permit. All battery/electric systems shall be installed at elevation 9'
or higher.
Premises Located at:
750 Brooks Rd, Greenport, NY 11944
SCTM# 51-1-16
Pursuant to application dated 02/24/2025 and approved by the Building Inspector,
To expire on 04/01/2027.
Contractors:
Required Inspections:
Fees:
SOLAR PANELS $100.00
ELECTRIC -Residential $125.00
CO-RESIDENTIAL $100.00
Flood Permit $150.00
Total $475.00
Building Inspector ��
yrra 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
Date Recerve
APPLICATION FOR BUILDING PERMIT
For Office Use Only
q]PERMIT NO. 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,anK4I
Owners Authorization form(Page 2)shall be completed.
Date:
OWNER(S)OF PROPERTY:
Name:- k SCTM#1000-053•CO -OI • U 0 - O I 1p • 000
Project Address: -75C) ` I NeCY- 126 Circanport ,
W h q 4
Phone#: -732 . 55Q . � ZZ-] Email:SQl-QkC� ��r� IC I Corn
Mailing Address:,15 I"(Y S ranocyt, T
CONTACT PERSON:
Name: ftutLch 5 1 I n c
Mailing Address:
Phone#: Lo 31 , ,CIS` e (II 1..0 Email C loa ..
DESIGN PROFESSIONAL INFORMATION:
Name:. N&Ifs U
Mailing Address: I - r1 s ly "' W '
Phone#: 6 ® (PZ(? • LPZ.9 Email..Ali h
t
CONTRACTOR INFORMATION:
Name: ' tic trl C
Mailing Address: U A NA Eh)
Phone#: 5 S D X 11 Email: 0
DESCRIPTION OF PROPOSED CONSTRUCTION
vother,�' Q�0,r
ew Structure ❑Addition (❑Alteration ❑Repair ®Demolition Estimated Cost of Project;
l ........... " - $
Will the lot be re-graded? ❑Yes ;RNo Will excess fill be removed from premises? ❑Yes LNo
1
PROPERTY INFORMATION
Existing use of property:51 fou1 l( Intended use of property:
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? ❑Yes RNo IF YES, PROVIDE A COPY.
Check BOx Aftelr Reading: The owner/contractor/design professional i 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(print name): T►rko rh y E-F(DL,.5-)--o SAAuthorized Agent ❑Owner
Signature of Applicant: �' Date: 2 "1 — ZU 2 S
STATE OF NEW YORK)
SS:
COUNTY OF 0 ;
rnth being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the
(Contractor,ment,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 off k. Z
Notary PhWIt
SANDRA MELISSA DISTEFANO CRUZ
NOTARY PUBLIC-STATE OF NEW YORK
OWNER�f � �� � � � No.01 D16391205
(Where the applicant is not the owner) Qualified in Suffolk County
My Commission Expires 04-29-2027
I " residing at � A.r �
VD I
ado hereby authorize to apply Y on
-p alf to the T rl of Southold Building D artment for pproval as described herein.
' row,
r.� ,
Owner's Signature Date
VJ' 2 AIYIA.4
Print Owner's Name
2
Building Department ApOication
AUTHORIZATION
(Where the Applicant is not the Owner)
"�✓ V,41,A.5
I, " siding at
(Print property owner's name) (Mailing Address)
do hereby authorize
Agent)
to apply on my behalf to the
Southold Building Department.
(Owner's Signature) (Date)
(Print Owner's Name)