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Home My WebLink About51814-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#: 51814 Date: 04/08/2025 Permission is hereby granted to: Alexander Warren 605 E Timber Branch Pkwy Alexandria,VA 22302 To: install roof-mounted solar panels and energy storage system(in garage)to existing single-family dwelling as applied for. Premises Located at: 2965 Marratooka Rd, Mattituck, NY 11952 SCTM# 123.-2-27 Pursuant to application dated 02/27/2025 and approved by the Building Inspector. To expire on 04/08/2027. Contractors: Required Inspections: Fees: SOLAR PANELS $100.00 ELECTRIC -Residential $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 1 1 97 1-0959 Telephone (631) 765-1802 Fax (631) 765-9502 9ltt), ://WN k°uSoLltlioldto,�vn]'IN".goy. Date Received APPLICATIONI For Office Use Only I I!.E E, E PERMIT NO. 50 Building Inspector. C I,,� "I pi r f r Applications and forms must be filled out in their entirety.Incomplete applications will not be accepted. Where the Applicant is not the owner,an Building Department Owner's Authorization form(Page 2)shall be completed. Town o, Southold Date. OWNER(S)OF PROPERTY: Name: �, 'An Jy SCTM#1000- �v23. OU � 0�'.�O - � ? , 000 Project Address: Phone#: G 3 1- 3 g 2 '7 O Lf I Email: ��✓ri�l-1 AZ 6.co F1 Mailing Address: Gl - o CONTACT PERSON: �h /� Name: Lo lrr#-, p� b)T'E D.- Mailin Address: g -7410 SvLAAd 6100 m4L44-► �, y. ILaS;L, Phone#: (D 3 `3 O 3 --7 0 L/ I Email: F)ie r j l TS cp� i�,- 02 S S , co Yr DESIGN PROFESSIONAL INFORMATION: Name: Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: Name: E�[ cry)cti V kit Mailing Address: 1 4 l ' .VCJ / ► A-4- Y'1AC0 Phone#: Ob Email: pt1 4. (z cos vs , c4p) DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑!Addition ❑Alteration ❑Repair 9❑Demolition Estimated Cost of Project: ther`Tm~1*-d & )a,- P V , Y«) + 7 qf3 kwVI A 9' 1.�(n 1 , r „V . Will the lot be re-graded? ❑YesXNo Will excess be rnorr d from premises? ❑Yes�Ao 3 r ant)I G454t inke J-Zt1 Ll Z's hr y )4 (.4'b 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? ❑Yes No IF YES, PROVIDE A COPY. Check ox After Reading.-ing: The owner/contractor/design professional is responsible for all drainage and storm water issues as provided by Chapter z36 of the Town Code. APPUCAATION 15 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 Z1OAS of the New York State Penal Law. Application Submitted By(print name):Lorraine Di Penta 99 Authorized Agent ❑Owner Signature of Applicant: Date: STATE OF NEW YORK) SS: COUNTY OF Suffolk ) Lorraine DiPenta .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 beforeme this day of 20 2S� . Not ublic PROPER ref OWNER AUTHIORIZA[ION (Where the applicant is not the owner) I, �►mE.Je 4 9) residing at X( ' M1 11/�uLh IQ— 1145� do hereby authorize IN' U►iYGcNt.s to apply on ! t my b e o e To of Southold Building Department for approval as described herein. Owiier's Signature.: Date LOUIS J ROMEO Notary Public,State of New York No.01 R06314813 Print Owner ame Qualified in Suffolk County Commission Expires November 17,20 2 . E C E fF BUILDING DEPARTMENT- Ele r all Ir @V�r7 2025 TOWN OF SOUTH Lb Town Hall Annex - 54375 Main Road Southold, New York 11971- M Telephone (631) 765-1802 - FAX (631) 765-9502 "arnesh southoldt nn m o seam' southoldtownn . cv APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: p2 Iq Company Name: E en c .-�C.. Electrician's Name. j` /Yli nI�I License No.: z5��, 9 F-t 6 Elec. email: Pe-rrn i ,S e b�� Elec. Phone No: aG3 t--7-79-'-2 c1 request an email copy of Certificate of Compliance � I Elec. Address.: 1 L41 a 5o o-►104, 0.J e- F-1 &-++s+LtC -J. l ! 5 O-- JOB SITE INFORMATION (All Information Required) 'Name: �Y m Address: qto kr O o AJ Cross Street: Phone No.: -1l Bldg.Permit#: 5,1 SP4 email: PP—rm d+S Q, -e-Qsiscc Vn Tax Map District: 1000 Section:Jai. Block: 0 �, yap Lot:0.;LI, BRIEF DESCRIPTION OF WORK, 'INCLUDE SQUARE FOOTAGE (Please Print Clearly): 7-7 Square Footage: Circle All That Apply: Is job ready for inspection?: YES NO Rough In Final Do you need a Temp Certificate?: YES NO Issued On Temp Information: (All information required) Service Size[I1 Ph 3 Ph Size: A # Meters Old Meter# ❑New Service❑Fire Reconnect[]Flood Reconnect❑Service Reconnect❑Underground❑Overhead # Underground Laterals 1 2 H Frame Pole Work done on Service? LJ Y N Additional Information: IA-� PV 4(,s sq..s I n 3CLYA PAYMENT DUE WI PPLI ATIO YS I F New York State Insurance Fund PO Box 66699,Albany,NY 122C6 I nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE (RENEWED) AAAAAA 823336604 ROBERT S FEDE INSURANCE AGENCY 23 GREEN ST STE 102 Fail 5' ' , HUNTINGTON NY 11743 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER ELEMENT ENERGY LLC TOWN OF SOUTHOLD DBA ELEMENT ENERGY SYSTEMS 54375 MAIN ROAD 7470 SOUND AVENUE SOUTHOLD NY 11971 MATTITUCK NY 11952 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE 12449 444-5 962287 07/13/2024 TO 07/13/2025 7/11/2024 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2449 444-5, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY, INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS:/NI/WW.NYSIF.COM/CERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER THE SOLE PROPRIETOR, PARTNERS AND/OR MEMBERS OF A LIMITED LIABILITY COMPANY. THE POLICY INCLUDES A WAIVER OF SUBROGATION ENDORSEMENT UNDER WHICH NYSIF AGREES TO WAIVE ITS RIGHT OF SUBROGATION TO BRING AN ACTION AGAINST THE CERTIFICATE HOLDER TO RECOVER AMOUNTS WE PAID IN WORKERS'COMPENSATION AND/OR MEDICAL BENEFITS TO OR ON BEHALF OF AN EMPLOYEE OF OUR INSURED IN THE EVENT THAT, PRIOR TO THE DATE OF THE ACCIDENT, THE CERTIFICATE HOLDER HAS ENTERED INTO A WRITTEN CONTRACT WITH OUR INSURED THAT REQUIRES THAT SUCH RIGHT OF SUBROGATION BE WAIVED. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STET S4 7*2 NCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 743799C06 _�� z