The URL can be used to link to this page

Home My WebLink About51888-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#: 51888 Date: 04/30/2025 Permission is hereby granted to: Sarah R Wood 150 Red Fawn Rd Southold, NY 11971 To: install roof-mounted solar panels to existing single-family dwelling as applied for. Premises Located at: 150 Red Fawn Rd, Southold, NY 11971 SCTM# 79.-2-7.1 Pursuant to application dated 03/25/2025 and approved by the Building Inspector. To expire on 04/30/2027. Contractors: Required Inspections: Fees: SOLAR PANELS $100.00 ELECTRIC -Residential $125.00 CO-RESIDENTIAL $100.00 Total $325.00 u id'ing Inspector TOWN OF SOUTHOLD —BUILDING DEPARTMENT Town Hall Annex 54375 Main road P. ®. Box 1179 Southold, NY 11971-0959 � Telephone (631) 765-1802 Fax (631) 765-9502 htt a, 'ID 1 ��d4wlt1 % Date Received PERMITAPPI]CATION FOR BUILDING For Office Use Only OR PERMIT NO. Building Inspector: n, 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. OWNER(S)OF PROPERTY- Name: dotnm W 0 k SCTM# 1000- 0 07. U 0 I I Project Address: 1570 ra,t 0. l l 7 1 Phone#: _ Email: Mailing Address: S 0 11�k 000 . 1Q . 11 CONTACT PERSON: Name: LD rrA i nC� Mailing Address: -7 47O V 17Lk d av?J % i r 16u4i �, s CJ Phone#: (P3 I 3 O ? �-7 0 q Email: Per ty�1 ,5 e, t,- ,S . co yy, DESIGN PROFESSIONAL INFORMATION- Name: Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: Name: Mailing Address: 7 l ®ht i161VO MA444V )\I-/. 11 q6 Phone#: 63 1 . 3 2 '-� a m Email: Y o, cg's s b com DESCRIPTION OF PROPOSED COINSTRUCTIONN ❑New Structure OAddition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: thter I in54-k-0 .So lo-C P\/ " w $J o a, V o o Will the lot be re-graded? ❑YesXNo Will excess fill be removed from premises? ❑YesNSZVo 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? ❑Yes ONO IF YES, PROVIDE A COPY. Ck Box After'Reading: The owner/contractor/design professional is responsible for all drainage and storm water Issues as provided by pter 236 of the Town Cade, APP'UCATION IS HEREBY MADE to the Building Department for the issuance of a ltvifding Permit pursuant to the Building Zone t3rdbnance 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):Lorraine DlPenta Eli Authorized Agent El Owner Signature of Applicant: Date: 3 13 /1� STATE OF NEW YORK) SS: COUNTY OF Suffolk Lorraine DI Penta 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 Tile l J RO EO u °lic,Mate of New Yale. No 01 R0631481 Sworn before me this Qualified in Buffalo County Commission Expires November 17, o,:�( IS day of I v t riA-1`L 20Z-5� Notary Public PROPERTY OWNER AUTHORIZATION (Where the applicant is not the owner) residing at Q Lb frtL-ttq-QJ do hereby authorize ENAO � apply to a I on my behalf'30 the Town of Southolq Building Department for approval as described herein. Owner's Signature Date k o d - Print Owner's Name 2 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 - FAX (631) 765-9502 _^ arnesh so Vh01 townn D - seandAsoutholdtow,nny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIe4N INFORMATION (All Information Required) Date: Company Name: EI-cm evl4- L4 L.LC— Electrician's Name: 6 eft License No.: < j; 'cI-t-t 6 Elec. email: Pe rM 94- G Elec. Phone No: , s ��- t C�II request an small copy of Certificate of Compliance Elec. Address.: 4 �,, -, 4t V e- - JOB SITE INFORMATION (All Information Required) Name: V 6_rLA_YZ �+OO Address: 15 pFAA0 JA Ellcl)-71 Cross Street: Phone No.: , 1 --7 - p Bldg.Permit#: K P�rr'�m 4s G small.Tax Map District: 1000 Section. Block. off-.Utz Lot: U BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): 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 Size1 Ph 3 Ph Size: A # Meters Old Meter# ❑New Service Fire ReconnectOFlood ReconnectE]Service Reconnect®Underground verhead Underground Laterals 1 2 H Frame Pole Work done on Service? F1 Y N Additional Information: PAYMENT DUE WITH APPLICATION NYSIF New York State Insurance Fund PO Box 66699,Albany,NY 122C6 I nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE (RENEWED) 6 A A A A A 823336604 ROBERT S FEDE INSURANCE AGENCY40A 23 GREEN ST STE 102 HUNTINGTON NY 11743 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER ELEMENT ENERGY LLC TOWN OF SOUTHOLD DBA ELEMENT ENERGY SYSTEMS 54375 MAIN ROAD 747C SOUND AVENUE SOUTHOLD NY 11971 MATTITUCK NY 11952 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE 12449 444-5 9622$7 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 WEB SITE AT HTTPS://WWW.NYSIF.COMICERTICE'RTVAL.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 STAT SDI NCE FUND DIRECT0R:lr,ISUR?,NCE FUN-UNDERWRITING