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Home My WebLink About51952-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#: 51952 Date: 05/28/2025 Permission is hereby granted to: Charles G Pardee 4891 Long Beach Rd SE 3#321 Southport, NC 28461 To: Install roof mounted solarpanelsto an existing single-family dwelling as applied for per manufacturer specifications. Additional certification may be required. Premises Located at: 6760 Great Peconic Bay Blvd, Laurel, NY 11948 SCTM# 126:11-3.1 Pursuant to application dated 04/18/2025 and approved by the Building Inspector. To expire on 05/28/2027. Contractors: Required Inspections: Fees: SOLAR PANELS $100.00 ELECTRIC -Residential $125.00 CO-RESIDENTIAL $100.00 Total $325.00 Building Inspector Town Halt Annex 54375 Main Load P. ®. Box 1179 Southold. NY 11971-0959 � Telephone (6.3 I) 765-1 802 Fax (63 1) 765-9502 � _,� , .•._,.ee p Cate Received APPLICATION m BUILDING PERMIT � For Office Use Only to 1 1 I � PERIUIIT'1\10. D Building Inspector: —JA—t— APR 1 8 2025 Applications and forms must be filled out in their entirety.Incomplete ( G applications will not be accepted. Where the Applicant is not the owner,an Ownees Authorization forma;JPage 2)shall be completed. a Date.' OWNER(S)OF PROPERTY; � Name:0, � SCTM soao- 00 — 11 f, y� �/ Project Address: (0-7 0 / Pit-+� �1�0�. ��il 1.11'� p ( � lu l: Phone#- �� ' � E m a i ��rrAa 4;!S � ��z - ,�,cc r Mailing Address: 's krp-e � l C014TAC PERSON: Name: LD r-rA-1 A-f Mailing Address: -7 4-7 o S oLAA, , &I ?--� Mo.-+ 9 j tci 5 VIL, k Phone#: jj y „-7 0 t4 1+ Email: P rf ,43 f, DESIGN PROFESSIONAL INFOR " Name: Mailing Address: Phone#: Email: CONTRACTOR INFORMATION- Name: �eg yit Mailing Address: Phone#: 0 ,-� Email: t DESCRIPTION OF PROPOSED CONSTRUCnON r � PV I�' '"t c � �✓ DNewStructure �i �i Iteraton �Pe air ❑l�molition Estimated Cost ther �m l�� 5 � Will the lot be re-graded? ❑YesNo Will excess fill be removed from premises? ❑Yes 10 i 1 PROPERTY INFORMATION Existing use of property: 9-Q---S Intended use of property: LV Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? ❑Yes�Jo IF YES, PROVIDE A COPY. X-Check Box After Reading: The owner/contractor/deslan professional is responsible for all drainage and sWrmu water issues as provided by Chapter z36 of the Town Code.APptICATiON IS HEREBY MADE to the Building Department for the issuance of a Building,Permit pursuant to the 13uliding,gone 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 WAS of the New York State Penal Law. Application Submitted By(print name):Lorraine Di Penta RAuthorized Agent ❑Owner Signature of Applicant: Date: L+ C L,/ 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 before me this day of Ap{1 20 Z 5 .. II Mary Public LOUIS J ROMEO Notary Public,State of New York No.01 R06314813 PROPERTY THORI TI Qu alified in Suffolk County (Where the applicant is not the owner) ommis aion Expires November 17,20 Zb residing at t 1'�CUYI! L LA LA-r-C, N�4 111q� do hereby authorize t-0 w" N !?2 to apply on my behalf t the wn of Southold Building Department for approval as described herein. Owner's Signature Date Print Owner's Name 2 BUILDING DEPARTMENT-- Electrlcall Inspector TOWN OF SOUTHOLD w Town Hall Annex- 54375 Alain Road - PO Sox 1179 Southold; New 'York 11971-0959 Telephone (531) 755-1 0 - FAX (631) 765-950 ov APPLICATION FOR EL.ECTRIOA IN�PEOTION ELE T ICIAN INEORMATOON (Au Information Required) Date: l Company Name: l -e 'n f,,+ �Electrician's Name: License No. .,„ Elec. email: P Flee. Phone No: -?q_ 79 t, ®I request an small copy of Certificate of C�ompliance 4 Elec. Address.:, ._ , JOB SITE INFORMATION (All Information Required) Htt Blame: �a-✓�.+� AA__Address:Cross ,Street:Phone No.: flBldg.Permit#: 15 email: E'�r� a aTax Iap District: 1000 Section: � o Block: O� BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Square Footage; Circle All That Apply: Is job ready for inspection?: YES 2NO E Rough In Final Do you need a Temp Certificate?: YES NO Issued On Temp Information: (All information required) Service Size 1 Ph 3 Ph Size: A # Meters Old Meter# ❑New Service❑Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground❑Overhead ' # Undergiround Laterals 1F12 H Frame Pole Work done on Service? Y Additional Information, 1 a, l zS k.IJ PAYMENT DUE T'H APPLICATION YSF New York State Insurance Fund PO Box 66699,Albany,NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE (RENEWED) "A A"A^ 823336604 ROBERTS FEDE INSURANCE AGENCY 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 7470 SOUND AVENUE SOUTHOLD NY 11971 MATTITUCK NY 11952 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DAT�71 12449 444-5 962287 07/13/2024 TO 07/13/2025 7/11/20 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://WWW.NYSIF.COM/CERTICERTVAL.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 SU NOE FUND DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER; 743799006