HomeMy WebLinkAbout51985-Z x 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#: 51985 Date: 06/10/2025
Permission is hereby granted to:
Nicholson JM Irry Trt
3985 Sound Ave
Mattituck, NY 11952
To:
remove and replace a new accessory ground-mount solar system as applied for. Must maintain a
minimum 15' setback from the rear yard lot line.
Premises Located at:
3985 Sound Ave, Mattituck, NY 11952
SCTM# 121.4-2
Pursuant to application dated 05/02/2025 and approved by the Building Inspector.
To expire on 06/10/2027.
Contractors:
Required Inspections:
Fees:
SOLAR PANELS $100.00
ELECTRIC -Residential $125.00
CO Accessory $100.00
Total $325.00
lid
u lding Inspector
TOWN OF ScflL'THOLD —BU1LD1-"),G DLPARYNIENT
If 'Town Mall Annex 54375 Main Road F. ®. Box 1179 Southold. NY 11971-0959
Telephone (631) 765-1802 Fax(631) 765-9502
P
Cate Received
i
For Office Use Only
PERMIT NO. Building Inspector; ,
p
Applications and forms most be filled out in their entirety.Incomplete ! I
applications will not be accepted. where the Applicant is not the owner,an
Owner's Authorization form(Page 2)shall be completed. i
1 l i
Date:
OWNER(S)OF PROPERTY-
Name:
-To h IJ i ,L&cr) SCTM#1000-101t OU
S Uy
M
Project Address,
ort
Phone#: Email• cc on
Mailing Address b S0 'ntA Vf, 1Y)4J4)b4r
CONTACT PERSON-
Name: Lo r-rA-,'n,-,
Bailing Address:
Phone#: 70q Email: P1ri 4.5 BLS ,5
DESIGN lP WESSIONAJ1w INFOAMA -
Name:
Bailing Address.
Phone#: Email:
CONTRACTOR INFORNAM ON.
Name: O f-["e�4+
Bailing Address: 4qo-
-'�s0 d a MA4 VCr, 5�;Y 11 �
Phone#: �� s �` D 4 Email: 4S
DESCRIPTION OF PROPOSED CONSTRUCTION
❑Nevv Structure ❑Addition ❑Alteration ❑Rep alr ❑Demolition Estimated Cost of Project:
'EXCher I P' 54-6,L d & )A-,- P V $
Will the lot be re-graded? ❑Yes No . ii! d°ces p o o-g a s fill b removed from remises. ❑Yes
o I`J u, x"s t7VLy lv r',k o �' yzS' N 5
01
t
PROPERTY INFORMATION
Existing use o...,, ...�.� � ,f property: Intended use of property: I`�k j_
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? Dyes> o IF YES, PROVIDE A COPY.
heck 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. APPUCATION 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 SY(prin name): `o r✓�� J 1 ' `' '� thorized Agent El Owner
Signature of Applicant: Date: 1Z�
STATE OF NEW YORK)
^((�� SS.
COUNTYOF�? �2X
being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the NIy 1
(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 day of ,20 21!�.
ry Public
LOUIS J ROMEO
Notary Public,State of New York
PROPERTY OWNER
13
Where the applicant a AUTHORIZATION No. in Suffolk
Co
Qualified in Suffolk County
( pp nt is not the owner) Commission Expires November 17,2Oa6
I, _—jU �r 010 Ls on residing at
,
l«5 do hereby authorize Lor�h���t '�- to apply on
my behalf to the trwn q outhold Building Department for approval as described herein,
Owner's SignatUfe Date
chol50yi
Print Cwvner's Name
2
;r BUILDING DEPARTMENT- Electrical Inspector
49,
TOWN OF SOUTHOLD
Town Ball Annex - 54375 Main load - PO Sox 1179
° Southold; New York 11971-0959
. Telephone (531) 765-150 - FAX ( 1) 755-95r02'
APPLICATION FOR PI �ECTRICAL INSPECTION
ELECTRICIAN INFORMATION (Au Information Required) Date:
Company Marne: El-cmellit, � Lo
;Electrician's name: Ina nil
a
I L No.:
License � � , � � � 6
Elec. Phone No: I�����q- ?9� �I request an email copy fi Certificate � � p py rt Icate of Compliance
Elec. Address.: �-1 I � �
JOB SITE INFORMATION (All Information Required)
Name. John I� � ch0,
A. Ila
Address: ;� YYlII�-f� �
Cross Street: I
e
Phone No.: ,
l Bldg.Permit#: email: PP_rrn a r_�J ' 5 J
Tax Map District: 1000 Section:loz/, 0oc-) ®lock: 01, pu Lot:00,;?, ors,
BRIEF DESCRIPTION OF WORK, INCLuaE SQUARE FOOTAGE QP{llease Print Clearly)
S + �_5! b s 4-h' y S �✓ s Tom ' i� r
i
Suare Footage:
CircleQ►I9 That Apply:
Is job ready for inspection?: LJ YES NO Rough In Final
Do you need a Temp Certificate?:, YES NO Issued On
Temp Information: (All information required)
Service Size Li
1 Ph3 Ph Size: A # Meters Old Meter#
❑New ServiceQ Fire Reconnect E]Flood Reconnect❑Service Reconnect Ounderground lverhead
underground Laterals 1 H Frame Pole Work done on Service? Y ICI'
Additional Information:
PAYMENT PE W9°TIC ,IF"t_ICATION'