HomeMy WebLinkAbout52275-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#: 52275 Date: 09/22/2025
Permission is hereby granted to:
420 Holden LLC
1895 Pequash Ave
Cutchogue, NY 11935
To:
Install roof mount solar to existing single family dwelling as applied for.
Disconnects must be located on the exterior, labeled, and readily accessible.
Premises Located at:
420 Holden Ave, Cutchogue, NY 11935
SCTM# 103.-14-17
Pursuant to application dated 08/06/2025 and approved by the Building Inspector.
To expire on 09/22/2027.
Contractors:
Required Inspections:
Fees:
CO-RESIDENTIAL $100.00
SOLAR PANELS $100.00
Total $200.00
Building Inspector
,M F 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 htt a:0/ww ,r.ao th ltlt wnn ., o
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Date Received
APPLICATION FOR BUILDING PERMIT
I I
For Office Use Only
L
PERMIT NO.
Building Inspector; l ° j
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: 7/24/2025
OWNER(S)OF PROPERTY:
Name:Jim Brodsky SCTM#1000- 103.00-14.00-017.000
Project Address: 420 Holden Avenue, Cutchogue, NY 11935
Phone#: (917) 715-2215 Email:jimbrodsky@gmail.com
Mailing Address:420 Holden Avenue, Cutchogue, NY 11935
CONTACT PERSON:
Name: Michael Calise
Mailing Address: 2941 Sunrise Hwy, Islip Terrace, NY 11752
Phone#: (631) 647-3402 Email: hppermitting@harvestpower.net
DESIGN PROFESSIONAL INFORMATION:
Name: Michael Dunn, R.A.
Mailing Address: 256 Orinoco Dr, Brihtwaters, NY 11718
Phone#: (631) 665-9619 Email: Glenn@grahamassociates .com
CONTRACTOR INFORMATION:
Name: Harvest Power LLC
Mailing Address: 2941 Sunrise Hwy, Islip Terrace, NY 11752
Phone#: (631) 647-3402 Email: hppermitting@harvestpower..net
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition MAlteration ❑Repair ❑Demolition Estimated Cost of Project:
❑Other $ 41'942.40
Will the lot be re-graded? ❑Yes ®No Will excess fill be removed from premises? ❑Yes ❑No
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PROPERTY INFORMATION
Existing use of property: Residence Intended use of property: (no change)
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.
El Check r Reading. The owner/contractor/design professional Is 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 Gass A misdemeanor pursuant to Section 210.45 of the New York State Penal Law,
Application Submitted By(pr' ame): MICh Calise .Authorized Agent ❑Owner
Signature of Applicant: Date: 7/24/2025
STATE OF NEW YORK)
SS:
COUNTY OF Suffolk )
Michael Calise being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the,Agent
(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�iefore me this
day of ,20
NOTARY DII A LA ZA
RY PUBLIC,STATE OF NEW YORK
Registration No.01 LA6034714
Qualified in Suffolk County
GoMmission Ex ices Ma 30,20
the applican is no fhf�'vvu�i �
Jim Brodsky residing at 420 hoiden Avenue
Cutchogue, NY 11935 do hereby authorize Michael Calise to apply on
my be If to the Town of Southold Building Department for approval as described herein.
7/24/2025
Owner's Signature Date
Jim Brodsky
Print Owner's Name
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