HomeMy WebLinkAbout52408-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
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#: 52408 Date: 10/27/2025
Permission is hereby granted to:
Paul Kesicki
1210 Ashamomaque Ave
Southold, NY 11971
To:
Install roof mount solar to single family dwelling as applied for.
Disconnects must be located on the exterior, labeled, and readily accessible.
Premises Located at:
1210 Arshamomaque Ave, Southold, NY 11971
SCTM#66.-2-28
Pursuant to application dated 09/23/2025 and approved by the Building Inspector,
To expire on 10/27/2027.
Contractors:
Required Inspections:
Fees:
CO-RESIDENTIAL $100.00
SOLAR PANELS $100.00
Teat S200.00
Building Inspector
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
7 Telephone (631) 765-1802 Fax (631) 765-9502 httr)s://www.sotitlioldtowiiny.gov
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only L L
s:
PERMIT NO. Building Inspector: o �
S L.'
Applications and forms must be filled out in their entirety. Incomplete
applications will not be accepted. Where the Applicant is not the owner,an E=,fisic in'n 'N,,partnnent
Owner's Authorization form(Page 2)shall be completed. `I~OOM of �OUt
Date: �(r7 1 a
OWNER(S)OF PROPERTY:
Name:Paul Kesicki SCTM#1000-66-2-28
17-Project Address: 1210 Arshamomaque Avenue, Southold, NY 11971
Phone#:631-492-0507 Email:Kesickipaul@gmail.com
Mailing Address:1210 Arshamomaque Avenue, Southold, NY 11971
CONTACT PERSON:
Name: Evelyn Polvere/Sunation Solar Systems
Mailing Address: 171 Remington Blvd., Ronkonkoma, NY 11779
Phone#: 631-750-9454 ext 346 Email:permitting@sunation.com
DESIGN PROFESSIONAL INFORMATION:
Name:William Fisher
Mailing Address:373 Aurora Way, Bluffton, SC 29909
Phone#:631-786-4419 Email:bill@fisher-ny.com
CONTRACTOR INFORMATION:
Name:Scott Maskin/Sunation Solar Systems
Mailing Address: 171 Remington Blvd., Ronkonkoma, NY 11779
Phone#: 631-750-9454 Email:permitting@sunation.com
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition BAlteration ❑Repair ❑Demolition Estimated Cost of Project:
❑Other $ -- bbl . O
Will the lot be re-graded? Dyes iONo Will excess fill be removed from premises? ❑Yes RNo
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PROPERTY INFORMATION
Existing use of property: Residential Intended use of property: Residential
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? ❑Yes BNo IF YES, PROVIDE A COPY.
❑ Check 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. 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 Class A misdemeanor pursuant to Section 210.45 of the New York State Penal Law.
Application Submitted By(print name): Cott Maskln BAuthorized Agent ❑Owner
Signature of Applicant: Date:
STATE OF NEW YORK)
SS:
COUNTY OF Suffolk
Scott Maskln 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 �32 e✓y) 20a'S
Nota",Public LYNN VITA
c r Jry NubEi,% State of New York
$ epgtrt :';,i 0 Vi�068399
is'I 5Ui ollc County
PROPERTY OWNER AUTHORIZATION vly Comnilssion Expires Oct. 28 2-0-
(Where the applicant is not the owner)
Paul Kesicki residing at 1210 Arshamomaque Avenue
I,
Southold, NY 11971 do hereby authorize Scott Maski n to apply on
my beha, n of Sot of ding Department for approval as described herein.
�l Z /Zs-
Owner's Signature Date
Paul Kesicki
Print Owner's Name
2