HomeMy WebLinkAbout53069-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#: 53069 Date: 06/16/2026
Permission is hereby granted to:
Polenas Farm LLC
57 Westgate Blvd
Manhasset, NY 11030
To:
install roof-mounted solar panels to an existing single-family dwelling as applied for.
Premises Located at:
1981 August Ln, Greenport, NY 11944
5CTM#53:6-46.10
Pursuant to application dated 04/02/2026 and approved by the Building Inspector.
To expire on 06/15/2028.
Contractors:
Required Inspections:
Fees:
SOLAR PANELS $100.00
CO-RESIDENTIAL $100.00
Total S200.00
Building Inspector
TOWN OF-�r
U A
LD - BUILDING DEPARTME
Town Hall Annex 543 75 Main Road Rc►�.d P. C), Box 1179
0959
Telephone(631) 765-1802 Fax (631) 765-9502
79 Southold, NY 1 Z 97 -.
CATION F',IIIIIIIIII4�PPLlCAR BUILDINGa�t�Received
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For office Use Only
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PE I`T` fV C��� Buy
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�� t �� `�cee � Where the Appll��nt ° not the owner# �n, K
�rP Author; on f r Pa `e�l shall completed*
D,I t o: 41212 026
fJw
roe' �"""'OLENAS FARM
Na �CTNI#xpgp_
d ress `� PORT,LANE
053.00 000.00 0401(�
Pr,�j�'ct �'► 1��1 AUGUST
NY 11'944
n e # 9�17-400--854 T
Phone Email:
Address: C���rl,�n7� ���
M��I�ng
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cON-"TAC-ir PERSONS ffff
Name**
a
Ma
ling Address:
Phone #=
Email:
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OF`ESSIONAL INFORMATIONI
Name:
Ma
i l i ng Address:
phone #:
Email:
INFORMATION:
ASSOCIATED,
Name: NEOS INC
Mail'" Address:3�' B BETHPAGEM R OADHICKSVILLE,
11801
Phone#:646-623-58 7$
Email:SBASHO@HOTMAIfL.oN OF PROPOSED CON C��SC�Ip�'I STRUCTIC�N
w Structure C�Addltian C]Alteration�Ne � d'Reparr 'Demolition
[j SYSTEM other SOLAR T i Estimated Cast of Pr
.� oJect:
Will the lot be re-graded? M Yes d No
Vllrll excess fill be removed from premises? Yes n No
010.
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
I this property? F-1 Yes F-1 N o IF YES, PROVIDE A COPY.
W Check Box Aft e r Reading: The owner/contractor/design professional is responsible for all drainage a n d 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 wilding 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
j punishable as a Class A misdemeanor pursuant to Section 210.4S of the New York State Penal Law.
Application Submitted By(print name): IgAuthorized Agent ElOwner
Signature of Applicant: Date:
STATE OF NEW YORK)
COUNTY OF (A
SPIRO BASHO being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the CONTRACTOR, A GENT
(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
2014
day of ,)d
Notary Public
TRISTAN SAADE
Notary Public-State of New York
NO.OISA0026792
Qualified in Nassau County PROPERTY OWNER AUTHORIZATION
My Commission Expires Jul 16,2028
011 (Where the applicant is not the owner)
SOTIR p'O L E NA residing at,57 WESTGATE BLVD, MAN HASS ET
NY, 1 1 030 do hereby authorize N EOS A���C�IAT ED, INC to apply on
my behalf to ft e Town of Southold Building Department for approval as described herein.,
41212 0 2 6
wnerl's Signature Date
rw_ Po te-m 4—
Print Owner's Name
2
...................
f BUILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
Town Hall Annex - 54375 Main Road - PO Box 1179
Southold, New York 11971-9959
Telephone 631 765-1892
n
APPLICATION FOR ELECTRICAL INSPE,CTION
..........
ELECTRICIAN INFORMATION (All information Required) Date.
Company Name: ............................ -Electrician's Names ---------
1 1> A 'S' -,S---O
................
License No..
i '` Elec. email* JI L
.......... T.M�U
Elec. Phone No [
:]I I request an email copy of certificate of compliance
Elec. Address... .m.. J i
.
.District
JOB SITE INFORMATION (All Information Required)
Name: L-G ..Address:
Cross Street:
m
Phone No..
Bldg.Permit#. e�a�l.. ,.. � , .....
Tax M a � � 160�D Section: �� � � Block: c)c .o o Lot
DESCRIPTION S
CRIPTION OF WORD INCLUDE SQUARE FOOTAGE (Please Print clearly)
LAI
Square Footage.
----- ----------- E
Circle All That Apply:
y p is job read for inspection?: El,
YES NO Rough In F-1 Final
Do you need a Temp Certificate?. YE:S NO Issued On
Y p
Temp Information: (All information required)
Service Size 1, Ph 3 Ph Size: A► # Meters Old Meter#
[:]New service
Fire Reconnect Flood Reconnect Service Reconnect F]UndergroundEloverhead�l
Under round Laterals 1 Ll IH FrameLJ
Pole Work done on service? Y "M NMI N N
Additional Information:
Y NT DUE, WITHPP