HomeMy WebLinkAbout53136-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#: 53136 Date: 07/17/2026
Permission is hereby granted to:
Vinbar Realty Corp
450 Snug Harbor Rd
Greenport, NY 11944
To:
Install roof mounted solar panels on an existing accessary barn as applied for.Additional certification
may be required.
Premises Located at:
6300 Wickham Ave, Mattituck, NY 11952
SCTM# 107.40-9.1
Pursuant to application dated 06/30/2026 and approved by the Building Inspector.
To expire on 07/16/2028.
Contractors:
Required Inspections:
Fees:
SOLAR PANELS $100.00
CO Accessory $100.00
Total S200.00
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Building Inspector
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
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Town Hall Annex 54375 Whin Road P. O. Sox 1 179 Southold, NY l 1971-0959
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Telephone (631) 765-1802 Fax (631) 765-9502 htt s: ��w��.southoldto nn�. ,o�
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Date Receivea
For Office Use Cnly
PERMIT NO,.
Building Inspector:,••,,.
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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'
Owner's Authorization form(Page 2)shall he competed. f
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Datev
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OWNER(5)OF PROPERTY:
Name: ` V l ��� SCTII # 1000-
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Project Address:
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Phone#: '
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Mailing Address: �Sa
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CONTACT PERSON.
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Name:
Mailing Address: r-
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Phone#:
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DESIGN PROFESSIONAL INFORMATION.
Name:
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Mailing Address: Ik
Phone#: Email
CONTRACTOR INFORMATION:
Name: ;'� ' �� i'"
Mailing Address: �c � �
Phone#:
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Email: � L
DESCRIPTION OF PROPOSED CONSTRUCTION
gyration ❑ e air ❑ moh . 0 +� f Project:
❑New Structure ❑Addition ❑Alte p � tiro o Estimated Cost o
AN 1�e
Other cl cu-
Will the lot be re-graded? ❑Yes to Ill excess fill be removed from premises? ❑Ye!"'RNo
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PROPERTY INFORMATION
Existing use of property: k Intended use of property:
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? ❑Yes LkKo IF YES, PROVIDE A COPY.
eck Lox After Readh1g: The owner/contractor/design professional is responsible for all drainage and storm water issues as provided by
apter 36 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 By(print name): Lo rrai 'ne E) )I -ej 4k �4uthori/zed Agent ❑Owner
Signature of Applicant: Qf vlU� Date:
STATE OF NEW YORK)
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COUNTY 0
Lo r being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the
(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
6'L_ day of � 20_ _ i
Notary Public
PROPERTY NERD AUTHORIZATION
(Where the applicant is not the owner)
1, +' e r,jA_j0Sresiding at 5 a
do hereby authorize ) r to apply
... pp Y on
G�
m!t0wn4er'sgnat_iure
outhold Building Department for approval as described herein,
Date
DEBRA A SEPULVEDA
Print Owner's Name NOTARY PUBLIC,STATE OF NEW YORK
Registration No.01SE6012697
2 Qualified in Suffolk ounty
.