HomeMy WebLinkAbout53137-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#: 53137 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 to an existing single-family dwelling as applied for.Additional
certification may be required.
Premises Located at:
6300 Wickham Ave, Mattituck, NY 11952
SCTM# 107:10-9.1
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 Single Family Dwelling-Addition /Alteration $100.00
Total S200.00
Building Inspector
^ � TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1 179 Southold, NY 1 1 971-0959
Telephone (631) 765-1802 Fax (631) 765-9502 https://ww% .southoldtowgp .gov
.. r
Date Received
APPLICATION FOR BUILDING PERMIT
EC E0V
For Office Use Only
1101
PERMIT N0. I Building Insg cts r—J
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Applications and forms must be filled out in their entirety. Incomplete Building Department
applications will not be accepted. Where the Applicant is not the owner,an Town of Southold
Owner's Authorization form(Page 2)shall be completed.
Date:
OWNER(S)OF PROPERTY: \ / ,p
Name: Vl G�✓l—E l� �!/� V I Uhr SCTM# 1000- w _
Project Address; Zio 0
Phone#: '3 J — 9 :J t - / Email: �Q a0
Mailing Address:
CONTACT PERSON:
Name'_. Lo rI'—a) n C' 1 pc-4-rr� ;; jj
Mailing Address: k7 � 3 D t�7Cl1 CL V`P_e aa4� 1>rL Jam/
Phone#: 3338--7 ® `!1 Email:
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address: tqZA
Phone#: Email:
CONTRACTOR INFORMATION:
Name: �I l)e r} Y ►'� t �Cet�
Mailing Address: S "" 1
C A L A,))L 1
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑ epair ❑Demolition 11 Estimated Cost of Project:
Other 'So Gir P✓ ' t d Mlt.�� �Y1fiPq
$ 5.93 95 0 o
Will the lot be re-graded? ❑Yes>lo Will excess fill be removed from premises? ❑Ye!�RN0
OD /"
17— PROPERTY INFORMATION
Ex sting 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
n , this property? ❑Yes 2)ko IF YES, PROVIDE A COPY.
Check.Box After Readlh1g: The owner/contractor/design professional is responsible for all drainage and storm water issues as provided by
Cha r 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 bui(ding(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(priqt name): L-L rya-/ x, Q j (/L )gAuthorized Agent ❑Owner
Signature of Applicant: / .e �`�/CTJti- Date: pU�
STATE OF NEW YORK)
SS: /
COUNTY O [ )
Lrr�Ahe- , being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the n�r Qr
(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 Os I? N
day of , Z
Notary Public
IPROPERTY UTI°i FU TIU I
(Where the app!icant is not the owner)
residing at Lt4
�iP�l� ✓� do hereby authorize l to apply on
my beha to t yun of Southold Building Department for approval as described herein.
Owner' ignature Date
Cck DEBRA A SEPULVEDA
NOTARY PUBLIC,STATE OF NEW yORR
Print Owner's Name Registration No.0 1 SE6012697
Qualified in Suffolk Co rlty
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