HomeMy WebLinkAbout53189-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#: 53189 Date: 08/10/2026
Permission is hereby granted to:
Brian Pessin
65 E 76th St 3DE
New York, NY 10021
To:
Install roof mounted solar panels to an existing accessory barn as applied for per manufacturers
specifications.
Premises Located at:
3200 Soundview Ave, Mattituck, NY 11952
SCTM#94.-2-5
Pursuant to application dated 07/31/2026 and approved by the Building Inspector.
To expire on 08/09/2028.
Contractors:
Required Inspections:
Fees:
SOLAR PANELS $100.00
CO Accessory Structure $100.00
Total $200.00
jX&
Building Inspector
ILDING DFPARTNJE`�7
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APPLICATI0% FOR BU LDING PERMIT
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53 1 1:8
1i s ark forms must
ust to fiiled cuL i,',their entiret!.1,-icornplete
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ppFcat4crrs oct '4V,1e--0e the Appikart 35 roz tine 0Nyr'e!, af:
foryn'J'page sha"l be zornq?'E't?d.
i Date
OWNER-,�S) OF PROPERTY;
Nar p.e SCTNI# c, o—/0J C 0
Project Address:
C
Phore#
�03 Email,
Mailing Ad&ess.-
LJ 119
CONTACT PERSON-
L D f_J_4.3'n,C,
FMTaHringAddress.: —7 W
7 L�-
Phone J -1312 q I F rn a'�11
DESIGN ERR OFESS�ON'A, � )Y,4FCRN?AT7,0Nr
Mailing Address:
Phone#: Email:
CONTRACTOR WfOfWA710N,
Name.*
C
Mailing Address:
Phone#:
Email:
DESCRIPM,ON OF PROPOSED COMTRUCTION
❑
New Structure OAddition CAlteration E—Repair DDemolition Estimated Cost of Project:
P V
Will the lot be re-graded? _7Yes�allo Will excess fill be removed from premises? DYes'9 I 1 11 l07
PROPERTY INFORMATION
Existing use of property: I&S Intended use of property: Ru
Zone or use d'Mrict in which premises is situated. Are there any covenants and restrictions with respect to
W"'
this property? E]Ye 'elo IF YES,PROVIDE A COPY.
*heck 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 15 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(sl 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): L_0 Pe 1-7-)—
Authorized Agent ClOwner
Signature of Applicant: Date:
STATE OF NEW YORK)
COUNTY OF�SGt7g--
L-0 je,--"�1..i /D ) 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 per-formed in the manner set forth in the application file therewith.
Sworn before me this
ay of
Notary PuEiric/7"i
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
1, By-i-OLn pcss) to residingat .3 ZO 0 &iiLoA.Vj'fv0e-
97/6-71 CA4
k-4), �-Lcck do hereby authorize Loo I.' to apply on
Jj
my behalf h Town of Southold Building Department for approval as described herein.
\all
Lo
Owner's Signature Date
r' L ro DEBRA A SEPULVEDA
i ,on NOTARY FUBLJCI STATE Of NEW y0RX
Print Owner's Name Registration No.OISE6DI2697
Qualified is Suff,
2 My Commission Expires