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Home My WebLink About46815-Z TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE 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 #: 46815 Date: 9/14/2021 Permission is hereby granted to: Cocopardo, Nancy 117 Oxford Blvd Garden City, NY 11530 To: Replace windows and doors and construct upper Peer deck at existing single family dwelling as applied for, with flood permit. At premises located at: 65 Beachwood Rd, Cutchogue SCTM #473889 Sec/Block/Lot# 116.-4-29 Pursuant to application dated 9/8/2021 and approved by the Building Inspector. To expire on 3/16/2023. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $299.60 Flood Permit $100.00 CO-ADDITION TO DWELLING $50.00 Total: $449.60 Building Inspector TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 https:i".'wcN %.southoldtow ay. Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only PERMIT NO, Building Inspector: Applications and forms must be filled out in their entirety. Incomplete applications will not be accepted. Where the Applicant is not the owner,an Owner's Authorization form(Page 2)shall be completed. Date: OWNER(S) OF PROPERTY: Name: _ SCTM# 1000- = �A_ , Physical Address: 5- f g-0 Phone#: Email: " cat cv¢ - Mailing Address: b � F - CONTACT PERSON: i Name: P-41 L Mailing Address: "7{ {$ } c�,— � Phone#: - Email: . DESIGN PROFESSIONAL INFORMATION: Name: -� 0�S F i i Mailing Address: �-1Zf' y i tz� Phone#: 1 Email: l 109 CONTRACTOR INFORMATION: Name: _ iA _ v Mailing Address: '1 { A- CT ` Phone#: Email: ro�1 4t ff DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition Alteration ❑Repair ❑Demolition Estimated Cost of Project: ❑Other tQ - Will the lot be re-graded? ❑Yes No Will excess fill be removed from premises? ❑Yes to 1 e PROPERTY INFORMATION Existing use property. 1 Intended use of property: c Zone or use district in which premises is situated: ' Are there any covenants and restrictions with respect to this property? ®Yes DNo IF YES, PROVIDE A COPY. 1 lCheck Box After Reading: The owner/contractor/designprofessional#s responsible for all drainap and storm water Issues as provilded by Chapter 236 of the Town Code. APPUCA-flON IS HEREBY MADE to the Building Departinent for the Issuance of a Building Permit pursuant to the Building Zone Ordinance sof the Town of Southold,Slk,County,Now York and other applicable ,Ordinances or Regulations,for the construction sof buildings, additiom,alterations or for removal or demolition as herein described.The applicant to comply with all applicable laws,ordinances,building , housing code and reguiations and to admit authorized Inspectors on premisesand In building(s)for necessary Inspections.False statements made herein are punishable as a class A misdemeanor pursuant to Section 210AS of the New York State Penal Law. Application bmitted By(prmt name): t a ?4WA— MIA"uthorized Agenter Signature of Applicant: R Date® STATE OF NEW YORK) SS: CION 'CF r. t 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 relief,and that the work will be performed In the manner set forth in the application file therewith. Sworn before me this day of - 20 ) t t _Public Vikkl J.Ranlob PROPERTYr Public,State of New YeA rN RIZTI No.01RA9053032 (Cali.- in Suffolk Counly (Where the applicant is not the owner) Clanneission Expirw January 02,20 23 1 Nancy A Cocopardo residing at 65 Beachwood Road, Cutchogue, New York o hereby authorize � � �� k j, l� �t� to apply on y behalf to the Town of Southold Building Department for approval as described herein. 9- - Cw, s Signature Date Nancy A Cocopardo PrintOwner's Name SIF !tLl Insurance Fund 8 CORPORATE CENTER DR,3RD FLR,MELVILLE, NEW YORK 11747-3129 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE """"^^ 113243487 PROIOS INSURANCE AGENCY INC 18 ROOSEVELT AVE PORT JEFFERSON STA NY 11776 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER FCER0oTIFICATE HOLDER PHIL RAPPA CONSTRUCTION INC VIJN OF SOUTHOLD 71 RISA COURT BOX 1179 FLANDERS NY 11901 OUTHOLD NY 11971-0959 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE 11449 391-0 819613 04/09!2021 TO 04/09/2022 9/2/2021 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED NTH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO, 1449 391-0, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS, COMPENSATION UNDER THE NEW YORKWORKERS' COMPENSATION LAIC WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY, IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY,INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WE ITE AT HTTPS:/NVWW.NYSIF.COMICERT/CERTVALASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN TIME EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION, PRESIDENT PHILIP F RAPPA VICE PRESIDENT KONRAD B GOELDNER A TWO PERSON CORP THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE INSURANCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER:368751147 U-26.3 _ ___ --.. DATE CERTIFICATE OF LIABILITY INSURANCE IMWDDyrM 09/02/2021 THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate Wderis an ADDITIONAL INSURE},the policy(ies)must have ADDITIONAL INSURED provisions or be end_ If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer riatits to the certificate holder in lieu of such endorsement(s). PRODUCERNAS: John Proios Proios Insurance Agency,Inc. PHONE (631)473-9200 FAX (631)473-9277 (A1C.No.Extl: _ fits, ): 18 Roosevelt Avenue E-MAIL ADDRMjohnproios@me.com Ste B INSURE S)AFFORDING COVERAGE _ NAIC# Port Jefferson Sta. NY 11776 INSURER A: Southwest Marine&General Ins INSURED INSURER B: Phil Rappa Construction Inc INSURER C: 71 Rise Court INSURER O: INSURER E: Flanders NY 11901 INSURER F: COVERAGES CERTIFICATE NUMBER: 21-22 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INR LiCY err POLICY UP LTR TYPE OF INSURANCE —4i—Ran D. POLICY NUMBERMWD _ tMMJD LIMITS COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE $ 1,000,000 FZA I —_ CLAIMS-MADE OCCUR PREMISES tEa 1 $ 100,000 4 MED EXP(Any one person) $ 5000 ° A PERSONAL&ADV INJURY $GL2021 RLH00374 08/18/2021 08/18/2022 1,000,000 GEN1LAGGREGATEE LIMITAPPLIES PER: gg GENERAL AGGREGATE $ 2,000,000 POLICY 1-1 JE a M LOC 3 2,000,000 s PRODUCTS $ OTHER: I Employee Benefits $ 1,000,000 AUTOMOBILE LIABILITY a COMBINED SINGLE UMiT Me d $ 1 ANYAUTO BODILY INJURY(Per person) is OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per acadent) is c HIRED NON-OWNED PROWERTY DAMAG-E AUTOS ONLY AUTOS ONLY i $ i is UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIM"ADN AGGREGATE $ DED RETENTION$ I $ WORKERS COMPENSATION 1 P'cR u i ti- AND EMPLOYERS'LIABILITY STATUTE -ER =.....- ANY PROPRIETORIPARTNER/EXECUTIVE [ E L EACH ACCIDENT YIN OFFICER/MEMBER EXCLUDED? NIA lMandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ i ° 1 { DESCRIPTION OF OPERATKINS/LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached it more space Is required) CERTIFICATE R CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of Southold ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 1179 AUTHORIZED REPRESENTATIVE Southold NY 11971-0959 14,14k, 1 ®1988-2013 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Suffolk County Dept of Labor,Licensing&Consumer Affairs HOME IMPROVEMENT LICENSE Name PHILIP F RAPPA Business Name This certifies that the bearer is duly licensed PHIL RAPPA CONSTRUCTION INC. by the County of suffolk License Number:HI-61885 Rosalie Drago Issued: 03/25/2019 Commissioner Expires: 03101/2023 •---�— I.�._I ._.._.w.._..1.....� t._.. .. r---' i__._.._.__.._ _ . t__..._1�r'r ..i...___-.____._.____......_. ._._..._t_-- __-�--..._._,...._._. ......... ... 4_ !. �.�..2::_�:r_. �'� /�� "Lot A7 I ry 1' c1fyj ` �- � �o G•e,�h��s 'N w�AOow� �,tts i`J J 5 r s MU 2`} or< `t' rr--. Z.,A10 'tom E-A- `rk� Sa�s3 (2� _._._........................... ..-.....--- �Fay �,,, ��..t_. a-r�sr�.. 7�r��S cz t - _.. �.. � _ I r4 64) S NE J-}-•rv��r25o�.1 Go C S e2,0 2-0 o� � W 13 Sr 2 tN a �� ►� 5 r c, C _ 01 il ti�� - ! �(k C�-s I w..`_" ' Seg-c�?ajQ,- . sR U je c F _ _.__ _....__._... ........._._._.....__ ... ..... .. ... .. .. .._.._. t WCA V ot"O 1 �/q4 . �t�!- FtN G NEE R 4. V11 . .� P OA C� E I N 13 s. S1 .- Joseph Fischetti, PE 1725 Hobart Road Southold,NY 11971 ��.c.i��rJ �� PROFESSIONAL ENGINEER i r \ �,� {�,"C ��.- _ Board Certified in Structural Engineering Telephone:(631)765-2954 Facsimile:(631)614-3516 Email:wingman@optonline.net 0 i a < Z q. 1 Q - - S'gczy,o TF't-CGL.I;1D:1: ?55tJ65 71 Yq IN iN 14 k ooc S Za2-Q 37 2.3 '/2 SstQ '` 65 FisCHETTI ENGINEERING Joseph Fischetti, PE 1725 Hobart Road Southold, NY 11971 PROFESSIONAL ENGINEER Board Certified in Structural Engineering Telephone: (631)765-2954 Facsimile:(631)614-3516 i Email:wingmanLmoptonline.net z