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HomeMy WebLinkAbout46963-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#: 46963 Date: 10/13/2021 Permission is hereby granted to: AW Frame LLC 1299 Ocean Ave Ste 333 Santa Monica, CA 90401 To. construct accessory in-ground swimming pool as applied for per HPC approval. At premises located at: 640 Skippers Ln, Orient SCTM # 473889 Sec/Block/Lot# 24.-1-10 Pursuant to application dated 9/28/2021 and approved by the Building Inspector. To expire on 4/14/2023. Fees: CO- SWIMMING POOL $50.00 SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 Total: $300.00 Burling Inspector TOWN OF SOUTHOLD—BUILDING DEPARTMENT n Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 Date Received APPLICATION FOR U I i For Office Use Oniy IIS t� PERMIT NO. Building in i �0 SEP 2d Applications and forms must be filled out in their entirety. Incomplete BUILDWO DEQ y, applications will not be accepted. Where the Applicantis not the owner,an TOWN OFSODft&D Owner's Authorization form(Page 2)shall be completed. Date:09/28/2021 PROPERTY:OWNER(S)OF Name:A.W. Frame L.L.C. SCTM#1000-24-01-10 Project Address:$40 Skippers Lane, Orient, NY 11957 Phone#:310-451-0744 Email:jjacobs@goodfriendjacobs.com Mailing Address:640 Skippers Lane, Orient NY 11957 1CONTACT PERSON: Name: Daniel Schillberg l } Mailing Address:2 Sky Drive, Cornwall, NY 12518 00 Ll i Phone#:646-645-3687 Email: Daniel @dado-architecture.com DESIGN PROFESSIONAL TI Name:DADO Architecture PLLC Mailing Address:2 Sky Drive, Cornwall, NY 12518 F q_ Phone#:646-645-3687 Email:Daniel@dado-architecture.com CONTRACTOR INFORMATION: Name:AGMEC Construction INC. Mailing Address: 1575 Tuckers Lane,Southold, NY 11971 Phone#:631-456-1284 Email:rpzecena@iCloud.com DESCRIPTION I ❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: Foil Other In Ground Pool $100,000 Will the lot be re-graded? ❑Yes W No Will excess fill be removed from premises? _ Yes ❑No 1 PROPERTY INFORMATION Existing use of property: Residential Intended use of property:Residential Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to R-40 this property? Dyes NNo IF YES, PROVIDE A COPY. R e - The owner/contractor/design professional is responsible for all drainage and storm water Issues _ 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 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,ordlnances,building code, housing code and regulations and to admit authorized Inspectors on premises and In bulkling(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): AC'MeC. CC�15r'Z1)C"W lk � Authorized Agent Downer Signature of Applicant: Date: 9/28/2021 STATE OF NEW YORK) SS: COUNTY OF Suffolk A(:� M cLOt\ist12U C,Tl�l� k q L being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the Contractor (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 417 J day of 20 PATRICIA CMOO E Notary Public NOTARY PUBLIC,STATE OF NEW YORK Registration No.01 M04861668 Oualifted in Suffolk Coun My . �i n June 16, AUTHOR (Where the applicant is not the owner) residing at A.W.FRAME L.L.C. 840 Skippers Lane, I, Orient, NY 11957 de hereby authorize to apply 1 on my behalf to the Town of Southold Building Department for approval as described herein. 09/28/2021 Owner's Signature Date Jeffrey Jacobs,CFO Print Owner's Name 2 STATE O1 NEW YORK WORKERS' COMPENSATION BOARD CERTIFICATE OF NYS WORKERS' CO-INIPENSATION INSURANCE COVERAGE la. Legal Name&Address Or Insured (Use street address only) 1b. Business Telephone Number of Insured I 631-276-3239 AGMEC Construction hic i 1675 Tuckers Lane lc. NYS Une"'ploYinent Insurance EiniAtiver Southold, NY 11971 1 Registration Number of Insured Work Location of Insured (Ontil reqWred ?f1 i coverage is I specifically finifted to certain locations in Nipv York Slate, i.e., a I d.Federal Employer Identification Number of Insured Wrap-1,1p Pofie.0 or Social Security Number 84-3620008 2. Name and Address of the Entity Requesting Proof of 3a. Name of Insurance Carrier Coverage(Entity Being Listed as the Certificate [jolder) 17.1rm Family Casually Insurance Co 3b. Policy Number of entity listed in box 'Ila" 3102W7184 Town Of Southold Po Box 1179 3c. Policy effective pel-iod Southold,NY 11971 1 11/1 1115/2021 3d. The Proprietor, Partners or Executive Officers are included. (()nIN.check box if all partners/orricers included) X all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above iii box "Y' imll-C% the business refLreneed above in box "la" for workers' compensation under the New Yloi-k State Law,, (To use this form,New York(NY)must be listed under lien/ 3A on the INFORMATION PAGE of the workers' ionipensation insurance policy). -111C insurance Carrier or its licensed agell, will send this Cei'micatLe of Inslitance io the enfit� fisied above as the certificale holder in lox"I"- The InA urance wX u/vo ootiji:Hle M-4 cerfifieate holfler 14 in;0&ms!Fc,nolicii is to mmimlivnew prenjillms W, 11'ain'r, -50 duvs IF thure arcretf-voils ofhel= tholl nonpalflnen, q1 prefuhUns that vancei the po' v or efin'n ule ihe iii-vured hom me h i coveraggv huhhwicd on tha(A-1l hc, :ie, 6/7I-Se r.-1;'es numv bc scni I v r t-1 ) k 5 e:UICH m� Otherivf%e, this Certificate jv valitipir fp1le). fjr ,bier this' is approveil bt: file insitraitee carrier or its ficemed rig ellf, or onfil the pofifLj, avpirafioti date fisted in &-v '43c". whichever is earlier. Please Note: Upon the cancellation of the workers' compensation policy indicated on this form, if the business continues to be named on <i permit, license or contract issued by a Certificate holder, the business must provide that Certificate holder with a new Certificate of Workers' Compensation Coverage or other authorized proof that the business is complying mvith the mandatory coverage requirements of the New York State Workers' Compensation Law. eN Under penalty of perjury, I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Kirk Associates 1,FD Wrillt MUM 01'authorized representative or lice riced agent ol-insurance carrier) Approved by: 09/27/2021 (Signature) MaLC) Title Manager—Kirk Associates Ltd Telephone Number of authorized representative or licensed agent of insurance carrier 631-727-776- Please Note: Onli? insitrunce carriers and their licensed twenis eire authorized to issue Form C-105.2. 112SUrailUe brokvrs are -VOT authorized to issite it C-105.2(9-07) www.wcb.state.ny.us CERTIFICATE OF LIABILITY INSURANCE DATE tMM,00 Y)Y 009/27/221 --ETHIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND 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. IMPORT ANT: It tlla certificate holder Is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. 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 rights to the certificate holder in lieu of such endorsements) oDUCER C ONTACr I NA11 Eric Kirk irk Associates LTD PHONE 631,727-7767 - 631-727-7941 JAM—No—ba) 8 First Street E-MA-L ADDRESS: Janice. ilormitnieameriC n-nattonai ti,om INSURI RCS}AFFORDfNts COVERAGE LAIC p iverhead NY 11901 INSU RA, Farm Family CaSUally Insurance Company 13803 iURED f�suREt�a. United Farm Ferrrlly Insurance Co:npsny- i 29963 AGMEC Construction Inc INSURER C.. 1 1675 TUCKERS LN (INSURER - I - iuNSUR R E ( ; Southold NY 11971 I W RIER F: DVERAGES CERTIFICATE NUMBER: 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. 4®- € DL.ISU I FOLI6Y EFF PCSLIO EXP 41 TYPE OF INSURANCE # PfCYNUM� - �D SMD.IYYYYJ LIMITS l COMMERCIAL GENERAL LIABILITY 1310 L6544 11115,,1020: 1111512021 I EACH OCCU RENCE $ 1,3 o, S0 4 CLAIMS-MADE OCCUR ! [ l `#" C O r� IBESFf c� ton-.1. S 100,000 [X i Cont-actual Liability E f °MED EXP{Anv ane e--sa:l PERSONAL 8 ADV tr:.ft,RY Is 1,007,0003 vEf 1 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATEs 2.000,000 POLICY iEyTo X�LOC - ., I I DU Ts-CO IOP AGG i S 2,000.L00 I i iTHER- AUTOMOBILE UA8ILITY a - = i COMB%E SHNGLE t,uAIT ]ANY AUTO j i �80DILY INJURY(Par parson) OWNED SCHEDULED 1 I BODILY INJURY Per accident E AUTOS ONLY �AUTOS � { ),$ i HIRED ;NON-OWNED PROPERTY O A,GE AUTOS ONLY AUTOS ONLY IPcrac fl $ - I UMBRELLA LIAS ] =OCCUR - -- ( EAO,�OCCURRENCE _ EXCESS LIAB S ;CLAIMS -MADE' AOr¢4�uaTE S DED I TENTION Sit i WORKERS COMPENSATION - ;3103W7921 1111 512020 .'11512021 :XI r -,TH_ =AND EMPLOYERS'LIABILITY YIN I aT,` E .R j sa`'PROPR E ORIPARTNE XFk-UTN1- OFFICEPUMEMSEREXC U 9i 3 NIA - I F €=,.L.Et ACCIDENT 100,0010 - (Mandatory 1t r,t t I E L_01I EASE.EA EMPLOYEE; 100,000 If - be under I ,. �._. ._ =DSCfR TncwFOPERt41,l�NSbell I i i E.L.DISEASE=taOnICYLIMIT !S _500,000 I I 3 I 1 SCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedulo,maybe attached if more space is required) :RTIFICATE HOLDER IS LISTED AS ADDITIONAL INSURED ®RTIEICATE HOLDER CANCELLATION Town Of Southold SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Po Box 1179 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Southold, NY 11971 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Kirk Associates ©1988-2015 ACORD CORPORATION. All rights reserved. -ORD 25(2016/03) Thq ACORD name and logo are registered marks of ACORD NEW Workers CERTIFICATE OF INSURANCE COVERAGE V— YORK I E =nsation DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW I PART 1.To be completed by Disability and Paid Family Leave Benefits Carrier or Licensed Insurance Agent of that Carrier I i — i la.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured CNK CONSTRUCTION INC. 631-664-8502 ATTN:GINNA PA DO 19 JOSICA DRIVE RIVERHEAD,NY 11901 1c.Federal Employer Identification Number of Insured or Social Security Number Work Location of Insured(Only required lFcoverage is specifically limited to certain locations in New York State,i.e.,Wrap-up Policy) 371930678 12.Name and Address of Entity Requesting Proof of Coverage 13a.Name of Insurance Carrier I (Entity Being Listed as the Certificate Holder) I SheiterPoint Life Insurance Company 1 Town of Southold - Building Department Town Hall Annex 3b.Policy Number of Entity Listed in Box 1 a" 54375 Main Rd. DBL621209 PO BOX 1179 3c.Policy effective period Southold, NY 11971-0059 09/01/2021 to 08=3'/2022 --------------- 4. Policy provides the following benefits: A.Both disability and paid family leave benefits. B.Disability benefits only. I C.Paid family leave benefits only. 15. Policy covers: A.All of the employer's employees eligible under the NYS Disability and Paid Family Leave Benefits Law. B.Only the following class or classes of employers employees: Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenoed above and that the namedl insured has NYS Disability and/or Paid Family Leave Benefits insurance coverage as described above. 9/24/2021 I Date Signed By IV (Signature of insurance carrier's authorized representative or NYS Licensed Insurance Agent of that Insurance-carrier) !Telephone Number 0-46-829-8100 Name and Title RiChard White, Chief Executive Officer IMPORTANT: If Boxes 4A and 5A are checked,and this form is signed by the insurance carrier's authorized representative or NYS Licensed Insurance Agent of that carrier,this certificate is COMPLETE. Mail it directly to the certificate holder. If Box 4B,4C or 513 is checked,this certificate is NOT COMPLETE for purposes of Section 220,Subd.8 of the NYS Disability and Paid Family Leave Benefits Law. It must be mailed for completion to the Workers'Compensation Board, Plans Acceptance Unit, PO Box 5200, Binghamton, NY 13902-5200. PART 2.To be completed by the NYS Workers'Compensation Board (Only if Box 4C or 5B of Part 1 has been checked) State of New York F_ Workers' Compensation Board According to information maintained by the NYS Workers'Compensation Board,the above-named employer has complied with the NYS Disability and Paid Family Leave Benefits Law with respect to all of his/her employees. Date Signed 9/2412021 By (Signature of Authorized YS Workers'Compensation Board Employee) Telephone Number 631-828-1935 Name and Title Bree Devereux Sandurs,licensed agent. Please Note:Only insurance carriers licensed to write NYS disability and paid family leave benefits insurance policies and NYS licensed insurance agents of those insurance carriers are authorized to issue Form DB-120.1.Insurance brokers are NOT authorized to Issue this form. DB-120.1 (10-17) DB-120.1 (10-17) New York State Insurance Fund 8 CORPORATE CENTER DR,3RD FLR,MELVILLE,NEW YORK 11747-3129 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE Im. OWE "A^ 371930678 CNK CONSTRUCTION INC. 19 JOSICA DRIVE ftt-i-0-9, RIVERHEAD NY 11901 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER CNK CONSTRUCTION INC. TOWN OF SOUTHAMPTON 19 JOSICA DRIVE 116 HAMPTON RD RIVERHEAD NY 11901 SOUTHAMPTON NY 11968 POLICY NUMBER I CERTIFICATE NUMBER POLICY PERIOD DATE 12522102-9 817464 19/01/2021 TO 09/01/2022 9/23/2021 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2522102-9, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW 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 WEBSITE AT HTTPS://WWW.NYSIF.COM/CERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE 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 GINNA PARDO CNK CONSTRUCTION INC. 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. BY CAUSING THIS CERTIFICATE TO BE ISSUED TO THE CERTIFICATE HOLDER, THE POLICYHOLDER UNDERTAKES TO PROVIDE THE CERTIFICATE HOLDER 15 CALENDAR DAYS' NOTICE OF ANY CANCELLATION OF THE POLICY. NEW YORK STATE INSURANCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 195245557 '6.3 DATE(MM/DDNYYY) CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF ONLY AND 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. 1MFORT : If the certfficate holder is an ADD NAI.-INSURED,the licy(Ies)must have ADDITIONAL INSURED provisions or be endorsed. 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 rights to the certificate holder in lieu of such endersementt(s). 'RODUCER CONTACT N Ems_ t On Your Team Insurance Agency �_ - -828-1935 V .N$t: 631-938-0220- 1733 North Ocean Ave `i : Br Y T - I Medford, NY 11763 tNSts S)AFFO NIS E i INV A: O to harp nsur D Cf I pant/ 0195 4SURED MSU R B CNK Construction Inc. SU RER C; C/O Ginna Pardo MSUPMR0: 19 Josica DriveINSURER E — _ —_ Riverhead, NY 11901 INSURERS. :OVERAGES CERTIFICATE NUMBER: 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. ODD— nn nnf) TYPEOFINSURANCE � POLYNtIM ���1� �EE` r � ,� .COMMERCIAL GENERAL LU\BILITY i �A a �� $ � � CLAIMS-MADE OCCUR PREMISE X RNYG306235-01 812712021`8J27120 PERsoNAL =- Y ur 'PPRO- AGGREGATE LIMIT APPLIES PER: GENERAL G-GREGA E ' i POLICY JECT LOC PRODUCTS S-GOMPIOPAGG OTHER- � - ._- $ _- _. AUTOMOBILE LIABILITY c 01 CEO SINGLE Mi; $ -Ee aegoo ftl I _ i ANY AUTO BODILY INJURY(Per person) _$ (OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident);$ 1 I� HIRED NON-OWNED PROP T`7 =A`GE _ – AUTOS ONLY AUTOS ONLY e- t, $ UMBRELLALIAB OCCUR EACHOCCURRE EXCESS LIAR CLA.INIS-, <' AGGREGATE $ DED REETENITICHN$ WORKERS COMPENSATIONO� € - PER r; AND EMPLOYERS'LIABILITY a A ER YIN C OFMCE1 cTBE R EXCLUDED DECLUD E.L.EACH ACCIDENT Fti = N!A (Mondatory In NK) ms 3If SC describe� E EASE S -EAE;PL€ EE' — D 1PTI0N OE 0PERA=n0NS tWw E,L.DISEASE-POLICY LIMIT ?SCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) CNK Construction Inc. is a home improvement company/contractor working on Residential Homes in Suffolk County. In the event the insurance policy is canceled (not renewed), lapses or is changed,fifteen (15)days prior written notification shall be given to the Licensing Review Board. ERTIFICATE HOLDER CANCELLATION own of Southold-Building Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN own Hall Annex ACCORDANCE WITH THE POLICY PROVISIONS. 14375 Main Rd. 'O BOX 1179 AUTHORIZED REPRESENTATIVE Southold, NY 11971-0059 ©1988-2015 ACORN}CORPORATION. All rights reserved. .CORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ACORDs provided by Forms Boss.www.FormsBoss.com; (c)Impressive Publishing 800-208-1977 C)ur Unio - _K Edward Webb,Chairperson Town Hall Annex Anne Surchin,Vice Chair ° � - 54375 Route 25 Robert Harper ° PO Box 1179 Joseph McCarthy , Southold,NY 11971 Mariella Ostroski - P Fax(631)765-9502 Tracey Dwyer,Administrative Assistant _ Telephone: (631)765-1802 Town of Southold Historic Preservation Commission Tuesday, September 29,2020 RESOLUTION # 9.29.20.2 Certificate of Aropriateness RE: 640 Skippers Lane,Orient,NY,SCTM# 1000-24.4-10 Owner: AW Frame LLC RESOLUTION: WHEREAS, 640 Skippers Lane, Orient,NY, is on the Town of Southold Registry of Historic Landmarks, and WHEREAS, as set forth in Section 56-7(b)of the Town Law(Landmarks Preservation Code)of the Town of Southold,all proposals for material change/alteration must be reviewed and granted a Certificate of Appropriateness by the Southold Town Historic Preservation Commission, and, WHEREAS, the applicant is requesting permission to construct a front and side yard fence, and, WHEREAS, the application includes the installation of a solid western cedar 4 ft.privacy gate with a natural wood arbor and continuous 4 ft. green wire fencing that will increase up to 6 1/2 ft. in height where permitted. WHEREAS, the applicant met with the commission for a pre-submission conference on August 18, 2020. WHEREAS, the applicant must comply with any conditions imposed by the zoning board of appeals. WHEREAS, a public hearing was held on September 29, 2020. NOW THEREFORE BE IT RESOLVED,that the Southold Town Historic Preservation Commission determines that the proposed work detailed in the above referenced application meets the criteria for approval under Section 170-8(A)of the Southold Town Code and, BE IT FURTHER RESOLVED,that the Commission approves the request for a Certificate of Appropriateness. MOVER: Commissioner Ostroski SECONDER: Commissioner McCarthy AYES: Chairperson Edward Webb,Vice Chair Surchin, Commissioner Harper, Commissioner McCarthy, and Commissioner Ostroski. RESULT: Passed Please nate that any deviation from the approved plans referenced above may require further review from the commission. Signed: __ 4 Tracey L Dwyer,Ap kation Coordinator or the Historic Preservation Commission Date: October 23,2020 Nunemaker, Amanda From: Burke,John Sent: Wednesday, September 15, 2O21 10:36 AM To: Nunennaker,Amanda Subject: RE: 640Skippers Ln Yes,the newly built structures donot require HPC approval. John }. Burke, Esq. Assistant Town Attorney Southold Town Annex 54375Route 25 (Main Road) P.O.Box ll79 Southold,New York 11971-0959 Office: 631.765-1939 Fax: 631.765.6039 E-mail: Fnmnn: Nunemnaker,Amanda Sent:Wednesday, September 15, 2O211O:31AM To: Burke,John~]ohnbu@southo|dtovvnny.gov> Subject: G4OSkippers Ln Hi John, I received the HPC approval for 640 Skippers Lane, Orient for a front and side yard fence. The Notice ofDisapproval was written for construction of a new swimming pool, pool house and tennis court. Tracey,the former secretary ofthe committee,told me that HPC did not grant approvals for these structures,other than the fence, since HPC only issues approvals for existing structures, not newly proposed. Can you please confirm this for me? Thank you very much. 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