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HomeMy WebLinkAbout47640-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#: 47640 Date: 4/4/2022 Permission is hereby granted to: Cedars 1883 LLC www_. ._........._... -_ .................................................. 316 W 79th St#11 W New York, NY......'.1..0.0.24 To: reconstruct existing pool deck and pool fence as applied for per Trustees Non-Jurisdiction letter. At premises located at: 825 Stephensons Rd. Orient _�._._._........ SCTM # 473889 ______________. ._.__._._ ._._.__.___..................... ....................wwwwww. _ __..... Sec/Block/Lot# 17.-1-11.5 Pursuant to application dated 1/13/2022 and approved by the Building Inspector, To expire on _„_,10/4/2023. Fees: CO-ADDITION TO DWELLING $50.00 SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $833.60 Total: $883.60 Building Inspector TOWN OF SOUTHOLD—BUILDING DEPARTMENT µ Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 iitl n ://w,Nw Sotitllolclto'W! LYOI Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only PERMIT NO. 141(0 Lo Building Inspector._ Applications and forms must be filled out in their entirety. Incomplete 022 applications will not be accepted. Where the Applicant is not the owner,an 31I DEPT Owner's Authorization form(Page 2)shall be completed. 70W,�OF SOUTHO L Date:January 6, 2022 OWNER(S)OF PROPERTY: Name:~Jonah XXXXSonnenborn .... _. . SCTM�X1nnn_478 �-7,m 1 Project Address:825 Stephensons Road, Orient, NY 11957 f l Phone#:917-543-4690 Email:.ionah.sonnenborn@gmaii.com Mailing Address:316 West 79th Street, 11W, New York, NY 10024 CONTACT PERSON: Name:Katie Sonnenborn Mailing Address: 316 West 79th Street, 11 W, New York, NY 10024 Phone#:917-951-6913 Email:ksonnenborn@gmail.com DESIGN PROFESSIONAL INFORMATION: Name:Stageberg Architecture, PLLC Mailing Address:25 Chapel Street, Suite 600 Phone#:(917) 685 4983 Email:jane@bscarchitecture.com CONTRACTOR INFORMATION: Name:Stellar Home Builders Mailing Address: 127 Hewitt blvd, Center Moriches, NY 11934 Phone#:6319261151 Email:manuelecontract@aol.com DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Struc......._. ture ❑Addition *Alteration ❑Repair ❑Demolition Estimated Cost of Project: ❑Other $ Will the lot be re-graded? ❑Yes *No Will excess fill be removed from premises? ❑Yes i*No 1 PROPERTY INFORMATION Existing use of property:tWo family Intended use of property:tWo family Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to R40 this property? ❑Yes *No IF YES, PROVIDE A COPY. W, Check flax Afteiir lkeadiin b The owner/contractor/design professional is responsible for all drainage and storm water Issues as 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,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):Stageberg Architecture, PLLC Authorized Agent ❑Owner Signature of Applicant: Date: 0(1-2-6 7 L STATE OF NEW YORK) S COUNTY OF L :�� ) 1 _._. „M ,4CA being duly sworn, deposes and says that(0 is the applicant (Name of individual si' ing con act) 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 day of 20 �2— No DEBORAH Efi RAN, 0Mt4aV Notary Public dMsto-:of Now r� NO.011 '6221482 Qualified in Richmond County PROPERTY OWNER „mi My Commission Expires May 3, 2022 (Where the applicant is not theowner) M Katherine and Jonah Sonnenborn residing at 825 StephensonS Road, Orient, NY 11957 do hereby authorize Stageberg Architecture, PLLC to apply on my bhalf to th Town o Southold Building Department for approval as described herein. January 9, 2022 Owner's Signature Date Katie Sonnenborn Print Owner's Name 2 Glenn Goldsmith, President � �� � Town Hall Annex 54375 Route 25 A. Nicholas Krupski,Vice President des P.O. Box 1179 Eric Sepenoski Southold,New York 11971 Liz Gilloolyx � ,a" � r Telephone(631) 765-189..2 Elizabeth Peeples 'yFax(631) 765-6641 Z%..I BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD March 24, 2022 Patricia C. Moore, Esq. 51020 Main Road Southold, NY 11971 RE: CEDARS 1883 LLC 825 STEPHENSON ROAD, ORIENT SCTM#: 1000-17-1-11.5 Dear Ms. Moore: The Southold Town Board of Trustees reviewed your letter received in this office on March 9, 2022 and the site plan prepared by Young & Young, dated March 8, 2022 and determined that the proposed replacement of an existing pool deck, pool fence and pool is out of the Wetland jurisdiction under Chapter 275 of the Town Wetland Code and Chapter 111 of the Town Code. Therefore, in accordance with the current Wetlands Code (Chapter 275) and the Coastal Erosion Hazard Area (Chapter 111) no permit is required. Please be advised, however, that no clearing, no removal of vegetation, no cut or fill of land or removal of sod, no construction, sedimentation, or disturbance of any kind may take place within 100' landward from the top of the bluff, or seaward of the tidal and/or freshwater wetlands jurisdictional boundary or seaward of the coastal erosion hazard area as indicated above, without further application to, and written authorization from, the Southold Town Board of Trustees pursuant to Chapter 275 and/or Chapter 111 of the Town Code. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction and Coastal Erosion Hazard Area, which may result from your project. Such precautions may include maintaining adequate work area 2 between the tidal wetland jurisdictional boundary and the coastal erosion hazard area and your project or erecting a temporary fence, barrier, or hay bale berm. This determination is not a determination from any other agency. If you have any further questions, please do not hesitate to call. Sincerely, Glenn Goldsmith, President Board of Trustees GG:dd DATs(MMI11112022 � CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A 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. IMPORTANT: If the 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 endorsement(s). PRODUCER CONTAUF _....m.. SPECIALIZED INSURANCE&SERVICES PHoYE �T 7 7 f rAac 17 :6 204 RTE.112 E-MAtL SRU SPEClALIZEDINSURANCE M PATCHOGUE, NY 11772 Drsq �_.... f... _ GE C _ 4.1 .. . ... . Auto-Home-Business-cycle-etc, _ 428C . AFFORDIN COVERA _. JErt sSUALTY 1...-,M. .__ ... .....w. . G INsuRERA: NSURANCE O 6 _....................................�...-..................... .. ...... INSURED INSURERS: STELLAR NOME BUILDERS INC _. .� __.__._... �_.... .x..—............_ INSURER C, ......... 127 HEWlTT BLVD ............... .a .ww............... ......�........_.. ........... ....... INSURER D: CENTER MORICHES, NY 11934INSURrRE INSURER F COVERAGES 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. ._ _ ...... ___w. AODL 175R �� POLICY E F" . ............ IN _ww__ LIMITS TYPE OF INSURANCE POLICY NUMBER M Dt1 _w POLIDCY EXP ,mMA m L266000549 10/22/2021 10/22/2022 CCURRENCE $ 1,000,000 A [ COMMERCIAL GENERAL LIABILITY Y EACH O....., Y CLAIMS-MADE OCCUR L*, iII .(l$4rrg.glYgR➢1t1 S-.w ..... . 100000 MED EXP jAny one persons $ 5000 PERSONAL&ADV INJURY $ 1000000 2 000 000 PRO- El NERAL AG....MP/OP A $..................�.......__.2QQQ0. OTHER: GEN'l..AGGREGATE LIMIT APPLIES PER: GE AGGREGATE _ PRO- POLICY JECT LOC PRODUCTS-Cop GG $.. ..$ AUTOMOBILE LIABILITY COMBINED SIN'Gt.E;LIMIT $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accldenL) $ ._... AUTOS ONLY AUTOS HIRED NON-OWNED 'PROPER DAMAGE— — $ AUTOS ONLY AUTOS ONLY (P IEhI)+92 _. .... UMBRELLA LIAB OCCUR EACH OCCURRENCE $ _. EXCESS LIAB CLAIMS-MADE AGGREGATEw ......__.. ._....... $..ww-......_M................., DED RETENTION .$........................._ $ WORKERS COMPENSATION PER OT - AND EMPLOYERS'LIABILITY YIN ANY PROPP3F,'TOR1PARTNER1EXEd UTNE_ N!A E.L.EACH ACCIDENT $ OFFICERMEMBER EXCLUDED? ( ISEASE-EA EMPLOYE $ (Mandatory In NH E.L.D .........................................................w 4tdundef OECaRPctOeN OF ERATIONS bobw E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CARPENTRY, DRYWALL,PAINTING,TILE, REMODELING CERTIICATE HOLDER IS LISTED AS ADDITION INSURED AS PER WRITTEN CONTRACT OR AGREEMENT CERTIFICATE HOLDER CANCELLATION TOWN OF SOUTHOLD BUILDING DEPARTMENT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TOWN HALL ANNEX 54375 MAIN ROAD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO BOX 1179 ACCORDANCE WITH THE POLICY PROVISIONS. SOUTHOL D, NY 11971 AUTHORIZED REPRESENTATIVE r ©1988-2015 AACORD All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD NEW Youx Workers' CERTIFICATE OF INSURANCE COVERAGE Compe1cnsatian LEAVE BENEFITS LAW NYS DISABILITY AND PAID FAMILY L PART 1.To be completed b abi..,.__._..._..._.._...w�._.....u...._.._. ...........�.,.�.ww.._....._...�..��....._:..� ._............. p ..wwww.. y NYS disability .....lity and Paid FamilyLeave benefits carrierg or licensed insurance agent of that came 1a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured _...._..,,, w _......_._ STELLAR HOME BUILDERS INC 631-926-1151 ATTN: PHIL MANUELE 127 HEWITT BLVD CENTER MORICHES, NY 11934 ic,Federal Employer Identification Number of Insured or Social Security Number Work Location of Insured{Only required if coverage is specifically limited to certain locations in New York State,i.e.,Wrap-Up Policy) 844229132 2.Name and Address of Entity Requesting Proof of Coverage _ 3a.Name of Insurance Carrier _M_.._. 'er (Entity Being Listed as the Certificate Holder) ShelterPoint Life Insurance Company TOWN OF SOUTHOLD-BUILDING DEPARTMENT TOWN HALL ANNEX 54375 MAIN ROAD 3b.Policy Number of Entity Listed in Box"1 a" PO BOX 1179 DBL653416 SOUTHOLD, NY 11971 3c,Policy effective period 12/09/2021 to 12/08/2022 4. Policy provides the following benefits: ❑X A.Both disability and paid family leave benefits. B, Disability benefits only. F] C.Paid family leave benefits only. 5. Policy covers; xjj(` A.All of the employer's employees eligible under the NYS Disability and Paid Family Leave Benefits Law. E] B.Only the following class or classes of employer's employees: 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 NYS Disability and/or Paid Family Leave Benefits Insurance coverage as described above. Date Signed 1/11/2022 By "it ht (Signature of insurance carrier's authorized representative or NYS Licensed Insurance Agent of that insurance carrier) Telephone Number 516-829-8100 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 5B 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 emailed to PAU@wcb.ny.gov or it can 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 NYS­Workers'Compensation Board(only if Box 4B,4C or 5B have been checked) State of New York 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(Article 9 of the Workers'Compensation Law)with respect to all of their employees. Date Signed By (Signature of Authorized NYS Workers'Compensation Board Employee) Telephone Number Name and Title 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 D8-920.1.Insurance brokers are NOT authorized to issue this form. 10113_120.1 (12.21) 111111111�i«iiiiiiiiiii��liii��iiiiii�uiiiiiii��1111111 NYSIF New York State Insurance Fund PO Box 66699,Albany,NY 12206 1 nysif.eom CERTIFICATE OF WORKERS' COMPENSATION INSURANCE nort AAAAAA 844229132 SPECIALIZED INSURANCE& SERVICES INC 204 ROUTE 112 PATCHOGUE NY 11772 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER STELLAR HOME BUILDERS INC. TOWN OF SOUTHOLD BUILDING DEPT 127 HEWITT BLVD TOWN HALL ANNEX 54375 CENTER MORICHES NY 11934 MAIN RD-PO BOX 1179 SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE 12560255-8 317898 12/01/2021 TO 12/01/2022 1/11/2022 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2560 255-8, 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 PHIL MANUELE STELLAR HOME BUILDERS INC 1 OF 1 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 STAT SUR NCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER:6821307 U-26.3 f� tl >..Cry i t. n 1 I, f „✓ {�„-y,..h rel �.,",... .�tl 1�y�,`,'C p/M v $ we c.+F r�M�� �„�,o r r v I "r"w �a+�•'"%' � � ,o-.,��y���� .t. s r ,V f r i 7 "ery$ a. ffrr.( rti u" J' }r:.,-C' �.....p y✓f ��>-)' �, .. sly d w.. 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