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Home My WebLink About46456-Z �o�og�FFal,f or Town of Southold 7/17/2022 y� P.O.Box 1179 W T? 53095 Main Rd cy o� Southold,New York 11971 r CERTIFICATE OF OCCUPANCY No: 43268 Date: 7/17/2022 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 785 Sutton Pl, Greenport SCTM#: 473889 Sec/Block/Lot: 33.-5-4 Subdivision: Filed Map No. Lot No. conforms substantially to the Application.for Building Permit heretofore filed in this office dated 5/5/2021 pursuant to which Building Permit No. 46456 dated 6/22/2021 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: two landings to existing single-family dwelling as applied for. The certificate is issued to Gullep,Tanya&Ghanian, Sarkis of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED th iz ignature s�FFo4''�� .. TOWN OF SOUTHOLD 40�° BUILDING DEPARTMENT ' TOWN CLERK'S OFFICE o • �aS SOUTHOLD, NY zY 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#: 46456 Date: 6/22/2021 Permission is hereby granted to: Gullep, Tanya 785 Sutton PI Greenport, NY 11944 To: demolish existing deck and construct (2) landings to existing single-family dwelling as applied for. At premises located at: 785 Sutton PI, Greenport SCTM #473889 Sec/Block/Lot# 33.-5-4 Pursuant to application dated 5/5/2021 and approved by the Building Inspector. To expire on 12/22/2022. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $209.60 CO-ADDITION TO DWELLING $50.00 Total: $259.60 Bui ding Inspector OE SOUTy�� -- ✓Il1`(C/ # TOWN OF SOUTHOLD BUILDING DEPT. �Tyc0U631-765-1802 INSPECTION [- ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I SULATION/CAULKING [ ] FRAMING /STRAPPING [ FINAL �R'�1d►�a�s [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: DATE INSPECTOR 8/2/2021 IMG_3639.jpg 15 f�C 400l,'A3 ' � ThCSG p 'cf(Jic5 dor }'h Cof,)CfefC_ C -cc- Rcl 30v�ko l CI 17 AUG 2021 fjr jDATC To DF-PT. - Y 3 t6 https://mail.google.com/mail/u/0/?ogbl#inbox/FMfcgzGkZkLgFg IFC HdJCwTIVTSftgjt?projector=1&messagePartld=0.0 1/1 8/2/2021 IMG-4604.jpg n 6D A li. _U - o ` os µ N N Yi N ' N VA Lzu s ncl D https://mail.google.com/mail/u/0/?ogbl#inbox/FMfcgzGkZkLgFgkInQrHstpgZzbXQSGc?projector=1&messagePartld=0.1 1/1 1 •1 •• �.� � •..y'(M ! �. Ari. r"5 i «.,,,x .. � j'_ d sC t�� ► `� '��,.x airs aP ..�� 's� ar� mw AW 14 . s Uff 1 • •1.1 M=Q riTaHTM117A1111• • • 1 0 0• • 0 • 0 - • .•-'. • 1 8/2/2021 IMG-4602.jpg ➢ c ' _ � Key+ ra f„ {•�F4 �• � - -t _ g .�; • ��il`i��I� 7�"..�A[f��' �!��,E�r..' i. k�j ..0 ,�ier�, 'fi? "r +�`�'��' „M n E -s +moi J ' M r r r ' r u..✓Ary '7'�,ai• .'�. .` , Z .,45M ✓i O P Y.' i i k https://mail.google.com/mail/u/0/?ogbl#inbox/FMfcgzGkZkLgFgklnQrHstpgZzbXQSGc?projector-1&messagePartld=0.3 1/1 FIELD'INSPECTION REPORT DATE COMMENTS b FOUNDATION(IST) ------------------------------------ 7� C FOUNDATION(2ND) z � � o CA ROUGH FRAMING& y PLUMBING INSULATION PER N.Y. S H STATE ENERGY CODE FINAL ADDITIONAL CMMENTS rc- � zs. 0 N b ` NH d ro H o��SufFoT� �� TOWN OF SOUTHOLD-BUILDING DEPARTMENT o� °y Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 oy • o�� Telephone(631) 765-1802 Fax(631) 765-9502 https://www.southoldto3ym.gov dol �a Date Received APPLICATION FOR BUILDING PERMIT or Office Use Only PERMIT NO. �S Building Inspector: MAY - 5 2021 Applications and forms must be,filled out in their entirety.Incomplete applications will not be accepted. Where the'Applicant'is-not the owner;an MG P Owner's Authorization form(Page 2).shall be completed. rr CT ` Date: W� 1 al OWNERS)OF PROPERTY: Name: 504,Ic1 5 6wic'n - - SCTM#1000- ProjectAddress:X65 Sullen (lace- Grcenpor} N;' 119N1J Phone#:(`a0l) 1B - ,5r Hl Email: S®hanJI 6'qd>7a� Mailing Address: Sukion Plticc C;rC-CnQ0r1 NY IIg4y CONTACT PERSON: , Name: Saricis Ohctnign Mailing Address: IB5 S-u Oso rbc n of NY I14N� -- -- _ C - p-z-- _ _ Phone#: U01 -g3 - 5r-Lu Email: 601) DESIGN PROFESSIONAL INFORMATION: Name: Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: a Name: -- Mailing Address: QCIGR SOU_ __64 r0 R.vCrh('Ctcl_-N Y_=_ll Phone#: G 3 1 - Wa - %0 3 Email: hU'qor;o5-rngponrylQncl3cajp,n9 :i,CoM DESCRIPTION OF PROPOSED,CONSTRUCTION: , ❑New Structure ❑Addition ❑Alteratio ❑Re air Demolition Estimated Cost of Project: Other 40nC P G•i t o mon Yade- " � $ Will the lot be re-graded? ❑Yes EA No Will excess fill be removed from premises? 1qYes ONO, 1 PROPERTY INFORMATION Existing use of property: Rt.5idcntici( Intended use of property: f,esidentiu) Zone or use district in which premises is situated; Are there any covenants�and restrictions with respect to Sochhold p;5;(, �� z T this property? ❑Yes o IF YES, PROVIDE A COPY. l�.Check.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 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 on Regulations,for the construction of buildings, - additions,alterations or;far removai or demolition as herein described.The applicant agrees to comply with all applicable laws,ordinances,building co,e C,.,.: housing code and regulations and to admit authorized inspectors on pre! ises,and in buildings)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(p ' wu'90 Rios ❑Authorized Agent []Owner Signature of Applicant: _ Date: 5 LQq) STATE OF NEW YORK) SS: COUNTY/OF Su(Eo(L ) V f Cin kIbs being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the Viccofct I1u50 R'0,5 - V690 0106 f1G5onry hof P (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 20c)- Notary Public JULIE OBRIEN Notary No t -state of Nei o' W York Qualified in Suffolk county My commission Expires May 14,202P PERTY OWNER AUTHORIZATION here the applicant is not the owner) I, 56 0- residing at � �U � �"I A WiL A f �y do hereby authorize + i'0 M lonrL, to apply on my behalf to the Town of Southold Building Department for approval as described herein. ;2.0 2, wner's Signature Date "Cl 1 Print Owner's Name 2 t r Suffolk County=peptof. .-=,...;. 'Labor,Liceinsing'k,69Licensing' nsumer i4ffairs HOME IMPROVEMENT LICENSE Name Am VICENTE H RIOS " This certifies that the Business Name bearer is duly licensed 'HUGO RIAS MASONRY CORP "by the County Of suffolk r '° Licetise Number:H-38547 Frawl�NasdeU,; Issued: '11/02/2005` Commissioner Expires- "11/0172021' 4 1 -�� HUGORIO-01 EKELLERSHON ,a►coRo� CERTIFICATE OF LIABILITY INSURANCE DAT5/312 DIYYYY) 5/3/2021 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(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 endorsement(s). PRODUCER CONTACT NAME: Lupton$Luce,Inc. PHONE FAX 225 Howell Ave A/C,No,Ft):(631)727-4114 (A/C,No):(631)727-7138 Riverhead,NY 11907 AonRlEss:info@luptonandluce.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:The Ohio Casualty Insurance Company 24074 INSURED INSURER B:Ohio Securily Insurance 24082 Hugo Rios Masonry Corp INSURER C: 4962 Sound Avenue INSURER D; Riverhead,NY 11.901 INSURER E 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMBS LTR INSD WVD MM D MM D A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE FX OCCUR BKO57920563 7/26/2020 7/26/2021 DAMAGE TO RENTED300,000 REMISES Ea occurrence $ MED EXP(Any oneperson) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY FI jE O F—] LOCPRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: B AUTOMOBILE LIABILITY EOMBBII aEeD SINGLE LIMIT $ 1,000,000 ANY AUTO BAS57920563 7/26/2020 7/26/2021 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS E BODILY INJURY Per accident $ X AUTOS ONLY X AUOTOS ONL� Pe�acER;e DAMAGE $ A X UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAR CLAIMS-MADE US057920563 7/26/2020 7126/2021 AGGREGATE $ 1,000,000 DED I X I RETENTION$ 10,000 A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY STATUTE X ERH Y/N XW057920563 7!26/2020 7/26/2021 500,000 ANY PROPMEMB RI PARTNERIEXECUTIVE ❑ E.L.EACH ACCIDENT $ (Mandatory in NH)EXCLUDED? N/A 500,000 E.L.DISEASE-EA EMPLOYE $ If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Southold Building Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 9 P ACCORDANCE WITH THE POLICY PROVISIONS. Town Hall Annex 54375 NY-25 Southold,NY 11971 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) @ 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD YORK workers' CERTIFICATE OF INSURANCE COVERAGE STATE Compensation Board DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW PART 1.To be completed by Disability and Paid Family Leave Benefits Carrier or Licensed Insurance Agent of that Carrier 1 a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured HUGO RIOS MASONRY CORP. 631-767-4370 4962 SOUND AVENUE RIVERHEAD,NY 11901 1 c.Federal Employer Identification Number of Insured or Social Security Number Work Location of Insured(Only required ifcoverage is specifically limited to certain locations in New York State,i.e.,Wrap-Up Policy) 201626908 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of.lnsurance Carrier (Entity Being Listed as the Certificate Holder) SheiterPoint Life Insurance Company Town of Southold Building Department Town Hall Annex 3b.Policy Number of Entity Listed in Box"1 a" 54375 NY-25 DBL237045 Southold, NY 11971 3c.Policy effective period 07/25/2020 to 07/24/2022 4. Policy provides the following benefits: ❑X A.Both disability and paid family leave benefits. F1 B.Disability benefits only. E] C.Paid family leave benefits only. 5. Policy covers: 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 employers employees: Under penalty of perjury,1 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 5/3/2021 By (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 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 513 of part 1 has 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 with respect to all of his/her 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 DB-120.1.Insurance brokers are NOT authorized to issue this form. DB-120.1 (10-17) 111 JigiiiiiuioiiioiiiiiiiiiiiiiiioiuiiiiiiiiiIIIIIII IWorkRK ers CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE.COVERAGE Board 1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured Hugo Rios Masonry Corp 631-742-8803 4962 Sound Avenue Riverhead,NY 11901 1 c.NYS Unemployment Insurance Employer Registration Number of Insured Work Location of Insured(Only required if coverage is specifically limited to 1d.Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.,a Wrap-Up Policy) Number 20-1626908 2.Name and Address of Entity Requesting Proof of Coverage . 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) The Ohio Casualty Insurance Company Town of Southold Building Department Town Hall Annex 3b.Policy Number of Entity Listed in Box"1 a" 54375.NY-25 XW057920563 Southold,NY 11971 3c.Policy effective period m19Ft9n?n to m/)a/9n?l 3d.The Proprietor,Partners or Executive Officers are F1 included.(Only check box if all partners/officers included) QX all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box"3"insures the business referenced above in box"1 a"for workers' compensation under the New York State Workers' Compensation Law.(To use this form, New York(NY) must be listed under.ltem 3A on the INFORMATION PAGE of the workers'compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2". Will the carrier notify the certificate holder within 10 days of a policy being cancelled for non-payment of premium or within 30 days if cancelled for any other reason or if the insured is otherwise eliminated from the coverage indicated on this certificate prior to the end of the policy effective period? YES EJNO This certificate is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers' Compensation contract of insurance only while the underlying policy is in effect. Please Note: Upon cancellation of the workers'compensation policy indicated on this form,if the business continues to be named on a 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 with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury,I certify that 1 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: Hallock Luce IV (Print name of authorized representative or licensed agent of.insurance carrier)' Approved by: (Signature) (Date) Title: President Telephone Number of authorized representative or licensed agent of insurance carrier: 631-727-4114 Please Note: Only insurance carriers and their licensed agents are authorized to issue Form C-105.2.Insurance brokers are NOT auTnorized to issue it. C-105.2 (9-15) www.wcb.ny.gov SUFFOLK CO.HEALTH DEPT.APPROVAL -50-1 H.S. NO. 8 — LIZ, L -n vr j i y I L STATEWNT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL �512: p0l wl-7 SYSTEM FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO, DEM OF HEALTH SERVICES. (S) APPLICANT SUFFOLK COUNTY DEPT. OF HEALTH rO re.C C/,JJN LAI,ie N:44-4:[),E Iwo 7 SERVICES - FOR APPROVAL OF 6j. CONSTRUCTION ONLY DATE: IFQ44 H.S.REF.NO.. 0,D %- APPROVED: tANK GA SUFFOLK CO.TAX MAP DESIGNATION DIST. SECT. BLOCK PCL r's OWNERS ADDRESS: iF '185 s w-E!1: t k:I Ll Y) • L)J e) TEST F40LE STAMP DEED:L,,,4/A P. • 4: A0 • MjFFOO CDUNT4ct)EKWW?W4F HEALTH ANGLE �YDWELLING ONLY DATE Fl%S.REF.NO. The S�wzw tli.vwP!ane.,'ti1)5bklln"iAI4Ci!itl8s for I'lls 10C3ti have heen I. and/or Chief of Bur4i p Cl k:A SEAL S- �i:FICE!KI-IAP t,-ri-402 1 2JOr2APHY 15 rG rJ1'_LIALALf' I WEIL N 2G *2�, GVAtZANTF.—'-E., T0 F...11(17 i; AN.22 Iyt7 ANIftijidik VAN IVYL.IP LICENS9D LAND SURVZYORS GREENPOOT NEW YORK APP OY D_AS NOTED DATE:: .P. FEE: Y: ` OCCUPANCY OR NOTIFY BU.ICDING DEPART E.T.-.AT USE I S'U N LAW F U' 765 :8-AM TO 4 PM FOR HE FOLLOWING:;INSPECTIONS:: WITHOUT CERTfFI,01`ti, I. FOUNDATION -TWO REQUIRED FOR POURED ,CONCRETE' _ OF OCCUPANCY 2. ROUGH,=.�ERAMING & PLUMBING 3. INSULATION; 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOP C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. COMPLY WITH ALL CODES OF RETAIN STORM WATER RUNOFF NEW YORK STATE & TOWN CODES PURSUANT TO CHAPTER 236 AS REQUIRED AND CONDITIONS OF " OF THE TOWN CODE e S V N FXING BOARD S ��USTEES J d Y Oti. ' I t !J �P kj Ul t r r 4t r F T. rp Al 9 � o 17 x eatj 1; II r p ,.