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HomeMy WebLinkAbout47923-Z TOWN OF SOUTHOLD �gUFFO�,� �dow~ W ooya BUILDING DEPARTMENT y z � TOWN CLERK'S OFFICE "oy • o�� SOUTHOLD, NY � x 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#: 47923 Date: 6/7/2022 Permission is hereby granted to: Soares, Manuela 200 W 70th St#10G New York, NY 10023 To: install deer fence as applied for. At premises located at: 555 S View Dr., Orient SCTM #473889 Sec/Block/Lot# 13.-3-8 Pursuant to application dated 5/3/2022 and approved by the Building Inspector. To expire on 12/7/2023. Fees: DEER FENCE $75.00 Total: $75.00 Buil g Insector SQfFOL��@ TOWN OF SOUTHOLD—BUILDING DEPARTMENT y Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 oy • a� Telephone(631) 765-1802 Fax (631) 765-9502 htWs://www.southoldtownny.gov Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only PERMIT NO. 4VO�3Building Inspector: MAY, - 3 2022 BUILDING DEPT. Applications and forms must be filled out in their entirety.Incomplete TOWN OF SOUTHOLD 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: �QYI(Af�OI �0/}2C 5_ SCTM#1000- 13 —3— g Project Address: SSS So0/IeA J , B n5\,Jh,5 t�Its, OV-1 of, f\JY (.10LS - Phone#: 646 -c( 3(- 066 Email: jM Soa2es�( ,Carte Mailing Address: Zoo VJQS Tv-'L $ k (0 �JY,/ NY c0 a3 CONTACT PERSON: Name: Gt.✓1 S o - Mailing Address: 2� 0 ��5 fi p `S t J YI ray (ao 3 Phone#: G�6 - L(31 6 6 Email: �t-1 s oa e-5' R c^-/ Com, DESIGN PROFESSIONAL INFORMATION: Name: Mailing-Arldress: Phone#: Email: CONTRACTOR INFORMATION: Name: C)S"J"Lao a. CLaMd4Gc�u�, QSwu( Mailing Address: VO (ja),, 11A, Pe Vic. Phone#: 63�. ��(� _ 165'fo Email: DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: L�LOther I>e e Y TeM Cy- $ 51006 " Will the lot be re-graded? ❑Yes $No Will excess fill be removed from premises? ❑Yes ❑No 1 6 PROPERTY INFORMATION Existing use of property: Intended use of property: ` Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? ❑Yes Po IF YES, PROVIDE A COPY. 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 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 210AS of the New York State Penal Law. Application Submitted By(print name): Man we Sotq(tF5 ❑Authorized Agent lRowner Signature of Applicant: _ ( Date: /2 2 STATE OF NEW YORK) SS:. COUNTY OF Man q Q LSV 90,4 being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)he is the 01— �r (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,/ 201-)-- - .. . Notaryublic RNORY LORA -7�.NQtary PGhlic=SWa --nf New York NR;01063651166 PROPERTY OWNER AUTHORIZATION Qualifiea-in New York County MkC.amm%§i®n-Expir@clan 14,2023 (Where the applicant is not the owner) I, residing at do hereby authorize to apply on my behalf to the Town of Southold Building Department for approval as described herein. Owner's Signature Date Print Owner's Name 2 A CERTIFICATE OF LIABILITY INSURANCE °ATE "YYY' 02//08/2008/2022 PRODUCER THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION CHRISTOPHER MANFREDI ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR PO BOX 1345 SOUTHOLD NY 11971 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# I (LANDSCAPING BY OSWALDO INSURER A: UTICA FIRST JUAN OSWALDO CHAMALE-CHAMALE INSURER B: PO BOX 142 INSURER C: PECONIC NY 11958 INSURER D: INSURER E:r COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS ADD' POLICY EFFECTIVE POLICY EXPIRATION LTR(NSR TYPE OF INSURANCE POLICY NUMBER DATE MMIDD/YYYY) DATE(MMIDDfYYYY)l LIMITS GENERAL LIABILITY ART5095677 02/08/2022 02/08/2023 EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY 50,000 PREMISES Es occurrence $ CLAIMS MADE rX]OCCUR MED EXP(Any one person) $ 5,000 j PERSONAL&ADV INJURY S 1,000,000 GENERALAGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,000 POLICY JECPRO T F LOC S , AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per Person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per eccidenl) I PROPERTY DAMAGE S (Par accident) i GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S � ANY AUTO EA ACC S OTHER THAN AUTO ONLY: AGG S EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE g —1 OCCUR EICLAIMS MADE AGGREGATE g S ' DEDUCTIBLE S RETENTION S $ i WORKERS COMPENSATION ANOA U• H- EMPLOYERS'LIABILITY YIN TORY LIMITS ER ANY PROPRIETOR/PAR TNER/EXECUTIVEF OFFICERIMEMBER EX LUDED? E.L.EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYE S I yes,descnbe under E.L.DISEASE-POLICY LIMIT S OTHER DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS: CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE e J. ACORD 25(2009/01) ©1988-2009 ACORD CORPORATION. Atrights reserved. The ACORD name and logo are registered marks of ACORD Suffolk County Dept. of Labor, Licensing & Consumer AM HOME IMPROVEMENT LICENSE Name JUAN CHAMALE-CHAMALE Business Name LANDSCAPING BY OSWALDO certifies that the er is duly licensed License Number H- 58.134 e County of Suffolk 02/23/2017 Issued : 1-It om �iissio�er Expit'eS : 021011202 1 RCN Webmail https://mail2.rcn.com/modeni/search/email/message/27857?e=kmw2... 222-41.pdf 1 /1 ± Sr-7.L4 Y4 OSTRCT: I&V `ECP04:IJ SLOOI:J LOT(S).0 V.P. -` 4 4F SOU 7, — vl + N�SOfOb•g ~~"� ti 67.011 V / � to J.1.114 4AJ 4B.7- L 1 �srr � 0Ar1lIVC =�� y m C u In w 1 (� W V4• f ' (1l 1( 1 S�NZ810 om w vrA1,�RJ, SIOpK nil FrM^F to 154.4/1 Ihf *Alf#SY.YYY V. 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