HomeMy WebLinkAbout49515-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
r >'� 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#: 49515 Date: 7/25/2023
Permission is hereby granted to:
Gallucci, William
....._ - ............ ...................... �mW
2 Christina Ct
North wort, NY 11768
To: Construct an accessory 22 x 26 square foot garage to an existing single-family dwelling
as applied for. Must maintain a minimum setback of five feet.
At premises located at:
1720 Bay Shore Rd Green ort
SCTM # 473889
Sec/Block/Lot# 53.-4-30
Pursuant to application dated 6/20/2023 and approved by the Building Inspector.
To expire on 1/23/2025.
Fees:
ACCESSORY $328.80
CO-ACCESSORY BUILDING $50.00
Total: $378.80
Building Inspector
r r' TOWN OF SOUTHOLD—BUILDING DEPARTMENT
r x"� Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
k
' Telephone (631) 765-1802 Fax (631) 765-9502 li,ttps,//www.soutlioldtownny.gov
Date Received
APPLICATION FOR BUILDING PERMIT
k R
For Office Use Only
J SUN 20 20
PERMIT NO. I 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:6/20/23
OWNER(S)OF PROPERTY:
Name:William and Gina M. Gallucci SCTM#1000-053.00 04.00 03.00
Project Address: 1720 Bay Shore Road, Greenport NY 11944
Phone#:(516) 594-3501 Email:wgallucci@peeriesselectronics.com
Mailing Address:2 Christine Court, Northport, NY 11768
CONTACT PERSON:
Name:Patrick Mattia
Mailing Address:256 Route 25A Wading River NY 11792
Phone#:(845)825-9914 Email:pmattia@jnsdevelopment.com
DESIGN PROFESSIONAL INFORMATION:
Name:Craig Arm
Mailing Address: 16 Library Ave Suite C Westhampton Beach, NY 11978
Phone#:(631) 767-6071 Email:Craig@dastudiony.com
CONTRACTOR INFORMATION:
Name:JNS Development
Mailing Address:256 Route 25A, Wading River, NY 11792
Phone#:(631) 929-5500 Email:Office@jnsdevelopment.com
DESCRIPTION OF PROPOSED CONSTRUCTION
L New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
❑Other $150,000
Will the lot be re-graded? ®Yes RNo Will excess fill be removed from premises? i@Yes El No
1
PROPERTY INFORMATION
Existing use of property:Residential Single Family home Intended use of property:
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
000 this property? ❑Yes iiNo 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 210.45 of the New York State Penal Law.
Application Submitted By(pri au e):Steve Zoumas ❑Authorized Agent @Owner
Signature of Applicant: Date: 6/20/23
STATE OF NEW YORK)
SS.
COUNTY OF UKo I K- )
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 belief; and
that the work will be performed in the manner set forth in the application file therewith.
Sworn before me this
"—day of cJ h 0200 i� �"•
No r bN'ic . .....�
MARY ZOUMAS
PROPERTY NEN AUTHORIZATION NOTARY PUBLIC,STATE OF NEW YORK
Registration No.01ZO6045952
(Where the applicant is not the owner) Qualified in Suffolk County
Commission Expires AUG. 7,2026
William Galluccl residing at 2 Christine Court, Northport, NY 11768
I,
do hereby authorize Steve Zoumas to apply on
my bhalf*tn Southo i ding Department for approval as described herein.
6/20/23
wner's Signature Date
William Gallucci
Print Owner's Name
2
CERTIFICATE OF LIABILITY INSURANCE DATE(30120 YYYY)
11130/2022
THIS 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.
IMPOR NT, 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).
o NAACT Dawn
'...PRODUCER NAME: Saviano
AssuredPartners Northeast,LLC PHONE (631)465 4000 _ P (631)465 4005
ARE. No �^ka. .AOC,.NIL
100 Baylis Road E`M L dawn.saviano@assuredpartners.com
ADDRESS:;
Suite 300INSURERf S)AFFORDING COVE.R'A.UE NAIL k
Melville NY 11747 wsuRER A. Southwest Marine&General Insurance Co 12294
23329
INSURED
Merchants Mutual Insurance Company
INSURER B:.
JNS Contracting,LLC INSURER C West American Insurance Company 44393
: -
....-..._ •-
256 Route 25A INSURER D:
INSURER E
Wading River NY 11792 WSJ REP F
COVERAGES CERTIFICATE NUMBER
2022-2023 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICNES 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS TMDE oONDIUIONS RANC OF SUCH PO POLICY wUN%BBrt MMIOD D CLAIMS,
AD 01,0131q ICY ' P _ �_......
rA
8. WV 'k'Y Mtd1C1DAY!"np9A LIMITS
D BY A
POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCEI OLtl Iq 9 9 ,�....
*��r - 1 000 000
✓^'�� COMMERCIAL GENERAL LIABILITY E1`+6 tl OCCURRENCE $
A 4 100,000
CLAIMS-MADE OCCUR 'PRrrMSFS a occuPrencel $• -
X' Contractual Liability ME tt k7 d+ one p essnl s 5,000
Y Y GL2021LH B00427 10/20/2022 10/2012023 &ADV NNJURY
1,OOQ000�
OEN E11111,ONAAGgd llEGAYF.� $ 2,000,000
GEN"L AGGREGATE W YMIT APPLIES PER: 2,000,000
**— PRO- PR{'bC'bhtOT,c;: COMPf(b4'•aFeG'T.u '.S
POLICY r""�.Y JECTLOC° Employee Benefits $ 1,000,000
OTHER: ......_ .....�........,,� ...._.. iC.' EINEfb,ggttGr E p.lAr1VT'
$ 1,000,000
AUTOMOBILE LIABILITY N'r,a nil ..
ANY AUTO
BODILY INJURY(Per person)
'.. ' .�—•
B �^ SCHEDULED INJURY(Per accident) $
AUTOS ONLY -1 AUTOS •"�� ��
IREpD NON-OWNED TeLEY Y CAP1061237 08106/2022 08/06/2023 Optional DaCaAhaAr E $
r RLYPt.:RT"V
AUTOS ONLY X AUTOS ONLY �"""""'� ....•
basic economic $ 25,000
4,000,000
UMBRELLA LIAB XOCCUR EACH w'.3✓wW'G"'UE R1;r4:w E'
A ,+ . EXCESS LIAB Y '.. Y EX2021 LHBOO127 10/20/2022 10/20/2023 AGGREG'ANRE: $ 4,000,000
'.., CBwARINSMAOIE .
DUO RE rd.NT80N$ . PESk %�T%i..
WORKERS COMPENSATION S",4'rNJT£: E,Rp,
AND EMPLOYERS LIABILITY
C�F'FIOEFtr"tR� NR
CIeD N'XEd,U'I"CVE":' Y� ET EACHAr�„tl Uq.IEI°"t'
ANY RIET I
�
. N/A
EL D)SfEASE•EA EMPLOYEE '$
(Mandatory In NH)
If yes,.des "under F..I DISEASE'•POLICY LIMIT '$
DESCRIPTION OF OPERATIONS betow ............. _ .... .._.'.
Inland Marine-Leased Rented BMW58936399 10/20/2022 10/20/2023 Limit $25,000
C Equipment
DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
The Certificate Halder is included as an Additional Insured as required by contract subject to the policy terms,conditions and exclusions,
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Town of Southold
5309 Main Road
'.AUTHORIZED REPRESENTATIVE
Southold NY 11971
A*—
All
rights reserved.
ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
17%,11111
NYSIF
New York State Insurance Fund PO Box 66699,Albany, NY 12206
1 nysif.com
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
A^A A^^ 262849109 w
ASSUREDPARTNERS NORTHEAST LLC
100 BAYLIS RD STE 300 �1,
MELVILLE NY 11747
SCAN TO VALIDATE
AND SUBSCRIBE
POLICYHOLDER CERTIFICATE HOLDER
JNS CONTRACTING LLC TOWN OF SOUTHOLD
256 ROUTE 25A 5309 MAIN ROAD
WADING RIVER NY 11792 SOUTHOLD NY 11971
POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE
12047795-6 560480 09/30/2022 TO 09/30/2023 11/30/2022
THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE
FUND UNDER POLICY NO. 2047 795-6, 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 WESSITE AT HTTPS://WWW.NYSIF.COMICERTICERTVAL.ASP.THE NEW
YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS.
THIS POLICY DOES NOT COVER THE SOLE PROPRIETOR, PARTNERS AND/OR MEMBERS OF A LIMITED LIABILITY COMPANY.
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 SUR NCE FUND
DIRECTOR,INSURANCE FUND UNDERWRITING
VALIDATION NUMBER: 97938284
U-26.3
MAP
OF
PROPERTY
ON THE
SUBDIVISION MAP OF
BAY SHORE R D. AMENDED MAP A, PECONIC BAY ESTATES
LOTS 101-103INCL.
FILED MAY 19, 1933 AS MAP NO.1124
_,.
�. SITUATE AT
ARSHAMOMAQUE
TOWN OF SOUTHOLD
56'53',38" E 150.00' SUFFOLK COUNTY,NEW YORK.._ _ ... g . .... .... _ .. _ .......... ...... AREA OF PARCEL = 18,750± SQ.FT. OR 0.430± ACRE
EXISTING LEGEND: �
lyfav�.
SANITARY
SYSTEM PROPERTY LINE
BENCHMARK
UTILITY POLE
.... _... '� ELECTRIC METER21
...... �/
N/F SANITARY CLEANOUT
A
ELINOR G. JAGEL AND
�� ✓ UNDERGROUND WATER
CHRISTOPHER J. JAGEL -
OVERHEAD WIRES w��
,'....... .�.....» —�� 5 FRONT Y9BP-�ETBA9K DECIDUOUS TREE
�o/o %� ��� �� � ifs
.r ...„._ DECIDUOUS BUSH i,r,,v "T:✓r,///��j %� /
I yy
CD
., ...,.,, ,✓ CONIFEROUS BUSH
o .'� _ LOCATION MAP
w o
, � PROPOSED ADDI74 TION....,. .... 4,9f—� .. ..._ •.,a N��� 0 DISTRICT: 7000 N.T.S.
wZ w LL ,,, �n I N SECTION: 05300
w LOT. 030.000
BLOCK 04.00
\Q
m= ^NN ”" IId 1 ACNb11N,hN '� � + 1II O RE GONVER7E0
,
y
BUILDINGS:
400"D AS NEEDED
DRCWAv TO 8E EXISTING GARAGE EXISTING STORY
RES,-ENCS �yTO ALLOW OR TO LIVINGPA
CE
(F.F. 70.41 (F.F. 10.4') "^ e7WH4$S
ORONfSYEWGE GARAGE
CONVERSION TO IMNG SPACE
^
O ZDNINmG
R-40(RESIDENTIAL-NON CONFORMING)
CD
� «..,.�.-, -.. ..1......._.. —40"1 "^�^ `r 1A SURVEY NOTES:
C1
.,r l J. H B.O'NW.GATSAM A 19 PoXfG I $Yd 49 1wClt )nIR04IC"USE
Wr8 .
.,
PROPOSED
COVERED PATIO ON �ih, "' '/ '" � ° 0. 41�NAU1Ht%'Mo T+A NowD110H 9Y'N'A(ICU1'0.'EY T'4T A 8{NW CAUld11MG A DCMOF RM E G9.eePRtA'R00N5 VERTIGL DATUM IS
CO ERE J ., ErlVf 5 SIU4..IS A VIOLATION OF
IpI QRCM'EWAhf" -GRADE SHCWc R ✓CLOD ✓DCS V P°°L "I (n CTION 1200,xupplomm"'�4 OF TK Nerr xa'ro.,w'ro.raK DnwGAWDec Inw.
�^' 5. �M'p,Y COMN.'G.�IROA,AHE CAQwML or NUS WKAT AURXW WH AN ORIGINAL OF THE LANA NUR46'IRNY"S'EMBOSSED'OR
BLOCK CURB S, ?S P POR aNOI 3RUX�NAT)G�PTE EI NEW YOANIXN'R3A'Ee AR90 IA+
PROPOSED BELGIUM I „„ I s. CCR'1+Pm:+Trtlaas WWIGwcCVJ�'rEPoCGM 91r+HA"C RdS 5ED TO EUC WAVED u1�EV w,,S pREPAME:G 1u+AOOOA: row.`E7 1�G E OF
am
¢ ` J pI rao-0 OrAND k✓Am v. SAID
'^ .. 22.0' 2q�.7"-- •• ••. WYe35' REAR YARD SETBACK ,®. ,'", eed�"G' warW.rvGBNLY9Akn L¢PERSONHe M5¢ktlu "MDR AND i THE SSGF t ullul 9EMALF 10 o 1RLE
�W 6 '„ 7. RIGHTS-OF-WAYI E NTT SHOWN ARE NOT CERTIFIED,ARE NOT MOFATOML4 TO A P N ryVryWNS OR S NO GwH M;
U qqqq 1 B, THE SURVEY CLOSES MATHEMATICALLY„
g, PROPOSED BELGIUM
.¢ � _ � ��k
: v 5ei.3 �
.I-1 Sy PROPOSED 1STY "Tek ,.•/
BLOCK CURB � �... � A-(IJ �',. 5JMWA40T nN:a'n.
Y �
a
I uv. GARAGE
(F.F:B.3'1 pg cv' EX. HOUSE = 1.906 SF J
¢ PROPOSED 20x40 POOL
XI i 3 :r I ADD TIRON PATIO = 1290 SF
08 SF (2" RAIN EVENT
IC TOTAL - 3,676 SFX2's/11'� PSY7Al2NPAq 1SF
vu Yu
Ifrr - IMPERVIOUS GARAGE ROOF
N u` R}'
u GARAGE - 572 SF
^^ .. -38„0 s PROPERTY - 18,750 SF
GARAGE
_5' .,..".„,.' ,, .... "'',, LOT COVERAGE = 3.676/18.750 = 19.61% < 20% (OK) 953 REQUIRED
ROOF (DW)
22.0' 91',.RFA6d 7A9'W9Y v'SE8 ,C1G CO° C",).
0X rye....._... ..._.��,,. ,® =�:. „-"""-'"w"'•.." ^m^ .:,,,. .�..,,.. __._ ..,a ..._____n il..=z 4...."' ".""":.^^ �....� ....... P'R'tT'J10 (,))BceP I..kFYtlNG S�9'R'.(AC"ClV6EES '3:"(DEEP
_3 .,S 3'dLKE �E^2 FCNCCo T
PROPOSED DRYWELL '', N 56°5,3',3 8' W 150.00 "
ofE
31 FOR GARAGE ROOF "' N/F W
RUNOFF
N/F
.. .. IJ n� THOMAS J, BYRNES
DOM
_ & MARYANN F A� � DATE BY DESCRIPTION APPROV. BY
DeNICOLA AND
CAROL DeNICOLA n a ' -"� "", t- BYRNES ,fid" REVISIONS
i * 1720 BAY SHORE RD
ENPORTae NY 11+341
SITE PLAN g GARAGE CONVERSION
SCALE: 1"=20'
30.4.
•
PROPOSED SITE PLAN
PTnaa
G
FESS ' L. K. McLEAN ASSOCIATES, P.C.
CONSULTING ENGINEERS 437 SOUTH COUNTRY RTI.,BRGOKHAVEN,NEW YORK 11719
4 aNm .N De919nea By: MF/CFD scale: AS NOTED
nrr "�r�,Ts9w/A'r«•mw.e,ar Twe
R'U _Drawl,By: MF Dote: JUNE 2023 c 9
"-A w m*� ^ Approved By: RAS File Nc. 151 15.000
micml rdw•a%-