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HomeMy WebLinkAbout49716-Z TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE �u wr 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 #: 49716 Date: 9/19/2023 Permission is hereby granted to: Pittorino, Deborah 10305 Soundview Ave Southold NY 11971 To: construct non-structural alterations to existing kitchen as applied for. Additional approvals/certifications may be required. At premises located at: 10305 Soundview Ave, Southold SCTM #473889 Sec/Block/Lot# 54.-8-8 Pursuant to application dated 8/18/2023 and approved by the Building Inspector. To expire on 3/20/2025 Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $200.00 CO-ALTERATION TO DWELLING $50.00 Total: $250.00 Building Inspector FFTOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 ai Telephone(631) 765-1802 Fax(631) 765-9502 littL)s://www.�;oLitholdt(.)wi'illv'.tllov Date Received APPLICATION FOR BUILDING PERMIT jj For Office Use Only PERMIT NO. Building Inspector: �o� 1 �3 02m m. Applications and forms must be filled out in their entirety. Incomplete 1C111q,PG 1 applications will not be accepted. Where the Applicant is not the owner,an Owner's Authorization form(Page 2)shall be completed. Date:8-18-23 OWNER(S)OF PROPERTY: Name:Deborah Pittorino scTM#1000-54-8-8 Project Address:10305 SOUNDVIEW AVENUE SOUTHOLD Phone#:917-254-1860 Email:DRIVERA@THESUCCESSIONGROUP.COM Mailing Address: CONTACT PERSON: Name:THOMAS J MCCARTHY REAL ESTATE INC - THOMAS MCCARTHY Mailing Address:46520 RTE 48 SOUTHOLD NY 11971 Phone#:631-765-5815 Email:TMCCARTHY.TMCCARTHY@GMAIL.COM DESIGN PROFESSIONAL INFORMATION: Name: Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: Name:MCCARTHY MANAGEMENT Mailing Address:46520 RTE 48 SOUTHOLD NY 11971 Phone#:631-765-5815 Email:TMCCARTHY.TMCCARTHY@GMAIL.COM DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: [i]Other NON STRUCTURAL RENOVATION OF KITCHEN $, [Wi�Ithe lot be re-graded? Dyes *No Will excess fill be removed from premises? Dyes RNo 1 Authentisign ID:DA75EC98-DC3D-EE11-A3F1-6045BDED1B5F PROPERTY INFORMATION Existing use of property:RES I DENTIAL Intended use of property:RESI DENTIAL Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to \2-4Q this property? ❑Yes RNo IF YES, PROVIDE A COPY. X Che k 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(print In .T M S J MCCARTHY BAuthorized Agent ❑Owner Signature of Applicant: "`---Bate: 8-18-23 STATE OF NEW YORK) SS: COUNTY OF SUFFOLK ) THOMAS J M CCARTHY being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the AG E N T (Contractor,Agent,Corporate Officer,etc.) of said owner or owners, and is duly authorized to peypr1mg,have performed the said work and to make and file this application;that all statements contained in this��" �N ^ "" ale to the best of his/her knowledge and belief;and that the work will be performed in the manner,"� alla�T� ation file therewith. too 01BOOD07727%* IN Sworn before me this _ o ULKALI06°OUN _ ,SUFFOLK CNTY „ COMM.EXP day of 0...__.- "�r z�iF Ito Not ry I a Iabli PROPERTY OWINEIRUTH T (Where the applicant is not the owner) DEBORAH PITTORINO residingat 10305 SOUNDVIEW AVE SOUTHOLD NY 11971 do hereby authorize THOMAS J MCCA RTHYto apply on myll't6`the Town of Southold Building Department for approval as described herein. re6oeAA PlIttoellAo 8-18-23 Owner's Signature Date DEBORAH PITTORINO Print Owner's Name 2 fE» » 0 CD ( co 0 w 0 i f c CL \ m /// . § g ), 2 / ( \ " ty R z > w \ F� = oA \ / \ \ 7 ( \ f \ \ ; ¢ / 0/ © [ 2 co { / { ( 2 ) §i % 2 § ¢ ) ; E ° m \\ / k t E . � THE STATE INSURANCE FUND 8 Corporate Center Drive,3rd Floor,Melville,NY,11747-3166 (888)875-5790 Document Type: Group No: Period Covered: *=R.IB. le No:IIV>=OR CATION PAGE 090 03/19/2023 TO 03/19/2024 92948 INSURED: 11143 348-9 REPRESENTATIVE: 363077 MCCARTHY MANAGEMENT INC ROY H REEVE AGENCY INC Policy No: 46520 ROUTE 48 13400 MAIN RD I 1143 348-9 SOUTHOLD NY 11971 PO BOX 54 Date: MATTITUCK NY 11952 01/30/2023 Document Number: E10001732913 PERIOD OF COVERAGE BEGINS AND ENDS AT TWELVE AND ONE MINUTE O'CLOCKAX EASTERN STANDARD TIME MP 1247 TYPE OF BUSINESS: CORPORATION (FOR PROFIT) INFORMATION PAGE RENEWAL POLICY THIS POLICY INCLUDES THESE ENDORSEMENTS AND/OR SCHEDULES: YOU MUST REPORT ANY CHANGE IN OWNERSHIP TO US IN WRITING WITHIN 90 DAYS OF THE DATE OF THE CHANGE. CHANGE IN OWNERSHIP INCLUDES SALES, PURCHASES, OTHER TRANSFERS, MERGERS, CONSOLIDATIONS, DISSOLUTIONS, FORMATIONS OF A NEW ENTITY, AND OTHER CHANGES PROVIDED FOR IN THE APPLICABLE EXPERIENCE RATING PLAN. EXPERIENCE RATING IS MANDATORY FOR ALL ELIGIBLE INSUREDS. THE EXPERIENCE RATING MODIFICATION FACTOR, IF ANY, APPLICABLE TO THIS POLICY, MAY CHANGE IF THERE IS A CHANGE IN YOUR OWNERSHIP OR IN THAT OF ONE OR MORE OF THE ENTITIES ELIGIBLE TO BE COMBINED WITH YOU FOR EXPERIENCE RATING PURPOSES. FAILURE TO REPORT -ANY CHANGE IN OWNERSHIP, REGARDLESS OF WHETHER THE CHANGE IS REPORTED WITHIN 90 DAYS OF SUCH CHANGE, MAY RESULT IN REVISION OF THE EXPERIENCE RATING MODIFICATION FACTOR USED TO DETERMINE YOUR PREMIUM. THIS REPORTING REQUIREMENT APPLIES REGARDLESS OF WHETHER AN EXPERIENCE RATING MODIFICATION IS CURRENTLY APPLICABLE TO THIS POLICY. THE EXPERIENCE RATING CHARGE SHOWN BELOW IS IN ACCORDANCE WITH YOUR PAST ACCIDENT EXPERIENCE UNDER THE EXPERIENCE RATING PLAN AS PROMULGATED BY THE APPROPRIATE RATING ORGANIZATION. # 89 03/30/1995 NEW YORK EXCLUSION OF EXECUTIVE OFFICERS) ENDORSEMENT THIS POLICY DOES NOT COVER FOR CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE SOLE EXECUTIVE OFFICER AND ONLY STOCKHOLDER OF THE INSURED CORPORATION, OR TWO EXECUTIVE OFFICERS WHO TOGETHER ARE THE ONLY OFFICERS AND STOCKHOLDERS OF THE INSURED CORPORATION, WHEN SUCH CORPORATION HAS OTHER EMPLOYEES WHO ARE REQUIRED TO BE COVERED BY THE LAW, AND THE CORPORATION HAS ELECTED TO EXCLUDE FROM COVERAGE THIS IS NOTA BILL. IMPORTANT PREMIUM CALCULATION, PLEASE RETAIN FOR YOUR RECORDS. FOR ATTACHMENT TO WORKERS'COMPENSATION-EMPLOYERS'LIABILITY POLICY (SEE REVERSE SIDE FOR CONDITIONS) PAGE 1 CONT. This poli�;y includes,with their permission some copyright sTpBterial of the NetiaDn�l Council on Compensation Insurl�ncw and the New York Compensation Insurance Rating Board, 3/NIF10SV2(10/2017) 1 MCCAMAN-02g , ( ® CERTIFICATE OF LIABILITY INSURANCE DATEcM/202Yyy) CERTIFICHIS AIFICATE TE DOESS ISSUED AS A MATTER OF NOT AFFIRMATIVELY OR NEGATIVELLYTION AMEND ONLY TEND ONFERS NO RIGHTS UPON THE CERTIFICATE R ALTER THE COVERAGE AFFORDED BY THE PO I THIS CIES 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 ri hts to the certificate holder In lieu of such endorsement(s), PRODUCER c ACT III1 SmolIno DGA Insurance Services,LLC PHONE FAX 3333 New Hyde Park Road AMc,Nsa,Exr: �13 745-1500 c,N� Suite 409 D e srM;olllno�raprrosins.com New Hyde Park,NY 11042 INSURER s' AFFORDING COVE6dAGE� NAIC - 'INSURERA:Southwest Marine&General Insurance Corry an 124 INSURED _LN SURER a, McCarthy Management Inc. L sORRc,„ mm 46520 Route 48 IINSURER D. — Southold,NY 11971 INSURER E m IN SU ERF-. COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAW 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 TRMIS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, II+p3RPOLICY NUMBER ADDL SUBR TYPE OF INSURANCE Wyk POLICY EFF POLICY X,P A X COMMERCIAL GENERAL LIABILITY E82H OCCURRENCE LIMITS 1,000„000 CLAIMS-MADE OCCURRENT 9/18/2022 9/18/2023 DAM M2 TO RENTI II 100,000 Il $ IExI EIIP An. ane rsor S 51000 PERSONAL,&ADV INJURY 3 1,000,000 GENLAGGREGATELIMITAPPLIESPER: f%ENERALAGGRF"ATE $ 2,000,,000 X POLICY PRO- 7 LOC JECTPRODUCTS-OOMPIOP AGG $ 2,000,000 OTHER. AUTOMOBILE LIABILITY COMBINED SINGLE.LIMIT ANY AUTO L0.II S 7 OWNED SCHEDULED SCIDILY ICIJURY Peraecson S AUTOS ONLY AUTOS BODILY INJURY Pera�oGMeml 3' AUTOS ONLY AIJO'I"Oa C Petr aPER n fl,AIw1AGE tl UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAR CLAIMS-MADE DEAGGREGATED RETENTION$ WORKERS COMPENSATION PER... DTH. AND EMPLOYERS'LIABILITY TA -5-- TIT T _if 'R... ANY PROS'RdETgO,�R�MARTNERIEXECUTIVE ��-hl daato n IVFh1)EXCLUDED? N/A E L.EACH,ACCIDENT _L_ If yyes,describe under E.L.DISEASE'-EA EMPLOYE DESC PTION OF OPERATICINS below .L,MSEA aE'-PO CY LIMIT i '$ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE OLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE EVIDENCE OF COVERAGE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ---------- AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marl-¢mf ee^nor's VAatis s.n •gyp M. 4T° 45, 4o"E. 50.0 t 'int 3"sn nth f ti 4 SovCh ��Fanct Al East bi Z d J O t41, tae D r all t� c o We ZLL. N x O OCJ x � 3 � 'N 0 State-. 20' z O = Lyon P i P e. � o4 Quav&htseol to the 'Lhtty- Count) MAP OF LAND Title 'Gwaranty ; Mcvt9s'e C-- SURVEYED o.SURVEYED FOR as surveyQd N ovemb*r 24, 1971 ALFRED GES7-=\'� NSKI UANTu', 5oV4 - AT .SOUTHOLD Licensed Lead Sur�eyoYS SUFFOLK COVNTY, N.Y. G ,reQnpott, New York 3t. t' r �