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Home My WebLink About49930-Z � TOWN OF SOUTHOLD f FM Ji ' ' BUILDING DEPARTMENT w, 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#: 49930 Date: 10/23/2023 Permission is hereby granted to: Carrin ton Alexander 350 Park St Staten Island, NY 10306 To: construct non-structural kitchen alterations to existing single-family dwelling as applied for. At premises located at: 2230 Cedar Dr SCTM # 473889 Sec/Block/Lot# 77.-2-19 Pursuant to application dated 10/10/2023 and approved by the Building Inspector. To expire on 4/23/2025. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $250.00 CERTIFICATE OF OCCUPANCY $100.00 Total: $350.00 Y� Building Inspector "01, TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone(631) 765-1802 Fax(631) 765-9502 hL'C) ://WW v.sou liol�dtownn . go Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only PERMIT NO, Building Inspector: Ili K"12023 Applications and forms must be filled out in their entirety.Incomplete applications will not be accepted. Where the Applicant is not the owner,an Building D®partmpnt Owner's Authorization form(Page 2)shall be completed. Town of Scury T-'Ad Date:10-6-23 OWNER(S)OF PROPERTY: Name:Alexander & Stephanie Carrington SCTM # 1000-77-2-19 Project Address:2230 Cedar Drive Southold NY 11971 Phone#:917-58-2175/718-208-7166 Email:Alex.carrington@gmail.com Mailing Address: CONTACT PERSON: Name:Thomas J McCarthy - Thomas J McCarthy Real Estate Inc 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 Mailing Address: Phone#: Email: DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: Fol Other Non Structural Kitchen Renovation $ Will the lot be re-graded? ❑Yes 10i No Will excess fill be removed from premises? Dyes ®No 1 PROPERTY INFORMATION Existing use of property:Single Family Residence Intended use of property:Single Family Residence Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to R-40 this property? ❑Yes A No IF YES, PROVIDE A COPY. ❑ Check Box After Read ing: The owner/contractor/design professional is responsible for all drainage and storm water Issues as provided by Chapter 236 of the Town Code. APPLICATION 15 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 e): ho 'CCa "" uthori2ed Agent ❑Owner Signature of Applicant: I Date: 10-6-23 STATE OF NEW YORK) SS: COUNTY OF Suffolk �} Thomas J McCarthy being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the AGENT (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. Swbefoet 11f�Or fty �`. 2063 '14�7.o1B0000�72�%. Notary Public QUALIFIED 1N ; SUFFOLK COUNTY S It COMM.EXP. 5-16-2027 a "\�„�stw��;..° � PROPERTY_ MVNER AUTHORIZATION r t w rlliolOfy� ��.�,� (Where the applicant Is not the owner} 1 Alexander Carrington &Stephanie Carrington residing at 2230 Cedar Drive Southold I, , New York 11971 do hereby authorize Thomas J McCarthy to apply on rbmtlalf to the Town of Southold BuildineQe 44rtment for approval as described herein. Alexander CGIPYIhgtOh 10/06/23 �tep6mie Cwiki3toh 10/06/23 Owner's Signature Date Alexander Carrington Stephanie Carrington Print Owner's Name 2 Suffolk County Dept.of Labor,Licensing&Consumer Affairs HOME IMPROVEMENT LICENSE Name THOMAS J MCCARTHY Business Name This certifies that the bearer is duly licensed MCCARTHY MANAGEMENT INC by the County of suffolk License Number:H-45254 Rosalie Drago Issued: 09/04/2008 Commissioner Expires: 9/1/2024 THE STATE INSURANCE FUND 8 Corporate Center Drive,3rd Floor,Malville,NY,11747-3156 (888)875-5790 Document Type: =Group No: Period Covered; IN1=0R3�1ATION PAGE R.B. File No: 090 03/19/2023 TO 03/19/2024 0000892948 INSURED: I 1143 348-9 REPRESENTATIVE: 363077 MCCARTHY MANAGEMENT INC ROY H REEVE AGENCY INC =Date: licy No: 45520 ROUTE 48 13400 MAIN RD 4,3 348— SOUTHOLD NY 11971 PO BOX 54 MATTITUCK NY 11952 01,/30/2023 Document Number: E10001732913 *PERIOD OF COVERAGE BEGINS AND ENDS AT TWELVE AND ONE MINUTE O'CLOCK A.M.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 3/30/1995 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 CORPORAT'I'ON HAS OTHER EMPLOYEES WHO ARE REQUIRED TO BE COVERED BY THE LAW, AND THE CORPORATION HAS ELECTED TO EXCLUDE FROM COVERAGE THIS IS NOT A BILL. IMPORTANT PREMIUM CALCULATION, PLEASE RETAIN FOR YOUR RECORDS, FOR ATTACHMENT TO WORKERS'COMPENSATION.EMPLOYERS'LIABILITY POLICY E (SEE REVERSE SIDE FOR CONDITIONS) PAGE 1 CONT. TFaNs policy Nr�oludes,r�iNl�a their permission some copyright materiaN�of the Na,tf'oroal Council on Cc:mp�nsaN(DI1 Insurance and the New York Compensation Insurance Rating Board.. 3/NIF10SV2(10/2017) 3� McCarthy Management, Inc. 2230 Cedar Dr' 11971 1000- 7-2-19 novations Nonstructural Kitchen Renovations: Remove & Replace Kitchen Cabinets, Appliances, Countertops, Sink & Flooring 46520 Route 48 Tel. 631.765.5815 Southold, NY 11971 >Fax.631.765.5816 office@ thomasjmccarthy.com