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Home My WebLink About50235-Z TOWN OF SOUTHOLD BUILDING DEPARTMENT 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 #: 50235 Date: 1/19/2024 Permission is hereby granted to: Shanahan, Michael PO BOX 857 Mattituck, NY 11952....................�.......................�.�..�...�.�.....................................................................................................................................................�� ......_ .........m� To: Construct alterations and additions to an existing single-family dwelling to include interior alterations, 22 windows in-kind, siding and demolish and replace existing deck in-kind as applied for. At premises located at: 2910 Park Ave, Mattituck SCTM # 473889 Sec/Block/Lot# 123.-8-15 Pursuant to application dated 12/15/2023 and approved by the Building Inspector. To expire on 7/20/2025. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $322.00 CO-ALTERATION TO DWELLING $100.00 Total: . ...................wv.,u.........�.....-$422.00 ........... ..� m�m...�.............................. Building Inspector 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 htt s:Hwwvw.southoldtownn . ov Date Received APPLICATION FOR BUILDING PERMIT r „ For Office Use Only PERMIT N0. : Q a Building Inspector; Ad�� A r C � Appl catior)s:and,,forms,must be filled out in their„entirety,Incomplete.. applications;virill notbe accepted ,,,aA/here the apphcarjts not the owner,an Owners Aut)orization form'(Page 2),shall;,be scmpleted., Date:12/12/23 OWNERS)OF PROPERTY: Name:Michael Shanahan, SCTM#1000-123.00-08.00-015.000 Project Address:2910 Park Ave Mattituck, NY 11952 Phone#:631-804-8019 Email:mshanahan702@gmail.com Mailing Address:2910 Park Ave Mattituck, NY 11952 CONTACT PERSON: Name:Ralph Michele Mailing Address:255 W Main St Smithtown NY 11787 Phone#:516-818-5368 Email:ralph@rjmdesignsny.com DESIGN%PROFESSIONAL INF,OR,M,,,ATION: Name:Michael Angelone Mailing Address:4 Pond Place PI Oyster Bay, NY 11771 Phone#:516-922-2024 Email:angel1 ss@verizon.net CONTRACTOR INFORMATION: Name:Ed Gatto Mailing Address:275 Bayer Rd Mattituck, NY11952 Phone#:631-834-9180 Email:edward.gatto22@gmail.com .QESCRIPTION OF P,ROPOSEQ.CONSTRUCTION ❑New Structure ❑Addition ❑Alteration IRRepair ❑Demolition Estimated Cost of Project: ❑Other Will the lot be re-graded? ❑Yes iRNo Will excess fill be removed from premises? ❑Yes @No 1 PROPERTY INFORMATION Existing use of property:reSidential Intended use of property:residential Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? ❑Yes @No IF YES, PROVIDE A COPY. 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 Zona Ordinance of the Town of Southold,Suffolk,County,New York and other applicable Laws,ordinances or Regulations,for the construction of buddings, 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 name : 1ph Michele @Authorized Agent ❑Owner 11 Signature of Applicant: Date: ��1 ��JVD CAROLYN ALLEN STATE OF NEW YORK) Notary Public-State of New York No.01 AL6122330 SS: Qualified in Suffolk County COUNTY OFc�IJ� �� My Commission FXpiraA,Alzrll ae•2025 f I .� 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. Sworn before me this �� day of Notary Public (Where the applicant is not the owner) Michael Shanahan I, residing at do hereby authorize Ralph Michele 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 NYSIF Now York State Insurance Fund PO Box 66699,Albany,NY 12206 1 nysit.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE (RENEWED) ^^^^^^ 113528926 EDWARD GATTO INC ", 275 BAYER ROAD MATTITUCK NY 11952 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER EDWARD GATTO INC THE TOWN OF SOUTHOLD 275 BAYER ROAD 53095 MAIN RD MATTITUCK NY 11952 SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE 11088153-0 52749 08/06/2023 TO 08/06/2024 12/12/2023 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1088153-0, 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 WEBSITE AT HTTPS://WWW.NYSIF.COM/CERT/CERTVALASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. EDWARD GATTO PRESIDENT OF EDWARD GATTO INC (A ONE PERSON CORP) 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 STAT SU NCG FUND vv DIRrECT0RjNSUMN0E FUND UNDERWRITING VALIDATION NUMBER:578127711 DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE F12112n023 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(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 a. PRODUCER Kaft Jackson Brian Mlcena PHONE . 631-821-2200 631-621-2296 100 S Jemay Ave Urlass,, Katio.Jaokso medcan-Naffonal.00m Unit33 INSURE S AFFORDING COVERAGE NAIC* East Setauket NY 11730 A: United Farm Family Insurance Compag 29963 INBURED INOURER 0: Edward Gatto Inc INSURERC: 275 Bayer Road rBURaa D INSURER E: Mattituok NY 11952 CURAGES CERTIFICATE'NUMBER: REVISION HUMBER: THIS 13 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. TYPE OF INSURANCE XM vign P NUMBER LIMITS A xCOMMERCIAL GENERAL LIABILnY 3102X1/379 0 07/2022 02/0 /2024. EACH OCCURRENCE t 1000000 CLAIMB-MADE 7 OCCURmoll 22ME2001 ',$ YYYYYYYY 100,000 MED EXP ft one enwn $ 5,000 PERSONAL A ADV INJURY S 1 000 000 GEA AGGREGATE 9 LIMIT APPLIES PER. GENERAL AGGREGATE $ Y 2,000,000 ' POLICY L--...1 j& 7 LOC PRODUCTS-COMP/OP AGO $ 2,00%000 000 $ AUTOMOBILE LIABILITYLn $ Mi it ANY AUTO BODILY INJURY(For Polson) $ OWNED SCHEDULED BODILY INJURY O'sI e�aldent} $ AUTOS ONLY AUTOS AUTOS ONLY AUTOS 0 LY $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE III EXCESS LIAR CLAIMS-MADE AGGREGATE D ON S $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANYPROPRIETORIPARTNERIEXECUTNE E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED7 NIA (Mand@Wry In NH) "DISEARR-EAEMPLOYES $ Ifyem6 deevlhe under I EJ_D LICY LI DESCIOPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 107.Additional Remsrhs Schedule,i a stischsd Nmoro space Is required) Residential Carpentry CERTIFICATE HOLDER CANCELLATION Town Of Southold SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 50963 Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Southold, New York 11971 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZEDREPREBEIVTATNE 0 119#04016ACORD CORPORATION.. All rights reserved. PARK AVENUE v_ I= JCL to Ce A w � n �I r 1 ti 1i�l� PIPE ?� P PNU o . tlI �. ONE STORY MAP OF FRAME HOUSE C la o �tl I A"S" R'/,8ED PRoPERry z ,�rw91a� w SITUATED AT Qq C ro i� '03MA T TI TUCK TOWN OF SOUTHOLD QIIIIi a1 - SUFFOL K CO., N.Y ��'►i 1� �a 4, o� I I 99. P/✓E M1M1M1 ICY' I ANG e S7833,00"W 52.00 PiNo y w :� N/FLY HANUW CERTIF/EU r LONG ISLAND MORTGAGE CGRP ► CHICAGO T/TLEINSCIRANCc a:O FOR: MICHAEL SHANAHAN sea and surveying & ��-- I 4Im 1 engineering p.c. 0 west main street G ICAGO TITLE INSURANCE MapoR, . as�ti (516) x`2'1.4455 'zeo- LANt1 5� riverhead, new yark 11901 (516}369-1717 April 21,1986 Job N° 86-1236 AREA. 6,843 SQ Fr. Xi 1571 Acres; 1000-123-08-15 Scale:I"=20' R-G