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HomeMy WebLinkAbout50248-Z TOWN OF SOUTHOLD r BUILDING DEPARTMENT q 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 #: 50248 Date: 1/24/2024 Permission is hereby granted to:. Inland Homes Inc PO BOX 117 Mattituck, NY 11952 To: install new windows to existing commercial building as applied for. At premises located at: 315 Westphalia Rd, Mattituck SCTM # 473889 Sec/Block/Lot# 141.-3-33 Pursuant to application dated 12/19/2023 and approved by the Building Inspector. To expire on ,7/25/2025. Fees: NEW COMMERCIAL, ALTERATION OR ADDITIONS $300.00 CO-COMMERCIAL $100.00 Total: $400.00 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 https://www,sotitholdto'ArnLly.gov Date Received APPLICATION n For Office Use Only tl PERMIT N0. Building Inspector: `' D E C 1 9 P02 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: i2 • 23 OWNER(S)OF PROPERTY: Name: :ECTM# 1000- p 0 Project Address: Phone#: C;Lit) U-7 41Email: �1 t Mailing Address:1P C), - CONTACT PERSON: Name: nolo C- Mailing Address: 1"I OV " _po Phone#: b3.i -705-4,530 Email:VCM Cool DESIGN PROFESSIONAL INFORMATION: V Name: Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: Name: 6CNAQ Mailing Address: Phone#: Emaily DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: ❑Other Will the lot be re-graded? ❑Yes 0 N Will excess fill be removed from premises? ❑Yes EJ No 1 PROPERTY INFORMATION Existing use of property: F.\M, Intended use of property: ALLc Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to �� 1•,+ this property? []Yes ONO 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(print ala )C(Q C, m uQ i((! Authorized Agent ❑Owner Signature of Applicant: -, Gate: STATE OF NEW YORK) SS: COUNTY OFj< ) being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)he is the (Contractor,Agen , 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 - �n 1U ' Notary Pu iic KYLEE S DEFRESE PROPERTY BALI T NOTARY PUBLIC-STATE OF NEW YOR �...-... ......_..._ ..°. ...._........_.._............ .. _.._ __... .._................._ No.01 DE6420156 (Where the applicant is not the owner) pualified in Suffolk County My Commission Expires 08-02-2025 n I, residing at do hereby authorize to apply on my behalf to e Town of Sout I I artment for approval as described herein. 12 l8 2 0 tier's Sign ure Date Print Owr r 5 lite 2 HAMPT-2 OP ID:VM DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 02/10/2022 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(ies) must 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. C 676-007 BADGE AGENCY,INC. PHOJIE� 516 0 C Na 516 �._... CONTACT TURA _ 1000 WoodburyRd,Suite 207 ic�I�k�Iix 676 0258 PRODUCER fdAME MICHAEL VENTURA Woodbury,NY 11797 EN AIL MICHAEL VENTURA ADDREs . Ir�suRER s)AFFaR�l .. m NG COVERAGE NAIC# INSURER A:Utica Mutual ....... ,._ INSURED„m_.. Hamptons SiIVerleafLaindsca Ing,Inc. INSURER B STATE.I�N_S INSURANCE FUND Kevin,Keyser . Grand Ave. INSURER 00640 C, Mattituck,NY 11952NN ER D• ..- INSURER F COVERAGES CERTIFICATE NUMBER: REVISIONNUMBER: THIS IS 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, ODEPOLICY a MMIDDLAIMS CI '^COMMETYPE OF RCIAL INSURALLABILITY POLF .NU”` RVE,BEENREDUCED EACHOCCURRE ILTREXCLUSIONS AND CONDITIONS OF SUCH POLCICIES.LIMITS S BY P--_ uMlrs F POLI 1 tl MMID/tNM IYYYY A NCE $ 000,0 .,. ❑X ART 5074759 04 08/24/2023 08/24/2024 74IACE�Cti rET7TI lti CLAIMS-MADE OCCUR X MED EXP Arch one Per�oe.I $ 1lll,Op RFk1WSES Q�a oc.cnarren ................ ..E?). $--- - 5,000 PERSONAL&ADV INJURY $_ 1,000,000 GEN L AGGREGATE G,EN LL E LIMIT APPLIES PER: ERAL AGGREGATE $ 000,00 POLICY F—]JECT �LOC P AGG $ PRS' PRODUCTS-COMP/O _000,000, I$ {THE : AUTOMOBILE LIABILITY COMBi E15 IN LE LIMIT $ i ANY AUTO ,mBODILY INJURY(Per person)^^^, ... __ ALL OWNED .....,._'_,SCHEDULED BODILY INJURY(Per accident) $ AUTOS -AUTOSP'a� __. HIRED AUTOS AUTOS ---- NON-OWNED Aalaipn� AMAX $ ... -.,.-___ ,.m,,,...�..... UMBRELLA OCCUR EACH EXCESS LIABAB ORRENCE :$ N �$ .,,,_ ......... .-.,,,,..,..,a. CLAIMS MAD ..... __AGGREGATE ...�� ...�.. ...., E Ila RETE14TION S PER WORKERS COMPENSATION X AND EMPLOYERS'LIABILITYSTATUTE. ER $ OII B ANY PROPRIETOR)PARTNEROEXECUTIVE Y X N/A 11 2370 133-7 08/27/2023 08/27/2024 E L EACH ACCIDENT $mm 101 w OFFICERIMEMBER EXCLUDED? 100 000 (Mandatory In NH) E.L DISEASE EA EMPLOYEE $.. ....... " ... If a.desculbe uhrder 500 00 D��CRIPTIONOFOPERATIONSbelow E.L DISEASE.POLICY LIMIT $ � 7 1� ........... DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE.HOLDER CANCELLATION SOUTHLD 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 PO Box 1179 53095 Rte 25 AUTHORIZED REPRESENTATIVE Southold, NY 1197101 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD JOSHUA R. WICKS P.L.S. SURVEYED BY:J.R.W. DRAWN BY:D.T.O. JOB NO,:1RWz3-03z5 P.O. BOX 599, Center I , N.Y. 11994 4Eslxua llaka�)lnsxl"01 - =t. /881-405-8108 ,',<M' .., GRA"ICSCALE TAX LAT 34 a anal Rei _ - tEtl RIGHT OF WAY '00" E 77.83 N 45°05 ill 51n1A1E GRAVEL V 1 MAffWK,OWN Or ray SUFFOLK COMP NEW Y09 O Q q _ Suffolk CcunW fax Map No,: s kV,,,iT ,T 1000-191,00-03,00033,000 DRN F nATf s Avon:10/Oy/2025 5CAX.1 20' WLL 10 2STY. 0 a F�s DG. 1 v E 1.8' S 45005'00" W 105.00' LONG ISLAND RAILROAD LOT AREA 6,020.12 S.F. 0.f4 ACRES) ' Im NEW, GUARANTEED T0: ARVIN X. AFYSER EMINENT ABSTRACT, INC. 111 I4 IIESTCOR LAND TITLE INSURANCE COMPANY MEADOWBROOX FINANCIAL MORTGAGE BANNERS CORP. ISAOA ATIMA L AN6 ° (.' ]eR ti_ '--@( `a*m..R3 F A w s R•;' .. A NOU1gH OF SECTION]?DB,SUB-DNI90N t'N4W 1 APC• '- J,i[F} a. $ i [RNC A C* 4% s'fi $ 'T F "S A tWR%"—k.fn CERIIFlCAiIONS ON #s.3T6 V N3F -mss •.a•iiFl%�i E i .L4 @' "�.:: 3=i SIIT'EYS AOOPIFD BY TVE NEV IORK STALE ."•••'a'••- _ a SD_e€SRSZ —�#.t4 fic t 'f t�€Aa TO 1HE IENDNO RO1... W 1 14T3E w <. _ -_—'a OR MK s M RST 4 4d3§�T 4 :ON ENgiOACHNEMS DW OR ME SNOW r. eV R� UiENT§ hit Cy:" HT EiiF§� fQ T�i.:�T S� �wm- q qg�y j g sA TM.ate eT<Tr J A VMf = -g - W 3a M fi i Ea 0 t RETNNING WN ,FOQS,PA1105 HINTING MEAS 1DD=NS TO 8 .*m-0 d, :TYPE OF LONSfRUCTION.(])PROPERTY CORNER MONUNEl05 WERE NOT SET AS PNT OF TNIS� „£{$S Tom.':��' ""-�—-N A Tom?SB RO-RC fA % i ��r 't a mg 1 D.-