Loading...
HomeMy WebLinkAbout49884-Z �SOFF �c. TOWN OF SOUTHOLD BUILDING DEPARTMENT `' TOWN CLERK'S OFFICE o . �. SOUTHOLD, NY 't�7�r�cfV 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 #: 49884 Date: 10/13/2023 Permission is hereby granted to: Crossroads Atlantic LLC c/o Solow Realty & Dev 9 W 57th St Ste 4500 New York, NY 10019 To: Demolish existing single family dwelling, attached and accessory decks, accessory structures and in ground swimming pool as applied for. At premises located at: 4455 Oregon Rd, Mattituck SCTM #473889 Sec/Block/Lot# 94.-3-4.1 Pursuant to application dated 9/28/2023 and approved by the Building Inspector. To expire on 4/13/2025. Fees: DEMOLITION $1,965.00 Total: $1,965.00 r Building Inspector � J , o�S�fFf)(�COG TOWN OF SOUTHOLD—BUILDING DEPARTMENT CA x Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 hqs://www.southoldtowmy.gov f Date Received APPLICATION FOR BUILDING PERMIT Z0VO I 1 For Office Use Only g F S E P 2 3 2023 PERMIT NO. Building Inspector:_ Applicationsand forms must be filled out in their entirety,Incomplete PTTNG I31�'P'[', Applications`will not be accepted. Where the Applicant is not the'owner,an Owner's Authorization form(Page 2)'shall'be completed. _ Date: q1S1 2d2-3 OWNERS)OF PROPERTY: ' Name:GQ ALI �_L,L_---_.__..._ SCTM#1000-q4-3-4.1 Project Address: Irk � ��Z _-� © �-� �_.a.--___. -----C_u.-���o Phone#: ------ _--1-q y- Email: DlVlGM6t.rMailing Address: Ljec.F 4;-7 STIfe-eI CONTACT PERSON: Name: Mailing Address: Phone#: Email: DESIGN PROFESSIONAL-INFO'RMATIONc Name: Mailing Address: Phone#: Email: ,CONTRACTOR INFORMATION; Name, - Mailing Address: Le -"-.-„- _-_"- Phone Email: ------ FF? - „DESCRIPTION OE PROPOSED CONSTRUCTION. El New Structure ❑Addition ❑Alteration ❑RepaiAremolition Estimated C st of Project: ❑Other $ Will the lot be re-graded? ❑YesXNO Will excess fill be removed from premises? ❑Yes)<No PROPERTY INFORMATION, Existing use of property: Intended use of property: 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. Check Box After Reading: The owner/contractor/design professional is responsibie'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. 1 Application Submitted By(print name): FreAV1 Y- q ev+n,-S ZIV uthorized Agent ❑Owner Signature of Applicant: Date: STATE OF NEW YORK) c SS: COUNTY OF Gr'�-k.. � 1 Ot-( Sr• being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (She is the C,&—n +"CC`b-r (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 terew' h. . SBARBARA H.TANDY Sworn before me this Notary Public,State Of New York No. 01 TA6086001 day of d , 20 A3 Co maqQualified In Suffolk efsolk CountyPMM Notary Public `T• PROPERTY OWNER AUTHORIZATION (Where the applicant is not the owner) I, Ddar/i L AS residing at c 34 '7 6CCti d F q X I L4 do hereby authorize ?l�eto--%tC.* 4Y#-y HC4+►!bp=?1d✓^r-LL to apply on my behalf to the Town of Southold Building Department for approval as described herein. 61— CA 7: 3 a Owner's Signature Date boor- ccdssaoc ,�s Alto-IN i� Print Owner's Name 2 N. J. MAZZAFERRO, P.E. PO Box 57,Greenport,N.Y, 11944 Phone- 516-457-5596 Consulting Engineer September 27,2023 Design, Construction, Inspection Page 1 of 1 --�. Town of Southold-Building Department 53095 Main Road Southold NY 11971 Re:4455 Oregon Road Cutchogue,N.Y. 11935 SCTM#- 1000-94.-3-4.1 Project—Residential Construction—Gas Installation Inspection - On September 27,2023 I did an inspection at the noted location.The purpose of the inspection was to verify that the local gas service(propane)to the main house and rear ti accessory building has been disconnected.The disconnection was done to facilitate the demolition of these buildings. The inspection results are: 1 —Gas installation included a buried tank for propane and portable propane gas cylinder tanks above ground. Gas was supplied through underground lines. 2—The buried gas tank was still in place but was open to the atmosphere. There was no propane gas stored in this tank.This tank is abandoned and will be removed as part of the demolition. 3—The portable gas cylinders have been removed from the site.The connecting pipe has been abandoned and will be removed as part of the demolition. Result-As of this date there is no propane gas stored at this site.The facilities have be n abandoned and completely disconnected. Thank You, Rrr.c N�N�Y 0 x Nicholas J.Mazzaferro,PE �^ A � DCO 01 Suffolk County Mer Affairs : Labor,Licensing r HOME lm?ROtirEMtNI LICENSE 4; d 't ",�' -: •:� Name FRANK FENOY Business Name AM This certifies that tine Pecos c BaY Management LLC bearer is duly licensed by the:County of Suffolk License Number:HI-6760 Li Rosalie Orago Issued: 0912012022 0910112024 Corn'nissioner Expires: DATE(MMIDDIYYYY) A�® CERTIFICATE OF LIABILITY INSURANCE 09/05/2023 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(s). PRODUCER CONTACT NAME: Sean Kiernan Westbury Lighthouse, Inc. ac°"N Erd: 516-338-0001 VI No).516-338-6020 976 Old Country Rd. E-MAIL RSS . Sean(a.LHAgent.com Westbury, NY 11590 INSURER(S)AFFORDING COVERAGE NAIL# INSURERA:Evanston Insurance Company INSURED INSURER B: Peconic Bay Management LLC INSURER C: 1977 Marlin Road INSURERD: LAUREL, NY 11948 1 INSURER E- NYSIF INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADOLTYPE OF INSURANCE lum SUER POLICY NUMBER PMOIUDQI EFF POMIDD EXP LIMITS LIY LTR SIM COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE W OCCUR PREMISES Fa occurrence $ 50,000 X 3AA594183 08/18/23 08/18/24 MED EXP(Any one person) $ 5000 A PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 POLICY E]JECT F-1 LOC PRODUCTS-COMP/OP AGG $ 1,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea acddent ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per acddent UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS LIABILITY STATUTE ER E O CROPRIE OWAR EEwED�CUTWE Y❑ N/A I 2576 967-0 8/26/23 0$/26/24 EL EACH ACCIDENT $ 100,000 (Mandatory in NH) E.LDISEASE-EAEMPLOYEE $ 100,000 If describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 100,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) GENERAL CONTRACTOR CARPENTRY, ROOFING, SIDING, WINDOWS, DOORS POLICY SUBJECT TO THE TERMS CONDITIONS EXCLUSIONS OF THE ACTUAL POLICY AT TIME OF ISSUE CERTIFICATE HOLDER CANCELLATION Town Of Southold-Building Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 54375 Main Road P.O. Box 1179 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Southold NY 11971 AUTHORLZED REPRESENTATIVE SEAN KIERNAN ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Y S ' F New York state Insurance Fund PO Box 66699,Albany,NY 12206 I nysif.com CERTIFICATE OF WORKERS3 COMPENSATION INSURANCE A A A A A A 843745220 WESTBURY LIGHTHOUSE INC 976 OLD COUNTRY ROAD WESTBURY NY 11590 SCAN TO VALIDATE .AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER PECONIC BAY MANAGEMENT LLC TOWN OF SOUTHOLD 1977 MANIN ROAD BUILDING DEPARTMENT LAUREL NY 11948 54375 MAIN ROAD P.O.BOX 1179 SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE 12576967-0 629164 08/27/2023 TO 08/27/2024 9/6/2023 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2576 967-0, 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 VIIEBSITE AT HTTPS://WWW.NYSIF.COMICERT/CERTVAL.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 CERTIRCATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE ''POLICY. NEW YORK STAT SUR NCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER:479446778 U-26.3 Laurel Lighting INC 1977 Main Road Laurel NY 11948 631-457-3363 Laurellightingjr@gmail.com September loth 2023 License#4718ME Crossroads Atlantic LLC 4455 Oregon Road Cutchogue NY 11935 To whom it may concern, This letter is to notify that all electrical power systems have been removed and disconnected to structures to be demolished located at 4455 Oregon Road Cutchogue NY 11935• Sincerely yours, Frank Fenoy DUCK POND ROAD X N/F MESKOURIS \+ \+ \ `�; w 100' _ BLUFF +�—x—x—x—x—x—x—x—x—x—x—x—x—� S 40°04'30" E S 40°14' E � w 1447.24' d W Z 1 1610.0' 1230.06' FE.0.1'N Z. sz SETBACK Of S 40009' E Ix K LINE I z.7'w r r X x GRAVEL DRIVEWAY GATE x X I - 10.0' PILLARS T/COMM. GATE I BUTTON POST X N IL 62.3' BOX FE.0.5'N 00 II I Inn O I4.p• U- � 1 1 o U. � 2 O m 00 X 1 METAL X POST 8 06 CM 1 591' 83.0' 1 24.0 SHED I FEN ERELU 8.v �108 x 1, o I o :��••��/ ONC I W T033' 62.3' J MAS PATIO ATJ .9;r O:AGGT W/PERGOLA 649' PROP -9–�-Ix SHS �z- m 5' 6_ ' 66.p' TOTAL AREA Q ° /X AVIAN 7'a GR/ga' v FR RES = 36.1943 AC " � M J)ECI 1° i° O 1�1 �O// / 62.1 , 69 ^o t_ PROP. I LL N, FFL.EL.=70.0' Z /59.3' / - p o ............... ............................................................................. .............................. 7.T ' ! _ . Q8� ' - 13.8' vi 3.. ..... ... 1 �DECK;8' ;`X21 �a ..� ........ ................................................................................ •3927 0'' ............................................................ mI FR CK 8.4, ei 36.0' n' 10, �1 DRYWELLS FOR ..... .398'55.4'. .......................................... X .1 / 59 .il .5• `66_MIN STORMWATER RUNOFF ........................................................ r^ i v F DECK i�Bhp R/O STEPELEC✓EIC—.,o TRANS. Lij Q o X .... .106.9'..70.1'1 .k q2 B. LINE EM WELL I O �wA7El� HEAD `(\ •101.2'......9�' - W LINE 1 + 70.2 o F- fib 68� 2 STY 64.8' 1 63.' IN-POOLND - - "- FR RES LU x 1 0" 2 FR #4455 I CD a HED O EXTG I Lo FFL.EL.=72.00' I 0 0ce) PROP. Lo Lo \ I o GEN IN-GROUND x z LLL I m o POOL 20'x40' 7,21 N BENCH 891' 1 N 390 0'30"W % 4295.0' NI )'wo WN/F MAVELLIA CEHA LINE AS PER SUFFOLK COUNTY GIS NOTE: NO WELLS WITHIN 150'OF SUBJECT PARCEL; SCALE 1"=80'(11"xl 7") SCTM 1000-094.00-03.00-004.001 SURVEYED:AUGUST 27,2021 DESCRIBED PROPERTY REVISED:JULY 29,2022 UPDATE:OCTOBER 30,2022 SITUATE AT MATTITUCK TOWN OF SOUTHOLD LAND SURVEY LONG ISLAND.COM ti-K� e SUFFOLK COUNTY, NEW YORK ;ro .= CERTIFIED TO: STACEY WARD BROOKS LAND SURVEYOR ©COPYRIGHT 2022 WARD BROOKS.ALL RIGHTS RESERVED.DUPLICATION OF THIS DOCUMENT IS A VIOLATION OF FEDERAL COPYRIGHT LAW. 11 OCEAN AVENUE THIS SURVEY HAS BEEN PREPARED IN ACCORDANCE WITH THE CODE OF PRACTICE ADOPTED BY THE NEW YORK STATE ASSOCIATION OF PROFESSIONAL LAND SURVEYORS. BLUE POINT NY. 11715 ,f CERTIFICATION SHALL RUN ONLY TO THE PERSON,THEIR INTEREST AND/OR ASSIGNS. 1 j• CERTIFICATIONS ARE NOT TRANSFERABLE. ^S 576-7794 r�7 77Q {.^� 1363-3179 /y�� 7Q '.t .? THE EXISTENCE OF RIGHTS OF WAY,AND/OR EASEMENTS OF RECORD,IF ANY NOT SHOWN ARE NOT GUARANTEED. (63 1 ) V/ 6-f I 94 (63 1 ) 363-3 1 I 9 ;,f Priv13� - ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209-2 OF THE NEW YORK STATE EDUCATION LAW. t i s DO NOT SCALE FENCES.OFFSETS SUPERCEDE. WARDBROOKSO@GMAIL.COM x `..` ^• ELEVATIONS REFER TO NAVD'88 INDICATED THUS OA0.0''.PROPOSED ELEVATIONS INDICATED THUS METES AND BOUNDS DESCRIPTIONS ARE FILED WITH SUFFOLK COUNTY CLERK AT INDICATED LIBERS&PAGES. FILE#11170