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Home My WebLink About50298-Z TOWN OF SOUTHOLD 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#: 50298 Date: 2/5/2024.m.,. ........_�._ ��................_,...A. Permission is hereby granted to: & C Prpr.. Hldnc,�ll Inc E...�... __. 158-11 Harry Jr Ave �.. VanArsdale � „____.,� .... ...._.._ FlushmgNY 11365 Tow Installation of replacement window and roof and siding repairs as required. Structural repairs will require an amendment. At premises located at: 0475 Oregon Rd, Cutchogue ..... . ..___— �,... ._ SCTM # 473889 Sec/Block/Lot# 83.-2-17.1 Pursuant to application dated 1110/2024 and approved by the Building Inspector,. To expire on . 8/6/2025. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $250.00 CO-ALTERATION TO DWELLING $100.00 Total: $350.00 _..... � .�. m_... _w......... Building Inspector YFFCiC 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 ws: �w y.so"erthkoldto�wp� ov, Date Received APPLICATION FOR BUILDING PERMIT � For Office Use Only PERMIT NO. S c)a {J Building Inspector. � M11 1 0 Applications and forms must be filled out in their entirety.Incomplete w. applications will not be accepted. Where the Applicant is not the owner,an Owner's Authorization form(Page 2)shall be completed. Date: 1/5/2023 OWNER(S)OF PROPERTY: Name:WJF FARMS, LLC sum#s000-83_2_17.1 Project Address: 10475 Oregon Rd, Cutchogue, NY 11935 Phone#:516-807-2575 Email:info@oregonroadorganics.com Mailing Address:8405 Cox Lane, Cutchogue, NY 11935 CONTACT PERSON: Name:W. Jonathan Fabb Mailing Address: 8405 Cox Ln, Cutchogue NY 11935 Phone#:516-807-2575Email:fabbjon@yahoo.com DESIGN PROFESSIONAL INFORMATION: Name: N/A Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: Name:Twin Fork Landscape Contracting, Inc Mailing Address: PO BOX 460, CUTCHOGUE NY 11935 Phone#:631-734-6643 Email:INFO@TWINFORKLANDSCAPECONTRACTING.COM DESCRIPTION OF PROPOSED CONSTRUCTION ❑New st ❑ ❑ IterationRe fir ❑Demolition eEs}timated Cost of Pct ❑Other WINDOWREPLACEMENT '510(ZKA tins &51, a Will the lot be re-graded? ❑Yes liRNo Will excess fill be removed from premises? []Yes giNo 1 PROPERTY INFORMATION Existing use of property:AG RI CU LTU RE Intended use of property:AG RI CU LTU RE Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to AG this property? Dyes MNo 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 210AS of the New York State Penal Law. Application Submitted By(grin a e): Jonathan Fabb ❑Authorized Agent ROWner Signature of Applicant: Date: / -5 - LCj 2,2-1 STATE OF NEW YORK) SSS: COUNTY OF tQ ) r 1 being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the i"-� (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 �- h da of _ , 20 �is 7 , 1 �, �" "e Y ��. Notary Public SHARON l..COt,GHLIN loiary puck,stale of New York PROPERTY" OWNER AUTHORIZATION NO,oi0 757 (Where the applicant is not the owner) died E ktaourity Commission Expires't00i'20"i-I I, 70—residing at f do hereby authorize �' �' to apply on my behalf t 4eT w outhold Building Department for approval as clescri ed h rein. t�4/ Aj —�N rear's Signature Date Print Owner's Name 2 NYSIF New York State Insurance Fund PO Box 66699,Albany,NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE C AAAAAA 113592577 " TWIN FORK LANDSCAPE CONTRACTING INC PO BOX BOX 460 CUTCHOGUE NY 11935 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER 10475 OREGON RD TWIN FORK LANDSCAPE CONTRACTING INC WJF FARMS, LLC PO BOX BOX 460 10475 OREGON RD CUTCHOGUE NY 11935 CUTCHOGUE NY 11935 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE 11229085-4 113233 03/23/2023 TO 03/23/2024 1/9/2024 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1229085-4, 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:I/WWW.NYSIF.COM/CERT/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 CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. WILLIAM J FABB(PRES) OF ONE PERSON CORP TWIN FORK LANDSCAPE CONTRACTING INC THE POLICY INCLUDES A WAIVER OF SUBROGATION ENDORSEMENT UNDER WHICH NYSIF AGREES TO WAIVE ITS RIGHT OF SUBROGATION TO BRING AN ACTION AGAINST THE CERTIFICATE HOLDER TO RECOVER AMOUNTS WE PAID IN WORKERS'COMPENSATION AND/OR MEDICAL BENEFITS TO OR ON BEHALF OF AN EMPLOYEE OF OUR INSURED IN THE EVENT THAT, PRIOR TO THE DATE OF THE ACCIDENT, THE CERTIFICATE HOLDER HAS ENTERED INTO A WRITTEN CONTRACT WITH OUR INSURED THAT REQUIRES THAT SUCH RIGHT OF SUBROGATION BE WAIVED. 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 SUR NCE FUND DiRECTORINSURANCE FUND UNDERWRITING VALIDATION NUMBER:779937239 U-26.3 CERTIFICATE OF LIABILITY INSURANCE FDATE(MWOONYYY) 01/09/2024 THIS CERTIFICATE 19 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 pollcy(les)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 endo e 4 PRODUCER EILEEN CUSHMAN GEORGE FORMES R 631-722-4100 M 1631-722-4 500 1116 MAIN ROAD SUITE A2 .EILEE .ICUSH N ERICAN-NATIONAL.C'OM P.O. BOX 2336 INSURERFJ AFFORDING COVERAGE NAZCA AQUEBOGUE,NY 11931 INSURER A:FARM FAMILY CASUALTY INS.CO. INSURED INSURER 0: TWIN FORK LANDSCAPE CONTRACTING INC. INSURERC: PO BOX 460 Ik SURER 0, CUTCHOGUE,N.Y. 11935 1 INSURERS: INS P: COVERAGES CN RTIFICATEE 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 W'MICH 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 SEEN REDUCED BY PAID CLAIM-S. R — _ .. .� MI. TITEOFINSURANci - UNITS A COMMERCIAL GENERAL LIABILITY I� TE s DD 000 _, 3152X1157 05/10/2023 05/10/2024 EACH OCCURRENCE $ 1 0_ CLAIMS-MADE Q OCCUR FVI90 000 XX' CONTRACTORS MEDExP oneperson) s ADVAMAGE �. PERSON,.ALMm8 ADV INJURY�.__. s.._._w._. 000 w._ iEN'LAKiGRECdATE LIMIT APPLIES PER: GENERAL AGGREGATE w $ 2.000.000 POLICY 0 Ci Ej LOC PRODUCTS-COMPIOPAGO S 21000.00D OTHER,, S A AUTOMo&LauAB LITY 3152C4133 DM=023 05110/2024I. LE IT $ 1,000,000 ANYAUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED AUTOS ,X AUTOS BODILY INJURY(Per accidenq S X HIREDAUTOS X NON-OWNED —Ax0p5 ��y{,;6 a AUTOS X 500 COMP 600 COLL �� S A X UMBRELLA— OCCUR 3101E3412 09/2812013;'D9128/2024 EACH OCCURRENCE S 1,000.000 EXCESS W►B CLAIMS-MADE AGGREGATE _ $ DED RETENTIONS S WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETORIPARTNERIEXECUTNE NIA E.L EACH ACCIDENT _ S OFFICERIMEMBEREXCLUDED7 ELDISEASE-EA b � (Mandatory in NH) . . mm. w ^..^ .. If yes.describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be amahed N mon apaae Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN WJF FARMS,LLC ACCORDANCE WITH THE POLICY PROVISIONS. 10475 OREGON RD CUTCHOGUE NY 11935 R ENTATIVE 4t4� Sr 19 014 ACORD CORPORATION. All rights reserved. ACORD 251201411011 The ACORD name and loco are realstered marks of ACORD Suffolk County Dept of Labor,Licensing&Consumer Affairs HOME IMPROVEMENT LICENSE Name WILLIAM J FABB Business Name This certifies that the TWIN FORK LANDSCAPE bearer Is duly licensed CONTRACTING INC by the County of suffdk License Number H-43006 P.&$44&Drager Issued: 06/13/2007 COmmissioner Expires: 06/01/2025 a. r E �NANDERSEN` WINDOWS & DOORS CREATED DATE SOLD BY: SOLD TO: 12/20/2023 !IRIVERREAD Ken Reilly eUILDING SUPPLY 250 David Court LATEST UPDATE Build Smarter.Build Better. Calverton, NY 11933 1/10/2024 OWNER Ken Reilly Abbreviated Quote Report QUOTE NAME PROJECT NAME QUOTE NUMBER CUSTOMER PO# TRADE ID TFLC TFLC 5108477 ORDER NOTES: DELIVERY NOTES: Item Q_yt Operation Location li 100 1 AA None Assigned RO Size=30 1/8"x 48 7/8" Unit Size = 29 5/8" x 48 7/8" , 71 ii TW24310, Unit, 400 Series Double-Hung, Equal Sash, Installation Flange,White Exterior Frame, White Exterior Sash/Panel, Pine 1 _�_;� wn/vhite- Painted Interior Frame, Pine w/White- Painted Interior Sash/Panel, AA, Dual Pane Low-E4 Standard Argon Fill Stainless Glass/Grille Spacer, Traditional, 1 Sash Locks White (Factory Applied), WhiteJamb Liner,White, Full Screen, 29.625-...---...• ----RO-30.125---. Aluminum Insect Screen 1:400 Series Double-Hung,TW24310 Full Screen Aluminum White PNA610121 Unit# U-Factor SHGC ENERGY STAR Clear Opening/Unit# Width Height Area (Sq. Ft) ---------------------------------- A1 0.3 0.31 NO Al 25.8750 20.2500 3.65000 Quote#: 5108477 Print Date: 1/10/2024 2:24:17 PM UTC All Images Viewed from Exterior Page 1 of 2