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Home My WebLink About50379-Z TOWN OF SOUTHOLD rc BUILDING DEPARTMENT ?� TOWN CLERK'S OFFICE d 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#: 50379 Date: 2/28/2024 wwwww_. Permission is hereby granted to: 9095 Sound Ave LLC . _..... ................165 Oliver St ...... ._._.... Riverhead 11901� .......�__. ._.w...._...__w ........._... w..._... To: add a two-compartment sink and trench drain to an existing restaurant as applied for. At premises located at: 9095 Sound Ave .Mattituck _.._...._.........................w_.___.......................... ._ ..............................._..� .___�. w....._...._ SCTM # 473889 Sec/Block/Lot# 121.-2-2.1 Pursuant to application dated 1/25/2024 . and approved by the Building Inspector. To expire on 8/29/2025.mryww Fees: NEW COMMERCIAL, ALTERATION OR ADDITIONS $300.00 CO-COMMERCIAL $100.00 Total: $400.00 Builing Inspector For ` TOWN OF SOUTHOLD —BUILDING DEPARTMENT 41 ` Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 klw tli ---a �Mlp ?'. Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only I E I warm IV- PERMIT NO, ,„ Building InspectorM --------—.., i JAN 25 20224 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. �'C'R dn' 1,17 I�"C::: 'IMI Date:January 17, 2024 OWNER(S)OF PROPERTY: Name: Brian Lewin ._.. .... .. .-_.m_...�.....� SCTM # 1000- Project Address:9095 Sound Ave Mattituck NY, 11952 Phone#:631-926-2527 Email:brianalewin@hotmail.com Mailing Address: CONTACT PERSON: Name: Lawrence & Peter Frasca Mailing Address:9095 Sound Avenue Mattituck NY 11952 Phone #: 43/ pp0 (o 7Email:BrewVenturesNY@gmail.com DESIGN PROFESSIONAL INFORMATION: Name: Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: Name: EME North Plumbing Mailing Address: 11500 Main Bayview Road Southold, NY 11971 Phone#:631-603-2414 Email:emenorthplumbing@gmail.com DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure RAddition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: ❑Other $24,000 WIII the lot be re-graded? ❑Yes RNo Will excess fill be removed from premises? RYes ❑No 1 PROPERTY INFORMATION Existing use of property: Brewery, Taproom Intended use of property:Same 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 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 21045 of the New York State Penal Laws Application Submitted/(P name): Lawre a FraSca []Authorized Agent ❑Owner Signature of ApplicantDate: / - 2 Z 1 CONNIE D.BUNCH STATE OF NEW YORK) Notary Public,State of New York SS: Na.01BU6185050 COUNTY OF Suffolk ) Qualified in Suffolk County Commission Expires April 14,2—nDy Lawrence F raSca being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)he is the_ (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 fife 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 _may of � 20 Notary Public PROPERTY OWNER AUTHORIZATION (Where the applicant is not the owner) residing at do hereby authorize to apply on my behalf to the Town of Sou Building Department for approval as described herein. Owner's Signature Date rr Print Owner's Name 2 � ►+ = CERTIFICATE OF LIABILITY INSURANCE DATE(MM12/28/120232023 Y) 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 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 Barbara Dammers NAME, Roy H ReeveA Agency,Inc. PiioNE (631)298 4700 9 AJ N LAIC N _www PO Box 54 A bdammers@royreeve.com �4EADR 5 ?.� reeve www_..... 13400 Main Road INSURERS)AFFORDING COVERAGE NAIC# Mattituck NY 11952 INSURER A: Merchants Preferred Ins Co 12901 INSURED INSURER B: Trumbull Ins CO 27120 EME Plumbing&Heating Inc. INSURER C; 11500 Main Bayview Road INSURER D: ...... �q_eMO, INSURER E: Southold NY 11971 INSURER F. COVERAGES CERTIFICATE NUMBER: CL23122820254 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. www MM 9133A �C' Lift R _www R TYPE OF INSURANCE WV POLICY NUMBER JMMtDO(YYYY MMIDDIYYYY)," LIMITS _.....,. .. .................... ...... ...._....� -.m....... ... COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 piA �. O E ww. 500,000 CLAIMS-MADE � OCCUR PF7E�w"M—s (S a?m�,r�n Contractual Liability MED EXP(Any one person) $ 5,000 -- ............. � A _...._. CTRIO03295 12/15/2023 12/15/2024 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 Pa.. IR CY0PRO ❑LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OLICY PRO r1"tE,', .. $ AUTOMOBILE LIABILITY 4.)�»16QNI'"O�i6r`"i'r F LIMM'P $ _LFn�ddaPata�9 --.... ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS ONLY AUTOS -----"� HIRED NON-OWNED PROPER"rY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident„)„w," UMBRELLA LIAB OCCUR _ EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY STA UTF FRH Y/N 100,000 ANY PROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $ B OFFICER/MEMBER EXCLUDED? EN1 N/A 12WECAJ6UYL 12/11/2023 12/11/2024 (Mandatory in NH) .J E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ E...... .._____-._ ............... .............. .� ......_ ._.. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) General plumbing,service&construction CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Suffolk County Dept of Labor,Licensing& ACCORDANCE WITH THE POLICY PROVISIONS. Consumer Affairs AUTHORIZED REPRESENTATIVE PO Box 6100 Hauppauge NY 11788 " @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ✓"�� 0 DATE(MMIDDIYYYY) ACC>RV CERTIFICATE OF LIABILITY INSURANCE 12/28/2023 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(es)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 endorsentent(s). PRODUCER NONE Barbara Dammers Roy HReeveA Agency, IHpNE (631)2984700 � C,Nn: (631)298-3850 Y 9 Y Af E PO Box 54 A�-An_Ssr bdammers@royreeve.com 13400 Main Road INSURERIS),AFF01tDXNG COVERAGE _ NAIC# Mattituck NY 11952 INSUrteaA: Merchants Preferred Ins Co 12901 INSURED INsuRR B: Trumbull Ins Co 27120 EME Plumbing&Heating Inc. INSURERc; __ 11500 Main Bayview Road INSURER D. www INSURER E: Southold NY 11971 INSURER F: COVERAGES CERTIFICATE NUMBER: CL23122820254 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. O ...�wwww.. UOR ww.. ._wdLTdy"ffw__,7*zL_1rVUVLIMITS LTR TYPE OF INSURANCE N D WVO POLICY NUMBER MMfeDN YY" I�MIDDWYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 171 R 500,000 CLAIMS-MADE ®OCCUR I�RUPRI'SfES Ea ori.ier $ Contractual Liability IAED EXP(Any one person) S 5,000 A CTRIO03295 12/15/2023 12/15/2024 PERSONAL.SACV INJURY S 1,000,000 GENERALAGRa6'.&`taNM ........," 4aI`N"8 PkKaGFiEC;AT LIMIT APPLIES PER: 2,000,000 PRO- PRODUCTS-COMPIt CIPAGG S 2,000,000 POI CY' JECT LOC $ - ---- " AUTOMOBILE LIABILITY _act'Sd D SINGLE tl�.rMll" $ '..ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) ,...... AUTOS ONLY AUTOS HIRED ' NON-OWNED HI.dI"ER"ES"OAIn1AG'sE $ Paa aad Ea ontl, AUTOS ONLY AUTOS ONLY �- - UMBRELLA LIAB=01,CCUR �.., ...EACH 04';4';.I.NN"�CRr�'�NE.. www '�S ,,....� EXCESS LIABAIMS-MADE AGGREGATEDED zIFE IV'r2a Lww..�,.-„„„„„ _ WORKERS COMPENSATION � _w "�&TUrTF TrR _ AND EMPLOYERS'LIABILITY """� ANY PR('1P1"4IS"f W.ERIC'AhN'�t NE' RBE'Xr.CUTCVE YIN N LL,µEACH ACCIDENT E 100,000 B or,r6CEMMEMEIrREXCLUDED? N� NIA 12WECAJ6UYL 12111/2023 12/11/2024 (Mandatory In NH) E I DMEASE aF-EA EMPLOYEE S 1001000 V yes,describe under 500,000 DESCRIP"TION OF OPERATIONS below E.L„d I SEAkSG-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) NNN General plumbing,service&construction CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Suffolk County Dept of Labor,Licensing& ACCORDANCE WITH THE POLICY PROVISIONS. Consumer Affairs AUTHORIZED REPRESENTATIVE P O Box 6100 Hauppauge NY 11788 k @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD B.P. M v C a ,. WnFV WtLDING DEPARTMENTAT S(Xi*R USED IN WA TEFi 631.765.1802 8AM TO 4PM FOR THE SESTE b !. FOLLOWING INSPECTIONS: 2/f 0 O�"' I 1. FOUNDATION-TWO REQUIRED FOR POURED CONCRETE 2. ROUGH-FRAMING&PLUMBING 3. INSULATION 4. FINAL-CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW AM G YORK STATE. NOT RESPONSIBLE FOR WN DESIGN OR CONSTRUCTON ERRORS EMEINGS"tl"E ER LINES NEE' T N0 SC-'O E CCUERNC ACOMPLY MH NEW YORK STATE&TOWN CODES AS REQUIRED AND CON ITIONS OF AN DC N S OT OUTHOLD WN LL BOARD SOPOL "MU IEE V&D REQUIRED BEFORE OLD Hpc OPENING,, E IS UNLAWFUL ........... 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