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Home My WebLink About50419-Z TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE N 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#: 50419 Date: 3/11/2024 Permission is hereby granted to: 1925 Grandview Inc .._ ................... .............. 109 Stratford Ave . _ _.........._ _ w --- ...................... ._. Garden City, NY 11530 To: Construct a pergola accessory to an existing single-family dwelling as applied for. At premises located at: 1925 mGrandview Dr. Orient ._..___-___.mm ............................ SCTM # 473889 _ ��.. ........�......... _______ Sec/Block/Lot# 14.-2-3.21 Pursuant to application dated ..... .2/7/2024 and approved by the Building Inspector. To expire on 9/10/2025. Fees: ACCESSORY $225.00 CO-RESIDENTIAL $100.00 Total: $325.00 _. ...� ..D............. ........._....._ Building Inspector �sa �wb TOWN OF SOUTHOLD—BUILDING DEPARTMENT 1 (111':" ` Town Hall Annex 54375 Main Road P. O. Box 1179 Southold NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 htti) ://www. ou ioldtow ji �,,ov �bRr Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only - E E � W E PERMIT NO.50 Building Inspector: 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: February 7th, 2024 OWNER(S)OF PROPERTY: Name: Patrick Treanor �TM 1000-14-2-3.21 Project Address:1925 Grandview Drive, Orient, NY 11957 Phone#:631-734-7923 1Email: creativeenvdesign@yahoo.com Mailing Address: P.O. Box 160, Peconic, NY 11958 CONTACT PERSON: Name:David Cichanowicz Mailing Address:P.O. Box 160, Peconic, NY 11958 Phone#:631-734-7923 Email:creativeenvdesign@yahoo.com DESIGN PROFESSIONAL INFORMATION: Name:Agent/Contact Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: Name:Creative Environmental Design Mailing Address:P.O. Box 160, Peconic, NY 11958 Phone#:631-734-7923 Email:Creativeenvdesign@Yahoo.com DESCRIPTION OF PROPOSED CONSTRUCTION ®New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: ❑Other Per $ 45,000.00 Pergola Will the lot be re-graded? ❑Yes ®No Will excess fill be removed from premises? ❑Yes RNo 1 a 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 JNo IF YES, PROVIDE A COPY. hey'k Box A'f'.eir 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 •David C1 ICZ WAuthorized Agent ❑Owner Signature of Applicant: Date: February 7th, 2024 STATE OF NEW YORK) SS: COUNTY OF Suffolk ) David Cichanowicz 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 , 20 .01-LAI Notary Pu FY L 11 PUElffi ,in RQPER"�W OWNER AUTHORIZATION l Eomr��,�° (Where the applicant is not the owner) � I Patrick Treanor residing at 1925 Grandview Avenue, Orient, NY 11957 I, do hereby authorizeDavid Cichanowicz to apply on half to the Town of Southold Building Department for approval as described herein.. February 7th, 2024 Owner's Signature Date Patrick Treanor Print Owner's Name 2 z � Suffolk County Dept.of Labor,Licensing&"Cdn,surrtdr Affairs HOME IMPROVEMENT LICENSE Name DAVID J CICHANOWICZ Business Name INDIAN NECK CORP DBA This certifies that the bearer is duly licensed License Number H-29895 by the County of suffolk Issued: 12/13/2001 Je4,,�Cater¢ a, Expires: 12/01/2025 Commissioner M t� DATE(MMIDDNYYY) CERTIFICATE OF LIABILITY INSURANCE �,. 11/20/2023 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(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 co ifer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAM� Matt Daley Farm Family Insurance PHONE 631 744 3350 F; Ne 631-744-3383 85 Echo Ave-Suite 2 E MAR matt.daley@l'arm-famity.com com AOD Ess,: y Miller Place, NY 11764 INSURERS AFFORDING COVERAGE NAIC# .www. INSURER A: Farm Family Casualty 13803 INSURED INSURERE,: ......... Indian Neck Corp. DBA Cr aative Environmental Design RC �_.INSURE : PO Box 160 ..�...�._... ._......_.. .._.�. ...... INSURER D. INSURER E: Peconic NY 11958 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. NOTWITHSTAN ING,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. ILTR... ..M.............._..... - _..------. .DIAL AT''I ....._- _--------- P0LICY CFF POLICV`EXP ........... ... TYPE OF INSURAN 'E POLICY NUMBER MM10DdYY MMIDDIYYYY. LIMITS A COMMERCIAL GENERAL L ABILITY ''3152X2360 06/01/23 06/01/24 EACH OCCURRENCE $ 1,000000 CLAIMS-MADE iOCCUR PRhESI 100,000 Eatru:currc�n�X) x Select Business P G MED eXP(Anp one person) $ 5,000 ................ ...._. -� PERSONAL&ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APP'I.ESPER: GENERALAGGREGATE $ 2,000,000 P'O- LOC 2,000 000 X POLICY❑ �_ PRODUCTS-COMPIOP AGG $ 2THE'R; $ AUTOMOBILE LIABILITY 193L R04_mtSINGIrEI.IMIT $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED g AUTOS ONLY HIRED �U' PODILY INJURY(Per accident) $ pS a V-OWNED ERTYDAMu4CE $ � AUTOS ONLY ,',AUTOS ONLY0 $ e41pi - • UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB _ CLAIMS-MADE AGGREGATE $ DED.. . IO RETENT .. $ N$ WORKERS COMPENSATION ,PSTATt1TE OTH- ANYPROPRIETORMARTNERBEXL'UTIVE Y❑ NIA EE.L.EACH.L SEAAC --_. �n.......� AND EMPLOYERS'LIABILITY OFFICIERNEMtlBFREX('LUIDE�D?- CADENT $ (Mandatory In NH), -EA EMPLOYEE $ IS es,describe under W a SCRIPTION OF OPERATIONS slow E.L DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) MASONRY/LANDSCAPIN 3/CARPENTRY CERTIFICATE HOLDER CANCELLATION Town of Southold PO Box 1179 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Southold, NY 1 971 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD W � NYSI New York Mate Insorm ce Fund PO Box 66699,Albany,NY 12206 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE (RENEWED) AAAAAA 112294493 AMWINS INSURANCE BROKERAGE LLC 200 ELWOOD DAVIS ROAD SUITE 200 LIVERPOOL NY 13088 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER INDIAN NEC CORP. TOWN OF SOUTHOLD T/A CREATI E ENVIRONMENTAL DESIGN PO BOX 1179 PO BOX 160 SOUTHOLD NY 11971 PECONIC NY 11958 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE Z1318 041 966723 05/01/2023 TO 05/01/2024 11/20/2023 THIS IS TO CE TIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1318 046-8, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' CO 'PENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS I THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW„ IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY,INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDAT 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 CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE U ON THE CERTIFICATE HOLDER. 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"�,G'�nT.YAI 'I.�.YIY',mW'i,YYG0.9Fm'v.(& �M'!� ,. WAY 44 s / r „ '.. � 29x50' NEW PERGOLA . GUNITE POOL o _.. 10 i U, DER RETAMG WALL r.e. �.�, VIAa� .- r%�r � 12'dia. 50NOTUDf w/ 28"dia. BIGFOOT FOOTER / R \\ I Gx 2 IPE GIRD \ � � 1 GxG IPE Cb\MN / \ / U U O O iD �o N N Lp N O � 0- co co N N 12'dia. 5ONOTUBE w/ 28"dia. BIGFOOT FOOTER \ � Gx 2 WE GIRD R � GxG WE b\MN 20' 2 2'-5 11211 PERGOLA PLAN SCALE: 1/2" = P-O" I x4 WE PURLIN I x4 WE PURIJN 2x8 WE RAFTERS @ I G"O.C. 2x8 WE RAFTERS @ I G"O.C. ANCHORED (2)w/ Y4"x 1 O"5IMP50N HEADER LOCKSN N N N N N N N N N N N N ANCHORED (2)w/ Ya"x I O"SIMPSON HEADER LOCKS Gx 12 IPE GIRDER Gx 12 IPE GIRDER Gx 12 IPE GIRDER 4"x G"51MP50N SCREWS 4"x G"51MP50N SCREWS r2x811PEGU5SET 2x8 IPE GUSSET 2x8 IPE GUSSET 2x8 IPE GUSSETON SCREWS 4"x 8"51MP50N SCREWS GxG WE COLUMN GxG IPE COLUMN 4"x 5"SIMPSON SCREWS 4"x 5"51MP50N 5CREW5 SIMPSON POST HOLDER 51MP50N POST HOLDER "x 8"5IMP50N 5TRONGTIE "x 8"51MPSON 5TRONGTIE 4" POURED CONCRETE SLAB 4" POURED CONCRETE SLAB (2)#4 RE BAR (2) #4 REBAR Ln 12'dia. 50NOTUBE w/ 1 2' dia. SONOTUBE w/ 25"dia. BIGFOOT FOOTER 28"dia. BIGFOOT FOOTER PERGOLA SECTION DETAIL PERGOLA SECTION DETAIL SCALE: 1/2" = P-0" SCALE: 1/2" = P-0" ISSUES/REVISIONS CLIENT/OWNER PROJECT DRAWING No. CREATIVE TREANOR -µ- R ENVIRONMENTAL 1925 Grandview Drive � .v Robert I. Brown Orient, NY 11957A. NEW ' DESIGN Architect P.C. SCTM No. l000-14-2-3.41 } 7 / �' A I 239160 RTE 25 20 Bay Ave. Greenport _NY PERGOLA L PECONIC, NY into@rlbrownarchrtect.com DRAWING TITLE 631-734-7923 631-477-9752 PERGOLA PLAN creativeenvdesign@yahoo.com PERGOLA DETAILS IT IS A VIOLATION OF THE LAW FOR ANY PERSON,UNLESS DATE SCALE ACTING UNDER E DIRECTION OF AARCHITECT TO ALTER ANY ITEM ONTHI DRAWNGINNSED ANYWAY..ANY o5 FEBRUARY, 2024 /�11 = 11_O11 AUTHORIZED ALTERATIN MUST BE NOTED,SEALED AND DESCRIBED IN ACCORDANCE WITH THE LAW.