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Home My WebLink About50522-Z °W TOWN OF SOUTHOLD `� BUILDING DEPARTMENT " TOWN CLERK'S OFFICE N` SOUTHOLD, NY � o 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 #: 50522 Date: 4/8/2024 Permission is hereby granted to: Petrone, Frankie 85 Leeward Dr Southold, NY 11971 To: construct accessory pavilion as applied for. At premises located at: 85 Leeward Dr, Southold SCTM # 473889 Sec/Block/Lot# 79.-7-32 Pursuant to application dated 3/1/2024 and approved by the Building Inspector. To expire on 10/8/2025. Fees: ACCESSORY $341.00 CO-ACCESSORY BUILDING $100.00 Total: $441.00 Building Inspector ^Y y 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 litil.)s://wNvw,southoldtowniiy.gov Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only C; PERMIT NO. � Building Inspector; -J- ;:,024 Applications and forms must be filled out in their entirety. Incomplete applications will not be accepted. Where the Applicant Is not the owner,an ,.F Owner's Authorization form(Page 2)shall be completed. Date: 02/22/2024 OWNER(S)OF PROPERTY: Name: Frankie Petrone SCTM#Z000-79-7-32 Project Address: 85 Leeward Dr, Southold, NY 11971 Phone#: 917-578-2504 Email: Fran kie.petrone7l @gmail.com Mailing Address: 85 Leeward Dr, Southold, NY 11971 CONTACT PERSON: Name: Frankie Petrone Mailing Address: 39-14 218th Street, Bayside, NY 11361 Phone#: 917-578-2504 Email: Fran kie.petrone7l @gmail.com DESIGN PROFESSIONAL INFORMATION: Name: Christopher Palmeri Mailing Address: 38-10 208th Street, Bayside, NY 11361 Phone#: 646-691-6728 Email: cfparch@gmail.com CONTRACTOR INFORMATION: i Name: Corey Catechis Mailing Address: 36-51 Bell Blvd Suite 202, Bayside, NY 11361 Phone#: 718-673-0385 Email: Corey.millennium@outlook.com DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: DOther Pavilion $25,000 Will the lot be re-graded? ❑Yes RNo Will excess fill be removed from premises? ❑Yes R No 1 PROPERTY INFORMATION Existing use of property: Residence Intended use of property: Residence Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? Eyes @9 No IF YES, PROVIDE A COPY. 19 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. Corey Catechis Application Submitted By(print a µ BAuthorized Agent ❑Owner Signature of Applicant: rn "" Date: Q2/21 L( STATE OF NEW YORK) SS: COUNTY OF.& I Corey Catechis being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, Contractor (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 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 ?—Cl—day of 1!��b 0A �1 Notary Public Veronica Magri Notary Public,State of New York ^^ No;01MA6295575,Suffalit County ,�� ' III OWNER I..L.� l 111 Commission Expires Jana 6,2026 (Where the applicant is not the owner) Frankie Petrone 85 Leeward Dr, Southold, NY 11971 I, residing at Corey Catechis do hereby authorize to apply on MY b alf to the Town of Southold Building Department for approval as described herein. z zy f Owner's SigKature Date Frankie Petrone Print Owner's Name 2 4% YSIF New York State Insurance Fund PO Box 66699,Albany,NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE (RENEWED) AAAAAA 113463908 MILLENNIUM CONTRACTORS LLC 36-51 BELL BLVD STE 202 ■ W& BAYSIDE NY 11361 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER MILLENNIUM CONTRACTORS LLC TOWN OF SOUTHOLD 36-51 BELL BLVD STE 202 54375 MAIN ROAD BAYSIDE NY 11361 SOUTHHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE Q2163 619-6 358934 09/27/2023 TO 09/27/2024 2/27/2024 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2163 619-6, 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://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 AFFORDS COVERAGE TO THE SOLE PROPRIETOR, PARTNERS AND/OR MEMBERS OF A LIMITED LIABILITY COMPANY. EFTHIMA CATECHIS 1 OF 2 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. BY CAUSING THIS CERTIFICATE TO BE ISSUED TO THE CERTIFICATE HOLDER, THE POLICYHOLDER UNDERTAKES TO PROVIDE THE CERTIFICATE HOLDER 15 CALENDAR DAYS' NOTICE OF ANY CANCELLATION OF THE POLICY,. NEW YORK STAT SU NCE FUND DIRECTOR,I NSU RANCE FUND UNDERWRITING VALIDATION NUMBER: 853559602 U-26.3 NEW YORK workers'STAXE Co CERTIFICATE OF INSURANCE COVERAGE mpensation Board NYS DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW PART 1.To be completed by NYS Disability and Paid Family Leave benefits carrier or licensed insurance agent of that carrier 1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured MILLENNIUM CONTRACTORS LLC. 917-589-65" 36-61 BELL BLVD STE 202 BAYSIDE,NY 11361 1c.Federal Employer Identification Number of Insured or Social Security Work Location of Insured(Only required if coverage is specifically Number limited to certain locations in New York State,i.e., Wrap-Up Policy) 113463908 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY Town of Southold 54375 Main Rd., 3b. Policy Number of Entity Listed in Box 1a LNY649568001 Southold NY 11971 3c.Policy effective period 10-01-2023 to 09-30-2024 4.Policy provides the following benefits: ❑x A.Both disability and Paid Family Leave benefits. ❑ B.Disability benefits only. ❑ C.Paid Family Leave benefits only. 5.Policy covers: -1 A.All of the employer's employees eligible under the NYS Disability and Paid Family Leave Benefits Law. ❑ B.Only the following class or classes of employers employees: Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the name insured has NYS Disability and/or Paid Family Leave benefits insurance coverage as described above. rez�- Date Signed 02-27-2024 B (Signature of insurance carrier's authorized representative or NYS licensed insurance agent of that insurance carrier) Telephone Number 212 553-8074 Name and Title: ELIZABETH TELLO-ASSISTANT DIRECTOR STATUTORY SERVICES IMPORTANT: If Boxes 4A and 5A are checked,and this form is signed by the insurance carriers authorized representative or NYS Licensed Insurance Agent of that carrier,this certificate is COMPLETE.Mail it directly to the certificate holder. If Box 413,4C or 5B is checked,this certificate is NOT COMPLETE for purposes of Section 220,Subd.8 of the NYS Disability and Paid Family Leave Benefits Law.It must be emailed to PAU@wcb.ny.gov or it can be mailed for completion to the Workers'Compensation Board,Plans Acceptance Unit,PO Box 5200,Binghamton, NY 13902-5200. PART 2.To be completed by the NYS Workers' Compensation Board(only if Box 413,4C or 5B have been checked) State of New York Workers' Compensation Board According to information maintained by the NYS Workers'Compensation Board,the above-named employer has complied with the NYS Disability and Paid Family Leave Benefits Law(Article 9 of the Workers'Compensation Law)with respect to all of their employees. Date Signed By (Signature of Authorized NYS Workers'Compensation Board Employee) Telephone Number Name and Title Please Note:Only insurance carriers licensed to,write NYS disability and Paid Family Leave benefits insurance policies and NYS licensed insurance agents of those insurance carriers are authorized to issue Form DB-120.1.Insurance brokers are NOT authorized to issue this form. DB-120.1 (12-21) D13-120 - 1 (12-21 ) DATE(MM/DD/YYYY) ACC)R" CERTIFICATE OF LIABILITY INSURANCE 02/26/2024 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). S BOURNIAS PHONE 2 _ FAX 1 0/ MERCEDES INSURANCE BROKERAGE,INC NTAT C7 8.281.0283 °.r 212-14 48 AVE MA°L @ COM ADYS:� .. ........._ .... ... EBROKERAGE... INFO MERCEDESINSURANC BAYSIDE NY 11364 INSURER(S)►AFFORDINGCOVERAGE NAIC# Mt Hawley Insurance Company an m 974 �� INSURERA y p y 37..,..� .. INSURED INSURER B Millennium Contractors LLC INSURER ......... .y...... 36-51 Bell Blvd.Ste 202 -INSURER Bayside, NY 11361 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. IN.�. ... TYPEOFINSURANCE Ab6LJ§UdR POL ._ ...._ °°°°.�n. °°°°..m LT . ICYNUMBER POLICY Y MM D/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 _ . . CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) 100,000 MED EXP(Any one person) $ 50,000 MGLO194339 08/17/2023 08/17/2024 °.^—_ 1,000,000 ... pw.. A Contractual Liability PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: AGGREGATE $ 2,000,000 PRO- S 0,000 POLICY JEO°I LOC PRODUCT COMP/OPAGG $ 2,00 ........°°.... OTHER: $ AUTOMOBILE LIABILITY Gt Y&WVBYNL'D SINGLE I PA1I6 $ Xka ANYAUTO ( person) $BODILY INJURY Per[ ___..,p, .. ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTPERT Y DAMAGE $ AUTOS UMBRELLA LIAB OCCUR EACH OC RENCE $CUR°°.ym. . ...... .. ... .. .,. EXCESS LIAB AGGREGATE $ CLAIMS-MADE DED RETENTIO N$ Is WORKERS COMPENSATION PER OTH AND EMPLOYERS'LIABILITY Y/N ... ...... OI 4 tlE BR'NPA RT k.ECUTIVE N/A EACH CIT OFFICE RIM EMBER EXCLUDED? H EL DISEASE EMPLOYEE_$ - If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Town of Southold is included as an additional insured as per written contract. CERTIFICATE HOLDER CANCELLATION Town of Southold SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 54375 Main Road ACCORDANCE WITH THE POLICY PROVISIONS. Southhold NY 11971 AUTHORIZED REPRESENTATIVE @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD SURVEY OF: PROPERTY LOCATED AT BAYVIEW LOT No. 23 AS SHOWN ON MAP OF LEEWARD ACRES FILED: JUNE 4, 1971: FILE No. 5599 f TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK LOT 22 S.C.T.M. # 1000-79-7-32 - 0 609.9 SF. AREA 4 A R oreQ0 JO, F SCALE: 1"=40' 'v NOTE: THE EXISTENCE OF RIGHT OF WAYS. WETLANDS AND/OR EASEMENTS OF RECORD 4Y IF ANY. NOT SHOWN ARE NOT GUARANTEED. rr�� F 4. V a ) co ^� � r'"A o GRATE ¢10 MHC Qo r Ilk, LEN = 39.27' CVD rrµ PORCH m CONC. e 9 HYDRANT l 4 F^" 7F WATER °q METER N A) LOT 24 UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. r COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYORS INKED �-�q T"l OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. 'r .000, C9 GUARANTEES OR CERTIFICATIONS INDICATED HEREON SHALL RUN ONLY TO " THE PERSON FOR WHOM THE SURVEY IS PREPARED.AND ON HIS BEHALF TO THE TITLE COMPANY.GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON.AND TO THE ASSIGNEES OF THE LENDING INSTITUTION. GUARANTEES OR CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS. CERTIFIED TO: 'ry SURVEYED BY: FRANKIE PETRONE PAUL BARYLSKI LAND SURVEYING LINDA PETRONE STEWART TITLE INSURANCE COMPANY PHONE 6 1- NY 119B2 CORNERSTONE LAND ABSTRACT LLC. PHONE -627- 1 6985 FAX 631-62�-3186 PAULBARYLSKI®YAHOO.COM 5241 JULY 30. 2022