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HomeMy WebLinkAbout50627-Z TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERKS OFFICE SOUTHOLD, NY .r ' 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 #: 50627 Date: 5/7/2024 Permission is hereby granted to: Culbert, Jill 5330 New Suffolk Rd New Suffolk, NY 11956 To: Emergency foundation repairs as applied for. May require additional certification. At premises located at: 5330 New Suffolk Rd, New Suffolk 3889 SCTM #47................._,. ...rv. Sec/Block/Lot# 117.-2-6 Pursuant to application dated 5/6/2024 and approved by the Building Inspector.. To expire on 11/6/2025 Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $580.00 CO-ALTERATION TO DWELLING $100.00 Total: $680.00 Building Inspector a J. TOWN OF SOUTHOLD-BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 r Telephone (631) 765-1802 Fax(631) 765-9502 igps—/i �� i, p m 1 Date Received "<*.5�L For Office Use OnlyMAY 6 I C )iJ 24 PERMIT NO._J© � 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: 21t" OWNER(S)OF PROPERTY: Name: B a-,'k-r., C',,Rx-f--� 1:ECT M #1000- -a Project Address: 5 33c �J CtnJ Svc � � G G7- S Phone#: L+ ej - T5 6 — I c i S Email: Mailing Address: CONTACT PERSON: Name: ISTV OrQ—k OLCCUS • w 5 Mailing Address: lS OA Vt� Phone#: 6 Email: C(yT-STU®0.V,\.W CG DESIGN PROFESSIONAL INFORMATION: Name: -�504-t-) CtZ o�J N t' Mailing Address: PO c"V- v'Z o s AAevt•Z4Z \.S\-A ti 0 (`ct G Phone#: 611 - ZS Z _ 116 7 Email: CONTRACTOR INFORMATION: Name: Mailing Address: is Gr W 1 Cil�i 12 i vcn Hc-r4,o Phone#: 63/-2 - 333 Email: GPTsTu DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ❑Alteration 26pair ❑Demolition Estimated Cost of Project: ❑Other 2l` 41 Li KG'fi `Li 2 3a Will the lot be re-graded? ❑Yes o Will excess fill be removed from premises? ❑Yes o wNmwmNwwwwA � l�'���� r" � *r;lr�„«w��� i �'7^;�,m��✓u�� w is y"� �s� �r 1�` ��1�7%r'?r��� uu I aA � °r" � � , �.. r �r s� � �r ✓ 'p�rrt � It ����j��l Ju�,�'� �'� 'G�^" tt �. r�T r y;✓ aIr J "i �y/�sd` P �r'�r r r .5 � 4fru � mrs 1 d `��, �Nu-�. � b�� � �,� "� �� 9"�a ilr'rJ ,,.. r "��'l�l��u/ �i�"�d �,^����'��,`�r�e ': r� �"• � o P4 r „4d, ,r e 'u'�r�r�l,�a i �'�/i r ii//r/yl�� �J,/ �i�Ju)Ni�fGr'✓xd s rwJ r� � �` w � �I��j� � !�ri f4��1 1 '�o�, r r� H✓'r r i ,r�, � i r � � "aF,'^, „��y tl , �,�, ✓ to r �,� " 1 sir onJ;�Y�i ,a Ri r r r , n �r j � ,f; fart �� �"" �:: f.a➢ � '� ,I� f. � A r if 1 / 9 BP l � a'� r�ir°r/ ",�Mw,tr ,7✓„�d ,r( � «�1/,r,t N�� r " � ���7;j�� � i III uuuuuuu uu uuuuu a I�� � I I rir /,r i ,I �Y f � 1 +/ /4;'J r'•" f� ,;( I JAW �y I 1� I �, -.'"�m+r6` �"'� d �. slim f W% r ri d o N . r / �b�vi��li»r/° r/IE Iaq�i�f "m r r��fi ya"-1 wn� r ,4 Il ,F�r�/1 n�s IFr� � a�iPl ��+ r�f'pw � � �"�"��„�• "� ✓r r f, x4 `�'" ��.,�via� rb�q � �9� "'"'n�.'m " rF� a'. I NEw ORK Workers' Certificate of Attestation of Exemption sTATE Compensation from New York State Workers' Compensation and/or Board Disability and Paid Family Leave Benefits Insurance Coverage "This form cannot be used to waive the workers'compensation rights or obligations of any party.** The applicant may use this Certificate of Attestation of Exemption ONLY to show a government entity that New York State specific workers'compensation and/or disability and paid family leave benefits insurance is not required. The applicant may NOT use this form to show another business or that business's insurance carrier that such insurance is not required. Please provide this form to the government entity from which you are requesting a permit,license or contract. This Certificate will not be accepted by government officials one year after the date printed on the form. In the Application of Business Applying For: (Legal Entity Name and Address): Building Permit Ams Home Improvements LLC 1549 Main Rd From:Town of Southold building dept 54375 main road Southold NY 11971 Riverhead,NY 11901-6006 PHONE:631-779-3727 FEIN:XXXXX1541 The location of where work will be performed is 5330 New Suffolk avenue,new Suffolk,NY 11901. Estimated dates necessary to complete work associated with the building permit are from May 7,2024 to June 21,2024. The estimated dollar amount of project is $10,001-$25,000 Workers'Compensation Exemption Statement. The above named business is certifying that it is NOT REQUIRED TO OBTAIN NEW YORK STATE SPECIFIC WORKERS'COMPENSATION INSURANCE COVERAGE for the following reason: The business is a LLC,LLP,PLLP or a RLLP;OR is a partnership under the laws of New York State and is not a corporation. Other than the partners or members,there are no employees,day labor,leased employees,borrowed employees,part-time employees,unpaid volunteers(including family members)or subcontractors. Partners/Members: stuart daccus DisabiliIX and Maid Family:Leave Benefits Exemption Statement: The above named business is certifying that it is NOT REQUIRED TO OBTAIN NEW YORK STATE STATUTORY DISABILITY AND PAID FAMILY LEAVE BENEFITS INSURANCE COVERAGE for the following reason: The business MUST be either: 1) owned by one individual; OR 2) is a partnership(including LLC,LLP,PLLP,RLLP,or LP)under the laws of New York State and is not a corporation; OR 3) is a one or two person owned corporation,with those individuals owning all of the stock and holding all offices of the corporation(in a two person owned corporation each individual must be an officer and own at least one share of stock); OR 4) is a business with no NYS location. In addition,the business does not require disability and paid family leave benefits coverage at this time since it has not employed one or more individuals on at least 30 days in any calendar year in New York State. (Independent contractors are not considered to be employees under the Disability and Paid Family Leave Benefits Law.) I,stuart daccus,am the Member with the above-named legal entity. I affirm that due to my position with the above-named business I have the knowledge,information and authority to make this Certificate of Attestation of Exemption. I hereby affirm that the statements made herein are true,that I have not made any materially false statements and I make this Certificate of Attestation of Exemption under the penalties of perjury. I further affirm that I understand that any false statement,representation or concealment will subject me to felony criminal prosecution,including jail and civil liability in accordance with the Workers'Compensation Law and all other New York State laws. By submitting this Certificate of Attestation of Exemption to the government entity listed above I also hereby affirm that if circumstances change so that workers'compensation insurance and/or disability and paid family leave benefits coverage is required,the above-named legal entity will immediately acquire appropriate New York State specific workers' compensation insurance and/or disability and paid family leave benefits coverage and also immediately furnish proof of that coverage on forms approved by the Chair of the Workers'Compensation Board to the government entity listed above. SIGN HERE Signature Hate (j GG /2#- Exemption Certificate Number Received 2024-03 267 May 20 I'k'Stla•ker *Colrtpenttiwn Board CE-200 01/2018 John Cronin, P.E. Engineering and Marine Consulting Capt.John C. Cronin, Jr., P.E. NYS Licensed Professional Engineer USCG Licensed Merchant Marine Officer P.O. Box 130 Shelter Island, NY 11964-0130 Voice: 631-252-1167 Email: wmicp� q..tt �fww May 1, 2024 Mr. BJ Green 5330 New Suffolk Rd New Suffolk, NY BY EMAIL ONLY Re: Emergency Repairs for Foundation at Cited Address Dear Mr. Green: This letter is in response to recent communications with you regarding foundation conditions encountered at your home after contractor-based partial investigative excavation aound the north, east and south perimeters involved with the basement area. Further engineering investigation has revealed serious and stability-threatening deterioration of the block foundation. While our work had revealed significant weakening of the concrete masonry units (refer to our earlier comments of April 27 wherein Swiss Hammer testing revealed loss of compressive strength), further investigative excavation has exposed crumbling and entirely breached and perforated block. Observed conditions demonstrate a badly weakened foundation that requires immediate repair. In the professional engineering opinion of the undersigned this condition constitutes an EMERGENCY. Recognizing that obtaining a Building Permit from the local code enforcement authority is both a requirment of the NYS Building Code and a legal need, it appears the Town of Southold cannot issue a permit in a sufficiently timely manner to address the instability. None the less I advise your contractor to take the necessary steps to commence a repair plan while, simultaneously, fiing the necessary douments to obtain a permit. Please feel free to include a copy of this letter with such filing. The repair work should attempt to comply as closely as possible with the requirments of Chapter 4 Foundations in the NYS Residential Code of New York State, and in particular the following: • Footing integrity • Use of anchor bolts • Use of grade 60#4 vertical rebar every 48" • Use of grade 60#4 horizontal rebar at mid-height and within 12" of the wall top • Full grouting of all block cells • Application of appropriate water proofing on the completed wall • Conveyance of all stormwater drainage away from the foundation I plan to make periodic visits to the site during the emergency repair effort and will coordinate such visits with your contractor. Please feel free to contact me with any further questions. e�tru r�you i of NEW pPHE John C.(Cronin, Jr., P.E. * ' 058221 ° a"SS 1� wa�ao r6 02 El Fw o z zu-o +�3 µ �LLW n � MZE � 3 'm E3 0 LU a = z �oz0 � na ' C Uo �az ¢� Z. spa o r 43 fJ) " n4vo z oz as CZ0 R K7 3- wav qu FR z ° =) 9 § ffi3 o `"c� �n a oas � 5 z ea u.u. rt � �� Uas�`3 W w81 Iw �✓ .3 cz- 1� yea >S11 6 r7 s $rt NHO r .w U U ^` u v J \1k