Loading...
HomeMy WebLinkAbout50419-Z SHFF01 0 Town of Southold 6/30/2024 a y� P.O.Box 1179 o _ 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 45319 Date: 6/30/2024 THIS CERTIFIES that the building ACCESSORY Location of Property: 1925 Grandview Dr, Orient SCTM#: 473889 Sec/Block/Lot: 14.-2-3.21 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 2/7/2024 pursuant to which Building Permit No. 50419 dated 3/11/2024 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: accessory pergolapplied for. The certificate is issued to 1925 Grandview Inc of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Au o ize gnature �SUFFQt,��o TOWN OF SOUTHOLD BUILDING DEPARTMENT y 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#: 50419 Date: 3/11/2024 Permission is hereby granted to: 1925 Grandview Inc 109 Stratford Ave Garden City, NY 11530 To: Construct a pergola accessory to an existing single-family dwelling as applied for. At premises located at: 1925 Grandview Dr, Orient 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 Building Inspector zf SOUTyOlo # # TOWN OF SOUTHOLD 'BUILDING DEPT. cou�m� 631-765-1802 o- q � o INSPECTI-ON [ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE-SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION' [ ] FIRE RESISTANT PENETRATION. [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O. [ ] RENTAL REMARKS: r nl�l CT� 4N.10, DATE Il INSPECTOR ; U r\ Robert I. Brown Architect, P.C: JUN 6 2024 205 Bay Avenue,Greenport,NY 11944 BUILDING DEFT. info@ribrownarchitect.com 631-477-9752 TOWN FF SGUT11O1 June 25, 2024 Town of Southold Building Department Southold,NY 11971 Re: Treanor Residence Pergola 1925 Grandview Drive Orient,NY 11957 Building Permit No. 50419 To whom it may concern, This letter is to confirm that based,on my inspection of this project,and to the best of my knowledge,belief and professional judgement,the concrete footings and the wood member connections conform to drawings and applicable codes. If you have any questions,or require additional information,please feel free to contact me. Thank you for your attention to this matter. i .Sincerely, ° yy S IrBq p r Robert Brown,A.I.A. 1 Cc: Creative Environmental Design,David Cichanowicz FIELD INSPECTION REPORT DATE COMMENTS ro FOUNDATION (1ST) — 1.3 H ------------------------------------ "C C FOUNDATION (2ND) o z -- o _ Iv H ROUGH FRAMING& PLUMBING Qr INSULATION PER N.Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS S OD �12�y r�• � r . Q o 0 z x ►o sufFottoo� TOWN OF SOUTHOLD—BUILDING DEPARTMENT N x Town Hall.Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 https://www.southoldtowm.gov Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only E C E D of E PERMIT NO. �� Building Inspector: F E B - 7 2024 Applications and forms must.be filled out in their entirety. Incomplete applications will not be accepted. Where the Applicant is not the owner,,an �t.�;l€€fr�{ �� Owner's Authorization form(Page 2)shall be completed. TO,fbta Of Southold Date: February 7th, 2024 OWNER(S)OF PROPERTY: Name: Patrick Treanor --- T scTM #1000-14-2-3.21 Project Address:1925 Grandview Drive, Orient, NY 11957 Phone#:631-734-7923 Email: creativeenvdesign@yahoo.com Mailing Address: P.O. Box 1.60, Peconic, NY 11958 CONTACT PERSON: Name:David Cichanowicz Mailing Address:P.0. Box 160, Peconic, NY 11958 Phone#:631-734-7923_ Email:creativeenvdesign@yahoo.com DESIGN PROFESSIONAL INFORMATION: Name:Agent/Cor tact Mailing Address: Phone 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: El Other Pergola $45,000.00 Will the lot be re-graded? ❑Yes ®No Will excess fill be removed from premises? ❑Yes ®No 1 PROPERTY INFORMATION Existing use of property:Re$Idential .. 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 ©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 210.45 of the New York'State Penal Law: ,, Application Submitted By(print ),David Ci icz BAuthorized Agent Downer 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 1'r , 20 P-ersa Notary Pu E SE MAFFSTATE OFNEWYIORW o.01MA6402379ROPERTY OWNER AUTHORIZATION Suff0k CountysDecefnber308% (Where the applicant is not the owner) Patrick Treanor residing at 1925 Grandview Avenue, Orient, NY 11957 I, David Cichanowicz do hereby authorize 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 Suffolk County Dept.of Labor,Licensing 4 CvnsunT6rAffairs HOME IMPROVEMENT LICENSE Name .; DAVID J CICHANOWICZ 1 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 JevutiferCotret-a, Expires: 12/01/2025 Commissioner d Ate--/ ® DATE(MM/DD/YYYY) O 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 certifi ate holder Is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIV ED, 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 CONTANAME:CT Matt Daley Farm Family Insurance PHONE 631-744-3350 FAX 631-744-3383 85 Echo Ave-Suite 2 ADDARESS: matt.daiey@farm-family.com Miller Place, NY 11764 INSURERS AFFORDING COVERAGE NAIC# INSURERA: Farm Family Casualty 13803 INSURED INSURER B: Indian Neck Corp. DBA Cr Dative Environmental Design INSURERC: PO Box 160 INSURER D: INSURER E: Peconic NY 11958 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT T E 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 CONDITIO14S OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IL R TYPE OF INSURANrG ADDDL S D POLICY NUMBER MM/DDY EFF MM//DPOLpY� LIMITS A COMMERCIAL GENERAL L 3152X2360 06/01/23 06/01/24 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENT CLAIMS-MADE PREMISES Ea oc ur ante $ 100,000 x Select Business P MED EXP Any one person $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPL ES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑JEST LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SC EDULED BODILY INJURY(Per accident) $ AUTOS ONLY AU OS HIRED NO -OWNED PROPERTY DAMAGE $ AUTOS ONLY AU OS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE I I ER ANYPROPRIETOR/PARTNER/EXE UTIVE El N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS elow E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOC TIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) MASONRY/LANDSCAPIN /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(2016103) The ACORD name and logo are registered marks of ACORD ' tI N Y S ' New York state Insurar ce Fund PO Box 66699,Albany,NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE (RENEWED) 0 0 AAAAAA 112294493 AMWINS INSURANCE BROKERAGE LLC 200 ELWOOD DAVIS ROAD a 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 Z 1318 04 -8 966723 05/01/2023 TO 05/01/2024 11/20/2023 THIS IS TO CERTIFY 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 IN 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:/IWWW.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. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE SUR NCE FUND t/ DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NU BER:541632407 U-26.3 PORK workers' CERTIFICATE OF INSURANCE COVERAGE STATE Compensation 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) 1 b.Business Telephone,Number of Insured INDIAN NECK CORP DBA CREATIVE LAND-SCAPE DESIGN. 39160,11OUTE 25 PECONIC,NY 11958 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) 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 3b.Policy Number of Entity Listed in Box I LNY323682 3c.Policy effective period 01/01/2024 to 12/31/2024 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: ❑X 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 employer's 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 named Insured has NYS Disability and/or Paid Family Leave benefits insurance coverage as described above. r rPizL(/- Date Signed 01-24-2024 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 carrier's authorized representative or NYS Licensed Insurance Agent of that carrier,this certificate is COMPLETE.Mail it directly to the certificate holder. If Box 4B,4C or 51B 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 4B,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 1 (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 DS-120.1.Insurance brokers are NOT authorized to issue this form. DB-120.1 (12-21) IIIIIII.11111�11111111111111111 'I,'ll'378=12©.1 (12-21 LEM r D ' 47 w sar aA5m DW WALK GATE ,\ RI-1 I Lj ±Lll I L+ I L+ LLJ I LLJ I Lu I o D J L 1�� ' � I f NEW PERGOLA IT04 1901, IT DER RETANNG WALL N On- *0 /\/\�/ / , / / --------------------- -70 - - - - / � s'- POOL EQUIP O I _ dl 70 O 7 A TO COVER ULT 1 G� Z N C� rn xV o g � 1 -T C7 1 7CS 1 C r 1 1 '1 0 o 0 1 1 v 7Q -4-L 70 m - C � O C '. < 7U 0 70 0 0 --- -- m --A 1 -< m z z QA L 710 q z 77 i CS1Nb� N6� � , � •� 5CREENPTIN MULF � aoOR D ?� COu 1- �T 5CIV # 1000-14-02-3o2l Revision # = Scale= Landscape Plan : '10-G-20 Landscape Design by= Dave cichanowicz mate: 2/7/2024 1 _ 10� 'I J25 Treanor Creative Environmental Uesi n APPROVED AS NOTED COMPLY WITH ALL CODES OF 12'dia. 50NOTUBE w/ / oA :3-I Z e.e# �d�f NEW YORK STATE&TOWN CODES 28" dia. BIGFOOT FOOTER `` I3Y AS REQUIRED AND CONO I ONS 04 GxG IPE GbLUMN / � Gx 2 IPE GIRD R ` � I � 3a5.00 ,� \ ` , NOTIFY BUILDING DEPARTMENT AT 631-765-1802 8AM TO 4PM FOR THE 0203.� FOLLOWING INSPECTIONS: w MWEES FOUNDATION-TWO REQUIRED A trnua u FOR POURED CONCRETE SDUT m a 0 o ROUGH-FRAMING&PLUMBING - Cu INSULATION FINAL-Lp N 8E COMPLETE FOR RUCTION MUST C O. 0 ALL CONSTRUCTION SHALL MEET THE 1�11 CrtCriol~li gllting lu Lu REQUIREMENTS OF THE CODES OF NEW Installed,mplcced of 0- N YORK STATE NOT RESPONSIBLE FOR (repaired,hall Conform DESIGN OR CONSTRUCTION ERRORS to Chapter 17Z of the Town Cods IN, Cor*{ruJiOrl mu4 cory)n I�Y5 VJ1� 12'dia. 50NOTUBE w/ 1' 28"dla. BIGFOOT FOOTER / �Si�e��lOn �� \r Gx 2 IPE GIRD R 9 6x6 IPE �\MN / \ C I I rr1a4j G E C cQ ( �SI I � 9 r*h qn c err a 20' 2 2'-5 11211 PERGOLA PLAN SCALE: 1/2" = 1'-0" I x4 IPE PURUN I x4 WE PURLIN 2x8 IPE RAFTERS @ I G"O.C. 2x8 IPE RAFTERS @ I G"O.C. ANCHORED (2)w/ 4"x 1 O" SIMPSON HEADER LOCKS N N N N N N N N N ANCHORED (2)w/ /4"x 10"5IMP50N HEADER LOCKS I I I Gx 12 IPE GIRDER Gx 12 WE GIRDER Gx 12 IPE GIRDER 4"x G"SIMPSON SCREWS 4"x G"51MP50N SCREWS 2x8 IPE GU55ET 2x8 IPE GUSSET ' 2x8 IPE GUSSET 2x8 WE GUSSETlo ' �'x 8"51MPSON SCREWS �'x 8"5IMP50N SCREWS GxG IPE COLUMN GxG IPE COLUMN 4"x 5"5IMPSON 5CREW 4 5 "x 5"SIMP50N SCREWS 5IMP50N POST HOLDER 51MP50H POST HOLDER 43."x 8" SIMPSON STRONGTIE 4"x 8"51MP50N STRONGTIE 4' POURED CONCRETE SLAB 4" POURED CONCRETE SLAB (2)#4 REBAR (2)#4 RIBAR i Lf� 12'dla. 50NOTUBE w/ 1 2'dia. 5ONOTUBE w/ 28"dla. BIGFOOT FOOTER 28" dia. BIGFOOT FOOTER PERGOLA SECTION DETAIL PERGOLA SECTION DETAIL SCALE: 1/2" = 1'-0" SCALE: 1/2" = P-0" ISSUES/REVISIONS CLIENT/OWNER PROJECT DRAWING No. TREAN O R « CREATIVE t ENVIRONMENTAL 1925 Grandview Drive Robert I. Brown Orient, NY 11957 � DESIGN Architect, P.C. SCTM No. l000-14-2-3.41 NEWAl 239160 RTE 25 zo5 Bad Ave. Greenport NY PERGOLA PECONIC, NY info@ribrownarchitect.com DRAWING TITLE 631-734-7923 631-477-9752 creativeenvdesign@yahoo.com PERGOLA PLAN � PERGOLA DETAILS IT IS A VIOLATION OF THE LAW FOR ANY PERSON,UNLESS DATE SCALE ACTING THE DIRECTION OF A LICENSED ARCHITE , TO ALTERNDER ANY ITEM ON THIS DRAWING IN ANY WAY.ANYT o5 FEBRUARY, 2024 1�Z 11 = 11�OII AUTHORIZED ALTERATIN MUST BE NOTED,SEALED AND DESCRIBED IN ACCORDANCE WITH THE LAW.