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HomeMy WebLinkAbout51326-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
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#: 51326 Date: 10/29/2024
Permission is hereby granted to:
Michael Nemeth
115 Ernest St
Massapequa, NY 11758
To:
Constructa porch landing and deck additions to an existing single-family dwellingas well as legalize an
"as built"outdoor shower as applied for.
Premises Located at:
2900 Stillwater Ave, Cutchogue, NY 11935
SCTM# 136.-2-15
Pursuant to application dated 09/06/2024 and approved by the Building Inspector.
To expire on 10/29/2026.
Contractors:
Required Inspections:
FOOTING/REBAR, FRAMING/STRAPPING , DRAINAGE, FINAL,
Fees:
Single Family Dwelling- Addition&Alteration $476.00
As Built Addition/Alteration $32.00
CO-RESIDENTIAL $100.00
Total $608.00
Building Inspector
0 � � � 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 htit)s://www.soutlioldtownnv,2ov
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
°
PERM
IT N0, Building Inspectors.. , ' ^'
Applications and forms must be filled out in their entirety. Incomplete Building Department
applications will not be accepted. Where the Applicant is not the owner,an Town of Southold
Owner's Authorization form(Page 2)shall be completed.
Date: — Zo
J p� 5,
OWNER(S)OF PROPERTY:
Name: , l :d-7A--L- N' -MF-rlj SCTM #1000- d 2-
Project Address: 2 C�a jTILL K)ATC-� AV C Ciu re,hc,94 e---- A.1 V cl3S'
Phone#: 3,) �3[� _ % ��C�E,.IT Email: GR T1�Fi�=ova/ 17E5i4�je AI 06.CoN
Mailing Address: P. 0. $O'�L li�00 6Ldc,J1 Ci
CONTACT PERSON:
Name: DYrU)ND CLG{-}Prr^lawi[ 2 e"'5:5-
Mailing Address: d, 66
-
Phone#: Email:
631 ', 3L`- 2 3 � r-�✓cam��xLs��� ' ,�
DESIGN PROFESSIONAL INFORMATION: r —
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name: ��'1/✓E �A/�)I�GIII�')�DVTj4L � Ili/�
Mailing Address: !' / ,/" t?6U%G NY //5�s- '
Phone#: 3) 7 ,2-3 or Email: % ✓C—FX! ' / r @ gip , Lct rYl
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition YAlteration ❑Repair ❑Demolition Estimated Cost of Project:
❑Other $
Will the lot be re-graded? XYes ❑No Will excess fill be removed from premises? ❑Ye�ANO
1
PROPERTY INFORMATION
Existing use of property: �� Intended use of property:
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? ❑Yes &M—o 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 15 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(p " e): bov)') el, mate--z Authorized Agent ❑Owner
Signature of Applicant: ° Date: =�
CONNIE D. BUNCH
STATE OF NEW YORK) Notary Public,State of New York
No. 01BU6185050
SS: Qualified in Suffolk County
COUNTY OF ) Commission Expires April 14, 2.._va4y
4v t U �c CJ1�'lL-aCvvI C 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 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
,L /vim � AVal G�
l� day of�Cy( "! ► , 20 � T
Notary Public
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
L /�j3'I�T/� residing
at M l� ITS JV residin at W
do hereby authorize '4'��� ��'� to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
Owner's Signature Date
Print Owner's Name
2
u
uJ llN�x�?6Swn'r�i,m�rrml
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y "W+X �u✓aro rn�,m
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Suffolk County Dept.of
Labor,Licensing&Consumer 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
je,,K, �,b Expires: 12/01/2025
Commissioner
v
" " v
VOW "ll orlc rs'
'" SrATL tom nsation CERTIFICATE OF INSURANCE COVERAGE
Board NYS DISABILITY AND PAID FAMILY LEAVE-BENEFITS LAW
PART 1.To be COT leted by NYS Disability and Paid Family Leave benefits carrier or licensed insurance,agent a that carrier
1a,Legal Name&Ad ess of Insured(use street address only) 1b.Business Telephone Number of Insured
INDIAN NECK CO IP DBA CREATIVE LAND-SCAPE DESIGN.
39160,ROUTE 25
PECONIC,NY 1195 1c.Federal Employer Identlficatlon Number of Insur d or Social Security
Work Location of Ind red fOMy required if coverage is specifically Number
limited to certain locar' s in New York Slate,le,,Wrap-Up Policy,) 112294493
2.Name and Address .f Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier
(Entity Being Listed s he Certificate Holder) HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY
3b.Policy Number of Entity Listed in Box•1a
LNY323682
3c.Policy effective period
01/01/2024 to 12131/2024
4.Policy provides the f Ilowing benefits:
❑X A.Both dl'a Ility and Paid Family Leave benefits.
❑ S.Disabill y benefits only.
❑ C.Paid Pam ly Leave benefits only.
5.Policy covers:
❑X A.All of the mployees employees eligitalo under"the NY Disablllty,and Paid Family Leave Benefits Law.
❑ B.Only th f II'owin,g class or classes of employer's employous
Under penalty of perl'a ,I certifythat I am an authorized representative or licensed agent of the Insurance carrier referenced bove and that the named
insured has NYS Dis bl it and/ r Paid FamilyLeave benefits insurance coverage as described above.
�J~
Date icmad 01- 4- 024 ly
(Slgnalura of insurance carrlor's aulhorizod roprosantntivo or NYS Ilconsad Insuronca agent of to t Insuranea carder)
Tele h,ogg Number 21 553-BO74 Name and Title: ELIZABETH TELL I—ASSISTANT DIRECTOR STATUTORY SERVICES
IMPORTANT: If fax s 4A and 5A are checked,and this form is signed by the insurance carrier's authorized rep esentative or NYS
Licen ed Insurance Agent of that carrier,this certificate is COMPLETE.Mail it directly to the certi Cate holder.
If lox 49,4C or 5B is checked,this certificate.is NOT COMPLETE for purposes of Section 220,Su d.8 of the NYS
Dls b lity and Paid Fancily Leave Benefits Lawn,it must be emalled to PAUQwcla.ny.gov or it can b mailed for
co, pl tion to theWorkers'Compensation Board,Plans Acceptance Unit,PO Box 5200,Bingham an,NY 13902-5200.
PART 2.To be co4le red by the NYS Workers' Compensation Board(Only if Box 4B,4C or 5B have been chec ed)
State of New'York
Workers' Compensation Board
According to infor a ion maintained by the NYS Workers'Compensation Board,the above-named employer has complied with the
NYS Disability an P Id Family Leave Benefits Law(Article 9 of the Workers'Compensation Lawl with respect to all of their employees,
Date Signed By
(Slgnaluro ofAuthorizad NYS Workors'compansatlon Board E ployea)
Telephone Number Name and Title
Release Note:i 7rdy ins ran a carriers licensed to write NYS disability and Fuld Family Leave benefits Insurance policies and NYS licensed insurance agents of
those insurance carrier, ar authorized to Issue Form DB-120.1.Insurance brokers are NOT authorized to Issue this form,
DB-120.1 (12-21) 1� � �ti�
DATE(MMIDDIYYYY)
CERTIFICATE OF LIABILITY INSURANCE 05/01/2024
MATTERTHIS CERTIFICATE IS ISS'y'ED AS A FORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATECERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY
ATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFO HOLDER, THIS
DIED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING I SURER(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 ovisions or be endorsed.
If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an enrla serpent. A statement on
this certificate does not co fer rights to the certificate holder in lieu of such endorsement($).
PRODUCER CONTNA E� Matt Daley
Farm Family Insurance PHONE 631-744-3350 No; 631-744-3383
EMAIL matt.dale Ifarm-famll com
85 Echo Ave-Suite 2 D REss: y
Miller Place, NY 11764 INSURER S AFFORDING COVERAGE NAICIr
INSURERA; Farm Family Casualty 13803
INSURED INSURER B: 11
Indian Neck Corp. BA CrLive Environmental Design P• 9 INsuRER c: ,
PO BOX 160 INSURERD:
INSURER E
Peconic NY 11958 INSURERF:
COVERAGES ( CERTIFICATE NUMBER: REVISION NU BER
TI-Ila IS TO CERTIFY THAT TI'-IE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOV 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 SU JECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
Mk I ®u D l POLICY EFF POLICY EXP LIMITS
LJ�Rw TYPE OF INSURANCE POLICY NUMBER MMIODdYYYY MIDW Y'YY
A COMMERCIAL GENERAL LIABILITY 3152X2360 06/01/23 06/01/24 EACHOCCURRENC- S 1,0010,000
06/01/24 06/01/25
CLAIMS-MADE EI OCCUR PREMISES(Ea mc irencP $ 100,000
x Select Business PnG MED EXP(Anemone dprson) S 5,000
PERSONAL&ADV I JURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPL16S PER: GENERAL AGGRE ...T.. $ 2,000,000
1:1PRO LOC PRODUCTS•COMP OP AGG $ 2,000,000
X POLICY JECT $
1.
OTI tlER;
AUTOMOBILE LIABILITY (EaCBINED occident GLE MIT $
ANY AUTO BODILY INJURY(Pe�person) S
OWNED SCHEDULED BODILY INJURY(Qaccident) $
AUTOS ONLY AU''OS
HIRED NO -OWNED PROPERTY DAMACa' S
AUTOS ONLY AUTOS ONLY Per a'cadent
UMBRELLA LIAB tAIM
CUR EACH OCCURRENC $
EXCESS LIAB S-MADE AGGREGATE $
DED RETENTION S OTH_ S
WORKERS COMPENSATION STATUTE ER
AND-MPLOYERS'LIABILITY Y I N
ANYPROPRIETORIPARTNEWEXE UTIVE F.L. T"❑ NIA .L.EACH ACCIDE $
OFFICJERIMEMSER.EXCLUDE.D7 ,w(Mandatory In NH)
11 es desedhe under E.L.DISEASE-POL16YLOYEE LIMIT $..
O SC RIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS I LOC I'TIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required)
MASONRY/LAN DSCAPINI
CERTIFICATE HOLDER CANCELLATION
TOWN OF SOTHOLD
64375 MAIN R AD SHOULD ANY OF THE ABOVE DESCRIBED POLICI S BE CANCELLED BEFORE
P.O. BOX 1179 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
SOUTHOLD, N 11971
AUTHORIZED REPRESENTATIVE
©1988-2015 ACORD CORPORATION. All rights reserve.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
b
NYSIF
Now York State fiis r ince Fund PO Box 666 9,Albany,NY 12206
nysif.com
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
A A A A A A 112294493
AMWINS INSURANCE BROKERAGE LLC
I
200 ELWOOD JAVIS ROAD
SUITE 200
LIVERPOOL N' '13088 SCAN O VALIDATE
AND SUBSCRIBE
POLICYHOLD R CERTIFICATE HOLDER
INDIAN NEL 'CORP.
TOWN OF SOUTHOLD
T/A CRE.A*E ENVIRONMENTAL DESIGN PO BOX 1179
PO BOX 160, SOUTHOLD NY 11971
PECONIC N ' 11958
N
POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE
Z1318 0" 5-8 738667 05/01/2024 TO 05/01/2025 5/1/2024
THIS IS TO CRI'IFY' THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK S ATE INSURANCE
FUND UNDER POLICY NO. 1318 046-8. COVERING THE ENTIRE OBLIGATION OF THIS POL CYHOLDER FOR
WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH R SPECT TO ALL
OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW.
IF YOU WISH T RECEIVE NOTIFICATIONS REGARDING SAID POLICY,INCLUDING ANY NOTIFICATION OF ANCELLA;TIONS,
OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS://WWW.NYSIF.COM/CERT/C'ERTU'AL, SP.THE NEW
YORK STATE I�N'SURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATI,NS..
THIS CERTIFIATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE
COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EX END OR ALTER
THE COVERAGE AFFORDED BY THE POLICY..
NEW YORK STATE MR NCE FUND
DIRECTOR,INSURANCE F"JND UNDERWRITING
VALIDATION UMBER:412189446
U-26.3
5TILLWATER AVENUE
------------- ......
RESIDENCE
.....—-----
EGDV
PROP05E� SITE PLAN _ . .QTY
FLOWER,GRA55
F"TAJN 2 12
0-
0. HMINCKOA G� 12
TOTAL LOL?�FT. �Z�i5�FT. �10
FLONEP,PEREmiAL
57 4" CATMNT T7
5RU3,
HYRAwEA,Ev,�Fq,5 5uvt&.R 2
5npfEN UiTLE FRNa,.%2 9
2
Fmo-�amxR 5-miD EvwAEEN L3RoAoLEAF
pAs (3f30;WeM &X15H ON 51',qVAW 3
[�)XW[;b:GPEENM2N TARN 2 1
C+R 5�JP LALAB - RY 10
46 11"
'wg'0;r........— 05MMTwy3 GpIAKI 2
05M*Tw-i GULFTUE 15
"P- 1,
'd, ............. 4
�X 1
54" 'NC EvER&W- O*ER
7." YO�,JAPAW-SiPLUM 9
....... YEW,PLLM FRD5 TATA 3
E PROPERTY LINE
OAY,Drm,*
TREE EvERGRLN
AR �qlTZ GREE-N GIANT 14
CO YpTms JAMMA 2 4
f3tLF UPRIGHT
2900 5-FILLWATER AVENUE,GUTHGGUE,NY
Revision #: Scale: Landscape Plan: 2-12-24 Landscape Design by: David Cichanowicz
Date: 10/23/2024 1 10' Nemeth Creative Environmental Design
�F#
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ME-fH RE51DENCE
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SCALE: 1/4" = 1'. D"
E�I5T(NG DECK \
---� AND 5TP5 TO
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PE RAILING DETAIL �J
2X6 TOR RAIL
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' CABLE RAILING ,
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-------------
EXI5TWG 0r
_ / \ TO BE REMOVED - !
PROPOSED DECK
3'.6'LEDGER BOARD NEW 5/4"x 4" IPE WOOD DECKING
CKOTING5TRU RE WITH HIDDEN CONNECTORS
EXISTING BTRUCNRE WITH '
101, 101,
(2),?BOLT5 @ 1 r OC.
'.' OVERHANG 2"x 8" LEDGER BOARD
CONCRETE BLOCK PIEI - LINE OP HOUSE CTU )
(
ATTACHED TO HOUSI-
�'- �l _
ANCHORED TO STRUCTURE 2
FOUNDATION WALL - _.___._.___.-____-..________. - _ _ - .. _ - - . .. ... ....... �O TWICE @ 24" O.C.
(2)2 z 1 O'P.T. - _I (2)2 z 10'P.T.
u
® (2)W P.T.DROP BEAM 5TRAPPED TO 105T
2x8 P.T. JOISTS @ I G"O.C.
p -
LINE OF DECK ABOVE
� 0 In
12'-4 1/2" - (2) 2x 10 P.T. DROP BEAM STRAPPED TO POST
,K —
N
7-2" 7-1" 7-2"
- - -
FOUNDATION PLAN
-__ (2)2'.10'P T. (2)r.10'P.T. (2)r.10'P.T. -
SCALE: J-" = 1 I - —
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(2)2'.101P.T. - (z)r.10•P.T. 4"X I G"X 8" H. CONCRETE --- - -- ..
BLOCKS RESTING ON
-- -- -" EXISTING FOOTING
SECTION A
3'-2 5/8" 9'-0 1/2" 9'-0 1/2"
SCALE: 1/2" = P-0"
A
FOUNDATION PLAN
SCALE: 4" = 1,
- PROPOSED DECK
CABLE GUARDRAIL WITH NEW 5/4"x 4" IPE WOOD DECKING
I"x 4"WOOD CAP WITH HIDDEN CONNECTORS
v SEE DETAIL `
3"x 8" LEDGER BOARD
v -"-_-------= ANCHORED TO STRUCTURE WITH
(2)4" BOLTS @ 12'OC.
z"OVERHANG
3'-G" G' 3'-G'
N 11 II
In DECK PLAN 2x8 P.T. JOISTS @ �X.X_)
SCALE: 4" = I' I G" O.C.
JOIST HANGER
41
(2) 2x8 P.T. DROP BEAM
STRAPPED TO POST
cn
GRADE
41�
u 4x4 P.T. POST SECURED w/
CABLE GUARDRAIL WITH METAL P05T HOLDER
� 3'-I I/2" (fYP)
I"x 4"WOOD CAP ;
:•'\ � SEE DETAIL
</
10" d)a. 50NOTUBE
S CABLE GUARDRAIL WITH I"x 4"WOOD CAP
24"x 24"x 1 2" POURED CONCRETE
3' 01. 19'-2" iv FOOTER w/(3)#5 REBAR IN EACH
--- --- -
- DIRECTION. MINIMUM 3'-O" BELOW
_. GRADE ON UNDISTURBED SOIL
DECK PLAN
SCALE: 41I =
SECTION B
VARIES I SCALE: 1/2" = I'-0"
GUARDRAIL DETAIL
SCALE: z" = I'
ISSUES/REVISIONS CLIENT/OWNER PROJECT DRAWING No.
CREATIVE NEMETH _
ENVIRONMENTAL �`� � � �`�
agooSTILLWATERAVENUE ��
Robert I. Brown CUTCHOGUE,NY U935 Q� ?� '
DESIGN
Architect P.C. NEW - 'Y
239160 RTE 25 205Bay Ave. Greenport NY DECKS
PECONIC, NY info@ribrovmarchitect.com DRAWING TITLE f :
631-734-7923 631-477-9752 PLANS AND
creativeenvdesign@yahoo.com
DETAILS DATE
IT IS A VIOLATION OF THE LAW FOR ANY PERSON, UNLESS SCALE
ACTING UNDER THE DIRECTION OF A LICENSED ARCHITECT, Sept. 5� 2024 TO ALTER ANY ITEM ON THIS DRAWING IN ANY WAY.ANY AS NOTED
AUTHORIZED ALTERATIN MUST BE NOTED,SEALED AND
DESCRIBED IN ACCORDANCE WITH THE LAW.