Loading...
HomeMy WebLinkAbout51586-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#: 51586 Date: 01/24/2025 Permission is hereby granted to: Ignacio S Varela 505 W 37th St Apt 261 New York, NY 10018 To: install roof-mounted solar panels to existing single-family dwelling as applied for. Premises Located at: 1420 Gabriella Ct, Mattituck, NY 11952 SCTM# 108.-4-7.29 Pursuant to application dated 11/25/2024 and approved by the Building Inspector. To expire on 01/24/2027. Contractors: Required Inspections: Fees: SOLAR PANELS $100.00 ELECTRIC -Residential $125.00 CO-R SIDENTIAL $100.00 Total $325.00 Building Inspector 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 littr)s://www.southoldtownny.rev Date Received APPLICATION FOR BUILDING PERMIT b v � For Office Use Only G PERMIT NO. Building inspector.,. Date:11/20/2024 #Z000 108.00-04 00 007 029 Name..�..I�nacio...Schlndler. .. .. .,u..�. .....� scrM.. �....,,. .,w ,u..� ...� . ....,.�.,,,,µ..,, � .w__ . .� Project Address 1420 Gabriella Ct Mattltuck, NY 11952 nachosc 53 # 6 363 Phone 31 66 Email ry m @al co �.. ... �,..�... .µ�..,.�. M,.�..w.��...� _ .... ....... ..�,.,.�,,. .....�_w_.w hindlner mal m _ ..,.�._. .�W.w..._ ,..w,..,� Mailing Address N w k, _ 952 g 1420_Gabriella Ct Mattltuck 11 Name:Sean Deptula MailingAddress de Zone Drive Ronkonkoma NY 11779 ,...w, �. ._.1.3 Trade _ .. ........ , �... ...... �..�.., . _. . .,..,.w. µ„ -_._ - �. .... Pho ne 631.-400-2680 o erations ._ �.,.:.� �,._. ............ . Email:or) .._.w_..._ essentialpower.net... Name: Michael Miele Mailing Address 705 Orrs Mills Rd NewWindsor NY 12553 .. ...__...� ..w��w�,e,��N.�� ...�.....�m.._._..w..._.....___ Phone# 845 629-9693 Email:mmielepe9vahoo coin Hil Name:NYS Essential Power Inc MailingAddress Drive, Ronkonkoma NY 11779 ,.,,.......,.,. 13 Trade Zone.. _ _.... _ .._,a. .. .... . Phone#:631 400 2680 Email operations@essentialpowrer net r � ❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: DOtherSolar Panels $11,000 Will the lot be re-graded? ❑Yes RNo Will excess fill be removed from premises? ❑Yes ONo 1 �G dM, fproperty: Intended use of ro ert ♦ Existing use o .. ��l���ltl�,l..�.,.,..._ P ,.p... ,Y..�Pw���.��.b���� ...,,.... .. Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? ❑Yes 9No IF YES, PROVIDE A COPY. Application Submitted By(print name):Sean Deptu la BAuthorized Agent ❑Owner Signature of Applicant: Date: 11/20/2024 STATE OF NEW YORK) SS: COUNTY OF Suffolk ) Sean Deptu la being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)he is the Contractor (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. LISA M, GUSTAM Sworn before me this P'�'� NOTARY PUBLIC,STATE OF NEW YOR 20 November 24 a- k Registration No. 01 GU6414369 day of 20 aw5 Qualified In Suffolk County Nojj Mpn 6 ires Februls &2 202 PROPERTY OWNER AUTHORIZATION (Where the applicant is not the owner) I, Ignacio Schindler residing at 1420 Gabriella Ct. Mattituck, NY 11952 , T 6NA&W SCE I do hereby authorize Sean Deptula to apply on my behalf to the Town of Southold Building Department for approval as described herein. 11 /20/2024 Owner's Signature LISA M. GUSTAM Ignacio Schindler � NOTARY PUBLIC,STATE OF NEW YORK ilia �� Registration No. 01GU6414369 Print Owner's Name Qualified in Suffolk County Commission Expires February 22,2025 2 BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD Town Hall Annex - 54375 Main Road - PO Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 `amesh@southoldtownny.gov — seand@southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: 11/20/2024 Company Name: NYS Essential Power Electrician's Name: Sean Deptula License No.: ME-64897 Elec. email:operations@essentialpower.net Elec. Phone No: 631-400-2680 211 request an email copy of Certificate of Compliance Elec. Address.: 13 Trade Zone Drive, Ronkonkoma, NY 11779 JOB SITE INFORMATION (All Information Required) Name: Ignacio Schindler Address: 1420 Gabriella Ct, Mattituck, NY 11952 Cross Street: Tabor Road Phone No.: 631-365-3636 Bldg.Permit#: C y email: nachoschindler@gmail.com Tax Map District: 1000 Section:108.00 Block: 04.00 Lot:007.029 BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Installation of rooftop residential PV solar system of (15) 460w modules & (15) microinverters Square Footage'. 1798, Circle All That Apply: Is job ready for inspection?: YES 71 NO ❑Rough In El Final Do you need a Temp Certificate?: YES R] NO Issued On Temp Information: (All information required) Service Size 1 Ph 3 Ph Size: A # Meters Old Meter# ❑New Service[]Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground❑Overhead # Underground Laterals 1 2 n H Frame Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION Suffco4k Cou O Consumer A ELECTRICALMASTER LICENSE Namel s; Busine", Harm lies"" Im. This cottifilos boaror Is d%A i N iIm 'y the, County of suffoW Isoww. �� W To "4#*l expk"oo, o"U2026 m loner Suffolk County Dept. of Labor, Licensing & Consumer Affairs HOME IMPROVEMENT LICENSE, Name SEAN R DEPTULA Business Name NYS Essential Power, Inc. This certifies, that the bearer is duly licensed License Number H-58999 by the County, of suffolk lss:uled-. 08/17/20,17 Roi4tize Prago- Expires: 08/01 /2025 Commissioner r NYS1 F New York State Insurance Fund PO Box 66699,Albany,NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE (RENEWED) ^^^^^^ 851275095 Ell,6,1M, AJ BONOCORE AGENCY INC 223 WALL ST#148 HUNTINGTON NY 11743 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER NYS ESSENTIAL POWER INC TOWN OF SOUTHOLD 333 SMITH ROAD TOWN HALL ANNEX SHIRLEY NY 11967 54375 ROUTE 25 SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE 12572 295-0 727177 06/14/2024 TO 06/14/2025 7/9/2024 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2572 295-0, 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:/fWWW.NYSIF.COM/CERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THE POLICY INCLUDES A WAIVER OF SUBROGATION ENDORSEMENT UNDER WHICH NYSIF AGREES TO WAIVE ITS RIGHT OF SUBROGATION TO BRING AN ACTION AGAINST THE CERTIFICATE HOLDER TO RECOVER AMOUNTS WE PAID IN WORKERS'COMPENSATION AND/OR MEDICAL BENEFITS TO OR ON BEHALF OF AN EMPLOYEE OF OUR INSURED IN THE EVENT THAT, PRIOR TO THE DATE OF THE ACCIDENT, THE CERTIFICATE HOLDER HAS ENTERED INTO A WRITTEN CONTRACT WITH OUR INSURED THAT REQUIRES THAT SUCH RIGHT OF SUBROGATION BE WAIVED. 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 30 CALENDAR DAYS' NOTICE OF ANY CANCELLATION OF THE POLICY. NEW YORK STAT S4 71*1 NCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER:69545291 I I_�F 0 DAT=7109/24I YYY) CERTIFICATE OF LIABILITY INSURANCE 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 confer rights to the certificate holder in lieu of such endorsement(s). ...PRODUCER ..�....... .__. .L .. CONTACT NAME Matthew Bonocore A.J.BONOCORE AGENCY,INC. PHONE _INC w gp145595P .�Co .. 223 Wall St#148 E-MAIL wp,mattheWl�onocore, bonocore corn Huntington,NY 11743 �.... INSURER,(Si„AFFORDING INSURER A: Acceptance Indemnity Insurance Company 20010....� INSURED INSURER e: mmGuard Insurance Com P.an 16495 mm.. NYS Essential Power Inc INSURER C: Mesa Underwriters Speciality Insurance Company 36838 333 Smith Road INSURER D New York State Insurance Fund_ e Fund. �.._._ _ ................. _ _..............._.. y� 523930 ....... mmm0INsuRERE: Ohi Security Insurance ComPan 2482 ... . ShirleyNY 11967 INSURERF: 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. I-N$R TYPE OF INSURANCE ADDL SUER' POLICX NUMEER � MM/OC EFF MMI POLICY EXP DDryyyy LIMITS ❑ MAWE RtE i Yti $ 100 00 X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 .. CLAIMS-MADE X OCCUR PREMISES�Em+pc�urre�uce) $ 0.. EXP _ P 5,000 Primary&NOn-Contributory MED (Any one erson� .$...A.. A X Contractual Liability Liability Y Y BND0013009 00 04/13/24 04/13/25 PERSONAL a ADV INJURY $ ... .. GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE Is 2,000,000'- POLICY❑X JEC LOC PRODUCT CO MP/OP AGG $ 2,000,000 JkCT ❑ PRODUC OTI'ER: $ Eaa�ri /t ,000,000 AUTOMOBILE LIABILITY COMEIN@W.D$INOLE'LIMIT $ 1mm X ANY AUTO BODILY INJURY(Per person) $ OWNEDJ SCHEDULED BODILY INJURY(Per accident) $ B _ AUTOS ONLY _. AUTOS Y Y NYAU587129 04/13/24 04/13/25 HIRED NON-OWNED PROPf RK_WDAMAGE. AUTOS ONLY AUTOS ONLY Pmr accdfzrril) $ COMP X COLL $ UMBRELLA ...�, EXCESS LIABIAB ,X OCCUR........... EACH„OCCURRENCEm � $ 2,000,000. C X CLAIMS�u1ADE Y Y MX0083001000258 04/13/24 04/13/25 AGGREGATE $ „ DED RETENTION$ S WORKERS COMPENSATION AND EMPLOYERS' LITY ANY PROPRIETOR/PARTINER/E,XECUTIVE Y/N / - Q6/14/24 O6/14/25 .E L EACH ACCIDENT ORH� $ 1,000 OOOw D OFFICER/MEMBER EXCLUDED. NA Y 1 2572 295 0 (Mandatory in NH) EL DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ 17000,000 Property/Inland Marine E Y Y BMO(25)66159930 04/17/24 04/17/25 Limit $10,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The Certificate Holder is Additional Insured as their interest may appear subject to policy terms and conditions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Southold THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town Hall Annex ACCORDANCE WITH THE POLICY PROVISIONS. 54375 Route 25 AUTHORIZED REPRESENTATIVE. Southold,NY 11971 ©1988-2015 AC'O CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD