Loading...
HomeMy WebLinkAbout51619-Z Of so TOWN OF SOUTHOLD BUILDING DEPARTMENT 3 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#: 51619 Date: 02/07/2025 Permission is hereby granted to: Figliozzi PJ Family Trt 39 Osborne Rd Garden City, NY 11530 To: Construct a pool cabana with outdoor shower accessory to an existing single-family dwelling as applied for per SCHD approval. Must maintain a minimum rear and side yard setback of 10 feet. Premises Located at: 120 Caiola Ct, Greenport, NY 11944 SCTM#33.-3-19.15 Pursuant to application dated 12/12/2024 and approved by the Building Inspector. To expire on 02/07/2027. Contractors: Required Inspections: Fees: Accessory-New Structure $579.00 CO Accessory Structure $100.00 Total $679.00 Building Inspector TOWN OF SOUTHOLD-BUILDING DEPARTMENT Town Hal Annex 54373 Majn Road P. d. Box 2 179 Southold,NY 11971-0959 '10cphune(631)765-1802 Pax(631)765-9302 � � ,; Date f APDLI - N FOR_ PERMIT (� For Of lee use orgy PERMIT NO. 110 r auiidina Inspeaor. Applications and forms must be filled out in their entirety.incomplete applications will not be accepted. where ate Applicant is not the owner,err Owner's Au v Eftge Zl st"11- ; Date: 1 OIMVER(S)OF PROPERTY: Name: § -- Sam#200d- i g f Project Address: 17.0 t g Phone#: Email: 1l1 i CONTACT PERSON: Name: ,� Ma ffing Address Phone#: - e Email: DESIGN PROFESSIONAL INFORMATION: Mailing Address: Phone#: Email: 0DNTRACtOR INFORMATKW. Name: Mailing Address: 2 2,l Phone#: Email: DESCRIPTION OF PROPOSED CONSTRUCTION ONew Structure OAddition Alteration ORepair O©emolition Estimated Cost of Project: $ 1" ,O O Will the lot be re-graded? OYes Will excess fill be removed from premises? ves ❑No 1 PROPERTY INFORMATION Existing use of property: L* PArn . QL&4.wU Intended use of property:5 �. I Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to Ar0 this property? Dyes Po 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. APPUCATION 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 buikling(s)for necessary Inspections.False statements made herein are punishable as a pass A misdemeanor pursuant to Section 210.45 of the New York State Penal Law. Application Submitte It'nt name): (J� � �1 Gj LA c.ZZl ❑Authorized Agent Owner Signature of App n , Date: j7, µmy 7_4 STATE OF NEW YORK) SS: COUNTY OF !jl-IE!�2.Ki) PETyr FI &U 'LA being duly sworn,deposes and says that(Xlhe is the applicant (Name of individual signing contract)above named, (Ahe 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 12 day of 20 24 JEFP-THALNEIMIM ary Public Notary rbblic,sane orNew No 0ITff4 IN13 Qualified to SOMA Comfy CaeamtsllonV4aq_R0PER TY OWNER AUTHORIZATION (Where the applicant is not the ownepr I, residing at do hereby autho ' to apply on my behalf to the Town of Southold Buildin epartment for approval as described herein. Owner's Signature Date Print 76", Name 2 T_H_ALHE_IME_R 26 November 2024 A R C H I T E C T U R E Southold Building Department TWENTY ONE Town Hall Annex Building 54375 Route 25A P.O. Box 1179 CENTER STREET Southold,NY. 11971 Attn : Tracey Dwyer NORTHPORT NEW YORK 20 Caiolahurt,Greeng2rt Building Permit Aggfig1tion : Pool House Dear Tracey, 11768 Attached is a Building permit application and accompanying paperwork for a 631 754 8621 detached Pool House. When the house was originally built in 2021,there was a permit for a Pool House, thafarch@me.cam and health department approval,but it was never built. This is a new application for a Pool House. Please contact me with any questions Sincerely, Jeff Thalheimer,R.A. 631. 697. 7720 thalarch@me.com Town Hall Annex - Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O. Box 1179 Southold, NY 11971-0959 BUILDING [DEPARTMENT NOTICE OF UTILIZATION TION OF TRUSS TYPE CONSTRUCTION. PRE-ENGINEERED 1 OOI CON�TRtJCTIO I AN�lO� TII SFR CONST UCTION Date: 12. 1.tC4 Owner: 91i�,� V4 4LAoz.z % Location of Property: Please take notice that the (check applicable line): New commercial or residential structure Addition to existing commercial or residential structure Rehabilitation to an existing commercial or residential structure to be constructed or performed at the subject property reference above will utilize (check applicable line): Truss type construction (TT) i/ , Pre-engineered wood construction (PW) Timber construction (TC) in the following location(s) (check applicable line): i Floor framing, including girders and beams (F) ✓ Roof framing (R) Floor an roof framing (FR) Signature: Name (person su itting this form): �1�.t✓�r'T1 4'k�►+'k R A Capacity(check applicable line): Owner Owner representative TnRegtS die Effaaw1f9i�R� r _ R 15 - Cyr— OW Q�LdR1f� C- OPEU 994f"LT CL FAUIS NEO f3aSEMELAT Sutfoik County Dept.of Labor,Licensing&Consumer Affairs HOME IMPROVEMENT LICENSE s Name RHETT W BRUNSWICK ;s � Business Name o \\\ : BBC ASSOCIATES INC.r,ea r 1$duly License Number H-34453 f€� Issued: 02/2612004 Expires: 02I01l2026 Commissioner s YOB workers' Y 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 carrie 1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured eec a Assocwres INC 631-821-2200 Po sox 611 CENTERPORT,NY 11721 1c.Federal Employer Identification Number of Insured or Social Security Number Work Location of Insured(only requiredifcoverage is specifically limited to 113434206 certain locations In New York State,Le.,Wrap-Up Policy) 2.Name and Address of Entity Requesting Proof of Coverage i 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) ShelterPoint Life Insurance Company Town of Southold Town Hall Annex 3b.Policy Number of Entity Listed in Box"1 a" 54375 Main Road DBL204711 PO Box 1179 3c.Policy effective period Southold, NY 11971 09/18/2023 to 09/17/2025 4. Policy provides the following benefits: ® A.Both disability and paid family leave benefits. ❑ B.Disability benefits only. C.Paid family leave benefits only. 5. Policy covers: ® A.All of the employers employees eligible under the NYS Disability and Paid Family Leave Benefits Law. ❑ B.Only the following class or classes of employers employees: I I Under penalty of perjury,I cerfify that I am an authorized representative or licensed agent of the Insurance carrier referenced ve and that the named insured has NYS Disability and/or Paid Family Leave Benefits insurance coverage as described above. Date Signed 4/9/2024 By (Signature of insurance carrier's authorized representative or NYS Licensed Insurance Agent of that insurance carrier) Telephone Number 516-829-8100 Name and Title Richard White, Chief Executive Officer €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. 3 If Box 4B,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 4113,4C or 58 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) I�II� � 1wi0�i1iiiii12i � � I� YM ACC 4/09/20 CERTIFICATE OF LIABILITY INSURANCE DATE 4 4/09/2024 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 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 PRODUCER IF Katie Jackson Brian Micena PHONEla (631)821-2200VA-; 100 South Jersey Ave katle. am nsfatior)a1- Unit 33 INSURER(S)AFFORDING COVERAGE NAIL S East Setauket, NY 11733 INsuREFtA..Farm Family Casual Insurance Company 13803 INSURED INSURERB:United Farm Family Insurance Company 29963 BBC Associates Inc INSURER C: 9 Bankside Drive North INSURERD: INSURER E: Centerport NY 11721 INSUSE F. COVERAGES CERTIFICATE NUMBI : 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. rGEMNAG� F INSURANCE POLICY NUMBER ev LIMITS OENERALLIABILnY 3101 L6894 O9/O7/23 O9/O7/24 EACH OCCURRENCE s 1€OOO,OOO ADE -DAMAGE TO RENTED 1X OCCURs ) 100,000 MED EXP An one person) $ 5,000 PERSONAL&ADVINJURY S 1,000,000 LIMITAPPLIESPER: ! GENERAL AGGREGATE $ 2,000,000 pq POLICY❑PRO- LOC PRODUCTS-COMP/OPAGG S 2,000,000 is OT M A AUTOMOBILE LIABILITY ! 3152C5891 05/12/23 05/12/25 t ;$ 1,000,000 JXANY AUTO ? BODILY INJURY(Per person) $ OWNED x SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS �mF HIRED NON-OWNED E $ AUTOS ONLY I x AUTOS ONLY €$ A X UMSRELLALIAB X occuR 3152E2305 OB/29/23 08/29/24 EACH OCCURRENCE $ 5,000,000 EXCESS LIAR CLAIMS- ADE AGGREGATE I$ S,000,OOO DED i RETF..MTION _ $ RK - B WORKERS COMPENSATION 3102W9 95 - 08/20/23 08/20/24 X 1 AND EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ 1 OO,000 ANYPROPRIETORIPARTNER/EXECUTIVE t r�YIN _ OFFICERIMEMBEREXCLUDED7 1 -- (Mandatory In NH) N/A E.L.DISEASE-EA EMPLOYEE! 100,000 If yes,describe under E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF PERATIONS below I I I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 1e1,AddkkmW Remaft Schedule,may be attached If more space is required) Carpentry CERTIFICATE HOLDER CANCELLATION Town of Southold SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town Hall Annex THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 54375 Main Road ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 1179 AUTHORIZED REPRESENTATWE Southold, NY 11971 ©1 fl15 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD *EWWorkers' CERTIFICATE OF ` ref nsatlon NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1 a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured BBC Associates Inc 516-884-2781 9 Bankside Drive North 1c.NYS Unemployment Insurance Employer Registration Number of PO Box 611 Insured Centerport, NY 11721 Work Location of Insured(Only required Hcoverage is speakelylimited to 1d.Federal Employer Identification Number of Insured or Social Security certain locations In New York State,i.e.,a Map-Up Policy) Number 2.Name and Address of Entity Requesting Proof of Coverage 3s.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Town of Southold United Farm Family Insurance Co Town Hall Annex 3b.Policy Number of Entity Listed in Box"1 a" 54375 Main Road 3102W9695 PO Box 1179 Southold,NY 11971 3c.Policy a period 0 023 to 08/20/2024 3d.The Proprietor,Partners or Executive Officers are included.(Only check box if all partners/officers included) ® all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box"3"insures the business referenced above in box"1 a"for workers' compensation under the New York State WorkerV Compenststion Law.(To use this form,New York(NY)must be listed under on the INFORMATION PAGE of the wofkaW compensattlon Insurance policy). The Insurance carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2". The insurance carrier mud notify the above cediffica#e holder and the WarkeW Compensation Board within 10 dep IF a policy is canceled due to nonpayment of premiums or within 30 days IF them are reasons oftw than nonpaynnent of premiums that cam the policy o eliminate the insured from the coverage ind= on this Certificate.(These notices may be sent by regular mail.)Othe this Certificate Is valid for one year after this form Is approved by the insurance carrier or Its licensed or until the policy expiration date listed In box"3c",whichever is earlier. This ceffmate is WRIed as a matter of info and confers no rights upon certificateholder.This certificatenot amend, extend or the coverage afforded by the policy listed.nor does R confer any rights or responsibilities beyond those oDritained in the referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect. Note:Plastse Upon canWilattion of the w lion policy Indicated on this form,If the busiviess continues to be named on a permit,liken car c ct Issued by a holder, must provide that holderwith a new Cartificaft of W m-Compensufflon covenlige or~sur0wrized proof that the businares is complying with the mandatory coverage requirements of the New York State Workers' Compensation Law Under penalty of perjury,I cerft that I am an aullhoirked mpresientative or licensed agent of the insurance carrier referenced above and that that named Insuned has the coverage as depleted on this form. Approved by: (Print name of authorized representative or ficensed agent of insurance carrier) Approved by: dew (Signature) (Date) Title: Telephone Number of authorized representative or licensed agent of insurance carrier: Please Note:Only insurance carriers and their licensed agents are authorized to issue Form C-105.2.Insurance brokers are NOT authorized to Issue it. C405.2(947) www.wcb.ny.gov SURVEY OF LOT 15 u�COUNTY ANT OF�RV'CC-e " OF ROCI�P'ORT Ej9TATRS SUFFOAPPROVAL OF CONSTStt1CT6a W ORs(t3 FCz SITUATE" AT G'REENPORT A SIN FAPt141 RE.51i��NCE AND w TOW OF SOUTHOLD SUFFOLK COUNTY, ArEW YORK H.S.Rot W. .I.D..l� +. Date— LOT 12 U6 b8 ^° ya° / owl�d pt346r sdPPty f.W_at this iecaarnr h�ra6 peen �,� I Thesewrmcp oro aoohd(Aendrnua,d.w 9'a�X0gn d FILED: 08/1i/2001 MAP No. 10837 Inspected andlor cexti86d 4Y tld6 eeSadLsarx6r'Fop-rnTAL. MD�OF� ��� �� S.C.T.M. No. 1000-33-03-19.15 14 7 A.c LOT AREA = 28,271 S.F. I ELEVATIONS PER NAV88 DATU1[ Craig Knepper, P.E.,Chle, ri`agement Font'DW SCDHS REF. No. R10-19-0010 6vra.s 2000 GALLON SEPTIC TANK a taLaRR ✓ e DMW I 10' DIA. X 13' DEEP LEACHING POOL 9 cwwrxrers as ccnW04"rs. "m rawsxrnaerA'.w+v anam0 ununcs fA5[WOT$Nor SN AND vmlll Mt'COGAiI.NS AaE fW?r aWaAMkM11t LOT 15 I "camrWmr+W*N,lom w a me s.,NIto as TO ma raamrr u N AAE fdN'mm PGWPm—u.SE.6IEa4Fw AW Not.wm'm.a"NX me be'NEN W6rM"MULL$rtiYNA Mlm_Alva AR Io n r yp or—rb 84MIlid'9 wm orwex CaM5or I000a rTh".EkYv^rEWl or p5N M'wMrS.0 80,0'+AM.0 FASP.4&Xt ro 9f"PNiGONp.!r AIK, w orpMW ME nar arAreuLrexm �� '✓' I �NAVIrA'WMTEb Af.irW NEW iMY AWNVA➢b INM.i WNr- p A M or p°' 1 or ON Tda9'dP q S MW SA E Eau Ariaw AW OPO 4F Nx9 SIoW w P Nbr m:waw.ro NVE wm xcmex:re.ws tiroWAAnx➢c'"w asb w,vc an eersruuu sew.sww. rxNsaarreeb n.rnue uwm cram. yQ' �✓ a'Uy .'S�. .f.. Ata./.uAaays of allo ensw+ces m WEUS serJr cEs Vas ure'm IacA M. t'""� TOWN OF":iti,;irtOLt7 "v�J 6•DOnA DRAW ranw Naucvwrrcrr5,r�€rn assenvAronvc•uwfou rNrnNAwrwu vbxnu+tm rwru % $ amexa.smaca rMn.Sr AAE Nar wxrnLs Laurrcws ANn buuerauu5 cwrvbr LOT 14 Iry { � N �� 9✓ "�r✓tgr o BUILDING DATA:xb•� FIRST FLOOR = 2,385.9 S.F. SECOND FLOOR = 1,299.6 S.F. GARAGE = 508 S.F. ""�. Aga ,�'�"+ A•� `����, Rg w. s" I OF Nlrtl,Y FRdbDP Dtrca ��. �����s sec 09 (1.3'staff) 133.92' ��� � sr. a��"�m, 0,3� 11 _..-- TRLR. •.".' n1'�RR1Z' ' WILT 3 Gw.v.,4,J-'3 46 CARAGR t"J b �, ,BLAND �4 J4, w 77 A 8•DIA.z 6•DS6P p,. x--^"' *. . GF-26.1 We ROOF DRAW , gvlCt'; .M.,,. O . . ICcrnr nr—..... a v e. SECCAFICO LAND SURVEWNG Pt '- Fn. 1O. n ltory 11oR. 500 Montauk High way N '77"10'61" W 161.36' Moriches, Now York 11955 LAM Ror on FORMEUY OP Phone: (631) 878-0120 Phone (631) 728-5330 TOW OF Sn6TRaLD pseccoticogbptonNne.not (RR m"s RAW) Pat C. Seccotico. PLS Pot T. Seccoflco. PLS 0112812029 MALE sRvaysD NYS Lic. No. 051040 NYS Lic. No. 049287 1113012021 FWAL RDRVRF copyright — 2021 Secco lco Land Surveying PC PROJECT No. 82250 SCALE: 1" = 30' DATE: 0310812021