Loading...
HomeMy WebLinkAbout51743-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#: 51743 Date: 03/14/2025 Permission is hereby granted to: Alexander P Nyren 75 Henry St Apt 25H Brooklyn, NY 11201 To: legalize "as built"finished basement to existing single-family dwelling as applied for. Additional certification will be required. Premises Located at: 630 Nokomis Rd, Southold, NY 11971 SCTM#78.-3-19.2 Pursuant to application dated 02/07/2025 and approved by the Building Inspector. To expire on 03/14/2027. Contractors: Required Inspections: Fees: As Built Addition/Alteration $1,383.00 CO-RESIDENTIAL $100.00 Total $1,483.00 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 httr)s://www.souttioldtowiiiiy.gov Date Received BUILDINGAPPLICATION FOR S11 . For Office Use Only PERMIT NO. Building Inspector: F I° 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:02/01/25 OWNER(S)OF PROPERTY: Name:Alexander Nyren and Kimberly Rittberg ]:SCT:M::#:1000-78.-3-19.2 Project Address:630 Nokomis Road, Southold, NY Phone#:917-364-4453 Email:alexkimnyren@gmail.com Mailing Address:630 Nokomis Road, Southold, NY 11971 CONTACT PERSON: Name:Krista Jones Mailing Address:PO Box 948, Cutchogue, NY Phone#:631-335-8175 Email:miilstonepropertyservices@gmail.com DESIGN PROFESSIONAL INFORMATION: Name:John McNeill Mailing Address:321 Riverside Drive, Riverhead, NY 11901 Phone#:516-376-8594 Email:jahn@mcneillarchitecture.com CONTRACTOR INFORMATION:` Name:Joel Daly General Contracting Inc. Mailing Address:PO Box 343, Southold, NY 11971 Phone#:631-765-1223 Email-joel@joeldalybuilders.com DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ■Alteration ❑Repair ❑Demolition Estimated Cost of Project: ❑Other 20,000 Will the lot be re-graded? ❑Yes ■No Will excess fill be removed from premises? ❑Yes ENO 1 PROPERTY INFORMATION Existing use of property:residential Intended use of property:residential Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to R-40 this property? ❑Yes ■No IF YES, PROVIDE A COPY. 0 Check Box After Reading: The owner/contractor/design profess[anal Is responsible for all drainage and storm water issues as provided by Chapter Z36 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 buiklingls)for necessary Inspections.False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210AS of the New York State Penal Law. Application Submitted B (print name): Jones ■Authorized pp y(p ) Agent ❑Owner Signature of Applicant: Date: ZI�'Z J STATE OF NEW YORK) ll COUNTY OF a I ) �ne-S 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 (o day of y .20 " Nota ublic LINDA B.SCHOLL Notary Public,State of New York AUTHORIZATIONPROPERTY OWNER No.30-4858259 Qualified in Suffolk County (Where the applicant is not the owner) Commission Exoires May 5,20 ZP Kimberly Rittberg residing at 630 Nokomis Road, Southold I, do hereby authorize Krista Jones to apply on my behalf to the Town of Southold Building Department for approval as described herein. 2-3-25 Owner's Signature Date Kimberly Rittberg Print Owner's Name 2 THE LOCATION O'fi_WL9,S AHO OE41RP0 4a'OL0 MOWN MOH ARC'FROM FIELD 08 — SERYAT,OHS AHO O14 FROM"TA OOTA/NCO FROM OTHER$ r..,. THE WATER SUPPLY AND SEWAGC OrRWOSAL E'Ye"7EN8 FOR TN4S ftft70EHCE ,.• .. ^Wi41,4CONFORM TO THE STAMAIPOS Of INC &UIPPOLK COVHTY OEPUYrAU7C9' OP 0 AL7'N SERVICES APPLICANT:------—————————— ADDRESS-------------TEL.— \ SU"QLE CQUAT-1 MALM DVAAT111iVT DAT .L °_L ' H. D. &BY. Tba Seseoa dispOsal and water supply laa311ties for this location have bssn iu3paated by this deparUmit and romid to be aatisSacto Chit � �ae ;6rartFiaaa now or formerly Henry w. Drum & Joseph So/ond CA V 'I 4dpy PW.8,5°`�8001`E -TEST amaAR al.•rB.e '� e; n O � tMo ccsSvooLs �,„, '�+-•.m'L N+•A,w•A;ar: aP� ,� - R1 a Moe Area =27,663sq-ft � � reewtM`LLYa ""ww w L� z y MJ'Ths.'r QO:bO 2 v ' Baca O now or formerly SOntol0 G. D o a A „. HIAWATHA IsPATH ... I NOTE ■=MONUMENT THERE ARE NOOWEl lNGS WITHIN/00' OF THIS PROPERTY OTHER THAN THOSE SHOWN HEREON WATER SERVICE-PRIVATE WELL 5 CIF IV,. REVISIONS YOUNG & Y O IV. DULY 11J/97$ 400 OSTRANDER AVENUE, RV'V 01 TE5T HOLE ALDEN W.YOUNG NG O O PROFESSIONAL ENGINEER AND v'V9VCY Ak TaP 901E LAND SURVEYOR.N.Y.B.LIC.NO.12.45 Ic,,Ry 4V OB A e LOAM UNAUTHOflI2Ep ALTERATN OR AION TO SURVEY FOR:_.,._,. .,,......,_. .A� 4rj�93 THIS SURVEY I IO OOITS A VIOLATION OF SECTION LESLIE E. KUNST 'M .RNa "" Nwrx 729 OF THE NEW YORR STATE£OUEATION i{t ......u,,,,,,,,,,,,,'Ak•e LAW SANG COPIES OF THIS SURVEY MAP NOT BEARI NO THE L ANO SURVEYORS INNED SEAL OR ELIBO55FU SEAL SHALL NOT BE CONSIOERED ............�n..... .,W�. ..a 10 BE AVALlo T.UE Gpar AT GUARANTEED TO: .,.,,w.w�.V...L, 6 3 OUAPA,Olt;INp1CATEU HEREON SHALL PUN - SOUTHOLD CHICA60 TITLE INSURANCE CO. 3NLr TO THE FCRSOII FOR WH 'HE TOWN OF RIVERHEAD SAVINGS BANK NURVEY 15 PREPAREO,AN)ON 11•S BEHALF sourHoca _ _ TC•,HC TITI L COMPANY,GOVERNMENTAL - AUENCY AND LCNJIYO M311TUTUN LISTFU A� {/ arT 11EgEON,Aryp TO THE ASS GNLES OF THE SUFFOLK CO., N.i. �µ.,F LFNO NG INSTIT.1T1- OUARANFTES ARE NO,TRANSFIRABLE TO ADDTCNAL SCALE J DATE; 'NO,..a INSTIIU11ON5 OR 3URSIXLEVT ONNERS. ! 1 40` JUL Y 5,1978 78-4W/Y1 NYSIF New York State Insurance Fund PO Box 66699,Albany,NY 12206 nysif.com CERTIFICATE OF WORKERS, COMPENSATION INSURANCE A A A A A A 452089839 JOEL DALY GENERAL CONTRACTING INC PO BOX 343 ffirli SOUTHOLD NY 11971 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER JOEL DALY GENERAL CONTRACTING INC ALEX&KIM NYREN PO BOX 343 630 NOKOMIS ROAD SOUTHOLD NY 11971 SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE 11374 005-5 637351 12/09/2024 TO 12/09/2025 1/16/2025 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY INO. 1374 005-5, 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://WWW.NYSIF.COM/CERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. JOEL DALY,PRES OF JOEL DALY CONTRACTING INC (ONE PERSON CORP) 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. NEW YORK aTAT U N :E FUND DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER:363475816 U-26.3 JOELDAL-01 SSCHMI DATE(MWDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 1/16/2025 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 WANED, 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 endorseme s. PRODUCER Neefus Sty Agency Pa Nr o Efd: 631)722-3500AXc Nlt 621 722-3591 711 Union vs. Aquebogue,NY.11931 i n3altlsuNe.cortt INB�IR��A RDIN„t�,,CQ, ,„VERAC>E NAIC�R R R :Mesa S ial Underwriters Insurance Co _ INSURED INSURER B;Merchanffi Preferred Ins Co 12901 Joel Daly General Contracting&Inc. PO Box 343 OUMB P Southold,NY 11971 NSURER E' INSURER F: COVERAGES CfMFICATE NUMBER: MOON NUMOM: 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 RESPECTTO 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. INSR JJL TYPE OF INSURANCE OM POLICY NUMBER POLICY EFF POLICY EXP LINTS A X COMMERCIAL GENERAL LIABILITY 1,000,000 CLAIMS-MADE 17X OCCUR MP013100310006801 6/9/2024 6/9/2025 Ie E�r RR D 100,000 MED EO(P A one � 5,000 V IWRY 1 1,000,000 E "LAG GR LIMIT APPLIES PER: RALA LTg 2,000.000 X POL11I TE T EILOC PR.P"C . MP P A 2,000,000 B AUTOMOBILE LIABILITY EO SINOLE LIMIT 11000,000 ANY AUTO CAP1050201 11/23/2024 11/23/2025 Y _� OVINED SCHEDULED AtITEO�SONLY X AUUTNOSyyNEp B DILYiNlI�RY�acddenR�„ $ X AUTOS ONLY X AUTO ONLY s R _ UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAO CLAIMS-MADE A REC�ATE.�.E --- ..,, DED RETENTION S WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY �— ANY PROPREIETORIPARTNERIEXECUTIVE Y- NT S �IIrMeMry in 9ER EXCLUDED9 N/A lMI ff Ejr_P§.FA .M .?LOYE..�......,...,.—....µ,...... If y describe under DE RIPTI N F PERATI S -POLO LIMIT i $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,AddtUml Remadcs Schedule,may be attached if more apace Is requlmd) _PER.T FiCAT H LDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE HEREOF, Alex&Kim Nyren ACCORDANCE WITH THE POLICY PROVISO SCE WILL BE DELIVERED IN 630 Nokomis Road Southold,NY 11971 AUTHORIZEDjj.�REPRRESENTATIVE ACORD 25(2016/03) 01988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD aworkers' CERTIFICATE OF INSURANCE COVERAGE Compensation Biaard 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'bf Insured(use street address only) 1b.Business Telephone Number of Insured JOEL DALY GENERAL CONTRACTING INC. 631-765-1223 PO BOX 343 SOUTHOLD,NY 11971 1c.Federal Employer Identification Number of Insured 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) gheltsrPoint We Insurance Company Alex&Kim Nyren 630 Nokomis Road 3b.Policy Number of Entity Listed in Box"1 a" Southold,NY 11971 DBL163715 3c.Policy effective period 04/02/2024 to 04101/2026 4. Policy provides the following benefits: R] 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 employer's employees eligible under the NYS Disability and Paid Family Leave Benefits Law. B_Only the following class or classes of employers employees: Under penalty of perjury,I certify that I am an authorized representative or lice agent W the.Insurance carrier referenced above and that the named insured has NYS Disability and/or Paid Family Leave Benefits insurance coverage as described above. Date Signed 1/16/2025 By 1 143=4r— (Signature of insurance carrier's authorized representable or NYS tkensed Insurance Agent of that insurance carrier) Telephone Number 51 -829 100 Name and Tdle Leston Welsh Chief I XeCutiye Officer IMPORTANT: If Boxes 4A and 5A are checked,and this form is signed by the insurance carriers 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 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 48.4C 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 (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) 111111, � �i � ;�1111 Suffolk County pot of Labor,Licensing&.ConiUmerAffairs 6 HOME IMPROVEMENT LICENSE Name JOEL M DALY Business Name This certifies that the This DALY GENERAL CONTRACTING bearer Is duly,I'icre INC by the Cou6ly ct sufi"dl' 'License Number H-13068 W ,T. Issues 11/01/1986' Commissioner Expires: 11/01/2026 I Y 'l r, r; r; r Y` r ji,