The URL can be used to link to this page

Home My WebLink About51823-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#: 51823 Date: 04/11/2025 Permission is hereby granted to: Benjamin Bennett 160 Ainslie St Apt 1 Brooklyn, NY 11211 To: Construct accessory outdoor shower,at a single-family dwelling, as applied for. Premises Located at: 1220 Ninth St, Greenport, NY 11944 SCTM#45.-6-9.2 Pursuant to application dated 08/15/2024 and approved by the Building Inspector. To expire on 04/11/2027. Contractors: Required Inspections: FOOTING/REBAR, FOUNDATION 1ST, FRAMING/STRAPPING, PLUMBING , ELECTRICAL- ROUGH, ELECTRICAL- FINAL, DRAINAGE, FINAL, Fees: Accessory-New Structure $125.00 CO Accessory Structure $100.00 1ata 225.00 Building Inspector . ' � TOWN OF SOUTHOLD—BUILDING DEPARTMENT ' Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 us �. V Telephone (631) 765-1802 Fax (631) 765-9502 Lt)s://www.southoldtowtiii ov Date Received IF APPLICATION FOR BUILDING PERMIT For Office Use Only PERMIT NO., � Building Inspector: AUG 02 Applications and forms must be filled out in their entirety.Incomplete ert applications will not be accepted. Where the Applicant is not the owner,an Bttllding Clop'a Owner's Authorization form(Page 2)shall be completed. Town of SOUthoid Date:08/16/2024 OWNER(S)OF PROPERTY: Name:Ben and Carolyn Bennett SCTIVI#1000-045.00-0600-009.002 Project Address: 1220 Ninth St, Greenport, NY 11944 Phone#:917-442-9487 Email:benneb@gmail.com Mailing Address: 160 Ainslie St, APT 1, Brooklyn, NY 11211 CONTACT PERSON: Name:Peter DePasquale (architect) Mailing Address:370 Lexington Avenue, Suite 407, NY, NY 10017 Phone#:516-383-5341 :EEmKaill:pete@gdp.work DESIGN PROFESSIONAL INFORMATION: Name:peter DePasquale (architect) Mailing Address:370 Lexington Avenue, Suite 407, NY, NY 10017 Phone#:516-383-5341 Email:pete@gdp.work CONTRACTOR INFORMATION: Name:North Fork Woodworks, attn: Scott Edgett Mailing Address:810 Traveler St, Southold, NY Phone#:631-298-7900 Email:scott@nfwoodworks.com DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ❑Alteration ❑ ❑ Estimated Cost of Project:Repair Demolition s.000 D othe r Outdoor Shower Will the lot be re-graded? ❑Yes �@No Will excess fill be removed from premises? ❑Yes ®No 1 Docusign Envelope ID:1993D390-6A1F-47A5-A283-ACF9D69A5161 PROPERTY INFORMATION Existinguse ofproperty: Intended use of property:Single Family Residence Single Family Residence 9 Y Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to R40 this property? RYes ❑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 name Peter DePasquale 19,Authorized Agent Downer Signature of Applicant: Peter J ePagWe Date: 07/18/2024 STATE OFM)W*6IK) Florida L NI V SS: COUNTY OF)" Broward) Lip Peter DePasquale being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, Agent (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 ,,;1 PAMPA 18 July 24 d� day of 20 Notary Public Luis Davila y �„� z�tIillPr P �� LUIS DAVILA tn� Notary Public-State of Florida G Commission HH519 '.. O' "NER. AUTHORIZATION Expires on April 21,20228�(Wh re the applicant Is not the own a� OF 4'ire uiplul�a Notarized remotely online using communication technology via Proof. Benjamin Bennett residing at 160 Ainslie St, Apt 1, Brooklyn, NY 11211 I, , do hereby authorize Peter DePasquale to apply on my behalf to the Town of Southold Building Department for approval as described herein. 07/17/2024 Owner's Signature Date Benjamin Bennett Print Owner's Name 2 NYSIF NY 12206 New York State Insurance Fund PO Box 66699,Albany, � nysif.comcom CERTIFICATE OF WORKERS' COMPENSATION INSURANCE (RENEWED) NA A A A A 272628352 AMWINS INSURANCE BROKERAGE LLC 200 ELWOOD DAVIS ROAD *40 SUITE 200 SCAN TO VALIDATE LIVERPOOL NY 13088 AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER NORTH FORK WOOD WORKS INC BENJAMIN AND CAROLYN BENNETT P O BOX 1407 1220 NINTH STREET SOUTHOLD NY 11971 GREENPORT NY 11944-0158 FPOLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE Z2280 317-5 685667 05/01/2024 TO 05/01/2025 4/15/2024 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2260 317-5, 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. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY,INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WESSITE AT HTT'PS-/IWWW.NYSIF.COMiICERTICERTVAL.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. PRESIDENT SCOTT EDGETT NORTH FORK WOOD WORKS INC 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 STAT UR. NCE FUND 4 DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 325615146 Suffolk County Dept.of Labor,Licensing&Consumer Affairs HOME IMPROVEMENT LICENSE Name KYLE JSCHADT Business Name This certifies that the 3earer is duly licensed NORTH FORK WOOD WORKS INC. iy the County of suffolk License Number:H-45819 Rosalie Drago Issued: 02/19/2009 Commissioner Expires: 02/01/2025