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HomeMy WebLinkAbout51824-Z , r 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#: 51824 Date: 04/11/2025 Permission is hereby granted to: Vega Family Trust 68-32 60th St Ridgewood, NY 11385 To: legalize "as built"alterations to existing two-family dwelling as applied for. Additional certification may be required. Premises Located at: 815 Hummel Ave, Southold, NY 11971 SCTM# 63.-2-23 Pursuant to application dated 02/18/2025 and approved by the Building Inspector. To expire on 04/11/2027. Contractors: Required Inspections: Fees: As Built Alteration $662.00 CO-RESIDENTIAL $100.00 Total $762.00 � � 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 i,tt :l�r "~ r ',sottlioiclto �ar Gov Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only ECE0WE PERMIT NO. + Building Inspector: F E B 1 132025 Applications and forms must be filled out in their entirety. Incomplete applications will not be accepted. Where the Applicant is not the owner,an Building Department Owner's Authorization form(Page 2)shall be completed. Town of Southold Date: Februarys 7, 2025 OWNER(S) OF PROPERTY:. Name: Vega Family Trust scTM # 1000- 63-2-23 Project Address: 815 Hummel Avenue Phone#: (917) 648-7077 Email:jopamave@gmail.com Mailing Address: 68-32 60th Street, Ridgewood NY 11385 CONTACT PERSON: Name: Joseph Paul Vega Mailing Address: 68-32 60th Street, Ridgewood NY 11385 Phone#: (917) 648-7077 Email: DESIGN PROFESSIONAL INFORMATION: Name: Hansen Architecture + Design - Christina Hansen Mailing Address: 420 State Street, Brooklyn NY 11217 Phone#: (917) 202-9706 Email: chansenl226@gmail.com CONTRACTOR INFORMATION: Name: Valor General Contracting Corp. - Elijah Krause Mailing Address: P.O. Box 160, Greenport NY 11944 Phone#: (631) 488-0539 Email: Valorgcc@gmail.com DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure *Addition ❑Alteration RRepair ❑Demolition Estimated Cost of Project: ❑Other $ $60,000.00 Will the lot be re-graded? ❑Yes ©No Will excess fill be removed from premises? ❑Yes ONo 1 PROPERTY INFORMATION Existing use of property: Rental Intended use of property: Rental Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? ❑Yes 101No IF YES, PROVIDE A COPY. 8 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): Joseph Paul Vega Authorized Agent ❑Owner Signature of Applicant: Date: February 7, 2025 STATE OF NEW YORK) A SS: COUNTY OF 64cc21°n 0-e7e- h being duly sworn, deposes and says that (s)he is the applicant Ugsc (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 7 day of - lo1ata or 20�..5- Notary Public FREDERICK ROMANN PROPERTY OWNER AUTHORIZATION Notary „atatec�fNewYork Noo..OI R083957 (Where the applicant is not the owner) Qualified in Queens County Commission Expires June 24,2 �* I, residing at do hereby authorize 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 NYSIF New York State Insurance Fund PO Box 66699,Albany, NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE A A A A A 922524315 MCMANN PRICE AGENCY INC 828 FRONT STREET GREENPORT NY 11944 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER VALOR GENERAL CONTRACTING CORP VEGA FAMILY TURST 33 MIDDLETON RD 815 HUMMEL AVE GREENPORT NY 11944 SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE 12590 251-1 703193 05/10/2024 TO 05/10/2025 2/5/2025 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2590 251-1, 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. PRESIDENT ELIJAH KRAUSE VALOR GENERAL CONTRACTING CORP A 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 STAT S4 71*1 NCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 496692007 VALOGEN-01 ------M. CERTIFICATE OF LIABILITY INSURANCE FDATE 21512 D/YYYY) a 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. If SUBROGATION If the IS WAIVED, holder Is an to the ADDITIONAL INSURED, RED,s a the y( ) have ADDITIONAL INSURED_ _._.... sub erms NSURED,the olic les must ha ED provisions or be endorsed. co policy,certain policies may require an endorsement. A statement on this certificate does not confer rl hts to the certificate holder in lieu of such endorsements. Co TACT' PRODUCER E Neefus Stype Agency PHONE ANC,No,Ext 11 722-3500 _ � ,N�l.(831 722-3591 711 Union Ave. E-MA L rbs 1nUr ,Oon� Aquebogue,NY 11931 gNSURE'R S AFF IRDINO COVEN 4GE ,,,,,NAIC 14 ...__m.., _....... INSURER A:Evanston Insurance Co. ....... '378 INSURED INSURER B ...... Valor General Contracting Corp INSURER c r�•�••.••� •.•�W -...•••• 33 Middleton Road _INSURER D .......m. _..... ..........._ . _ ... Greenport,NY 11944 NNSURER E: _. .. ........ _COVERAGES,....... ... _!CERTIFICATE NUMBER., NUMBEIR;..... .......� 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. _...._ POLICY EFF... POLICY EXP INSR.. _.... .,..-...._...._..IN �DDtm �R¶ ._,...._ LIMITS TYPE OF INSURANCE a POLICY NUMBER - ... 1,0001000 A X COMMERCIAL GENERAL LIABILITY EACH OCCLMRENCE DAMAGE TO RENTED 100,000 CLAIMS-MADE X I�OCCUR AA766"106 3/17/2024 3/17/2026 �g p� y�� mmmm•, 5 ..... m_�, .... _-- 5,000 MED EXP to vY ne peuxan6 S fIERSGNAL fvDV INJURY 1,000,000 GE.N"L AGGREGATE LIMIT APPLIES PER: ELATE .. � 2,OOtl„000 EC ERAI. AGGB_LGAT X. PONICY PRO- ❑ Loc ....._ PRNDOCCTS COhtiPNOP AG G„_ 2,000,000 •OTHER; $ COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY � .tea i fl L...... ...... OWNED SCHEDULED PBODILY INJURY AifAeraccide) $ AUTOS ONLY AUTOS �y HNY ADUTO NOa�pWC^9 D p f�E f'CODILY I J , _t PtE22n ANR SONLY ALNT05ON 4 F�'WP e d Y?A Per t_ $ UMBRELLA LIAB OCCUR F,,LAACH OCCURRENCE $' EXCESS LIAB CLAIMS-MADE ANaOaREt WORKERS EMPLYCOMPENSATION IEN25 LN LOITY� .._ DED RETENTION$ PER OTI& A Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE N/A A •- (Mandatory ­ OFFICER/MEMBER BE EXCLUDED. D L DISEA,aF 'EA EY N.LOYN'�,E ITmm ......❑ P-I fnAl H A 1 Ifg?es,describe under _ S - D'F.SCRIPTION OF OF'r:RA"rTONS below E L.DISE'�AWLw POLICY LIMN1'; DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) _ _ _ .-...... ...... CANCELk.A ... ........_ CERTIFICATE..HOLDER T1O111 ... ................. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Vega Family Trust ACCORDANCE WITH THE POLICY PROVISIONS. 816 Hummel Avenue Southold,NY 11971 .. ........ ........ AUTHORIZED REPRESENTATIVE ....... .. ._.. ..... ACORD 25(2016/03) 01988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD