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HomeMy WebLinkAbout51909-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#: 51909 Date: 05/09/2025 Permission is hereby granted to: Angelo S Chantly 80 Watersedge Way Southold, NY 11971 To: install generator as applied for. Must maintain a minimum 5'rear&side yard setbacks. Premises Located at: 80 Watersedge Way, Southold, NY 11971 SCTM#88.-5-54 Pursuant to application dated 04/01/2025 and approved by the Building Inspector. To expire on 05/09/2027. Contractors: Required Inspections: Fees: GENERATOR $125.00 ELECTRIC -Residential $100.00 CO-RESIDENTIAL $100.00 Total $325.00 --Ltding Inspector ea 41 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 htt S://WWW.SOL)tlloldtownDy.gov Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only PERMIT NO, Building Inspector: AJ Applications and forms must be filled out in their.entirety. Incomplete t ( ny' applications will not be accepted. Where the Applicant is not the owner,an 1 ,, au OIL Owner's Authorization form(Page 2)shall be completed. Date:3/10/2025 OWNERS)OF PROPERTY: Name:Angelo Chantly SCTM#1000-088.00-05.00-054.000 Project Address:80 Watersedge Way, Southold NY 11971 Phone#:917-502-1980 Email:mydogjd@aol.com Mailing Address:80 Watersedge Way, Southold NY 11971 CONTACT PERSON: Name: 'yo-In e aJ ronHReh� Mailing Address: Phone#: Email: DESIGN PROFESSIONAL INFORMATION:' Name: Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: Name:Calogero Ferraro, President, Powerful Electric of Long Island Inc Mailing Address:29 Evergreen Drive, Manorville NY 11949 Phone#: 631-806-8513 Email: info@powerfulelectricli.com DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: DOther Generator $30,000 Will the lot be re-graded? ❑Yes ®No Will excess fill be removed from premises? ❑Yes ®No 1 PROPERTY INFORMATION Existing use of property:Residential - Single Family Intended use of property:Residential -Single Family Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to Southold - Residential this property? ❑Yes @No IF YES,PROVIDE A COPY. 19 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 I punishable as a Class A misdemeanor pursuant to Section 210.45 of the New York State Penal Law. Application Submitted By(ttririfcae Calogero FerraroglAuthorized Agent []Owner Signature of Applicant: Date: 3f 3►I Z S STATE OF NEW YORK) SS: COUNTYOF1 v ) / er,v being duly sworn,deposes and says that(s)he is the applicant (Name of ikdiviclual signing contract)above named, (S)he is the Ca12 T"C7 V (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 31 day of I"lQ-� 20 2-5 N i GAMS Moaiy Public,state+af Iewr'Yof Re Istration No.01AD6065U ualified In;Suffolk County I orrIffilssion Expires October 22, . (Where the applicant is not the owner) I, residing at ' Angelo Chantly 80 Watersedge Way Southold NY 11971 Calogero Ferraro,President,Powerful Electric of Long Island,Inc do hereby authorize to apply on my behalf to the Town of SouWold Building Department for approval as described herein. O .hfgrtat Ire Date Angelo Chantly Print Owner's Name 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 w amesh southoldtownn ov seand southoldtownn ov ` APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (Au Information Required) Date: Company Name: ow+e1-44 / e4/—#-"( 194 /h C- Electrician's Name: a loq era r ate' License No.: j20ZS 0 Elec. email: " Elec. Phone No: 1", ,0(r_p513 21 request an email copy of Certificate of Compliance Elec. Address.: -2 ✓a"� JOB SITE INFORMATION (All Information Required) Name: Address: old' 1117 I Cross Street: gr4 bar'v �e a et Phone No.: (o—?S"/ 3 Bldg.Permit#: email: weA4 leek ch. oln' Tax Map District: 1000 Section: Fr Block: .5 Lot: S BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): 2 Ca, tAJ 14(�-4 eo lim a Square Footage Circle All That Apply: Is job ready for inspection?: YES NO [:]Rough In Final Do you need a Temp Certificate?: El YES � NO Issued On Temp Information: (All information required) Service Size 1 Ph3 Ph Size: A # Meters Old Meter# ❑New Service❑Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground❑Overhead # Underground Laterals 1 2 H Frame Pole Work done on Service? Y nN Additional Information: PAYMENT DUE WITH APPLICATION S.C.T.M. NO. DISTRICT: 1000 SECTION:88 BLOCK:5 LOT(S):54 I OT COVERAGE OWELUW WICANTILEVERS: 1917 S.F. 1ST& 2ND FLR WOOD DECKS: 1482 S.F. SWIMMING POOL, 920 S.F. I PERGOLA: 357 S.F. ON GRADE POOL DECK : NIA LOT I LOT 54 TOTAL: 24.B% or 4676 S.F. LOT 53 HNYL SHED MAX ALLOWABLE 20Y = 3769 S.F. I 7 a S 66°22 10" E 116.68' STK. PIPE Y. d1XN FEITDEWOODRA L FCgg 4' ESTATE FENCE 0.2'E 7"S w Z STONE PATIO O � � �' INGRD�JND WOOD is ~ SkWMM)NG POOL DECK ' �2t�at46 ON GRADE 6.a* STONE PATIO 5 1.2' 183 j=., GAT O.B'W WOOD 1E DECK My ROOF :«a 6.0' CID1ST 4 :r55 S�OFME U �1 STONE PATIO8O �yO a) VITAL WOOD DECK 240 DECK W STK. "E m 1E 114 „ SLATE WALK o ZND LOT 56 2ND FLR. '8,0 CANTILEVER MM 2ND FLR. 1 1.6' WOOD DECK W O O LOT 55 C7 raj � CQ FLAG POLE zl ° u. °'� N 66022'10" W 81.33' W.M. EDGE OF PAVEMENT WATERSEDGE WAY ZONED R-40 THE WATER SUPPLY, WELLS, DRYWELLS AND CESSPOOL NON—CONFORMING LOT LOCA77ONS SHOWN ARE FROM FIELD OBSERVA77ONS AND OR DATA OBTAINED FROM OTHERS. Fo . AREA: 18,844.3 S.F. OR 0.43 ACRES ELEVA77ON DATUM: evi evA to Y, L7NAUTN=ZE ALIERATKeY1'0R AO0FnW TC TN1S SUR4aEY 1S A N7CI:ATTDN OF SECTION r209 1 THE NEW YORK STATE EDUCATION LAW; COPIES OF TNYS SURWEY � �7 MAP NOT BEARJNC THE LAND SLTR4EYDR EMBOSSED SEAL SHALL NOT fiE 04ISCDEREO TO 8E A k+ALBO TRUE COPY OUAIRANTEES INDICATED HEREON SHALL RUN ONLY TO .THE PERSON TN7RDAd THE SUFdwEY 1S PREPARED ANO D HIS BEHALF TO 7NE 71TLE COMPANY COYERld1RENTAL AGENCY AND tENDANO TNS717TPTT0N t/STED NEREDAT AND TO 71dE AS570NEE5 OF 7HE L T7TLDA7 NOT'7RANSFERA7AtEDR OSSMDYldN HEREdANOMTHL!� '7URES ANC'FO4 A SCPFNC PUSS£ ANCM U THLREFLE THEY ARENOTE0 TO ENT THE PROPERTY LINES d7R EdE THE ERERTTON FENCESAODf771 PAL STRUC7URES OR AND OTHETR 7MPROVEAIENI:9 EASEMEN7V ^ is R7ANOM SL+RSURFACE S ESS REOORDED OR L91PRF0 ARE NOT OUARANTEEO UNLESS PH"Y5ICALLY EMDENT OhI T7NL PREAIMSES AT THE TIME OF SUR4EY SURVEY OF. LOT 55 1TF NFL CERTIFIED TO: ANGELO S. CHANTLY; MAP OF:TERRY WATER , 0 1m �t FVRST AMERICAN TITLE INSURANCE CO. OF N.Y., S ITLm DECEMBER 29, 1958 AS #2901 L SITUATED AT: SOUTHOLD . ' ex Tom OF:SOUTHOLD SUFFOLK COUNTY, NEW YORK 1 0508 2 y Prafeasional lad Surveying and Deafgn A P.O. Bog 153 Aquebogue, New York 11931 FILE y 14-105 SCALE: 1"=20' DATE:AUG. 4, 2014 N.Y.S LISC. NO. 050882 PHONE(631)208-1688 FAX(631) 298-1588 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 A 871941510 1 POWERFUL ELECTRIC OF LONG ISLAND, INC. 29 EVERGREEN DR MANORVILLE NY 11949 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER 80 WATERSEGDE WAY POWERFUL ELECTRIC OF TOWN OF SOUTHOLD LONG ISLAND, INC. 54375 MAIN ROAD 29 EVERGREEN DR PO BOX 1179 MANORVILLE NY 11949 SOUTHOLD NY 11971-0959 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE 12553 244-1 262466 08/07/2024 TO 08/07/2025 3/31/2025 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2553 244-1, 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 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 SU NCE FUND lhe e4l DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER:619245535 U-26.3 Ys workers' CERTIFICATE OF INSURANCE COVERAGE rATE Compensation Board DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW PART 1.To be completed by Disability and Paid Family Leave Benefits Carrier or Licensed Insurance Agent of that Carrier 1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured POWERFUL ELECTRIC OF LONG ISLAND,INC. (631)806-8513 DBA POWERFUL ELECTRIC 29 EVERGREEN DRIVE MANORVILLE,NY 11949 1 c.Federal Employer Identification Number of Insured or Social Security Work Location of Insured(Only required if coverage is specifically limited to Number certain locations in New York State,i.e.,a Wrap-Up Policy) 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) New York State Insurance Fund(NYSIF) TOWN OF SOUTHOLD 54375 MAIN ROAD 3b.Policy Number of Entity Listed in Box"1 a" PO BOX 1179 DBL 7535 98-3 SOUTHOLD,NY 11971 3c.Policy effective period 08/05/2024 to 08/05/2025 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 employer's employees eligible under the NYS Disability and Paid Family Leave Benefits Law ❑ B.Only the following class or classes of employer's employees: Under penalty of perjury,I certify that I am an authorized representative or licensed agent of 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 3/31/2025 By . ". � ��� (Signature of insurance carrier's authorized representative or NYS Licensed Insurance Agent of that insurance carrier) Telephone Number 866)697-4332 Name and Title Kristin Markwica,Head of Disability Insurance Unit IMPORTANT: If Box 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. 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 mailed for completion to the Workers'Compensation Board, DB Plans Acceptance Unit, PO Box 5200, Binghamton, NY 13902-5200 PART 2.To be completed by the NYS Workers'Compensation Board(Only if Box 4C or 5B of Part 1 has 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 with respect to all of his/her 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 (10-17) Certificate Number 832006 �& CERTIFICATE OF LIABILITY INSURANCE °ATE/31/2025rY) 01/31/2025 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 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 erdorsemen s. PRODUCER CI1rltirl SWLIMM Brian O'Keefe Insurance Agency, Inc. PHONE 631.580.3276 FAX e: 631.580.3277 State Farm Insurance Company E•MMIR Christine@brianokeefe.biz r' 411 Furrows Road INSURE S AFFORDING COVERAGE NAIC# Holbrook NY 11741 INSURERA: State Farm Fire and Casualty Company 25143 INSURED INSURERB. State Farm Mutual Automobile Insurance Company 25178 Calogero L&Jennifer Ferraro INSURERc: Powerful Electric of Long Island Inc. I...RER.. 29 Evergreen Dr INSURERE: Manorville NY 11949 INSURER F 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. LTR TYPE OF INSURANCE LICY NUMBER LIC1 ExP LIMITS INS'R At1D1 U PCILICYEPF PO COMMERCIAL GE 11 NERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE OCCUR DAMAGETUREPREMO E N uvre $ 300,000 MED ED EXP An one person) $ 25,000 A X X 92-C9-C201-1 08/11/2024 08/11/2025 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 ❑ PRO-JECT ❑ PRODUCTS-COMP/OP AGG POLICY PRO- LOC $ 4.000,000 OWNED V OTHER: AUTOMOBILE LIABILITY 293 1873-ADI-32 07/01/2024 07/01/2025 Ea accidents N' LE L M T $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PR POiTYDAM E $ 1,000,000 AUTOS ONLY AUTOS ONLY Mel aqc UMBRELLA LIAR OCCUR EACH OCCURRENCE $ 4,000,000 A EXCESS LIAB CLAIMS-MADE 92-130-D178 02/11/2025 02/11/2026 AGGREGATE $ DED RETENTION $ WORKERS COMPENSATION PER TH AND EMPLOYERS'LIABILITY STATU E ANY PROPRIETOR/PARTNER/EXECUTIVE Y� N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE$ If yes,describe under DESCRIPTION OF OPERATIONS below E,L DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of Southold Building Department AUTHORIZED REPRESENTATIVE 54375 Main Road PO Box 1179 Southold NY 11971-0959 s?� 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD 1001486 132849.13 04-22-2020 y�yy o\ -