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
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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
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6.a* STONE PATIO 5 1.2'
183 j=., GAT O.B'W
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2ND FLR.
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FLAG POLE
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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
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