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HomeMy WebLinkAbout50627-Z .�4aoF soOryOlo Town of Southold P.O. Box 1179 A 53095 Main Rd Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 46909 Date: 03/13/2026 THIS CERTIFIES that the building SINGLE FAMILY DWELLING-ADDITION AND ALTERATION Location of Property: 5330 New Suffolk Rd New Suffolk, NY 11956 Sec/Block/Lot: 117.-2-6 Conforms substantially to the Application for Building Permit heretofore,filed in this office dated: 05/06/2024 Pursuant to which Building Permit No. 50627 and dated: 05/07/2024 Was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: Alterations and repairs to existing foundation as applied for. The certificate is issued to: Jill Culbert , Brian Green Of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL: ELECTRICAL ,CERTIFICATE: PLUMBERS CERTIFICATION: :l VU o ' e Signature o�g�FE-SO o TOWN OF SOUTHOLD �� ay BUILDING DEPARTMENT y x TOWN CLERK'S OFFICE "o • �r�� 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#: 50627 Date: 5/7/2024 Permission is hereby granted to: Culbert, Jill 5330 New Suffolk Rd New Suffolk, NY 11956 To: Emergency foundation repairs as applied for. May require additional certification. At premises located at: 5330 New Suffolk Rd, New Suffolk SCTM # 473889 Sec/Block/Lot# 117.-2-6 Pursuant to application dated 5/6/2024 and approved by the Building Inspector. To expire on 11/6/2025. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $580.00 CO-ALTERATION TO DWELLING $100.00 Total: $680.00 Building Inspector OF SOGIyO # # TOWN OF. OS UTHOLD BUI DNG DEPT. Ioo�m,� 631-765-1802 INSPECTION [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: CV dad P �elwce DATE INSPECTOR _ pF SOUTy�� f # TOWN OF SOUTHOLD BUILDING DEPT. courme�' 631.765-1802 o INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ]' RENTAL REMARKS: c - Vi z DATE a INSPECTOR �o�aOP SOGIyO�o TOWN OF SOUTHOLD BUILDING DEPT. 'Gum, 631-765-1802 �ovl,� INSPECTION [ ] FOUNDATION .1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] SULATION/CAULKING [ ] FRAMING/STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ]' FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] -FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL . REMAR KS: qA.L, CQKv j,, DATE . INSPECTOR John Cronin, P.E. Engineering and Marine Consulting Capt.John C. Cronin,Jr., P.E. NYS Licensed Professional Engineer USCG Licensed Merchant Marine Officer P. O. Box 130 Shelter Island, NY 11964-0130 Voice: 631-252-1167 Email: capticcpe@optimum.net May 1, 2024 Mr. BJ Green 5330 New Suffolk Rd New Suffolk, NY BY EMAIL ONLY Re: Emergency Repairs for Foundation at Cited Address Dear Mr. Green: This letter is in response to recent communications with you regarding foundation conditions encountered at your home after contractor-based partial investigative excavation aound the north, east and south perimeters involved with the basement area. Further engineering investigation has revealed serious and stability-threatening deterioration of the block foundation. While our work had revealed significant weakening of the concrete masonry units (refer to our earlier comments of April 27 wherein Swiss Hammer testing revealed loss of compressive strength), further investigative excavation has exposed crumbling and entirely breached and perforated block. Observed conditions demonstrate a badly weakened foundation that requires immediate repair. In the professional engineering opinion of the undersigned this condition constitutes an EMERGENCY. Recognizing that obtaining a Building Permit from the local code enforcement authority is both a requirment of the NYS Building Code and a legal need, it appears the Town of Southold cannot issue a permit in a sufficiently timely manner to address the instability. None the less I advise your contractor to take the necessary steps to commence a repair plan while, simultaneously, fling the necessary douments to obtain a permit. Please feel free to include a copy of this letter with such filing. The repair work should attempt to comply as closely as possible with the requirments of Chapter 4 Foundations in the NYS Residential Code of New York State, and in particular the following: • Footing integrity • Use of anchor bolts • Use of grade 60#4 vertical rebar every 48" • Use of grade 60#4 horizontal rebar at mid-height and within 12" of the wall top • Full grouting of all block cells • Application of appropriate water proofing on the completed wall • Conveyance of all stormwater drainage away from the foundation I plan to make periodic visits to the site during the emergency repair effort and will coordinate such visits with your contractor. Please feel free to contact me with any further questions. ery//trul our .��,OF NEW y ( v� � 4'� O Q .SOPHER C John C. Cronin, Jr., P.E. * ���� �0y z Z O � � 058221 p'��FESSIONP� MELD INSPECTION REPORT DATE COMMENTS FOUNDATION (IST) --------------------------------- con FOUNDATION (2ND) ROUGH FRAMING & PLUMBING 55 ----- 4 at-= INSULATION PER N.Y. STATE ENERGY CODE FINAL Il ADDITIONAL COMMENTS -t—,-o c,+ 073L/ -4- 0 o�SUfFQ(�coG TOWN OF SOUTHOLD—BUILDING DEPARTMENT H x Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone (631) 765-1802 Fax(631) 765-9502 https://www.southoldtomDa.gov Date Received APPLICATION FOR BUILDING PERMIT � � � For Office Use Only »' �7 MAY - 6 2024 PERMIT N0. 5© (o / Building Inspector:- J'X� Applicatioris,and''forms must be filled out in their entirety:Incomplete applications wilt n6t be,accepted.•Where the Applicant is.nottFie owner,an Owner's Authorization form(Page 2)shall be completed; Date: p5 O Cf 2 t f OWNER(S)OF PROPERTY Name: �,�,,�.�. R r,�t-� SCTM#1000 -JF__I Project Address: 3 Phone#: — S 6 01 S Email: Mailing Address: CONTACT PERSON Name: Mailing Address: Phone#: 3 Z 6 '333 Lf- C& DESIGN POFESSIONAL:,INFORMATION Name: Mailing Address: 'Pp S(tEt'iZ. L ��_ \fit_ Phone#: 691 Z�- Email: ..CONTRACTOR INFORMATION Name: 11nn C _ Mailing Address: Phone#: 3 33._ Email: G T STv �1M_l«t.�_l,-_�.CL►�4 DESCRIPTION OF'PROPO,SED CONSTRUCTION ❑New Structure ❑Addition ❑Alterations epair ❑Demolition Estimated Cost of Project: ❑Other �F4VV0 1 at✓ ►Gt7'� i2 i �LG--fi l�i� $ 2�SdG Will the lot be re-graded? ❑Yes o Will excess fill be removed from premises? ❑Yes o 1 PROPERTY INFORMATION Existing use of property: rr--�� � Intended use of property: Zone or use district in which premises is situated: Are there any covenants aRckestrictions with respect to this property? ❑Yes 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 SHE 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 Widings,' additions,alterations or..for remoyal'or:demolition as herein described.The,appiicaot agrees to'complywith all applicable laws,ordinances,building code, housing code:and regulations and to admit authorized insped'ors'on premises,and in building(i)for necessary inspections.False statements made herein are punishable as"a Class A misdemeanor pursuant to Section210.45 of the New York State Penal Law. . Application Submitted By(print name): - SlGthorized Agent ❑Owner Signature of Applicant: Date: CONNIE D.BUNCH STATE OF NEW YORK Notary Public,State of New York SS: No.01 BU6185050 COUNTY OF ) Qualified In Suffolk County Commission Expires April 14,2Oa Fr 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. `Sw�o(rrn, before me this day of 20 2[ 7 Notary Public PROPERTY OWNER AUTHORIZATION (Where the applicant is not the owner) Brian Green 5330 New Suffolk Rd. I, residing at New Suffolk,NY Stuart Daccas (AMS) do hereby authorize to apply on my behalf to the Town of Southold Building Department for approval as described herein. 4ZZc Y4 as�0 6lz Owner's Signature Date Brian Green Print Owner's Name 2 IN K Workers' Certificate of Attestation of Exemption ATE Compensation p from New York State Workers' Compensation and/or Board Disability and Paid Family Leave Benefits Insurance Coverage "This form cannot be used to waive the workers'compensation rights or obligations of any party." The applicant may use this Certificate of Attestation of Exemption ONLY to show a government entity that New York State specific workers'compensation and/or disability and paid family leave benefits insurance is not required. The applicant may NOT use this form to show another business or that business's insurance carrier that such insurance is not required. Please provide this form to the government entity from which you are requesting a permit,license or contract. This Certificate will not be accepted by government officials one year after the date printed on the form. In the Application of Business Applying For: (Legal Entity Name and Address): Building Permit Ams Home Improvements LLC P 1549 Main Rd From:Town of Southold buildingde t 54375 main road Southold NY 11971 Riverhead,NY 11901-6006 PHONE:631-779-3727 FEIN:XXXXX1541 The location of where work will be uerformed is 5330 New Suffolk avenue,new Suffolk,NY 11901. Estimated dates necessary to complete work associated with the building permit are from May 7,2024 to June 21,2024. The estimated dollar amount of project is $10,001-$25,000 Workers'Compensation Exemption Statement: The above named business is certifying that it is NOT REQUIRED TO OBTAIN NEW YORK STATE SPECIFIC WORKERS'COMPENSATION INSURANCE COVERAGE for the following reason: The business is a LLC,LLP,PLLP or a RLLP;OR is a partnership under the laws of New York State and is not a corporation. Other than the partners or members,there are no employees,day labor,leased employees,borrowed employees,part-time employees,unpaid volunteers(including family members)or subcontractors. Partners/Members: stuart daccus Disability and Paid Family Leave Benefits Exemption Statement: The above named business is certifying that it is NOT REQUIRED TO OBTAIN NEW YORK STATE STATUTORY DISABILITY AND PAID FAMILY LEAVE BENEFITS INSURANCE COVERAGE for the following reason: The business MUST be either: 1) owned by one individual; OR 2) is a partnership(including LLC,LLP,PLLP,RLLP,or LP)under the laws of New York State and is not a corporation; OR 3) is a one or two person owned corporation,with those individuals owning all of the stock and holding all offices of the corporation(in a two person owned corporation each individual must be an officer and own at least one share of stock); OR 4) is a business with no NYS location. In addition,the business does not require disability and paid family leave benefits coverage at this time since it has not employed one or more individuals on at least 30 days in any calendar year in New York State. (Independent contractors are not considered to be employees under the Disability and Paid Family Leave Benefits Law.) I,stuart daccus,am the Member with the above-named legal entity. I affirm that due to my position with the above-named business I have the knowledge,information and authority to make this Certificate of Attestation of Exemption. I hereby affirm that the statements made herein are true,that I have not made any materially false statements and I make this Certificate of Attestation of Exemption under the penalties of perjury. I further affirm that I understand that any false statement,representation or concealment will subject me to felony criminal prosecution,including jail and civil liability in accordance with the Workers'Compensation Law and all other New York State laws. By submitting this Certificate of Attestation of Exemption to the government entity listed above I also hereby affirm that if circumstances change so that workers'compensation insurance and/or disability and paid family leave benefits coverage is required,the above-named legal entity will immediately acquire appropriate New York State specific workers' compensation insurance and/or disability and paid family leave benefits coverage and also immediately furnish proof of that coverage on forms approved by the Chair of the Workers'Compensation Board to the government entity listed above. SIGNI / HERE Signature: Date: 0,5106 l `1Y��^E,� k..' i �� 4}`�•~ uYnbr '�\•� ti � i y��, > ce r ved e Y RxenptlnCerficeN `` � Ma 2024 034267 >a h K,, Y. 62024 4Y4 N,c uX' `�:f�ih .� s`� �1,�n. i� Tx.' v�1. �Y�{ �T� y�.� .. tn} r ? r h M j NT;S Workers,Com--pensahonBoard, f �t,.,y} ',� �• y,;x Y� ' '� !4, `,.,, F. >7 `�`'S'*• ? `� ....�,`��.`Y, _ >�� �< Y \\ .�;;� �'y .•3:, ..r;'`y �'•-,`J .�" ri.� ��'„ ;ice>.p�x�. - ��z.,_ ,: ,�_ -r 4 _"� "�.,�..J -.u. ^�c`'� 'a. -' s�%-.. �� ,,�•r v,.jt CE-200 01/2018 ©ad PROVED AS NOTED laJrr�t� rzP` V� -F� 5B.P� 5o1�a7 I N01 IFY BUILDING DEPARTMENT AT / 631 765-1802 8AM TO 4PM FOR THE 4 ,- ,p FO OWING INSPECTIONS: /�`?r�e`✓�� ' '�� 1 cs�- '�' OUNDATION-'fWO REQUIRED OR POURED CONCRETE ROUGH-FRAMING&PLUMBING ' 0 INSULATION --- W i912rA-TP FINAL-CONSTRUCTION MUST f rL4•I l4Ca QYl} }��)/„F•,1 !J I BE COMPLETE FOR C.O. 7. fD ,� �`� D1�II? A CONSTRUCTION SHALL MEEPTHE RE UIREMENTS OF THE CODES OF NEW Y K STATE. NOT RESPONSIBLE FOR 1_ I _. N OR CONSTRUCTION ERRORS , , COMPLY WITH ALL CODES OF 40, ��- EW YORK STATE&TOWN CODES IS REQUIRED AND CONDITIONS OF S01liMTWJNZM wUiIl01D=AI=m w. ry -To 0�� 11-0 JOHN CRONIN PE �,pf NEw Engineering and Marine Consulting Q� Yo Additional �'t S�pPHER c .f� Capt.John C.Cronin,Jr.,P.E. ��\ �O Certification Licensed Professional Engineer,NY and N * y USCG Licensed Merchant Marine Officer) =o May Be Required. wo P.O.Box 1,30,Shelter island,NY 4,1964-0130 058221 captjccpe@optimttm.net 631-252-1167 OFESSIONP� 6/alb 5330 NEW SUFFOLK ROAD- NEW ALARMS FOR RENTAL PERMIT RENEWAL BASEMENT CARBON MONOXIDE ALARM- PLACED ABOVE MECHANICALS i Y \\ \ \ 111 �A 1 +E rs 7 _ z _ C� DEN SMOKE AND CARBON MONOXIDE ALARM i i OVERHEAD VIEW OF EXTERIOR LIGHT WELL 1 1 1 .i e E � �.f,��,�' � � �`� '��'' y. _ �t�I-Y. ,•� A.♦ Bey �r'; t i y L 4f���-�5f ���yyY mow.. a� 1. � _ 4r tia�"`r,��Xh tS I�� � •{ •. 1�:�µ•+a_ - tt• .64�_ /�-a - 1 �`�� ..._;,,yam,_ t ��- ',[.•� `�. 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