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Town of Southold 2/28/2019 r) =At P.O.Box 1179 53095 Main Rd l'?; ;,e;;J Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 40237 Date: 2/28/2019 THIS CERTIFIES that the building ALTERATION Location of Property: 2540 Bridge Ln., Cutchogue SCTM#: 473889 Sec/Block/Lot: 85.-2-23 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 4/9/2018 pursuant to which Building Permit No. 42609 dated 4/26/2018 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: interior alterations/repairs from flood damage and new windows in an existing one family dwelling as applied for. The certificate is issued to Spielman,Beverly of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED ut ed Signature TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE 4j 'VI ~`' � SOUTHOLD� NY � %';':� - "p\-'•fir' 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#: 42609 Date: 4/26/2018 Permission is hereby granted to: Spielman, Beverly 420 E 79 St New York, NY 10021 To: construct interior alterations/repairs from flood damage and replace windows to existing single-family dwelling as applied for. Any additional work will require additional approvals/plans. At premises located at: 2540 Bridge Ln., Cutchogue SCTM # 473889 Sec/Block/Lot# 85.-2-23 Pursuant to application dated 4/9/2018 and approved by the Building Inspector. To expire on 10/26/2019. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $250.00 CO -RESIDENTIAL $50.00 Total: $300.00 I pector Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings,property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1%lead. 5. Commercial building, industrial building,multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. 'Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957)non-conforming uses, or buildings and "pre-existing"land uses: 1. Accurate survey of property showing all property lines,streets,building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant.If a Certificate of Occupancy is denied,the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy-New dwelling$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00, Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,Businesses$50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential $15.00, Commercial$15.00 f Date. �l` --20 1 E3 New Construction: Old or Pre-existing Building: (check one) Location of Property: i�rJ q bn dae� La� l.,J U+C hr{� House No. Street Hamlet Owner or Owners of Property: 11'1 Suffolk County Tax Map No 1000, Section Gj Block Lot a�j Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: / V Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ �-(� c)Q Applicant Signature a / ✓ *pF SOUTy� * TOWN OF SOUTHOLD BUILDING DEPT. 7651602 INSPECTION [ ] FOUNDATION 1ST [ ] UGH PLEIG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: &PA UkOAOn 131 IA/f Dr?4 wa4 elms Aye, � S DATE INSPECTOR SOUIyo h� �O * * TOWN OF SOUTHOLD BUILDING DEPT. �ycourme 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ INAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: nn 4 � iA 1( y a/vjMfo-td DATE 10I ( u uo 1INSPECTOR �)J"()OVIAVQ FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION(1ST) ------------------------------------ 4 � FOUNDATION (2ND) z � o ROUGH FRAMING& PLUMBING .. INSULATION PER N.Y: V&00' VW440'� � STATE ENERGY CODE cow n cvyo-J- o%q - w FINAL �q ADDITIONAL COMMENTS t �fr— z rn '-o - z d -------------- TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD, NY 11971 —404s of Building Plans \ TEL: (631) 765-1802 Planning Board approval FAX: 631 765-9502 eve Southoldt wnny.gov PERMIT NO. 6 Check ' Septic Form N.Y.S.D.E.C.• Trustees C.O. pplication I� ood Permit Examined ,20 Single&Separate D �12 Truss Identification Form D Storm-Water Assessment Form 1�,aii Contact: Approved ,20\ Disapproved a/c ; .,- �l TOWN OF SUMOLD Phone: 910 Expiration ,20 Buildi ctor - - APPLICATION FOR BUILDING PERMIT Date , 20 INSTRUCTIONS a. This application MUST'be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises,relationship to adjoining premises or public streets or areas, and waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application,the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e.No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed.within 18 months from such date.If no zoning amendments or other regulations affecting the property have been enacted in the interim,the Building Inspector may authorize, in writing,the extension of the permit for an addition six months. Thereafter,a new permit shall be required. 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, or 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 for necessary inspections. (Signature of applicant or name,if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises �1-� (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on whichp oposed work will be done: �Q 9 `ho , Q v House Number StreefJ tainlet County Tax Map No. 1000 Section C3 Block a Lot o� 3 Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy- b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Addition Alteration Repair ,Removal Demolition Other Work_ -61crA Ju rnnc .4o, re m i (Descr' ion) `4. Estimated Cost Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units r 1 umber of`d_`weling�uAits on each floor L ' 7..._ PMd If garage, number of cars ,4 i 6`, If business, commercial or mixed occupancy, specify nature and extent each type of use. 7, Dimensions of existing structures, if any: Front 'T, -.-Tear Depth Height .Number of Stbries1141 s: ul Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories �8. Dimensions of entire new construction: Front _ _ Rear Depth Height Number of Stories' Size of lot: Front Rear Depth `1* Date of Purchase Name of Former Owner 1`�Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded? YES NO '� Will excess fill be removed from premises? YES NO 14. Names Owner of premises Address Phone No. Name of Arc ' ect Address Phone No Name of Contract Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO -K * IF YES, SOUTHOLD TOWN TRUSTEES'&D.E.C: PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey,to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? * YES NO * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OFS IAC, SM+l l being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the y 0c' In a 1V I, (Contractor,Agent, Corps to 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 knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. S orn to before me this �{ CEY L. DWYER t�1 day of NOTARY'BSC,STATE OF NEW YORK NO.01 DW6306900 N SUFFOLK COUNTY Notary Public COMMISSION EXPIRES JUNE 30,2 Signature of Applicant .�}w., �.,, : r r � �.� 4 D �L .},�,• cry. y ±� S �... :� _ � �5� _ �;_ .2 �-e�, ������ ��cQ t f t w P� � 2 t ffiy Iz MP ge af Vt Wk Y t s• m� fl �..r3 t} a i y w � s s ' °kVL '� g V2, fi f tiS e k t ,t jol s a • .43 rr e i �� �. ._ _ �� '� � .,. ''� '� � �� 1 6 ��e � ��1 ,li� J:' 1. 1,i gym!>:�t - *, �. �,����� � r` 5{t .'l. ►�s I!" � .i,� '{ `' r ` ; .�. �, � � r n � _ - �� �'v 1" . y 5 ��,_ �� k �tu-"�_ .� .. �. `i _ �_, -.:5°w _ y. �r � , i `{a� c9 ����� � �. ;. _� _- _� _- .. _-- __. -- __ � . r """ t i; [; ��-���1 �'� BUILDER'S JOB NO.,j&?6 lhTL.E NO. 0 fT KI ME EXISTENCE OF RIGHT Of WAY, AND OR/EASEMENTS OF RECORD, 1F ANY. NOT SHOWN ARE NOT 7257"WCP4. `° GUARANTEED. z N d • G %I ` ) 1-1 LU > ,Q : •. at '� v� cin. cf? c 5 A=l C) b w p CL i H ad 1p LL. Pd **j 4117, o r' W + .ASf'HAGT �tiM,'�'",bs4r�v'T wc� cq Ez..3'89 nro �� g q. w.��. �--• ¢9 THIS SURVEY WAS PREPARED lN1IACCORDANCE WITH THE EXISTING CODE OF PRACTICE FOR LAND SURVEYS ADOPTEDBY THE NEW YORK STATE. ASSO- CIA110N OF PROFESSIONAL LAND SURVEYORS. V-110 ye,All-I UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF L$CTiON 7209 SUBDIVISION 2 OF THE NEW YORK STATE EDUCATION LAW, COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYQR'$ INKED SEAL OR EM$OSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY, CERTIFICATIONS INDICATED HEREON SHALL RUN ONLY•TO, THE PERSON, FOR WHOM THE $URVEY IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HE EO AND TO THE ASSIGNEES OF THE LENDING INSTITUTION. CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBStQ�ENT, OWNERS. ' SUFFOLK COUNTY TAX MAP DIST.-/4900 9ECT.•--&5 BLK.-V >:.Q' 'ozl MAPND.�.r�IG? DATE QK. I � G ENGINEERS LOTS BLOCK ND RVEYORS MAP OF 1404/4o4AA? : ! i D ORD AVE. LOCATION: � TOWN OF,�t-�c�� cam, ��./�,�,� Co. /�,�.'�!• *°+y?� � � a�� 77� SURVEYS-Me7gV 70 CERTIFIED TO:IZJ,'z;Z/rte SCALE ,, FILE N©. �J �G HOWARD $1j#TON CO.. N. Y. C. 4808H Sr a -COUNTY CLERK'S CLERK'S OFFICE STATE OF NEW YORK COUNTY OF SUFFOLK I, JUDITH A. PASCALE, Clerk of the County of Suffolk and the Court of Record thereof do hereby certify that I have compared the annexed with the original BUSINESS CERTIFICATE filed in my office on 04/11/2017 - and, that the same is a true copy thereof, and of the whole of such original. In Testimony Whereof, I have hereunto set my hand and affixed the seal of said County and Court this 04/11/2017 SUFFOLK COUNTY CLERK JUDITH A.PASCALE SEAL 1 cut,o-s% a—OZ'£0 RVW S3'dldX3 NOISSIWWO-' U l ALNno:))11O3d(ls NI Q3I3Iltl[lb b8ZTZZ93Wt0.ON NAM M9 N H33W d O yid 1.2itllON ._ �p�axa papa(s)t�+��► q M&jo Ampq uadn uosmd 2*.io (s)pmpt&q=,IT'ia=ftasvi MR IIa(s)aaueaca Ate/ Sq IMP Poa`(sac)tutaedW=W=YM M ap Paenaa9ca,Sa4Nlaq PaIAP= at paq (ate)s<(s}aaffiotVA u �Mw (S)i�u►Ep� (p ; jo sesaq MD us M'o`pamad io=ai umamt,tl MOS12d X °� U pale Ciisuosad 'Dardis 'amaaojaq ` �a�C aq{ u< 1 ;o� L -Vvo _,ss 7�1 n�s xr � ( mox Alksm ao 3F.Y.Is (W-60E 7dw ams viol SRI of p2m2popmompv Ia�craS?SJ jo a*UD aORWM sap poiap aeEq I`3 gH&SSHLIM M saw :Iva of`aft jo SMA ggia um sal m I]age jo SMA wowso am ssal IOU m I falgvvgddvfi alajdwoZ)J -ssouesnq 3=wu ao iouaoo io uo km og anoqu pagraads (s)aum oqt Sutsn Ajsnox&aid (s)uosmd alp 04 asaaalU!ut xmmns aip=I TM 4q=jaqM I ` Te aPPM I PUB st a=u IIn.I�Tlii r uo,•r�csa zo aur a la un o o luno a ` inn w nna o a� a ui ssaussn �uga�su� so 'gapnpuoo um-lo ob Puaau! I Xqt)4q= Aganq I `of l § mwl snm Iudaua�, oa auensmd t N TOWN OF SHELTER ISLAND 38 North Ferry Road, P.O. Box 970 Shelter Island New York 11964 Reed Karen:Building Inspector Tel. (631)749-0772 J. Chris Tehan:Building Inspector Fax (631)749-9305 HOME IMPROVEMENT CONTRACTOR'S LICENSE THIS CERTIFIES THAT Beth Santillo 685 Sigsbee Road Mattituck, NY 11952-3319 santillobeth@vahoo.com 631-902-8821 is duly licensed under Shelter Island Local Law No. 1 of 1975 to perform general contracting in the Town of Shelter Island. LIC. # 1273 Dated: June 6, 2017 Expires: June 6, 2018 Red aren, Building Inspector © UTICA FIRST INSURANCE COMPANY CONSTITUTED IN OHIO AS UTICA FIRST INSURANCE COMPANY(MUTUAL) P.O.Box 851,Utica,NY 13503-0851 POLICY MAILER PAGE POLICY NUMBER: ART 5109539 00 B C HOME IMPROVEMENT BETH SANTILLO DBA 685 SIGSBY RD MATTITUCK NY 11952 For Sales and Service contact your agent: AGENT: 3326008 RIVERHEAD LIGHTHOUSE INC 221 WEST MAIN ST RIVERHEAD, NY 11901 631-369-9600 Additional policy forms: FORM NAME FORM NAME AP-100 (1.00) UTICA FIRST INSURANCE COMPANY Utica First is excited to introduce our new online "POLICY HOLDER SERVICE CENTER" As a Utica First Insurance policy holder, you will now be able to setup an on-line account that will allow you to access your policy information. This information includes: Policy Documents - View your policy on-line - View policy forms for new, renewals and endorsements Online billing and payment information - Pay your bills on-line -View billing statements View policy details View information for any claims associated with your policy Go Paperless - Easy access to your online account for your policy - Eliminate mail - Environmentally friendly View contact information for your Utica First Agent Available on-line 24 hours -7 days a week To access this new insured website you will first need to register by entering some basic policy information and the Online Access Code shown below. Policy Number ART 5109539 00 Mailing Address Zip Code 11952 Service Center Access Code 9 4 9 8 13 8 Instructions: Go to www.uticafirst.com and click the 'Policy Holder' tab. In the drop down menu click on 'Account Registration'. CONTRACTORS SPECIAL POLICY DECLARATIONS PAGE New Business Declaration UTICA FIRST INSURANCE COMPANY CONSTITUTED IN OHIO AS UTICA FIRST INSURANCE COMPANY(MUTUAL) Direct Billed- Insured Home Office-5981 Airport Road,Oriskany NY 13424 Mail Address-P.O.Box 851,Utica,NY 13503-0851 Policy Number: ART 5109539 00 Renewal of Number. StreetNAMED INSURED AND MAILING ADDRESS (Number County, tate,Zp aeity') Agent 3326008 B C HOME IMPROVEMENT RIVERHEAD LIGHTHOUSE INC BETH SANTILLO DBA 221 WEST MAIN ST 685 SIGSBY RD RIVERHEAD, NY 11901 MATTITUCK NY 11952 POLICY PERIOD:12:01 A.M.Standard Time at the Location of Designated Premises. 01/17/18 01/17/19 From To Item Prot. Rate Cons't Description and Location Number Class Group of Property Covered 1 PR 02 F Description: CARPENTRY Location: 685 SIGSBY RD MATTITUCK, NY 11952 County: SUFFOLK AGREEMENT In return for your payment of the required premium,we provide the insurance described in this policy. LIABILITY INSURANCE COVERAGE LIMITS ANNUAL PREMIUM Each Occurrence Limit $ 1,000,000 /per occurrence Medical Payment Limit $ 5,000 /per person General Aggregate Limit (other than Products/Completed Work) $ 2,000,000 Aggregate Limit (Products/Completed Work) $ 2,000,000 Fire Legal Liability $ 50,000 /per occurrence Personal and Advertising Injury $ 1,000,000 /per occurrence Property Damage Deductible $ 0 included PROPERTY INSURANCE COVERAGE DEDUCTIBLE LIMIT AUTOMATIC REPLACEMENT ACV PROTECTIVE ANNUAL INCREASE% COST DEVICES PREMIUM Building Business Personal Property Loss of Income Business Personal Property- Off Premises FORMS AND ENDORSEMENTS SEE FORMS INVENTORY PAGE ANNUAL FORM NUMBER DESCRIPTION PREMIUM BAI-1 Blanket Additional Insured (Contractors) Included $150 Minimum Retained Premium ANNUAL Name and Address SUB TOTAL $2,601.00 of Mortgagee: NYS Fire Fee $ 0.00 POLICY TOTAL $2,601.00 Our uthon epresentative Countersignature Date 01/25/18 AP-1(11-90)(REV 1/94) COMPANY COPY UTICA FIRST INSURANCE COMPANY FORMS INVENTORY PAGE CONSTITUTED IN OHIO AS Policy Number: ART 5109539 00 UTICA FIRST INSURANCE COMPANY(MUTUAL) Named Insured: B C HOME IMPROVEMENT Home Office-5981 Airport Road,Onskany NY 13424 Mail Address-P.O.Box 851,Utica,NY 13503-0851 Agent: RIVERHEAD LIGHTHOUSE INC 3326008 FORMS INVENTORY AP 0231NY (10/08) Exclusion - Water Damage PRIV0401 (04/01) Privacy Statement GL890LA (1.00) Asbestos Liability Exclusion XSP1 (12/96) Excl-Commercial Spray Painting AP-100 (1.00) Contractors Special Policy CP-380 (12/86) New York Amendments CP-382 (10/87) N.Y. Amend (Anti-Arson End't) GL-212 (01/87) Exclusion Explosion Collapse UFR-1 (07/11) Roofing Exclusion Endorsement AP 0643 (12/99) Known Injury or Damage Amend. AP 0233UF (01/08) Exclusion - War & Military Act AP 0851UF (09/09) Other Insurance Amendment AP 0852UF (09/09) Information Distribution and SNEXNY (1.00) Snow Removal Exclusion AP-0611 (01/99) Loss of Income 72WaitingPeriod XCNTR (1.00) Excl of Injury to Emp,Contract AP 0853UF (01/10) Exclusion-Communicable Disease AP 5454 (03/10) NY Amendatory Endorsement AP 0690 (06/02) EIFS Exclusion AP 0230UF (11/05) Silica Exclusion AP 0365UF (02/07) Virus Or Bacteria Exclusion AP 0700 (01/15) Certified Terrorism Loss CL 1045F (01/15) Notice of Terrorism Coverage CL 0605 (01/15) Certified Terrorism Prem Discl DN 0700T (01/15) TRIPRA Discl Notice TLBX (1.20) ToolBox Endorsement BAI-1 (1.10) Blanket Additional Insured Issued Date: 01/25/18 FORMINV 0609 COMPANY COPY .. AME' Riverhead Lighthouse,Inc. Q , 631-369-9600 ac No: 631-369-9678 221 West Main Street WC-ME-MAIL Riverhead NY,11901 ADD)�It ss' INSURENS)AFFORDING COVERAGE MAIC0 INSURERA:UITICA FIRST INSURANCE COMPANY INSURED INSURER B; EIC - BC HOME IMPROVEMENT INSURER C 685 Sigsby Rd INSURER D Matlituck, NY 11952 INSURER E: 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 13E ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERf.IS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR AODL SUBR POLICY EFF POLICY ExP { LTR TYPE OF INSURANCE I POLICY NUMBER I Mr.VDOlY'fYY I hthllDBIYYYY ! LIMITS GENERAL LIABILITY EACH CCCURRENCE 5 1000000 COh1h1ERCtA1 GENERAL LIABILITY PRE%CSES(Fa c�-Lur.OKe 9 --- 50000 A CLAIMS-MADE 0 OCCUR ti'RT5109539-00 1/17/18 01/17/19 MED EXP Iaer One pefun) S 1000 PERSONAL&ADV INJURY 5 2000000 GENERAL AGGREGATE __ S 2000000 GENL AGGREGATE LIMIT APPLIES PER PRODUCTS-CO?MPIOP AGG I S INC 17 POLICY PRO- LOC E AUTOMOBILE LIABILITY COMBINED SINGLE LItAIT L a accdent) S ANY AUTO BODILY INJURY(Por person) S ALL OVNiEb SChEDULED AUTOS AUTOS BODILY INJURY(Par accOenq S NON-01ANED PROPERTY DAMAGE HIRED AUTOS AUTOS UMBRELLA UAB i -(f OCCUR � EACH OCCURRENCE Is EXCESS LIAB CLAVAS.}AAOE AGGREGATE I DED RETENTION S I IILr,� WORKERS COMPENSATION 1tiC STATU- OTH AND EMPLOYERS'LIABILITY Y I N rp ANY PROPRIETORIPARTYER/EXECUTIVE r NIA E,L EACH ACCIDENT 5 OFFICERAIF—MUER EXCLUOP-07 — {Mandatery In NMI E L DISEASE-EA EMPLOYEE S Ie Ons. fPTION nc OOF OPERATIONS bNctiv E L.DISEASE-POLICY LIMIT I S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Addltlonal Remarks Schedule,If more apace Is required) HOMEIMPROVEMENT CERTIFICATE HOLDER CANCELLATION Tom Caruso SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 25 Oak Lane, ACCORDANCE WITH THE POLICY PROVISIONS. Sag Harbor, NY 11963 AUTNORlYEb 1'iEPRE NTATNE f ©1988-2t)1 AC RD ORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ORD p1 AP _ 0 ED AS,NOTED ELECTRICAL DATE: B.P:# INSPECTION REQUIRED FEE:- BY: -NOTIFY",BUILDING DEPART AT". 765=f802,:$"AM TO A PM; 'FOR'THE'+ _FOLLOWI 4.INSPECTION& 1. ,FOUNDATION.= TWO RE� 1AED 'FOR POURED CONCRETE '--- 2. ONCRETE '-2. ROUGH:=;:'FRAMING k PLUMBING 3. INSULATION - 4. FINAL - CONSTRUCTION MUST' BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE, FOR DESIGN 09 CONSTRUCTION ERRORS. q E,_, c' v - - - '',j u 4 .}ais t ) }fr(,,u-• ' - ' � " RETAIN STORM WATER RUNOFF PURSUANT TO CHAPTER 236 OF THE TOWN CODE. �. y :9i� '',1� _..1: •'�`�.�"a.�`��",:l}•41Y`=r•�1�'�"14�7�s''S!�-CS`L-''L - -- Y .\ _.� _ - _ `'4 1�� '`�- --3's'�_LSr•F,�.?�?<b)�+Y e�.3�'%?1:'):tif+tL'kti-1L?��,�_"4Lr,+,oSc�It '� _ - - �I o-G f n o•vrn Sof x. � s � � -�.i+wS•* •M'a•oMzS of h°-o,hobA£ •a ,.s- � ug -- � '- �5, • — —'�-�� -•-----•-i' a;9 -- I�;" — -b-zt -- - - -�-��•---- ,p--;,3;5-�! -- -8-�► � - --� ,- ' - - - - , r Q t 'i f. ate• J.oa ` t ��r_ •dn /- II ,� ,: pin' � , Ld Ok . .}`� .•-.• ala;f � _ I�a •� £ � f;d _ p-Z ru N `�j Q '' N N - •� -. - it o 9 0 �`, � N!pA m 'FC � ,• r s � p _w o; J -•�. -- _ �H��o,z,slH, ` i —o-s— O ® �-��� p a ��n � a . r r. N a rx• m r �_ h' IO t 0 - f• i 00-,�!L C1.�9 " ��• 1tv00� d•�� 0 j� I . %x_i-�% ••� �_ — 01-02 !--— a 2 �' ., ` IJ �\:' -Q#�H 47X2•L I .,-Z{l — �'l[,'N TAk \`\ (7. 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LLLJ , _ III I'Iry 1II I I _ - _ _ CHDF4iZ-SkiINGLC l o,� i II f I tl t I I I , f II I i I I � 1 I oJ�--- 1 APPROVED AS NOT Dg DATE: J Bd i d -- DEOTIFY DEPARTMENT AT 17 -- b60 )AM to 4PM FOR REQUIR- - - -- - 7()5.2 ED INSPECTIONS: I BEFORE BACKFILLING FOU NDA• _- -'--"" TION OR START FRAMING 2.FRAMING INSPECTION ORE COVNG P;F:S ANY KIND 3,BEFERIETED VHEm , D IBLE FORPESIGN 4,FINAL NO7 RESP 15 OR CON5TRUCTI ON ERRORS - -� — — ^— -- 5.ALL CONSTRUCTION MUST MEET REQUIREMENTS OF NY. STATE CODE AND TOWN KOU5ING CODE&ZONING rY CtN�'•C„t:�:�"covl€rizii6'V? s ci Larr� _��� J�� T TLlt-`� S N r\ a g q• T C1 4 c1-Q� 4O"NEIY C _ M`rSns E�O•p C.O Lr0 N 1 A�.,, .?(11'..�T ��r r' >•�� ��- •r -0ESlcz.r.1is, �` 4>Y'1'16 r� 1 v i '7 • �...,... _...._ _.......� ,_,�, SuF`Fotik�o�ySULZ'�hl•CS�pC.S\G1V� - ;\�'•�J Standard Width= RO: 36 7/16" fir:--' Anderseni =' 1=_�_ —ii(S' UNIT: 35 15/16" WINDOWS-DOORS Standard Height= RO: 36 7/16" tClrrerican UNIT:35 15/16" t - I" to smart Andersen.••` . . t �, p! Frame Width=35 15/16 Frame Height=3515/16 =till*`ie;s-rte --�-- 200-1 70 Series NF Single Casement-70NCW1, Left,35.9375 x $285.79 $_242.90 1 ($42--89)" $242.90 35.9375,/White- White Begin Line 200 Description ----Line 200-1-- 70 Series NF Single Casement-70NCW1 Glass Construction Type=Dual Pane Drywall Return=No Overall Rough Opening=36 7/16"x 36 7/16" Glass Option=Low-E Extension Jamb Type=None Overall Unit=35 15/16"x 35 15/16" High Altitude Breather Tubes=No Re-Order Item=No Installation Zip Code=11901 Glass Strength=Standard Room Location=None U.S.ENERGY STAR®Climate Zone=North Central Glass Tint=No Tint Unit U-Factor=0.29 ENERGY STAR Required=No Specialty Glass=None Unit Solar Heat Gain Coefficient(SHGC)=0.22 Standard Width=R0:36 7/16" 1 UNIT:35 15/16" Gas Fill=Air U.S.ENERGY STAR Certified=Yes Standard Height=RO:36 7/16" 1 UNIT:35 15/16" Fmelight Grilles-Between-the-Glass Clear Opening Width=23.75 Frame Width=35 15/16 Colonial Clear Opening Height=30.688 Frame Height=35 15/16 Grille Pattern=Colonial Clear Opening Area=5.061 Unit Code=211x211 Exterior Grille Color=White SKU=261615 Venting/Handing=Left Interior Grille Color=White Vendor Name=S/0 SILVER LINE BLDG PRD Hinge Style=Hinge with Wash Mode 3W3H Vendor Number=60660514 Hinge Type=Standard Performance Rating=PG30 Customer Service=(888)888-7020 Exterior Color=White Insect Screen Type=Full Screen Catalog Version Date=03/01/2018 Interior Finish Color=White End Line 200 Description f _j Standard Width= RO:381/4" UNIT: Andersen. 373/4 WINDOWS-DOORS Standard Height= R0:521/2" Am.erican UNIT.52" Cransm3ari'Asa i I A:I----� Andersen., �.••o., ? (. n ';h, Frame Width=37 /4 Frame Height=52 t'u"!0v Ve'SIGP;Y �$c• a."I _ g`�' 300-1 70 Series NF Double-Hung-3001,3901 Equal Sash, AA, $298.44 $253.65 6 ($268.74) $1,521.90 37.75 x 52,/White- White Begin Line 300 Description ---Line 300-1---- 70 Series NF Double-Hung-3001,3901 Specialty Glass=None Extension Jamb Type=Interior Extension Jamb Overall Rough Opening=381/4"x 521/2" Gas Fill=Air Extension Jamb Profile=Standard Overall Unit=37 3/4"x 52" Finelight Grilles-Between-the-Glass Extension Jamb Species=Pine Installation Zip Code=11901 Colonial Extension Jamb Color=Primed U.S.ENERGY STAR"Climate Zone=North Central Grille Pattern=Colonial Overall Jamb Depth Range=4 9/16"to 6 11/16" ENERGY STAR Required=No Exterior Grille Color=White Overall Jamb Depth=4 9/16" Standard Width=R0:38 1/4" 1 UNIT:37 3/4" Interior Grille Color=White Extension Jamb Configuration=Complete Unit Standard Height=R0:52 1/2" 1 UNIT:52" 3W2H Extension Jambs Frame Width=37 3/4 Number of Sash Locks=Double Extension Jamb Application Location=Factory Page 2 of 3 Date Printed:4/4/2018 8:00 PM „= I' Standard Width ”= RO: 36 7 16 l J Andersen nkaI°` —'t': --' UNIT. 3515/16" WINDOWS-DOORS Standard Height= RO:36 7/16" erican - ;; UNIT: 3515/16" Frame Width=3515/16 Frame Height=3515/16 s .Q 6' r�* '.��"�$. .,... .�a,'6�`x� ;��.-.s'��i'�.x�,����'•^."��:.2i_.. t3• ;;� - .•.m . - z- .- �.f, s� y', i - e';,'. �• H".x.- -gin; g w v,.' x�y,':.. :r��` *���'., �:�' 4 :S?,`�„` � 0 9:t' � -� 200-1 70 Series NF Single Casement-70NCW1, Left,35.9375 x $285.79 $242.90 1 ($42.89) $242.90 35.9375,/White- White �" � ''�`ti <��y.N ,.A & •�^�r'" .ask; '" 3..'� '''�"v.;;��'� .,����� a-., � +y,,.:..,-;i s�'=.:.� c �^'S;A',•.,,�i- 4 Begin Line 200 Description ----Line 200-1-- 70 Series NF Single Casement-70NCW1 Glass Construction Type=Dual Pane Drywall Return=No Overall Rough Opening=36 7/16"x 36 7/16" Glass Option=Low-E Extension Jamb Type=None Overall Unit=35 15/16"x 35 15/16" High Altitude Breather Tubes=No Re-Order Item=No Installation Zip Code=11901 Glass Strength=Standard Room Location=None U.S.ENERGY STAR®Climate Zone=North Central Glass Tint=No Tint Unit U-Factor=0.29 ENERGY STAR Required=No Specialty Glass=None Unit Solar Heat Gain Coefficient(SHGC)=0.22 Standard Width=R0:36 7/16" 1 UNIT:35 15/16" Gas Fill=Air U.S.ENERGY STAR Certified=Yes Standard Height=RO:36 7/16" 1 UNIT:35 15/16" Finelight Grilles-Between-the-Glass Clear Opening Width=23.75 Frame Width=3515/16 Colonial Clear Opening Height=30.688 Frame Height=3515/16 Grille Pattern=Colonial Clear Opening Area=5.061 Unit Code=211x211 Exterior Grille Color=White SKU=261615 Venting/Handing=Left Interior Grille Color=White Vendor Name=5/0 SILVER LINE BLDG PRD Hinge Style=Hinge with Wash Mode 3W3H Vendor Number=60660514 Hinge Type=Standard Performance Rating=PG30 Customer Service=(888)888-7020 Exterior Color=White Insect Screen Type=Full Screen Catalog Version Date=03/01/2018 Interior Finish Color=White End Line 200 Description (;s , ^^ Standard Width= RO:38 1/4" ( UNIT: L AndersenA: .� ' (`''' `.;j , ;:; 373/4" WINDOWS-DOORS Standard Height RO:521/2" J A erican ,; UNIT: 52" __. Cra Sman ,..... Frame Width'_ _ dth=37 3/4 ane I ' ,E^, Frame Height=52 .r 7�?T-M- I . . . a ;z„e;s`.r-t,,:',�+d+''.. `"y '.}A„�:�;. ��? 300-1 70 Series NF Double-Hung-3001,3901 Equal Sash, AA, $298.44%* $253.65 6 ($268.74) $1,521.90 37.75 x 52,/White- White s- �4.*`v,a r 0 t "'-i`w.m°. a :'-.a•,.4,' "+ ,s," `4°'�' 'z ^l, - , " ."` rr '�'S#A:.,.sv. ' Begin Line 300 Description ----Line 300-1---- 70 Series NF Double-Hung-3001,3901 Specialty Glass=None Extension Jamb Type=Interior Extension Jamb Overall Rough Opening=381/4"x 521/2" Gas Fill=Air Extension Jamb Profile=Standard Overall Unit=37 3/4"x 52" Finelight Grilles-Between-the-Glass Extension Jamb Species=Pine Installation Zip Code=11901 Colonial Extension Jamb Color=Primed U.S.ENERGY STAR°Climate Zone=North Central Grille Pattern=Colonial Overall Jamb Depth Range=4 9/16"to 611/16" ENERGY STAR Required=No Exterior Grille Color=White Overall Jamb Depth=4 9/16" Standard Width=RO:381/4" UNIT:37 3/4" Interior Grille Color=White Extension Jamb Configuration=Complete Unit Standard Height=RO:521/2" UNIT:52" 3W2H Extension Jambs Frame Width=37 3/4 Number of Sash Locks=Double Extension Jamb Application Location=Factory Page 2 of 3 Date Printed:4/4/2018 8:00 PM rd Floor 261111 —121611- 12' 7" Left Rear Bedroom Right Rear Bedroom �-3',4,1 3' 4"--i 3, 3' Left ar Bedr m Cl Righl I ar Bim} m Cl 818111 11811 12' 1 Hallway 12' 3"t-4' g.. Bathroom T to Aef { 11' 8" � N Master Bedroom erg et 1.0 � -cn Left Front Bedroom 31 Middle Closet 141511 [� 321911 - - ?nd Floor BEVERLY SPIELMAN 3/21/2018 Page:25 tin Level L} �C)r, l "I �--- 61311--� 5' 8" o 51911— 21 11" .c 8' 1" 2' it o, Kitchen Dining Room iv }-4' 1 t► t tt I.-81 6" M an ry - 121811- -r 2' 8"`r + 16' 5" Bathroom �O N 611111 - M 3 ' 9 ' (V C Living Room 60 °O "cn -- JL Le_ = ft Room 1218" 19' 6" 3312" Main Le,,,ei BEVERLY SPIELMAN 3/21/2018 Page:24 Basement 311211 Basement 00 � N N 20' 2"— Garage 10' 411— Basement 0' 4" Basement BEVERLY SPIELMAN 3/21/2018 Page:2(