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HomeMy WebLinkAbout43399-Z Town of Southold 4/16/2019 0 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 40329 Date: 4/16/2019 THIS CERTIFIES that the building ALTERATION Location of Property: 6520 Skunk Ln, Cutchogue SCTM#: 473889 Sec/Block/Lot: 104.-5-4.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 1/17/2019 pursuant to which Building Permit No. 43399 dated 1/17/2019 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 to an existing one family dwelling as applied for. The certificate is issued to Cifarelli,Richard of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 43399 12/3/2012 PLUMBERS CERTIFICATION DATED 4/10/2019 M ituck Pl bmg ,--"'AutVriAed Signature i f7 TOWN OF SOUTHOLD SUffQi BUILDING DEPARTMENT ao� oGy� C11 TOWN CLERK'S OFFICE o . SOUTHOLD, NY o , 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#: 43399 Date: 1/17/2019 Permission is hereby granted to: Cifarelli, Richard PO BOX 389 Cutchogue, NY 11935 To: Alter kitchen & two bathrooms as applied for. Replaces BP# 39561 At premises located at: 6520 Skunk Ln SCTM #473889 Sec/Block/Lot# 104.-5-4.1 Pursuant to application dated 1/17/2019 and approved by the Building Inspector. To expire on 7/18/2020. Fees: PERMIT RENEWAL $165.60 Total: $165.60 r Building In sp TOWN OF SOUTHOLD �� oG BUILDING DEPARTMENT C* TOWN CLERK'S OFFICE o • 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#: 39561 Date: 2/27/2015 Permission is hereby granted to: Cifarelli, Richard PO BOX 389 Cutchogue, NY 11935 To: alter kitchen &two bathrooms as applied for At premises located at: 6520 Skunk Ln, Cutchogue SCTM # 473889 Sec/Block/Lot# 104.-5-4.1 Pursuant to application dated 2/27/2015 and approved by the Building Inspector. To expire on 8/28/2016. Fees: PERMIT RENEWAL $165.60 Total: $165.60 din inspe Su=Fot TOWN OF SOUTHOLD /(, BUILDING DEPARTMENT TOWN CLERK'S OFFICE co o . • 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#: 37349 Date: 7/9/2012 Permission is hereby granted to: Kohn, Barbara PO BOX 389 Cutchogue, NY 11935 To: alter kitchen & two bathrooms as applied for At premises located at: 6520 Skunk Ln, Cutchogue SCTIVI # 473889 Sec/Block/Lot# 104.-5-4.1 Pursuant to application dated 6/22/2012 and approved by the Building Inspector. To expire on 1/8/2014. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $331.20 CO -ALTERATION TO DWELLING $50.00 Total: $381.20 Building Inspector 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 DepL 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) tion-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 cpmpleted 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, E 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 Date. New Construction: Old or Pre-existing Building: (check one) Location of Property: b6go n House No. Street Warrilet Owner or Owners of Property. Suffolk County Tax Map No 1000, Section_ O Block �7 Lot L/, Subdivision Filed Map. Lot: Permit No. 0 Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Subinitted: $ —/ Applicant Sig -e pF SO(/j�,®l® Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O. ox 117 Southoldld,,NY 119711-0959 G ® roger.richerta-town.southold.nV.us �` � ®lac®UNTY,�c� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To. B Kohn Address: 6520 Skunk La (80 Haywater) City: Cutchogue St: NY Zip: 11935 Budding Permit#: 14'�)� CyJ 37349 Section: 104 Block: 5 Lot. 4.1 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE contractor: DBA: First Class Electric License No: 34075-me SITE DETAILS Office Use Only Residential X Indoor X Basement Service Only Commerical Outdoor 1st Floor X Pool New Renovation X 2nd Floor Hot Tub Addition Survey Attic Garage X INVENTORY Service 1 ph Heat gas Duplec Recpt 8 Ceding Fixtures 2 HID Fixtures Service 3 ph Hot Water elec GFCI Recpt 3 Wall Fixtures 2 Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures 5 CO Detectors Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliancesdw Dryer Recpt Emergency Fixtures Time Clocks Disconnect F1 Switches 9 Twist Lock Exit Fixtures TVSS Other Equipment. 3-exhaust fans Notes: Inspector Signature: Date: Dec 3 2012 J 81-Cert Electrical Compliance Form.xls �` Vre Telephone(631)765-1802 P.O.Box 1179 'Par(fill11 7MA—09 Southold,NY 11971-0959Uzz '< '. BUaZING DEPA.RTMEW ; APR 1 6 � TOWN OF SOUTH[O]GD { 2019 ; CERTIFICATION " Date; /0 l ,Building Permit No; Owner -- (Please pr' -Plumber: �c�. �v C �v - -(Please print) I certify that the solder used•in the water supply system contains less than 2/10 of 1% lead. .' (Plumbers Signature) Sworn to before me this day of �w :20 ' j CHELSEA L. CHALONE Rotary Public, State of New York Registration#01CH6287106 Qualified In Suffolk County Commission Expires Aug. 5, 20 Notary-Public J c� �= C6, unty f•°, , ,. ;; cou TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION I FOUNDATION I ST Vr-R-OUGH PLI3G. "ODATION 2ND INSULATION FRAMING/STRAPPING FINAL FIREPLACE & CHIMNEY FIRE SAFETY INSPECTION FIRE RESISTANT CONSTRUCTION FIRE RESISTANT PENETRATION ELECTRICAL (110 ELECTRICAL (FINAL) REMARKS:_ 7 <�w LLd=L Q_s 7-� �L DATE -INSPECTOR 3 7 fjf so TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPEC MN ] FOUNDATION IST 17ROUGH PLBGi. FOUNDATION 2ND INSULATION FRAMING/STRAPPING FINAL FIREPLACE & CHIMNEY FIRE SAFETY INSPECTION FIRE RESISTANT CONSTRUCTION FIRE RESISTANT PENETRATION ELECTRICAL (ROUGH) ELECTRICAL (FINAL) REMARKS:- 06r DATE INSPECTO o OF SO(/lyolo , G TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING/STRAPPING [ ] FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) 43X4,,ELECTRICAL (FINAL) REMARKS: oCC DATE t� f INSPECTORF-` Ll q SOUIyo� # # TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION - FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] SULATION [ ] FRAMING /STRAPPING [ FINAL Aa�k f [ ]- FIREPLACE & CHIMNEY [ ] FIRE SME"TYWASPFECT^O [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: vn 1)z DATE ? INSPEC OR �aOF SOOIyo TOWN OF SOUTHOLD BUILDING DEPT. �ycou765-1802 - INSPECTION - FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I ULATION [ ] 4,1 FRAMING /STRAPPING [ FINAL IL� � � tis � 1 [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: DATE INSPECTOR 1. ! ! 0 � • 13 • 1 1. 1r_ • •UGH FPA"G : r PLUMBING l i • STATE ENERGY CODE VQRAUr ADDITIONA COMMENTS a ' rA ti �1t • 06/04/2012 11:44 7656641 BOARD OF TRUSTEES PAGE 02 TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL 33 (. Board of 1Hfealth SOUTHOLD,NY 11971 4 sets of Building Plans TEL:(631)765-1802 Planning Board approval FAX:(631)765-9502 survey. SoutholdTown.NorthFork.net PERMIT NO, Check Septic Form N.Y.S,D.E.C. Trustees C.O.Application Flood Permit Examined —,20 Single&Separate Storm-Water Assessment Form ' � Contact: Approved 20 Mail to: Disapproved a/c y Phone: 7—L,(,q Bxpiratlon , 20# 7r&DIt Building nspectorAPPLICATION FOR BUILDING PERNIIT INSTRUCTIONSDate mplotely filled in by typewriter or in ink and submitted to the Bullding Inspector with 4 sets oFee according to schedule. T(h'� 1�� lot and of buildings on premises,relationship to adjoining premises or public streets or areas,and waterways, Q.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 promises 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 perm it shall be required. APPLICATION 1S 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. J r (Sign re of ap Hcant o ate,If a corporation) (Mailing addfels of&icaat) State whether applicant is owner,lessee,agent,architect,engineer,general contractor,electriclau,plumber or builder a Name f owner of premises (As on the tax roll or latest deed) U 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. Loca 'on of land on which proM�u-sed work will be done: House Number Street Lr _., 06/04/2012 11:44 7656641 BOARD OF TRUSTEES PAGE 03 Subdivision Filed Map No. Lot „State existing use and occupancy of premise and intended a and o.eupancy of proposed construction: a. Existing use and occupancy a.�r %t�k ,✓ b. Intended use and occupancy 411 f Nature of work(check w iclt applicable):New Building Addition Alter Repair al Demolition Other We (Veserlption r „,i!Estimated Cost Fee (Tobe paid on filing this application) If dwelling,number of dwelling units_ Numbcr of dwelling units on each floor If garage, number of cars ,fi-'If business,commercial or mixed occupancy,specify nature and extent of each type of use. ,X'Dimensions of existing structures,if any:Front Rear ey ---Depti' Height Number of Stories ,,-Dimensions of same structure with alterations or additions: Front Rear Depth Heigh Number of Stories Dimensions of entire new construction:Front Rear Depth Height Number of Stories ..(Size of lot:Front ����-Rear Depth U' Date of Purchase VO//Name of Former Owner ��U Zone or use district in which premises are situated -W.boes proposed construction violate any zoning law,ordinance or regulation?YES ANO ' Al-Will lot be re-graded?YES 0 Will excess fill be removed from premises?YES N 1'N,ames of Owner of premises ��4ddress ®� � . Name of Architect Address Phone No �03f Jp T Name of Contractor_ Address Phone No. a.Is this property within 100 feet of a tidal wetland or a freshwater wetland? YES __NO— * O�— *IF YES,SOUTHOLD TOWN TRUSTEES&D.E.C.PERMITS MAY BE IRED. b.Is this property within 300 feet of a tidal wetland?R YES NO *IF YES,D.E.C.PERMITS MAY BE REQUIRED. 1 Provide survey,to scale,with accurate foundation pian and distances to property lines. -1-17'lf elevation at any point on property is at 10 feet or below,must provide topographical data on survey. rAre there any covenants and restrictions with respect to this property?*YES NO *IF YES,PROVIDE A COPY. STATE OF NEW YORK) SS: COuNn� F � / E �„Q/ / _being duly sworn,depose and says that(s)he f the applicant arae of individ 1 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 makg@ARW1 dl} filWn; that all statements contabaed in this application are true to the best of his knowledge and belief, Stliftof New York performed in the manner set forth in the application ,filed therewith. No.01 BU6185050 Qualified in Suffolk County m' i Sworn to before me ti' Commission Expires April 14,2A (o --day of r✓ 20 fs� �n�^/ Y6 ,L1jPt&t­, I$S Town HoU Am= Telephone(631)7 02 54375 Main Road P.O.Box 1179 mroger. ,ax R6_xw(6n'NZ6uT95o1nv.us. Soudiold,NY 11971-0959 BUMDING DEPARTAffNT TOWN OF 89tiMOLD APPLICATION FOR ELECTRICAL INSPECTON REQUESTED BY: Q>mpany Name, Name: License No.: Address-- Phone Na.. 11—41(_92;L 41 ....................I __ J013.81TE INFORMATION: (1ndicates required'Information) *Name.- *Address, *Crass Street; *Phone No-- Permit No.: 3 Tax-Map District: 1000 See on:.– 0 Block: Lot: *BRIEF DESCRIPTIO OF WORK(Please Print Clearly) iplease Circle All That Apply) *Is job ready for inspection: No �Ough D *Do-you need a Temp.Certificate. in Final YES NO _ Tamp information(it needed) *SerVICe Size: 1 Phase 3Phase 1001 0 200 300 350 400 other 10 'New Service: Re-connect Underground �tjl(IerofMeters Change of Service Overhead Additional Informaffon: PAYMENT ni 11z WIT14APPLIGATION VLC �� ,82-Request for Inspection Form # 6EbE665L166 �� Z6 Z6-5Z-LO To-Connie Page 1 of 2 2012-06-25 16.31:00(GMT) 19175913431 From-Richard Cifarelli FAX COVER SHEET TO Connie COMPANY FAX NUMBER 16317659502 FROM Richard Cifarelli DATE 2012-06-2516:30:35 GMT RE 80 Haywaters Cutchogue COVER MESSAGE Richard Cifarelli 917 664 6854 r Southold Town Building Department P.O.Box 1179 Permit#: 37349 .{ 53095 Main Rd Cm ! Southold,New York 11971 Permit Date: 7/9/2012 'frjol �ao� (631)765-1802 Expiration Date: 1/8/2014 Parcel ID: 104.-5-4.1 BUILDING PERMIT RENEWAL LETTER Dated: 2/11/2015 Applicant: Kohn, Barbara Location: 6520 Skunk Ln, Cutchogue Work Description: ALTERATION alter kitchen&two bathrobms as applied for A FEE OF $165.60 IS REQUIRED TO RENEW THIS BUILDING PERMIT. Owner: Kohn, Barbara Address: PO BOX 389 Cutchogue,NY 11935 The permit listed above has expired. No work is permitted or authorized beyond the expiration date. Please submit the above fee made payable to the Town of Southold. Mail to the Town of Southold Building Department, P.O. Box 1179, Southold, New York 11971 THANK YOU, SOUTHOLD TOWN BUILDING DEPT. r,ra;7-- Southold Town Building Department �4�guEFOl,tc�G�, P.O.Box 1179 Permit#: 39561 53095 Main Rd w Southold,New York 11971 Permit Date: 2/27/2015 o4,y �yy4�� (631) 765-1802 Expiration Date: 8/28/2016 Parcel ID: 104.-5-4.1 BUILDING PERMIT RENEWAL LETTER Dated: 1/3/2019 Applicant: Cifarelli,Richard Location: 6520 Skunk Ln, Cutchogue Work Description: ALTERATION alter kitchen&two bathrooms as applied for A FEE OF $165.60 IS REQUIRED TO RENEW THIS BUILDING PERMIT. Owner: Cifarelli, Richard Address: PO BOX 389 Cutchogue,NY 11935 The permit listed above has expired. No work is permitted or authorized beyond the expiration date. Please submit the above fee made payable to the Town of Southold. Mail to the Town of Southold Building Department, P.O. Box 1179, Southold, New York 11971 THANK YOU, SOUTHOLD TOWN BUILDING DEPT. pF SOUj�®l Town Hall Annex Telephone(631)765-1802 54375 Main Road N Fax(631)765-9502 P.O.Box 1179 G • Q Southold,NY 11971-0959 �Q Comm BUILDING DEPARTMENT TOWN OF SOUTHOLD January 30, 2019 Richard Cifarelli PO Box 389 Cutchogue NY 11935 TO WHOM IT MAY CONCERN: The Following Items(if Checked)Are Needed To Complete Your Certificate of Occupancy: Electrical Underwriters Certificate A fee of$50.00. Final Health Department Approval. Plumbers Solder Certificate. (All permits involving plumbing after 4/1/84) Trustees Certificate of Compliance. (Town Trustees#765-1892) Final Planning Board Approval. (Planning#765-1938) Final Fire Inspection from Fire Marshall. Final Landmark Preservation approval. Final inspection by Building Dept. Final Storm Water Runoff Approval from Town Engineer BUILDING PERMIT —43399 - Alteration -_�, q I Client#:360332 MATTIPLU4—� ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYI) 3/28/2019 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(les)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 any rights to,the certificate holder in lieu of such endorsement(s). PRODUCER" " CONTACT ; NAME: USI,Insurance Services-Con --r PHONE 516 419-4000 FAX 877,727-5171 AIC No Ext: (AlC,No 333 Earle Ovington Blvd.,Suit k® 1 ti aDORIEss: 800 Uniondale, NY 11553 � INSURER(S)AFFORDING COVERAGE NAIC# _ INSURER A:Merchants Mutual Insurance Company 23329 INSURED 6 eulj INSURER B•Merchants Preferred Insurance Company 12901 Mattituck Plumbing&Heating C INSURER C: P.O.Box 1429 INSURERD: Mattituck, NY 11952 Y'", T. 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 CONTRACTOR 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. LTRR TYPE OF INSURANCE NSRADDLSUBR WVD POLICY NUMBER MMIDDY EFF MM/DDY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY X BOP9091992 04/01/2019 04101/2020 EACH OCCURRENCE $110001000 CLAIMS-MADE ®OCCUR PREMISES Eaoccu ence $500,000 MED FRCP(Any one person) $15,000 PERSONAL&ADV INJURY $1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,000,000 X POLICY F JECT_ LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER $ B AUTOMOBILE LIABILITY XCAP9265648 4/01/2019 04/01/202 COMBSINGLE Ea accidentd."t) $1,000,000 X ANY AUTO, - BODILY INJURY(Per person) $ -OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPER RTY AUTOS ONLY X AUTOS ONLY Per accidentDAMAGE $ A X UMBRELLA LIAB X OCCUR X CUP9139509 04/01/2019 04/0112020 EACH OCCURRENCE $1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $1,000,000 DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER_ ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT 1$ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate of Insurance CERTIFICATE HOLDER CANCELLATION Richard Cifarelli SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO BOX 389 ACCORDANCE WITH THE POLICY PROVISIONS. Cutchogue,NY 11935 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S25330950/M25316220 HZVZP n r I w z 4-1 4 v cn N JA ILL. r . z4 I i 4� PLUMBING AL s PLUMBING WASTE Z &WATER LINES NEED O) TESTING BEFORE C0'1E13!NG O --(PLUMBER CERTIFICATION Q3 ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY 121340 , 24 3'Z — � SOLDER USED IN WATER SUPPLY SYST ISA CAN O • \ _ EXCEED 2Il b OF 1%LEAD. N 42 " t 43 -� �IyN I III L J IJ aS ! ty 3- 2 x CC 10 1i� li � Gvl � l� 3!0 Or tW APPROVED AS NOTED �fc ' :V DATE B,P.# 7 I ' L }' FEE: BY ) t2 rle- I �/ N h�)TIFY Bull DING nEP4R i MFNT AT I 7�-,' P`2 o rAtvl TO 4 PM FOR THE I 1 't JUNDATION�-TWOEC REQUIRED I FOR POURED CONCRETE I C 2 POUGP-FRAMING,PLUMBING, , L TRAPPING, ELECTRICAL&CAULKING 3 INSULATION I 4 FINAL•CONSTRUCTION&ELECTRICAL -- MUST BE COMPLETE FOR C.O. C040 2 e40 ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW k _ — YORK STATE, NOT RESPONSIBLE FOR t i 1 �2 wi DESIGN OR CONSTRUCTION ERRORS, ELECTRICAL KI(QDW y �4 °. Q52519 pFES S lolA w45lIvu e6® G . p, ` DP, CUTc HC CA U E SCALE: ,J/� f .f1IB APPROVED BY: DRAWN BY DATE:j U C— 114(D1 REVISED DRAWING NUMBER i D� 1