HomeMy WebLinkAbout45217-Z �1yFF0(
Town of Southold 10/11/2020
P.O.Box 1179
W 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 41512 Date: 10/11/2020
THIS CERTIFIES that the building WINDOWS
Location of Property: 335 Calebs Way Unit P53, Greenport
SCTM#: 473889 See/Block/Lot: 40.1-1-53
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
9/4/2020 pursuant to which Building Permit No. 45217 1 dated 9/17/2020
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:
one window replacement to existing single-family dwelling as applied for. (Unit 053).
The certificate is issued to Arnold,Craig
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
A o ed i ature
TOWN OF SOUTHOLD
��ot�gllEFO(,�c0, BUILDING DEPARTMENT
y z 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#: 45217 Date: 9/17/2020
Permission is hereby granted to:
Arnold, Craig
335 Calebs Way 53
Greenport, NY 11944
To: install window replacements to existing single-family dwelling as applied-for.
At premises located at:
335 Calebs Way Unit P53, Greenport
SCTM # 473889
Sec/Block/Lot# 40.1-1-53
Pursuant to application dated 9/1/2020 and approved by the Building Inspector.
To expire on 3/19/2022.
Fees:
SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $200.00
CO -ALTERATION TO DWELLING $50.00
Total: $250.00
Building Inspector
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTAIENT
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 allproperty lines,streets,building and unusual.natural or topographic
features.
2. A properly completed application and consent to inspect signed by the applicant Ha 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$15.00
Date. Q la/2o
New Construction: Old or Pre-existing Building: (check one)
Location of Property: 553 C&E$S I JA y (J 2F6r1009i NY /1 Sy 7
House No. Street t Hamlet
Owner or Owners of Property: Coeogl G a jejv ow)
Suffolk Couutity Tax leap No 1000,Section Block Lot
Subdivision l� Filed Map. Lot:
Permit No. 1�a (� Date of Permit_ Applicant= 571-031 E7 71' MFA OlaoA)
_Health Dept.Approval: Underwriters Approval:.
m
Planning Board Approval: '''
Request for. Temporary Certificate Final Certificate: (check one)
Fee Submitted:$
Applicant Signature
Am
AUTHORIZATION
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* TOWN OF SOUTHOLD BUILDING-DEPT.
co 765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] SULATIOWCAULKING
[ ] FRAMING /STRAPPING [ FINAL lhl�
` [ ] FIREPLACE &CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
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DATE 1041WIP INSPECTOR
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FIELD INSPECTION REPORT DATE C01k MENTS-
FOUNDATION(IST) 77 1
FOUNDATION(ZND)
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PLUMBING `3
INSULATION PER N.Y. �y
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTNIENT Do you have or need the following,before applying?
TOWN HALL. Board of health
SOUTHOLD,NY 11971 4 sets of Building Plans
TEL: (631)765-1502 Planning Board approval
FAX: (631)765-9502 �ISurvey
Southoldtownny.gov PERAM NO. Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
Flood Permit
Examined 20 Single&Separate
Truss Identification Form
Stone-Water Assessment Form
Contact:
Approved 20� Mad to: -ZOTT W(.1C+PlPrN
Disapproved Cpl 60rj-0nl.3c/2Y C1
LA 4 Phone: 6f60) g5;2, 411.2 06033
Expiration ` 20
Buiw6ldvXs e or
� "PLICATION FOR BUILDING PERNM
.4 202
Date D �8 20 00INSTRUCTIONS
INC,DFFT'
a. M cats e completely filled in by "ter or in ink and submitted to the Building Inspector with 4
sets of pl �blcuiate 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 IS 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,budding 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)
.3,q1,0j EMEQgOw_)? SGhlwEe_ Le it, C; lc
(Mailing address of applicant)
State whether applicant. owner,less ,agent,architect,engineer,general contractor,electrician,plumber or builder
��nliee
Name of owner of premises C 6Z A IG 13 oeNOLJ
(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. 3,35- ���5 � Unit
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
53 CO tIE-6E Lt&ly C,.pFEnI fo,zr , N y 119 1-/
House Number Street Hamlet
County Tax Map No. 1000 Section Block Lot
—T
EZEMOVE A/Vo/ kEPGfiC/_= I WIIVDOU f 056 c,. lm G4,_C, MO S??ZG{a_g9492 CHAYrC-F-S.
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 RESl 0-=111/H'L
b. Intended use and occupancy �5 SEN i�/� L
3. Nature of work(check which applicable):New Building Addition Alteration
Repair >< Removal Demolition Other Work
4. Estimated Cost 3, 03 Fee (Description)
(To be paid on filing this application)
5. -If dwelling,number of dwelling units Number of dwelling units on each floor
If garage, number of cars
- n
6. If business,commercial or nixed occupancy,,specify nature and extent of each type of use.
7. Dimensions of existing structures,if any:Front Rear Depth
Height Number of Stories
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
9. Size of lot:Front Rear Depth
10.Date of Purchase Name of Former Owner
11. 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 of Owner ofpremises Cgh IG A"OL1 Address 53 M96S airy Phone No. (914) 603 9.264
Name of Architect Address Ent PO!�W t`JY Phone No - _
Name of Contractor NOME,DIr Por USA Address Phone No.
a46T pAC6S Fe-ery,2] ATLAN i-A I G-A 30333
15,a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO C
$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 REQ -
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 N0-
IF YES,PROVIDE A COPY.
I U,I r'jo tS
STATE OFK)
SS:
COUNTY OF COO I , )
ELZE I C---,A M F K--I)Po IJ being duly savors,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)He is the (`y[►J i
(Contractor,Agent,Corporate Officer,etc
of said owner or owners,and is duly authorized to perform or have performed the said work and to snake 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.
Swgm to before me,thi
y of 2� IAL SEAL
LILIA A ALIC I TATE O DEZ ( ��i��/ ®-V
NOTARY PUBLIC,STATE OF ILLINOIS
Not 1 c MY C EXPIRES 6/03/ Signature of Applicant
s $ Go Permits,LLC
AV 105 Buttonball Ln_
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Scott Doughrnan
Phone:860 952-4112
Fax:860-430-6719
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To:Town of Southold-Building Department
Subject Permit Application for: Cielg IG AeN0tD_ _53- 0-ft E8S LdAY 0RZtEN A0P 1 NY
The above listed homeowner has contracted with Sears Home Improvements to replace the windows
in his home.The below listed documents are included with this letter.
a Notarized permit application
• CO Application
® Check for$250 payable to Town of Southold
0 Contract with Horne Depot RISA detailing scope of work
® Morrie Depot Suffolk County License
4 Cerfificate of Irsurarice
a Letter of Authorization from.Home Depot USA alfov ing GoPermits-to subnit documents on their behalf
• Windows_specification_specsheet
Please mote the following:
• Please mail original permit to the owner.
m Please fax or e-mail'a copy of the permit and receipt to:
Fax: 860-430-6719(atm;Scott Douchman)
Emaik scottdouglimaanftopermits Lrg
• If fax'or e-mail is not available,please mail a copy of the permit and receipt to:
Go Permits,LLC
105 Buttonball Ln_
Glastonbury,Cr M33
Thank you!
Ella Mendron, Permit Expediter
Go Permits, LLC
Phone:847-671-4606
€-lzbietarnendrQrt-,'Q�gopermits.org
Go Permits LLC,105 Buttonball Ln.Glastonbury CT 06033,scottdoughmanC5)goperrnits.org
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CERTIFICATE OF LIABILITY INSURANCE 02!11120,19
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMA71ON ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
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Show Receipt Detail Page 1 of 2
RECEIPT
Suffolk County Government
SUFFOLK COUNTY LABOR.LICENSING&CONSUMER AFFAIRS
P-O:BOX 6100 HAUPPAUGE,NY 11788
James M.Andrews
Application:H-53429
Application Type.ConsumerAffairs/Licenses/Home Improvement/NA
Address:
Owener Name:
OwmerAddress:
Application Name:
Receipt No. 149086
Payment Method Ref,Mumher Amount Paid Payment Date Cashier lD Received Comments
Check 3148046 -51,800.00 0912112018 CLEMON RENEWAL
Work Description:
z;is $uf folk County Dept of
labor,Licensing&Consumer Affairs
WHOME EMPROVEMENT LICENSE
Name
RICHARD:TOUSEY {'
Busihess Name
HOME DEMI U.SA INC.'
E This ce-r>es Matthe
bearer is duly licensed -License-Number M-534
_by the•County of Suffolk
Issued: 05/1*5/2014 =_
omSStoftL'f s® r Fkoirts: iW0112020
Commissioner
https:Hay.prod.county.suf/portlets/fee/receiptView.do?mode=view&autoPrint=false&recei... 9/21/2018
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DATE: ®g a8 120
ATTN: 'Town Building Inspector
RB: PERA41T AUTHORIZATION°TION L .
To Whom It May Concern:
In accordance with Public Act 91-95, this letter serves as written authorization and
notification that Go Permits LLC, and its employees and agents have the authority to
represent us in theiprocurement of permits and pertinent documentation on our behalf.
This letter or a photocopy thereof may be regarded by any building ficial as it's authority
to recognize Go Permits LLC as our authorized Agent to sign on our behalf applications for
permits-and any other related documents that may be required by you,and we agree that,
for all purposes,we and not Go Permits LLC or it's employees and agents shall be deemed
to be the signer of any such applications and related documents.
Scope of work. d2EMOVE A'0 CEPLOCE 4 411,tupoij, -
S MF sI2E No sr_c-U,e
Location 53 a A LEBS 09 y
G�eE�N�o�r,
NY
40 95a- 41119,
Authorized Agent Go Permits LLC3(l�T MCNJ
Service Agent Name
Best Regards,
g
- ' . - I I -C'
Lice ee Signature - t K- - e &License Number
NOTE: PLEASE MAIL PERMIT TO:
' -�6 f ° Zo R
RE",' �-KLIIAR
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=IST.4f i"�U5 1,45{ 1TH®�►t-Home Seni�ces,in -
40 Oser Avenue- Suite 17•Hauppaugeed iz`'"i Ti;: ar =Phone:631-478-6101 •Fax:631-435-4837•Toll € in li�areh _ -
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Home Improvement Agreement: Pagel
Home Depot License#'s- For the most current listing www.Homedepot.com/LicenseNumbers
NY:Amherst HI-04712, Lockport 2395; Buffalo LT12-10023782, City Tonawanda 33257, East Hampton 4499, Long Beach
4917,N.Tonawanda 368.16,Nassau County H1171050000-H1771053000,New York City 0900456-DCA,900457-DCA,
0900458-DCA,0910621-DCA,0910622-DCA,0920734-DCA,0922474-DCA,0968605-DCA,1003822-DCA,1003823-
DCA,1003825-DCA,1003828-DCA,1003830-DCA,1003833-DCA,1026224-DCA,1075580-DCA,1129555-DCA,1129556-
DCA,1129557-DCA,1129562-DCA,1129564-DCA,1133444-DCA,1152032-DCA,1152034-DCA,1152035-DCA,1152036-
DCA, 1152038-DCA,.1152039-DCA, 1152040-DCA, 1178447-DCA,1186042-DCA, 1212045-DCA,_1223272-DCA,_1251871- .
DCA, 1318292-DCA, Niagara Falls 971, Putnam County PC 689, Rockland County H-06464,Southampton L002442,
Suffolk County 47874-ME,55323-ME,53429-H,57713-H,54888-MP,50222-MP,Town of Tonawanda:1854,Westchester
County WC18484H06,Yonkers'5675,47874-ME
Vance Comerford
SalespersonName: Registration No. applicable):
Home Depot U.S.A., Inc.,("Home Depot')or Service Provider named below will furnish, install and/
or service the equipment listed below at the price,terms and conditions as outlined on this form.
arnold Craig Long Island 1-15YYUSK6
Customer Last Name ustomer First Name Store //Branch Name Customer Lead/ PO#
53 calebs way I lGreenport INY 11944
Customer Address City State Zip
(917) 603-9264 craiga48@hotmail.com
Home Phone# Work Phone# Celt Phone# Customer Emait Address
NOTICE OF RIGHT TO CANCEL: 'YOU MAY CANCEL THIS AGREEMENT WITHOUT PENALTY
OR OBLIGATION BY DELIVERING WRITTEN NOTICE TO HOME'DEPOT AT:
40 Oser Avenue Suite 17 1 11-lauppauge INY 11788
Address city State- Zip
Or Email: customercancellationnortheast@homedepot_com
Service Provider Email Address
BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING, UNLESS THE STATE
SUPPLEMENT PROVIDES A DIFFERENT CANCELLATION PERIOD. THE STATE SUPPLEMENT
CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN YOUR STATE.
YOUR PAYMENT(S)WILL BE RETURNED WITHIN TEN (10) BUSINESS DAYS AFTER HOME
DEPOT'S RECEIPT OF YOUR NOTICE. YOU MUST MAKE AVAILABLE FOR-PICKUP BY HOME
DEPOT OR SERVICE PROVIDER, AT YOUR SERVICE ADDRESS,AND IN SUBSTANTIALLY THE
SAME CONDITION AS WHEN DELIVERED, ANY MERCHANDISE OR MATERIALS DELIVERED
TO YOU. OR YOU MAY'CONTACT HOME DEPOT FOR INSTRUCTIONS REGARDING RETURN
SHIPMENT AT HOME DEPOT'S EXPENSE.
THE LAW REQUIRES THAT THE HOME DEPOT GIVE YOU A NOTICE EXPLAINING YOUR RIGHT
TO CANCEL. PLEASE SIGN BEL W TO ACKNOWLEDGE THAT YOU HAVE BEEN GIVEN ORAL
AND WRITTEN NOTICE OF YQKR PICK TO ANCEL.
Acknowledged by: 08/20/2020
C Omer' �Signaa Date
Contract Price and Payment Schedule : P ent of the Contract Price is due upon signing unless a
different payment schedule is required by law, specified below or in a payment addendum.
Contract Price: $ 3702.73 Includes all applicable taxes. Excludes finance charges.*
Sales Tax: $ 10.00 (If-applicable)
*Maximum deposit ONLY applicable in MD, MA, ME(33966), NJ, W1(99%)
Dep. 125.0 % Deposit Amount $ 925.69 Remaining Balance $ 12777.04
The Home Depot-2455 Paces Ferry Road,N.W.Bldg.8,3,Atlanta,Georgia 30339-Customer Care:1411110-466,3337
460 HDE Customer Agreement(24 Jul.16) v 0.1.7
1y
Home Improvement Agreement: Page2
Finance Charges:
*Any interest payments or other finance charges will be determined by Customer's separate cardholder--
or loan agreement, to which The Home Depot is NOT a party, and will be in addition to Customer's
payment under this Agreement. Customer is subject to the terms and conditions of the cardholder or
loan agreement, as applicable. No funds should be made payable to Service Provider;,however, Service
Provider may collect Customer's payment(s) made payable to The Home Depot.
Insurance proceeds will will not be used to pay some or all of the total-amount of sale.
Description of Work to be Performed:
Installation of 1mrinclovis
A more detailed description of the work to be performed is included in the section entitled Scope of
Work which appears on page of this Agreement.
Anticipated Delivery Date/Installation Schedule
Approximate Start Date: 10/15/2020 1 Approximate Finish Date: 11/12/2020
All dates are approximate and subject to change based on unforeseen events including inclement
weather, permitting delays, and delays in confirming insurance coverage of Your claim for any repair, if
applicable.
Electronic Records Authorization:
You are entitled to a paper copy of this Agreement it you choose. If you consent to an e-mailed copy, your
consent applies to this Agreement and all subsequent documents and written communications related-to
this agreement By contacting your Service Provider, you may update your email address;withdraw your
consent, or obtain a paper copy of the Agreement,or related documents at no'charge. By providing your
consent and verifying your email address above,you confirm that you have access to a computer that can
receive and open emails and PDF documents.
"nithisparagraph, I consent to receive only electronic records related to this transaction.
Mal
Acceptance and Authodzation:
By signing below, you authorize Home Depot to (a) arrange for Service Provider to perform Installation
andlor (b) order and arrange for the delivery of special order merchandise, including special order
merchandise that may be custom made, as specified in this Agreement. Do not sign if blank or
incomplete. (Service Provider's/permitting information may need to be provided to.You later.) By signing,
you acknowledge that you have read, understand, and accept this Agreement in its entirety, including
the General Terms and Conditions and State Supplement, if any. You further acknowledge receiving a
complete py f-this Agree t. Keep it to protect your legal rights.
08/20/2020 The Home Depot
C mer' ignature Date Service Provider Name
08/20/2020 40 oser Avenue Suite 17
C -Ste
er(if a ble) Date Service Provider Address
X 08/20/2020 Hauppauge NY 11788
Si On B half o Ho Depot Date City State Zip
50061-HS, R-1-128533-13-00262
Service Provider p4one Number Service Provider License Number
The Home Depot-2455 Paces Ferry Road,N.W.Bldg.B-3,Atlanta,Georgia 30339-Customer Care:1-800-" 337
480 HDE QM=WAWWMent(24 JuL 18) v 0.1.7
odd
,A,PPRIO ED AS NOT D
DATE: R.P.#
FEE:. �� BY:—=
NOTIFY BUILDING DEPARTMENT AT
765-1802 8 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH'- FRAMING & 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 OR CONSTRUCTION ERRORS.
COMPLY WITH ALL CODES OF
NEW YORK STATE & TOWN CODES
AS REQUIRED AND CONDITIONS OF
SOUTHni n nWX DL nNM BOARD
`SGUTI�eEB T-OWMMES
AI Y.R.nor+
-o
OCCUPANCY OR
USES UNLAWFUL
WITHOUT CERTIFICA7
OF OCCUPANCY
f;9
f.
Andersen Wood PEC SHEET Sr,: Vanes Comerford Meseure Tech: INSTALLER:
Branch Name: Long Island Job#: 1.15YYUBKO Prepared By: I$M:
FED SPR
Ship To LocatIon: Customer Name: orolg amold Date: 08/2D/2020 Page I Of I 8HEETN REP
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