HomeMy WebLinkAbout44363-Z ago FFOt/(,oG Town of Southold 12/21/2020
P.O.Box 1179
0
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 41697 Date: 12/21/2020
THIS CERTIFIES that the building ADDITION/ALTERATION
Location of Property: 250 Rogers Rd, Southold
SCTM#: 473889 Sec/Block/Lot: 66.-2-15
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
10/24/2019 pursuant to which Building Permit No. 44363 dated 11/1/2019
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:
alteration(sliding glass door)and entry addition to an existing one family dwelling as applied for.
The certificate is issued to Kane,Douglas
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
h riz d ignature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CL'ERK'S OFFICE
oy . 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#: 44363 Date: 11/1/2019
Permission is hereby granted to:
Kane, Douglas
PO BOX 1296
Southold, NY 11971
To: make an alteration (sliding glass door) and addition (entry) as applied for.
At premises located at:
250 Rogers Rd, Southold
SCTM # 473889
Sec/Block/Lot# 66.-2-15
Pursuant to application dated 10/24/2019 and approved by the Building Inspector.
To expire on 5/2/2021.
Fees:
SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $211.20
CO -ADDITION TO DWELLING $50.00
Total: $261.20
uildin I
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$25.00,Additions to dwelling$25.00,Alterations to dwelling$25.00,
Swimming pool$25.00,Accessory building$25.00,Additions to accessory building$25.00,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. October 15th 2019
New Construction: Old or Pre-existing Building: %/ (check one)
Location of Property: 420 Rogers Rd Southold
House No. Street Hamlet
Owner or Owners of Property: Doug Kane
Suffolk County Tax Map No 1000, Section 66 Block 02 Lot 15
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: `/ (check one)
Fee Submitted: $ 60
plicant Signature
q4 3 OF SOUTyO�
# # TOWN OF SOUTHOLD BUILDING DEPT.
cou765-1802
1 " A
INSPECT ON
"] FOUNDATION 1ST [ /ROGH PLBG.
FOUNDATION 2ND [ LATION/CAULKING
FRAMING /STRAPPING [ L
[ `]-FIREPLACE & CHIMNEY [ " ] FIRE SAFETY INSPECTION
[ ]" FIRE RESISTANT-CONSTRUCTION [ ] FIRE"RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
DATEl qbQ V INSPECTOR
FIELD INSPECTION REPORT -DATE COMMENTS j +
FOUNDATION (IST)
------------------------------------
FOUNDATION (2ND) trJ
ROUGH FRAMING& H
PLUMBING
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INSULATION PER N.Y. y
STATE ENERGY CODE
FINAL
ADDITIONAL COMMENTS
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„ --TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOV HALL Board of Health
SOUTHOLD,NY 11971 4 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631)765-9502 Survey
SoutholdTown.NorthForkxet PERMIT NO. ”/36 3?, Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
Flood Permit
Examined 20 Single&Separate
Storm-Water Assessment Form
1 Contact:
Approved 20 Mail to. Robert Wilson
Disapproved a/c PO Box 49 Southold NY 11971
Phone: (631)504-8842
Expiration ,20
uil
—APPLICATION FOR BUILDING PERMIT
OCT 242019
Date October 15th , 20 19
INSTRUCTIONS
a,-
0-3
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.
(Sign6ir rre,6f applicant or name,if a corporation)
.`" PO Box 49 Southold NY 11971
(Mailing address of applicant)
State whether applicant is owner, lessee,agent, architect, engineer, general contractor, electrician,plumber or builder
Agent
Name of owner of premises Doug Kane
(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 which proposed work will be done:
420 Rogers Rd Southold
House Number Street Hamlet
County Tax Map No. 1000 Section 66 Block 02 Lot 15
Subdivision Filed Map No. Lot
x Y
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy Single family residential
b. Intended use and Occupancy Same with new sliding glass door at rear of house and entry stoop to access door.
3. Nature of work(check which applicable): New Building Addition V Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost Fee
(To be paid on filing this application)
5. If dwelling,number of dwelling units 1 Number of dwelling units on each floor 1
If garage, number of cars
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front 20.4 Rear 30.3' Depth 30.9'
Height 16' Number of Stories 1
Dimensions of same structure with alterations or additions: Front 20.4' Rear 30.3'
Depth 34.9' Height 16' Number of Stories 2
8. Dimensions of entire new construction: Front 7' Rear 7' Depth 4'
Height 4' Number of Stories 1
9. Size of lot: Front 68.00' Rear 68.00' Depth 116.00'
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated R-40
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO V
13. Will lot be re-graded? YES NO V Will excess fill be removed from premises? YES NC ,l
420 Rogers Rd.
14. Names of Owner of premises Doug Kane Address Southold NY 11971 Phone No. (631)504-8842
Name of Architect Address Phone No
Name of Contractor Address Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES V NO
* 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) CONNIE D.RUNCh'
SS: c'taryNo.01Public,
U6185050 of New York
COUNTY OF ) Qualified in Suffolk Coun4l
oa, w Q �iC 'Sr�� �ti 14•;2�0
Robert Wilson being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
I OINN OF SOUTHOLD
(S)He is the Agent (,I I Q110 , nrzpA gTMgFF 1T
(Contractor,Agent, Corporate Officer, etc.) P.O. Box 1179
Scutholr4, MY. 11971
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.
Sworn t� before meth's
day of 2d I
Notary Public Signa of Applicant
Scott A. Russell ,��®S11 /rSTOIKMWA\TIED.
SUPERVISOR MANAGEMENT
-SOUTHOLD TOWN HALL-P.O.Box 1179
53095 Main Road-SOUTHOLD,NEWYORK 11971 Town of'Southold
CHAPTER 236 - ST®RMWATEZ MANAGEMENT WORK SKEET
( TO BE COMPLETED BY THE APPLICANT )
DOES TIES PROJECT INVOLVE ANY OF THE ]FOLLOWING: IfI
Yes No (CHECK ALL THAT APPLY)
„ ❑❑✓ A. Clearing, grubbing, grading or stripping of land which affects more
(it than 5,000 square feet of ground surface.
l ; ❑® B. Excavation or filling involving more than 200 cubic yards of material
within any parcel or any contiguous area.
E3® C. Site preparation on slopes which exceed 10 feet vertical rise to
100 feet of horizontal distance.
❑® D. Site preparation within 100 feet of wetlands, beach, bluff or coastal
erosion hazard area.
❑® E. Site preparation within the one-hundred-year f loodplain as depicted
{ = on FIRM Map of any watercourse.
❑® F. Installation of new or resurfaced impervious surfaces of 1,000 square
Il feet or more, unless prior approval of a Stormwater Management 1
Control Plan was received by the Town and the proposal includes
,F in-kind replacement of impervious surfaces.
If you answered NO to all of the questions above, STOP! Complete the Applicant section below with your Name,
Signature, Contact Information, Date & County Tax Map Number? Chapter 236 does not apply to your project.
If you answered YES to one or more of the above,please submit Two copies.of a Stormwater Management Control Plan
and a completed Check List Form to the Building Department with your Building Permit Application.
APPLICANT (Property Owner,Design Professional.Agent,Contractor,Othe0 S.C.T.M. 1000 Date
rt, lit
DUtnct
NAME- Robert ilson 66 2 15 10/24/2019
Section Block Lot
FOR BUILDING DEPARTMENT USE ONLY****
(
II� ContactInfolmation. (631)504-8842 „! "!! ,
Reviewed By:
+ — — — — — — — — — — — — — — — — — -- il: lit
!16 !If II. Date: Il
Property Address/Location of Construction Work: — — — — — — — — — — — — — — — — — '
420 Rogers Rd Approved for processing Building Permit.
® Stormwater Management Control Plan Not Required.
t _ _ _ _ _ _ _ _ _ _ _ _ _ _
_
Southold NY 11971 Stormwater Management Control Plan is Required
(Forward to Engineering Department for Review.)
FOR1V1 # SMCP-TOS MAY 2014
L
Town Nall Annex .jt Telephone(631-1802
54375 Main Road 1 - - _, Fax(631) 7349502
P__ o, Box 1179 a
'
Southold, NY 11971-0959
BUILDING DEPARTMENT
NOTICE OF UTILIZATION OF TRUSS TYPE CONSTRUCTION, PRE-ENGINEERED
WOOD CdNSTRUCTION.ANDIOR TIMBER CONSTRUCTION
Date: October 15th 2019
Owner_ Doug Kan
Location of Property: 420 Rogers Rd. Southold NX 11971
Please.take notice that the (check applicable line):
New'residential structure,
-
�/ Addition to existing residential skri c lire
<x Rehabilitation to art existing residential structure
to be constructed.or perfom�ed at the subject property ref nce above will rtti[ize
(check applicable line): r
y Tress type construction (TT),
,v Pre-engineered wood construction�Pffl n
V Timber construction (TC).
z .
in the following iocation(s)(check applicable line):
' N/ Floor framing,including girders and bums (F) l
Roof framing (F�)
Floor and roof flaming (FR)
• P
Signature:
Name
.(person submitting this form): " Robert,VVilson
Capacity(checkMapplicable'line): {
Owner
V ._- Owner representative
TrussResReo•15.dmx Effective 111/2015
3
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ROMAN At_PHANUNIERtG
_—DESiGNATI'ON-OF COMS T RUCT ION
(PNIS} flit/ HYPE RASED ON SECTION 602 OF
THE BUILDING CODE OF NEW
YORK STATE
" f N'
REFLECTIVE
WHITE
112" $TROKE'
4.
COMPOREUTS'YHAT-AR16 OF '
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"F" FLOOR FRAC IN0,.#RCLUDING
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DIVISION OF CODE EN FORCEKE T
AND ADMINISTRATION
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8 0 H No 88 - SO - 148
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
FOR APPRO',AL OF CONSTRUCTION ONLY
DATE HS REF. NO
APPROVED
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(
DWELLING) LOT 7 DWELLING ,
I
HIPPODROME DRIVE
AREA T, 888 SQ. FT.
The wafer sy�/y and sawn& disposal
systems for /h7s residence wg conform SURVEY OF
!o fhe slandards of The Suffolk Cody
Department of Heat* Services. LOT 6
MAP OF BEIXEDON ESTATES , BLOCK 4 "
prep"d in mcordwee %a ft nilhbrrt M FILED MAR 16 , 1946 FILE NC 1472
sfa &-1 for Nile survey s as eslabltshed
For wrh'use by The Mw York°S to [. � AT SOUTHOLD
'ftA llba' TOWN OF SOUTHOLD
SUFFOLK COUNTY, N.Y.
SL"-r'1'01 K rn 1N1 Y rjEj, ,;`?;r 3r NF�LTf1 S 066 �- 02 - 15
DAA if't'lrck'' -'+;I• ofo ySCALE I11 - 20 '
�virrr taw 6- €7,�M��, , ; i+,L $ SD f S E Q ?_9 , 1988
AMi W sAWY taw Ix
The sovs ^e �r.Cl'1,i-4 fn`11�t,4
PncF eaoMN toAwr 1: I�nv� h� •, Ir - !hl ..•I'Tier)'and!oc MARCH 3 , 1989 (u C j
MAV '' okL��ra,��.es a.ru IE: isw �wk: ' lit. MAY 15 1989 If Inal survey )
C
PALFM'N
sAnv " Ch+ef of Bureau of Wastekater Nlanagemei
D 9 CERTI F1 ED TO
/rr o C L� LONG ISLAND MORTGAGE CORP
-+ 0 AMERICAN TITLE INSURANCE COMPANY
. _ ANNE RILEY
pE�rO
(51 W) p
S. LIC. No. 49618 ,
K
5,�� r .� ,
P. O. Box 9
MAW ROAD 'r
SOUTHOLD, N.Y. 11971 ELEVATIONS ARE REFERENCED 1% -
TO AN ASSUMED DATUM location to foundation .^,^
D K It 8 C ~ s S Pro,-AP fat
r
RETAIN STORM WATER RUNOFF KANE RESIDENCE
PURSUANT TO CHAPTER 236 420 ROGERS RD.SOUTHOLD N.Y.
OF THE TOWN CODE.
EXISTING: SINGLE FAMILY RESIDENCE
SCTM# 1000-66-2-15
ZONE AC .18 ACRES
PROPOSED:
ADD NEW 6' SLID. DOOR AT REAR OF
EXISTING HOUSE. ADD NEW REAR
ENTRY STOOP.
—D n
GENERAL NOTES
4 T E. 1, P.Tt�...=X .*s6.r 1 All work shall conform to the requirements of the Resdenlal Code of New York
/// State,County and Town Department Regulations,Utility Company requirements and
best trade practises,
v _ _ _ 2 Before commencing work the Contractor shall file all documents required by the
FELE- '' �1 ' -�-_—• Building Department,pay all fees required by local agencies and obtain all retuned
NO
I I ry SUtLLIy�•-� �)• Y,I�I l�J14.1�1 I'lT 3 The Contractor shall visit the ste and verily all dimensions and the awstng
7165-1802 U O A%.,!A%.,! I v 4 PM FOR THE conditions affecting the work prior to construction Any discrepancies which would
interfere with the satisfactory completeuon of the work described herein shall be
p rr� C•
�+ reported to the architect or property owner Do not scan work until such wnditions
FCLLG1�,tliti IN`JPL�i1 IG f' have been examined and a course of action mutually agreed upon Failure o notify
• FOUNDATION - T`>�fO �`OUIRED the owner or architect of unsatisfactory conditions will be construed as an acceptance
41 of the conditions to property perform the required work
/� POURED t�)r-n r�r'� D IGT E 4 All work is to conform to the drawings and specifications of the architect and
FOR POURED I�lJN�1t7 I engineer consultants.
5 The Contractor us to maintain a complete and up to date set of plans or the
2. ROUGH - FRAI��IING & PLUMBING job site at all times
I /t 6 The draw rigs are not to be scaled under any circumstances
3. INSULATION 7 It shall be the Contractor's responsibility to ascertain all prevailing procedures
1 including storage and toilet factlmes,protachon of existing work to remam.access to
4 FINAL - CO TRUCTI ON MUST wok area,hours of permitted work.avadablhty,of water and elecmc power and all
other conditions and restrictions for thus particular location In order to execute the
L1 t- /+r^1 Af11 E-;E ,I, L G� work In a careful and orderly manner with the least possible disturbance to the public
CJI CO elf_L 6 The Contractor shall make the neccesary arm" to ublmes and services �t
R temporarily disconnected while performing the work es required )
ALL CGi�ISTRUCI Ieid SHALL fiEET THE 9 The Contractor shall provide all dimensions and cut-outs for other trades
I 10 The Contractor shall provide proper shoring and bracing for all remaining structure
REQUIREMENTS OF THE CODES OF NEVv
�T prior W removal of existing structure
by cednre
CORKi 4TL• NOT RESPONSIBLE 11 Plumbing,electrical,HVAC and similar work shall be performedRESPONSIBLE FOR persons who shall artange for and obtain all required Inspections The General
DESIGN OR CONSTRUCTION ERRORS. shall be responsible for scheduling all other Inspections as required
12 The Contractor is solely responsible for construction safety and shall hold the
owner and architett harmless from litigation ansng out of the Contractor's fa,Wre to
provide corMmctlon safety means and methods
CONSTRUCTION NOTES
EXISTING HOUSE COMPLY WITH ALL CODES OF 1 All feelings shall rest on undisturbed soil at a minimum of 36"below fin grade
NEW YORK 2 Poured concrete shall have a minimum psi of 2800 at 28 days unless rated
3 SII plates shall be preserved.treated wood and be Installed above a 16 oz
NO CHANGES copper tennme shall fl S C3C.�'11 I I O OF 4 Shin New shall conform to ASTM D and
m and be installed m accordance
�'y'.7 I-4Gtd 11 R with the New York State Building Code and manufacturers specifications
5 Pomgs shall be mstalled by a licensed contractor to a depth and bearing agreed
S {1 Tn,AI DA upon by as engineer and certificates shall be Issued stating same
6 Unless otherwise noted all framing and structural wood components shall be
#2 or better Douglas Fu
7 Al framing techniques and methods shall be as prescriptive design based on
SOl6 AD AF&P Wood Frame Construction Manual for One and two Family Dwellings(WFCM)
or as specified in 8301 2 1 1
8 All building envelope components shall comply with Chapter 6 of the Enogy
IIIS TOWN TRUSTEES Conservation Code of the State of New York
9 F,'btooking shall be provided in all wood tamed construction in accordance
with NYS Code R 602 8 to form an effective fire banter between stones and
between the top story and roof space ,
N.Y.S.D 10 Protective panels shall be provided for glazed openings in accordance wth
NYS cede R301 2 1 2 d they are required
11 All portions of the new structure are designed to comply with local geographic
and climatic adeoa as sated in the following table
GEOGRAPHIC & CLIMATE DESIGN CRITERIA
GROUND SNOW LOAD 45 ps1
WIND SPEED 120 MPH
NEW 72" x 80" SLID. GLASS DOOR SEISMIC DESIGN CATATGORY B
2-2x12 HEADER ABOVE WEATHERING SEVERE
FROST LINE DEPTH 36-
TERMITE THREAT MODERATE 70 HEAVY
12 X 12 LEDGER FASTENED TO HOUSE WITH DECAY SLIGHT TO MODERATE
WINTER DESIGN TEMPERATURE 11
711
1/2" DIA. LAG BOLTS @16' O.0 STAGGERED N>C�Vy FLOOD HAZARD AS NOTED
J 5 E .r /�- A-101 FIRST FLOOR PLAN
PLAN HANDRAIL TO CODE �P �' �'1 /4" = 1a_oa1 �, r,r�
1 4x ACQ. POSTS ANCHORED TO r— ,.3-','ir' w FIRST FLOOR PLAN
8" D A`�P E�k(S �I fp 9��/ y� n` 7+ _. +' _� SCALE AS NOTED OCTOBER 1ST 2019
f 1 bl�".�( BPO IR..j 91NCRETE FTG �� i
USE 16 UNLAWFUL �°ARoFES � A 101
Vi"ITHOUT CEHTIFICAT SSRT
I' 1 OF 1
OF 0 OU C U gy� �N C gar r.ds I draRin Cx 9dlll is
PO BOX 49
JOAN CHAMBERS SOUTHOLD NY 11971
631-294-4241
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