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HomeMy WebLinkAbout47807-Z t TOWN OF SOUTHOLD ., BUILDING DEPARTMENT IN TOWN CLERK'S OFFICE V o-5 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#: 47807 Date: 5/11/2022 Permission is hereby granted to: Orsini .».Mark............._._........................_.-.........w.. .____. w—. —_m_m_w.. -_,_.__w._._._. _._._._ 550 W 45thStApt 1807 ww __w..... ...... New..... 036..........................._ _ www_www._._._. ..........................._ ._...._ _____wwwwww.............................................................................................__....................................................... To: Install in ground vinyl swimming pool at existing single family dwelling as applied for. Must maintain minimum 110 feet from edge of pond to pool or Trustee approval will be required. Minimum 10 foot setback from property lines to pool and / or pool equipment. At premises located at: 580 Gin Ln., Southold SCTM # 473889 Sec/Block/Lot# 88.-3-8.1 Pursuant to application dated 4/12/2022 and approved by the Building Inspector. To expire on 11/10/2023. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO- SWIMMING POOL $50.00 Total: _.__.-................. .._«........$300.00 Building Inspector 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 4 sets of Building Plans__ TEL:(631)765-1802 Planning Board approval___ FAX:(631)765-9502 Southoldtownny.gov PERMIT NO. sly Check______.._ Septic Form—.......... N.Y.S.D.E.C. Trustees--- C.O.Application Flood Permit Examined 20 Single&Separate CE V FEE Truss identification Form—....— Storni-Water Assessment Form— Approved___.. 20 2 2092 Contact: N BUILDNG DEPT Mail to:—A)-L,.vN I t Disapproved a/c kD, a&a TOWN OF SOUP40 ......... ....... Phone: Expiraliou---............--,20 Building Inspector APPLICATION FOR BUILDING PERMIT Date 1. -Z 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. CA--- re f (Signature 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 -11 v l C-41- 15-1tI2._w w _w (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. 57 Plumbers License NO. Electricians License No. Other Trade's License No. 1. Location 9f land on whichoposed wok will be don Ct House Number Street Hamlet County Tax Map No. 1000 Section— Block Lot-15-1 subdivision--..------ Filed Map No.- Lot 2. State existing use and occupancy of premiss and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy,.....AI 3. Nature of work(check which applicable):New Building-__ Addition Alteration Repair Removal Demolition µ Other Work 4. Estimated Cost '50 qqo Fee 5. If dwelling,number of dwelling units (To be paid on filing this application) If garage, number of cars of dwelling units on each floor-,.--—.-- 6. If business,commercial or mixed 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 Z 3 '-X-'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_NOZ�Will excess fill be removed from premises?YE�NO 14.Names of Owner of premises Z4adc- 0­5�w: Address5ii o cz- A— _Pi QrNo) -2,'5 L Name of ArchitectAddressUc, c Name of Contractor 1-1- X01 Address iik/ye-k_1±—�- Phone No 15 a.Is this property within 100 feet of a tidal wetland or a freshwater wetland?*YES 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) SS: COUNTY 0 being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the OU-t- L-, -e f, (Contractor,Agent,Corporate Officer,etc.) of said owner or owners,and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief,and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this day of Girt 20 N-o-taiy­Vulbric Signature of Applicant CONSENT TO INSPECTION JACV C-5 the undersigned,do(es)hereby state: Owner(s)Name That the undersi!�tied(is)(are)the owner(s)of the premises in the Town of Southold,located at which isd designated on the Suffolk County Tax Map as District 1000, Section tVBlock !> ,Lot 16�— - That the undersigned(has)(have)filed,or cause to be filed,an application in the Southold Town Building Inspector's Office for the following: y- A That the undersigned do(es)hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property,including any and all buildings located thereon,to conduct such inspections as they may deem necessary with respect to the aforesaid application,including inspections to determine that said premises comply with all of the laws,ordinances,rules and regulations of the Town of Southold. The undersigned,in consenting to such inspections,do(es)so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used in subsequent prosecutions for violations of the laws,ordinances,rules or regulations of the Town of Southold. Dated: 9 (Signature) (Print Name) GREGORY PINTO NOTARY PUBLIC.STATE OF NEW YORK NO.01-PI6090453 (Signature) OUALIFIED IN SUFFOLK COUNTY W COMMISSION EXPIRES APRIL 14, Z 3 (Print Name) 04 CC,VI LA PA I Buildinp,I)epartment Application AUTHORIZATION (Where the Applicant is not the Owner) ...........-residing at (Print property owner's name) (Mailing Address) do hereby authorize (Agent) to apply on my behalf to the Southold Building Department. (Owner's Signature) (Date) (Print Owner's Name) Wnw.uMdY I X .n Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HAIL 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 electrickl ic)stallatiun from Board of Fire Underwriters. 4. Sworn statement from plutnbt r certifying that the solder used in system contains less than 2/10 of 1%lead. 5. Commercial buildi "industrial building,multiple residences and similar buildings and installations,a certificate of Code Compliance cdi ffirchitect of dngincer responsible for the building. 6. Submit Planning Board Approval of comp`lete�lasSte 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$15.00 Date. New Construction: \// VOo^ ( Old or Pre-existing Building: (check one) _ Location of Property: J 6 111 Z, So U-1-" House No. Street Hamlet I r w; .�y!C�)wner or Owners of Property: /�av -5; Si I iffolk County Tax Map No 1000,Section _ _Block Lot J Subidivision Filed Map. Lot: Permit No. _Date of Permit._ µ Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate __......__-.Final Certificate: (check one) Fee Submitted:$ _ �A ant� lnrature �.---� DUNRIA CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 16 0:3x12/2021 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 ri hts to the certificate holder in lieu of such endorsement(s). PRODUCER 845-783-2555 cpNTACT Walter Rose Agency Inc Walter Rose Agency,Inc PHONE 845-783-2555F" 845-783-2425 8 Stage Road talc No Ex :_. )Avc Monroe,NY 10950 sa walterroseagency.COm NSURERI.�IAFFORDING COVERAGE A Mutual 20230 I3Nsu ED Utica National ofTexas43478 unrItEe Manufacturing Corp a Dunrite pools ..... 3510 Veterans Memorial Highway Bohemia,NY 11716 -------. 1NME __ _. INSURER F: COVERAGES CERTIFICATE NUMBER. REVISION NUML39R' 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 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. INSR� xxxxxTYITRPEOFINSURANCE ADDL SUB pOLICYNUMBER POLICY EFF POLICY EXP LIMITS A JX COMMERCIAL GENERAL LIABILITY EACH g0.qR„RENCE 1,000,000' CLAIMS-MADE [X]OCCUR TO RENTED 300,000 OCCUR CLP 9791864 04/01/2021 04/01/2022 E •. ��,� ,c _ MED EXP An one ersgn) 5,000 P RS NAI &AV INJL RY $ 110001000 G'NLAGGREGAT'LIM IT APPLIES PER: ,,FN „AGGRF-(,T„ATF 2,000,000 POLr1Y�JECT FILOC PR( CTR QqMaQEAgg2,000,000 OT"H AR B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 _a& = ......... w X ANY AUTO 4822099 12131/2020 12131/2021 BODILY NJ RY Per erson) _,wwwww,,,, _ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY NJURY Peracoident ALRTOS ONLY »...W AUO OS ONLY PROPERLY DAMAGE . Per accident S _ UMBRELLA LIAB LJ OCCUR EA H URRENCE EXCESS LIAB CLAIMS-MADE A R C' T DEDm RETENTION$ WORKERS COMPENSATION PER 6TH- AND EMPLOYERS'LIABILITY YIN ----- ANY PROPRIETOR/PARTNER/EXECUTIVE A H A I. FNT........... q 4'°F"E'C.Ei,pdCvfiFMBER EXCLUDED? �N/A Eandaloryin NH) If yes,deacrlbe Under I J�d�i�4Bi ±�i�Pl�� , D ES MPTON OF OPE RATIONS below E. .DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Swimming Pools -Installation, Servicing Or Repair-Below Ground CERTIFICATE SOUTH02 SHOULD ANY OF THE AAQVE DESCRIBED POLICIES BE CANCELLED BE)=OFA Town of Southold THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 530950 Route 25 PO BOX 1179 AUTHORIZED REPRESENTATIVE Southold,NY 11971 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 4TAIIRK Compensation workers' CERTIFICATE OF INSURANCE COVERAGE Board NYS DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW PART 1.To be completed by NYS disability and Paid Family Leave benefits carrier or licensed insurance agent of that carrier 1a.Legal Name&Address of Insured(use street address only) ib.Business Telephone Number of Insured DUNRITE MANUFACTURING CORP 3510 VETERANS MEML HGHWY BOHEMIA,NY 11716 1c.Federal Employer Identification Number of Insured or Social Security Number Work Location of Insured(Only required if coverage isspecdicallyNintedto certain locations in New York State,i.e.,Wrap-Up Policy) 112245133 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) ShelterPoint Life Insurance Company Town of Southold 530950 Route 25 3b.Policy Number of Entity Listed in Box"la" PO Box 1179 DBL593730 Southold, NY 11971 3c.Policy effective period 01/01/2021 to 12/3112022 4. Policy provides the following benefits: A.Both disability and paigfamily leave benefits. B.Disability benefits only.' C.Paid family leave benefits only. 5. Policy covers: ® A.All of the employers employees eligible under the NYS Disability and Paid Family Leave Benefits Law. ❑ B.Only the following class or classes of employer's employees: Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has NYS Disability and/or Paid Family Leave Benefits insurance coverage as described above. Date Signed 12/15/2021 By W40, 4f (Signature of Insurance carrier's authorized representative or NYS Licensed Insurance Agent of that insurance carrier) Telephone Number 516-,829-01 QQ Name and Title Richard White Chief Executive Officer IMPORTANT: If Boxes 4A and 5A are checked,and this form is signed by the insurance carrier's authorized representative or NYS Licensed Insurance Agent of that carrier,this certificate is COMPLETE. Mail it directly to the certificate holder. If Box 413,4C or 5B is checked,this certificate is NOT COMPLETE for purposes of Section 220,Subd.8 of the NYS Disability and Paid Family Leave Benefits Law_It must be emailed to PAU@wcb.ny.gov or it can be mailed for completion to the Workers'Compensation Board,Plans Acceptance Unit,PO Box 5200, Binghamton,NY 13902-5200- PART 2.To be completed by the NYS Workers'Compensation Board(only if Box 4B,4C or 5B have been checked) State of New York Workers' Compensation Board According to information maintained by the NYS Workers'Compensation Board,the above-named employer has complied with the NYS Disability and Paid Family Leave Benefits Law(Artide 9 of the Workers'Compensation Law)with respect to all of their employees. Date Signed By (Signature of AuthorFre"NYS Workers'Compensation Board Employee) Telephon Ntirnh r Name and 1 ilia Please Note:Only insurance carriers licensed to write NYS disability and paid family leave benefits insurance policies and NYS licensed insurance agents of those insurance carriers are authorized to issue Form DB-120.1.Insurance brokers are NOT authorized to issue this form. DB-120.1 (12-21) IllllDriu2i0iii1�ii�ii1i � ,iil Nom" Workers' CERTIFICATE OF NYS WORKERS' COMPENSATION INSURANCE NATE Compensation COVERAGE Board 1a. Legal Name&Address of Insured(Use street address only) 1 b.Business Telephone Number of Insured 516-543-1616 Dunrite Manufacturing Corp 3510 Veterans Memorial Highway 1c.NYS Unemployment Insurance Employer Bohemia,NY 11716 Registration Number of Insured Work Location of Insured (Only required ff coverage is speciffcally Ifmited to certain locations in New York State,Le.,a 1d.Federal Employer Identification Number of Insured Wrap-Up Policy) or Social Security Number 112245133 2.Name and Address of the Entity Requesting Proof of 3a. Name of Insurance Carrier Coverage(Entity Being Listed as the Certificate Holder) AmTrust Insurance Company of Kansas Inc Town of Southold 3b. Policy Number of entity listed in box"I a" 530950 Route 25 KWC1223367 PO Box 1179 Southold,NY 11971 3c. Policy effective period 10120/2021 to 1020/2022 3d. The Proprietor,Partners or Executive Officers are included.(Only check box if all partners/officers included) all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box "3" insures the business referenced above in box "1a" for workers' compensation under the New York State Workers' Compensation Law.(To use this form, New York(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2". The Insurance Carrier will also notify the above certificate holder within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail.) Otherwise,this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent,or until the policy expiration date listed in box"3c", whichever is earfier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend,extend or alter the coverage afforded by the policy listed,nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note:Upon the cancellation of the workers'compensation policy indicated on this form,if the business continues to be named on a permit,license or contract issued by a certificate holder, the business must provide that certificate holder with a new Certificate of Workers' Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers' Compensation Law. Under penalty of perjury, I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: (Print name of authorized representative or licensed agent of insurance carrier) Approved by: 10/13/2021 (Signature) (Date) Title: President of Walter Rose Agency, Inc Telephone Number of authorized representative or licensed agent of insurance carrier: 845-783-2555 Please Note: Only insurance carriers and their licensed agents are authorized to issue Form C-105.2. Insurance brokers are NOT authorized to issue it. C-105.2(9-17) www.wcb.state.ny.us Jaa ( ` �� � I Suffolk County Department of Labor, Licensing & ; Consumer Affai rs VETERANS MEMORIAL HIGHWAY * HAUPPAUGE, NEW YORK 11788 ; ' , ' I DATE ISSUED: 3/1/1977 P , No. 3585-K Ell SUFFOLK COUNTY Home Improvement Contractor License Maw, This is to certify that Ii fig: �� doing business as T BAR 15WUI\ EIN _ ACT NG CORPMA, having furnished the requirements set forth in accordance with acid subject to the provisions of a licable laws rules � • and regulations of the County of Suffolk" State of New York is hereby licensed to conduct business as a HOME Ica � IMPROVEMENT CONTRACTOR, in the County of Suffolk. i License Category 0111 U _ ri-ss Pools/Spas Suffolk County ept..of x Labor,Lieens€ng. -Consul or_ ffairs DUNRITE POOLS �� � WQM�ITNPROVEfulRf�ti'l;1CRNs`E I� l 0 irne A KENNEFti JBARTHMAN �2I�GlGGI� - tas iiQss:N' a Commissioner Bearer is duly.lt wd DUNRITEit4ANOMACTURING CORP-DBA t )y the County o s ffif� License Number, - 58 Rosale'Draga Issued: 01/0-1-11977al- I Comm'resianer lrei�. 0310M2023 , Fr 3 va Fm tl&4 -7---.T- M,gwyly me none V-0 4 Aw TDIVING BOARD 26 w 41 ed 25 1 -4 'e-e i WN an FN 0,A, T�v m as inn m 7 77 �:E: n:!f j!Q ,We FVOI- PLAN COP-NER CONNECTION DETAIL 4M£9 sYf OF_ @ Ll 0 0 M===" -51DE SECTION Of NEW ,g tea � w Elf- mtee_ 11 APR 1 1 ME IL u END SECTION BUH DING DEPT 70M-1�OF SOURHOLD DUNRITE POOLS, INC, -------------- TYK PINK STIFFNER TYPICAL WALL SECTION AT W M-AME S.C.T,M. N0, DISTRICT: 1000 SECTION:88 BLOCK:3 LOT(S):8.1 I r I, k f r o� 9 "-mCSH WATEa ry4 �PONII.-" PIPE SSS 60 Ile a Z GIPAGE UNDER 4ti�y4LM1}x,.. ti wb p H r f U.P. Yf.N, O W' PIP 4- U.P. w plr,MV t y II II q ryrp t ry .w _ i9 BUILDING DEPT 'DOWN OF SOIJTI-tl01-1 b THE WATER SUPPLY, WELLS DRYWEGLS AND CESSPOOL LOCATIONS SHOWN ARE FROM FIELD OBSERVATIONS AND OR DATA OBTAINED FROM OTHERS. AREA:28,615.65 SQ.FT, or 0.66 ACRES ELEVA77ON DATUM: ------------------------- UNAUTHORIZED ALTERATION OR ADD177ON TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE: THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE NOT INTENDED TO MONUMENr THE PROPERTY LINES OR TO GUIDE THE ERECTION OFFENCES ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS, EASEMENTS AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE TIME OF SURVEY SURVEY OF: P/0 LOT 2 & LOT 3 INCL. CERTIFIED T0:ARTHUR 0. WELLS; MAP OF:BAY HAVEN ROSE M. WELLS; FILED:JAN. 22, 1959 No.2910 FIDELITY NATIONAL TITLE INSURANCE SITUATED AT:SOUTHOLDSERVICES, LLC; TOWN OF:SOUTHOLD - KENNE"TH_M WOYCHUK LAND SURVEYING, PLLC SUFFOLK COUNTY, NEW YORK Professional Lend Surveying and Design A 41vr P.O. Box 153 Aquebogue, New York 11931 FILE p 16-69-1 SCALE:1"=40' DATE:JUNE 5. 2016 LL ___w PHONE(831)298-1588 FAX (831) 298-1588