The URL can be used to link to this page

Home My WebLink About48351-Z TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, NY n� 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#: 48351 Date: 9/29/2022 Permission is hereby granted to:. WJF Farms LLC 8405 Cox Ln ._s.... .. ..... .........� _ � �—..... Cutchogue, NYmmmmm11935 To: Construct a 40 x 60 non-habitable agricultural storage building as applied for per ZBA and Planning Board approvals. At premises located at: 12595 Oregon Rd,..........Cutch ug .._........................... SCTM # 473889 Sec/Block/Lot# 83.-2-12.7 Pursuant to application dated .8/24/2022 and approved by the Building Inspector. To expire on _..........9129/2023................... Fees: FARM BUILDING-NEW $150.00 CERTIFICATE OF OCCUPANCY $50.00 Total: _....................... $200.00 .rr.......... � ..... _...._._.. _...... Building Inspector TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone(631) 765-1802 Fax(631) 765-9502 izttpCb� ar.sotioloal ,.'ry Date Received APPLICATION FOIIL I I For Office Use Only � y Y � W' PERMIT NO. Building Inspector:� i � �� d' �i 3 r Al Applications and forms must be filled out in their entirety.Incomplete ALIG 1 2022, applications will not be ted. Where the Applicant is not the owner,an Pp accepted. Owner's Authorization form(Page 2)shall be completed. TcV „, Date:8/9/22 OWNER(S)OF PROPERTY: Name: W. Jonathan Fabb SCTM#1000-83-02-12.7 Project Address:12595 Oregon Rd, Cutchogue NY 11935 Phone#:631-735-9195 Email:info@oregonroadorganics.com Mailing Address:8405 Cox Lane Cutchogue NY 11935 CONTACT PERSON: Name: W. Jonathan Fabb Mailing Address:8405 Cox Lane Cutchogue NY 11935 Phone#:516-8070-2575 Email:fabbjon@yahoo.com DESIGN PROFESSIONAL INFORMATION: Name:N/A Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: Name:W. Jonathan Fabb/ TFLC Mailing Address:PO BOX 460, Cutchogue NY 11935 Phone#:631-734-6643 Email:info @twinforklandscapecontracting.com DESCRIPTION OF PROPOSED CONSTRUCTION ion ❑Alteration ❑Repair ❑Demolition dto'g(op� Estimated Cost of P roject: ❑Othertructure ❑Addit �r Will the lot be re-graded? *Yes 0N Will excess fill be removed from premises? []Yes @No 1 PROPERTY INFORMATION Existing use of property:Agriculture Intended use of property:Agriculture Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to AG this property? ❑Yes *No IF YES,PROVIDE A COPY. ❑ Check BOX After Reading: The owner/contractor/design professional is responsible for all drainage and storm water issues as provided by Chapter 236 of the Town Code. 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,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(s)for necessary inspections.False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the New York State Penal Law. Application Submitted By(print name): j a5,�- ❑Autholrized Agent XOwner Signature of Applicant: Date: �' � 4 STATE OF NEW YORK) SS: COUNTY OF, being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the CLIY " If (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/her knowledge and belief;and that the work will be performed in the manner set forth in the application file therewith. Sworn be ore me this day of 20 Notary Public PROPERTY i�TY OWNER AUTHORIZATION SHARON L. 8ofNe l� Notary ILLI , " (Where the applicant is not the owner) No.OIC04863757 CkiallfiedIn S Count COMMIiS�Expires l I, residing at do hereby authorize to apply on my behalf to the Town of Southold Building Department for approval as described herein. Owner's Signature Date Print Owner's Name 2 b OFFICE LOCATION: MAILING ADDRESS: Town Hall Annex a � � P.O.Box 1179 54375 State Route 25 x ��w ��`, Southold,NY 11971 (cor.Main Rd.&Youngs Ave Telephone:631765-1938 Southold,NY www,southoldtownny.gov Wl tn PLANNING BOARD OFFICE TOWN OF SOUTHOLD C June 7, 2022 i Mr. Jonathan Fabb 8405 Cox Lane Cutchogue, NY 11935 Re: Site Plan Determination -WJF Farms Agricultural Storage Building 12595 Oregon Road, Cutchogue SCTM#1000-83.2-12.7 Dear Mr. Fabb: The following resolutions were adopted at a meeting of the Southold Town Planning Board on Monday, June 6, 2022: WHEREAS, this site plan is for the proposed construction of a 60' x 100' (6,000 sq. ft.) agricultural pole barn, including employee bathrooms, an office and storage with a 19- space parking lot, and a 60' x 40' (2400 sq. ft.) agricultural storage barn on in the AC Zoning District, Cutchogue; and WHEREAS, on November 4, 2021, Jonathan Fabb, owner, submitted a Site Plan Application for review; and WHEREAS, at their work session on December 6, 2021, the Southold Town Planning Board accepted the site plan application as complete for review; and WHEREAS, on December 6, 2021, the Southold Town Planning Board, pursuant to State Environmental Quality Review Act (SEQRA) 6 NYCRR, Part 617.5 (c), determined that the proposed action is a Type II Action as it falls within the following description for 6 NYCRR, Part 617.5(c)(3) agricultural farm management practices, including construction, maintenance and repair of farm buildings and structures, and land use changes consistent with generally accepted principles of farming; and WHEREAS, on December 6, 2021, pursuant to Southold Town Code §280-131(H), the Southold Town Planning Board agreed to waive the requirement for a public hearing regarding this application which involves uses strictly related to agriculture; and WJF Farms Page 2 June L2022 WHEREAS, pursuant to Southold Town Code §280-133(C) and as detailed in work session staff report on December 6, 2021, the Planning Board agreed to waive certain application requirements of§ 280-133 for this application which involves uses strictly related to agriculture (but excepting retail winery operations); and WHEREAS, on December 22, 2021, the Planning Board, pursuant to Southold Town Code §280-131 C., distributed the application to the required agencies for their comments; and WHEREAS, on January 6, 2022, the Southold Town Fire Inspector stated there were no objections to the proposed site plan; and WHEREAS, on January 11, 2022, the Southold Town Code Enforcement officer verified that there were no open violations on the subject parcel; and WHEREAS, on January 13, 2022, the Southold Town Engineer reviewed the proposed application and determined that the certain revisions were required in order for the application to meet the minimum requirements of Chapter 236 for Storm Water Management; and WHEREAS, on January 25, 2022, the Southold Fire District determined that there was adequate fire protection and access for the proposed action; and WHEREAS, on February 4, 2022, the Suffolk County Department of Health Services (SCDHS) granted a wastewater permit for an Agricultural Building @ 336gpd Ref#C-1 9- 0002; and WHEREAS, on February 6, 2022, the Agricultural Advisory Committee provided comments supporting the proposed project for approval; and WHEREAS, on February 7, 2022, the Town of Southold Local Waterfront Revitalization Program Coordinator reviewed the proposed project and determined it to be consistent with the Southold Town LWRP policies with certain recommendations issued; and WHEREAS, on February 10, 2022, the Architectural Review Committee reviewed the proposed project and recommended items addressed by the Planning Board; and WHEREAS, the NYS Department of Environmental Conservation (NYSDEC) issued an approval for the installation of one 8" diameter agricultural irrigation well from February 2020 — February 2030; and WHEREAS, the Suffolk County Farmland Committee granted an Agricultural Development Permit and Special Use Permit (PFC2020016 and PFC2020017) to conduct site disturbance associated with the installation of the electric utility infrastructure, water utility/irrigation infrastructure, and sanitary system infrastructure, in association with a nursery stock, fruits and vegetable operation; and WJF Farms Page 3 June 7 2022 WHEREAS, on February 28, 2021, the Southold Town Planning Board determined that with exception of revisions detailed in the work session follow up letter, all applicable requirements of the Site flan Regulations, Article XXIV, §280— Site Plan Approval of the Town of Southold have been met; and WHEREAS, on May 12, 2022, Jonathan Fabb, owner, submitted revised site plans and information as required; and WHEREAS, on June 1, 2022, the Southold Town Chief Building Inspector reviewed and certified the proposed Agricultural Storage Building as a permitted use in the A-C Zoning District; therefore be it RESOLVED, that the Southold Town Planning Beard hereby waives the requirement for a public hearing and certain application requirements as described above; and be it further RESOLVED, that the Southold Town Planning Board has determined that this proposed action is consistent with the policies of the Town of Southold Local Waterfront Revitalization Program; and be it further RESOLVED, that the Southold Town Planning Board approves the Site Plan with conditions, listed below, to the site plan entitled "WJF Farms, LLC" prepared by James J. Deerkoski, P.E., dated April 8, 2022 and authorizes the Chairman to endorse the Site Plan. Conditions 1. All Suffolk County Farmland Committee requirements shall be met as issued for Committee Resolution Number PFC2020016 and PFC2020017; 2. The four (4) approved exterior light fixtures shall be shielded so the light source is not visible from adjacent properties and roadways and shall focus and direct the light in such a manner as to contain the light and glare within property boundaries and conform to §172 of the Town Code. Any future exterior lighting must be approved by the Planning Board by letter prior to installation. In addition, please be aware of the following Town Code requirements: ➢ The Town Engineer must be contacted prior to beginning site work. Proposed storm water run-off containment systems must be inspected by the Town Engineer at the time of installation. ➢ Approved site plans are valid for eighteen months from the date of approval, within which time all proposed work must be completed, unless the Planning Board grants an extension. ➢ Any changes from the approved site plan shall require Planning Board approval. WJF Farms Pacie 4 June 7,2b22 ➢ Prior to the issuance of a Certificate-of Occupancy, the Planning Board must inspect the site to ensure it is in conformity with the approved site plan, and issue a final site inspection approval letter. Should the site be found not in conformance with the approved site plan, no Certificate of Occupancy may be issued until the Planning Board approves the changes. A copy of the Approved Site Plan is enclosed for your records. One copy will also be sent to the Building Department and the Town Engineer/Highway Department. If you have any questions regarding the above, please contact this office. Respectfully, Donald J. Wilcenski Chairman Encl. cc: Building Dept. w/map Town Engineer wlmap By signing this letter, the applicant acknowledges that there are Town Code requirements and conditions, including those listed above, that must be satisfied prior to the issuance of a Certificate of Occupancy. Print name: Applicant Signature: Date: s 'BOARD MEMBERS " ° Southold Town Hall Leslie Kanes Weisman,Chairperson m 53095 Main Road•P.O. Box 1179 P � �� Southold,NY 11971-0959 Patricia Acampora Office Location: Eric Dantes Town Annex/First Floor, Robert Lehnert,Jr. 54375 Main Road(at Youngs Avenue) Nicholas Planamento Southold,NY 11971 http://southoldtownny.gov ZONING BOARD OF APPEALS Vol TOWN OF SOUTHOLD March 22 2022 Tel.(631)765-1809 Fax (631)765-9064 y WJF Farms LLC BULDiiN G i P TOINI'l OF SCUT 8405 Cox Lane Cutchogue,NY 11935 RE: Appeal No. 7604 12595 Oregon Road, Cutchogue SCTM No. 1000-83-2-12.7 Dear Applicants; Transmitted for your records is a copy of the Board's March 17, 2022 Findings,Deliberations and Determination,the original of which was filed with the Town Clerk regarding the above variance application. Before commencing any construction activities, a building permit is necessary. Please be sure to submit an application along with a copy of the attached determination to the Building Department. Pursuant to Chapter 280-146(B)of the Code of the Town of Southold any variance granted by the Board of Appeals shall become null and void where a Certificate of Occupancy has not been procured,and/or a subdivision map has not been filed with the Suffolk County Clerk,within three(3)years from the date such variance was granted. The Board of Appeals may, upon written request prior to the date of expiration,grant an extension not to exceed three(3) consecutive one(1)year terms. IT IS THE PROPERTY OWNER'S RESPONSIBILITY TO ENSURE COMPLIANCE WITH THE CODE REQUIRED TIME FRAME DESCRIBED HEREIN.Failure to comply in a timely manner may result in the denial by the Building Department of a Certificate of Occupancy,nullify the approved variance relief,and require a new variance application with public hearing before the Board of Appeals If you have any questions,please don't hesitate to contact our office. Sincere' , -, Kim E. Fuentes Board Assistant Encl, cc: Building Dept. BOARD MEMBERS soy Southold Town Hall Leslie Kanes Weisman,Chairperson �"� + 53095 Main Road•P.O.Box 1179 Southold,NY 11971-0959 Patricia Acampora Office Location; Eric Dantes CA Town Annex/First Floor, Robert Lehnert,Jr. i► y 54375 Main Road(at Youngs Avenue) Nicholas PlanamentoSouthold,NY 11971 ' RECEIVED http://southoldtownny.gov �0 '3o 0.uA ZONING BOARD OF APPEALS TOWN OF SOUTHOLD A4�. Tel.(631)765-1809 •Fax(631)765-9064 Southold Town Clerk FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF MARCH 179 2022 . ZBA FILE: 47604 NAME OF APPLICANT: W. Jonathan Fabb/WJF Farms,LLC PROPERTY LOCATION: 12595 Oregon Road, Cutchogue,NY 11935 SCTM# 1000-83-2-12.7 EARA DETERMINATION: The Zoning Board of Appeals has visited the property under consideration in this application and determines that this review falls under the Type II category of the State's List of Actions, without further steps under SEQRA. SUFFOLK COUNTY ADMINISTRATIVE CODE: This application was referred as required under the Suffolk County Administrative Code Sections A 14-14 to 23,and the Suffolk County Department of Planning issued its reply dated November 22,2021 stating that this application is considered a matter for local determination as there appears to be no significant county-wide or inter-community impact. LWRP DETERMINATION: The relief, permit, or interpretation requested in this application is listed under the Minor Actions exempt list and is not subject to review under Chapter 268. PROPERTY IY FAC"ISIDESCRIPTIO : The subject property is a conforming 11.66-acre parcel located in an Agricultural Conservation Zoning District. The parcel runs 334.510 feet fronting Oregon Road along the southerly property line, runs 1,180.370 feet on the easterly property line, 485.30 feet along the northerly property line, and 1,216.890 feet along the westerly property line. The parcel then turns 99.58 feet on the South side and then runs 200 feet on the West side to return to Oregon Road. The parcel is currently not improved with any structures. On the East side of the property there is a 10-foot-wide easement for water service as well as for electric and light. All as shown on a survey prepared by John Minto,L. L.S. dated August 1, 2019, ASIS OF APPLICATION: Request for a Variance from Sections 280- 14; and the building inspector's notice of disapproval based on an application for a permit to construct an agricultural pole barn/shed at; 1) shed located less than code required minimum side yard setback of 20 feet located at 12595 Oregon Road, Cutchogue,NY SCTM# 1000-83-2-12.7. RELIEF RE( LlhST1 T): The applicant requests a variance to construct a agricultural pole barn/storage building with a side yard setback of 10 feet from the property line where Town Code requires a minimum side yard setback of 20 feet. Page 2,March 17,2022 #7604,Jonathan Fabb, WJF Farms SCTM No. 1000-83-2-12.7 ADDITIONALNIORMATION: New York State De artment of Environmental Conservation. The parcel has the benefit of a permit to install and operate an agricultural irrigation well from the New York State Department of Environmental Conservation; permit dated 2/19/2020. The entire parcel is subject to a Development Right Purchase (PDR) by the.County of Suffolk. Liber 12495, Page 3 83 of recorded March 7, 2007.- Suffolk Counter Farmland Committee on June 10, 2021, the Committee extended a permit to construct 1) Morton barn and associated electric and water utilities and two employee restrooms and associated sanitary infrastructure 2) One crushed stone driveway and parking areas; 3) One pole barn; 4) one underground irrigation main; and 5) one irrigation well and one irrigation pump and one auxiliary diesel engine. FINDINGS OF,ACT I EA SONS FO BOARD ACTION: The.Zoning Board of Appeals held a public hearing on this application on March 3,2022 at which time written and oral evidence were presented. Based upon all testimony, documentation, personal inspection of the property and surrounding neighborhood, and other evidence,the Zoning Board finds the following facts to be true and relevant and makes the following findings: 1. Towyn Law "267-b 3 b L . Grant of the variance will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. The neighborhood is an older neighborhood consisting of single- family homes, commercial, and agricultural properties. The parcel to the West of the applicant's parcel is vacant land which is in agricultural production. The construction of the subject pole barn will not result in any change to the character,of the neighborhood and will not visually or in any other way adversely impact adjacent properties. 2. Town Law 267- 3 b 2 . The benefit sought by the applicant can be achieved by some method, feasible for the applicant to pursue, other than an area variance. The applicant could build the barn with a code conforming side yard setback. However-, the applicant has irrigation in place and would need to move a substantial amount of agricultural irrigation if the proposed barna is located in a code conforming location.. Additionally, locating the proposed accessory building with a conforming side yard setback would interrupt the crop rows in agricultural production. 3. Town Law 267-b 3 b 3 . The variance granted herein is•mathematically substantial, representing 50% relief from the code. However, the applicant has approval to build the barn in the proposed location from the Suffolk County Farmland committee, and the Southold Town Planning Board, and the barn will be located along a lot line which is shared by a neighboring farm. 4. Town Law 267-b 3 b . No evidence has been submitted to suggest that a variance in this residential community will have an adverse impact on the physical or environmental conditions in the neighborhood. The applicant must comply with Chapter 236 of the Town's Storm Water Management Code. 5. Town Law 67-b 3 b 5 ., The difficulty has been self-created. The applicant purchased the parcel after the Zoning Code was in effect and it is presumed that the applicant had actual or constructive knowledge of the limitations on the use of the parcel under the Zoning Code in effect prior to or at the time of purchase. 6. Towyn 'Law 4267-b. Grant of the requested relief is the minimum action necessary and adequate to enable the applicant to enjoy the benefit of a pole barn while preserving and protecting the character of the neighborhood and the health, safety, and welfare of the community. b Page 3, March 17,2022 #7604,Jonathan Fabb,WJF Farms SCTM No. 1000-83-2-12.7 RESOLUTION,OF THE,BOARD: In considering all of the above factors and applying the balancing test under New York Town Law 267-13,motion was offered by Member Dantes, seconded by Member Weisman (Chairperson), and duly carried, to GRANT the variance as applied for, and shown on the Architectural plans by .lames A Koppenhaver(Sheets A.l through A.4)dated November 8,2021,and Site Plan prepared by Tames Deerko ki,P.; .,labeled S-1 and dated March 10,2020. The Board reserves the right to substitute a similar design that is de minimis in nature for an alteration that does not increase the degree of nonconformity. Any deviationf°om the survey, site plant andlor architectural drawings cited in this decision will result in delays andtor a possible denial by the Building Department of a building permit, and may require a new application and public hearing before the Zoning Board of Appeals. .any deviation fe^om the variances)granted herein as,shown on the architectural drawings, site plan and/or survey cited above, such as alterations, extensions, or demolitions„ are not authorized under this application when involving nanconformities under the zoning code, This action does not authorize or condone any current or fut°tare use, setback or other feature of the subject property that may violate the Zoning Code, other than such uses, setbacks and other features as are expressly addressed in this action. IMPORTANT TIME LIMITS ON THIS APPROVAL Pursuant to Chapter 280-146(B) of the Code of the Town of Southold any variance granted by the Board of Appeals shall become null and void where a Certificate of Occupancy has not been procured, and/or a subdivision map has not been filed with the Suffolk County Clerk,within three (3)years from the date such variance was granted. The Board of Appeals may, upon written request prior to the date of expiration, grant an extension not to exceed three (3) consecutive one (1)year terms. lT IS THE PROPERTY OWNER'S RO ONSIl3I ITY TO lrNSURI COMPLIANCE WITH T:HE CODE REQUIRED TIM" FRAME DESCRIBED HFRI+�11" . Failure to comply in a timely manner may result in the denial by the Building Department of a Certificate of Occupancy, nullify the approved variance relief, and require a new variance application with public hearing before the Board of Appeals Vote of the Board: Ayes: Members Weisman(Chairperson) Dantes, Acampora, Planamento and Lehnert. This Resolution was duly adopted (5-0). ilie Ka ees Weisman, Chairperson Approved for filing -�/,;f / 2022 NYSIF New York State Insurance Fund PO Box 66699,Albany,NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE (RENEWED) AAAAAA 113592577 TWIN FORK LANDSCAPE CONTRACTING INC PO BOX BOX 460 CUTCHOGUE NY 11935 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER COASTAL CONTRACTOR TWIN FORK LANDSCAPE CONTRACTING INC TOWN OF SOUTHOLD PO BOX BOX 460 TOWN HALL ANNEX CUTCHOGUE NY 11935 54375 ROUTE 25 SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE 11229085-4 388396 03/23/2022 TO 03/23/2023 8/9/2022 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1229 085-4, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY,INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS:/MIWW.NYSIF.COM/CERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. WILLIAM J FABB(PRES) OF ONE PERSON CORP TWIN FORK LANDSCAPE CONTRACTING INC THE POLICY INCLUDES A WAIVER OF SUBROGATION ENDORSEMENT UNDER WHICH NYSIF AGREES TO WAIVE ITS RIGHT OF SUBROGATION TO BRING AN ACTION AGAINST THE CERTIFICATE HOLDER TO RECOVER AMOUNTS WE PAID IN WORKERS'COMPENSATION AND/OR MEDICAL BENEFITS TO OR ON BEHALF OF AN EMPLOYEE OF OUR INSURED IN THE EVENT THAT, PRIOR TO THE DATE OF THE ACCIDENT, THE CERTIFICATE HOLDER HAS ENTERED INTO A WRITTEN CONTRACT WITH OUR INSURED THAT REQUIRES THAT SUCH RIGHT OF SUBROGATION BE WAIVED. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK ST SUR NCE FUND 4 DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER:363620082 U-26.3 oATE(nalaloorryYY! CERTIFICATE OF LIABILITY INSURANCE os/osnoz2 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 pollcy(les)must be endorsed. H 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 rights to the certificate holder In lieu of such endorsemen s. PRODUCER EILEEN CUSI IMAN GEORGE FORMES PN E,11 .631.-722-4100 %N.631-7224500 1116 MAIN ROAD SUITE A2 ,IML EILE'EN. USHMIAN AMERICAN-NATIONAL.0 M P.O. BOX 2336 INSURE S AFFORDING COVERAGE NAIC 0 AQUEBOGUE,NY 11931 INSURERA:FARM FAMILY CASUALTY INS.PO. INSURED INSORM B TWIN FORK LANDSCAPE CONTRACTING INC. INsuRERc: PO BOX 460 INSURER D CUTCHOGUE,N.Y. 11935 INSURER Ea URER P: 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 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. NLIMI . TY POLICYIIUMBER i LWnB A XX OCCUR S 11000,000 CLAIMS-MADE COMMERCMI.GENELIABILITY 3152X1157 5110)202205110/2023 EACH OCCURRENCE 350,000 XX CONTRACTORS MED EXP one s 5 000 ADVANTAGE PERSONAL I&AOV INJURY $ 1,000,000 GEN"L ADGRE13ATE LIMIT APPLIES PER: GENERAL AGGREGATE S 200 00 X POLICY 0 JECT LOC PRODUCTS-COMP/OPAGG S 2.000.000 OT 5 A AUTOMOBILE LIABILITY 3152C4133 05/10/2022 5/10/2023 " L s 1 000,000 ANY AUTO BODILY INJURY(Per person) f ALL OWNED SCHEDULED BODILY INJURY(Per accdent) E AUTOS X 'AUTOS 1xx HIREDAUTOS �X N-ONOWNED =AMA 1500 COMP 500 COLL s A X UMBRELLALIABOCCUR 3101 E3412 OWW2021 09/28/2022. EACH OCCURRENCE s 1 000 000 EXCESSLIAB HCLAIMS-MADE AGGREGATE S OED RETENTIONS S WORKERS COMPENSATION I PER I I Or". AND APL*YM'UAS$U W YIN ANY PROPRIETORIPARTNERIEXECUTIVE E L,EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? NIA (Mandatory In NN) E DISEASE•EA EMPLOYEE S If m.doe ho under 0 RIPTION Of PIRATIONS Leel E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Addhimul Remarks Schedule,may be attached H man spass b required) LOCATION :WJF FARMS,LLC 12595 OREGON ROAD,CUTCHOGUE NY 11935 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TOWN OF SOUTHOLD-BUILDING DEPARTMENT THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN TOWN HALL ANNEX 54375 MAIN RD ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX 1178 'AUTHORm�DRE EN'rArlrrE SOUTHOLD NY 11971 0 198"014 ACORD CORPORATION. All rights reserved. ACORD 25(20141011 The ACORD name and loco are reaistered marks of ACORD Suffolk County Dept.of Labor,Licensing&Consumer Affairs HOME IMPROVEMENT LICENSE Name WILLIAM J FABB Business Name This certifies that the SHELTER ISLAND DRIVEWAYS INC Dearer is duly licensed Dy the County of suffolk License Number:H-53952 Rosalie Drago Issued: 08/18/2014 Commissioner Expires: 08/01/2024 Of