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HomeMy WebLinkAbout48892-Z TOWN OF SOUTHOLD etc BUILDING DEPARTMENT 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 #: 48892 Date: 2/10/2023 Permission is hereby granted to: Castano, Jose PO BOX 703 ._._.W.... _. Mt. Sinai NY 11766 ���� .. .... ._�.._............... .... �....._ ...................... _... ............... _.._ . .................. To: Demolish (as per Town Code definition) and reconstruct a single family dwelling as applied for per SCHD and ZBA approvals. At premises located at: 1700 Grat_11hwohl Rd, New Suffolk SCTM # 473889 _..._ ....... ........ Sec/Block/Lot# 117.4-3 Pursuant to application dated 1/27/2023 and approved by the Building Inspector, To expire on 8/11/2024. m Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $1,772.80 CO-RESIDENTIAL $50.00 Total: $1,822.80 Building Inspector TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephones(631) 765-1802 Fax,(631),7,65-9502 htts:�`www.southoldtowriW o Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only PERMIT NO. V Building Inspector:�� Applications forms must out in •entirety, ��s di 1p EST applications will dnot be accepted.bfillWhere the hAppl cnt is nothe oHO wnE., TOWOhN T VQ � Owner's Authorization form(Page 2)shall be completed. 1.3 Date: OWNER(S)OF PROPERTY: Name. g SCTM# 1000- 11-1 — Lf 3 Physical Address 700TWQ UL D • 9W su Fed L Q, .- Phone#: co3 s Email: Mailing Address: '700 (219M WC294D• ri F— 9 v FF44•1 CONTACT PERSON: Name: - =W__ Y Mailing Address: )90 T S ETA✓►CF-1- 11733 Phone#: 16-16 . 316 , 99-6 Email:v Si FA,LO 0404 • 5-O M DESIGN PROFESSIONAL INFORMATION: Name: N ®n(Z to Mailing Address Ar'4 ,. __-OL- 0� Q Svc ON ( G,f P Phone#: _ 14 9 7— q q3(o Emaik JAN SIp4pLF SrA1Qc)4eJ0L HAib CC1 M CONTRACTOR INFORMATION Name: to ``�� , /- Mailing Address: (�a0 CD)QATH %JC)b(L KID, NRW 90Fr-01N•`l' 1 IQ L16 Phone#:63 1.65' Email: , ay , 4Apf• 1J0^T DESCRIPTION OF PROPOSED CONSTRUCTION /rNew Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: ❑Other $ 5,C) (goo Will the lot be re-graded? ❑YesFZfVo Will excess fill be removed from premises? ❑Yes No 1 PROPERTY INFORMATION Existing use of property: I tended use of property° 1 Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? ❑YegXNo 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 Subm"Itte IflAt narne),:, V4 Dov bet\ j-,/ tMuthorizecl Agent ❑Owner Signature of Applican Date: 9//-2 O'A J STATE OF NEW YORK) COUNTY OF �Z ) A nAve� I JuaLe, being'duly sworn, deposes and says that(s)he is the applicant (Name of.individual signing coil ra:ct)above Clamed, (S)he is the r (Coi4ractor,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 before me this 3—day of .,20 2 Notary Public ANGELA MORRIS PROPERTY-OWNERAUTHORIZATION Notary Public,State of New York NO. 01 M06403123 (Where the applicant is not the owner) Qualified in Suffolk County My commission Expires Jan 21, 2024 ill ... residing at_.. 7e w4 -New 9V Frei. K do hereby authorize to apply on my beh If tot TOW' Southold Building Department for approval as described 'herein, 1�2 A . Owner's Sig ature °Date Print Owner's Name 2 SURVEY OF: PROPERTY LOCATED AT NEW SUFFOLK TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK 'Ell 20 All 1 [ ....,-. AEWSYAssIw�€3aA3a TANK VOLUME-749 GALLONS S.C.T.M. # 1000-117-4-3UP FORCE GALLONS X B.34 IBS/CAL=0,247 LBS 5% `� ' AREA = 11,892.00 SF. GEORCE ROAD ° SCALE: 1 =30 ttx — DDMN FORCE WEIGHT of TANK:463 les } P SAND COVER:so IBS/Cu.FT, t 0 µ _T1MANUFACTURER SCS�ETE DEADMAN APPRO%1,800 LBS AS PER V 011N r1F� AIH T• 1nfer PRIECKST CONCRETE DEADMAN-1,600 LBS ' - ALL RESIDENCE'S v � D'12xC SLIM CDVM-54 M F- Sam > WITHIN Iso' NOTE: THE EXISTENCE OF RIGHT OF WAYS, - 84 CU.F.T SAND COVER X so Las9 cu.Fr.-7,5so IRs > / nt - F N HAVE PUBLIC WATER WETLANDS AND/OR EASEMENTS OF RECORD ° 7,560 IBS+1.600 IBS-9,360 LBS oNP A '< tret �- IF ANY, NOT SHOWN ARE NOT GUARANTEED. x �re ifA"� DEAD MAN z Y� '� 12'1'x1'PRECAST CONCRETE DEADMAN-1,800 LBS �� '+ flE51DENCE ELEVA11ONS REFER TO 1988 NAV= , 1111 L I— 6'EI2'X1'SAND COVER-64 Cu.Fr. �. LAND N/F ELEVATIONS SHOWN THUS *rex= x A B4 cu.F.r SAND COVER:9, Les/cu.Fr.-7,580 Bs FE FENCE ROSEMARIE F 7,560 LBS+1,800 LBS-9,380 IBS BLANCHARD TOTAL ODYM F(N(LF � - a � � `�•�#� � � � ,. 9,360 LBS+9,360 IBS+483 LBS-18,183 LBS SAFETY FACTOR: 3,07: 1 RESIDENCE , [ LAND N/F ` L s .. >v MARTHABAK�F -� �. xA 1 L SEVER LINES FROM THE BUILDING TO THE SEPTIC TAMC ; _ .� SHALL.HAVE A MINIMUM PITCH OF ONE QUARTE(INCH PER ,o.... _ ->-,-` _ L - _w cavi FBOT AND A CLEAN OUT DR MANGOLE EVERY FIFTY(50)FEET. W .rzs 2 uov. H. THERE SMALL BE NO BENDS IN THE SEVER LIMES TO THE { SEPTIC TANK.IF BENDS ARE UNAVOIDABLE,TNN,FOR BENDS - - K "''�� - •. i VITFIOI THE FIRST TEN FEET FROM THE HOUSE FOUNDATION - —_r RESIDENCE THE SEVER LINE SHALL BE CONSTRUCTED OF CAST-IRON ' [^ Y FROM TTE HOUSE. _T UP TO AND TH[ LAAO N/F LONG SWEEP ELBOWS SHALL BE USED AND=SHALL NOT --� -`-` � 3 IT IXCEEO FORTY-FNS C49➢EGRESS AS MEASURE➢ALONGIHE $ -- ; -€ DICKERSON AVIS OF THE STARTING PIPE FOR BENDS FURTHER THAN TEN i as. � —5- s£ ><a _ RIE FEET FROM THE HOUSE FONMATION AN APPROVED MANHOLE OR I € _ jI �} 3 'c6F ' CLEAN-NT SHALL BE INSTALLED.FOR PROJECTS WITH A LARGE NUMBER OF BENDS CONSULT THE DEPARTMENT PRIORum. TEST HOLE DATA TQ INSTALLATION1R�TK Im�3. UNSUITABLE SD0.S SHALL BE REMOVED ANO REPLACED WITH - E 'j ' 8021 011:]0 AM CLEAN SAm ACRPTAHLE TO THE DEPARTMENT.FORA %sw +3ara. YsII£ vi-(o nnvlEx .c[(T nuN)iF) "—astT DIAMETER SIX FEET GREATER THAN TIE SEPTIC TANK ». ,; _ 1'e]�OL. 1 EXTENIDNG DOWN INTO A MIN SIX FOOT STRATA 6. OF ACCEPTABLE SAND AND(RAVEL IN THOSE AREAS x#� ws.��ab : et -moi 1 F --' 9 G S5-DJD' AMO fR4L .�P ID,>7' VIERS THESE CRITERIA CANNOT BE TET,CONSULT THE 1EPARTIENT.PERCOLATION TESTS VILL BE REQUIRED IN ADDDRDANCE WITH 10 NYCRR APPENDIX 7544 FOR ABSORPTION 3.0'-10.0 at€txwL. SYSTEMS WHERE GROUNDWATER IS LESS THAN OR EQUAL TO a'EVR EIGHT FEET BELOW GRADE AND VIERS UNSUITABLE SOILS FT OITS TA11'1`SEl .. �. `; ov�cc cvao xc v - 4. SEVER LINE TRENCHES SHALL BE FIRMLY TAMPED BY HAND _ _ r., -� 500 �E D. INE PIPES)SNAG 8E SECURELY CEMENTER AT THE PmNT OF ENTRY IN TO THE SEPTIC TANK - - .�F_ •''" [[:oa 6. SEPTIC TANG SHALL BE A MIN T3••➢`F#9(€l TSL; l iA } I v 1 ^� H 7. AL TTc*v"FIAu.Sitk MIN L ®®®®_ '�` -- -y t 1 _ 3t-- I ' B ALL. RETAINING WALLS WITHIN FDF - I+Et _ THE STALL BE,GONSTRUCTE➢OF WAT -"K•= - _ - - 3" •. e OR AD OF n BE,1m; CE TIE 4P Yi'�C , E OF TIDG SIAT4€d M;tp f _:- _ OR EMBOSSED SEAL WALL NOT$ TO.BE A VALID TRITE L'OPY. _- GUARANTOES OR CERTIRCATONS MEAT31 HEMoOR SHALL RUN ONLY 70 -�. . _11ATS° As Tx STIE.[. :Tea„u vs0Vt s 11 THE FOR THE 19 PREPARED,AND ON HIS BEHALF ID - .[[E�° [.[AL�x� 9° SURVEYED BY. TETLTraQAE€+ 1aeArAND sml>TN =x PAUL BARYLSKI LAND SURVEYING m7w Hunim,,vnTOTm AsmaAmow or 78E uEHONG immMan-AL OAKDALE NY 11769 OA~MM -T - WT TO ADOMONAL a= ` - ":`• rammunoms DR messamfl ammuS PHONE 631-294-6985 FAX 631-627-3186 PAU LBARYLSKI®YAHOO.COM DECEMBER 1, 2021 4937—P APRIL 30, 2022 - SANITARY OFFICE LOCATION: MAILING ADDRESS: Town Hall Annex �� P.O.Box 1179 54375 State Road Route 25 Southold,NY 11971 (cor.Main Rd. &Youngs Ave.) Southold,NY Telephone: 631 765-1809 http:Hsoutholdtownny.gov 0"'00 umv ZONING BOARD OF APPEALS Town of Southold January 23, 2023 I_[[ 5 Andrew Dunleavy 551 Pond Path Setauket,NY 11733 Re: ZBA Application#7724, Castano TOWN o5D 1700 Grathwohl Road,New Suffolk SCTM No. 1000-117-4-3 Dear Mr.Dunleavy; Transmitted for your records is a copy of the Board's January 19, 2023 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. 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 call the office. Sincer j �. , Kim E.Fuentes Board Assistant Encls. cc: Building Department JA 4 OFFICE LOCATION: MAIIJ NG ADDRESS: Town Hall Annex �v so" a, r P.O.Box 1179 01 54375 State Road Route 25 ° t� Southold,NY 11971 (cor.Main Rd. &Youngs Ave.) Southold,NY Telephone: 631 765-1809 http://southoldtovv=y.gov 0 ZONING BOARD OF APPEALS RECEIVED Town of Southold 9"go g47, JAN 2 3 2023 FINDINGS,DELIBERATIONS AND DETERMINATION MEETING OF JANUARY 19,2023 9w- )L�� Southold Town Clerk ZBA FILE: 7724 NAME OF APPLICANT: JEANNE AND JOSE CASTANO PROPERTY LOCATION: 1700 Grathwohl Road,New Suffolk,NY SCTM#1000-117-4-3 SE RA 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 ADMWMATIVE CO E: This application was referred as required under the Suffolk County Administrative Code Sections A 14-14 thru 14-25, and the Suffolk County Department of Planning issued its reply dated.September 2 ,2022 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 DETERMDIATION: This application was referred for review under Chapter 268, Waterfront Consistency review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards.The LWRP Coordinator issued a recommendation dated December 29,2022.Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department,as well as the records available, it is recommended that the proposed action is EXEMPT from Coastal Consistency Review. PE.OPE&TY FACT' /DESCRIPTION: The subject property is a nonconforming 11,892 square foot parcel located in the R40 Zoning District, The northerly property line measures 115.10 feet and is adjacent to Grathwohl Road, the easterly property lint;measures 1.50.00 feet and the southerly property line measures 46.91 feet and the westerly property line measures 152.68 feet. The is an unusual, shaped property. The parcel is improved with a one-story frame dwelling with an attached wood deck in the rear of the property. There is an 8.0 ft.by 8,0 f1,shed located right off the rear deck on the easterly corner of the property as shown on the survey map prepared by Paul Barylski, LS and last revised January 10,2022. BASIS OF APPLJQATIO : Request for a Variance from Article XIII, Sections 280-124; and the Building Inspector's August 11,2022 Notice of Disapproval based on an application for a permit to demolish(as per Town Code definition)and reconstruct a single-family dwelling at; 1) located at less than the code required minimum rear yard setback of 35 feet; located at 1700 Grathwohl Road, New Suffolk,.NY. S "TM#1000-117-4-3. Rl LIEF RE UESTID: The applicant requests avariance to demolish(as per Town Code definition)and reconstruct a single-family dwelling. The proposed construction,on this nonconforming 11,892 square foot lot located in the R- 40 Zoning District is not permitted pursuant to Article XXIIf Section 289-124,which states lots measuring less than 20,00 square feet in total size require a minimum rear yard setback of 35 feet. The proposed construction will have a rear,yard setback of 26A feet, The new additions will be to the front of the dwelling that faces Grathwohl Road, and the existing footprint will remain in the rear of the dwelling as shown on the Site Plan drawings by Zachary T. Clanahan,Architect,dated July 31,2021. Page 2,January 19,2023 #7724,Castano SCTM No. 1000-117-4-3 ADDITIONAL,lNF0 TION: During,the Public,Hearing held on January 5,2023 the neighbor to the rear of the property stated she had no subjection to the second story addition. The applicant will be installing a new I/A Innovative Advanced sanitary system as approved by the Suffolk County Department of Health Services. A Certificate of Occupancy No.Z10337 was issued January 7, 1981 for a Private One Family Dwelling. A letter of non jurisdiction was issued on March 8,2022 by the Town of Southold Board of Trustees,although, advised that no disturbance shall take place within 100 feet landward from the top of the bluff, or seaward of the tidal and/or freshwater wetlands. FINDINGS OIC 11—REASONS FOR BOARD ACTION: The Zoning Board of Appeals held a public hearing on this application on January 5,2023 at which time written. and oral evidence were presented. Based Capon 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. Town Law 26_7-b 3 b 1 Grant of the variance will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. The proposed reconstruction is in peeping with the character of the community. Many of the homes in the area have been improved and enlarged. The residence faces'fest Creek, but is on the landward side of Grathwohl Road. The proposed addition will be added to the front of the existing dwelling and only the interior walls are proposed to be demolished. 2. Town Law 267-b 3 b * The benefit sought by the applicant or cannot be achieved by some method,feasible for the applicant to pursue,other than an area variance, Due to the nature of the unusual shape of this property,there is very little rear yard and there will be no further building to the rear of the property. The new reconstruction will be to the front of the properly and the new roof lines will be conforming to 35-foot minimum code required rear yard setback. 3. Town Law 267- 3 b„ The variance granted herein is mathematically substantial, representing 24.57% relief from the code. However,the existing rear yard setback will not change. The existing dwelling conformed to the prior Zoning Code when it was originally built. The exterior perimeter walls will remain and the new roof line will conform to the 35-foot rear yard setback. The architectural drawings show attic space above the second floor to be used for storage and will remain unconditioned space with no finished walls or ceilings, and no heating or air conditioning. 4. Town Law 267-b 3 b 4 , 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. . . Town Law267-Ia 3 b 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, Town Law §267-b. Grant of the requested relief is the minimum action necessary and adequate to enable the applicant to enjoy the benefit of a reconstructed dwelling while preserving and protecting the character of the neighborhood and the health,,safety and welfare of the community. Page 3,January 19,2023 #7724,Castano SCTM No. 1000-117-4-3 1ES0LU N dETIDEBf A9Q:In considering all of the above factors and applying the balancing test under New York Town Law 267-13,motion was offered by Member Weisman(Chairperson),seconded by Member Dantes,and duly carried,to GRANT the variance as applied for, and shown on the Site Plan and Architectural Plans (Sheets S-1 &A- 1 thru Al l &D-1))prepared by Zachary T. Clanahan,Architect, and dated July 31,2021. SUBJECT TO THE FOLLOWING CONDITIONS: 1. The third story attic shall be used only for storage, and shall remain unconditioned space (no heating or air-conditioning). 2. The applicant shall install a new I/A Innovative Advanced septic system approved by the Suffolk County Department of Health Services. This approval shall not be deemed effective until the required conditions have been met.At the discretion of the Board of Appeals,failure to comply with the above conditions may render this decision null and void That the above conditions be written into the Building Inspector's Certificate of Occupancy, when issued 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. IMPORTANT L11"hd1TS ON'1HE APPROVALM GRANTED.HEREIN Please Read Carefully Any deviation from the survey,site plan and/or architectural drawings cited in this decision, or work exceeding the scope of the relief granted herein, will result in delays and/or a possible-denial by the Building Department of a building permit and/or the issuance of a Stop Work Order, andmay require a new application and public hearing before the Zoning Board of Appeals. Any deviation from the variance(s) granted herein as shown on the architectural drawings, site plan and/or survey cited above, such as alterations, extensions, demolitions, or demolitions exceeding the scope of the relief granted herein, are not authorized under this application when involving nonconformides under the zoning code. This action does not authorize or condone any current or future 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. Inff L11 1TS ON TIUS 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 3EREly terms. PROPERTYOWNER'S SPONSIBILITYTO NSUCQWTNCE IT CODE REUID TIME '=l Page 4,January 19,2023 #7724,Castano SCTM No. 1000-117-4-3 FRAME DESCRMED IEERFfN. 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),Acampora, Dantes,Lehnert,and Planamento (5-0). 1e Kanes Weisman, Chairperson Approved for filing f /9;� /2023 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Division of Environmental Permits,Region 1 SUNY d Stony Brook,50 Circle Road,Stony Brook,NY 11790 P:(631)444-0365 1 F (631)444-0360 www dr' .11y'gov LETTER OF NO JURISDICTION -TIDAL WETLANDS ACT May 10, 2022 Jose Castano PO Box 703 Mt. Sinai, NY 11766 Re: Application #1-4738-04896100001 Castano Property: 1700 Grathwohl Road SCTM# 1000-117-4-3 Dear Jose Castano: Based on the information you submitted the Department of Environmental Conservation has determined that the above referenced parcel located landward of the functional paved roadway, Grathwohl Road, that is greater than 100 feet in length as shown on the survey prepared by Nathan Taft Corwin III, last revised 8/14/2018, constructed before August 20, 1977 as shown on Tidal Wetlands Aerial Photo 710-540, is beyond the jurisdiction of the Article 25 Tidal Wetlands Act. Therefore, in accordance with the Tidal Wetlands Land Use Regulations (6 NYCRR Part 661), no permit is required to conduct regulated activities on that parcel. Be advised, no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundary, as indicated above, without a permit. It is your responsibility to ensure that all precautions are taken to prevent any sedimentation or disturbance within Article 25 jurisdiction which may result from your project. Such precautions may include maintaining adequate work area between the jurisdictional boundary and your project (Le. a 15' wide construction area) or erecting a temporary fence, barrier, or hay bale berm. This letter shall remain valid unless site conditions change. Please note that this letter does not relieve you of the responsibility of obtaining any necessary permits or approvals from other agencies or local municipalities. Sincerely, Kevin Kispert Permit Administrator cc: A. Dunleavy BMHP File tvy RK Departmentof Environmental cawrrezarrrrr,.w. Conservation DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE F_ 08/28/2021 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 AND THE CERTIFICATE HOLDER. IMPORTANT: f the O ertiRODe holder r ,'is an ADDITIONAL INSURED,the policy(les)must have ADDI'T'IONAL 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 rights to the certificate holder in lieu of such endorsement(s). CON! PRODUCER PHONE _ 631-698-4776. "NRW Cotten Coverage Insurance �i 631 698 6091 530 Horseblock Road ' E-IIAAdI_ R 0. Box 557 JAODR _.._... ......... _"_.­. _.._. ..._.. ..... Farmingville,NY 11738 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: American European Insurance Co 23337 ED Jose Castano DB_._... .v.._ . _...... _........�...._. .,.,�.....��_ ...r.�...,,�_....�...... ..,.—._. INSUR...-,.-.�...�.,..o . A Castano Home Improvement INSURER B: __ PO BOX 703 INSURER C Mt Sinai, NY 11766 INSURER[I.: .......,m,m..—.......... __.. LLJ INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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, CONDITIONS OF SUCH SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _IT __ _ EXCLUSIONS ._ LTR COMMERCIALND CO NERAL LIABILITY A,DD�. BR...SKP5000752 POLICY NtdM�SIER. IDDIYY Y MdkWV'tdDIYYYY LIMITS TYPE OF IN H PQLICIE _ AGE.... ..,v......._...—_.,........ POLdCYEF'F POLICYE,XP ff .0410212021 10212022 EACH OCCURRENCE $ 500 606 DAMAGE TO mosa I 100,000 0 CLAIMS-MADE LRr OCCUR `MED EXPAally one person) -- � -�"" -" 00 PERSONAL&ADV INJURY $ 500,000 1,000,000 ATE LIMIT APPLIES PER: GENERAL AGGREGATE S ,- 1,000,000 GEN'LPAOG�REG PRO LOC PRODUCTS COMP/OPAGG S JECT d'W1"I ISR COMBItJ 'D SINGLE LIMIT 5 AU... AUTOMOBILE LIABILITY BEODILY INJURY(Per person) S .. ANYAUTO ..,._. ...,,�...._... .... .... __-.,�„- ..... OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS PROPERTY DJ MAGE a HIRED NON-OWNED '..(Per�acooenl q _. .. AUTOS ONLY AUTOS ONLY UMBRELLA LIABFOCCUR EACH OCCURRENCE _$ EXCESS LIAB L,gIMS,p9q'„A'OEi AGGREGATE 3 DI O IWETLhIGTOIN$ z WORKERS COMPENSATION ISIB,ARI,IrE, OTRH• AND EMPLOYERS'LIABILITY Y I N E L,EACH ACCIDENT ANY PROPRIF.TO-AMARTNER�EXEOUTI�VE 5 OFFICEWMEMSER EXCLUDED? El N 1 A ” ._. (Mandatary in NH} E L,DISE •EA EMPLOYEE $ DISEASE It yya9,deschi e under ASE-POLICY LIMIT $ D I:SC RI IpTot,OF O Pf RAT IONS Wow w 6 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) 1700 Grathwohl Rd, New Suffolk, NY 11956 has been listed as additional insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town Of Southold Building Department ACCORDANCE WITH THE POLICY PROVISIONS. RO BOX 1179 Southold, NY 11971 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Suffolk County Dept of Labor,Licensing$Consumer Affairs HOME IMPROVEMENT LICENSE Name v-; JOSE L CASTANO i Business Name This certifies that the 3earer is duly licensed CASTANO HOME IMPROVEMENT :Py the County of suffolk License Number:H-46483 Rosalie Drago Issued: 07/22/2009 Commissioner Expires: 07/01/2023