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HomeMy WebLinkAbout48951-Z �0 1pG Town of Southold 8/26/2023 a y, P.O.Box 1179 co "o F 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 44496 Date: 8/26/2023 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 505 Saltaire Way,Mattituck SCTM#: 473889 Sec/Block/Lot: 100.-1-18 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 2/16/2023 pursuant to which Building Permit No. 48951 dated 2/23/2023 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: accessory in-ground swimming pool fenced to code as applied for. The certificate is issued to Yeager,Kathleen of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 48951 6/13/2021 PLUMBERS CERTIFICATION DATED juthoNed Signatur �sufFot,� TOWN OF SOUTHOLD moo Cody BUILDING DEPARTMENT C* z" TOWN CLERK'S OFFICE "oy . opt 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#: 48951 Date: 2/23/2023 Permission is hereby granted to: Yeager, Kathleen 505 Saltaire Way Mattituck, NY 11952 To: construct accessory in-ground swimming pool as applied for. Pool equipment must be located a minimum of 10 feet from property lines in the rear yard. At premises located at: 505 Saltaire Way, Mattituck SCTM #473889 Sec/Block/Lot# 100.4-18 Pursuant to application dated 2/16/2023 and approved by the Building Inspector. To expire on 8/24/2024. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO- SWIMMING POOL $50.00 Total: $300.00 Building Inspector SOUjyol 0 Town Hall Annex Telephone(631)765-1802 54375 Main Road P.O.Box 1179 �Q Sean.deylin(Qtown.Southold.ny.us Southold,NY 11971-0959 D�yCOU�'�� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Kathleen Yeager Address: 505 Saltaire Way city:Mattituck st: NY zip: 11952 Building Permit#: 48951 Section: 100 Block: 1 Lot: 18 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: Electrician: Hart Electric License No: 53942ME SITE DETAILS Office Use Only Residential X Indoor Basement Service Commerical Outdoor X 1 st Floor Pool X New X Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors Sub Panel A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO Transfer Switch UC Lights Dryer Recpt Emergency Strobe Heat Detectors Disconnect Switches 4'LED Exit Fixtures F1 Sump Pump Other Equipment: Intermatic Pool Panel 8 Circuit/ 3 Used, Pentair Intelliconnect 120GFI, 3 Lights - 30OW Transformer 120GFI, Heater, Pump 220GFI Notes: Pool Inspector Signature: Date: June 13, 2023 41/ S. Devlin-Cert Electrical Compliance Form SOUIyO� - - - # TOWN OF SOUTHOLD BUILDING DEPT. courm1 631-765-1802 -INSPECTION [\/FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: Pam/ l DATE qzOY INSPECTOR lam �vqx # # TOWN OF SOUTHOLD BUILDING DEPT. `ycourm, 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: cc !a r 0, (o16 12, - DATE INSPECTOR / pF SOUT /� saw * # TOWN OF SOUTHOLD BUILDING DEPT. o�ycoU631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) f ELECTRICAL (FINAL) [ ] CODE VIOLATION /[-] PRE C/O [ ]' RENTAL REMARKS: DATE INSPECTOR SOUryolo * # TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: lc c e�f f2 i AevetZSe L4,kA V Loc,4- of DinP- 6AP-M v Wl�.WOW ReZ*,(6A0--r !TOW(, &W DATE INSPECTOR pF SOUTyo� # # TOWN OF SOUTHOLD BUILDING DEPT. Vgq rl p ffm io 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG- [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ FINAL e0-01 [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL Of REMARKS: - S ' -everse bock- 4AA 4V or poo i�,s x.11 cax,��l�lc DATE INSPECTOR ho�aOF SO(/T�°� TOWN OF SOUTHOLD BUILDING DEPT. � o � � 631-765-1802 urm, INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ NAL pd-e� 12-o- [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: ��- as DATE g� 02 3 '�3 INSPECTOR ELD INSPECTION REPORT PATE COMMENTS l 5 6 FOUNDATION (1ST) ------------------------------ FOUNDATION (2ND) z i ROUGH FRAMING& y PLUMBING r INSULATION PER N.Y. H STATE ENERGY CODE 1'151 2e I►u,4 a.Pana, )01,4. x10 FINAL pp� p,�� o a e sh2�(, o A(L ISS or• w Ga g.a3.a OK- -�0,2- G•o ADDITIONAL COMMENTS y i2 3 71,44 " 3 0� e 1p t GCS Kea 0424.- on � o � z Z!-4 � Ll im =oma°S� y TOWN OF SOUTHOLD—BUILDING DEPARTMENT y a Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 'y�'oi Sao �4 Telephone(631) 765-1802 Fax(631) 765-9502 https://www.southoldtownny.gov Date Received APPLICATION FOR BUILDING PERMIT L l For Office Use Only PERMIT NO. �/ Building Inspector: A FES b 2 23 . ftWING DEPT Applications and forms must be filled out in their entirety-'Incomplete 76ifUN®FS®11TH®I D applications will not be accepted. Where the Applicant is not the owner,an Owner's Authorization form(Page 2)shall be completed. Date: OWNER(S)OF PROPERTY: Name:' SCTM#1000- Project Address: J� �� ��� Q- 1 l —� Phone# b� Email: QC�� Mailing Address:.Z• OI _� . . .(.C��D�O . CONTACT PERSON: Name: , Mailing Address: Phone# TFEmil: -Co.ci - DESIGN PROFESSIONAL INFORMATION: Name: Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: ' Name: - -, Mailing Address: 73 Phone#: 31 Email: DESCRIPTION OF PROPOSED CONSTRUCTION ;Ne Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: Other u�J i i S i M �,J G T�O $ Will the lot be re-graded? ❑Yes o Will excess fill be removed from premises? es ❑No 1 PROPERTY INFORMATION Existing use of property: Intended use of property: Zone or use district in which premises is situated: Are,there any covenants and restrictions with respect to this property? ❑Yes X&o IF YES, PROVIDE A COPY. Check Box After Reading: The owner/contractor/design piofessional 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,:Newyork 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'buildings)for necessary inspections.False statements made herein are punishable as a Class A misdemeanor pursuant to Section 230AS of the New York State Penal Law. Application Submitted By(pri na e): Authorized Agent []Owner Signature of Applicant: Date: . 21 STATE OF NEW YORK) SS: COUNTY OF Sstgkk ) 1 being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the � 2 (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 before me this j day of /� ✓✓G✓�l .20 �4 Notary Public CAROL ANN STENSLAND Public-Stde of PROPERTY OWNER AUTHORIZATION Notary No.01 ST607OW6 wYo (Where the applicant is not the owner) qualified in Suffolk Courdy my come nlsslon Exp.03/11/2026 I, elf 1'�i E-o LaO-&�— residing at .2 L4 ueAj 0 P± L 2- 141A II V I I Qj o hereby authorize 7�)4wz-" M 1 k/�w to apply on my behalf to th wn of Southold Building Department for approval as described herein. o2 —I1 --23 Owne sSiignature Date -v Print Owner's Name 2 o��SufFOI�`®G 1 B 171It iDEPARTMENT-Electrical Inspector y WN OF SOUTHOLD r, 0`"Torn Magi Annex - 54375 Main Road - PO 60S,l '-1CA 79` Southold, New York 11971-0959' ®yam ao� Telephone (631) 765-1802 - FAX (631) 765-95btin ' 6 l ' ' rogerrasoutholdtownnv.a (ac� ov — seandsoutholdtownny.a20ov 23 APPLICATION FOR ELECTRICAL INSPECTION , ELECTRICIAN INFORMATION (Ali information Required) Date: Company Name: ElecA6C, inc Electrician's Name: gef,,h License No.: L'E_ s39 H a Elec. email: filar g grr,w.I Elec. Phone No: 631 . 411. ol &(E ®I request an email copy of Certificate of Compliance Elec. Address.: JW6 RA04, n o k 10Y 070 JOB SITE INFORMATION (All Information Required) Name: f Address: 505 3ct1 fo lye, VVt? Cross Street: We V e C(cf Lane Phone No.: BIdg.Permit#: 9Oct 51 email: Tax Map District: 1000 Section: Block: Lot: BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): ro 0) Square Footage: Circle All That Apply: Is job ready for inspection?: ❑ YES ❑NO ❑Rough In Final Do you need a Temp Certificate?: ❑ YES 0 NO Issued On Temp Information: (All information required) Service Size❑1 Ph❑3 Ph Size: A #Meters Old Meter# ❑New Service❑Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground❑Overhead # Underground Laterals 1 2 D H Frame Pole Work done on Service? Y Additional Information: Fool J bond %ns fec,40 19' w.t be- fevay CL PAYMENT DUE WITH APPLICATION n�, OROS-afFp(�.COG BUILDING DEPARTMENT- Electrical Inspector �� yam► TOWN OF SOUTHOLD C* Town Hall Annex - 54375 Main Road - PO Box 1179 o • Southold, New York 11971-0959 y O� Telephone (631) 765-1802 - FAX (631) 765-9502 rogerr _southoldtownny.gov - seand(aD-southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMA ION (All In ormation Required) Date: Company Name: Electrician's Name: License No.: Elec. email: Elec. Phone No: ❑I request an email copy of Certificate of Compliance Elec. Address.: JOB SITE INFORMATION (All Information Required) ` Name: -e Address: 5 Cross Street: Phone No.: Bldg.Permit#: S email: Tax Map District: 1000 Section: Block: f Lot: BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): pw . Square Footage: Circle All That Apply: Is job ready for inspection?: ❑ YES [] NO ❑Rough In ❑ Final Do you need a Temp Certificate?: ❑ YES ❑ NO Issued On Temp Information: (All information required) Service Size❑1 PhF—]3 Ph Size: A #Meters Old Meter# ❑New service[:]Fire Reconnect[:]Flood Reconnect❑Service Reconnect❑Underground❑Overhead # Underground Laterals 1 2 D H Frame .D Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION � ��, 'r' � i in� �fh � �n��z5" IZ � �� ,i. /f•, /E �•.. -.. .SIF. � w•, �' M.� �r� y�•' "y'/II, y..•; ,�'., �• �"�"f • '�. _- �. ��,• � -m. �.- .rs•,. •rf1p. F .'i► «+#' '�'_`� �� '• r... �'l��i�', •�/� gra � � �..�e.{'mow„ `�!` �.l., r .� -•� �' � „� �- �r � - •`t •c �� �"' �� � :w-' �.. 'ai.'i � �j "�C� !�'•• G� ' �!c''s fwd".. �' t��� wq" - .r..i- •iM.�. fir. I,'l �Y' 'fir A^' yd's Suffolk County Dept. JM HOME IMPROVEMENT r r'. r•r . Name CHRISTOPHER A HART rs . Business Name7his certifies that the TRI- PANE rrrc r:f INSTALLATIONS r. •'./� r rer is duly licensed ` County of i ,. .. � RosalieLicense Number: H-55804 • • Issued : 09/03/2015 ♦ * Expires : ! ' . 1 ry.. NYSIF ntw ru•k R -.. PO Itwx Ii",Albany,NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE u A A A A A A 113127112 TRI-PANE INSTALLATIONS INC i Ohl/ 8 CEDAR PLACE FARMINpDALE NY 11735 © � SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER TRI-PANE INSTALLATIONS INC TOWN OF SOUTHOLD BUILDING DEFT 8 CEDAR PLACE TOWN HALL ANNEX FARMINGDALE NY 11735 54373 MAIN ROAD P.O. BOX 11 79 SOUTHOLD NY 115I1d145f1 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE H 864 181-3 772612 04107i2022 TO 04107,12023 2712023 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 864181-3, 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 44DCATED 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:IAVWW.NYSIF COMICERTICERTVAL.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. PRESIDENT CHRISTOPHER HART TRI-PANE INSTALLATIONS INC TWO PERSON CORP THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIrICATE HOLDER THIS CERTIFICATE DOES NOT AMFNn FXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY, NEW YORK STAT SU NCE FUND T�Yr DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 1088945850 U-26;1 Al W°`�"�' CERTIFICATE OF INSURANCE COVERAGE All Comp�tl!#tltl ' Board NYS DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW PART 1. To be completed by NYS Disability and Paid Fancily Leave benefits carrier or[icon sed Insurenos pent of that carrier — -- 1a.legal Name a Address of Insured(use street address only) tb.Business Telephone Number of insured TRI-PANE INSTALLATION INC. B CEDAR PLACE FARMINGDALE,NY 11735 1c.Federal Employer kk"Afficeiion Number of Insured or Social Security V111011 Looabon of Insured ,s atwuitcel►y Number 7ntysal In r,.rrra,n kicW ars r Non-Ya'ir State a Mrsp up Pbk y1 113127112 2 Name and Address of Entity Roque"rroo( m of Coverage— 3a.Nae of Insurance Carrier (Ertity Being Listed as the Certificate Holder) HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ANNEX 54371 MAIN ROAD 3b. Policy Number of Entity Lined in Bax la P.O.BOX iin SOUTHOLD NY 11971-0939 1.1116115111 3c.Policy~five period 01-01-2023 to 12.31•Z013 -- d.'o90y provides the following benefits: Q A.Both disability and Paid Family Leave benNtts. ❑ 0.Disability benefits only C.Paid Fancily Leave bsnehh only. 5 Policy coven. LXJ A,All Oft"employers employees eligible under the NYS Dlsabinty and Paid Family Leave Benefits Law. 8 only the toflowing class or classes of employers employees Under penaky of perjury,1 certify that I am an authorized representative or licensed agent of the,assurance carrier referenced above and that do named.,....._ Insured has NYS Disability and'or Paid Fatuity Leave benefits Nrwrance coverage as described above. Date 511 nod 02-07-2023 j5y F rear), ta:araatura M M+wranca uniary amdkwk d wgreaer um—or lit"Maenaaa hnueaaue aeeni W that twwaau aewlani 4 Telephone Nurwber (2121553-MT4 Name and Title, ELIZABETH TEU.O-A6010TANT OWEC'TOR_STATUTORY IIEILWES _ II(�IMPORTANT, If Boxes SIA and SA are checked,and this form is signed by the insurance carrier's authorised representative or NYS Licensed Insurance Agent of that caller,this certificate is COMPLETE.Mail it directly to the certificate holder. It Box 48,4C or SEI Is checked,this certificate is NOT COMPLETE for purposes of Section 220,Subd.if of the NYS Disability and Paid Family Leave Benefits,Law it must be emailed to PAijQwcb.ny.gov or it can be mailed for ccmhletlon to the Workers'Compensation Board, Plants Acceptance Unite PO Box 5200,Binghamton.NY 13902-5200. PART 2 To w,tzunpluted by the NYS Workers'Compensation Board(only N Bots 48,4C or 58 have been checked) State of New York Workers' Compensation Board According to Information maintained by the NYS Workers'CompensaliDn Board the above-named eincloyer has complied with the NYS Disability and Paid Family Leave Benef is Law lArticle 9 of the Workers; CDmhensatlon Law)wi— resciect to all of their employees, Cate Signers By tstsealuw ar Mrehon=eC ws Yrakwi cuenaeewee illarr Ilreyitstiwj_ ---- TMephone Number Name and THIe Pfsese Mote: to wte NYS d►sab1ty.aid parol vaqvv,Awl heneks wSur9ree pa',c es and IW��itiniissd;Maaxsnse agents o� these �s.xanpa Cerriera ase euthy�tel Iv issue dorm D&t7P r Insurance Arokei s are W r aufhorfred to Issue We fort OB-120.1 (12-21) raw.— .• . . t t .r. ACCaRLf CERTIFICATE OF LIABILITY INSURANCE SDA 1-'2oW 2073 THIS CERTIFICATE IS ISSUED AS A MATTER OF INF0kMATION ONLY AND CONFERS NO R1GP4TS UPC* THE CERTIFICATE HOLDER. THIS CERTFICATF DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND. EXTEND OR ALTER THE COVFRAGF AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE Of INSURANCE DOER NOT CONSTITUTE A CONTRACT BETWEEN THE ISSLING INSURFRISI AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTrICATE HOLDER. IMPORTANT. It the Csrblicate holder is an ADDITIONAL INSURED, the pohcyiwsl must halve ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require sr. endorsement. A statement on this certit,"Ie dues riot confer rights to the Certificate holder or Neu of suds atdtxsement S . MOoucuuAte.TAO Bob Hannan StateFwm Bob Hannan wqN! 5tA-561 7360 r•" No, I A t.tM3: 29 E.Marr+ck Ra EW.boc hanna�.def�staTria-rn-rim I+Iete"S;AMOI)IMG COVERA:E RAIC 9 Valley Sbeern NY 11580F.8'4 031IMER A Ste to=arm F+re am C:as,:ally CrWipany Ikito p Fins) 25183 sl�URla INMIRER a Scam Farm KODII A juwY *de knJrarxe COMP"(inc!L 261 r8 TRI-PANE'INSTALLATIONS IMsuP�R c 8 CEDAR-IL MUM 0 "'IBURER IF FARMNIGOALE NY 117355,1210 oisuRasr COVERAGES CERTIFICATE NUMBER REVISION NUMBER: THIS 18 10 CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO T►•E INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REOUIfREMENT, TERM OR CONomaN U1F ANv CONTRACT OR OTHER DOCUMEN' WITH RESPECT TO WHICH THIS CERTIFICATE MAY DE iMr!D ()R k4AV PERTAIN, THE INSURANCE AFFORDED BY THE POUCIFS DESCRIBED HEREIN IS SJWECT TO ALL THE TERMS, EXCLUSIONS AND CONDI-IONS OF SUCi-POLICIES LIMITS_SHCr^MAY HAVE BEEN REDUCED BY PAID CLAIMS POLICY NUItaER POLICY FRi POSY nP TR TYPt;OF INSURANCE Latus costsllRCIA11,0CM tAL LUlsRd17 EALH c`c.:nRF?CF 1 1,000000 i Ct A,W,0&Q X i:Ct ,iN ZAaAA.24'0 RENTED p+ L4Es IEA ton_-*roI 4> 100,000 YEDEXV'A�yrentpMeon} f 5.000 A N N 92-CX-Y517-3 07110,2022 OTO W2023 -,c�a ADV KKOW GEWL AOORECIATE LIMIT APM.ieS PER GENERAL A(3OFte'3ATi .. ..•.s 2.000 OWC�Rr} .- - i POLICY JEC' LOC PreoaucTs•carrnx Arc s 2000000 OIKER AUTONOW .E JAaIUTY s ANY AJ TU 26'54364-F2432 0&7412022 08+24,2023 ..tEI WArANI,...:.. _... s 2859104-A19-32 ROM r'MIURYIPerrorw s 500,Ot10 B owroD Y x is`�AuToft N N 07119/2022 07/1912023` HMO �kKIN-17AM" 2654288-F2632 BODILY'Nwk' '°"""" """ t g00 000 ALTOS DAtLY -{AUTMONLY 0&2612022 Ob+26,2023 L QS 1 OOO 2618316-E15-32 0&05+'2022 O5+tS2O13 ; UISSRSLLAtIRa OCCUR FACT dCCtliiRCNeE f Sloo�e uAa � , .__,_,.......... ,_,_,.,,._....�_.... -- E AWREGATE S tt� It AM NW%AnVW wllifry PEP otw ANY PAOPPW0 7PARTNW1;4 ff*ffn,F Y-'N S'AtuTJk.:_.-._�.kR t .0"40M01chl Lx'ZLL0LC" M,A E L n'ACHACCOM S k LU BLASE EA EMPLOYEE ; OF TI - E L.OralASE PM C-.&01' De eGJrPT10N OF OPMATIONS 1 LOCATIONS'VDOCLES (ACGM 191,Ad*ftnd RawtrM.•Srp.ete..#My N 0"C""M mw_o spa,,,, rnubM: _ I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED W Towr O'Southold BLII&na O &pt Town foal Arneli ACCORDANCE WITH THE POLICY PROVISIONS. 54375 Main Rd PO BO1t 1 1 r9 AUTHORIZED REPRESENTAT" Southold NY 11971.0959 Ave W.4- 'M Inn,,.,cos"Mw-pr~on 02007,2023 0 1!160-WIS ACORD CORPORATION, All rights reserved. ACORO 25(201&031 The ACORD nwne and logo are registered marks of ACORO 100140=6 tBUTS"S 4'•I s 7977 y r cam/ -. •r. ,•� � .!r �+P� � �. � -� ,`-�• �,;� •-- t +7' �'" JC � .► / � `� ,C �►� �. 'fir. , + ! .y � i /jam .�r r't� .�s-. ►,,., rr ���• iI• "� � '^.. � '„"' 1• yrs i. 'i .r -fir. tl"- � �.: /�" .g. .�'. ,,;Sr �#..� ��� '�r' "G' '�., ^ 11� 1�.. ��• �` ♦ }!" �. r .�. y�. ,4,C. � '-, f Suffolk County Dept. of Labor, Licensing & Consum6i • jrs R; • HOME IMPROVEMENT •... Name CHRISTOPHER A HART r: r E Business • • t the • INSTALLATIONS PANE )earer is duly licersed • County of suffolk RosalieLicense Number: H-55804 . • Commissiorer Expires : 9/ 1 /2023t, SURVEY OF LOT 21 MAP OF SALTAIRE ESTATES FILE No. 4682 FILED AUGUST 3, 1966 - • . : SITUATE -: •:' ���QQH�° R� MATTITUCK } G °vim i, o 22 Z25.00c °MON ..;Z TOWN OF SOUTHOLD S LO ((� SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-100-01 -18 ;;' SCALE 1 "=30' �� N p�°N a a•` •:+ 0. DECEMBER 19, 2022 0 i^I SCE \ �\ B�FJ�W •• j °Rpt o• (n •a•• pSP�' .: •. •.•. �°y� .p.•. 6 N 324 ,tl d . AREA = 22,500 sq. ft. ,' 00030 44 o m : .ti : s :a>., 0.517 ac. 1,0T 0 "D°w O 0c N ,r "`wwx c CERTIFIED T0: W ppp Oaf q.2 i, B ! •a •co• Fp�N° MON• y � O 0, ':•••• Valerie Kokelaar OWN' OON° Z W 5 ' R° $' o Jane Novatt y .0. �o� ,2 `R°N Z �, o ' ' a Westcor Land Title Insurance Company ` � 0% j/ ERioi Ra • MERS Inc. as Nominee for Rocket Mortgage, LLC ISAOA V �O OS 0,�, 21 135, 325 90 L SOR a$N Q O J •A•.. CON°21�N�5aAFJ� ( � �. '- •,a 1?515 11 :. e. 0LOT ,� ® °2 �O o'••asp` s pRN r A0 . y� �o PREPARED IN ACCORDANCE WITH THE MINIMUM o01. STANDARDS FOR TITLE SURVEYS AS ESTABLISHED °5 �s BY THE LULLS. AND APPROVED AND ADOPTED FOR SUCH USE BYQRK STATE LAND Q y� CE 2 TIRE ASSOCIATIO O F�Np MON' y,�owl- �20°' v� /eC� 10T O C5 -1 AF 5111M (� r 7- 1,0T ?s NX.S. Lic. No. 50467 UNAUTHORIZED ALTERATION OR ADDITIONNathan Taft Corwin III TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW Land Surveyor COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR �v EMBOSSED SEAL SHALL NOT BE CONSIDERED Successor To: Stanley J. Isaksen, Jr. LS. TO BE A VALID TRUE COPY. Joseph A. Ingegno LS. ONLYCERTIFICATIONS TO THE CAT HE PERSON FOR WHOM THE SURVEY INDICATED HEREON SHALL RUN Title Surveys — ye Subdivisions — Site Plans — Construction Layout Y ONLY IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND PHONE (631)727-2090 Fox (631)727-1727 LENDING INSTITUTION LISTED HEREON, AND . TO THE ASSIGNEES OF THE LENDING INSTI- OFFICES LOCATED AT MAILING ADDRESS TUnON. CERTIFICATIONS ARE NOT TRANSFERABLE P.O. Box 16 1586 Main Road THE EXISTENCE OF RIGHT OF WAYS Jamesport, New York 11947 Jamesport, New York 11947 AND/OR EASEMENTS OF RECORD, IF E—Mail: NConxin3®aol.com ANY, NOT SHOWN ARE NOT GUARANTEED. - - - - - - - 42-2, APPROVED AS NOTED DATE: FEE: BY:_ RETAIN STORM WATER RUNOFF NOTIFY BUILDING DEPARTMENT AT PURSUANT TO CHAPTER 236 765=18b2 8 AM TO 4 PM FOR THE OF THE TOWN CODE. FOLLOWING;INSPECTIONS: 1. FOUNDATION.- TWO REQUIRED FOR POURED CONCRETE. .2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST ELECTRICAL BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE INSPECTION REQUIRED REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED AND CONDITIONS OF "IaIAT SLY": GUT v„ ` R F,NCLOSE POOL TO„CQDfh-- � '-NNING BOARD COMPLETION`;'*; '-� —UPON:�' 'BEFORE WATER -L,ld Otbo TRUSTEES _)XUPANCY OR 1SEIS:UNLAWFUL VITHOUT CERTIFICV 'F OCCUPANCY SECTION G106 .EN,PRAPMENT PRO TECTIOWREQUIRED POOL AND PROPF TY TO CONFORM TO N.Y. STATE RESIDENTIAL S1•,TION G107 OODE APPENDIX G 2 0 Cc' EDITION PC& ALARM REQUIRED POOL TO CONFORM TO ANSIMSPI SnwbARDS AG103.1 919E(PT) A C C Pig P 0 ABPA cAp. DPMa1 S AM 4.nnw). u � Cz) �OIH�uti-r►� tir`catio 4 A A 1 f VA�vD 3 'TuBQ 1N GRAYEL Slj•KB , �1L7E{Z ptiMP C1dTo�. ' Poo L P L 1,4 ' . ,�� ---------------- 1:5 el 400 T ljv CCtrCRAL•NOTCi� •.��:�'• ••'�; . L THC DCi16N IS awsCO OMA DRAIHACC SOIL WIT14 10jC3•LT.:, '• �•� blxfl 11LE ' 1Yf l�dtG tY1R O � CROUkO MATER SHALL Not Cml WITHIN r ' r• �4' THC LIMITS Of THC • �quOl KWAVATION.Ir CFCu 1rATEIt C`XISTS VnTHtf.9'-O'RELAW !WAW lj g GRAOC sfCCcIAL-DSWATCfiNC rAWTICi.WILD.pC"OUIRtO. 1, y jr� _f {, wn+!uKa--- WAT�&���.D"ti��PO"S_AL.a LIMITCO TO OwWAt PmomT,Y. v. •�• y t �t m L 1.0 su/�t7•ARs:C ALWnD WITHI►I 1�-0 Or SHALLOW CHO K ANO 4"Cr OI DCCP Cr, w17;'� '!•; y�' N�MYWsrAT(G, S.THC haWMATKALLY APPUCO CCNCRCTC CeVkn CI SHALL b'• �$ i VALVE A►1p DC A 014 MIX WIT)l A MAXIMUM Of.3�z•CALLOH3 Or f �µ O.RAYE1.PSPdE ><ATCR prat S=or c¢e.ENT. 1 8 '' ,•• —"'Flt"q q„t �a e;N E MhT�G f'{-Ur')DINS • tP>rlNdt8t1�N"�' E• RGNrORCINO STEEL SHALL DC INTCANCINATF CRAOC •� •' i sk-LCT STCCL Wan A MINIMUM LAP Or ]o:aAR•' •' VAV ouwcrcRa. iY % , ;�yA•o mr 6" IYt1•Iw J S. POOL 1rATER iUPPLY OY OwNCIa'S CaROEk _ O pool TO ac XZPT rULL 00A,NC !! TMI%!9•N4 •:, :!• I ryhbl { fIICC1NIC >•CATHCR,;' VMS PVYP'CAPAGTY'TO OC SVrrtCICNT TO "PTY TOOL ' nINIIN►h :, . � �� PKlM <5• IN 24 MOYRS. t• • HAVZ• /1/ t1�I•I>< Cf Q �7� �" I1'6rRFILCA L ••'' MT• is sc. AI.�1�Gfi lO N mots t Ra wII H. ROY JAF'F'E, P.E. firms iir `TMS' 747�> Southampton,'IVY; �kCJFfiS��r,:,s�