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Home My WebLink About23049-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF O~CUPANCY No Z-24192 Date MARCH 5, 1996 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property 4055 BAYS~n~R Bo~fl G~E~NPORT~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 53 Block 6 Lot 20 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SE~£M~BER 19, 1995 pursuant to which Building Permit No. 23049-Z dated OCTOBER 5, 1995 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 P~a_ISE ~?STING ACr~$ORY GAP~z & EXISTING ONE FAMILY DW~T~.IN~ WITH AN a~ITION & DECK ADDITION AS APP~ID ~OR. The certificate is issued to ~a~3.v GUIDO (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N-376032 - JANUARY 24, 1996 JAM. 24, 1996-HA~DY PLUMBING & ~%TING ding Inspect~ FORM NO.$ TOWN OF $OUTHOLD BUILDING DEPARfMENT TOWN HALL SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ~,e .............. ~~..~ .................... ~.~.~ N£ 23049 Z Building Inspector. Fee ~..../~ ......... Rev. 6/30/80 Fo~--a No. 6 TOWN OF SOUTHOLD BUILDING DEP.%P, TM~YT TO~ F~L 765-!802 ~--~ Tr OF OCCU?-~NCY APPLICATION FOR CER~I=~C~-- k. This application must be filled in by typewriter OR ink and submitted to the building inspector with :he following: for ne~ 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 Aoorova! from 5ea!Bh Deot. of water supply and sewerage-disposal(S-9 form). .~ ~ __re 3. A~proval of electrical installation from Board of TM Under~rri~ers- 4. $~orn s%a~ement from plumber certifying tha~ the solder used in system contains less than 2/10 of 1% lead. 5. ~ Commercial building, industrial building~ multiple residences and si~%lar buildings and insta!iat%ons, a certificate of Code Compliance from architect or engineer responsible for ~he building. 6. Submi~ Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses: or buildings and '¥re-exis~ing" land uses: i. Accurate survey of proper~y show~ng a~ property ~ streets, building a~d unusual natural or topographic features- 2. A properly completed application and a consent to inspect si~ed by 5he applicant. if a Cerzificata of 0ccupa~cy is denied, [he Building inspector shall state the reasons therefor in writing to 5he applicant. Fees - ~ = ~?; O0 .~dd~ions to dwelling $25.00, .-, = v - New ~we__-n= ~-~- ' ' '-' ' · ' · $25 ~eratmons to..aw?,=~~S25 00 Businesses $50.00. Additions ~ accesso~ ~um~a~ . · · 2. Certificate of Occupancy on Pre-~xistin~ Buiidin~ - 5100.00 3. Copy of Certificate of Occupancy - $20.00 &. Uoda~ed Certificate of Occupancy - $50.O0 5. T~mporary Certificate of Occupancy - ResidenBia! $15.00, Co~eraia! $15.00 . ....................... - . ~. Old Or ~re-~is~i~E Buildin~ ...... Loca~io~ of Proper~y...~-u ~ .................. 5ouse No, /SZree~ 9nwer or O~ers of ?roper~ .... ~ ..... ~ ....................................... :~:~ ~ ~ ~ ~0o0, s~:~o~ .... a~5 .... ~o~...~ ........... ~ ...................... ' . ........ Filed Map ............ Lo~ ...................... ................... ................. 3kanninE 5oard Approval ........................ _ . .... ~ ~e~;~ca5e .......... ~n~ Carsiczce ........... . ~ o~ .... Fee Submitted: ~ ..~ ..... ' ................. ~. 56%~ ..... ' ............. [~ T~I~ G~IFIES THAT · · in the fottowing tocation~ ~ B~se~nt ~ Ist Fl. ~ 2nd Fl. Section Bilk ~t ~ ~ ~ .... and found to be in compliance with the Na~onal Elect~cal Code. ~ ~sexaminedon FIXTURE EPTACLES SWITCHES ~ FIXTURES ~ ~ECKS OVENS DISH WASHERS D"YERS I ~RNACE ~TO~~ "LL IUNIT HEATERS SYS'"$ OTHER APPARATUS: G. ~' C, I: 3HOKE DETE(. P{ R: -. ~ EXHAUST FANS AMT. H P. DIMMERS F]-M SAGE ELE_., INC. 550 I'LARIN~E PLACE GREENPOgT, N3', 11944 LIC,#3635E C :~,:' ~,A L MANAGER 1] .Per- This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT~ THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. TOWN OF SOUT[IOLD O~FICE OF BUILDIHG INSPECT'fOR P:O. BO?'. ~ 28 TO'~V N HALL SOUTHOLD. N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No. cgAouc)oC (please p~int) P lum20er ~ ~~ (plea~ print) I certif.y that the solder used in the water supply system contains less than 2!10 of 1% lead. vorn to befora me this 0'~ day of ~ Public, ~ County (pLumber's signature) .~. llo~ary Public JOYCE M. WILKIN$ Notary Public, State of New ¥o~k No. 4952246, Suffolk Courtly Term Expires June ! 2, 19..~ RECEIVED ADJUSTERS, INC CC:Town Board Town Attorney Buildincl Pep(. hn an ]~m~. J~C~l~u!l~, Jr. Koy Keeve Agency Southold fn~,. b~.,Lta'IMS ADMINISTRATORS' ADJUSTERS' INVESTIGATORS ~I~"th~~L~'AVENUE, HAMDEN, CT 06'18 PHONE 203-288-646! FAX 203-281-4586 October 12, 2001 Certified Return Receipt Requested_ 53095 Route 25 .~P.O. Box 1179 ------.~'6~"~X?~_-"' '~~~.,' Somhold, ~ 11971-0959 ~ Insured: Southold, Town of Claimant: Guido, Sally Policy #: 3QX119564-01 Effective Dates: 01/01/01 to 01/01/02 Our File: K2-002814(mdm) Dear Sir or Madam: Network Adjusters, Inc., is the authorized Claims Administrator for American Protection Insurance Company. This denial letter is being sent to you at the direction of American Protection Insurance Company. Under policy number 3QX119564-00, with effective dates 01/01/01 to 01/01/02, coverage is provided for Public Officials Liability. With respect to the Public Officials Liability coverage, there is a limit of $1,000,000 each claim with an annual aggregate limit of $1,000,000. There is a $10,000 deductible. The forms and endorsements that are part of this coverage are: ZC 25305 09/99, ZC 25183 05/99, ZC 24961b 05/99, POF 120a 05/99, POF lb 05/99, POF 2b 05/99, POF 32b 05/99, POF 48a 05/99, POF 49a 05/99, POF 20a 05/99, POF 57a 05/99, POF 70a 05/99, POF 7la 09/99, POF 73a 09/99, POF 74a 09/99, POF 75a 09/99, POF 76a 09/99, POF 79a 09/99, POF 80a 09/99, End #A. We received a Notice of Claim titled Sally Ann Guido, Claimant against, Town of Southold, New York. In this Notice Sally Ann Guido, through Counsel, Ciarelli and Dempsey, allege that the Town of Southold was negligent in issuing a Certificate of Occupancy for additions to the Claimant's home. The claimant, Sally Ann Guido along with Richard Saetta applied for a building permit on October 5, 1995. The Town of Southold approved the permit. On March 5, 1996 the Town of Southold issued a Certificate of Occupancy to Sally Ann Guido, stating that the work performed conformed with the Application for Building Permit. On July 7, 2001, while entertaining guests at her home, the deck constructed, within the parameter of the above-mentioned building permit, collapsed allegedly injuring the Claimant and other's at her residence, including Richard Saetta. The claimant seeks monetary relief for injuries and damage. Please refer to the Public Officials Liability coverage portion of the policy. "SECTION II COVERAGES INSURING AGREEMENTS WE will pay on behalf of the INSURED all LOSS that the INSURED shall be legally obligated to pay resulting from a WRONGFUL ACT but only with respect to CLAIMS first made against the INSURED during the POLICY PERIOD. The WRONGFUL ACT(S) must occur within the POLICY TERR ITORY. EXCLUSIONS The following section of this policy restricts coverage. Please read these exclusions very carefully. This insurance does not apply to and WE shall not be obligated to either make any payment or to defend any SUIT in connection with any CLAIM or SUIT made against the INSURED: 3. For any LOSS whether direct, indirect or consequential, arising from or caused by bodily injury, sickness, emotional distress, mental anguish, humiliation, disease or death of any person or for LOSS to or destruction of any property, tangible or intangible, including diminution of value or loss of use. SECTION I DEFINITIONS CLAIM means written demand from any party intending to hold an INSURED responsible for damages resulting from a WRONGFUL ACT covered by this policy. CLAIM also means an INSURED'S knowledge of circumstances that could reasonably be expected to give-rise to such notice. LOSS means any compensatory monetary amount, including punitive damages where permitted by law, for which the INSURED(S) is legally obligated to pay as a result of WRONGFUL ACT(S) covered by this policy and shall include, but not be .limited to, judgments and settlements. SUIT -- means a civil proceeding in which monetary LOSS is alleged because of a WRONGFUL ACT to which this insurance applies. SUIT includes arbitration or any other alternative dispute resolution proceeding in which such LOSS is claimed and to which the INSURED must submit or does submit with OUR consent. SUIT does not include or mean an administrative hearing or proceeding." After careful review of the Notice of Claim, we deny coverage under the Public Official Liability coverage of policy # 3QX119564-01. This policy specifically excludes any "LOSS whether direct, indirect or consequential, arising from or caused by bodily injury, sickness, emotional distress, mental anguish, humiliation, disease or death of any person or for LOSS to or destruction of any property, tangible or intangible, including diminution of value or loss of use". Please be advised that this denial is based on a thorough review of the allegations which were stated in the Notice of Claim and does not imply they are of merit. This letter should not be construed as a waiver of any of the other terms and conditions set forth in the policy and American Protection Insurance Company does not waive its right to rely on all conditions within the policy both now and in the future. American Protection Insurance Company specifically reserves its right to rely on the conditions of the policy should additional or new allegations arise out of this matter. Should you receive any additional information which you feel may change the basis of the allegations, we invite you to submit them to us for a future coverage analysis. Very truly yours, Matthew D. MacDonald Telephone Ext. 111 mdm~macdco.com C. Roy H. Reeve Agency, Inc. P.O. Box 54, 13400 Main Road Mattimck, NY 11952-0054 Attention: Barbara J. Dammers C. Corieri & Associates 1527 Franklin Avenue Mineola, NY 11530 /I~~CHANTS Merchants Mutual Insurance Company Merchants Insurance Company of New Hampshire, Inc. .,~ ['J..INSUP, ANCE GROUP 250 Main Street P.O. Box 903 Buffalo, New York 14240 (716) 849-3333 Auguat 6, 2001 TOWN OF SOUTHOLD BUILDING DEPARTMENT OFFICE OF THE BLDG INSPECTOR TOWN HALL SOUTHOLD, NEW YORK 11971 PEET. RE: CLAIM NO: CC001720 01 INSURED: RICHARD SAETTA CLAIMANT: SALLY ANN GUIDO DATE OF LOSS: 07/07/01 To Whom It May Concern: This letter and notice form will serve as formal notice of a claim for damages/injuires with respect to the above-mentioned claim. Our investigation indicates that your office issued a Certificate of Occupancy on March 5, 2001 for the deck addition at 4055 Bayshore Road in Greenport. Please be advised that on July 7, 2001 this deck collapsed causing injuries to those listed on the Notice of Claim form. Please advise us of your position on this matter. Thank you for your prompt attention. Sincerely, Tammy Moorhouse Claims Representative (800) 952-5246 ext. 3114 CC: File STATE DEPAP. T,,MENT OF E~.IVIPDNI,,~,.NTAL CONSERVATIOi,I Regulatory Affairs Unit Bldg. 49, SU~Y-- Room SI;ony Braol~...~r *~1794 Cil6) 751--7900 A review has been ~ade of your proposal to: New York State ~part~nc of Environmental Conse~aC/on has found -- parcel ~X~ project to be: Greater than 300' from inventoried tidal wetlands. dward of a substantial n-made stru,,ture greater than lO0' in length constructed prior to September 20, 19~7.. __Landward of 10' contour elevation above mean sea level on a gradual, nat- ural *lope. __Landward of topographical crest of bluff, cliff or dune in excess of 10 feet in elevation above mean sea level. - Therefore, no permit under Article 25 (Tidal Wet.ands of the Environmental Conservation Law) is required at this time since the current proposal is beyond State mandated JUrisdiction pursuant to this act. However, any additional work or modifications to the project may require a permit, It ia your responsibility to notify this office, in writing, if such additional work Of modifications are contemplated. ' Very truly youre, r-~r? ,, .--~. i/ Daniel J. Larkin ~gional Super,or of ~gulato~ AffMr~ DJL:RNT:cz Albert J. Kmpski, President John Holzapfel, Vice President William G. Albertson Martin H. Garrell Peter Wenczel Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD August 31, 1995 Richard Saeta General Contractors Inc 4 Bootleg Alley Greenport NY 11944 Re: SALLY A. GUIDO SCTM #53-6-20 DEPT. Dear Mr. Saeta, The following action was taken by the Board of Trustees at their regular meeting of August 31, 1995: RESOLVED that the Southold Town Board of Trustees approve the request for a Waiver to raise the house, add a 6' X 10' addition to existing house and a 10' X 14' deck as shown on revised survey received 9/1/95 with the condition that hay bales or silt fence be placed during construction. If you have any questions, please call our office. ,~Ve r/f truly_your ~, ~ ,q' Albert J. Krupski, Jr. President, Board of Trustees AJK:djh cc. CAC 765-1802 BUILDING DEPT. .,,NSPECTION [ ATION 1ST [ ] ROUGH PLBG. [ /~ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE& CHIMNEY REMARKS:.~ DATE INSPECTOR~ 76S-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION I ST [/].~UNDATION 2ND [ [/~FRAMING [ ] ROUGH PLBG. ] INSULATION ] FINAL [ ] FIREPLACE & CHIMNEY DATE /~,'/~// I~///~ISPE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ~ UGH PLBG. [ ] FOUNDATION 2ND [ ~NSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY_-- INSPECTIO [ ] FRAMING [ ] FINAL [ ] FIREPLACE & OHIMNEY _ REMARKS-- ~ DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: - DATE //'~ ~/'~ ~ INSPECT~*~~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [..] I~ION /J [ ] FRAMING [w ] FINAL []FIREPLACE & CHIMNEY. · ~ i~~~ DATE .~//~~*~_// ,.SP ECT~ IN,qUI,ATION PER H. Y. STATE EHERGY CODE l';'°~l"~'~'e'~^"?l'~-~ BOARD OF HEALTH ...... ...... ~ ld°"~"~'ii'"'q'l':"i;"~'C~:'~'i,,w 3SURvEySETSOF PLANS ....... SOUTHOLD, N.Y. 11971 .~2?. ' / G3~. BLDG, DE~ C A g ~ ~WN OF SOl~ / TEL: 765-180~ '~anffned :]~~., ,9~ MAI, TO~ ~¢--/~ ~ Approved .~.~.. / ~7~¢ . · ., 19~Pe~it No ....... Disapproved a/c ..................................... (Building Inspector) I ~ /PLICATION FOR BUILDING PERMIT INSTRUCTIONS Date SE~ER 15 19 95 a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspect_4 with i 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 street or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli cation. , c. The work covered by this application may not be com~nenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permi 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 whatever until a Certificate of Occupanc: shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Depamnent for the issuance of a Building Permit pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o 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 t~ admit authorized inspectors on premises and in building for necessary inspections. .... ~.I.ClJ..a.Rp..d.A..15~r..A' .o.~.~..lh~...Cg.N..W4.cTg.R..I.~.C,... (Signature of applicant, or name, if a corporation) 4 p..00i~..~..A.L.L~¥. 9.~.~.~.~.Pg.RT..~.L .1.1.966 ............. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder GENERAL CONTRACTOR Name of owner of premises SALLY A GUIDO (as on the tax roll or latest deed) If applicant is a..¢l:irporation, sigrt~ure of ~hlJ.v authorized officer. ........ ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .... 1.3.08.6. .H.I. .............. Plumber's License No...1.5.9.3. P. ................. Electrician's License No...3. t~3.5. E. ............... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. · mS.ORE ROAD REENPOR ltouse Number Street ttamlet County Tax Map No. 1000 Section . .Q5.3 ............. Block 6 ................. Lot . .20 ............... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing nde and occupancy of premises and intended use and occupancy of proposed construction: ~a Existing use and occupancy RESIDENTIAL ............. '~ ' tended use and occupancy RESIDENTIAL 3. Nature of work (check which applicable): New Building ' Addition . ..X ....... Altera,tion Repair' . ............. Removal ............... Demolition .............. Other Work FOUN!)$TIOIq ..... (Description) 4. Estimated Cost $ 50,000.00 Fee ' (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... 1 ......... Number of dwelling units on each floor., lgig ........... If garage, number of cars .1 ............................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .... lqA .............. 7. Dimensions of existing structures, if any: Front. 5R'..-. 8': ..... Rear . ~'..~ 1~". .... Depth . .~8'.-: .lO't ..... Height ............... Number of Stories . .ORR ................................................... Dimensions of same structure with alterations or additions: Front . .5.8.'. - .8.". ....... Rear . 5.8'..: .8". ........ Depth ............... 58' - 10" . ................. Height S/u'qE ........... Nmnber of Stories..O.N.R. ................. .. 8" Rear . 58'..~ .8: Depth .58'..-~ .10". 8. Dimensions of entire new construction: Front 5~a'..-.. ............... Height . .SAHB ......... Number of Stories . .ORIt ..................... . .............................. Size of lot: Front .... 1.(~. ............... Rear ...1.0.0. ................ Depth . .1,5.0. ................. Date of Purchase ............................. Name of Former Owner ............................. Zone or use district in which premises are situated ......... R.E.S.I.D.R.N.T.I../~. ................................. Does proposed construction violate any zoning law, ordinance or regulation: NO ....................... Will lot be regraded . .No. ........................ Will excess fill be removed from premises: X Yes No Name of Owner of premises S.& .I&.Y...GU..I..DQ ......... Address .G.R.B.E.N.P.O.R.T. ......... Phone No. 4.7..7.'i[3.9.5 ....... Name of Architect ........................... Address ................... Phone No ................ Name of Contractor .~I.C..I~.R.D..S.A..L~..A. ........... Address . .G.R.E.E.N.P.O.R.T. ........ Phone No. 4.7.7..-:1.6.3.3. ....... Is this property located within 300 feet of a tidal wetland? *Yes ..]~.. No ..... *If yes, Southold Town Trustees Permit ma~ be required. PLOT DIAGRA~ Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from ~i vperty lines. Give street and block number or description according to deed, and show street names and indicate whether nterior or corner lot. SEE AII'ACHED SURVEY AND PLANS 10. 11. 12. 13. 14. tS. !T~ATE OF NEW Y..DI~K, .OUNT¥ ..... S.S ........ R. I.C.H.A.R.D..S.h..E~..~ ........................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) bove named. GENERAL CONTRACTOR te is the ......................................................................................... (Contractor, agent, corporate officer, etc.) ,f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the .'ork will be performed in the manner set forth in the application filed therewith. .worn to before me this .......... [. ~ ~ .... /./ '" 'J/d4ut/6 f. ~...~.'}eo~oe~ .... , 19 ~otary Push?,{ e'r ..k. nty NOTARY PUBUC: a {; I.Y. ' ' " /(iignature of applicant) ~- ~ Term Ex~i~e~ May 31, ¢JVO~ BLDG. DEPT. N aaor-reAv~ 0 /"x ,-a · .. ~ J