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HomeMy WebLinkAbout49356-Z �O\OS11FF0(c y Town of Southold 9/24/2023 - P.O.Box 1179 W ti 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 44571 Date: 9/24/2023 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 12700 New Suffolk Ave, Cutchogue SCTM#: 473889 Sec/Block/Lot: 116.-6-14 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 5/9/2023 pursuant to which Building Permit No. 49356 dated 6/9/2023 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: "as built"alterations and repairs to pre-existing seasonal cottage as for. The certificate is issued to Cagnazzi,Robert&Kim of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 49356 9/18/2023 PLUMBERS CERTIFICATION DATED 9/11/2023 Do la Natsch 12 dr A rizek4ignature suFF X` TOWN OF SOUTHOLD BUILDING DEPARTMENT y x 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#: 49356 Date: 6/9/2023 Permission is hereby granted to: Cagnazzi, Robert 39 Connelly Rd Huntington, NY 11743 To: legalize "as built" alterations and repairs to pre-existing'seasonal cottage as applied for. Additional certification may be required. At premises located at: 12700 New Suffolk Ave, Cutchogue SCTM #473889 Sec/Block/Lot# 116.-6-14 Pursuant to application dated 5/9/2023 and approved by the Building Inspector. To expire on 12/8/2024. Fees: AS BUILT-ACCESSORY $200.00 CO-ACCESSORY BUILDING $50.00 Total: $250.00 Building Inspector pF SO�T�Q! 0 Town Hall Annex Telephone(631)765-1802 54375 Main Road P.O.Box 1179 a� sean.devlina-town.southold.ny.us Southold,NY 11971-0959 Q�yCOUNTI,�� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Robert Cagnazzi Address: 12700 New Suffolk Ave city,Cutchogue st: NY zip: 11935 Building Permit#: 49356 section: 116 Block: 6 Lot: 14 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: Electrician: ESCO Electric License No: 43646ME SITE DETAILS Office Use Only Residential X Indoor X Basement Service X Commerical Outdoor X 1st Floor X Pool New X Renovation X 2nd Floor Hot Tub Addition Survey X Attic Garage INVENTORY Service 1 ph X Heat Duplec Recpt 25 Ceiling Fixtures g Bath Exhaust Fan 3 Service 3 ph Hot Water 30A GFCI Recpt 3 Wall Fixtures 6 Smoke Detectors 2 Main Panel 200A A/C Condenser Single Recpt Recessed Fixtures 10 CO2 Detectors Sub Panel A/C Blower Range Recpt Gas Ceiling Fan Combo Smoke/CO 2 Transfer Switch UC Lights Dryer Recpt Emergency StrobeHeat Detectors Disconnect Switches 23 4'LED Exit Fixtures Sump Pump Other Equipment: Hood, Fridge, Oven, DW, Septic Disconnect, 200A Panel 40 Circuit/ 22 Used Notes: AS BUILT NO VISUAL DEFECTS " Seasonal Cottage Inspector Signature: Date: September 18, 2023 S. Devlin-Cert Electrical Compliance Form so�ryo_ Town Hall Annex l Telephone(631)765-1802 54375 Main Road , Fax(631)765-9502 P.O.Box 1179 G "Q Southold,NY 11971-0959 BUILDING DEPARTMENT (�! GIVE TOWN OF SOUTHOLD S E P 1 4 2023 I UH,DING DEPT. C E R T.I F I C A T_I-O_N e - Date: 9111/23 Building Permit No. 49356 Owner: Robert Cagnazzi (Please print) Plumber: ouColCAS (Please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plumber Signa re) Sworn to before me this 12th day of Sepember , 20 23 Notary Public,: Suffolk.._ . C.oun'ty EJOSE L ESCALANTE NOTARY PUBLIC STATE OF NEW YORK SUFFOLK COUNTY LIC.#01 E86241144 EXP. ��OF 50h°�q4 # # TOWN OF SOUTHOLD BUILDING DEPT. courm, 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN ULATIOWCAULKING [ ] FRAMING /STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL R ARKS cook ` �l -Oro • n I Tj 1 DATE 1 INSPECTOR ho��OF SOUlyO� y 9 73g�o 127 6v # # TOWN OF SOUTHOLD BUILDING DEPT. Cnu631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION KELECTRICAL (ROUGH) ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: S � DATE INSPECTOR —IP iG,f9' Nev �, /� OF SOUTyo� 1 � I Z 70 0 6 v �`\ V T//�Y'//_/'�y Ik # 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: 14 u (2 a!-r/+tft DATE II INSPECTOR Austin Patterson Disston ARCHITECTURE&DESIGN JUL 1 4 202 T 7 i July 13,2023 Southold Building Department 54375 NY-25 Southold,NY 11971 Re: Cagnazzi Cottage 12700 New Suffolk Avenue, Cutchogue To whom it may concern, I have inspected the property and found the following: • Foundation: The existing piers remain and the structural integrity is acceptable. • The rough framing structural integrity is acceptable. • The rough plumbing was done by a licensed professional and is acceptable. • Insulation: The house is insulated with R-30 insulation although the structure is seasonal and unheated. Please let me know if you require any additional information. Best Regards, Stuart Disston �p ARP, Senior Principal yJ T02�i1 02432 qT�OF NE`s v 149 Water Street,Suite 201,Norwalk,CT 06854(203)2554031144 Quogue Street,PO Box 1707,Quogue,NY 11959(631)653-1481 www.apdarchitects.com FIELD INSPECTION REPORT DATE COMMENTS b FOUNDATION (1ST) a ----------------------------------- ip [ FOUNDATION (2ND) z 0 d cn o � ROUGH FRAMING& PLUMBING (lb y 1 t r INSULATION PER N. Y. _ STATE ENERGY CODE Oya .p( r FINAL ADDITIONAL COMMENTS • 12 . 23I c0 re c b�(eTCVI (-37Sev\) I 2 0 ce G 1 U4 3 - o tL Y l�Lj Q A. \kvi - CAWV -ft z 0� 0 _ � z x x - - d b H o� FFotK�o� TOWN OF SODTHOLD—W"ING DEPARTMENT �a Town Hall Annex 54375 Main Road P.O.Bog 1179 Southold,NY 11971-0959. Telephone 631 765-1802 Fax 631 765-9502 https://www.southoldtownnv. ov i�Received APPLICATION FOR BUILDING PERMIT vis �o�ceUse Only ® t lln is 11 w it PERMIT NO. Buffding1wpw°Dr MAY 169 1 3LD Applications and forms must be filled oat in their.eiitiretjfr Irtcoanplete < appiications wilt not beaaccepted. Where On Applicari!t is not the owner,an UUY�IHVV Ul P1 "0vkwes Authornation`fann`(Page 2)sliaB.6eoomple�ed: 7ti�9"opanumn ® Date:wao OWNERS)OF PROPERIM. _. Name:Robert and Kim Cagnazzi SCM#1000-116.00-06.00-014.000 Project Address:12700 New Suffolk Ave., Cutchogue Phone#:(fi31)220.4395 Emaik lob@ cagnazzi_com Mailing Address:1270,0 New Suffolk Ave., Cutchogue, NY 11935 WNTACT PERSONc Name:Bryan Stinson/Hobbs Inc. Mailing Address:PO Box 1274,Bridg.ehampt9n, NY 11932 Phone#:631 33"872 ETgil:bstinson@hobbsinc.com DESSIGN PROFESSIONAL INFORMATION:. . Name:Stuart Disston/Austin Patterson Disston Architects Mairing Address:PO Box 1707, Quogue NY 11959 Phone#:631 853-14$1 Email•sdisstonO apdarphitects.com LbONTRACFOR INFORMAFI011i: " Name:Hobbs Inc. Mailing Address:p0 Box 1274, Bridgqhamptqq,,NY 11932 Phone#:631338.0872 Email:bstinson@ hobbsinc.com DESCRiPTIOM OF PROPOSED:-CONSTRUCnON ❑New Structure []Addition DAlteration BRepair ❑Demolition EstimatedCostofProject: �OtherR�Zlal'-1 f f k'&4iqxtwzwr-�, gnd s mnaemarwomBOR•al $ea000m Will the lot be re-graded? []Yes BNo Will excess fill be removed from premises? ❑Yes B No 1 PROPERTY INFORMAT110N..:. Existing use of property: intended use of property.sww,.E*&v Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to RA this property? 59Yes❑No IF YES,PROVIDE COPY. ®Check Box After Read /a �p ri r 1-.ewws�fqs ae d�ai a wW sh �s as pnwitied by Or+pteUSofthe twin Codr:AMNAT10N1SHErMYMAWtotla&Aii gq=WxMttuffieb 'araswiffmi► dl purwantt6VWBU1dtngz0rie arm==afthe Tmn otsm oki saW ammy,Wwyo*and oma%*9Cd a tars,Ori or RaSieW0 m,fartfit nosbuction of buldkgM s&WJom,aiterVansorfarrenoralordenoigonasherebdas69w&.h g A.- Rapeestom 1yvithsRappiabfek wSamms,bOdingcode, hoar code wW,n p v&=and to admftstun rtd iupee>oes on prentm a o in far neceowbakestateneftmadt heein are puaishaUeasaChmAmisderieaiorpuramaitoSediwr210,13orthi NewYori thftDealtaw:. Application Submitted By(print na ):Bryan Stinson/Hobbs Inc. ®awed Agent 110wner Signature of Applicant: - Date: Jr $ ZOZ 3- STATE OF NEW YORK) COUNTY OF 5 J M) K } rvQ� Sfiwornr) being duly sworn,deposes and says that(s)he is the applicant (Name o individual signing contract)above named, (S)he is the tAw, 1irG (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 Pfmv g day of Q y .2o 23 Notary Public LINDA B.SCROLL Notary Public,State of Ya It No.30-4658259 PROPERTY OWNER AUTHORIZATION Qualified In Suffolk Counq- (Where the applicant is not the owner) Commission ao'ires May S.20 I, Robert Cagnazzi residineat 12700 New Suffolk Avenue, Cut gue, NYdflnerebyauthorize Bryan Stinson/Hobbs Inc. to apply on m beh t Town Southold Building Department for approval as described herein. Owner's Signature Date Robert Cagnazzi Print Owner's Name 2 U.S. DEPARTMENT OF HOMELAND SECURITY OMB No. 16so-000a Federal Emergency Management Agency Expiration Date:November 30,2018 National Flood Insurance Program ELEVATION CERTIFICATE Important:Follow the instructions on pages 1-9. Copy all pages of this Elevation Certificate and all attachments for(1)community official, (2)insurance agent/company,and(3)building owner. SECTION A—PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name Policy Number. Karin Stiles&Thomas Stiles A2. Building Street Address(including Apt., Unit,Suite, and/or Bldg. No.)or P.O.Route and Box No. Company NAtC Number. 12700 New Suffolk Avenue arty State ZIP Code New Suffolk New York 11935 A3. Property Description(Lot and Block Numbers, Tax Parcel Number, Legal Description,etc.) Suffolk County Tax Lot 1000-116-6-14 A4. Building Use(e.g., Residential, Non-Residential,Addition,Accessory, etc.) Accessory A5. Latitude/Longitude: Lat.40'59'28" Long,72'29'17" Horizontal Datum: ❑ NAD 1927 ❑ NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 5 Aa. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace orenclosure(s) 1,278 sq It b) Number of permanent flood openings in the crawlspace or enclosure(s)within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b sq in d) Engineered flood openings? ❑Yes ❑ No A9.For a building with an attached garage: a) Square footage of attached garage sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade c) Total net area of flood openings in A9.b sq in d) Engineered flood openings? []Yes ❑ No SECTION B—FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1. NFIP Community Name 8 Community Number B2.County Name B3. State Town of Southold Suffolk New York B4. Map/Panel B5.Suffix B6. FIRM Index B7. FIRM Panel 88. Flood Zone(s) 89. Base Flood Elevation(s) Number Date Effective/ (Zone AO, use Base Revised Date Flood Depth) 36103CO501 H H 09/25/2009 09/25/2009 Shaded X N/A 810. Indicate the source of the Base Flood Elevation (BFE)data or base flood depth entered in Item B9: ❑FIS Profile X❑ FIRM ❑Community Determined ❑ Other/Source: 811. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ® NAVD 1988 [] Other/Source: B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area (OPA)? ❑Yes ❑ No Designation Date: ❑ CBRS ❑ OPA FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 1 of 6 ELEVATION CERTIFICATE OMB No.1660-0008 Expiration Date: November 30,2018 IMPORTANT:In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address(including Apt.,Unit,Suite, and/or Bldg.No.)or P.O. Route and Box No. Policy Number: 12700 New Suffolk Avenue City State ZIP Code Company NAIC Number New Suffolk New York 11935 SECTION C—BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings' ❑Building Under Construction' ❑x Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete, C2. Elevations—Zones Al—A30,AE,AH,A(with SFE),VE,V1—V30,V(with BFE),AR,ARIA,ARAE,ARIA1—A30,AR/AH,AR/AO. Complete Items C2.a—h below according to the building diagram specified in Item A7.In Puerto Rico only,enter meters. Benchmark Utilized: Vertical Datum: Indicate elevation datum used for the elevations in items a)through h)below. ❑ NGVD 1929 ❑ NAVD 1988 ❑Other/Source: Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. a) Top of bottom floor(including basement,crawlspace,or enclosure floor) 7. 7 Q feet ❑ meters b) Top of the next higher floor ® feet ❑ meters c) Bottom of the lowest horizontal structural member(V Zones only) ® feet ❑meters d) Attached garage(top of slab) ❑X feet F1 meters e) Lowest elevation of machinery or equipment servicing the building 7 7 x❑ feet ❑ meters (Describe type of equipment and location in Comments) 0 Lowest adjacent(finished)grade next to building(LAG) 6, 3 ❑X feet ❑ meters g) Highest adjacent(finished)grade next to building(HAG) 7 1 ❑x feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs,including 6 5 ❑R feet [] meters structural support SECTION D—SURVEYOR,ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer, or architect authorized by law to certify elevation information. I certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false statement maybe punishable by fine or imprisonment under 18 U.S. Code, Section 1001. Were latitude and longitude in Section A provided by a licensed land surveyor? ZYes ❑No ❑Check here if attachments. Certifrer's Name License Number John C. Ehlers 50202 OF .•• Title `��Oma C: k"fz Land Surveyor z � Company Name �r John C.Ehlers Land Surveyor Address 6 East Main Street city State ZIP Code j Riverhead New York 11901 Signature Date Telephone j� 07/12/2017 (631)369-8288 Copy all pagfs of this Elevation Certificate and all attachments for(1)community official,(2)insurance agent/company,and(3)building owner. Comments(i cluding type of equipment and location, per C2(e),if applicable) Lowest equipment serving the building is a hot water heater on first floor. FEMA Form 086-0-33 (7115) Replaces all previous editions. Form Page 2 of 6 BUILDING PHOTOGRAPHS ELEVATION CERTIFICATE See Instructions for Item A6. OMB No. 1660-0008 Expiration Date: November 30. 2018 IMPORTANT:In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No. Policy Number: 12700 New Suffolk Avenue City State ZIP Code Company NAIC Number New Suffolk New York 11935 If using the Elevation Certificate to obtain NFIP flood insurance affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken, "Front View"and"Rear View", and, if required, "Right Side View"and "Lett Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. A -- t�: s 4 s df't1` 'eeW.. - k' 1� NNE= .—...... P%do One . Photo One Caption Front 07.10.2017 a t r: Philo Two .. . Photo Two Caption Rear 07.10.2017 FEMA Form 086-0.33(7115) Replaces all previous editions Form Page 5 of 6 7 N W E _ UTIL. POLE WAR MAIN N NY TT-0- EW 173.25, 1/43 SVFFO I (DEED S79. LK A VENUE ' .S7 • S 35.00 E N ' 35lOQ'!E POLE EDGE OF PA �� 1 1142 'G VEMENT ' I I 1 I I I °KErPR 1)4I ILIAE AS MOryUMEry>ED 1 L4 ' CA TE I X41 7.3•W 1 1 FEN I 1 � 34g 50!I 1 1 / / POLE FEN #40 os•W / 1 1 / / J a o k- FEN 4 2'W O 1 U CENERA TOR I UT/ w ��llIf I Z TROSFpRMER L I /�-OI O ROP O VL' UE TCR CJI 77�� a U EL. PANEL IDp ' ,oo oo�I E0�o cNR O1FRo 0 sr / •� / p5 _v o& g zs.r Lc1 BLOCK qp 0 // �ry �F0,T r ">, CL 4 RON O / 6eJF 0 ,� v /�., DIV S v \ \ (7� Q) W W FEN STONE DRIVEWAY / COLF�FO' QOM \\\\\\ I /•'\�\{ GAS Q) � 0 0 o8" OW DW STONE DRIVEWAY O xcl O 4- 20.2' SLATE WALK \ E0'�'. FEN $7' m \ On ' �9•DW m o 5.2.m 2,.8• n PARC 3$. 19.2, 21.7• o !� .y4.�S / / \\\ • / OF w w rn 30 oo as 2 & / 77.2'NAO STORY� E WOOD FENCE \ [,OcqRGCA TE P S� � Q 3 DW 22La'� 87, % 71. �� \\\ /• / QE`�Q\G��� ^_sz o \0' COVERED _ 90' PLANTER PATIO WT N DECK ABOVE DW -27 SPA - _ SLArc 'A TIO�- ` 82 J n/\ \� / �✓ - Ow DW K PLANTER GRASS \ \\\r• ,Gell, f SLATE - PATIO PROPANE O / (-\0 Gp�GQ DW 3 •/ O` w ' P '� FEN Q OOL E0. POO .N RETURN POOL \ N FEN \ FEN \ c\11 - 02E FEN \j1, 11E \ ?0tiF kFrF46J ' APR. 18, 2023 AMEND LABEL \ NOV. 21, 2022 ADDED SEPTIC LINE OCT. 25, 2022 FINAL SURVEY Gq TF\ MAR. 08, 2021 SET STAKES NOV. 13, 2020 LOCATE FOUNDATION \ AUG. 24, 2020 STAKE FOR CONSTRUCTION \ JUN. 09, 2020 AMEND PROP. STRUCTURES SEP. 28, 2019 LOCATE ADDITIONAL TREES — � / \ AUG. 29, 2019 LOCATE TREES �ONf AUG. 15, 2019 AMEND PROP. STRUCTURES JUL 23, 2019 AMENDED 0 ISTING epce OF \\ // \ �3 ? NE(i4B) JUL 09, 2019 CORRECTTEDXPERMETER SURVEY APR. 01, 2019 IND. PROP. STRUCTURES Survey for: DATE: JAN. 03, 2019 N ROBERT CA GNAZZI JOB N0: 2018-657 w & KIM CA GNAZZI CERTIFIED TO: wM \ \ At B ERT AllI'D�oZ/,rZl KMCAGNAZZI H J�?98! CutchogueCOSIC yy3 Town ofr.�.• ` ef �� y Southold ' `,?-, Suffolk County, New York - S.C.T.M.: 1000-116.00-06.00-014.000 40 0 I 40 .I��-d""'NR` SCALE:1"=40' DAVID H. FOX, L.S. P.C. N.Y.S.L.S. #50234 ADJACENT LOT COVERAGE SANITARY MEASUREMENTS FOX LAND SURVEYING HOUSE = 4864 S.F. A B NOTES: 64 SUNSET AVENUE PORCHES = 244 S.F. WESTHAMPTON BEACH, N.Y. 11978 TERRACE & PATIO = 2829 S.F. ST 59.5' 106.0' 1. AREA = 113,982 S-F. (631) 288-0022 DECKS = 983 S.F. ADJACENT AREA = 105,749 S.F. POOL & SPA = 672 S.F. DP 93.5' 78.0' 2. ■ = MONUMENT FOUND, ® = STAKE FOUND. ISAu VIOLATION ALTERATION OR OF ON ro THIS K STA COTTAGE = 1271 S.F. LG1 79.0' 65.0' E A VIOLATION OCCPIE ON 7209 OF THE NEW YORK STATE COTTAGE PORCH = 264 S.F. 3. REFERENCED DEED L. 12580 CP 627 & L. 915 P. 303 EDUCATION LAW. COPIES of TSE SURVEY MAP NOT BEARING WALKS = 159 S.F. LG2 108.0' 27.0' THE LAND SURVEYOR'S INKEO SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. 4. ELEVATIONS REFERENCED TO N.A.V.D. (1988). SHOWER = 32 S.F. LG3 107.0' 77.0' 5. FLOOD ZONE BOUNDARIES SHOWN HEREON ARE CER PERSON FOR WHOM INDICATED HEREON IS PREPARED ONLY AND ON HIS APRON = 740 S.F. BEHALF TO THE TITLE COMPANY. GOVERNMENTAL AGENCY ARBOR = 58 S.F. LG4 129.0' 49.0' FROM FIRM PANEL NO. 36103CO501 H LAST DATED AND LENDING INSTIOF THE TUTION LISTED HEREON AND To THE SEPT. 25, 2009. ARENOTSTRAW TRANSFERABLE ENDINTOI NSTITUTION ADDITIONAL NSTITUTIO S' TOTAL = 12,116 S.F. OR 11.5% OR SUBSEOUENT OWNERS DWG: 2018-657 ---------- now or Leonard fO P- rMeHy Wes Amy p. se/I III 14'eSsell -t;3 AS �1.4t I L$ 303 a c 99 463.48- - ---------- ---------- I r C?6 tr 4 NEW 'SUPFOLKAVeNUE 41 IFro4� �q�� /' IOW __r.,._ 2, AS PREPARED BY ------------ FOX LAND SURVEYING: 9 CL. r Ile 0 X. / 7 2020 a Nam, APPROVED BY MM I BOARD OF I RUSTEEC l MM TOWN OF SOUTHO Ausbn Panmo.Dint= vo DATE .(;-qgr [;_pr CAGNAZZI PMEDENCR 4L9 lRusrms Sim FLx m000mMoN Inv, U UUSM MGM Ei El HIM-- NEWSUFFOLKAVIENUE 27803S.00. MEED 110AMMe Afc4umcqzo, PIXWOW = Qmft c, 04) 346.50, 0 eW-443C /1 41 Au All YS E.V 46 w wr Z/ t. 6 i 7 � t SUE PLAN LEGMD am um 7631@6 NPJ1}B tSc^--flB'WW38447—tee ,:b aw COW= •••-�.••• �- wamova tSlG'TO=Lam —ex--am— i mum —4—®—®_ t 61YGi�iSt4 �O�-L9^�R' � - um &7.7Ima , am am Vam=MIM fma QfbO!=Prim 97644 75ID31 in ORM ft r4 19a1T A F6q.-(8:�1e�8 l= I : tl(6.iR GAB 'LL , Ml p cua1 MTCA to W Rk77ouvx H7 wo " -' 1 1 4 i AS PREPARED BY FOX LAPD®SURVEYING: MXA-119,8138 V poakcd7*"A.10&7H v 1 IK7(9S w mw L 12M a 477 6 u 819 P=3 ♦[I(YAl' to 310.44(18>1m. I 31 FLM ma SMAMAM Sim mnm me RIOT 711'$1 PMM AC 3.91tl9'MM N LAST GAT=, XM.M 2m atmtAfv Kim®v icm Og9CCY1. 7 IPFRM rm CY 8A1 WCAIM t 1 , . .. .: ..��i.. '. 014 � t'^�• �� F�wrzvc' eov0re tacE� { C Rti1t.[t�!_yY �3 rV4 . fia � p m• fir" jfy' { EDM OF A. �A? ot 41 4�cO"�f' s'�:i 8 a FI ._ SM PLAN __ .._._.__.... if : c�$1 7 r O h (} ra rad Rom APPROVED BY =4Fjygp '1/ t RC38.3dd,T5c'ii•Tf'=-ZS6�evcs* Pis mmm mugBOARD OF 1 RUSTEES THE WMMWX SWIM IM MALL ISE S CMSED LOOP=11 4 TOWN OF SOUTHOLI 1Y kCOMPOSED OF A TOTAL Cr,SIX WELLS THAT WILL BE OH9A 1� •` �� Lt1rr 3��A AT 457 of�FEET Cm" � HOLM SNU CE SM WBAS ROLL BE/ACA SA 10. t@ � �? 1�PFT TYDAL L6ff ATE zr l pnnwi rm TFC GwnwuL mus"u.6c PLASTIC zQy� �R DeSIGPIDP", TM RPPUCATM ALL P6+ [NE l-/q _t,;•¢k{ Vf?pA'�f'ig1 4jA I0AL B+tFI.L P t9 EACH WELL TO TPM t4ARi HOUSE AS'HO i.E M9+T'i TO GE A CC I.ATSAL LOW P WTAflffi TOA UEPt'fit W 43-54 INCHES SaM GRAM OR e� TO ATM TA'uX-t°,V 6 Lf a. yT(1SYTFP►AWRPI)rtnJ Aqp/1¢J7A9q g ' LIMIT OF &UO Afc�C#dA0Y�l6 AS T_4Mll�14iItRFRM P MTTi1T9�n L j GZ431 eqIt g NEW PROPOSED STRLICTURESa, ASREAOF Ibr'RASIRUC7UlkEE t ISTNRNi.. CE C3U+'fTiTB -i TRUSI£.EJil'iiISDICnON 2$.9'77nasqfd _f REDUCTION OR MEAOP RELOCATIONOF STRUCTURES PREVIOUSLY NON-TURF BUPPET& __...�._. APP'ROVE®ttY1OW1® ._..._.; 16,734.6040 SETRACK UNE 18LM a tea" I➢=ft 0 RAA r 4433 AP ' 0011ME a 3773 Sr S • 772 if GARAGE 0 Met Tvvtlm SO POINOWS 296 bf MCM t8114mt7 r 3044 Lf. "z cecx . 745 Lf om no if. 71&YA1 0 4337 Lf 07 4.18 COTTAM .1771 8I } 00"Aa N�tOt+ 364&f ' j# V-WS • 727 SJ ` 9th 2a$f AFMM .1635 IT i TOTAL a 15M2&f w t&c3 D f 1 i i .( STOPMOATM UUM°AL { 10M lb OVTTAM OM Mr- {j 5706 Lf,a W97S t,0•MCP. 4 5w Cf /48.84.23 vs s 151 4'DEEP x Bs tim uS i 00. °tea,-tea•-i.�... 28T wR,L P 3Sa7 t�R£63 _ u,w:3a is.wn_,riaa E + 4g—4 44 DAM � _....___...-_ LSSLIM ivflBS...,..._ � n6 a GA3T3 MYl aP Q.4b.s ..w..�.47 1..._..1.....�.-.�.-........_�... ..-...__.x,._....-.-.....-........,,_..-..._._..._... W.`N A44s$III Patterson L4V8S®li 6I'iAJ L®dl ' a(a5�4a sme 7n4.a)r°e.445e�aY�11A3taagta.3°LS,jntm14G:am� 3 ttSY 1cAS FEST 101E t CAGNAZZI RESIDENCE + a0t4rf 5q•se)m L➢��m9 aL�at.�!� 1Rn:+fi�0;�,1) Ww6 �4..12.,M....tiw.D._19 3 $m»..x.,._.l•Y."M--..._JZ,....c._1.Y._C.w_.....u. PMW Yom 11935 - Tha° gT13 TRUSTEES SITE PLAN rLIMAT1 N _ ...', P(m;w No. i pxojcc%pgptu Sw T5 .Dnwm No: m a ( "' 6m IRD14 +,Ttom Dx,CBSITE xb>lrzed ms.7/31/2020 for (F TRUSTEE MODIRCATI®Af rwar4.daa m.LAArswx°9wazwar rrw^a aese...e..v:a n..•*,)m�++ vaa�'.a+�+cmi:re., ,u+�:em.c:�wu}w.v-tx..wen➢xan ' •:t e+w�m..w.a.a.5i"w�w.n.>�usa.+cw,�.r.._w.... 3 �mwrmere4.ozmemes5 _ r1czT�:Da T 5ch1 t ENSIGNIA `... / PREMIER TITLE I"Laurel Road,Best Nordport,NY 11731 631-+"3-1338*Yaw 01-523-1339 as argent for Fiat Ama7can ITtle Insurance Company Title Number:EPTA 1"998 �.. SCHEDULE A DESCRIPTION ("ended 3/6/18) All that certain plot,piece or pard of land situatk lying and being in Cutchogue:,Tovs►n of :..��,,,� ; Southold,Coway of Suffolk and State of New York,boundod and described as follows:' , ��� •.� BEGINNING at a point on the southerly side of New Suffolk Avenue whore some is intersected by the division line of Taut Lot 15,land Now or Formerly of Cele and the herein subject premises,Pact of Tax Lot 14; RUNNING THENCE along said division line the following courses and distances: 1) South 37 degrees 10 minutes 56 seconds Went.182.30 fe ert; 2) South 43 dem 52 minutes 10 scoonds Wed,113-30 feat; 3) South 21 degrees 24 minutes 35 seconds West,254.37 fbet to the high water marls at time of rarvey done by Michael J.Scalice on WWI8_of Peoonie Riven, THENCE running along the high water mark at time of survey done by Michael J.Scalise on 2/23118 of Peconie River,North 67 degrexs l 1 minutes 31 seconds West 16S.S3 to the division line between Tax Lot 13,land Now or Formerly of Wessell and the bor+a:in subject premises,Part of Tau Lest 14, r•� °Y1 THE KE along said division line,North 11 ., degrees 25 minutes 00 sarcosis East 471.55 feet(474.52 feet High Water Mark)to the southerly aide of New Suffolk Avenue; SIM'1'`' THENCE Due East along the southerly aside of New Suffolk Avenue.South 79 degrees 35 00 sands East 346.50 feet to the point and place of BEGINNING DECLARATION OF COVENANTS THIS DECLARATION made this day of , 2022 by Robert Cagnazzi and Kim Cagnazzi, residing at 39 Connelly Road, Huntington, NY 11743, hereinafter referred to as "DECLARANT(S)II: WITNESSETH: WHEREAS,.DECLARANT(S)is/are the owner(s)of certain real property located on 12700 New Suffolk Avenue, Town of Southold, County of Suffolk, State of New York, described in the Suffolk County Tax Map as District 1000, Section 116,Block 6,Lot 14 which is more particularly bounded and described as set forth in Schedule "A" annexed hereto, hereinafter referred to as the Property; WHEREAS,the Property is situated on lands within the jurisdiction of the Board of Trustees of the Town of Southold (hereinafter the Trustees) pursuant to Chapter 275 of the Town Code of the Town of Southold or its successor, and various activities conducted upon the property may thus be subject to the regulation and approval of the Trustees prior to being conducted; WHEREAS, the DECLARANT(S) therefore made application to the Trustees for a permit pursuant to the Wetlands Law of the Town of Southold to undertake certain regulated activities;and WHEREAS, as a condition of the granting of a Wetlands Permit to undertake such regulated activities,the Trustees required to perpetually maintain a Non-Disturbance buffer located between tidal wetlands and edge of bank, fluctuating width of Non-Disturbance buffer a minimum of 20' to a maximum of 55' and install and perpetually maintain a Non-Turf buffer along the landward edge of the Non-Disturbance buffer up to existing edge of clearing; and from the easterly wetlands establish and perpetually maintain a 35' wide Non-Disturbance buffer up to existing edge of clearing; and from the easterly wetlands establish and perpetually maintain a 35'Non-Disturbance buffer, and install and 1 perpetually maintain a 15' Non-Turf buffer along the landward edge of the Non-Disturbance Buffer; with the condition of the installation of an I/A septic system, that no more than 16 trees be removed, that the driveway be previous, and that the pool be saltwater only; and as depicted on the site plan prepared by Austin Patterson Disston Architects dated August 30, 2019, and stamped approved on October 16, 2019. WHEREAS,the DECLARANT has considered the foregoing and has determined that the same will be for the best interests of the DECLARANT and subsequent owners of the Property, NOW,THEREFORE,the DECLARANT(S)do/does hereby covenant and agree as follows: 1 .Upon the substantial completion of the aforementioned permitted activities there shall be established to perpetually maintain a Non-Disturbance buffer located between tidal wetlands and edge of bank,fluctuating width of Non-Disturbance buffer a minimum of 20' to a maximum of 55', and install and perpetually maintain a Non-Turf buffer along the landward edge of the Non-Disturbance buffer up to existing edge of clearing; and from the easterly wetlands establish and perpetually maintain a 35' wide Non-Disturbance buffer and install and perpetually maintain a 15' Non-Turf buffer along the landward edge of the Non-Disturbance Buffer;with the condition of the installation of an UA septic system,that no more than 16 trees be removed,that the driveway be previous,and that the pool be saltwater only; and as depicted on the site plan prepared by Austin Patterson Disston Architects dated August 30, 2019, and stamped approved on October 16, 2019. "Exhibit B" 2.These covenants shall run with the land and shall be binding on the DECLARANT(S), his/her/their heirs, assigns, purchasers, or successors in interest and may only be modified after a public hearing and upon resolution of the Trustees. 2 IN WITNESS WHEREOF,the owner(s)has/have duly executed this instrument this day of Robert Cagnazzi Kim Cagnazzi STATE OF NEW YORK) COUNTY OF ) On the day of , in the year 2022,before me the appeared Robert Cagnazzi and Kim Cagnazzi,personally known to me or proved to me on the basis of satisfactory evidence to be the induvial(s)whose name(s) is/are subscribed to the within instrument and acknowledge to me that he/she/they executed the same in his/her/their capacity, and that by his/her/their signature(s)on the instrument,the individual or the persons on behalf of which the individual(s) acted,executed the instrument Notary Public 3 t' :j: v"h.,% r�, _ + •r•'l'Ix � } '-i'•'ti'•,s' _ ;,rj'r��p• r 'L,1,� ,,/.�v:tic.��` •� �tii..,usy;.,` Jx- � �' ��p 'vSi' i Y €ammrsnW.rrn__ _.__�_—.__-9.:T,!+^^v^m^��.^ng=n^^•!*;v!^i•a�=^'%kF-r—w_—w,^..�,j,r.•T.9mrtma-TrT'^�'T`m.2r^^1...Mm.w.t�,r__—_ ^rm_nc1.o�O^C�S s',/ -�' BOARD OF SOUTHOLD TOWN TRUSTEES `- SOUTHOLD,NEW'YORK i r PERMIT NO.9560 DATE: OCTOBER 16.2019 ISSUED TO: ROBERT&KIM CAGNAZZI • ! PROPERTY ADDRESS: 12700 NEW SUFFOLK AVENUE:CUTCIIOGUE � SCTM#1000-116-6-14 4 ' AUTHORIZATION M Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on October 16.2019 and in consideration of application fee in the sum of$250.00 paid by Robert&Kim Cagnazzi and subject to the Terms and Conditions as stated in the Resolution,the Southold Town Board of Trustees authorizes and permits the following: ' �f i e Wetland Permit for the existing one-story,1,271sq.ft cottage with 264sq.ft.attached covered porch;demolish and remove 3,814sq.ft of existing gravel driveway east of cottage and a 1,824sq.ft dwelling;construct a proposed r` 4,439sq.ft.footprint,two-story dwelling with 1,000sq.ft attached garage and 1,907sq.ft.porch and balcony;install gutters to leaders to drywells to contain roof runoff;construct a 4,407sq.ft raised terrace approximately 2'-3'above r w grade;proposed 774sq.ft in-ground swimming pool,retaining walls and steps to grade;adjacent to existing cottage, ' .•; construct 2,525sq.ft of new walkways,stepping stones(total 131.25sq.ft),and formal garden area(235sq.ft); proposed 457sq.ft.gravel parking area north of cottage and landward of gravel driveway(802sq.ft within Trustee /. jurisdiction);419.63 linear feet of proposed pool fencing and gate;establish a 4'wide access path to the beach;from t. Peconle Bay install and perpetually maintain a Non-Disturbance buffer located between tidal wetlands and edge of r I bank,fluctuating width of Non-Disturbance buffer a minimum of 20'to a maximum of 551,and install and i perpetually maintain a Non-Turf buffer along the landward edge of the Non-Disturbance buffer up to existing edge r of clearing;and from the easterly wetlands establish and perpetually maintain a 35'wide Non-Disturbance buffer, t t Iand install and perpetually maintain a 15'Non-Turf buffer along the landward edge of the Non-Disturbance Bufler; with the condition of the installation of an I/A septic system,that no more than 16 trees be removed,that the •-a I driveway be pervious,and that the pool be saltwater only;and as depleted on the site plan prepared by Austin Patterson Disston Architects dated August 30,2019,and stamped approved on October 16,2019. �a 1N WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, 1: ` and these presents to be subscribed by a majority of the said Board as of the 16th day of October,2019. .•• E....a.... .•,,_:...et....,i,,..�.m.....,�w...�..,4:_:r+!.k/.•.ntvxSt4.2i.S.w.s..LAAi.-uextui..Fiwor .uuoluo.aaa.+L. ,�, _ate—_ �' .8 •w' "^;?;""� ,,,.,„,w' l r •-.,. + ro+✓� �_: . r /�.2 �.�j` ��•.-v�•c.:-.'� '^\�.."•L'_w��•��•+ ��!".:Ls�1."r� :n.n,m....„y.,,,ra� �,�•�•+•.—,..•,��•e'•'� � ��:%'� �: - TERMS AND CONDITIUva The Permittee Robert&Kim Caanazzi.residing at 12700 New Suffolk Avenue.LuAhogue, New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: I. That the said Board of Trustees and the Town of Southold are released from any and all damages,or claims for damages,of suits arising directly or indirectly as a result of any operation performed pursuant to this permit,and the.said Permittee will,at his or her own expense,defend any and all such suits initiated by third parties,and the said Permittee assumes full liability with respect thereto,to the complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for a period of 24 months,which is considered to be the estimated time required to complete the work involved,but should circumstances warrant,request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely,or as long as the said Permittee wishes to maintain the structure or project involved,to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents,and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized,or if,in the opinion of the Board of Trustees,the work shall cause unreasonable obstruction to free navigation,the said Permittee will be required, upon due notice,to remove or alter this work project herein stated without expenses to the Town of Southold. 8. The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety(90)calendar days of issuance of this permit. 9. That the said Board will be notified by the Permittee of the completion of the work authorized. 10. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit,which may be subject to revoke upon failure to obtain same. 11 No right to trespass or interfere with riparian rights. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights,title, or interest in real or personal property held or vested in a person not a party to the permit. Labor,Licensing&Consumer Affairs HOME IMPROVEMENT LICENSE Name JOSEPH PERNA Business Name This certifies that the HOBBS INC Dearer is cluly licensed 7y the County of suBolk License Number:H46915 Rosalie Drego Issued: 12/17/2009 Commissloner Expires: 12/01/2023 This license Is tete property of Suffolk County l Department of Labor,Licensing&Consumer Affair. t Possession of this license does not guarantee its validity. Additional Business Name i License Category H1-GC i t i ,��SUEFp BUILDING DEPARTMENT- Electrical Inspector , Gy' TOWN OF SOUTHOLD icy ` Town Hall Annex - 54375 Main Road - PO Box 1179 ,.. Southold, New York 11971-0959 4,� Telephone (631) 765-1802 - FAX (631) 765-9502 ' a-''r rogerlD-southoldtownny.aov - seandCaD-southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: 6- 3c) - 2_2 Company Name: Electrician's Name: 6 r3 2.,-C License No.: 43 G-/j& Elec. email: 65co 0155c® — &�Fc*c.. CM/,/ Elec. Phone No: El request an email copy of Certificate of Compliance Elec. Address.: /S u-�u,e:c��i��n �2 '�� 40 .T W JOB SITE INFORMATION (All Information Required) Name: 9 -�142 2 / Address: /2 �©© Veu," S,a./��d- 94V. e"rc#o "E Cross Street: Phone No.: Bldg.Permit#: IZ/9 Q11 5_6 email: Tax Map District: 1000 Section: Block: Lot: BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE-FOOTAGE (Please Print Clearly): `t- S¢k V-1 CSL Square Footage: Circle All That Apply: O 23 Is job ready for inspection?: YES [:] NO ❑Rough In 3 1:1 Fina, Do you need a Temp Certificate?: � YES ❑ NO Issued On� 149 5 406lej �• Temp Information: (All information required) f Service Size®1 Ph❑3 Ph Size: 2®© A # Meters I Old Meter# ©New Service❑Fire Rec nect❑Flood Reconnect❑Service ReconnectN]Underground❑Overhead # Underground Laterals 1 2 H Frame Pole Work done on Service? Y DN Additional Information: PAYMENT DUE WITH APPLICATION � 15v 1913 4 2lo`% re_ C,, I oq 92Z. �P q 3S BUILDING DEPARTMENT-Electrical Inspector t a < : TOWN OF SOUTHOLD v ti; Town Hall Annex-54375 Main Road-PO Box 1179-Southold, NY 11971-0959 Telephone (631) 765-1802JM=< - Temporary Certificate # Date � 2023 Customer Name Electrician Name � L LC_ Address la­700 _AVe. , 0 e-mail e-mail e4.,,-C) (CD eSCo — 2 I e Gf-Vl L , 6M Phone License# 4s6 `7 (F, Size o2 A Phase 1 Overhead Underground #of Meters :Remarks #of Underground Laterals 1 2 New "H" Frame or Pole H P Fire Reconnect Was work done on Service? Y/N Flood Reconnect Old Meter# Service Reconnected Application for electrical service equipment is on file with the town of Southold.On the applicant's notification that this installation is complete,the town will conduct a premises inspection of the service equipment. This verification is valid for 90 dzWrop the date above. Authorized by LL,22� SUf fpL C= ;t4 BUILDING DEPARTMENT- Electrical Inspector "Iry ®G� TOWN OF SOUTHOLD `f Town Hall Annex - 54375 Main Road - PO Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 rogerr(aD-sso gov seand(cDsoutholdtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: Company Name: � GC Electrician's Name: Cf�;Cj License No.: 3 (O Z/6 Elec. email: �5CO 0 Elec. Phone No: i W,, w-7:7 D I request an email copy of Certificate of Compliance Elec. Address.: /5- t�,Y�,,��ti�C� �2 ,�,,�1er,� i3 ,r W JOB SITE INFORMATION (All Information Required) Name: C� � Address: /2 - -oo C1, c oo Cross,Street: Phone No.: Bldg.Permit#: /-j9 '�,5 email: Tax Map District: 1000 Section: Block: Lot: BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Square Footage: Circle All That Apply: 1�( Is job read for inspection?-. YES NO Rough In 3 ' ❑ Fina J Y P � ❑ ❑ I Do you need a Temp Certificate?: YES ❑ NO Issued Ono �dQ� Temp Information: (All information required) Service SizeAl Ph[—]3 Ph Size: 200 A # Meters Old Meter# ©New Service❑Fire Rec nect❑Flood Reconnect❑Service ReconnectMUnderground❑Overhead # Underground Lateralsyl JD2 H Frame Pole Work done on Service?--EY N Additional Information: PAYMENT DUE WITH APPLICATION IP ( '50 I S13 _;'CtAA 4,21o�% �-2 G� i 0q 9-ZZ. �P 4 (0 i PERMIT 4 Address: Switches Outletsw Y G FI's I Surface 4 Sconces H H's Ig UC Lts Fans Fridge r HW - ExhaustCII Oven W/D� Sm6kes1 DW Mini� I , Carbon Micro Generator Combo 'J I Cooktop Transfer AC 1 AH Hood Service Amps Have Use >pecial: L46 :omments C r' V AP,-Rn VED AS NOTED DATE: B.P.it DE COMPLY WITH ALL CODES OF FEE: NEW YORK STATE & TOWN CODES NOTIFY BUILDING DEPARTMENT" AT AS REQUIRED AND CONDITIONS OF 'CIS ANG.Y OR 765-1802 8 AM TO 4 PM FOR THE , FOLLOWING INSPECTIONS: _ 436,'M leLu " "' 1. FOUNDATION,- TWO REQUIRED �Jri . N f��L. FOR POURED CONCRETE S OARD NIT# UT-CE-ATIF10A� 2. ROUGH - FRAMING & PLUMBING S v i N TRUSTEES a A� `j 3. INSULATION )FOO 'VFkAIVG`,:T . FINAL - CONST4U�:TION MUST BE COMPLETE CO. ALL CONSTRUCT''N SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. Additional Certification May Be Required. S L� O� O� OJ L II I I BEDROOM II I I C-109 II IL 11 CLO. TH LIVING ROOM c-llo c-los C-101 0 "PLUMBING FIXTURES,TYPICAL II II II II DINING I I REMOVE WALL C-103 II I I i i BEDROOM I I I I C-107 I I I I II II MC-10MUDROOM I� J1I - - - - J — — I I I I BATH I I KITCHEN I I C-106 I II C-102 I I I I NEW APPLIANCES I I NEW PLUMBING MECHANICAL I AND CABINETS I FIXTURES,TYP. C-105 r---------TRASH ----,�------- U � DW �� & RANG i ii FRIDGE/Z ' " I J� 0 0 RECYCLE i ii FREEER EJ drywa- 11 tin J itv A IA�1^jK► �kED ARC/y,T COTTAGE PLAN S (A a -M L4 S�P�� C DIS'q 1 n — t o Q J SCALE. 1/4 - 1 -0 0 Lknaln 4 ram X- 9`r�TyFNSE NO- T HE O•THE SS N DrawingTitle: Austin Patterson Disston COTTAGE PLAN a d�l A-100 Project Title: Project No.: 18014 Date:5/4/2023 p Architects CAGNAZZI RESIDENCE Scale: 1/4" = F-0" 376 Pequot Avenue,PO Box 61,Southport,CT 06890(203)255-4031,fax(203)254-1390 apdnrchit;ct,.com 12700 NEW SUFFOLK AVENUE,CUTCHOGUE,NEW YORK 11935 44 Quogue Street,PO Box 1707,Quogue,NY 11959(631)653-1481,fax(631)653-6605 YORr( workers'SYQTE Compensation CERTIFICATE OF INSURANCE COVERAGE Board DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW PART 1.To be completed by Disability and Paid Family Leave Benefits Carrier or Licensed Insurance Agent of that Carrier 1 a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured HOBBS, INC. 27 GROVE STREET 203-966-0726 NEW CANAAN, CT 06840 Work Location of Insured(Only required if coverage is specifically limited to 1 c.Federal Employer Identification Number of Insured certain locations In New York State,i.e.,Wrap-up Policy) or Social Security Number 06-0692219 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Standard Security Life Insurance Company of New York Town of Southold tY P Y 54375 Route 25 3b.Policy Number of Entity Listed in Box"1 a" Southold, NY 11971 R93836-000 3c.Policy effective period 1/1/2014 to 5/3/2024 4. Policy provides the following benefits: 0 A.Both disability and paid family leave benefits. [] B.Disability benefits only. [] C.Paid family leave benefits only. 5. Policy covers: Q A.All of the employer's employees eligible under the NYS Disability and Paid Family Leave Benefits Law. [� B.Only the following class or classes of employer's employees: Under penalty of perjury, I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has NYS Disability and/or Paid Family Leave Benefits insurance coverage as descylled above. Date Signed 5/5/2023 By (Signature of insurance carrier's authoriz d representative or NYS Licensed Insurance Agent of that Insurance carrier) Telephone Number (212) 355-4141 Name and Title SUPERVISOR-DBL/POLICY SERVICES IMPORTANT; If Boxes 4A and 5A are checked,and this form is signed by the insurance carrier's authorized representative or NYS Licensed Insurance Agent of that carrier,this certificate is COMPLETE. Mail it directly to the certificate holder. If Box 4B,4C or 5B is checked,this certificate is NOT COMPLETE for purposes of Section 220, Subd. 8 of the NYS Disability and Paid Family Leave Benefits Law. It must be mailed for completion to the Workers'Compensation Board, Plans Acceptance Unit, PO Box 5200, Binghamton,NY 13902-5200. PART 2.To be completed by the NYS Workers'Compensation Board(only if Box 4C or 5B of Part 1 has been checked) State of New York Workers' Compensation Board According to information maintained by the NYS Workers'Compensation Board, the above-named employer has complied with the NYS Disability and Paid Family Leave Benefits Law with respect to all of his/her employees. Date Signed By (Signature of Authorized NYS Workers'Compensation Board Employee) Telephone Number Name and Title Please Note: Only insurance carriers licensed to write NYS disability and paid family leave benefits insurance policies and NYS licensed insurance agents of those insurance carriers are authorized to Issue Form DB-120.1. Insurance brokers are NOT authorized to issue this form. DB-120.1 (10-17) 111111111°!°°!°!°�!°�°°i°°°�°4°!°!�Q1!°!°!°1111111 HOBBS-1 ACORO" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYY`n �—•� 03/31/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder Is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER 203.789-0100 c TacT Maureen Sullo Duble&O'Hearn Insurance PHONE 203.789-0100 FAX 203-789-0583 a division of Fred C Church (A/C,No,Ext): A/C,No 655 Long Wharf Drive E Ls .maureens@ u e-o eam.com New Haven,CT 06511 Michael S.Reilly INSURER(SI AFFORDING COVERAGE NAIC N INSURER A:Travelers Indemnity Co of Amer 25666 INSURED INSURERS:Trav Prop Cas Co of America 25674 ebbs,Inc, Charter Oak Fire Ins.Co. 25615 r.John Kennedy INSURER C, . 2 Grove Street Phoenix Ins.Co. 26623 New Canaan,CT 06840 INSURER D: INSURER E:Starr Indemnity 8r Liability Co INSURER F: C-OVERNES CERTIFICATE NU R• REVISIQN NUM@gEJ*, THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUB POLICY NUMBER POLICY EFF POLICY EXPLTR VYYYYI LIMITS B X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 2'000,000 CLAIMS-MADE �X OCCUR X DT-CO.1691M679-TIL-23 03/31/2023 07/01/2023 DQ&GT RMENT�uD, $ 1,000,000 MED EXP(Any one erson 10'000 PERSONAL 6 ADV INJURY 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER; I GENERAL AGGREGATE 4,000,000 POLICY j�T F-1 LOC PRODUCTS-CO P/OPAGG 4,000,000 OTE : (+ AUTOMOBILE LIABILITY COMBINED SINGLE LIMB $ 1,000,000 X ANYAUTO 810-91<938638-23-26.13 03/3112023 07/01/2023 BODILY INJURY Per erson $ OWNED SCHEDULED AUTOS ONLY AUUTNO�SW Ep BODILY INJURY Per accident $ AUTOS ONLY A070S NN FO PERTY AMAGE racclde t B UMBRELLA LIAB X OCCUR EACH OCCURRENCE 10'000,000 X EXCESS LIAB CLAIMS-MADE 1000579525221 03131/2023 07/01/2023 AGGREGATE $ 10,000,000 DED I X I RETENTION$. 10,000 Q WORKERS COMPENSATION X PER OTH- ANDEMPLOYERS'uABIUTY UB-OK498808-23-26.13 0313112023 07/01/2023 STA! 600,000 A ANY PROPRIETOR/PARTNER/EXECUTIVE NIA A E.L.EACH ACCIDENT OFFICER/M M �2 EXCLUDED? _J UB-OK508831.23.26•V 03131/2023 07101/2023 600,000 (Mandatory in ) E.L.DISEASE-EA EMPLOYEE it es,describe under 500,000 ESC P O 0 TIONS below E.L.DISEASE- I Y I IT DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Robert and Kimberly Cagnazzi are Included as an additional insured solely with respect to general liability coverage as evidenced herein if required by a signed written contract with respect to the named insured. re: 12700 New Suffolk Avenue, Cutchogue, NY CERTIFICATE HOLDER CANCELLAIJON CAGNAZZ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Robert and Kimberly Cagnazzi 12700 New Suffolk Avenue Cutchogue,NY 11935 AUTHORIZED REPRESENTATIVE ACORD 26(2016/03) ©1988.2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD