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HomeMy WebLinkAbout48361-Z �S�FPOLk Town of Southold 5/21/2024 5.ell P.O.Box 1179 o �:{ 53095 Main Rd Southold,New York 11971 4` CERTIFICATE OF OCCUPANCY No: 45191 Date: 5/21/2024 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 1720 Bay Shore Rd, Greenport SCTM#: 473889 Sec/Block/Lot: 53.4-30 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 8/24/2022 pursuant to which Building Permit No. 48361 dated 10/3/2022 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- r�pool with spa, fenced to code, as applied for The certificate is issued to Gallucci,William&Gina of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 48361 04/04/2024 PLUMBERS CERTIFICATION DATED 1 h rize ignature �SUFFoc TOWN.OF SOUTHOLD ��o gay BUILDING DEPARTMENT y z TOWN CLERK'S OFFICE SOUTHOLD, NY 0 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#: 48361 Date: 10/3/2022 Permission is hereby granted to: Gallucci, William 2 Christina Ct . Northport, NY 11768 To: Construct an in ground pool with spa to a single family dwelling as applied for. Must maintain a 5' accessory setback. At premises located at: 1720 Bay Shore Rd, Greenport SCTM #473889 Sec/Block/Lot# 53.4-30 Pursuant to application dated 8/24/2022 and approved by the Building Inspector. To expire on 41312024. Fees: IN-GROUND SWIMMING POOL $250.00 CO- SWIMMING POOL $50.00 Total: $300.00 Building Inspector pE SOUr��l 0 Town Hall Annex Telephone(631)765-1802 54375 Main Road P.O.Box 1179 �Q sean.devlinCcD_town.Southold.ny.us Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: William Gallucci Address: 1720 Bay Shore Rd city,Greenport st: NY zip: 11944 Building Permit#: 48361 Section: 53 Block: 4 Lot: 30 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: Electrician: LC Electric License No: 38043ME SITE DETAILS Office Use Only Residential X Indoor Basement Service Commerical Outdoor X 1st Floor Pool X New X Renovation 2nd Floor Spa X Addition Survey Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan Service 3 ph Hot Water GFCI Recpt 1 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 1 4'LED Exit Fixtures Sump Pump Other Equipment: Aqualink 12 Circuit Pool Panel /4 Used, Hayward Salt Generator 120GFI, 4 Lights- 300W Transformer 120GFI, Heater, Pump 220GFI Notes: Pool w/ Spa Inspector Signature: Date: April 4, 2023 S.Devlin-Cert Electrical Compliance Form pF SOU,yO� y 3 r 7 Zn ' sA.� l2c # # TOWN OF SOUTHOLD BUILDIVG DEPT. courmN 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: tzc� C2k- DATE 10 2 INSPECTOR i you H�3� 17Z0 OF SOUL # TOWN OF SOUTHOLD BUILD DEPT. �yco 631-765-1602 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) IX ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ]] PRE C/O [ ] RENTAL REMARKS: am Iv O < DATE — INSPECTOR '0- K�3� Jeffrey Sands Architect November 20th, 2022 Property/swimming pool location: Gallucci Residence 1720 Bayshore Road LE IE 11 ` / IE' Greenport, NY MAY 1 1 2023 H .RE: Swimming pool rebar and drywell inspection t"OFS�1F1lEKU Attention Town of Southold Building Department: Upon inspection of swimming pool rebar and drywell at above mentioned property, I find all to have been installed to meet current building code requirements. Sincerely, ED,q,9C �F�EY M. 2 m 2789A ypQ� OF NE\ Jeffrey Sands Architect 6 Evergreen Lane, East Quogue, New York 11942 phone-631-375-5997, fax, 631-576-8916 email—ieffrey sandsahotmail.com FIELD INSPECTION REPORT DATE COMMENTS �o FOUNDATION (1ST) W o'er H ------------------------------------ FOUNDATION (2ND) � O N � 0 7H� ROUGH FRAMING& PLUMBING G r INSULATION PER N.Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS q02 0 23 0 0 /e c 74-:Ze D C)3 -0 �1221 7,v f2.cc d e e,r tuba r m N H z �x E� �y x d r� ►e H �o�°S°FFatk�oG TOWN OF SOUTHOLD—BUILDING DEPARTMENT y a Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 wo��ol �oo� Teleph-bne (631) 765-1802 Fax (631) 765-9502 https://www.southoldtomm.gov Date Received APPLICATION FOR BUILDING PERMIT J�Q For Office Use Only I V ( I ® PERMIT NO. Building Inspector: AUG 1 8 2n72 Applications and;forms:mdst be'filledout'irrtheir,entirety,.lr�corn plete,;:'`;: BUILDING DEPT. applications'will`not be accepted: Where the Applicant'is:riot the;ouvner;an '; TOWN OF SOUTHOLD Owner's Authorization form(Page"2)shal1,be completedi;,''`t:"1, '< "°;.' <•` Date: I(0 10-Zo-i)L Zs.- ,OW tR SCTM#1000- Name: �i 11 C a c, �., ®.. a�-I, 0v 'oaf? Project Address: �—I ao )r e 1, Phone#: Mailing Address: CON7A PER CT S N: Name: Mailing Address: {� l�l 1 1 9 LI9 Phone#: _ qs•3-(.PL4 0 1 Email: �C�S 5 DESIGN PROFESSIONAL INFORMATION : -- Name: Mailing Address: Phone#: Email: r�r f• " C' T A CON R CTOR IN FORMAT FORMATI Name: . 1'Ob lS Mailing Address: I 1 bo,--i go cQY f + Os) vf- w44 .l icz cLPa Phone#: U31_ Ciob.. WE Email: sales icKs o D IPTI ESCR ONOF PROPOSED: "ONSTR ❑New Structure ❑Addition ❑Alteration ❑Repair El Demolition —1 Estimated Cost of Project: 41�%ther N ow $ 13al. o Will the lot be re-graded? ❑Yes o Will excess fill be removed from premises?Xes ❑No 1 PROPERTy',INFORMATION Existing use of property: as YYllL Intended use of property: A �� Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? ❑Yes� i o IF YES, PROVIDE A COPY. ❑,Check Box After Reading: The owner/contractor/design;profe`ssional is responsible for all drainage and storm water Issues as provided by ,i; Chapter,236 of the Town Code..APPLICATION.IS.HEREBY'MADEto'the Building'Department'for the,issuance.ofa Buildfng Permit;pursuen#_#o the Building Zone; Ordinance of the Town:of,Southold;.Suffolk;±County,,New;York and'.oflieyapplicable'Laws;;Ordiriances or;Regulations;:-forahe`construction°of buildings;.,: additions,alterations or for removal,or'demolitiorras herein;described The`applicant agrees'to,comply with, ll applicable;laws;ordinance's,building code,. 'housing code and regulations and to.admit'authorized inspectors on premises"and in buildmg(s)for neces'sary.inspections.False statements made herein are punishable as a Class A misdemeanor pursuant to,5ection'210.45:of the'New York State penal•Law, _<' Application Submitted By print name):' 0, Uy 1b �ithorized Agent ❑Owner Signature of Applicant: 4A�U& ma&� Date: �) /�►®tea STATE OF NEW YORK) COUNTY OF SU I' ) Ka4—ewl'o, MRxeur-16c) being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the h2cn+- (Contrka6r,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 1l041day of 20 Notary Public MICHELE A MEDUSKI PROPERTY OWNER AUTHORIZATION Notary Public,State of New York Reg.No.01ME6393343 (Where the applicant is not the owner) Qualified in Suffolk County Commission Expires June 17,2023 I, residing at do hereby authorize to apply on my behalf to the Town of Southold Building Department for approval as described herein. Owner's Signature Date Print Owner's Name 2 Building Department Application AUTHORIZATION (Where the Applicant is not the Owner) I, W l N1 A'm �(� (UC.Ct residing at (1 ZO 1 AA� co ae f-- 10A4n (Print property owner's name) (Mailing Address) Getz( o2i �t'�u c�Ctl(L�C{q do hereby authorize �A- M (Agent) to apply on my behalf to the Southold Building Department. � rz2,- (Owner's Signature) (Date) I1, +64 (�,,o (yC, (Print Owner's Name) Ay+;s l � 't BUILDING DEPARTMENT- Electrical Inspector r'1 &r":. TOWN OF SOUTHOLD 's Town Hall Annex - 54375 Main Road - PO Box 1179 P � y Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 roc�err soufholdfowni rev seandCc�southoldtovvnny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: 1/4/2023 Company Name: LC Electrical Contracting Electrician's Name. LC Electrical Contracting License No.: ME -38043 Elec. email:office@lcelectricalcontracting.com Elec. Phone No: 631-874-0485 01 request an email copy of Certificate of Compliance Elec. Address.: 22 Woodbine Lane, East Moriches NY 11940 JOB SITE INFORMATION (All Information Required) Name: Gallucci, William Address: 1720 Bay Shore Rd, Greenport NY Cross Street: Phone No.: Bldg.Permit##: 48361 email: Tax Map District: 1000 Section: Block: Lot: BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Unground pool with Spa Square Footage: Circle All That Apply: Is job ready for inspection?: -vv)Q o � YES ❑ NO Rough In ❑ Final Do you need a Temp Certificate?: ❑ YES NO Issued On Temp Information: (All information required) Service SizeF1 Ph F3 Ph Size: A # Meters Old Meter# ❑New ServiceE]Fire Reconnect®Flood Reconnect®Service Reconnect®Underground[]Overhead # Underground Laterals F1 1 FJ2 H-Frame Pole Work done on Service? PJ Y N Additional Information: PAYMENT DUE WITH APPLICATION C 3 BUILDING DEPARTMENT- Electrical Inspector ` TOWN OF SOUTHOLD Town Hall Annex - 54375 Main,Road - PO Box 1179 ' Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 r :-^. h � rocerr southoldtownny.ctov seand ra southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: 1/4/2023 Company Name: LC Electrical Contracting Electrician's Name: LC Electrical Contracting License No.: ME-.-38043 Elec,email:office@Icelectricalcontracting.com Elec. Phone No: 631-874-0485 El 1 request an email copy of Certificate of Compliance Elec. Address.: 22 Woodbine Lane, East Moriches NY 11940 JOB SITE INFORMATION (All Information Required) Name: Gallucci, William 6 Address: 1720 Bay Shore Rd, Greenport NY Cross Street: Phone No.: Bldg.Permit #: 48361 email: Tax Map District: 1000 Section: Block: Lot:.. ' BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Unground pool with Spa Square Footage: Circle All That Apply: Is job ready for inspection?- 1_W1Q 4A_ R] YES ® NO F&/]Rough In ® Final Do you need a Temp Certificate?: ® YES ❑ NO issued On Temp Information: (All information required) Service SizeF_11 Ph❑3 Ph Size: A # Meters Old Meter# ❑New Service[:]Fire ReconnectoFlood Reconnect®Service Reconnect[]Underground❑overhead # Underground Laterals 1 2 H Frame Pole Work done on Service? MY N Additional Information: PAYMENT DUE WITH AIPPLICAT[QN 23 `7 � 1®l) � C 1D3L�03 Uy vcr y car 7-..,0 / RECEIVED MAP; J(N 2 9 2�q2y 96 t s�,Yt ON THE SUBDIVISION.MAPOF AMENDED MAP A 5PEo�vcC BAY ES TATES .0 101 1l . ; -s FILED MAY 19,1933:AS MAP NO.1124 SITUATE AT BAY SHORE RD. ®I- ARSHAMOMAQUE S SISSY38�a ISo.DD. :. TOWN OF SOUTHOLD x °D --—�-- SUFFOLK.COUNTY,NEW YORK > AREA OF PARCEL c 16,750t SOFT. OR 0.430t ACRE KR S�BANOFF ANUST� v'I EIINORNGF JAGEL I i 1 er— 1 I as-euar sANRARY . DRTANCEG��BUIDINC u Ir ir �` 8 bl m 1 1 LT0 O + II , TO mt. I i. NEASUFEMENTSAFEINPCLOFDANCE NTTHU.S STANDAFOS. f/0 j - I- - I — 2 BEARINGS ARE IN NEW rOFASTATE PLANE LOOROIWITE SYSTEM LONG L-IT 99 Dr IGO ": t J/�1 1 {�L�`x o /•�T I 0 m I"1' L1r, Los � IR cqr ma � LOT IDS ' J. MORIZONTALOATUMIS REFERENCED TONADe](301f)MR01/GXUSEOF RTN GPS ' I � Q 1 � �µ� I � � I OBSERVATIONS VERDCAL DATUMIS REFEFFNCEOTO N.1VpE9(GEOTf2A} :� LS— _I +`L'C:ECC.".3�D3«O,�.Cr:atr;�ClAtS9,^kG#%:CF.',. S}uCtII>�-<CIIKCQGfiG4 - I _ - - - 1. ➢ROPERTYIS SUBJECT TO RESrMCRON5 A5 pESLRIBEp IN UeER f302f OFDFE05 AT➢AGE SIT. FILL NAF LING- N y6 W'W 130.O(r FIL:NP?LrIz 5. UTUUTXORIZ£DALTERAitt—AODITIONTOASURVEYGAPBFMINOFUCENSFO l a _ WWY0 SrAT IEDUVr0MLAWRONOF SEGTIONT309.5UeNVI510N20F RIE _ - NEWYORN STATE FDUG PON(AIV. nnx?fEN xtit DOMENICK/DeNICOLA �1 yl THOMASNJ.F BYRNES _ B. ONLY LOBES FROMTNEORIGINAL OFTNR SURVEY 6t4RKEDWTTHANORIGMILL OF AND &MARYANN BYRNES - ME—— CAROL rMfED'SEALSNALL BE LONSIOERED IO BE CAROL DeWCOLA -' vauD TRUEco➢IEs .. .. LOT.I6 - .- - �� 1 - 7 ACCOR�OGA.VD' IIWWNaTME�sMGWDIF0FPMCTI LANDSWSYEP OPR EOIx 1 - LQT,17 t COT 18 ADOPTED BY TNENEWYORR SiATEASSOCUIDONOF➢ROFESSroNAI[ANC "W.P fF aUECST AiM,—71-1.' cF✓N THE SW'FOLA 40h - S,iA E DRB SAT CERRFIGTiONSSNA{LRUNONLYTO TXEPERSQV FOFWXOM THESNtVEYlS➢R£PAREDANDONXISBJIALFT0NLSMDGOMPANY,.. GOVERNMETOF ME ENCY AND f£NOING MSTIIURON LLSTEO HEREON ANDTO THE T,0A AS G EESOFTNELENIXNG INSTTRNION CERTIFIGDON$ARE NOT]FANSFERiBLE /G-�� TOApOR10NAL LVSDTUilONS CR SUBSEpUENTOMI'ERS SITE PLAN z; �� a RICH S-0FWAY NOTSXOMNAPE NOTCEFDFIED: SUFFOLKCOU1dI!DEPARTN,WOFHEAUNSERVICES MAIL r=aD' s. TXEsuRveruosEs,vaTXEeuncAur. APPROVAL OFC"'f•TRLICTED WORKS FOR I0.UNDERGRDUNDUTWTT£SSXOWNONTMSSURVEYARE FROMUNIIJYNA A SINGLE F MRai Ido. . E RU NdRR PS' ORY N OYRENCE BEGV;ALLLIAWMRON SHB AS ON1-0GNUFN S6AN YX E NDate JUL yO s-8-2D MF - - AS PER COMMLNA DATED 8-7-20 CFD L 'ST The serape d�poaalaw �f 'Bt 0k4lacafon Ime-!lean �- ' �� eT6 DESCRD.�'NON APPROV.HlT titd�ledld 8DOIDf by O,Ib mc6vl .._..._. � � .. .".REVISIONS I, ev be aolayFORA f3�R00#IS ® - :.—Tm aD aid found ao ❑ Z * Town of Southold StMTOD[CDDAl7,Net.York •- .._;....._sANT.ART LLG mpT !'� 050528_ O� q„:",: _::L, l C een o1720 rt Noes re Yok- Craig.Knepper,P.E.,Chief __..._. mEAGPDMD Rio VI d• °.- Office of Wastewater Management avDaeAD �, i- �1AN95 � A9-bullti s,noey U._..._._..� . : 4 p._.. -;'tDEaLwus svrH, �' .. 1-1C. MCLEAN.ASSOCIATES P.C. . ... __...LYWTTigq�r BUDI : ` I ky cembamBlXmA➢w made semen eauxaMvej s3NSOL COUNTRY ROAD,BNOOIKAVEN,NBR YONK DSTRICT DDo - ^_. dDrme an TN!??015endupdandonQS9A20t0 _CI^/`� 1k>iped sr 7.L/r.L scale: 1•-4D•- 4hea1 N. oboes T�o�1L���s..G..Juke-rre-- nre.n Br r.i s. DeLe; DS/mT/zD 1 Lor NY—S. D I .. .ADPreved 8T.DP7/ITS nle No. 15116.001_ JS .—.v�.r_�--c— _-_— _ _ �__. �_._. _ _"�=S..=..�..,..--__•......_""'^.- q-_.�"3 F05DATEAv CERTIFICATE OF LIABILITY INSURANCE (MM/°D/YYYY) /10/2022 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(ies)must 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 CONTACTNI E Nicholas Zulkofske Brookhaven Agency,Inc. PHONE(AtC No 631 941-4113 FAX 631 941-4405 100 Oakland Ave,Ste 1 E-MAIL certificates@brookhavenagency.com Port Jefferson,NY 11777 INSURERS AFFORDING COVERAGE NAIC# INSURERA: Philadelphia Indemnity Insurance Co. INSURED INSURER B: Merchants Mutual Insurance Co. Patrick's Pools,Inc INSURERC: Wesco Insurance Co. PO Box 3024 INSURER D: East Quogue NY 11942 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR POLICY NUMBER LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1 00O 000 A CLAIMS-MADE X OCCUR DAMAGE TO RENTED $100 000 x Contractual Liability X PHPK2386555 02/28/2022 02/28/2023 MED EXP(Any oneperson) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRO- I LOC PRODUCTS-COMP/OP AGG $2,000,000 POLICY�ECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $500,000 B X ANY AUTO BODILY INJURY(Per person) $ ALL AUTOS OWNED SCHEDULED X X CAP9267113 07/12/2021 07/12/2022 BODILY INJURY(Per accident) $ AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION S $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY Y/N C OFFICERIMEM ER EXCLUDED?PROPRIETOR/PARTNER/EXECUTIVEANY N/A E.L.EACH ACCIDENT $1 OO,000 WWC3587728 05/13/2022 05/13/2023 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Town of Southold is included as additional insured per written contract. CERTIFICATE HOLDER CANCELLATION Town of Southold,Town Hall Annex SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 54375 Main Rd. ACCORDANCE WITH THE POLICY PROVISIONS. Southold,NY 11971 AUTHORIZED REPRESENTATIVE <NSZ> ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD 9�oad APPROVED AS NOTED DATE IU"3"aa B.P.# f 0 �o FEE: 3�D OD BY NOTIFY BUILDING DEPARTMENT AT 765-1602 8 AM TO 4 PM FOR THE COMPLY 1NITH ALL CODES OF ;! FOLLOWING INSPECTIONS: NEW YORK STATE &TOWN CODES 1. FOUNDATION-TWO REQUIRED FOR POURED CONCRETE AS REQUIRED AND CONDITIONS OF :> 2. ROUGH-FRAMING,PLUMBING, STRAPPING, ELECTRICAL&CAULKING ......,.,�,b.SOUTNOLDTOWN 3. INSULATION 4. FINAL-CONSTRUCTION&ELECTRICAL MUST BE COMPLETE FOR C.O. SOMOLDTOWNPI, NNGBOAM ; ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW SOLROLDTOMTRW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. N.Y.S.DEC OCCUPANCY OR RETAIN STORM WATER RUNOIf aimmim USE IS UNLAWLFUL ��O N CODE. WITHOUT CERTIFICATE OF OCCUPANCY "IMMEDIATELY" ENCLOSE POOL TO CODE UPON COMPLETION BEFORE"WATER" ELECTRICAL INSPECTION REQUIRED nitt NoWo •1. y. l R�: f. M _ t - V I 10 )01 ....... ------ s4h) ulx IT Y I ' ro �• - � i . I ! 1. � I _ �__�____.._�_..._._ . y �--- f;,. -fix „s � - � - � E � «-. •, � 1 ;_-�`" �:�—:�—�" y-= �i,._.._ •ra'y: / 1 4S 9 i { 3 - ��� , —.+4_.M.+. � }%.�t 1,'f ,�....�e1�� I� _ 3_�-:—�-•� - 4 � �.SLl —..�- �L��L�� { `•� ��''J{.�,� '�'C'} F `�p''$${{{{{{ W^� • {j� �� � � r ��2 s 4. B 1LD NG DEP 'A f f � `(� �iy� � �,a9 yi c-QllrrHAI -fill F J _,_ , r