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HomeMy WebLinkAbout51020-Z TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE w 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#: 51020 Date: 8/1/2024 Permission is hereby granted to: Montes De Oca Anna 980 Manhanset Ave Green ort, NY 11944 To: construct alterations to existing single-family dwelling as applied for. At premises located at: 980 Manhanset Ave Green port SCTM #473889 Sec/Block/Lot# 34.-5-20 Pursuant to application dated 6/3/2024 and approved by the Building Inspector. To expire on 1/31/2026. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $492.50 CERTIFICATE OF OCCUPANCY $100.00 Total: $592.50 Building Inspector dr TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 ht1[p .��v so tholdtowlin Date Received APPLICATION BUILDING For Office Use Only M Y PERMIT NO. 4 I� Building Inspector. Applications and forms must be filled out in their entirety.Incomplete applications will not be accepted. Where the Applicant Is not the owner,an Building Department Owner's Authorization form(Page 2)shall be completed. Town of Southold Date: 6/3/24 OWNER(S)OF PROPERTY: Name: Justin Concannon 7jscTM# 1000-34.-5-20 Project Address: 980 Manhanset Avenue, Greenport, NY 11944 Phone#: 631-905-8132 Email:jc989898@gmail.com Mailing Address: 172 Fifth Street, Greenport, N'O( 11944 CONTACT PERSON: Name: Roric Tobin Mailing Address: 172 Fifth Street, Greenport, NY 11944 Phone#: 917-626-1381 Email: roric@rorictobindesigns.com DESIGN PROFESSIONAL INFORMATION: Name: Frank Uellendahl Mailing Address: 123 Central Avenue, Greenport, NY 11944 Phone#: 631-680-0041 Email:frank.uellendahl@gmail.com CONTRACTOR INFORMATION: Name: DCF Construction Mailing Address: P.O. Box 450, Shelter Island, NY 11964 Phone#: 631-833-6259 IEMail:floresdc1583@gmail.com DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition RAlteration ❑Repair ❑Demolition Estimated Cost of Project: ❑Other < 100,000.00 Will the lot be re-graded? Dyes ®No Will excess fill be removed from premises? ❑Yes BNo 1 r PROPERTY INFORMATION Existing use of property: Single family home Intended use of property: Single family home Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to R-40 this property? ❑Yes ONo IF YES, PROVIDE A COPY. B heck Box After Read!n : The owner/contractor/design professional Is responsible for all drainage and storm water issues as provided by Chapter 236 of the Town Code. APPUCATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold,Suffolk,County,New York and other applicable Laws,Ordinances or Regulations,for the construction of buildings, additions,alterations or for removal or demolition as herein described.The applicant agrees to comply with all applicable laws,ordinances,building code, housing code and regulations and to admit authorized inspectors on premises and in building(s)for necessary inspections.False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210AS of the New York State Penal Law. Application Submitted By(print name): Roric Tobin BAuthorized Agent ❑Owner Signature of Applicant: " Date: 6/3/24 CONNIB D.BUNCH STATE OF NEW YORK) Notary Ilublio,State of New York SS: No. 01i U0185050 ) Quallfled in Suffolk County COUNTY OF r��,� Commission Expires April 14,2—_� being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)he is the (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 ..01 day of ��1�- Z� � � «v`0 Notary Public PROMEiC"f'f, QWMER AUT'1 1 ) 1 TI (Where the applicant is not the owner) Justin Concannon residing at 980 Manhanset Avenue, Greenport, NY 11944 I, Roric Tobin do hereby authorize to apply on my e#lf to the T +rn of Southold Building Department for approval as described herein. Owner's Si nature Date Print Owner's Name 2 ei Generated by REScheck-Web Software Compliance Certificate R r � EC Ef W Project THE CONCANNON RESIDENCE Energy code: 2018 IECC J111 2 6 20P4 � Location: Southold, New York Construction Type: Single-family uilding Department Project Type: Addition Town of Southold Climate Zone: 4 (5572 HDD) Permit Date: Permit Number: All Electric false Is Renewable false Has Charger false Has Battery: false Has Heat Pump: false Construction Site: Owner/Agent: Designer/Contractor 980 MANHANSET AVE JUSTIN CONCANNON FRANK UELLENDAHL GREENPORT, NY 11944 OWNER ARCHITECT 172 FIFTH STREET GREENPORT, NY 11944 Compliance: 5.7%Better Than Code Maximum ILIA: 247 Your UA: 233 Maximum SHGC: 0.40 Your SHGC: 0.32 The%Better or Worse Than Code Index reflects how close to compliance the house is based on code trade-off rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home. grade t.iruam�awoffs pare no Iluung r con�a'oaieired iin the U or Ipcifforrrr7rnunrce conrullphauirnra ICuath iin 1R1l::'�a,lluu:r:lr. Each h rallalb aaua..,giruurle �a s�ua�nnllally in the sll)eu:nfor d r fiirn a9:um.zone ilanu,.ust ruueet:the irrdilfiirnuurn energy code oru.aa.ulluadon II1 value a lid depth req uh'ern7a,nts,, Enyelgne ASS-emblies Gross Area Cavity Cont. Prop. Req. Prop. Req. Perimeter Ceiling 1: Flat Ceiling or Scissor Truss 497 30.0 0.0 0.035 0.026 17 13 Wall: Wood Frame, 16" o.c. 781 16.0 0.0 0.066 0.060 38 34 Window: Wood Frame 48 0.300 0.320 14 15 SHGC: 0.32 Window 2: Wood Frame 80 0.290 0,320 23 26 SHGC: 0.32 Window 2:Wood Frame 80 0.290 0.320 23 26 SHGC: 0.32 Floor 1: All-Wood Joist/Truss 498 30.0 0.0 0.033 0.047 16 23 Window:Wood Frame 30 0.300 0.320 9 10 SHGC: 0.47 Window:Wood Frame 232 0.300 0.320 70 74 SHGC: 0.29 Project Title: THE CONCANNON RESIDENCE Report date: 07/25/24 Data filename: Page 1 of10 Gross Area Cavity Cont. Prop. Req. Prop. Req. Perimeter Window: Wood Frame 80 0.290 0.320 23 26 SHGC: 0.32 Compliance Statement: The proposed building design describe h e iWnsistt the building plans, specifications, and other calculations submitted with the permit application.The propose b ildiigned to meet the 2018 IECC requirements in REScheck Version : REScheck-Web and to comply with the man at red in the REScheck Inspectioi Chec I'st. 4 blame-Title Sig a ure Dat Project Title: THE CONCANNON RESIDENCE Report date: 07/25/24 Data filename: Page 2 of10 REScheck Software Version : REScheck-Web Inspection Checklist Energy Code: 2018 IECC Requirements: 0.0% were addressed directly in the REScheck software Text in the "Comments/Assumptions" column is provided by the user in the REScheck Requirements screen. For each requirement, the user certifies that a code requirement will be met and how that is documented, or that an exception is being claimed. Where compliance is itemized in a separate table, a reference to that table is provided. sectlon Plans Verified Field Verified Value V omplies� Comments/Assumptions nspection/Plan Review slue & Re ID # Pre- !_-.._.. ...... s. _.....w._. _..._._ _ _._. oaoe _. . ,,,. ❑Com .... ...... ........... A _.....m .. 103.1, 'Construction drawings and mplies 103.2 documentation demonstrate ❑Does Not [PR1]1 ;energy code compliance for the []Not Observable building envelope.Thermal envelope represented on ❑Not Applicable j construction documents. 103.1, 'Construction drawings and ❑Complies 103.2, 'documentation demonstrate ❑Does Not 403.7 ,energy code compliance for [PR3]1 :lighting and mechanical systems. ❑Not Observable !Systems serving multiple ❑Not Applicable ;dwelling units must demonstrate compliance with the IECC ;Commercial Provisions. _ 302 1 Heating and cooling equipment is Heat Heat� ti :Heating: ; ing ,❑Complies 403.7 sized per ACCA Manual S based Btu/hr Btu/hr '❑Does Not [PR2]2 on loads calculated per ACCA Cooling: Cooling: [INot Observable Manual J or other methods Btu/hr Btu/hr approved by the code official. ❑Not Applicable Additional Comments/Assumptions: L1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: 980 MANHANSET RESIDENCE Report date: 07/24/24 Data filename: Page 3 of10 section . ......�_.. 30 .2.1 A ,,.__. 9�,,..w.. ..�......_ .. � ....... Comments/Assumptions � # p Foundation Inspection Complies? Comments As protective covering is installed to ❑Comp lies [FO11]2 protect exposed exterior insulation ❑Does Not and extends a minimum of 6 in, below grade. ❑Not observable ❑Not Applicable 0 + raw-and ice-melting system controls ❑Complies [FO12; ' installed, ❑Does Not ;❑Not Observable'; ❑Not Applicable Additional Comments/Assumptions: 9Impact� _.. p' Low Impact(Tier 3) 1 High (Tier 1) 2 Medium Impact (Tier 2) 3 Project Title: 980 MANHANSET RESIDENCE Report date: 07/24/24 Data filename: Page 4 of10 Section 9 9 ..- -. p.. ..,.. ...-. Plans V lue Value Verified .. .. Fief Verified .... . . .... .... ......... -... Re � # Framing /Rough.-In h In Inspection Complies? Comments/Assumptions 402.3.1, average)-factor(area-weighted U- U ❑DoespNot �table fo r valuePeAssemblie T02.1.1, 'Glazing lies See thes 402.3.3, 402.5 ;[]Not Observable [FR2]1 ,❑Not Applicable 303.1.3 U-factors of fenestration products ❑Complies [FR4]1 are determined in accordance ❑Does Not ;f with the NFRC test procedure or .taken from the default table. ❑Not Observable ❑Not Applicable ; 402.4.1.1 IAir barrier and thermal barrier ❑Complies [FR23]1 installed per manufacturer's ❑Does Not instructions. ❑Not Observable ❑Not Applicable ; 402.4.3 Fenestration that is not site built ❑Complies [FR20]1 is listed and labeled as meeting ❑Does Not AAMA/WDMA/CSA 101/I.S.2/A440, [:]Not Observable or has infiltration rates per NFRC 400 that do not exceed code ❑Not Applicable limits. 402 4.5 IC-rated recessed lighting fixtures ❑Complies [FR16]2 sealed at housing/interior finish ❑Does Not and labeled to indicate :52.0 cfm leakage at 75 Pa. ❑Not Observable ❑Not Applicable 403.3.1 Supply and return ducts in attics ❑Complies [FR12]1 insulated >= R-8 where duct is ❑Does Not >= 3 inches in diameter and >_ R-6 where < 3 inches.Supply and ❑Not Observable return ducts in other portions of ❑Not Applicable ,the building insulated >= R-6 for diameter>= 3 inches and R-4.2 for< 3 inches in diameter. 403.3.2 'Ducts, air handlers and filter ❑Complies [FR13]1 boxes are sealed with ❑Does Not !joints/seams compliant with ❑Not Observable International Mechanical Code or International Residential Code, as ❑Not Applicable applicable. ._- . . _ _.. __.. s. . 403.3.5 Building cavities are not used as ❑Complies [FR15]3 ducts or plenums. ❑Does Not ❑Not Observable ❑Not Applicable .-.-.._ ..........� 403.4 HVAC piping conveying fluids R R ❑Complies [FR17]2 above 105 °F or chilled fluids ;❑Does Not below 55 °F are insulated to >_R- 3 ;❑Not Observable ❑Not Applicable 403.4.1 Protection of insulation on HVAC ❑Complies [FR24]1 piping, ❑Does Not ❑Not Observable ❑Not Applicable 403 5.3 Hot water pipes are insulated to R- R ❑Complies [FR18]2 >>_R-3. ❑Does Not r G❑Not Observable ' ❑Not Applicable 03.6 Automatic or gravity dampers are ❑Complies [FR19]2 installed on all outdoor air ❑Does Not intakes and exhausts. ❑Not Observable ❑Not Applicable 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: 980 MANHANSET RESIDENCE Report date: 07/24/24 Data filename: Page 5 of10 Additional Comments/Assumptions: Project Title: 9DUK4ANHANSETRESIDENCE Report date: 07/24/24 Data filename: Page 6ofl0 Section TPIans Verified Field Verified Insulation Inspection Value Value Complies? Comments/Assumptions & Re ID .���....._9m_,-�.J, m ....,.v..._._,. .........�. . w, _ ...... �,_....,.... �..� 303.1 All installed insulation is labeled []Complies [IN13]2 or the installed R-values ❑Does Not i provided. ❑Not Observable i ❑Not Applicable 4021_177 Floor insulation R-value. R--� R ❑Complies ;See the Envelope Assemblies 402.2.6 j❑ Wood ❑ Wood ❑Does Not ;table for values. [IN1]1 ;❑ Steel ❑ Steel ❑Not Observable ❑Not Applicable 303.2, Floor insulation installed per ❑Complies 402.2.8 manufacturer's instructions and ❑Does Not [IN2)1 in substantial contact with the ❑Not Observable 1:01 underside of the subfloor, or floor `framing cavity insulation is in ❑Not Applicable contact with the top side of sheathing, or continuous insulation is installed on the underside of floor framing and extends from the bottom to the ;top of all perimeter floor framing members. 402.1.1, Wall insulation R-value. If this is a R- R- ❑Complies See the Envelope Assemblies 402.2.5, mass wall with at least 1/2 of the ❑ Wood ;❑ Wood ElDoes Not table for values. 402.2.6 :wall insulation on the wall ❑ Mass ❑ Mass ;❑Not Observable [IN3]1 exterior,the exterior insulation requirement applies (FR10). ❑ Steel ❑ Steel ❑Not Applicable 303.2 ;Wall insulation is installed per ❑Complies [IN4]1 manufacturer's instructions. ❑Does Not ❑Not Observable ; ❑Not Applicable Additional Comments/Assumptions: High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: 980 MANHANSET RESIDENCE Report date: 07/24/24 Data filename: Page 7 of10 Section D Final Inspection Provisions Value Value Complies Comments/Assumptions Plans Verified Field Verified ................. w.11 �.. ........... .. m ....... . ----- r d ...�... . _ ...u. ...... 402.1.1, (Ceiling insulation R-value. R- R- ;❑Complies See the Envelope Assemblies 402.2.1, [J Wood ;E] 'Wood �ODoes Not table for values. 402.2.2, ;® Steel ❑ Steel 'E]Not Observable 402.2.6 [FI1]1 ❑Not Applicable 303.1.1.1, ;Ceiling insulation installed per ❑Complies 303.2 manufacturer's instructions. ❑Does Not [FI2]1 Blown insulation marked every ❑Not Observable 300 ft2. ❑Not Applicable 402 2.3 ..... ,a. ,w- Vented attics with air permeable ❑Complies [FI22]2 insulation include baffle adjacent ❑Does Not to soffit and eave vents that extends over insulation. ❑Not Observable o� ❑Not Applicable 2 2.4 Attic access hatch and door R- R ❑Complies [F13]1 insulation >_R-value of the !❑Does Not adjacent assembly. ❑Not Observable ; ❑Not Applicable 402.4.1.2 i Blower door test @ 50 Pa. <=5 ACH 50 = ACH 50 = ❑Complies [FI17]1 ach in Climate Zones 1-2, and lElDoes Not <=3 ach in Climate Zones 3-8. '❑Not Observable ❑Not Applicable 403.3.3 Ducts are pressure tested to cfm/100 cfm/100 ❑Complies [FI27]1 'determine air leakage with ft2 ft2 ❑Does Not either: Rough-in test:Total leakage measured with a ❑Not Observable pressure differential of 0.1 inch 1❑Not Applicable w.g. across the system including the manufacturer's air handler enclosure if installed at time of !test. Postconstruction test:Total ; leakage measured with a pressure differential of 0.1 inch w.g. across the entire system including the manufacturer's air handler enclosure. _ 403.3.4 Duct tightness test result of<=4 cfm/100 cfm/100 ❑Complies [F14]1 cfm/100 ft2 across the system or ft2 ft2 ❑Does Not <=3 cfm/100 ft2 without air handler @ 25 Pa. For rough-in '❑Not Observable =tests, verification may need to ❑Not Applicable occur during Framing Inspection, 403.3.2.1 'Air handler leakage designated ❑Complies [FI24]1 by manufacturer at<=2%of ❑Does Not design air flow. ❑Not Observable ❑Not Applicable 403.1.1 Programmable thermostats ❑Complies [Fl9]2 installed for control of primary ❑Does Not heating and cooling systems and initially set by manufacturer to ❑Not Observable code specifications. ❑Not Applicable ; 1.2 Heat pump thermostat installed ❑Complies [FI10]2 on heat pumps. ❑Does Not ❑Not Observable ❑Not Applicable 403 5 1 Circulating service hot water ❑Complies [FI11]2 systems have automatic or ❑Does Not accessible manual controls. ❑Not Observable ; ❑Not Applicable 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: 980 MANHANSET RESIDENCE Report date: 07/24/24 Data filename: Page 8 of10 # Final�lns Inspection Prov�si � Section Plans Verified Field Verified p ons Complies? Comments/Assumptions & Re ID Value Value .......... e w o qw .n........_ .m................m.-� _......� . ............. . � m.... . .H .. .....�...... _....._u. 403.6.1 All mechanical ventilation system ❑Complies [FI25]2 fans not part of tested and listed ❑Does Not HVAC equipment meet efficacy and air flow limits per Table ❑Not Observable R403.6.1. ❑Not Applicable 403 2 Hot water boilers supplying heat ❑Complies [FI26]2 through one-or two-pipe heating ❑Does Not systems have outdoor setback ❑Not Observable ; control to lower boiler water temperature based on outdoor ❑Not Applicable temperature. 3.5.1.1 Heated water circulation systems ❑Complies [FI28]2 have a circulation pump.The ❑Does Not system return pipe is a dedicated return pipe or a cold water supply ❑Not Observable pipe. Gravity and thermos- ❑Not Applicable syphon circulation systems are not present. Controls for circulating hot water system pumps start the pump with signal for hot water demand within the occupancy. Controls automatically turn off the pump when water is in circulation loop is at set-point temperature and no demand for hot water exists. 3.5.1.2 Electric heat trace systems ❑Complies [FI29]2 comply with IEEE 515.1 or UL ❑Does Not 515. Controls automatically adjust the energy input to the ❑Not Observable heat tracing to maintain the ❑Not Applicable desired water temperature in the piping. 2 Demand recirculation water ❑C+omplies [F130]2 systems have controls that ❑Does Not manage operation of the pump and limit the temperature of the ❑Not Observable water entering the cold water ❑Not Applicable piping to <= 1049F. 403.5.4 Drain water heat recovery units ❑Complies [F131]2 tested in accordance with CSA ❑Does Not B55.1. Potable water-side pressure loss of drain water heat []Not Observable recovery units< 3 psi for ❑Not Applicable individual units connected to one or two showers. Potable water- side pressure loss of drain water heat recovery units < 2 psi for individual units connected to three or more showers. 404.1 90%or more of permanent ❑Complies [FI6]1 fixtures have high efficacy lamps, ❑Does Not ❑Not Observable ❑Not Applicable 404 1 1 Fuel gas lighting systems have ❑Complies [F123]3 no continuous pilot light. ❑Does Not ❑Not Observable ❑Not Applicable 401 3 Compliance certificate posted. ❑Complies [F17]2 ❑Does Not ❑Not Observable ❑Not Applicable 1�Hig,h Impact(Tier 1) J2 Medium Impact(Tier 2) J,,3„ Low Impact(Tier 3) Project Title: 980 MANHANSET RESIDENCE Report date: 07/24/24 Data filename: Page 9 of10 Sec tIeiI p Value field Vedfled omplles7 Comments/Assumptions Ft , ICf _,_w # Final Inspection Provlslons Mans Verlfled E Value -- ._ .... Manufacturer manuals for ❑Compiles 13 mechanical and water heating ❑Does Not systems have been provided. ❑Not Observable ; ❑Not Applicable l Additional Comments/Assumptions: 1 High lnnpact(Tier 1) 2 Medium Impact(Tier 2) 3 Low impact(Tier 3) Project Title: 980 MANHANSET RESIDENCE Report date: 07/24/24 Data filename: Page 10 of10 Energy Efficiency Certificate ISSNEMINOMMOMMIMOM Above-Grade Wall 16.00 Below-Grade Wall 0.00 Floor 30.00 Ceiling /Roof 30.00 Ductwork (unconditioned spaces): uuWW W W Window 0.30 0.32 Door 0.29 0.32 Heating System: Cooling System• Water Heater: Name: Date: Comments �V� Vmor Ar,,% y � A\ yA. A\yvy a y \�\ \�, of Suffolk County is license s the property • �� - nsumer Affairs, xDepartment. Labor Licensing & Co ;�- o� a its validity . � ense does not guarantee �r Possession of this license Additional 13usin-ass Name Category License \ • • W10 - .Carpent ry; H43 - framing Hf3 id _ Windows and Siding, r 'U-1 41 im v yy \3 N Y'S I F New York state Insurance Fund PO Box 66699,Albany, NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE AAAAAA 352690698 ISLA INSURANCE&SERVICES INC 3A W MONTAUK HIGHWAY .. ' HAMPTON BAYS NY 11946 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER DCF CONSTRUCTION LLC JUSTIN CONCANNON PO BOX 450 980 MANHANSET AVENUE SHELTER ISLAND NY 11964 GREENPORT NY 11944 I POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE 12530 868-5 856367 11/24/2023 TO 11/24/2024 6/3/2024 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2530 868-5, 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 INDICATED 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://WWW.NYSIF.COM/CERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER THE SOLE PROPRIETOR, PARTNERS AND/OR MEMBERS OF A LIMITED LIABILITY COMPANY. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STAT S7UNCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 180250188 U-26.3 DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE " 06/03/2024 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 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 CONTACT glexa Torres ISLA Insurance&Services Inc (631 494-9 -(A1..".9 9x* ) CYO+~ PHONE 000 1FAx (631)777-6853 Y E-MAIL �.. insurance,com 3A West Montauk Hwy toms ISIa INSURER(S�AFFORDING„COVERAGE NAIL"# Hampton Bays " NY 11946 INSURERA: UTICA FIRST INS CO 15326 INSURED INSURER B: DCF CONSTRUCTION LLC INSURERC: P.O. BOX450 ...�NSURER.D:...�,m.,,.�.......�......................�_.m.,..�,..-.. ..—..—.. __..................................................., INSURER E: ShelterIsland NY 11964 INSURER.��....................................................................................................................................... ,..m...�.,... 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. ILTR ^^ TYPE OF INSURANCE M D 9aUBR" POLICY NUMBER IT m......... .-... .. LIMN wVD POLICY EFF POLICY EXP LIMITS WDDfYYYY M /DD COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR PREMISES E:eoocurrence­,,.,5100,000 MED EXP(Any one person) $ 5,000 A Y Y ART3001003570 11/20/2023 11/20/2024 PERSONAL&ADV INJURY $ 1,000,000 GEN'L _AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,00 0,000 - P POLICY❑ PROdECB" F—] LOC .PRODUCTS-COMPIOP AGG $ 1,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ____— ,,....... ANY AUTO BODILY INJURY(Per person) $ .......­_�............. ... OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPENC. C]AMAE $ AUTOS ONLY AUTOS ONLY ( . .. )),e......-- ._.,.,.,.,...._._._.-. - UMBRELLA LIAR OCCUR EACH OCCURRENCE $ _"._.... EXCESS LIAR CLAIMS-MADE AGGR EGATE $ DE RETENTION$ $ WORKERS COMPENSATION PER OTH AND EMPLOYERS'LIABILITY Y/N m$TA,,,T�ITE,,,, - ER"""""" ANY OFFICER/MEMBER FFICEMEMB HR EXCLUDED?PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA E.L,DISEASE-..P....EMPN-1111L....,,,.,..- (Mandatory $ ' ) EA OYES $ yes,describe under DESCRIPTION OF OPERATIONS below E,L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER ADDED AS ADDITIONAL INSURED. CARPENTRY,SIDING AND FRAMING SERVICES BLANKET-AI CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Justin Concannon 980 Manhanset Avenue AUTHORIZED REPRESENTATIVE Greenport NY 11944 � � "' ©1988-2015 ACORD CORPORATION. All rights reserved. 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