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HomeMy WebLinkAbout50901-Z $OF 80Ulyo(o Town of Southold * P.O. Box 1179 �o0 53095 Main Rd Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 45903 Date: 01/29/2025 THIS CERTIFIES that the building DECK Location of Property: 4045 Narrow River Rd Orient, NY 11957 Sec/Block/Lot: 27.-2-2.4 Conforms substantially to the Application for Building Permit heretofore,filed in this office dated: 05/13/2024 Pursuant to which Building Permit No. 50901 and dated: 07/03/2024 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: Deck addition to existing single-family dwelling as applied for. The certificate is issued to: Denise Spatny Of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL: ELECTRICAL CERTIFICATE: PLUMBERS CERTIFICATION: ut ed ignature SufFoc,t TOWN OF SOUTHOLD ao� �oGy� BUILDING DEPARTMENT y TOWN CLERK'S OFFICE o • 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#: 50901 Date: 7/3/2024 Permission is hereby granted to: Spatny, Denise 4045 Narrow River Rd Orient, NY 11957 To: construct deck addition to existing single-family dwelling as applied for.. At premises located at:. 4045 Narrow River Rd, Orient SCTM #473889 Sec/Block/Lot# 27.-2-2.4 Pursuant to application dated 5/13/2024 and approved by the Building Inspector. To expire on 1/212026. Fees: ` SINGLE FAMILY DWELLING ADDITION OR ALTERATION $308.00 CO-ADDITION TO DWELLING $100.00 Total: $408.00 Building Inspector OF SOUTyO� # TOWN OF SOUTHOLD BUILDING DEPT. Cou 631-765-1802 0 INSPECTION [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS ION/CAULKING [ ] FRAMING/STRAPPING [ INAL [: ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION_ =] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] 'ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: DATE Y INSPECTO FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION (IST) ----- -------- ------------------------------------- -----._......._ ? FOUNDATION (2ND) --- -- ----- --- - ' -------- ---- .._.._. .._-- "' TZ O ---- - ------------------- - ------ ------ ----'--- --- ..__..... --------- ------- ----- -1 ROUGH FRAMING& -------- ---------- ----- - ------ --- - --- PL UMBIN G - -- -..._.. ._...---- ------------ --------- c� y r INSULATION PER N. Y. --'------ ------------ ------- --... ---— — ---- ------- � STATE ENERGY CODE -__--- ---------.--------------.'__.__-- .007 FINAL -.----- ADDITIONAIL COMMENTS We ------------- 0 ----- - Z a ----------------------------- 0 -o o�og11FF0��-co 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'https://www.southoldtownn gov Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only d J PERMIT NO. Building Inspector: `. M AY 1 3 ?O24 Applications and forms must be filled out in their entirety. Incomplete applications will not be accepted. Where the Applicant is not the owner,an, Owner's-Authorization form(Page 2)shall be completed. Date: 51 13 2 4- OWNER(S)OF PROPERTY: . Name: C�r .n1 c P+'"�' ''P,.._____.__—___ 1000- '2�, .-Z -• Z. Project Address: Phone#: - ---__---_- ---- - - Email: Mailing Address: z40%45 1,,�0 ©w {2 �'L,p 0{�t __ - 'CONTACT PERSON: _ -- Name: h LLJ Mailing Address: Phone#: ' 5-- -' o'!�-_ ----- - Email:-`S�tm A3 DESIGN PROFESSIONAL'INFORMATION: Name: Mailing Address: Phone#• . -St Email- . ._ . . CONTRACTOR INFORMATION: Name: s `� Mailing Address:- 6tc)_ Phone#_ 3 Email: ��� DESCRIPTION OF PROPOSED CONSTRUCTION I El New Structure Addition ❑Alteration ❑Repair-❑Demolition Estimated Cost of Project: ❑Other �QG♦L $ ��zt, ®o Will the lot be re-graded? ❑Yes N40 Will excess fill be removed from premises? ❑Yes o 1 1 ` PR OPERTY INFORMATION Existing use of property: Intended use of property: V-tL5 i d 1_A,1_ --- Zone or use district in which premises is situated: Are there any covenantsnd restrictions with respect to ------ ----- --_ - - �- "-v— -µT--� - this property? E]Yes L�JNo IF YES, PROVIDE A COPY. -� Check Box-After Reading; The owner/contractor/design professional is responsible for all drainage and storm water issues as provided by Chapter 236 of the Town Code:APPLICATION IS HEREBY M ADE 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 ail applicable laws,ordinances,'buildingcocte, housing code and regulations and to admit authorized inspectors ori'premises and In building(s)for necessary inspections.False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the New York Sfate Penal Law.. B name): C>�%6$, Authorized Agent LzOwner Application Submitted y(print Signature of Applicant: Date: . STATE OF NEW YORK) SS: COUNTY OF ,�F%b ) 1 - being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, e 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 20 y �s �` AR0N KR�MRR N N ,nY�ary'Public State of New York . No.'01 kR6221360 14, Qualified ins uffolk Coun ,t;,•CommiSS'on Expires PROPERTY OWNER AUTHORIZATI (Where the applicant is not the ow r) I� residing at do hereby authorize to apply on my behalf to the Town of Southold Building Department for approval as described,herein. Date Owner's Signature Print Owner's Name 2 NOTICE COVENANT TO THE DEED DECLARATION THIS DECLARATION, dated day of f L J ,201�is made by 0�'�-&, � (hereinafter the "Declarant"),whose address is - 7 �l9s WITNESSETH WHEREAS,the Declarant is the owner of certain real property located in the Town'of Southold, County of Suffolk, State of New York, Tax Map#District 1000, Section 27,Block 2, Lot(s) 2.4 which real property is more particularly described in Exhibit A annexed hereto.(hereinafter referred to as the "Property"); and WHEREAS,the Property is situated in or adjacent to regulated freshwater wetland 0-8 of the Orient Quadrangle which has been inventoried and mapped by the New York State Department of Environmental Conservation(hereinafter"Department"),pursuant to Environmental Conservation Law(hereinafter"ECL") Article 24 (also known as the"Freshwater Wetlands Act") and Part 664 of Title 6 of the New York Code of Rules and Regulations (hereinafter"6 NYCRIV); and WHEREAS,various activities conducted both in and adjacent to freshwater wetlands are regulated by the Department pursuant to ECL Article 24 and Part 663 of 6 NYCRR and require-written authorization from the Department prior to being conducted; NOW,THEREFORE, in recognition of the Department's jurisdiction as set forth above,it is the responsibility of a party having any right,title, or interest in the Property,to obtain from the Department or any successor organization,a current description of all activities which are regulated pursuant to ECL Article 24 and Part 663 of 6 NYCRR,and to obtain written authorization from the Department prior to such regulated activities being conducted on the Property. Regulated activities include,but are not limited to clearing of vegetation; application of chemicals;excavation; grading and filling;and erection of any structures_ By: r l STATE OF NEW YORK ) ss. . COUNTY OF .,qA s s q u ) On the Z Z"° day of in the year 201 , before me,the undersigned, a Notary Public in and for said state,personally appeared -h E/yi 5E SPv N y ,personally known to me or proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his capacity, and that by his signature on the instrument,the person or entity upon behalf of which the R!,wson-a ted,,.executed the instrument. PHIL POLLACK Notary Public,State Of New York NOTARY PUBLIC No.01 P06071221 Qualified irt Nassau Co12- my . Commission Expires 3 1 t 0 SURVEY O F: NOTE: WELL AND SEPTIC SYSTEM LOCATION PROPERTY LOCATED AT ORIENT BY OTHERS. B.O.H. REF. No. TEST HOLE(NOT TO SCALE) ETA LOT N o. 4 AS SHOWN ON SEPTIC LOCATION a0 BY: ROY K. REISSIG. PE MAP OF SETTLERS AT OYSTERPONDS -A- 'B' 'c' 'D' �� OCTOBER 29. 2016 a 9:00AM FILED: MAY 4. 1964: FILE No. 7729 TOWN OF S O U T H O L D S.T. 31' 55' W 0.0'-0.1' TOPSOIL PT L.P.1 41' 44• F 3 SUFFOLK COUNTY. NEW YORK a p 0.1'-4.0' BROWN CLAYEY SILT SM L.P.2 55.5' 57' m o WATER S.C.T.M. # 1000-27-2-2.4 L.P.3 44' 58.5' AREA = 11.06 ACRES TLAND BO THE NYWERADU DARY WELL 76' 83'FRESHWATER 4.0'-9.0' WET BROWN SAND SP SCALE: 1..=10 AS DELINEATED BY D. LEWIS ON ELEVATIONS REFER TO 1988 NAVD S 73056'30"E 1/17/17 POND 12.08' 2.0 EL RAD = 1800.00' LEN = 197.92' WETLAND NAIL LINE GRAVEL FND 50 RIGHT OF WAY DRIVEWAY 6 FOR POSSIBLE FUTURE HIGHWAY DEDICATION LOT 8 RAD = 550.00' LEN = 128.55' VACANT �KO �O so 0'3• o^ 3v 'S'N \ COMMERCIAL LAND o °w �\ oev"F 50.0 �Rg S ' "BOAT YARD" 500 ZONE AE 6.0 D.W. CONC. / D' D.W. PROPOSED(SE DETAIL)K sF BgC�gNp S 08058'00"W / ..................... MON. \ ti O k 25.00' / ^' 2 STY FRAME � VACANT RESIDENCE (SEE DETAIL) TEST WELL / A HOLEc? CONE AE 6.0 f� O S C V D STOOP o � ZONE 'X' / s606" o A 63 ,, o'er 2 STY FRAME 'A' J �ST RESIDENCE PROPOSED DECK O LP3 / \ 16.5' X7.2' c O LP1 LP2 4v IR 2 00 POND N VACANT 2.3 EL ° o FEMA INFO o ►� LOT 5 COMMUNITY MAP No. 360813 I MAP No. 36103CO086H RESIDENCE WITH WELL SEPTIC NOTE: THE EXISTENCE OF RIGHT OF WAYS. /•0 [N Wes` WETLANDS AND/OR EASEMENTS OF RECORD IF ANY. NOT SHOWN ARE NOT GUARANTEED. / CO Ax", s Y� SURVEYED BY: /0PDLE ` ` L 'A •Opt � 's:>*; , PAUL BARYLSKI LAND SURVEYING SLATE DR OTHER POLE oN°' STOPPER OR SUITABLE COVER / r II PATCHOGUE NY 11772 END PLUG v�Z� 0 o PHONE 631-294-6985 (�aso7s2 FAX 631-627-3186 10 4 x s 10' 8' DIA 10 / /��/ °F P� PAULBARYLSKI®YAHOO.COM PIPING SEPTIC TANK PIPING L.P. GRADING UZZ� DOGE 6901� �, SAND 14•0 POLE Q5 6 DECEMBER 12. 2016 5 Z FF. EL. p)� LOCKING CASTING LOCKING CASTING TO GRADE 5-6-2017: REVISIONS TO GRADE � m E:ISTING POLE 1/4. CLEAN-OUT A• PROP. GROUND °j {j�l 11-13-2017: REVISIONS PIT 4" 95 u�ADE mm R 24" 1' MIN. 24" 11-26-2017: STAKE OUT HOUSE SEMER PIPE 1' MIN 1 MIN **,,AREA OF PROP 0 y" 6' MIN TOP [lIV 2' MAX. 4 DIA B 2' MAX 2' MAX FILL SLAB 3-31-2018: FOUNDATION LOCATION MIN. s 4' DIA r(' 114' ' "LN ze- ze- h PROPOSED MIN. ^' y 4' DIA MIN. 0 11-9-2018: PLOT SANITARY SEPTIC TANK 1/8. 0 0 O O o Togs < CLASS �� w 5-19-2020: FINAL SURVEY a e>� `° o 0 0 o A W VACANT PIPE 40a 0• a� m Iie• 0�J ,� DEPTH 11S 1� t� M t3 o < OR EOUIVALENr z o< J PITCH 5-2-2024: PROPOSED DECK ti� N '°E `m 4.0 m �s 4' DIA MIN. ' 3.o MIN. 30 3.0'W. > DEPTH CLASS 2400 UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION o� OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. Ir w COLLAR M 00 coLLR (L 0 B ,,, OR EQUIVALENT COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYORS INKED =i BncKFILL WITH HIGHEST 6 ALENT cLEnN snNO AND EXPECT LENGTH OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GRnvEL NATERInL GROUND WATER GRD. WATER LENGTH GUARANTEES OR CERTIFICATIONS INDICATED HEREON SHALL RUN ONLY TO SEPTIC TANK THE PERSON FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO HIGHEST EXPECT THE TITLE COMPANY. GOVERNMENTAL AGENCY AND LENDING INSTITUTION SANITARY SYSTEM DETAIL tO�GROUND WATER LISTED HEREON. AND TO THE ASSIGNEES OF THE LENDING INSTITUTION. GUARANTEES OR CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL TYPICAL 1000 GALLON SEPTIC TANK INSTITUTIONS OR SUBSEQUENT OWNERS. 2270-PROP-DECK pft­- :.:/ NY51 F New York Stato insurance Euntl Pb Box 66699"Albany,NY.12206 nysifcom CERTIFICATE OF WORKERS'COMPENSATION INSURANCE(RENEWED)': A A.A AAA, 112994098 . HAMOND SAFETY MANAGEMENT LLC. 6800.JERICHO TURNPIKE SUITE 105W: � f SYQSSET NY 1179:1 ,SC.AN TO:VALIDATE: ANQ SUBSCRIBE. . POLICYHOLDER` CERTIFICATE HOLDER siD BEEBE&SONS BUILDERS INC., TOWN OF;$OUTHOLD P O BOX 979 Pb BOX"1979 CUTCHOGUE -I 1, 35 SOUTHOLb NY .1'' LPOLICY NUMBER' CERTIFICATE NUMBER POLICY PERIOD DATE G2096 932 5 .` 35675 01701/2024 TO 01/01/2025 12/7/2023 THIS IS TO:CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS;INSURED WITH:THE NEW YORK STATE:INSURANCE. FUND UNDER POLICY NO 209693275 . 5 COVERING THE ENTIRE• OBLIGATION OF `:THIS POLICYHOLDER WORKERS' :COMPENSATION UNDER THE-NEW--YORK.WORKERS' COMPENSATION LAW WITH: RESPECT TO':ALL OPERATIONS IN THE STATEi OF NEW YORK EXCEPT AS ;IND]CATED BELOW AND WITH RESPECT TQ:OPERATIONS- OUTSIDE OF NEW PORK "TO THE POLICYHOLDER'S REGULAR NEW YORK'STATE EMPLOYEESQNLY. tF YOU WISH`TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY;:INCLUDING ANY,NOTIFIGATION t?F CANCELLATIONS, OR,TO VALIDATE THIS CERTIFICATE;1/1SIT OUR WEBSITE AT HTTPS:/IWWW NYSIF COM/CERTLCERNAL ASP THE NEIN_ YORK STATE INSURANCE'FUND ISNOT LIA BLE IN THE EVENT OF FAILURE TO GIVE:SUCH':NOTIFICATIONS::: THIS;POLICY DOES NOT COVER CLAIMS OR SUIT THAT ARISE FROM'BODILY INJURY SUFFERED BY THE OFFICERS OF.THE`. INSURED CORPORATION SIDNEYD BEEBE PRESIDENT ``.THOMPS E BEEBE VICE;,PRESIDENT -SID BEEBE&SONS BUILDERS"INC THEiPOLICY'INCLUDES A WAIVER OF:SUBROGATION ENDORSEMENT.,UNDER WHICH::NYSIF AGREES'TO WAIVE ITS RIGHT OF:SUBROGATION TO BRING AN ACTION AGAINST'THE CERTIFICATE HOLDER TO"RECOVER AMOUNTS,:It PAID IN WORKERS COMPENSATION AND/OR;MEDICAL BENEFITS TO:OR ON:BEHALFOF AN.EMPLOYEE OF OUR dNSURED-IN.THE EVENT THAT; PRIORI TO TH..E DATE';OF THE ACCIDENT THE CERTIFICATE.HOLpER HAS`ENTERED INTO?A WRITTEN: ' CONTRAC7,INITH OUR INSURED THAT.REQUIRES THATSUCH '.HT OF SUBROGATION BE WAIVEQ - THIS::CERTIFICATE IS ISSUED AS A. MATTER OF ::INFORMATION;ONLYANQCONFERS NQ. RIGHTS NOR.INSURANCE COVERAGE #UPON 'THE CERTIFICATE BOLDER: THIS `CERTIFICATE DOES :.NOT AMEND, :'EXTENII' OR ALTER THE(COVERAGE AFFORDED;BY THE'.POL'ICY._ BY:CAUSING:THIS CERTIFICATE TO>',BE ISSUED TO;THE CERTIFICATE HOLDER .THE POLICYHOLDER UNDERTAKES TO :PROVIDE THE; :CERTIFICATE HOLDER 30 CALENDAR :;DAYS':NOTICE`':OF ANY CANCELLATION OF THE POLICY: ' NEW'Y_pw STAT SUR NCE FUND: DIRECTOR,INSURANCE FUND UNDERWRITING_ V4 DATION:N.UMBER 14532681;5 U 263" . ARC. TE(MM/DDlYYYYI CERTIFICATE OF LI ILI ABTY INSURANCE. °A 0 510 8120 24'- THIS CERTIFICATE I§ISSUED'AS A MATTER OF INFORMATION ONLY-AlD CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES:NOT AFFIRMATIVELY OR,NEGATIVELY AMEND,EXTEND.OR ALTER THE COVERAGE AFFORDED;BY,THE POLICIE$> i BELOW. THIS CERTIFICATE OF INSURANCE DOES N01 CONSTITUTE A CONTRACT BETWEEN 'THE'ISSUING:INSURER(S),AUTHORIZED REPRESENTATIVE-OR PRODUCER,AND THECERTIFICATE HOLDER IMPORTANT If the certificateiholder-Is an ADDITIONAL INSURED,the poII Mes)muet ha1.ve ADDITIONAL INSURED provlslons or'be endorsed If SUBROGATION IS WAIVED,subject#o the terms and conditions of the policy certain 0611dies'may require an;er dorsement A statemeriYon this certificate does not confer rights tothe'certificate holder ie Ileu of such endorsements) :;' PRODUCER - _._. ... . _.. ..CON - -racT Debra Slmtcich . NAME-:: :''• r. RoyH ReeveAgency,Inc. PHONE � (631)298-4700 F (631)'298 3850 ac.No PO Box 54 E MAm ' dsimlacti ro reeve3;roin :ADDRESS:_: G Y -. 13400 Main Road' ;. .. . - _:.: .. -: INSURER(S)AF.FORDING'COVERAGE. MatGtuok NY 11952 irlsuRERq: Mesa Underwriters Specialty 1- Col - . INSURED: - ; iNsuRER a': Merchants Mut lns Co 23329. Sid Beebe 8,SonsBuilders Inc. .. . INSURERC2' - PO Box 979 INSURER pi: .Cutchogue NY 1793.5 <IN$URER E ,: _.._::INSURERf:: ... COVERAGE$,, CERTIFICATENUMBER CL244520837':. REVISION NUMBER THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUREDAAMEDABOVE,FORTHE P.OLICYPERIOD INDICATEO:.:NOTWITHSTANDINOANY•REQUIREMENT,TERMOR:CONDITIONOF ANY GONTRACT:OROTHERD000MENTWITHRESPECTTOWHICH'THIS_' CERTIFIQATE;MAY-BE ISSUED OR MAY PERTAIN,THE INSURANCEAFFORDED BYTHE POLICIES;DESCRIBEDHERElN I$SUBJEC f 70AL1 THE TERMS;; ... EXCLUSIONS AND CONDITIONS OF SUCH PO'N IoESwLI IroMITS SHOW ao CYt uMSER EN.REDUCED BY PAID CLAIMS > . INSR LTR TYPE OFINSURANCE'' MM/D LICY FF D POLICY ND LIMITS X COMMERCIAL:GENERALLIABILITY. P CLAIMS-MADE. ❑X t.00CUR _ EACH'OCCURRENCE . 'PREMISES Ea oecuirenee - $ 100,Of]0 .. _ ,. MEOEXP(Anvone'derson) ;$ 5,000' A:. MP0082001007774- 04103/2024 .0!M312025 P . . - .. ,.: .. SONALBADV:INJURY...... 000000. GEN LAGGREGATE LIMITAPPLIES PER- - - GENERALAGGREGATE : $ 2,000,000 POLICY❑JEC LOG_ - - 7PRODUCTS:-:COMP/OPAGG'.',$-2,0 00,000:., OTHER: �4uTOMOBILE LVU31LrTY' .. :.. C 88BNIN�ED SINGLE LIMIT 'enn .$ jD00,00D ANYAUTO - BODILYINJURY(PerPersoa --$ B: OWNED SCHEDULED. GAPI068395�. ..:04/03/2024'� 04/03/2025" BODILY INJURY(Peraaident)'�$ . AUTOS;ONLY AUTOS HIRED NON . AUTOS ONLY -AUTO PROPERTY.DAMAGE ant) $ d motoris UMBRELLALIAB .00CUR.. Underins t $ 1000.000 -: EACH.000 RRENCE P$ .. EXCE$311AB CLAIMSMADE`. . :AGGREGATE_ ,$ DED; RETENTIONS . - - .WORKERS COMPENSATION AND EMPLOYERS LIAeIUTY - - -9T7 tJTE ER� - - ANY PROPRIETORIPARTNERIEXECUTIVE YIN.'. - - OFFICERIMEMBEREXCLUDED? - �.:;NlA - EL FACHACCIDENT $ (Mandatory:IriNFi)- .E.L msEASE-EA EMPLOYEE'�S Ryes;describe under_.: - ..::DESCRIP.TION OF:OPERATIONSaelb,V - - •- - DI9EASE-POtICYLIMIT` �S DESCRIPTION OFOPERATIONS%LOCATIONS!VEHICLE§(4CORD,701,Additional ReniAo.Sehedula;.may ba attached It more apace Is rtiquliedj - - CERTIFICAmimiotDER CANCELLATION'. SHOULD'ANY OF:THE ABOVEDESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION.DATE THEREOF,NOTICE WILCBE DELIVERED IN;' Town of Southold ACCORDAtJCE WITH THEPOLICY PRpVISIONS. PO Box 1179 AUTHOR¢ED;REPRESENTAnm,.. .' - Southold NY 11971' ©19884015ACORD CORPORATION._:AII H hts;reseive.d. ACORD25(2016/03) - ThetACORD name alidtogo awregistered.marke cfACORD.. r APPAQVED AS NOTED D B.P. 6 FEE i b BY: RETAIN STORM WATER RUNOFF NOTIFY BUILDING DEPARTMENT AT PURSUANT TO CHAPTER 236 631765.1802 8AM TO 4PM FOR THE OF THE TOWN CODE, FOLLOWING INSPECTIONS: 1. FOUNDATION-TWO REOUIRFD FOR POURED CC?IgCRFTF 2. ROUGH-FRAMING&PL ;,AE' a 3. INSULATION 4. FINAL-CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTON ERRORS ELECTRICAL INSPECTION REQUIRED COMPLY WITH ALL CODES OF NEW YORK STATE&TOWN CODES AS REQUIRED AND CONDITIONS OF SOUT}iO ,OWN ZBA SOUTHO OWN PLANNING BOARD •w.--....._....SOUTHO TOWN TRUSTEES N18,D C SO OLD HPC SC OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICI! OF OCCUPANCY { y. Ire ik , 5d ,v ... .. u ( i- a14 tv ix At 0A, 44 r- �S , a7 �,y xt LW4tft(�y w �. f. b ' REYIS(ON DATE � •ISSUEI S. O�} �k. N.J. MAZZAFERRO P.E. ow►wN sr:.nuM PROFESvi SIONAL ENGINEER DATE: h 2. P.O.BOX 57,GREENPORT NY,11944 p % 40 5Ak.457.5596 EMAIL nickmazzafeno@verizon.net SCALE:%�&41k )UATZ. A {C mz m OA) SHEET NO: 40 '1 s WATizola rd\uz m � 5 WOO Zr77, Z,- ZA Cet9 M Y gets �'