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HomeMy WebLinkAbout51512-Z .of souryo� Town of Southold * * P.O. Box 1179 o� 53095 Main Rd Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 45974 Date: 02/13/2025 THIS CERTIFIES that the building DECK Location of Property: 4415 N Bavview Rd Southold, NY 11971 Sec/Block/Lot: 79.-3-14 Conforms substantially to the Application for Building Permit heretofore,filed in this office dated: 10/31/2024 Pursuant to which Building Permit No. 51512 and dated: 01/02/2025 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: Geoffrey Wells , Cynthia Wells Of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL: ELECTRICAL CERTIFICATE: PLUMBERS CERTIFICATION: A o e 0 ature �o��oFse�,ya�o TOWN OF SOUTHOLD BUILDING DEPARTMENT 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#: 51512 Date: 01/02/2025 Permission is hereby granted to: Geoffrey M Wells 4415 N Bayview Rd 'Southold, NY 11971 To: reconstruct deck addition to existing single-family dwelling as applied for. Premises Located at: 4415 N Bayview Rd, Southold, NY 11971 SCTIVI#79.-3-14 Pursuant to application dated 10/31/2024 and approved by the Building Inspector. To expire on 01/02/2027. Contractors: Required Inspections: FOOTING/REBAR, FRAMING/STRAPPING,DRAINAGE, FINAL, Fees: Single Family Dwelling- Addition&Alteration $495.50 CO-RESIDENTIAL $100.00 Total S595.50 Bui ing Inspector YYY DAVID TURNER ARC ITECT, P. C . 1-24-25 Southold Department of Buildings Town Hall Annex Building 54375 Route 25 PO Box 1179 Southold, New York 11971 Re: 4415 North Bayview Road, Southold, NY CERTIFICATION LETTER The Foundation and Framing (including Ledger Board) for the rear yard deck has been completed and complies with 2020 Residential Building Code. Sinc ere l , D 'd Turner RA 16162 (EaED q/qC G�5 K. rU yr_�, _ I `S'T No. 16162 I, qTQ� ;i i; I h 1; 366 WEST 30TH STREET, FIRST FLOOR NEW YORE, N.Y. 10001 PHONE: (212) 594-0840 L i, P i SO(/l�°� # # TOWN OF SOU.THOLD BUILDING DEPT. courm N 631-765-1802 �,�e,,..- JNSPECTION [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. . FOUNDATION 2ND NSULATIOWCAULKING [ ] -FRAMING/STRAPPING ( FINAID___i [ ] FIREPLACE & CHIMNEY {: ] FIRE-SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: 04 w - �o DATE INSPECTOR oF soulyO� TOWN OF SO.UTHOLD BUILDING DEPT. "you 631-765-1802 J � [ LNS. PECTION [ ] FOUNDATION 1ST/ REBAR [ ] -ROUGH PLBG. [ ] FOUNDATION 2ND [ ] ULATION/CAULKING [ ] FRAMING /STRAPPING [ FINAL RP/ [ : ]' FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION FIRE RESISTANT CONSTRUCTION : [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE.VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: DATE INSPECTOR- -IELD INSPECTION REPORT DATE COMMENTS FOUNDATION (1ST) ------------------------------------- FOUNDATION (2ND) C cn z " o ROUGH FRAMING& PLUMBING TIT-1 41) INSULATION PER N.Y. STATE ENERGY CODE j — ------- ol FINAL — — -- ADDITIONAL COMMENTS -- ---- _ - z g�EFbLK TOWN OF SOUTHOLD—BUILDING DEPARTMENT x Town Hall Annex 54375 Main Road P.O.Box 1179 Southold,NY 11971-0959 Telephone(631)765-1802 Fax(631)765-9502 bgps://www.southoldtownnYov Date Received APPLICATION FOR BUILDING PERMIT !D ,�;_ For Office Use Only �} f D., f 3�3 1 444���� PERMIT NO. Building Inspector: I' OCT 3 p A^ Applications and forms must be filled out in their entirety.Incomplete ' applications will not be accepted. 'Where the Applicant Is'not the owner,an BUMDING 7)F '. Owner's"Author`izationfform(Page 2)shall be completed. - TO 4W S YA Date: OWNER(S)OF PROPERTY: Name:Geoffrey Wells---- SCTM#1000 079.00-03 i00-014.00 Project Address:4415 N BayView Road, Southold, NY 11971 Phone#:646 9190002 1Emailwritegw@gmail.com Mailing Address:4415 N Bayview Road, Southold, NY 11971 'CONTACT PERSON:, Name Geoffrey Well. Mailing Address:4415 N Bayview Road, Southold, NY 11971 Phone#:616.91.9-0002 Email:WCltegw@gmail.com DESIGN PROFESSIONAL INFORMATION: Name:David Turner David Turner Architect PC Mailing Address:366 West 30th Street. New York NY 10001 Phone#:91 7 91 6-9451 Email davidturner@verizon.com CONTRACTOR INFORMATION: Name:Steven Kaplan & Mario Tocay(MGT Carpentry) Mailing Address:94 Overlook Drive Mastic NY 11950 Phone#:631 745-5931 Email:sdWp aLi@hotmafl.com DESCRIPTION OF PROPOSED,CONSTRUCTION" ❑New Structure ❑Addition RAlteration ❑Repair ❑Demolition Estimated Cost of Project: El Other $- vao Will the lot be re-graded? ❑Yes BNo Will excess fill be removed from premises? BYes []No 1 PROPERTY INFORMATION;: Existing use of property: gingle Family Intended use of property: Residential Zone!or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? ❑Yes ®No IF YES,PROVIDE A COPY. ®Check Box After Reading: The owner/contr actor/design;professlonal is responsible for all drainage and storm water issues as provided by. Chapter 236 of the Town Code.APPLICATION IS HEREBY MADE to the Building Department for the Issuance of a Building Perrnit pursuant to the,Building Zone- Ordinance of the Town.of Southold,Suffolk,County,New York and other applicable,Laws,Ordinances`or Regulatlons,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 Inspector's on premises and in buildings)for necessary inspections.false statements made herein are ` punishable as a Class A misdemeanor pursuantto Section216AS of the New York State Penal'Law. i Application Submitted By(prin name): (,� ❑Authorized Agent XiOwner Signature of Applicant:R _ Dat /o STATE OF NEW YORK) COUNTYOF ' Jz �� 1 ry -P 4aP 4 VIf C,I 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 57 3Lday of 20 Notary Public ENotary IA PRIKAS GANLEY blic-StateofNewYorkPROPERTY OWNER AUTHORIZATION .OIPR5003206 ed in Suffolk County (Where the applicant is not the owner) ion Expires Oct 19,2026 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 SHIPS DRIVE SURVEY OF PROPERTY_ sc o _ LIBER 12718, PAGE 610 OF DEEDS Lo N/F CORA FITZGERALD CLF COR. Q� I V o RECORDED JANUARY 25, 2013 NO JAMES HALL 1.2 S = W v MAIL N 1.3'W U Z 2 SI TUATE: aox I— S68037'30"E o.1'N o.3'N 190.59' `° _ SOUTHOLD, TOWN OF SOUTHOLD, i FOUND, WOOD R/W + — — SUFFOLK COUNTY NEW YORK 6 STOCKADE FENCE MON. R STOCKADE S.C.T.M. 1000—079.00—03.00—014.000 cWi 1.8'S FENCE COR. z 1.9'S CERTIFIED TO: O W WELL 1 1.5'W CASING y � CYNTHIA WELLS Q GEOFFREY WELLS A/C 0 72 7 � 36.3' N STANDARD NOTES= cc N CONC. .� i� 1­ N � PAD SN 1. COPYRIGHT 2024 DENNIS W. LAYTON LAND SURVEYOR, P.C. PP 2. UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY MAP C.E. gR�CK N W a BEARING A LICENSED LAND SURVEYORS SEAL IS A VIOLATION vi 7.8' OF SECTION 7209, SUB-DIVISION 2, OF NEW YORK STATE W y EDUCATION LAW. J. ONLY BOUNDARY SURVEY MAPS WITH THE SURVEYORS (D b a EMBOSSED SEAL ARE GENUINE TRUE, AND CORRECT COPIES OF R/O STONE �u a W S THE SURVEYORS ORIGINAL WORK AND OPINION. Q�1n W W & BRICK J J Q o o Q 4. CERTIFICATIONS ON THIS BOUNDARY SURVEY MAP SIGNIFY THAT W PLAT. �N J 3 a ao S^ THE MAP WAS PREPARED IN ACCORDANCE WITH THE CURRENT wM W � c� W Y O g 3°' m `O EXISTING CODE OF PRACTICE FOR LAND SURVEYS ADOPTED BY uu' W ~ THE NEW YORK STATE ASSOCIATION OF PROFESSIONAL LAND (V M cJ- m ON m 3� m20 m Wv SURVEYORS, INC. THE CERTIFICATION IS LIMITED TO THE N cv d' 5.6 � n c� o _ LP W Z a ,, PERSONS FOR WHOM THE BOUNDARY SURVEY MAP IS (V BRICK coi 64.4' m 2 PREPARED, TO THE TITLE COMPANY, TO THE GOVERNMENTAL O N PAD AGENCY, AND TO THE LENDING INSTITUTION LISTED ON THIS Z Q W BOUNDARY SURVEY MAP. 3.8' 12.2m m 5. THE CERTIFICATIONS HEREIN ARE NOT TRANSFERABLE. 6. THE_LOCATION OF UNDERGROUND IMPROVEMENTS OR w N o ENCROACHMENTS ARE NOT ALWAYS KNOWN AND OFTEN MUST �r c� M BE ESTIMATED. IF ANY UNDERGROUND IMPROVEMENTS OR � ENCROACHMENTS EXIST OR ARE SHOWN, THE IMPROVEMENTS OR ASPHALT DRIVEWAY N m p WITH BBC EDGING o Z �O ENCROACHMENTS ARE NOT COVERED BY THIS SURVEY. Q. N Z THE OFFSET (OR DIMENSIONS) SHOWN HEREON FROM THE 75.0' m (� STRUCTURES TO THE PROPERTY LINES ARE FOR A SPECIFIC 26.7' PURPOSE AND USE AND THEREFORE ARE NOT INTENDED TO O GUIDE THE ERECTION OF FENCES, RETAINING WALLS, POOLS, CONC. m /BRICK PATH BRICK PATH PATIOS, PLANTING AREAS, ADDITIONS TO BUILDINGS, AND ANY LID _ BRICK OTHER TYPE OF CONSTRUCTION. 8. COPIES OF THIS SURVEY MAP NOT BEARING THE LAND FOUND \ to 4' CHAIN LINK FE. BRICK 1.4'N SURVEYORS INKED OR EMBOSSED SEAL SHALL NOT BE PPS MON. ' CLF 0.1'N CLF 0.1'S CONSIDERED TO BE A VALID COPY. STK FE. MAIL ^ 6' STOCKADE FENCE N/F PHILOMENA , „ COR. STOCKADE BOX , N68 37 30 W � KILCOMMONS SURVEYED BY: C.U., G.L. 0.3'N N/F ELLEN LOVE 180.53 FENCE COR. REVOCABLE DENNIS W. LAYTON DRAWN BY: D.L. 1.90S OF TRUST PROFESSIONAL LAND SURVEYOR JOB: D24-116 2.5'W (LOT 5) NEW YORK LICENSE NO. 050920 SHEET: 1 OF 1 NOTES: DENNIS W. LAYTON 1. PROPERTY ADDRESS: 4415 NORTH BAYVIEW ROAD, SOUTHOLD, NEW YORK 11971. LAND SURVEYOR, P.C. 2. LOT AREA = 22,730 SQ.FT. (0.52 ACRES). Mtn ,` 15 FROWEIN ROAD,SUITE E2 J. THIS SURVEY WAS COMPLETED USING A TRIMBLE S7 ROBOTIC TOTAL STATION. 050920 J� DENNIS W. LAYTON 4. PROPERTY CORNER MONUMENTS WERE NOT SET AS A PART OF THIS SURVEY. s�` Q- d layt.nmm�. CENTER MORICHES, NEW YORK 11934 . 5. ALL DISTANCES ARE IN US SURVEY FOOT. "�20 OtAND S�Q 6. SURVEYED ON AUGUST 29, 2024. SGPL� .!`ry I DWLAYTON.COM ACo10l31/2024 Y) ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/ 024 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()es)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 Paula Eglevsky NAME: Morley Agency Inc PHONE (631)283-3100 FAX (631)287-0081 A/C No Ext: A/C No 32 Hampton Road E-MAIL enc Paula@ morley 9 y a .com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC it Southampton NY 11968 INSURERA: Utica First Insurance Company INSURED INSURER B: MGT Carpentry Corp. INSURER C: 94 OVERLOOK DR INSURER D: INSURER E: MASTIC NY 11950-4910 INSURERF: COVERAGES CERTIFICATE NUMBER: 24-25 GL I REVISION NUMBER: THIS IS TO CERTIFY THATTHE 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 ADUL 5UBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR D G D 50,000 PREMISES Ea occurrence $ MED EXP(Any one person) $ 5,000 A ART3001304180 08/01/2024 08/01/2025 PERSONAL&ADV INJURY $ 1,000,000 P`'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? NIA E.L.EACH ACCIDENT $ El (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If 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) Carpentry CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town Of Southold ACCORDANCE WITH THE POLICY PROVISIONS. 53095 Rte 25 AUTHORIZED REPRESENTATIVE Southold NY 11971 1/ � ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 26(2016103) The ACORD name and logo are registered marks of ACORD NYSI F New York State Insurance Fund PO Box 66699,Albany,NY 12206 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE �. �", .0 ^AAAAA 842911464 NFP PROPERTY&CASUALTY SERVICES INC INS, 2 HAMP 3 TON RD SOUTHAMPTON NY 11968 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER MGT CARPENTRY CORP TOWN OF SOUTHOLD 94 OVERLOOK DRIVE 53095 RTE 25 MASTIC NY 11950 SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE 12572 770-2 338624 09/05/2024 TO 09/05/2025 10/31/2024 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2572 770-2, 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 CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. PRESIDENT MARIO G TOCAY MGT CARPENTRY CORP THE POLICY 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 WE PAID IN WORKERS'COMPENSATION AND/OR MEDICAL BENEFITS TO OR ON BEHALF OF AN EMPLOYEE OF OUR INSURED IN THE EVENT THAT, PRIOR TO THE DATE OF THE ACCIDENT, THE CERTIFICATE HOLDER HAS ENTERED INTO A WRITTEN CONTRACT WITH OUR INSURED THAT REQUIRES THAT SUCH RIGHT OF SUBROGATION BE WAIVED. 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 SUR NCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER:516379071 U-26.3 7 ® DATE(MM/DDIYYYY) A�o CERTIFICATE OF LIABILITY INSURANCE 10/31/2024 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 Paula Eglevsky NAME: Morley Agency Inc A/CNNo Ext: (631)283-3100 AIC,No: (631)287-0081 32 Hampton Road ADDRIess: Paula@morleyagency.com INSURER(S)AFFORDING COVERAGE NAIC# Southampton NY 11968 INSURERA: Utica First Insurance Company INSURED INSURER 8: MGT Carpentry Corp. INSURER C: 94 OVERLOOK DR INSURER D: INSURER E: MASTIC NY 11950-4910 INSURER F: COVERAGES CERTIFICATE NUMBER: 24-25 GL 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 INSD WVD POLICY NUMBER MMIDDfYYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE Fx_]OCCUR PREMISES Ea occurrence) $ 50,000 MED EXP(Any one person) $ 5,000 A ART3001304180 08/01/2024 08/01/2025 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2.000,000 POLICY ❑JECTPRO- ❑LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Carpentry CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town Of Southold ACCORDANCE WITH THE POLICY PROVISIONS. 53095 Rte 25 AUTHORIZED REPRESENTATIVE Southold NY 11971 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD NYSI F New York State Insurance Fund PO Box 66699,Albany,NY 12206 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE 0. - .0 AAAAAA 842911464 NFP PROPERTY&CASUALTY r SERVICES INC Q 32 HAMPTON RD SOUTHAMPTON NY 11968 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER MGT CARPENTRY CORP TOWN OF SOUTHOLD 94 OVERLOOK DRIVE 53095 RTE 25 MASTIC NY 11950 SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE 12572 770-2 338624 09/05/2024 TO 09/05/2025 10/31/2024 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2572 770-2, 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 CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. PRESIDENT MARIO G TOCAY MGT CARPENTRY CORP THE POLICY 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 WE PAID IN WORKERS'COMPENSATION AND/OR MEDICAL BENEFITS TO OR ON BEHALF OF AN EMPLOYEE OF OUR INSURED IN THE EVENT THAT, PRIOR TO THE DATE OF THE ACCIDENT, THE CERTIFICATE HOLDER HAS ENTERED INTO A WRITTEN CONTRACT WITH OUR INSURED THAT REQUIRES THAT SUCH RIGHT OF SUBROGATION BE WAIVED. 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 SU NCE FUND 4 * DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER:516379071 U-26.3 god, AP R VED AS NOTED DATE' �� B.P.#_ S�I�2 F OCCUPANCY OR NOTIFY BUILDING DEPARTMENTAT USE IS UNLAWFUL 631-765-1802 8AM TO 4PM FOR THE FOLLOWING INSPECTIONS: WITHOUT CERTIFICAT 1. FOUNDATION-TWO REQUIRED _ FOR POURED CONCRETE ,r OCCUPANCY 2, ROUGH-FRAMING&PLUMBING 3. INSULATION 4. FINAL-CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OFTHE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTON ERRORS RETAIN STORM WATER RUNOFF ,PURSUANT TO CHAPTER 236 COMPLY WITH ALL CODES OF ' OF THE TOWN CODE. NEW YORK STATE& OWN CODES . AS REQUIRED AND NDITIONS OF "" ' ""' Al ;�"s r So TOWN ZBA SOUTH LD TOWN PLANNING BOARD n SO OLD TOWN TRUSTEES Y NX .DEC S OLD HPO d HD . (2) — 2" X 12" (PT) POST I AREA OF WORK o I EQ EQ � I 2" X 10" (p160 (PT) z II II 43' II II 14, m \ /i•, I� r- I '� I VQ STORY FRAF@ � EQ� GYff LN6 EQ J 224 x 10" JOISTS 2" X 10" II I II @ 16" O.G. BLOCKING I U, II i II Q I I II II II = 1/2" BOLT METAL OIST �24O. .s � HANGER G zL1 LL II 1 (2)- 2"xIV P.T. BOLTED } iv _ `TOGETHER WITH 1/2" BOLTS I r II — o24"O.G. (2)- 2"xIV P.T. z0 II 4" x 4"P05T DECK FRAMING PLAN METAL BASE HOLDER Q FOR WOOD POST SCALE 1/5 1'-0' II � GRADE LINE — — — — ^'n n>.; � 12250' NORTH BAYVIEW ROAD PLOT PLAN UP NT5 �r DAVID TURNER ARCHITECT, P.C. 366 WEST 30TH STREET,FIRST FLOOR,NEW YORK,N.Y. 10001 6" COMPOSITE DECKING orOFROUBEFo I O (212)594-0840 WOOD POST PROJECT r 4415 NORTH BAYVIEW ROAD 6" TRIM SOUTHOLD, N.Y. i 14 SHEET _ SEGTION A THRU DEGK rA HOUSE DECK PROPOSAL NT5 �OO DATE: 10-25-24 UP S.G 1.T.M 1000-0 ci.00-0500-014.000 I �G`yt � PROJECT No: DRAWING BY: CHK BY: DEGK PLAN (V NEW DECK TO SUPPORT 50 LBS PER. * DWG No: x,�,�B•.,_o• SQUARE FOOT LIVE LOAD. r 1 A- 1 ALL WOOD MEMB 00 - 00 ERS TO BE PRESSURE TREATED. h s STET ..161� 3 CAD FILE No: 1 of 1