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33042-Z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold; N.Y. CERTIFICATE OF OCCUPANCY No: Z-33099 THIS CERTIFIES that the building NEW DWELLING Location of Property: 925 WILLOW TERRACE LA ORIENT (HOUSE N0.) (STREET) (HAMLET) County Tax Map No. 473889 Section 26 Block 2 Lot 31 Subdivision Filed Map NO. Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 9, 2007 pursuant to which Building Permit No. 33042-Z dated MAY 17, 2007 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 ONE FAMILY DWELLING WITH FIRST AND SECOND FLOOR COVERED PORCHES, REAR DECKS AND ATTACHED TWO CAR GARAGE AS APPLIED FOR. The certificate is issued to JOSEPH G MANZI, JR TRUST (OWNER) of the aforesaid building. SIIFFOLR COUNTR DHPARTMEN'P OF HEALTH APPROVAL R10-OS-0202 04/29/08 ELECTRICAL CERTIFICATE NO. 3049765 05/30/08 PLLIMBHRS CERTIFICATION DATBD Date: 06/16/08 06/12/08 CHARLES SANDERS zed Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL Old or Pre-existing Building: 765-1802 "~ --~ '" ~ - l' J 1 ~ 6 ~; APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building DEpartment with the fglldt_}fg;__` A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1 % lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Platming Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic feahtres. 2. A properly completed application and consent to inspect signed by the applicant If a Certificate of Occupancy is denied, the Building Inspector shalt state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy -New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Switmning pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy -Residential $15.00, Commercial $15.00 Date. ~ /~ f. New Construction: ~QQ . ~~ 6 - Sr, g 2~ 3 ~ _ _A_.. _-- _~ __ ,, r ~ ~ . r~ r (check one) Location of Property: 9 Z5 G/i LLOw Tu tZRA L.~~ LAti c- O Rt t-NT _ House No. Street Hamlet Owner or Owners of Property: ~~dG/l~,f~~ ~~;~ i_c~P~~ ~~~ Suffolk County Tax Map No 1000, Section .2 ~ Block Z Subdivision Permit No. 3 3a ~~ Date ofPemiit. Health Dept. Approval Planning Board Approval: Lot ~ ~ Filed Map. Lot: Applicant:/~ ,~~~~-~yi.~ww(~ata,•e Cam, 2 h 10 d L d y o 'L, Underwriters Approval: F}`/ i3oq:Z h of Ei/!. U,vntr~rr~ t j ~c/~S .tPP~ 3v`F~76 i curi p g o ~G7G)~ Request for: "femporary Certificate ~ ~~ Fee Submitted: $ `f ~ ~- ~ ~~3U~i L ~ ~~ ~~B Final Certificate: ~ (check one) ~~ ~~~~_ Applicant Signature FEB D3 'D4 11=0aF1M SOUL HOLU BLiILGlf{~ 631 765 95(72 Tour. Hull, 53045 Mein Road P.O. Dox l l79 Southold, New York ] 1971-6959 $ ~ aq x ~! # ~a~~ BUILDING DEPARTMENT TOWN OF BOUTHOLD CERTIFICATION Fax (571) 765 A50: Tclophane (631) 7GS-1602 Dater I I `lam Building Permit No. ~ 3 ~ y 2 O-Nner: ~~a/t'~~~6U6to~ty 5,~.~Li G/A~lc:a~ -~ W ~' dZ~tGN~~ ~~~I (Please/pant) Plumber ~_ 1 ~/U~ ly~~~~ (Please print) Iced. I certify Ihat the solver used in the water supply system contains less than 2/10 of 1% (Plumbere Signa[urei Sworn to before me this ~ oZ day DrJu n P_~ ~oon~ ~7 / }1 ) DUR(S DAYTON -»`~`- -- -- --- NOTARY PUBLIC, State of New Vork No. 4753763 Quali'led in Suffolk County Nora;yPubhc _l.oun[y ~,m I.aignExpireaun,j/,o~D/0 GAS ~,~i 33oY,2 BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by AFTON ELECTRICAL CONT, INC 2 BENTNOR STREET MASTIC, NY 11950, Located at 925 WILLOW TERR. LANE ORIENT, NY 11957 Application Number: 3049765 Section: 26 Block: 2 ROCKHALL DEVELOPMENT CORP. P.O. BOX 702 ROCKY POINT. NY 11778 Certificate Number: Lot: 31 Building Permit: 330422 3049765 BDC: ns11 Described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Basement, First Floor, Second Floor, Outside, Attic, A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having jurisdiction, and found to be in compliance therewith on the 30th Day of May, 2008. Name ~ Rate Rating Circuits Tvne Alarm and emergency equipment Sensor 2 0 0 Carbon Monoxide Sensor 6 0 0 Smoke Appliances and Accessories Air Conditioner 1 0 Above 1500 BTU Exhaust Fan 3 0 F. H.P Furnace 1 0 Oil Future Appliance Feeder 1 0 20 Amps Hydro Massage Tub (Therapeutic) 2 0 Pump Motor 1 0 1 H.p Service Service Disconnect: 0 200 cb Servicel Phase3wService Rating200Amperes Wiring And Devices Dimmer 34 0 120 V Fixture 2 0 High Intensity Fixture 2 0 Low~S`~age Fixture 4 0 Flouresent Continued on Nezl Page 1 of 2 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by AFTON ELECTRICAL CONT, INC 2 BENTNOR STREET MASTIC, NY 11950, ROCKHALL DEVELOPMENT CORP. P.O. BOX 702 ROCKY POINT, NY 11778 Located at 925 WILLOW TERR. LANE ORIENT, NY 11957 Application Number: 3049765 Section: 26 Block: 2 Certificate Number: Lot: 31 Building Permit: 330422 3049765 BDC: ns11 Described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Basement, First Floor, Second Floor, Outside, Attic, A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, _or other authority having jurisdiction, and found to be in compliance therewith on the 30th Day of May, 2008. Name ~ Ra[e Ratine Circuits Tv e Fixture 84 0 Outlet 92 0 Incandescent Outlet 122 0 Fixture Receptacle 1 0 Gen, Purpose 20a Receptacle 1 0 Appliance 3a0 Receptacle 8 0 Dryer Receptacle 71 0 GFCI Switch 41 0 Gen, Purpose Gen, Purpose seal 2 of 2 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. FORM N0. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 33042 Z Date MAY 17, 2007 Permission is hereby granted to: WALTER & WF REICHEL 449 1/2 HENRY ST BROOKLYN HTS,NY 11231 for CONSTRUCTION OF A NEW SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 925 WILLOW TERRACE LA ORIENT County Tax Map No. 473889 Section 026 Block 0002 Lot No. 031 pursuant to application dated MAY 9, 2007 and approved by the Building Inspector to expire on NOVEM Fee $ 1,705.60 ORIGINAL Rev. 5/8/02 330~~- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 1 NSPECTION [ FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]FRAMING /STRAPPING [ ]FIREPLACE 8~ CHIMNEY [ ]INSULATION [ ]FINAL [ ]FIRE SAFETY INSPECTION Gr/~ [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION 3~ °`~ ~~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 1 NSPECTION [ ] F ATION 1ST [ ]ROUGH PLBG. [ FOUNDATION 2ND [ ]INSULATION [ ]FRAMING /STRAPPING [ ]FIREPLACE & CNIMNEY [ ] FlRE [ ]FINAL [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT PENETRATION REMARKS: DATE INSPECTOR 3~0~-~ z- TOWN OF SOUTNOLD BUILDING DEPT. 765.1802 1 NSPECTION ~- z /' ~"'4~ ~, [ ]FOUNDATION 1ST ~ROUGN PLBG. [ ]FOUNDATION 2ND [ ]INSULATION FRAMING STRAPPING [ ]FINAL [ ]FIREPLACE 8~ CNIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESIST NN CONSTRUCTION [ ]FIRE RESISTANT PENETRAT/ION RAM KS: A!' _~, ~ ,, -tQ~ ~ rte'" ~~,.e-k,~~ ~~ ~- ~ ~ ~~~~~ J -~^ ~ INSPECTO/p~~°~~ DATE ~ 3 °~~ TOWN OF SOUTFIOLD BUILDING DEPT. 765.1802 1 NSPECT ON [ ] F NDATION 2ND [ FRAMING /STRAPPING [ ]FOUNDATION 1ST [ OUGN PLBG. [ ]FIREPLACE 8~ CHIMNEY [ ]INSULATION [ ]FINAL [ ]FIRE SAFETY DATE INSPECTOR [ ]FIRE RESI~IT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION 3 ~ ~~~--- ,% TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 1 NSPECTION [ ]FOUNDATION 1ST [ ] LIi~BG. [ ]FOUNDATION 2ND [ INSULATI~~ [ ]FRAMING /STRAPPING [ ]FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION REMARKS: _iN ~ccil [ ]FIRE RESISTANT PENETRATION ~ ~~~ ~v ~rvr~-- DATE ~ ~~ INSPECTOR ~~©~L~ TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING /STRAPPING [ ]FIREPLACE & CHIMNEY [ ]ROUGH PLBG. [ ]INS ION [ FINAL [ ]FIRE SAFETY INSPECTION DATE ~ INSPECTOR [ ]FIRE RESIS~ CONSTRUCTION [ ]FIRE RESISTANT PENETRATION ~ 3 n~y~ TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 1 NSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING /STRAPPING [ ]FIREPLACE 8~ CHIMNEY [ ]ROUGH PLBG. [ ]INSULATION [ ' INAL [ ]FIRE SAFETY INSPECTION DATE l ~~ INSPECTOR _~ [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION ~IEFFREY T. BUTLERS P.E. 2O OVERHILL RD. SHOREHAM NEW YORK 1 7 786 63 1 -208-8850 LIC ENH EO PRO FEHHIO NAL ENHINEER M EMHER NATIONAL SOCIETY OF PROFEHHIONAL ENHINEERH January 15, 2008 Town of Southold Building Department Re: Proposed Residence-Orient Permit # 330422 Dear Sirs: Please note the following concerning this application: • I have inspected the strapping and anchoring pursuant to the building code for the front porch ceiling and floor and find that the work conforms to the plan as filed with this application. Please call if you should have any additional concerns about this application. P.E. -~ _ __~ FIELD INSPECTION REPORT DATE COMMENTS -' / O ~ ~} ,~ FOUNDATION (1ST) - L . W ~ FOUNDATION (2ND) .- .L ~ py U z -U .~ c d- y ROUGH FRAM ` ING & PLUMBING ~ ° G~11k-0 ltid" +~-~re-: tc~~9-- dLerur~ C , ~ - - - cam- t , l t~o ~~ ~,~,o ~' ~ -~x INSULATION PER N Y _ y . . STATE ENERGY CODE ~ Z ;~ F ~, ~~ T ~ ~ Z E.L (~, FINAL ~ . ~ .3 c7~ f w W ADDITI NAL CO NTS 1 6 ~- ` ~_ ~ .i _~ ~ z m / O ~ ~ ---- ~ ~ - ~C b -- _ J -- C, y ~~ O z ~ _ y • ~ , x nd C ' y ~ " TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL BUILDING PERMIT APPLICATION CHECKLIST SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 33 ~ ~ a'~ www. northfork.net/Southold/ PERMIT NO. Do you have or need [he following, before applying? Boazd of Health 3 sets of Building Plans Planning Boazd approval Check Septic Form N.Y.S.D.E.C. Examined 20 Approved ,20~ Disapproved a/c Expiration _ , 20 m~~y 9 zr Phone: 1 y ~ ~~ 5 5 APPLICATION FOR BUILDING PERMIT Date -v1 ~ , 20~ INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a pemut shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. E Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an addition six months. Thereafter, a new permit shall be required. APPLICATION 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, or 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 for necessary inspections. Rockl,cZJ I T~~'c-~olJr*~c.,-~- Co (Signature of applicant or name, if a corporation) p- o . [3o x 702 t2oclC.~ P-E . N~1 11 778 ~ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, genera] contractor, electrician, plumber or builder Name of owner of premises 1n/Ci.) }~.,- 1- ~n' S ~ . I ~ 4. KZ G~`~C ~' (As on the tax roll or latest deed) If appli t is a o ra '~ !signature of duly autly6rized officer (N e and title co ora4~ officer) ` Bui ers License No. Plumbers License No. p I ~, b Te c ~ 11-P 7 - tM h Electricians License No. Pv c c . v ~ I c c L; c ~l ~ C7~o - Other Trade's License No. 1. Location of land on which proposed work will be done: 9 25 t,~i. I I b~ ~ rc,r-rctc e. L n c Ot--i cn House Number Street Hamlet Contact: \ Mail County Tax Map No. 1000 Section o Block z Lot 3 Subdivision_J~~p_p F Wr~l pl„/ Ter race Filed Map No. ~p"~ Lot ](Name) S LG 1, 2. State existing use and occupancy of premises and inteppded use and pccupancy of proposed construction: a. Existing use and occupancy 1/ Q C Ctrl -F' ~ Cc,r, Cf b. Intended use and occupancy ~' n 1 C t Ccm ~~ 1 e t C 3. Nature of work (check which applicable): New Building / Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost ! 7 ,_O U O . O U Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units ~ Number of dwelling units on each floor If garage, number of cars ,?_ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front - ~ear,~._ _ Depth Height Number of Stories 8. Dimensions of entire new construction: Front 5 f3 ~ Rear J~8 ~ Depth 2 9.'-1 ~ Height Number of Stories .2 9. Size of lot: Front 12 3. 75 Rear I I ~) . O U Depth 1 8 8 . 9t-I 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES_ NO ^~ 13. Will lot be re-graded? YES ~/ NO Will excess fill be removed from premises? YES NO ~ 14. Names of Owner of premises W t-P Re-'chc I Addressy44~/~ F~IC.,.,,5F B.r.~id;~,Phone No. Name of Architect e a~ c v + l e r' Address P6 &~xG34 Sha ck+~+~ Phone No 2(~3 -8~i`i0 Name of Contractor Ru r kJ-, , I I be v . <o ~ ~ Address PO Perk 767 f2 p F Phone No. 7i-V4 - ~ ~,`~ 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO / * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? *YES NO * IF YES, D.E.C. PERMITS MAYBE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF S~; ro..~,) ,..~0 S c n ~ (j M GnZ ~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)Heisthe ~br~ ~-rC~G~r (Contractor, Agent, Corporate Officer, 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 tme to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Swom to before me thi ~da f~~20U~ otary Public FREDERICK J.NAPOLRANO Notary Public, State of New York Re~. No.01NA6089519 Cuarfied in Suffolk County Corrrnission Expires March 24, c7 D l Wl~ i/'i= K O F /~L p G c° q ~-~ ~ /,F~,,-t, 1. ~i ~ v v" ,- c p ~ ~' L .~ r ~, 1 ~,C U~ 'G)"/7 titer. ( l REScheck Software Version 4.0.1 ~ 33 ~ ~'~-- Compliance Certificate _ Project Title: Proposed Residence Report Date: 12/06/07 ~~ ~ ~ ~ ' Data filename: J:\Manzi\2007_Jobs\070017 rowe dr orient\Odent2.rok Energy Code: New York State Energy Conservation ~.r._"4."+V ' Construction Code Location: Suffolk County, New York Construction Type: Detached 1 or 2 Family Heating Type: Non-Electric Glazing Area Percentage: 16% Heating Degree Days: 5750 Construction Site: Owner/Agent: Designer/Contractor: C/O Willow Terrace Lane Manzi Homes East Jeffrey Butler, P.E., P.C. and Rowe Lane 631-744-2655 206 Lincoln Street Orient, NY Riverhead, NY Permit Date: 4/4/07 631-208-8850 ~~;^ F ~] -.J ~~~.,~~. Ceiling 1: Flat Ceiling or Scissor Truss: 1590 30.0 0.0 56 Wall 1: Wood Frame, 16" o.c.: 1836 15.0 0.0 116 Window 1: Vinyl Frame, Double Pane with Low-E: 290 0.340 99 Door 1: Solid: 42 0.220 9 Wall 2: Wood Frame, 16" o.c.: 1282 15.0 0.0 84 Window 2: Vinyl Frame, Double Pane with Low-E: 196 0.340 67 Floor 1: All-Wood Joist/Truss:Over Unconditioned Space: 1378 30.0 0.0 45 Boiler 2: 84 AFUE The proposed building represented in this document is consistent with the building plans, specifications, and other calculations submitted with this permit application. The proposed systems have been designed to meet the New York State Energy Conservation Construction Code requirements. When a Registered Design Professional has sta p d and signed this page, they are attesting that to the best of his/her knowledge, belief, and professional judgment, such plans ors a cations are in compliance with this Code. T~aEf T- u+lar• ~.E•. P.C_ ~ la c Name - Titl~ e~ ~ ~ ~ a Dat Project Notes: Revised, converted garage to living space ~ 'r, /~~ ~, . ~~,~Q"~ ~~~w T. B~~~F-vp~fi ~ ~~ :• >k r }~ ~ ! ~ ~`' . / w 11'2 Proposed Residence Page 1 of 4 REScheck Software Version 4.0.1 Inspection Checklist Date: 12/08/07 Ceilings: ^ Ceiling 1: Flat Ceiling or Scissor Truss, R-30.0 cavity insulation Comments: Above-Grade Walls: ^ Wall 1: Wood Frame, 16" o.c., R-15.0 cavity insulation Comments: ^ Wall 2: Wood Frame, 16" o.c., R-15.0 cavity insulation Comments: Windows: ^ Window 1: Vinyl Frame, Double Pane with Low-E, U-factor: 0.340 For windows without labeled U-factors, descdbe features: #Panes-Frame Type Thermal Break7YesNo Comments: ^ Window 2: Vinyl Frame, Double Pane with Low-E, U-factor: 0.340 For windows without labeled U-factors, describe features: #Panes -Frame Type Thermal Break? -Yes - No Comments: Doors: ^ Door 1: Solid, U-factor: 0.220 Comments: Floors: ^ Floor 1: All-Wood Joist/Truss:Over Unconditioned Space, R-30.0 cavity insulation Comments: Heating and Cooling Equipment: ^ Boiler 2::64 AFUE or higher Make and Model Number: Air Leakage: ^ Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage are sealed. ^ Recessed lights are 1) Type IC reted, or 2) installed inside an appropriate air-tight assembly with a 0.5" clearance from combustible materials. If non-IC rated, fxtures are installed with a 3" clearance from insulation. Vapor Retarder: ^ Installed on the wane-in-winter side of all non-vented framed ceilings, walls, and floors. Materials Identification: ^ Matedals and equipment are installed in accordance with the manufacturer's installation instructions. ^ Materials and equipment are identified so that compliance can be determined. ^ Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. ^ Insulation R-values, glazing U-factors, and heating equipment efficiency are cleady marked on the building plans or specifications. Proposed Residence Page 2 of 4 ~ Insulation is installed according to manufacturer's instmctions, in substantial contact with the surtace being insulated, and in a manner that achieves the rated R-value without compressing the insulation. Duct Insulation: ~ Supply ducts in unconditioned attics or outside the building are insulated to R-8. ~ Return ducts in unconditioned attics or outside the building are insulated to R-0. ~ Supply ducts in unconditioned spaces are insulated to R-8. ~ Return ducts in unconditioned spaces (except basements) are insulated to R-2. Insulation is not required on return ducts in basements. Duct Construction: ~ All joints, seams, and connections are securely fastened with welds, gaskets, mastics (adhesives), mastio-plus-embedded-fabric, or tapes. Tapes and mastics are rated UL 181A or UL 181 B. Exceptions: Continuously welded and locking-type longitudinal joints and seams on ducts operating at less than 2 in. w.g. (500 Pa). ~ The HVAC system provides a means for balancing air and water systems. Temperature Controls: ~ Each dwelling unit has at least one thermostat capable of automatically adjusting the space temperature set point of the largest zone. Electric Systems: ~ Separate electric meters exist for each dwelling unit. Fireplaces: ~ Fireplaces are installed with tight ftting non-combustible fireplace doors. ~ Fireplaces have a soume of combustion air, as required by the Fireplace construction provisions of the Building Code of New York State, the Residential Code of New York State or the New York City Building Code, as applicable. Service Water Heating: ~ Water heaters with vertical pipe risers have a heat trap on both the inlet and outlet unless the water heater has an integral heat trap or is part of a simulating system. ~ Circulating hot water pipes are insulated to the levels in Table 1. Circulating Hot Water Systems: ~ Circulating hot water pipes are insulated to the levels in Table 1. Swimming Pools: ~ All heated swimming pools have an on/off heater switch and a cover unless over 20 % of the heating energy is from non-depletable sources. Pool pumps have a time clock. Heating and Cooling Piping Insulation: ~ HVAC piping conveying Fluids above 105 degrees F or chilled Fluids below 55 degrees F are insulated to the levels in Table 2. Proposed Residence Page 3 of 4 Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes Insulation Thickness in Inches by Pipe Sizes Non-Cireulating Runouts Circulating Mains and Runouts Heated Water ° Up to 1" Up to 1.25" 1.5" to 2.0" Over 2" Temperature ( F) 170-180 0.5 1.0 1.5 2.0 140-169 0.5 0.5 1.0 1.5 100-139 0.5 0.5 0.5 1.0 Table 2: Minimum Insulation Thickness for HVAC Pipes Fluid Temp. Piping System Types Range(°F) Heating Systems Low Pressure/Temperature 201-250 Low Temperature 120-200 Steam Condensate (for feed water) My Cooling Systems Chilled Water, Refrigerant and 40-55 Brine Below 40 NOTES TO FIELD: (Building Department Use Only) Insulation Thickness In Inches by Pipe Sizes 2' Runouts 1" and Less 1.25" to 2.0" 2.5" to 4" 1.0 1.5 1.5 2.0 0.5 1.0 1.0 1.5 1.0 1.0 1.5 2.0 0.5 0.5 0.75 1.0 1.0 1.0 1.5 1.5 Proposed Residence Page 4 of 4 REScheck Software Version 4.0.1 Compliance Certificate Project Title: Proposed Residence Report Date: 05/03/07 Data filename: J:\Manzi\2007_Jobs\ORIENTOrient2.mk Energy Code: New York State Energy Conservation Construction Code Location: Suffolk County, New York Construction Type: Detached 1 or 2 Family Heating Type: Non-Electric Glazing Area Percentage: 15% Heating Degree Days: 5750 Construction Site: Owner/Agent: CIO Willow Terrace Lane Manzi Homes East and Rowe Lane 631-744-2655 Orient, NY Permit Date: 4/4/07 Designer/Conlractoc Jeffrey Butler, P.E., P.C. 206 Lincoln Sheet Riverhead, NY 631-208-8850 Ceiling 1: Flat Ceiling or Scissor Truss: 1378 30.0 O.u as Wall 1: Wood Frame, 16" o.c.: 1622 15.0 0.0 103 Window 1: Vinyl Frame, Double Pane with Low-E: 243 0.340 83 Door 1: Solid: 42 0.220 9 Wall 2: Wood Frame, 16" o.c.: 1282 15.0 0.0 84 Window 2: Vinyl Frame, Double Pane with Low-E: 196 0.340 67 Floor 1: All-Wood JoisVfruss:Over Unwnditioned Space: 1378 30.0 0.0 45 Boiler 2: l;4 AFUE The proposed building represented in this document is consistent with the building plans, specifications, and other calculations submitted with this permit application. The proposed systems have been designed to meet the New York State Energy Conservation Construction Code requirements. When a Registered Design Professional has stamped and signed this page, they are attesting that to the best of his/her knowledge, belief, and professional judgment, such plans ors ifications are in compliance with this Code. TP~~re~Ru-FIt'_r. P E.. P.f-. ~ 07 Name -Title ~~ at re Da %C~F NFtyY f;~ cY T. a~ O~ 1~/~v /4~P T~ /~~ J ,V O..tf Y' t _` i ~ ~Wa-0 ~.ti ~I.a ~.Ij sir ~ ~ ~ '. I~lil y'` 1J r r~ !~ , v Proposed Residence Page 1 of 4 ''"' _. -__.. - a- '_... a.. , . e'', imt~.. .t ~ ..e.ai;. F c6.. oe,la'~s_. saa ~iai:.. _..~. ~/ REScheck Software Version 4.0.1 Inspection Checklist Date: 05/03/07 Ceilings: ^ Ceiling 1: Flat Ceiling or Scissor Truss, R-30.0 cavity insulation Comments: Above-Grade Walis: ^ Wall 1: Wood Frame, 16" o.c., R-15.0 cavity insulation Comments: ^ Wall 2: Wood Frame, 16" o.c., R-15.0 cavity insulation Comments: Windows: ^ Window 1: Vinyl Frame, Double Pane with Low-E, U-factor: 0.340 For windows without labeled U-factors, describe features: #Panes _ Frame Type Thermal Break? -Yes - No Comments: ^ Window 2: Vinyl Frame, Double Pane with Low-E, U-factor: 0.340 For windows without labeled U-Tactors, describe features: #Panes _ Frame Type Thermal Break? -Yes _ No Comments: Doors: ^ Door 1: Solid, U-factor: 0.220 Comments: Floors: ^ Floor 1: All-Wood JoisVTruss:Over Unconditioned Space, R-30.0 cavity insulation Comments: Heating and Cooling Equipment: ^ Boiler 2::84 AFUE or higher Make and Model Numher: Air Leakage: ~ Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage are sealed. ~ Recessed lights are 1) Type IC rated, or 2) installed inside an appropriate air-tight assembly with a 0.5" clearance from combustible materials. If non-IC rated, fztures are installed with a 3" clearance from insulation. Vapor Retarder: ~ Installed on the warm-in-winter side of all non-vented framed ceilings, walls, and Floors. Materials Identification: U Materials and equipment are installed in accordance with the manufacturer's installation instructions. ~ Materials and equipment are identrfied so that compliance can be determined. ~ Manufacturer manuals for all installed heating and coaling equipment end service water heating equipment have been provided. ~ Insulation R-values, glazing U-factors, and heating equipment efficiency are clearly marked on the building plans or specifications. Proposed Residence Page 2 of 4 ~ Insulation is installed according to manufacturer's instructions, in substantial contact with the surtace being insulated, and in a manner that achieves the rated R-value without cempressing the insulation. Duct Insulation: ~ Supply ducts in unconditioned attics or outside the building are insulated to R-8. ~ Return ducts in unconditioned attics or outside the building are insulated to R-0. ~ Supply ducts in unconditioned spaces are insulated to R-8. ~ Return ducts in unconditioned spaces (except basements) are insulated to R-2. Insulation is not required on return ducts in basements. Duct Construction: ~ All joints, seams, and connections are securely fastened with welds, gaskets, mastics (adhesives), mastic-plus-embedded-fabric, or tapes. Tapes and mastics are rated UL 181A or UL 181 B. Exceptions: Continuously welded and locking-type longitudinal joints and seams on ducts operating at less than 2 in. w.g. (500 Pa). ~ The HVAC system provides a means for balancing air and water systems. Temperature Controls: ~ Each dwelling unit has at least one thermostat capable of automatically adjusting the space temperature set point of the largest zone. Electric Systems: ~ Separate electric meters exist for each dwelling unit. Fireplaces: ~ Fireplaces are installed with tight fitting noncombustible fireplace doors. ~ Fireplaces have a source of combustion air, as required by the Fireplace construction provisions of the Building Code of New York Slate, the Residential Code of New York Sfafe or the New York City Building Code, as applicable. Service Water Heating: ~ Water heaters with vertical pipe risers have a heat trap on both the inlet and outlet unless the water heater has an integral heat trap or is part of a circulating system. ~ Circulating hot water pipes are insulated to the levels in Table 1. Circulating Hot Water Systems: ~ Circulating hot water pipes are insulated to the levels in Table 1. Swimming Pools: ~ All heated swimming pools have an on/off heater switch and a cover unless over 20 % of the heating energy is from non-depletable sources. Pool pumps have a time clock. Heating and Cooling Piping Insulation: ~ HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to the levels in Table 2. Proposed Residence -.._ ....__. ... _. _... Page 3 of 4 Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes Insulation Thickness in Inches by Pipe Sizes Non-Circulating Runouts Circulating Mains and Runouts Heated Water Up ro 1" Up to 1.25" 1.5" to 2.0" Over 2" Temperature (°F) 170-180 0.5 1.0 1.5 2.0 140-169 0.5 0.5 1.0 1.5 100-139 0.5 0.5 0.5 1.0 Table 2: Minimum Insulation Thickness for HVAC Pipes Piping Syslem Types Fluid Temp, Range(°F) Heating Systems Low Pressure/Temperature 201-250 Low Temperature 120-200 Steam Condensate (for feed water) Any Cooling Systems Chilled Water, Refrigerant and 40-55 Brine Below 40 NOTES TO FIELD: (Building Department Use Only) Insulation Thickness in Inches by Pipe Sizes 2" Runouts 1"and less 1.25" l0 2.0" 2.5" to 4" 1.0 1.5 1.5 2.0 0.5 1.0 1.0 1.5 1.0 1.0 1.5 2.0 0.5 0.5 0.75 1.0 1.0 1.0 1.5 1.5 Proposed Residence Page 4 of 4 OS-22-2007 13:22 SDUTHOLD BUILDING DEPT 16317659502 ~3~~a i~~(Gh~~PRGE1 ~l, J-~ I Erosion Sedimentation and Storm•water Run-off Control Plan ASSESSMENT FORM Yes No A. Does this project meet the minimum standards for classification as an Agricultural Project. Note: If you answered Yes to arty of the above, a Storm•water, Grading, Drainage & Erosion Control Plan is not required. ACTIONS REQl1iRiNG TiiF SIJRMiSSiON OF ASTORM-WATER. GRADAVG. DRAINAGE &_EROS(ON CONTROL PLAN CERTIFIED BY A llESIGN PROFF.SSiONAL IN TILE STATE OF NEW YORK. Item Number: (A Check Mark (J) for each question is required for complete application) 1. Will this project retain all Storm-Water Runoff generated tm Sitc? (This will include all run-off created by site clearing and/or construction activities as well as all Site improvements and the permanent creation of impervious surfaces.). 2. Will this project require any land 611ing, y~rading tx excavation where there is a change to the natural existing grade involving more than 200 cubic yards of material within any parcel? 3. Will this application n:yuirc land disturbing activities encompassing an area of tive thousand (5,000) square feet of ground surface or more? 4. is there a Natural Water course rmting through the site or is this projcet within Onc hundred (IUO) feel of wetlands or a beach? 5. Will there be site preparation on slopes which exceed fafteen (15) feet of vertical rise to (fie hundred (lUU) feet of hotircmtal distance? 6. Will driveways, parking areas ur other impervious surfaces direct Storm-Water Run-off into and/or in the direction of a Town Rightot=Way'l 7. Will this application require the placement of material, removal of vegetation and/or the constmction of any item within the Town Right-of--Way or road shoulder area? (This item does not include the installation of ddveway aprons.) R_ Will there be site preparation within the one hundred (100) year Iloodphfin of any watcreoursc? Yes No ~~ ~~ 0 v _l/ ~~ ~~ ~~ Note: If any answerto questions one through eight is answered with a check mark In the Box, a Storm•water, Grading, Drainage & Erosion Control Plan is required and must be submitted for review prior to Issuance of any building permit. STATF, OF NEW YORK, COiJNTYOF .............._.........................,.,, ss That i, ... S..eSE~.~.......~.(?v.t\Z...1........_... _........ being duly swum, deposes and says that he/she is the applicant for Permit, (N;m,e of individual signing UocumrnQ And that He/She is dte ,,,.,., ~.,1~ S e P 1~ ...... ~..~ .~. F:.t ......................................................_ _......... _.................. (Owner, Cbnlnu:lur, Agent. Cmyomle Officer, ele J Owner and/or representative of the Owner or Owner's, and is duly authorized m perform or have perfomxd the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belier; and that the work sill he performed in the manner set tonh in the application filed herewith. Sworn to hhbefore me tlus; /~~J/ ..........4Y.~,....,. ..day of.l..r,~ ........................ 20... Notary Public: ..... ... ................................. FREt)ERICK J. NAP6LI4ANr) Notary Public, Stste of New York Hera No.O1NA6089519 Quaatied in Suffolk Coun Commission 6fpires March 24~ ~O~I New York State Insurance Fund Workers' Compensation & Disability Benefits Specialists Since 1914 199 CHURCH STREET, NEW YORK, N.Y. 10007-1100 Phone: (888)997-3863 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ~~~~~~ MANZI HOMES EAST LLC P O BOX 702 ROCKY POINT NY 117780702 POLICYHOLDER CERTIFICATE HOLDER ROCKHALL DEVELOPMENT CORP TOWN OF SOUTHOLD P O BOX 702 BUILDING DEPT ROCKY POINT NY 117780702 53095 MAIN ROAD SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER PERIOD COVERED BY THIS CERTIFICATE DATE Z 973 905-3 805994 10/01/2006 TO 07/01/2008 5/22/2007 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 973905-3 UNTIL 07/01/2008, 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. IF SAID POLICY IS CANCELLED, OR CHANGED PRIOR TO 07/01/2008 IN SUCH MANNER AS TO AFFECT THIS CERTIFICATE, 30 DAYS WRITTEN NOTICE OF SUCH CANCELLATION WILL BE GIVEN TO THE CERTIFICATE HOLDER ABOVE. NOTICE BY REGULAR MAIL SO ADDRESSED SHALL BE SUFFICIENT COMPLIANCE WITH THIS PROVISION. THIS CERTIFICATE DOES NOT APPLY TO BUILDING DEMOLITION. 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 STATE INSURANCE FUND ~/~~~ DIRECTOR,INSURANCE FUND UNDERWRITING This certificate can be validated on our web site at https://www.nysif.com/cert/certval.asp or by calling (888) 875-5790 U-26.3 VALIDATION NUMBER: 441618188 02/29/2007 10:01 FA% 8918749175 PLLRB TECH ~ 002 ACORD CERTIFICATE OF LIABILITY I' SURANCE DP ID DATE,MMT)DIYYYYI vXODUCER ~ PLDLDI-3 Oa/a0/OT THI CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The B&G Group Intl ON Y AND CONFERS NO RIGHTS UPON THE CERTIFICATE , . HO DER. THIS CERTIFN:ATE DOES NOT AMEND, EMEND OR 55 WeeC Altlae COUrtT Suite 400 ALTI ER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Plainview MY 11$03 Phonet516-576-0400 SaXS516-576-1177 INSU ER9AFFORDINGCOVERgGE NAIDS INSURED INSURE R q; Tower IIIAAratltlp CO. OE MY INSUR B: xi1LoO1a waeloaa3 xvaPeaMa co Plumbtpch inc wsu c; A..rsa.a xneaewLLau.s ~onP 056 417 Mara 8qrear Cantor Moriehe^ MY 11934 INSURE 0: rLOC naF.eu;aaov ze.. oo, INSU E: COVERAGES THE POLICIES OF IHSURANCE LISTED BELOW HAVE BEEN L99UED TO THE B/BUF$:O FUMED ABOVE FO THE POLICI' PERIOD wDICATEO. NOTW OHSTANOINO ANY FIEDUIREYENf, TERM OR CONDrtIDN OF ANY CONTrtACT OR OTHER DOCULIENf WITH RESPECT OWNICN THI6 CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCFUBEO HEREW IS SUBJECT TO ALL E TERMS, EXCLUSIONS AND CONDmONS OF BIICH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS. IR LTR N$R TYPE OF INSURANCE POLICY NUMBER DA MIW Dm Dq wIT LNRTs GENERAL LUV3ILITY EACH OCCURRENCE $1,000 ODD A X X COMMERCWLOENEFIALLMBILI7V CDS.a510410 pa/1 /07 Oa/14/08 PREABSESEaoccurann $100/ODD CLAIMS MADE ~ OCCUR MED EXP IMy ms prim) S 5 ~ OOO x Contract Liao. pERSONALBADVINJURY s1 000 000 7C aired Mon-Owned GENERAL AGGREGATE , , $ 1 000 000 GENL AGGREGATE LIMIT APPLIE$pER: pROWCTS•COMPIOPAGG , , LS, DDD DDQ POLICY JEC - LOC AU TOMOBILE LM&lm ' COMBMIED $NGLE uM1T $ ANY AUTO (Ea aCNCenQ ALL OWNED gUTOS SCHEDULED AUTOS eooav lalum (Par penm) $ HIRED AUT08 NON•OWNEO AUTOS BODILY IWURY (PeraWdml) E PROPERTY DAIMGE $ (Par BCdaMll) GARAGE LIABILDY AUTO ONLY-EA ACCIDENT i ANY AUTO OTHERTHAN ~'~ ' S AUTO ONLY: ACC S EXCE99NMBRELLA LIgBIUTV EACH OGCURRENCE S LOOOOOO B X _ owuR ~ culM$MAOE 8809305030 03/a /06 03/21/07 IIOGREGATE s 1000000 t DEDUCTIBLE 1 K RETENTION SIDF OOO $ WORKERS COMPENSATION AND EMpwrERS•LwBILm X TORY LIMIT9 ER C ANY PROPRIETOWPAHTNERIE%ECUTIVE O WC6$14530 11/07 /06 11/07/07 E.L.EACrAOCIDENT $100000 FFICERIMEMBER EXCLUDEDT p r.daampemaer E.L. DISEASE • FA EMPLOYE L 300000 SPECIAL PROVISIONS bNw E.L. DISEASE•POLIC'/11MIT [SDDDDD OTHER D Disability DeL144398 01/17 05 01/17/09 CovaraQa DESCRIpT10N OF OPERATpN51 LOCATgNBIVlNICLEBI EXCLU$KINS ADDED BY ENDORSEMENT/SPEC -ROVRNONL ' Rockhali DewloyBnent Cory, ie included as additional insured with respect to aasned insured subject to Policy terms, conditions, d aXCluaicna. CERTIFICATE HOLDER CANCE LA.TION SHOOED ANY OF THE ABOVB DESCRIBED PDLK%IE8 BE GANC[LLED BF1-0RL THE EXPIIUTN7N MTE F, THE eBUING INSURER WILL [NDEgyDR TO MAIL SO DAYS WRITTEN NOTIOE O THE CERTPICATE HOLDER NAM[D TD THE LEFT, BUT FAILURE TO DO BO SHALL ROtlkhall DeVe3op$nent COrp. IMPDLE OBLIGATION OR LIABILITY OF ANY KIND UPON TILE IN$URIR.IT$I10EMTa di P~_O. BOX 70a REPRES NTATNEB. ROC,ky P01At MY 1177$ R sppp~REBEN AT E r Y 1 r~.r-eJ-7 Arnon ne canna ma. ""° "" """"..r ~ ®ACORD CORPORATION 1888 Frgm: Lynda Wertheim At: Sutton Agenry FaxID: James F Sutton Agenc To: Patrida Date: 1/152007 11:42 AM Page: 2 013 CERTIFICATE OF LIABILITY INSURANCE OP ID L DATE (Mnwomw) acoRV . PUCCI-1 01/15/07 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION James F. Sutton Agency Ltd. ON LY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 149 E. Main Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P. O. Box 76 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. East Islip NY 11730 Phone: 631-581-7978 Fax:631-581-7507 INSURERS gFFORDING COVERAGE NAIC# INSURED WsImERA. Merchants Mutual Ins. Co. 204 INSURER B' AIG Puccio Electric Corp INSLRER C. 63C Clinton Street Center Moriches tTY 11934 INSURER D. INSLRER P COVERAGES THE POLICIES OF INSURPNCE LISTED BELOW NAVE BEEPI ISSI£D TO THE INSURED NAMED ABOVE FOR TIE POLICY PERIOD INDICATED. NOTVJRHBTANDING PNY REOUIREMENi, TERM OR CONDITION OF ANV CONTRACT OR OTHER DOCUMEM WI1H RESPECT i0 WHICH THIS CERTIFIGIE MAY BE ISSUED OR MAY PERTAIN, THE INSU:AWCE PFFOFDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, E%CLUSIONS PND CONDITIOIJG CF SUCH PCLICIEG AGGREGATE LIMITS J'HOWN M41' HAVE BEEN REDUCED BY PAID CLAIMS. LTR NS TVPE OF WSURANCE PDLICY NUMBER DATE (MMIDDMQ GATE (MMIODM'I LIMR3 GENERAL LIABILI$V EACH OCCLRRENCE 31000000 A X coMMERaAL GENERAL UABUm CCP9135321 09/12/06 09/12/07 PREMISES IEa OCCUrencal 3100000 CLAIMS MODE OCCUR MED EXP (My me perspnl 35DDD X contractual PERGONAL BPOVINJURY ;SOOOOOO X GL Complete GErrERAL AGGREGATE 32000000 GEN'L AGGREGATE LIMIT PPPLIES PER. PRODUCTS-COMOIOP AGG $ZOOOOOO PRO POLICY JECT LOC AUT OMOBILE LIABILf1Y COMBINED SINGLE LIMIT (Ea eccidenU $ ANY ALfTO ALL OWNED aJTOs BODILY INJURY SCHEDLLED AUTOS (Par persanl $ HIRED ALII05 BODILY INJURY NO&i~WNED AU$OS (Per aaidenp $ PROPERTY DPMa=E ~ (Per accdeN GARAGE LIABILf1Y AUi0IXJL1'-EA ACCIDENT 3 Nff ALRO OTHER THAN EA ACC 3 PUTO CRJLY AGC 3 E%CESSNMBRELLA LMBILIIV EACH OCCURRENCE 3 OCCUR ^ CLAIMS MADE AGGREGATE $ DEDUCTIBLE 3 RETENTION $ 3 WORKERS COMPENSATION qND TORY LIMITS ER B EMPLOYERS'LIABILnY ANY PRCPRIETOR/PARTNERIEXECUTIVE 3361418 12/03/06 12/03/07 eL EACH ACCIDENT ; 100000 OFFICERrtAEMBER E%CLULfD~ E. L. DISEASE-EA EMPLOYEE 3100000 u yes. tlsscnoe waver svEaAL PROVISIONSOpIpw e.L DISEASE-P000r umR 3500000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLE31 E%CLU3WNS ADOEO BY ENDORSEMENT I SPECIAL PROVISIONS revised certificate with updated work comp CERTIFICATE HOLDER CANCELLATION AOCKHO2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1HE E%PIMTION GATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 30 SHALL Rockhall Development COrp IMPOSE ND OBLIGATNJN OR LIABILITY OF ANY KWD UPON THE WSURER,fR AGENT90R PO Hox 702 aocky POlnt NY 11778 REPRESENTATIVES_ _ -_ 1988 • • ~oa~ _? ~ _2 ~ 3~ TOWN OF SOUTHOLD PROPERTY 33~~2- CARD ~ ~1-zz OWNER STREET a2 VILLAGE DIST: SUB. LOT / ~o ~~ l e ~ ~ L .~ w 'A, 1~(~ 4 o w ~ {-ac e {^-! e h r~' ,2 /' ~ r r ~ „. FORMER OWNER N E ACR. ~9 f ! ~eYYct« S W TYPE OF BUILDING RES. SEAS. VL. ~~ FARM CO~Mh. CB. MICS. Mkt. Value LAND. ..IMP. TOTAL DATE REMA R KS ( ~ AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Acre Value Tillable FRONTAGE ON WATER Waodlond , FRONTAGE ON ROAD Meadowland DEPTH House Plot BULKHEAD Total DOCK T !' ~~ Fidelity National Title INSURANCE COMPANY• 900 Merchants Concourse, Westbury, New York 11590 • (516) 334-6727 • Faz (516) 334-7459/7460 TOWN OF SOUTHOLD RE: Certified Land Abstract, Inc. AUTHORIZED AGENT Gentlemen: Please be advised that Certified Land Abstract, Inc., is an agent for Fidelity National Title Insurance Company, and as such is authorized to issue and sign Title Certificates, Binders, Policies, and Endorsements on behalf of this Company for properties located throughout the State of New York. This authorization is effective immediately and is valid until December 31, 2007, unless otherwise notified. Should you have any questions, feel free to contact the tmdersigned. Very truly yours, eorge A. Keenan Assistant Vice President-Agency Counsel cc: Certified Land Abstract, Inc.-Jayne CERTIFIED LAND ABSTRACT INC. 300 Garden City Plaza, Suite 170A Telephone: 516-739-3600 Fax: 516-739-3609 VARIANCE SEARCH COUNTY OF NASSAU) ss.: STATE OF NEW YORK) GEORGE SANDBERG, being duly sworn, deposes and says: That he resides at 300 Garden City Plaza, Garden City, New York and is over the age of 21 years and that he is the Operations Manager of CERTIFIED LAND ABSTRACT INC. Certified Land Abstract, Inc. is a duly authorized agent of Fidelity National Title Insurance Company of New York. That under his direction, title was examined to the parcels of land described in the annexed Schedule and labeled parcels: A, B, C, D & E. That said examination, dated March ] 3, 2007, discloses a chain of title to determine if any contiguous property was owned by an owner of the property involved since the date of any previously applicable Zoning Ordinance as of April 1983. And, that this affidavit is made to assist the Town of Southold to reach any determination which requires as a basis therefore the information set forth herein and knowing full well that said Town of Southold will rely upon the truth thereof. CERTIFIED LAND ABSTRACT INC. --George ~ndbe Operations Manager Sworn to before me, this l ~ d~f April, 2007. v tarp ublic JAYNE SALVATORE Notary Public, State of New York Qualified in Suffolk County No.52-4686286 ~~y; Commission Expires June 3Q ~ D E S C R I P T I O N S PARCEL "A" 1000-026.00-02.00-031.000 (SUBJECT PROPERTY) ALL that certain plot, piece or parcel of land, situate, lying and being at Orient, in the Town of Southold, Suffolk County, New York, shown and designated as Lot No. 10 on a certain subdivision map entitled, "Map of Willow Terrace, Section 1" at Orient, Town of Southold, Suffolk County, New York, which said map was filed in the Suffolk County Clerk's Office on November 28, 969, as Map No. 5407. ALSO known and designated on the Real Property Tax Map as: DIST: 1000 SEC: 026.00 BLK:02.00 LOT: 031.000 PARCEL "B" (ADJOINING SOUTH) 1000 - 026.00 - 02.00 - 030.000 PARCEL "C" (ADJOINING EAST) 1000 -026.00 - 02.00 - 039.011 PARCEL "D" (ADJOINING NORTH) Rowe Drive PARCEL "E" (ADJOINING WEST) Willow Terrace Lane GEORGE SANDBERG, being duly sworn, deposes and says: That he resides at 300 Garden City Plaza, Garden City, New York and is over the age of 21 years and that he is Operations Manager of CERTIFIED LAND ABSTRACT INC. That the above is the true description of the subject premises and of the adjoining premises as shown on the record in the Suffolk County Clerk's Office. CE IED LAND ABSTRACT INC. GEORGESANDB Operations Manager Sworn to before me this ~~ ~a~y ofApril, 2007, Notary Put~4ic.~iate ~f New York Qualf>e:S .r, S+.iNoll~ County No.rL-4686286 Commissicn Exp;res !une 30, ~~~.~ CHAIN OF TITLE FOR PARCEL "A" 1000-026.00-02.00-031.000 ROBERT 1. DOUGLASS Liber: 6830 P 403 TO Dated: 10/24/70 WALTER REICHEL & PRISCILLA REICHEL, His Recd: 10/28/70 wife LAST DEED OF RECORD STATE OF NEW YORK) )SS.: COUNTY OF NASSAU) GEORGE SANDBERG, being duly sworn, deposes and says: That he resides at 300 Garden City Plaza, Garden City, New York and is over the age of 21 years and that he is Operations Manager of Certified Land Abstract Inc. That the above are the true chains of title as shown on the record in the Suffolk County Clerk's Office. CERTIFIE GEORGE SANDBERG, Operations Manager Sworn to before me this ~~7 dy a of April, 2007. v ry ublic , JAYNE SALVATORE Notary Public, Srate of New York t]ualified in Suff,tk County No. 52-4Ei80286 ~~~ Cornmissicn t~<;~ires June 30, -"'Y CHAIN OF TITLE FOR PARCEL "B" 1000 - 026.000 - 02.00 - 030.000 WILTON Y. DOWNS & BERTHA E. DOWN, His Liber: 7570 P 29 wife Dated: 1 / 12/74 TO Recd: 1 / 15/74 MARIE LISE GAZARIAN &NATHALIE GAZARIAN Liber:9992 P 559 GENERAL L. RAINS, DEPUTY COUNTY Dated: 3/6/86 TREASURER Recd: 3/7/86 TO COUNTY OF SUFFOLK COUNTY OF SUFFOLK Liber: 10439 P 299 TO Dated: 10/2/87 MARIE-LISE GAZARIAN &NATHALIE Recd: 10/7/87 GAZARIAN PIERRE GAZARIAN & JEAN GAZARIAN & Liber: 12274 P 241 MARIE-LISE GAZARIAN, AS HEIRS-AT-LAW Dated: 7/18/03 AND SOLE DISTRIBUTEES OF NATALIE Recd: 9/26/03 GAZARIAN TO MARIE-LISE GAZARIAN LAST DEED OF RECORD STATE OF NEW YORK) )SS.: COUNTY OF NASSAU) GEORGE SANDBERG, being duly sworn, deposes and says: That he resides at 300 Garden City Plaza, Garden City, New York and is over the age of 21 years and that he is Operations Manager of Certified Land Abstract Inc. That the above are the true chains of title as shown on the record in the Suffolk County Clerk's Office. CERTIFIED LAND ABSTRACT INC. Manager Sworn to before me this JAYNE SA,LVATGRE Notary Public, State of New York Qualified in Suffolk County No. 52-46436285 Commission Expires June 30~~ A CHAIN OF TITLE FOR PARCEL "C" 1000 - 026.00 - 02.00 - 039.011 ROBERT J. DOUGLASS & NANCY R. Liber: 7421 P 285 DOUGLASS, His wife Dated: 5/28/73 TO Recd: 6/18/73 WILLOW TERRACE FARMS, INC. WILLOW TERRACE FARMS, INC. Liber: 9632 P 499 TO Dated: 8/20/84 STUART MAGER & CAROL MAGER, His wife Recd: 8/31/84 LAST DEED OF RECORD STATE OF NEW YORK) )SS.: COUNTY OF NASSAU) GEORGE SANDBERG, being duly sworn, deposes and says: That he resides at 300 Garden City Plaza, Garden City, New York and is over the age of 21 years and that he is Operations Manager of Certified Land Abstract Inc. That the above are the true chains of title as shown on the record in the Suffolk County Clerk's Office. CERTIFIED LAND ABSTRACT INC. ager Sworn to before me this ~~ day of April , 2007. ota li J.A':'aJE ~i~LVAT6RF Notary GeiGlFC, S*.a:e of New York Qualii+e:d ire S"uliolk County No. 52-4686Ld6 t;ornmission E;cplres June 30;~D? 1 w '~ CHAIN OF TITLE FOR PARCEL "D" ROWE DRIVE -DEDICATED STREET - TOWN OF SOUTHOLD STATE OF NEW YORK) )SS.: COUNTY OF NASSAU) GEORGE SANDBERG, being duly sworn, deposes and says: That he resides at 300 Garden City Plaza, Garden City, New York and is over the age of 21 yeazs and that he is Operations Manager of Certified Land Abstract Inc. That the above are the true chains of title as shown on the record in the Suffolk County Clerk's Office. CERTIFIED LAND ABSTRACT INC. GEORG IIBIRfi; Ctp'erations Manager Sworn to before me this da~f April, 2007. ~ ~__ o~ blic JAYNE SAt VATORE Notary Public, Stale of New York Qualified in Suffolk %ounty No. 52-4t36h"186 l:ommission Expires June 90, ~~ 1 ~ ,~ CHAIN OF TITLE FOR PARCEL "E" WILLOW TERRACE LANE -DEDICATED STREET - TOWN OF SOUTHOLD STATE OF NEW YORK) )SS.: COUNTY OF NASSAU) GEORGE SANDBERG, being duly sworn, deposes and says: That he resides at 300 Garden City Plaza, Garden City, New York and is over the age of 21 years and that he is Operations Manager of Certified Land Abstract Inc. That the above aze the true chains of title as shown on the record in the Suffolk County Clerk's Office. CERTIFI INC. -_ , perations Manager Sworn to before me this ~/~~d~April, 2007. C f~a-~a'~zl.~~l y bli ~ ~~ JAY^dE S•`::'J%:TC4iE Notary F;eplic, 6<<-^:, of Pdntn~Ynf~f Cluuli~.o~f ui S-9f5~,:~ !:.m.mty Wo. 52-~.ii;+ ~8S l;ElrY2miS3:~iS ?':tG:res Junk 30,< mod, SURREY OF LOT 10 MAP OF WILLOW TERRP~GE, SEGT) ON ONE FILED NOVEMBER 28, 1969, FILE No.5401 SITUPcTE: ORIENT Vie` TOWN: ORIENT SUFFOLK GOUNTY, NY a~e~;;~~ SURVEYED 07-26-2005 SUFFOLK GOUNTY TAX >< \ 1000-26-2-31 ~a>a~ T®: 1P.R~aAwwh ID. Rlfadden ]Liberty Title Agency a 9 T -'SC ~- /_ ~.-._ 4 i U ~~ h ~- ~, . "~ ~~~:5 "~~e , II :, G,~ ~, POe. j F~e ro I ooo,. i ~a - ~~ ~,- NOTES: • MONUMENT FOUND p PIPE FOUND cP Q 0 s Via„ ELEVATIONS REFERENCE SUFFOLK COUNTY TOPO MAPS AREA = 25,665 sf or 0.59 acres GRAPHIC SCALE I"= 30' b e`- O, Dwelling Well and Se tic so' + to r~'iL lUJ~~I~° °21'30"E 82.29' _ 0 in ~ W Kt ~ _ O ~~ U) ~~' ~% ~ i V.~~ .Q ~ O O 1 / 1 / 'bi O~e i1 ®~ ~ ~ i P~ No~Se ~ ~Q, o ~ ~ ~ ~ ~ ~ J ~ ~/' 1 \ / ~ ~@ ~ \ ~ ~ ~ \ ~~ 1 ^ Q / 1 ~Y ~ 1 `` `1/~V -o `~ bl~~d~noj 9 , '(~VCCJ//mil h° M d • ~ ~ T OY.~ ~ ~~ 4o w o ~ 5~ ~°ZO e, , LQO ~~ 0 cp ~f ~°v -° ~ \ ~ '~ii.;:F(..~ ,.'{•,{~4TyDFY>~~rgF~;?.~rT~Nlr-A..,`* ..,. , ~.: M .. _ __ _ j „ ~Ai.,.. ~~ ~ ~f ~7; ) , ~ _ ,_ APPROVEr'3 i ~ J ~; .t r ~ ~~,~~` ?J`v~ , ~~ 1 _ I EXPIRES THF..E^, YEAF c FaUM DID e ~ i; r AP .''"v'A.L O - O c:. well I50'~ ~ ~, c~ ~ ~ ~ ,g z ~ l~ FF ~C ^. sc ~~ Op QS v t r OQ C~:T h cP O ~~~~ ~i f~ * '`~ ~J Q O ~~~S 5020 yr, ~~ LAND SuP 6 EAST MAIN STREET N.Y.S. LIC. NO. 50202 RIVERHEAD, N.Y. 11901 369-8288 Fax 369-8287 REF. Z:\pros\OS\OS-243.pro u.~t( 3Ta SURVEY OF LOT 10 4 a ~ w °"°w T~ 2~^ ~ a ~~+ M/~P OF WILLOW TERR,4GE, SECTION ONE FILED NOVEMBER 28, 1966, FILE No.540~ SITUATE: ORIENT TOWN: ORIENT \ SUFFOLK COUNTY, NY SURVEYED 01-26-2005 FOUNDATION LOCATION 07-17-200"1 SUFFOLK COUNTY TAX # 1000-26-2-31 (~iTII+~ Ta: Bos CH13riPANO NOTES: N W E S ~~ '30"E Yl of ~~~ p ~ fl 9 L 0~ ~ Q O ~ 6~~3 o - fl \\,~ ,,,~--------1 9 0 ` 3Z \.a 1 $ 19 ~ I ~ ~ 1 0 ~ \\ - 1 ~ ~ ~ .lie - - \ 1 $ ¢' -C1 la`s \\ z"~ ~- 11 5~ ~ ~ ~ ~ i \ ~9• 11 a >00,-~ T ~ 9 0 .~ ' r\ ~ ' ~ f '~ ~ ~ \\\ ~ ~Q.\ 5~ O~ \O 1111 SV . c ~1 //~~ L\O1 \ ~P Z~ ~ 1 oee ~ JUI , , ,, ~L0 ~ ND _ - `\ - \--11~ ~ 1889 , „~ ~ `r ' 5~4~~, qp ~~ ~~`~ ~_, ~ ,~ • MONUMENT FOUND O PIPE FOUND .. po~~P~~~o~~ piwy ~immc.5'n'db~e vn wvape armwa swi wii [e umm.si w ba wm /w ~~ AREA = 25b65 sf or OS9 acres JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET N.Y.S. LIC. N0.50202 GRAPHIC SCALE I"= 40' ~ ~ RIVERHEAD, N.Y. 11901 369-8288 Fax 369-8287 REF.-\\Compagserver\proaWS\OS-243.pro J:1Memi\2007 JebeWRIF1lTafle phn_new /ootprinl2tlwg, 57/711WLi1:49 PM i i 11~M ~ ~ ~o ~~ ~ ~ ~ ZZN ~~~ ~° ~ A z ~ / _ C ` ~ ~ ~- \ -~~ ~ y \y 6 ~ `x~ V / ~s .5~~~~ ~ \~ ~ p"~j N bs 'p ~ ~ o~ ~~o ~~~~ ~ ~ ~ ~ O ~ d ~ ,~ A-, , ~ .~ -p z i , o, ~ o ~ (1 ~ $ m D rn ~ ~ \ ~ N 1- ~'~ ~ m ~ c~\ I$ ^-' vi N rn ~ \ I~ ~ In A ° ~ ~ cv_ ~ ~ ~ J off ~ i i ~~~~ , ~.., o ~ I~ N ~ ~ 0 i~ ~~ 6 . ~ .,~ ~~ N ~ I ~ ~ i ~ E ~ ~~~'i' ~ - O ~ / ~ i ~~ry1 ln~~ YY r~ ;~ ~ 1 !.y 1 / ~ .. ^ ',i'~s ~ '~Iyq~ ~ L '1 1j ~ ~i ~ i ,` Q J ~'. 'f 4 a \\ i \ \.J/ _/ ~: _--- S ITE PLAN PROPOSED RESIDENCE JEFFREY T. BUTLER, P.E. ORIENT, NY S.G.T.M.# 1000-26-2-31 P.O. BOX 634 SHOREHAM, NEW YORK TEL.: 631.208.8850 FAX: 631.127 .8033 COUNTY OF SUFFOLK TOWN OF SOUTHOLD 3j SUR\/EY OF LOT 10 M~4P OF WILLOW TERR/~GE, FILED NOVEMBER 28, 1969, FILE No.5401 SITUATE: ORIENT TOWN: ORIENT SUFFOLK COUNTY, NY SURVEYED 07-26-2005 FOUNDATION LOCATION O'1-17-200 UPDATE 02-08-2008 SUFFOLK COUNTY TAX ~ 1000-26-2-31 SUFFOLK COUNTY DEFT. OF HEALTH SERVICES REF. ~ RIO - OS - 0202 C~tT1PJ» TO: BOH CEL13IdfANO TMENT OF HEN-TM ~~fC,ES SUFFO-xDpUNT'f DEPAR VA1- NSTRUCT S OENCE S FOR ppPROA SINGLE FAMILY RE ~"LD'L- ~.._ H.S. Ref. No. t~ oea+ APR 2 at a„d~,om 7ete ~~sal a~'"st~r suPdY or o'h°~ MS. (he ardla °e by ti"5 p° ~ gEOR00 `~`e°~,,aan FoR~ ~` , l W ~ J. H'A~ Menages puke of Wastewa` NOTES: ~ MONUMENT FOUND p PIPE FOUND AREA = 25,665 sf or OS9 acres GRAPHIC SCALE I"= 40' SECTION ONE ~/. ®~ aao ~~ ~~ ~ ~o '30"E ~~ V .13~•~~ ~'PO o~ p~ ~ ~ , C o 3~' ~ ~~ ' ~ ~> ,- .- , `EP t'' Ti i ~i i\~b / ~ ~ i mNi i i ,'~~;' z°p " i of O ?g i/ ,' ''99 s i m~ ~ ~ , 56 ~ ~ L ' t~'` /~//~~ \ Oy \O '~~ ~ ate, ~ ~, ,., 9~, ° lg8 „„" S~ 4°Z~' ~1,~ ~ „t A ~ q lJ~ ° W - 9 O, 3 Z ~ ~ g j ~ O `y' O U O ~ 'S q3 ~ ~ '} O 8 q ~ .. „ FE 08£ ~~ N W E S p ~ ~~~~ III MP~t 3 ~'~ 2008 a,..., wow. a "w~~.:a~n'xw' ~'..mw'~ .w,.a,aa~ r.a~i o. ~e..n a a. ~~ ~,~,, ~ py .w.1'b.`a.~b ~.m...u,..,. q'w w.. ran zau hnauu~ d w ~ea~ewvi W ia.rw. ero a..ry n p.ys•ey ro tMnil b me tiw cm,vy q~asnm~- ~...., ~a ~.„., M~ w~~, b,.• ~ ma JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET N.Y.S. LIC. N0.50202 RIVERFIEAD, N.Y. 11901 369-8288 Fax 369-8287 REF.-\\Comnaaserver\nros\07\07-165.oro