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HomeMy WebLinkAbout34676-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33884 Date: 08/05/09 T~IS c~TIFIES that the building HOT TUB & DECK ADD. Location of Property: 1100 ESPLANADE SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 88 Block 6 Lot 13.49 Sut~division Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 1, 2009 pursuant to which Buildin9 Permit NO. 34676-Z dated MAY 11, 2009 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 WITH HOT TUB ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to BRITT D & PATRICIA HURLEY (OWNER) of the aforesaid building. SUFFOL~ CODI~TYDEPARTMENTOF ~]~ALTHAPPROVAL N/A Er.RCTRICAL CERTIFICATE NO. 4031224 06/26/09 PLUMBERS U~TIFICATION DA'r~u N/A Rev. 1/81 Form No, 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPA~ Yhis application must be filled in by typewriter or ink and submitted m the. Building De Y BLD6 DEPT TOWiX OF SOUTHOLI) ent w,th the following: For new building or 'new use: 1. Final surv~j of property with accurate location of aH Imilding% pr0pe~y line~;.street% and unusual natural or 2. Final Approval from Health Dept. of water ~apply and sewerage-diSPosal (S-9 form). 3. Appmva~ of electrical installation from Board of Fire Underwriters. 4. Swom stat .~. ent from plumber eertify~ that'the solder used in system containn less than 2/10 of 1 ~A!ead. 5. Comme,~inl building, industrlal buildinglmultiplc xv. aidanee~ and similar buff .dings and installati0m, a certificate of Code Compliance fi,b;- amhite~t or en~,,~- responm'ble for the building. 6. ,qUbmit Planning Boa_rd AppwVal of completed site plan requi~-mon~; For existing'buildings (prior' to April 9, 1957) n~n-conforming use~, o.r. buildings and -pre-existing- land. uses: I. Accurate survey ofp~l~ s~bowing all p~ylincs, str~t~, building and.unusual, natural or topographic features. 2. Apvbpc~ly completed'applicat~o~ and cons~t to inap~t signed by tl~ appl/cant If a ~ficate o~Occupancy is d¢~i~ct, tl~ Building Xnspector shall state th~ reasons therefor in writing'to thc applicant. C. Fees L Certificate of Occupancy - New dwellhag $25,00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory buil~ling. $25.00, Additions to accessory building $25.00, BusinesSes $50.00. Certificate of Occupancy on Pre-existing Building - $100.00 3. Cop~( of Certificate of Occupancy -' $.25 4.' Updated'Certificate of Occupancy - $50.00 T~mpotary Certificate of OCCUpan6y - Residential $15.00, Commercial $15,00 Date. , J.uly 27, 2009 New Construction:. D e c k g g p ~ OJd or Pre-existing Building; LocationofProperly: 1100 Th~ E.qpl~nado~ HoUSe No. Street OWner or Owners ofpr°pert~. Britt and Pat Hurley. -- Suffolk County Tax Map'No 1.000, Seetiun 08 g Subdivision .Angel Shores Date of Permit, permit No. ':1//676-7__ Health Dept. Appm~l: Planning Board Approval: Request for: Temporary Certificate Fee Submittbd: $ 25.00 (check one) ~nurh.nld Bleck 0006 Fil~ M~.'9729 5/11/2009 AppliCant: Schl±ck Undenvrite~Appmval: Hamlet Finai Certificate: X X (check one) Gerald B 1 u m~~ ~/~_~.~._ Applicant Signature Lot 013.049 'Lot: ~7 Landscaping BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STRE[-I ~ NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by ALL WAYS ELEC. CORP. 262 ORINOCO DRIVE BRIGHTVVATERS, NY 11718, Located at Application Number: 4031224 Section: Block: Described as a Residential 1100 THE ESPLANADE SOUTHOLD, NY 11971 Lot: * HURLEY 1100 THE ESPLANADE SOUTHOLD, NY 11971 Certificate Number: 4031224 Building Permit:. BDC: ns11 occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: deck lighting,Outside, Deck, 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 thez6th Day of J.ne, Z0Og. Name QTY Rate Rating Circuit~ Typ~ Wiring And Devices Fixture 3 0 Incandescent Switch 1 0 Gen, Purpose I of I seal 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 ALL WAYS ELEC. CORP. * HURLEY 262 ORINOCO 1100 THE ESPLANADE DRIVE BRIGHTWATERS, NY 11718, SOUTHOLD, NY 11971 Located at 1100 THE ESPLANADE SOUTHOLD, NY 11971 Application Number: 3029789 Certificate Number: 3029789 Section: Block: Lot: Building Permit: BDC: ns11 Described as a occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: OUtside, 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 April, 2007. Name 0TY Rathe Rating Circuit Type Miscellaneous supply power to self contained hat tub Wiring and Devices Disconnect I 0 60a Pool/Spa seal I of l 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 NO. 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. 34676 Z Date MAY 11, 2009 Permission is hereby granted to: BRITT D HURLEY 1100 THE ESPLANADE SOUTHOLD,NY 11971 for : CONSTRUCTION OF A DECK ADDITION WITH HOT TUB AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 088 pursuant to application dated MAY Building Inspector to expire on NOVEMBER 1100 ESPLANADE SOUTHOLD Block 0006 Lot No. 013.049 1, 2009 and approved by the 11, 2010. Fee $ 450.00 Authorized Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUG/HPLBG. [ ] FOUNDATION 2ND [ ] I/N,tULATION/ [ ] FRAMING / STRAPPING [ ~ FINAL ] FIREPLACE & CHIMNEY ] FIRE RESISTANT CONSTRUCTION [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION REMARKS: DATE INSPECTOR~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION FOUNDATION 1ST [ ]ROUGH PLBG.  [ ]INSULATION [ ]FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: DATE FIELD INSPECTION REPORT t DATE l ~ COlVIMENTS /~ ~.. ~ FO~ATION (2~) ~ · ROUGHF~G& ~ q pL~G ~ ~S~A~ON PER N, Y. q STAT~ ~RGY COD~ ~DITION~ COUNTS ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork. net Examined ~/]/ , 20 0f Approved ~:{ ( , 20 0 ~ Disapproved a/c PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval Survey. Cheek Septic Form N.Y.S.D.E.C. Tmstees Flood Permit Storm-Water Assessment Form Contact: Mail to: Expiration sets [{/~/! , 2J~} Phone: ~ _ ~ ~-~ I Building Inspector )~~//~PLICATION FOR BUILDING PERMIT ~/ ~Jk~' 1 2~~cj /~J/ Date Apri~ 28 .,2009 ~ ~ ~ INSTRUCTIONS al~2i~f~~ ~:~:~ft~ ~1~o~~ }~ ~h~e~fiter or in i~ ~d submi~ed to ~e Building Inspector wi~4 b. Plot pl~ show~g location of lot ~d of buildings on pre~ses, relatio~hip to adjoining pm~ses or public sweets 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 permit 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. f. Every building permit shall expire if the work authorized has not commenced within 12 months at, er the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the prope~y 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, housin~gcode, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ,~/:=.,.,..~/{ ~ (Si~ature of applicant or name, if a co~rporation) 620 Pulaski Road ......... ~..NY .L17~O . t~admg aaarcss ofapphcant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Landscape Contractor Nameofownerofpremises Mr. and Mrs. Britt Hurley If applicantfl(a corpomlion, s.'~$nature of duly (Nam"~ and title 6f corpo~rate officer) Gerald Blum, President Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 17 ? 6 q- H (As on the tax roll or latest deed) authorized officer 1. Location of land on which proposed work will be done: 1100 The Esplanade, Southold, NY 11971 House Number Street County Tax Map No. 1000 Section Subdivision ^ngol Shnres Hamlet 88 Block 6 ', .,,' t 13.49 FiledMap,No. 9,~3'9~~' .. ~, "LOt ~g,.;, ~+w PLEASE NOTE: The existing pool has a C.0. and the rear yard is fenced as per pool code. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy /~ e ~ i d ~ n c e Re-surfacing an exist±ng deck & adding a small b. Intended use and occupancy~l~,qr_ r e c r e a t i o n a 1 u s e. Nature of work (check which applicable): New Building Repair Removal Demolition Estimated Cost $18,400 If dwelling, number of dwelling units If garage, number of cars Addition Alteration Other Work D e c k Fee $200 (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. House 7. Dimensions of existing structures, if any: Front 66.1 ' Rear 57.9 ' Height. Number of Stories 2 9. Size of lot: Front 10. Date of Purchase _Depth 36.1 ' Rear Dimensions of same structure with alterations or additions: Front Depth. Height Number of Stories DECK 6 "720-' Depth 5" 8. Dimensions of entire new construction: Front 68 ' -6" Rear Height 2-6" Number of Stories n/a _ 590 squar~ ftf 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 X 13. Will lot be re-graded? YES__ NO X Will excess fill be removed from premises? YES__ NO X 1100 The Esplanade 14. Names of Owner ofpremises Mr. &Mr s. Hur 1 e yAddmssSo, ~- b n ~ d, NY Phone No. o 1 7- ~ ~. ~-o qn~ Name °fArchitect Frank Ccoualdo Address H,,n~-ingran PhoneNo Name of Contractor 5ch!±ck Landgcaping Address6?o Greenlawn, NY 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO X * 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 X * IF YES, D.E.C. PERMITS MAY BE 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. 18. Are there any covenants and restrictions with respect to this propen~y? * YES__ · IF YES, PROVIDE A COPY. NO X STATE OF NEW YORK) SS: COUNTY OF ) Gerald Blum being duly swam, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the Landscape Contractor (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 tree 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. Swarm to bqfore me this 2-~;~'V~x day of - Not Signature o~m~t LOT ~EA= 4-0,000 N 29'40'40"E 160.00' S 2g'4.0'4.0"W NOTE CONSERVATION EASEMENT LINE IS 100 FT FROM FRESHWATER WETLANDS AS DEIJNEATED BY NfS DEC ON JAN. 29,1988 NOTE: CESSPOOL, SEPTIC TANK &: WATER SERVICE LOCATIONS BY OTHERS. CERT~RED ONLY TO: N.Y. LIC. No. 04.8992 HAROLD F. TRANCHON 'JR. PENN. LIC. No. 2115-E 6-27-2007 LOCATE PATIO AROUND POOL, RELOCATED FENCE HOT TUB and POOL EQUIPMENT 4-13-2007 CONFIRM CONSERVATION EASEMENT STKS. & SET S/W PROP. CRNR., LOCATE POOL, FENCE AS EXISTS end DRIVEWAY 8-23-2006 STAKED C(~NSERVATION EASE)lENT LINE RNAL SURVEY 5-21-2002 LOCATED FOUNDATION 12-20-2001 JOB No. 00-655 FILE No. ANGEL SHORES SURVEY FOR LDT NUMBER 47 MAP OF ANGEL SHORES SITUATED AT EL~YMIE'W TOWN OF SOUTHOLD - SUFFOLK COUNTY N.Y. SCALE 1" = 50' DATE 1-22-2001 FILED MAP No. 9729 DATE 8-2,3-1995 TAX MAP No. (REF ONLY)1000--88--6--15.49 DiSK .500 HAROLD F. TRANCHON JR. P.C. LAND SURVEYOR 1866 WADING RNER-MANOR RD. WADING RN'ER, NEW YORK, 1'1792 631-929 -4695 OWNER TOWN OF SOUTHOLD PROPERTY RECORD CARD ISmEE~ I/~ I ~,~,~E ACR. , TYPE OF BLD. PROP. c..~24 0 LOT LAND IMP. TOTAL DATE 0o~ FRONTAGE ON WATER FRONTAGE ON ROAD DEPTH BULKHEAD TILLABLE WOODLAND MEADOWLANi HOUSE/LOT TOTAL 88-6-13.4!) 9/02 E:~ten I~on Extension Extension Patio Deck Breezewa Pool 88.-6-13.49 88-6-13.49 9/02 Foundation Basement Ext Walls Fire Place Bath Floors Interior Finish Heat Woodstove Dormer Attic Rooms 1st Floor Driveway _/ Rooms 2nd Floor Dinette Kit¸ BR. LOT A~= ~0,000 mq. ft. N 2~"4.0'4.0"E 180,00' NOTE CONSERVATION FJkSEMENT UNE IS 100 Fr I~ FRESH~TER WETLANDS AS DEUNEATED BY NYS DEC ON JAN. 2g, lg88 NOTE: CESSPOOL. SEPTIC TANK & SER'VlCE LOCATIONS BY OTHERS. 6-27-2007 LOCATE PATIO AROUND POOL, RELOCATED FENCE HOT TUB and POOL EQUIPMENT 4-15-2007 CONFIRM CONSERVATION ~EIdENT STKS. ~ SET S.,/'W PROP. CRNR., LOCATE POOL. FENCE AS EXISTS and DRP,/EWAY 8-23-2006 STN(ED CONSERVATION EASEMENT LINE FINAL SURVEY 5-21-2002 LOCATED FOUNDATION 12--20--20~I JOB No. 00--6~ SURVEY FOR ~P ~ ~ SHOR~S ~r~IATED AT ~ ~LE No. ANGEL SHORES Suffolk County Executive's Office of Consumer Affairs VETERANS MEMORIAL I-HGHWAY * HAUPPAUGE, NEW YORK 11788 DATE ISSUED: 10/1/1989 No. SUFFOLK COUNTY Home Improvement Contractor License This is to certifv that doing business as GERALD T BLUM SCHLICK LANDSCAPING INC 17263-H having furnished the requirements set forth in accordance with and subject to the provisions of applicable laws, rules and regulations of the County of Suffolk, State of New York is hereby licensed to conduct business as a HOME IMPROVEMENT CONTRACTOR, in the County of Suffolk. Additional Businesses NOT VALID WITHOUT DEPARTMENTAL SEAL AND A CURRENT CONSUMER AFF,~ IRS ID CARD Director ACORD~ CERTIFICATE OF LIABILITY INSURANCE I DATE(MM/DD/'~Y)04/28/2009 PRODUCER Serial # 127554 THIS CERTIFICATE IS ISSUED AS A MA3q'ER OF INFORMATION FARM FAMILY CASUALTY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EX3-END OR 859 CONNETQUOTAVENUE ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ISLIP TERRACE, NY '11752 63'~-277-7770 INSURERS AFFORDING COVERAGE NAJC~ INSURED INSURER A: FARM FAMILY CASUALTY SCHLICK LANDSCAPING INC INSURER S: 620 PULASKI RD INSURER C: GREENLAWN, NY 11740 INSURER D: ~ INSURER E: :OVERAGES 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 POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. .,,'"~__~t TY~ o~,..~,.A.,=E ,.o,.,,=','.u,,,.,E. DA.., t~"~'"~ o~,.,~ ,,.,,.,,OW" ,-,,,,.TS GENERAL LIABILITY EACH OCCURRENCE 1,000,000 A X COMMERCIALGENERALUABIMTY 3152X4200 9/1/08 9/1/09 DAMAGETORENTED I CLAIMS MADE [] OCCUR NED EXP (An~ one ~erso.t 5,000 PERSONAL & ADV INJURY 1,000,000 GENERAL AGGREGATE 2,000.000 x-'l ~,_,cY [-I ~55°~ [--I,-o~ AU~TOMO~ILE LIABILITY 3152C5217 9/1/08 9/1/09 COMBINED SINGLE LIMIT 1,000,000 EXCE~.~'UM BRELLA LIABILITY EACH OCCURRENCE 4,000,000 3152E2496 9/1/08 9/1/09 A X----~CCCUR [=~ CLAIMS MADE AGGREGATE 4,000,000 DESCRIPTION OF OPERATION S~.OCATIONSAfEHICLES/EXC LU SIONS ADDED BY ENDO~SEM£NT/SPECIAL PROVISIONS LOCATION: MR, & MRS. BRITT HURLEY, 100 THE ESPLANADE, SOUTHOLD, NY 11971 CERTIFICATE HOLDER CARCELLATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYSWRITTEN TOWN OF SOUTHOLD B U ILDI NG DEPARTMENT NOTICE[ TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL TOWN HALL ~MPOSE NO OBLIGATION OR LIABILITY OF ANY KiND UPON THE INSURER, ITS AGENTS OR SOUTHOLD, NY 11971 REPRESENTATIVES~ ACORD 25 (2001108) © ACORD CORPORATION 1988 PDF created with FinePrint pdfFactory trial version http://www.fineprint.com New York State Insurance Fund Workers' Compensation & Disability Benefits Specialists Since 1914 8 CORPORATE CENTER DR, 3RD FLR, MELVILLE, NEW YORK 11747-3129 Phone: (631) 756-4300 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE SCHLICK LANDSCAPING INC 620 PULASKI RD GREENLAWN NY 11740 POLICYHOLDER CERTIFICATE HOLDER SCHMCK LANDSCAPING INC TOWN OF SOUTHOLD 620 PULASKI RD BUILDING DEPARTMENT GREENLAWN NY 11740 TOWN HALL SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER PERIOD COVERED BY THIS CERTIFICATE DATE I 888 993-3 614554 06/01/2008 TO 06~)1/2009 4/28/2009 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POMCY NO. 888 993-3 UNTIL 06/01/2009, 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 SAID POLICY IS CANCELLED, OR CHANGED PRIOR TO 06/01/2009 IN SUCH MANNER AS TO AFFECT THIS CERTIFICATE, 10 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. THE NEW YORK STATE INSURANCE FUND DOES NOTASSUME ANY MABILITY IN THE EVENT OF FAILURE TO GIVE SUCH NOTICE. THIS CERTIFICATE IS ISSUED AS A MATI'ER 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. U-26.3 NEW YORK STATE INSURANCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING This certificate can be validated on our web site at https:/h,wvw.nysif.com/cerdcertval.asp or by calling (888) 875-5790 VALIDATION NUMBER: 82530035 Town of Southold Erosion, Sedan & S-~o~ ASSESSMENT FOR..~. Db4rT~ S.ctlon I~oc~ L~ {~ERTIFIED BY A EBIGN PROFESBIO I .... ~=~ ....... Item Number: (NOTE: A Check Mark (~) fro- each Ot/asffon ts Requb'ed fo~ a (:~mplete AppflcaLion) Yes No I v~, tJ~s Project RetCh All Storm-Water Run-Off ~is ~ Mil ~ude ~ ~ ~e ~t ~ d ~ su~.) 5 is ~ a ~iu~ Wa~r ~ ~ ~gh ~ S~? / 6 ~ ~ be SI~ ~ ~ ~ng Grade S~ ~ ~ F~en (15) f~ of Ve~l ~se to O~ Hund~ (1~'). H=~ ~n~? ~ll DHv~, Pe~ng ~ ~ o~ Imp~0u, Su~ ~ S~d ~ ~ S~Wa~r RunOff in~ --d/or in ~ d,~ of a T~ ~ht~f~ ~y I~m ~n ~e 9 ~l *is P~ Requlm Si* P~on ~ln*e ~ Hund~ (1.) Year ~HMn ~y W.~me? ~ ~ NO~: If ~y Ans~ to Qu~tlons One ~mugh NI~ b ~swe~d wRh a C~ Ma~ In ~ Bex, a ~-WMr. G~M~, D~e & ~lon Co~l Plan Is Required and M~ ~ 8ubml~d ~r R~Mw ~or ~ I.usn~ ~Any Building Pe~ EXEMPTION: Ooas this project meet 1he minimum standards for dasslflca~on as. an AgriculbM PmJe~ Note: g You Answered Yea ~o this Question, a Storm-Water, Grading, Drathage & Erosion Control Plan is NOT Requlredl Yea No STATE OF NEW YORK, CO~..~. ~- Su£folk And that he/she is the ........ L,~d-~-pe.-.Co~.t..va~.t.o.~ ................................................................... : ............................ (O~ner. ~. Agea~ coq=e~m omcer, ate) Owner and/or representative of thc Owner of Owner's, and is duly authorized to pedorm or have performed the said work and to make and file this application; that ~11 statcmems contained in lifts application are true to the best of his knowledge and belie~, and fl~t the wodc will bc p~rformcd in thc manner set forth in thc application fled herewith. Sworn w before me this; .............. .................... .............. .......... o..o ....... ..... Ouallfi~l In S~Ik County., Con~nission Expl~ .Jan 18, 20 1../ SCHLICK DESIGN GROUP DESIGN SITE PLANNING CONSTRUCTION LANDSCAPES FOR LIVING From the desk of Gary Blum April 28, 2009 Town of Southold Building Department P.O. Box 1179 Southold, NY 11971 To Whom It May Concern: This project entails resurfacing an existing deck and adding a small boardwalk. There is no regrading of property. Yours truly, 620 Pulaski Road, Greenlawn, NY 11740-631-261 6660 Fax 63%754 3434 Website: wwwSchlickDesignGroup corn · E Mail: Sl:hlickdesign~optonlrrle net SCHLICK DESIGN GROUP DESIGN SITE PLANNING CONSTRUCTION LANDSCAPES FOR LIVING April 28, 2009 Town of Southold Building Department P.O. Box 1179 Southold, NY 11971 To Whom It May Concern: Please accept the enclosed permit application for a deck resurfacing and boardwalk for Mr. and Mrs. Britt Hurley, 1100 The Esplanade, Southold. Enclosed are the following: Application for building permit Erosion/storm-water assessment form 4 copies of architect's drawings 1 copy of the survey Suffolk County home improvement license Insurance certificates $200 filing fee If there are any questions or missing paperwork, please call me at (516) 903-1317. Yours truly, Gary Blum 620 PULASKI ROAD, GREENLAWN, NEW YORK 11740 * (631 )-261-6660 '~ FAX (631 )-754-3434 Website: SchlickDesignGroup com· E-Ma sch ckdes qn@optonline.net 1"- POUNPATION PLAN I/4" --I'-0" RETAIN STORM WATER RUNOFF PURSUANT TO CHAPTER 236 OF THE TOWN COPE. APPROVED AS NOTED pEE:qS¢,Ob By. ~,®', ....... NOTIFY BUILDING DEPARTMENT AT 765-1802 8AM TO 4PM FORTNE FOLLOWING INSPECTIONS: 1, FOUNDATION - TWO REQUIRED FOR POURED CONCRETE oE~/i'~lM ~ RESIDENTIAL BUILDING CODE OF THE STATE OF NEW YORK COMPLIANCE FORM PROJECT LOCATION: 1100 THE ESPLANADE SOUTHOLD, NY MAP OF. ANGFL SHORES UPON] COM PL c-~N 'UNDERWRffER~ CERTIFICATE BEFORE "W.,-I PLANNING ., DESlaN OR CONSTRUCTION ER~.1 LOCAL DESIGN CRITERIA (TABLE R301 2(1) UNLESS OTHER~SE NOTED) BUILDINGS AND S~UC]'dRES AND PARTS ]HEREOF, SHALL BE CONSTRUCTED TO SAFELY SUPPORT ALL LOADS, INCLUDING DEAD LOADS, U~Z LOADS, ROOF LOADS, FLOOR LOADS, SNOW LOADS, ~ND LOADS, AND SBSMIC LOADS AS PRESCRIBED BY '~tlS CODE. FLOOR LIVE LOAD (TABLE 9301.4) ROOF LIVE LOAD (TABLE R301,5) ROOF SNOW LOAD BASIC WIND SPEED 110 ~ND EXPOSURE CATAGORY (R~01.2.1.4) HIGH W~ND (> 110 mph) DESIGN CRITERIA SEISMIC DESIGN CATAGORY (SDC) C 40 ~ ALL CONSTP, ~eT,re, N ,~HALL MEET THE RE©' ,, ,- FHE CODES OF NE 4 ~ ,~, ,,,., 4 2. OCCUPANCY USE IS UNLAthFUL ,,,VylTHOUT CFIITIFICATE R~F OCCUF'AHC',Y AF & PA 1995 HIgH WIND EBI'RON SDC C & D PROVISIONS (R501.2,2) N.A. ~ZATHERING AREA SEVERE FROST UNE DEPTH 3 FEET TERMI~ AREA MODERATE/HEAVY DECAY AREA SLIGHT/MODERA~ WINTER DESIGN TEMPERATURE I1' F ICE SHEILD UNDERLAYMENT FLOOD HAZARDS AS PER 5LO" 28' G" N~W P!~CK / gXB11Nd OV'C~LLINd FLOOR PLAN WHIRtPOOt ~A N~W P~CK ~ ~r~:~r.~~ DESORIPT1ON DATE FRANK C. GESUALDO ARCHITECTS - PLANNERS '77 ~R HI~ ~ ~YPICAL POST TO CONC, PIeR HUN~NGTON,~117~ ~ (~1) 4~11~ F~ (~1) 4~ }YPtCAL POST TO BUILT-UP CIRDER PC CllON C(We~ECTOR HURLEY P-J=DIDENCE 100 THE ESPLANADE $OUTHOLD, NY DECK Pt_AND pod ,~. "'~ I/4"~1'-0" A ~" 9-19-06 "~ '~" 06610 t *, I