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Home My WebLink About35170-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~RTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE O~ OCCUPANCY No: Z-34264 Rte: 04/07/10 THIS CERTIFIES that the building SOLAR PANELS Location of Property: 5055 NEW SUFFOLK RD (HOUSE NO.) County Tax Map No. 473889 Section 110 Subdivision NEW SUFFOLK (STREET) (HAMLET) Block 8 Lot 32.8 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 16, 2009 purs,,~nt to which Building Permit NO. 35170-Z dated NOVEMBER 23, 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 SOLAR PANELS ON A ONE FAMILY DWELLING. The certificate is issued to EW & A SUESSER 2007 TRUST ( OWNER ) of the aforesaid building. SIIF~LKCOLR~T~fDEPART~E~FT OF }~]~%LTHAPI~RO~-AL N/A ELEurKICJ~L C~TIFIC3%~]~ NO. 11786 11/20/09 PLI~4BERS CERTIFICATION DA'r~u N/A Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOVVN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: 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 topogrfiphic 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 Planning 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 features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall 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, Swimming 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 New Construction: Location of Property: House No. Owner or Owners of Property: AIz£,e£~' Suffolk County Tax Map No 1000, Section Old or Pre-existing Building: Street (check one) Block Hamlet Lot Subdivision Permit No. ,~ 5'/?o - ~- Date of Permit. Filed Map. Applicant: Lot: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~ Final Certificate: (check one) Applicant/g t~ure + SUFF-OLK BUREAUol 40 Nottingham Dr., Middle Island, NY 11953 Telephone: 1 631 495 8136 Fax: I 631 980 6455 Emaih SBEIGS@gmail.com Date: Nov 20,2009 Name: Alfred Susser Address: 5055 New Suffolk Rd. Town, State: Cutchogue, NY Zip Code: 11935 Cross Street: Off rt 25 SITE LOCATION Phone: (631) 734-2300 Cell: (631)- Application: 11786 Municipality: Southold Permit Number: Hagstrom Map: Tax Map District: Section: Block: Lot: DBA: Dawn Electric Corp. Name: Kenneth Leitch Address: PO Box 519 Town, State: Central Islip, NY Zip Code: 11722 CONTACT DETAILS Phone: (631) 582-8686 Cell: (631 ) 445-0444 Fax: (631) 582-7282 License No.: 391 - ME INFORMATION FOR TEMP CERTIFICATE Service: Phase: Details: xxx xxx xxx xxx xxx Number of Meters: 0 Temp Certificate Not Requested! Description: Solar Job...48 Sanyo HIP210NKHAS 48 Enphase M210 Micro Inverters GENERAL INFO Rough Inspection: ROUGH INSPECTION NOT REQUIRED INSPECTION RESULTS Final Completion Date: Assigned To: Unassigned FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 35170 Z Date NOVEMBER 23, 2009 Permission is hereby granted to: ALFRED & MARIANN SUESSER PO BOX 331 NEW SUFFOLK,NY 11956 for : INSTALLATION OF SOLAR PANELS AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 110 pursuant to application dated NOVEMBER Building Inspector to expire on MAY 5055 NEW SUFFOLK RD NEW SUFFOLK Block 0008 Lot No. 032.008 16, 2009 and approved by the 23, 2011. Fee $ 200.00 AuthorlzeQ Signature ORIGINAL Rev. 5/8/02 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) PEIAMIT NO. 35170 Z Date NOVEMBER 23, 2009 Permission is hereby granted to: for : ALFRED & MARIA/TN SUESSER PO BOX 331 NEW SUFFOLK,NY 11956 INSTALLATION OF SOLAR PANELS AS APPLIED FOR at premises located at 5055 County Tax Map No. 473889 Section 110 pursuant to application dated NOVEMBER Building Inspector to expire on MAY NEW SUFFOLK RD NEW SUFFOLK Block 0008 Lot No. 032.008 16, 2009 and approved by the 23, 2011. Fee $ 200.00 Authorlze~ignature COPY Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ [ ] FOUNDATION 2ND [ [ ] FRAMING / STRAPPING [ [ ] FIREPLACE & CHIMNEY [ [ ] FIRE RESISTANT CONSTRUCTION [ ] ROUGH PLBG. ] INSULATION ] FINAL ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION REMARKS: DATE INSPECTOR~ ~ ~'IELD ]I~SPECT!oN REPORT'I DATE [ ' COMMENTS ~O~ATION FO~ATION (2~) ROUGH ~G & PL~G ~D~ION~ COUNTS TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 76~9S02 www. nor th fork. nel/Sonthold/ Disapproval a/c PERMITNO. ~ ~ B~dlLD1NG PERMIT APPLICATION CHECKLIST Do you have or n~d the following, b~fo~e applyingO Board of Health 4 ~ts of Building Plato Plaraning Board ai~oval Survey_ Cheek N.Y.S.D.E.C. Truat~z Building Inzpector I j NST UCr o s ' :ts of plans, ~ . ' g to schedule. -'-""W'P~. t plaa showing loca~on oflo~ a~d of Im0flln~ ~ ~ relationship to adjoinln~ p~mis~s or public s~n~ts or anms, aad war.ways. c. The work covered by this ~ppllcafion may n~ be c~mm~a~d befo~ is~uam~ of Buildin~ pm~it. d. Upon approval of this application, th~ Building ~ will ~ a Building p~nnit to th~ ~ppli~L Such a p~nnit shall be kept on the p~mis~a available for in~p~c~:m throughout thc woP~ e. No building shall b~ occupied or u.~d in whole or in part fi~r any pmpo~ what so ~ ~ ~ B~g ~ i~u~ a C~rtifi~ of Occupancy. f. Every building p~nlt shall explr~ if tl~ w~k au~aoriz~d has not ~omm~ac~d within 12 months at~- th~ da~ of prop~t~y have b~a ~ao.~:l in lt~ intuit, fl~ Bla'lding I~ may alltho~ in wrlting, tl~ e~l~aaion of th~ p~mit ~ ~ addi~on six mon~, Thiamin-, a n~w I~mnit ~l~)l b~ ~ APPLICATION IS HEREBY MADE to th~ Building Dqna tmem for th~ issua~ of a BuilflinE Building Zone O~din~a~ ofth~ Town of Southold, Suffolk County, N~w ~ and ~ a~plicablc Laws, Orai~ or R~gulatioas, for the construction of buildings, additi~s, or alta'a~ons of f~t~noval or d~nolitio~ aa ~ d~c~'l~d. Tl~ appllcaat agr~ t~ ~omply with all ~pplkabl¢ law~, o~llt~u~, building ~, housing ~ and r~gulafi~, and to ad. it aufl~orized inspectors on p.~.Ases and in b~fllnE fer m:~e~aary insp~ion~. (Si_' .~ of appli~m ~x mine, ff a con~-alion) (M~iling add~ of.~plicantL/ Slale whelhcr applicant is owner, l~se~, a~ent, architect, m~ineer. ~ contractor, electrician, plumber or builder (As on g~e tax mil or lalest deed) If applicant ~ a c~rp~ion, s~ of duly au~horlzed officer Oq~n¢ and title of ~orpom~ Plumb~ Lieen~ No. Elet~a'ici~ Licen~ No. 2 ~ I- ~ ~- Other Trad~'s Licens~ No. 1. Location of l~and on which propg_ sed work will be done: Hous~ Number Street Hamlet ' / / County Tax Map No. 1000 Section ~,q Block Subdivision A~f'~- ~'., [~ ~.,, Filed MapNo. 2. State existing use and occupancy of promises and intended use and occupancy of proposed coniston: a. Exisfing use and occupancy I')~_to ---~,~ ~ (~ b. lntended useandoccupancy .r-~ ,~c~ ~ 3. Nature of work (check which applicable): New Buil~.~g1 x~ddifion Alteration Repair Removal Demolition Oth~i' Work (Description) 4. Estimated Cost 7 (~ ~tc ~s ~ ~<' Fee ............ ~ · (To be paid on filing this application) 5. ~; owemng, number ox owe,rog umts_tla~Number of dwelling units on each floor aamae, numt~ro~cars ,~ /c~ - 6. I f business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front ._?~'~9 t Rear ~'O ~ Depth /c, o · Height ? ~ ' Number of Stofie~ Dimensions of same structure with alterations or additions: Front .Rear C~4~_ D~pth Height Number of Stories ', ~ ~-Dimensions of entire new construction: Front ]Rear Depth ~_.,~ Height Number of Stories 9. Size of lot: Front / 9.~ / Rear f ~ cfi. R ~ Depth [ 10. Date of Purchase / .q ~,~ Name of Forme~ Owner ~'-.,. g~ ,~ 11. Zone or use district in which premises are situated proposed eons~etion violate any zoning law, ordinance or regulation? YES NO 1 2. Does 13. Will lot be re-graded? YES NO '~ill excess fill be removed from premisea? YES NOJ 14. Namea of Owner of premise~/q/(,,e.~0 <'~ a ¢~-e~Addre~ Phone No. Name ofAmhitect ~ ,, Addre~ .Photo:No Name of Contractor k',- ;e ,~{~ I ~. Co ,~ n 4, v v ~'4t 0~.ddr~ 5 7/6. <; ~ u. 15 a. la this property within 100 feet of a tidal wetland or a freshwater wetland? iYES//~ NO __ * IF YES, SOUTHOLD TOWN TRUSTEES & D.£.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet ofatidal wetland? * YES///--- NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. ! 6. 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 b~low, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF GI~. ;r~ ~T ..(~., ]/~'-/I~ ? being duly sas~n, deposes and says that ($)he is the agglieant [m~ae o~mmwaum signing eontra~t) a~ove named, (Co~trac6'C, ^gvat, Comora~)ffieer, etc.) of said owner or owners, and is duly authorized to perform or have performed tim said work and to maim and file this application; that all stat~nents ~Orltained in this applieali~m am tree to the In~t of iris knowl~ ~ ~; ~ ~ ~ ~ ~ ~ Notary Publi¢~ Si~-~ of Applicant '~lO~jnS '089L~OGO~LO ON ,; P/~?.'7 q,.~,k~0 Ei-E~T[~ICAL n;Tr,!ENT AT ~'-~ .~ SERVICE ENTRY" ~ FOR THE .... T THE -:', Or ,~EW ,,,;, 3LE FOR .;~. ~,,~;,..~,~,.~,~,,N ERRORS. ROOF PLAN SCALE: 1/16"= P-O" NOTE: ~//1~% / DATA SUBJECT TO ENGINEER'S REVIEW AND APPROVAL ' HARVEST POWER PROGRAM --,.,~.' BY FRIENDLY CONSTRUCTION CO. INC. ~ JOB LOCATION: CLIENT: FIGURE: AFFORDABLE SOLAR 5055 New Suffolk Road, Alfred Suesser POWER FOR Cutchogue, NY 11956 LONG ISLAND DRAWN BY: PDL I DATE: 4/28/09 Array #1 13 Enphase 30 A 13 Sanyo HIP 210NKHA5 ....... M210 Micro ....... 240 V Modules Inverters AC Disconnect Array #2 13 Enphase 30 A ....... 13 Sanyo HIP 210NKHA5 ....... M210 Micro ....... 240 V ........... , Modules Inverters AC Disconnect Main Panel I ..... I 200A 120 / 240 V Array #3 11 Enphase 30 A 11 Sanyo HIP 210NKHA5 ...... M210 Micro ....... 240 V ............ Modules Inverters AC Disconnect Array#4 ~'~ Enphase 30A ', 11 Sanyo HIP 210NKHA5 ...... M210 Micro ........ 240 V ~ ~ A~/~'~ ,~ ;Vi ' - - 7 HARVEST POWE~ by FRIENDLY CONSTRUCTION CO. INC. .~ ~ -~:. Job Location: Client: Figure: 5055 New Suffolk Rd. Alfred Suesser Cutchogue, NY 11956 i -- E Thomas D. Reilly P.E. Consulting Engineer "For every house is built by someone, but the builder of all things is God" Hebrews 3:4 4 Bezel Lane Smithtown, N.Y. 11787 Tel: (631) 724-7888 Fax: (631) 724-5740 November 09, 2009 Town of Southold PO Box 1179 Southold, NY 11971 Attention: Pat Re: Solar Panel insta!la§on for Suesser Residence 5055 New Suffolk Road Cutchogue, NY 11956 To Whom It May Concem, Please be advised that we have examined and analyzed the existing roof flaming at the above-named location and have determined that it is adequate to support all anticipated super-imposed loads from the proposed solar panel installation without overstress in accordance with the requirements of the Residential Code of New York State. Additional Design Criteria and Information: 1. Roof Live Load = 20psf 2. Snow load = 20psf · 3. Wind Load(120mph) = 26psf 4. Wind Uplift = 40psf 5. The mounUng brackets meet or exceed NYS Code requirements for the above design cdteda. 6. The actual in field attachment to the roof will meet or exceed ResidenUal Code of New York State Requirements. Very truly yours, Suesser Solar 11 9 2009 TDR:js "b° CERTIFICATE OF LIABILITY INSURANCE Loouc THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION LoVulloAssoclates, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CEKnFICATE DOES NOT AMEND, EXTEND OR 6450 Transit Road ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. INSURERS AFFORDING COVERAGE NAIC ill ~su~o Friendly Co.~ln.=tion Company, Inc ~ ~: ASPEN INSURANCE UK LTD. 1t20337 112 Cedar Avenue ~ I~ Isllp, NY t1751 ,~SURE~ C: ~NStJRER D: COVERAGES ~a~. u,ma.rrY CR2~60809 64/09/2009 04/0g/2010 F-~.~ $ t,000,000 A -- CERTIFICATE HOLDER CANCEU. ATION 53095 Rout~ 25 P.O. Box tt79 $outhold, NY 11971 ACORD 2S ~ 1988-2089 ACORD CORPORATION. NI dghts reseh'ed. The ACORD ~m and logo are registered marks of ACORD For more information contact: ARM-Capacity of New York LLC at 646-459-2400. STATE OF NEW YORK WORKERS' COMPENSATION BOARD CERTIFICATE OF NYS WORKERS' COMPENSATION INSURANCE COVERAGE la. Legal Nme & Address of Insured (Use street address only) Friendly Co~stroeflon Co. In~ 57A Saxon Avenue Bay Shore, NY i17~6 WorkLoeation of Insured (On/y re~lred~fcomm~eb~otciflc~ll~ tim/ted to ~ Ioc~o~ t~ No., York .$~te, i.e., a F/r~p-f]p lb. B~ness Telephone Number of Imured 631-647-3402 le. NY$ Unemployment Insuronea Employer Registrntinn Number of Insured Id. Federal Employer Idonflfienflon Number of Insured or Social Seenttty Number 2. Nme and Address. of the Entity Requesting Proof of Coverage (Entity Being Lis~i as the Cerflfleate Holder) Town of SouthoM Town HaH 53095 Route 25 P.O. Box 1179 Southold, NY 11971 11=29~9027 3a. Name of Insurance Carrier New Hampshire Insurance Co. 3b. Pobey Number of entlty listed in box ~la~ WC1009535 3e. PoHey effective period 07/20/2009=07/20/2010 3d. The Proprietor, Farmers or Execnflve Officers are [] included. (O~l~.aetkb~t~anpann~,~0flk~nh~ande~) X aH excluded or certain parmers/ofF~eers exeloded. compensation under ~he New Yodc S'-u~o Workers ' Compensation Law. (To use fids form, New York (NY) must be ~ under Item 3A on the INFORMATION PAGE ofthe workers' eompemation insuranee poliey~ The Insurance Carrler ~r ifs licensed agen~ will send this Ceriificate of Insursn~e to the entity listed above as lh~ certificate holder ~n box "2". The Insurance Carrier will also not~ the above ce. rtOTcote hold~ witlgn I0 days IF a poli~y i~ canceled due to nonpaym~t of premium~ or within $0 day~ IF there ~'e reasons other than nonpayment of premlrons that cancel the policy or ~llmlnate the lmured from the ¢overag~ indi~ot~ on th~ Cert~eate. ff/~re no~i~s may be stat by ~ r~iL ) O~e~i~ tk~ Certi_ fla~ is mlid for o~e year ~er ~is form b appro~! by ~e ~rtmce carrier or its Ileen~ed agent, or until t~e policy expiraflo~ date listed in box ~3e", wh~Aw~er i~ earlier. Please Note: Upon the cancellnfion of the workers' compensation policy indicated on this form, if the business eontinues to be named on n permit, lieeme or eoatraet issued by a certifieate holder, the business must provide that eertifleate holder with a new Certiikate of Workers' Compemm~on Coverage or other nuthorized proof that the business is complying with the mnndntery coverage requiremena of the New York State Workers' Compensation Law. Under penalty of perjury, I certify that I am an authorized representative or Ilceasod agent of the insuronee earrier referenced above and that the named in~red has the coverage as dep_.i~ed on this form. Please Note.. Only im'ura~we carriers and their liee~e.d agent~ are authorized to i~sue Form C-105.2. In~ranc~ brokers are NOT a~thorized to isle it. C-105.2 (9-07) www.wc, b.~mt~.ny.us STATE OF NEW YORK WORKERS' COMPENSATION BOARD CERTIFICATE OF INSURANCE COVBRAGE UNDER THE NYS DISABILITY BENEFITS LAW PART 1. To be cmnpleted by Disability Benefits Carrier or Licensed Insurance Agent of tliat Carrier I a. Legal Name and Address of Intoned (Use street address only) 1 b. Busmess Telephone Number of Insured 631-647-3402 Friendly Construction Co. Inc. lc. ~'S Unemployment Insurance Employer Rcgis~'ation 57A Saxon Avenue Ntunber of Inaured Bayshore, NY 11706 ld. Federal Employer Identification Ntenber of Insured or Social security Number 11-2959027 3a. Hame of Inauranee Carrier 2. Name and 'Address of the Entity l~que~ Proof of Coverage (Entity Being Listed as the Certificate Holder) Town of Sou~cl Town Hall 53095 Rauts 25 P.O. Boo( 1179 Sotlthold, NY 11971 Zurich American Insurance Company. 3b. Policy Number of entity hsted in box ' la": 53684474 ~. Policy effective period: 0760/2009 to 07./20/2012 4. Pohcy covers: a [] All of the employers employees e[igibte under the New York Disability Benefits Law b[~] Only the following class ~ classes of the employers employees: Under penalty of perjory, I certify that I am an authorized representative or hcensed agent of the insurance carrier referaneM above and that the r~med insured has l'~'S Disability Benefits msorence coverage as deSCribed above. mte Sign 0n6/2 By (Sigam~ ofimmrance cani~'s m~t~d t~esea~e or ]~'S Lic~ed Inv~ance Agmt of tl~t m~mnCe c~i~) Telephone Number Title Administrative Services Mauage~ · ~ORT.~: fibs( "4a" is c]~cla~ and tt~ fora L~ s~d by t~ msarauco ca~,, aetlx~zed ~im~t~.-;e ~ ~-S ~ ~o ~ ~ c~ ~ certificste i~ C(~IPLETE. M~dl i~ d~, to t~ cealffic~te PART 2. To be completed by NYS Workers' Compensation Board (Only if box "4b" of Part I has been checked) State Of New York Workers' Compensation Board Telephone Number Title Please Note: Only msturauce carriers hcensed to write lxPtS disabihty benefits insurance policies end NYS licensed msorauce agents of those waurauee carriers are authorized to issue Form DB-120.1. Insurance brokers are NOT authorized to issue this form. DB-I20.1 (5-06) Additional Instructions for Form DB- 120.1 By siLmmg this form, the mSUXan¢¢ canner identified in box ~3' on this form is c~rtifymg that it is insuring the business r~ferenr:¢d inbox ' la" for dissbili~' benefits under the New York State Dissbility Benefits Law The Insurance camex or i(s ficensed agent will send valid for the earlier of one year after tliis form is appnn~d by the insurance carrier or its licensed agent, or the policy expiration date listed in box Please Note: Upo~ the c*J~ellatimt of the disability b~tefi[~ policy fltdimted o~ this fora}, ff the Intsh~e~ ~l~n)~ 1o ~ ]tamed on a ~llit license or contract ism~ed by a c~lificate hold.r, the bnsi~l~ ~mtst provide that ~rlificate holder with a new C~ntificat~ of NYS Disability Benefits Coverage o~ other author, ed proof that the b~isless is oomplying with the mandatmy coverage requi~uents of the New Yo~k State Disability Benefits Law. DISABILITY BENEFITS LAW §220. Subd. 8 (a) The head of a state or municipal department, board, commission or office authorized or required by law to issue any permit for or in connection with any work involving the employ, neat of employees in empio~meat as defined in (his article, and not withstanding any general or special statute requiring or authorizing the issue of such permits, shall not issue such l~rmit unless proof duly subscribed by an inst~ance carder is produced in a form satisfactory to (he chair, that the payment of disability benefits for all employees has been seeured as provided by this article. No~hing herein, hox~ever, shall be construed as creating any liability on the part of such state or municipal departmeat, board, commission or office to pay any disability benefits to any such employee if so employed. Co) The head of a state or municipal department, board, commission or office authorized or required by law to eater into any contract for or in connection ~vith any work involving the employment of employees in employment as defined in this article, and notwilhstanding any general or special statute requiring or authorizing any such contract, shall not eater into any such c~atract unless proof duly subscribed by an inst~ance carrier is produced in a form satisfactory to the chair, that the paymont of disability benefits for all employees has been secured as provided by this article. DB-120.1 (5-06) I'l)X*ll llall Annex ,5 [375 Mare Road P.O. Box 1179 Soud~old. NY 119714)9,59 Tclepl~onc (63 [ ) 76,3-1802 1~ x ((31) 7(, .t, 02 I~UILDIN(; I)I~;PARTMENT TOWN OF SOUTHOLD March 15, 2010 E & A Suesser 1'70 Mimosa Way Portola Valley, CA 94028 RE: 5055 New Suffolk Road, New Suffolk TO WHOM IT MAY CONCERN: The following items are needed to complete your Certificate of Occupancy: Application of Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. A fee of $25.00 __ Final Health Department approval. Plumbers Solder Certificate. (All permits involving plumbing after 4/1/84) Trustees Certificate of Compliance. __ Final Planning Board approval. __ Final Fire Inspection from Fire Marshal. __ Final Inspection from the Building Dept. Final Landmark Preservation approval. Building Permit: 35170-Z solar panels SITE DATA ENLARGED SITE PLAN KEY MAP SITE pLAN