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Home My WebLink About35920-ZTown of Southold Annex 54375 Main Road Southold, New York 11971 7/15/2011 CERTIFICATE OF OCCUPANCY No: 35069 Date: 7/15/2011 Location of Property: SCTM #: 473889 Subdivision: THIS CERTIFIES that the building DECK 2725 Wells Avenue, Southold, Sec/Block/Lot: 70.-4-16 Filed Map No. conforms substantially to the Application for Building Permit heretofore 9/27/2010 pursuant to which Building Permit No. Lot No. filed in this officed dated 35920 dated 10/5/2010 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: deck addition to an existing one family dwelling as applied for. The certificate is issued to Stanton, Matthew (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED /ffu~(o ri~qdr ~igna~ur e 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. 35920 Z Date OCTOBER 5, 2010 Permission is hereby granted to: MATTHEW F STANTON 2725 WELLS AVE SOUTHOLD,NY 11971 for : CONSTRUCTION OF A DECK ADDITION TO AN EXISTING DWELLING AS APPLIED FOR PER TRUSTEES DEC. #7360 at premises located at 2725 WELLS AVE SOUTHOLD County Tax Map No. 473889 Section 070 Block 0004 Lot No. 016 pursuant to application dated SEPTEMBER 27, 2010 and approved by the Building Inspector to expire on APRIL 5, 2012. Fee $ 563.60 Authorized Signature ORIGINAL Rev. 5/8/02 Form No, 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN 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: .6. For new building or new use: 1. Final survey of propertY with accurate location of all buildings; property lines, streets, and unusual natursl or topographic feature~. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board 0fFire Underwriters. 4. Sworn statement from plumber ceHfying tha~ the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, indnstrial building, multiple residences and similar buildings and installatious, a certificate of Code Compliance from architect or engineer responsible for the building. 6, Submit Planning Board Approvat of completed site plan requiremena. 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 $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00, · Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00. Businesses $50.00. 2. Ceytifieate 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: Old or Pre-existing Building: House No. Street Owner or Owners of Property: /14 & 'b~q*oo ~tuffolk County Tax Map No 1000, Section r') 0 Snhtivision Permit No. ~q~O Date of Permit. Health Dept. Approval: Planning Board Approval: (check on~e~) Hamlet BIeck V' Lot Filed Map. Lot: Applicant: Request for: Temporary Certificate Foe Submitted: $ ~) ~/~ Underwriters Approval: Final Certificate: / Applicant Signature TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 I SPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONS'nlucTION[ ] FIRE RESISTANT PENLq'RATION REMARKs: ~ ~ DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ] FOUNDATION 1ST [ ]~UNDATION 2ND [~] FRAMING / STRAPPING [ ] FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL [ ] FIRE SA~=; f INSPECTION [ REMARKS: ] RRE RESIST~IT COlISlllUCTION [ ] FIRE RESISTANT PENETRATION DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTIO N [ ] FOUNDATION 1ST [ ] ROU/GHPLBG. [ ]FOUNDATION 2ND [ ]I~ULATION / [ ] FRAMING / STRAPPING [ ~/~ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: DATE ~/----~~__ INSPECTOR TOWN OF SOUTHOLD BUILDING DEPARTI TOWN HALL SOUTHOLD, NY 119 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.North} Examined i]'~8EP 27 2010 ~'k.', ~t PERMIT NO BLDG. __ TOWN OF SOIJTHOLD Approved Disapproved a/c /o~--, 20 /o BUILDING PERMIT APPLICATION CHECKLIS'I Do you have or need the following, before applying'? Board of Health 4 sets of Building Plans Planning Board approval Survey_ Check Septic Form N.Y.S.D.E.C. Tmstees Flood Permit Storm-Water Assessment Form Contact: Mail to: Phone: Expiration .~/5'720 .? ~ ~ Building I-fispector (~]) APPLICATION FOR BUILDING PERMIT Date ,20/a INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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 pe~xnit 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 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. ~} ( 'gnat're of app]]cvlnt or name, if a corporation) ~' (Mailing a-dcl-ro(s o f applic ant ) / State whether applicant is owner, lessee, agent, architect, engineer, ge~al contr~acto.~lectrician, plumber or builder Name of owner of premises ~ A. 4-/-e~,2 r-~ ~'+a.v-~,,~ (As on the tax roll or latest deed) If al~licant is a~orpoA-ation, sign3ture of duly authorized officer ~x,) -(Namle and titl~of~t~rpo~at~officer) Builders License No. ~_-;-~r~ ~ ~ ] otL/t Plumbers License No. Electricians License No. Other Trade's License No. Location of land on which proposed work will be done: -~7 ~x- '- a~ ~//¢ .f~,...,~ . Hoase Number Street Hamlet County Tax Map No. 1000 Section... ~)D Block tS) ~/ Subdivision Filed Map No. Lot o/f Lot 2. State existing use and occupancy of premises and int.ended use and occupancy o~proposed construction: a. Existing use and ocCUpancy b. Intended use and occupancy .~Am'~-~ 3. Nature of work (check which applicable): New Buildibg Repair Removal Demolition 4. Estimated Cost Fee 5. If dwelling, number of dwelling units / If garage, number of cars .2_ -Addit'iiS'h - Alteration Other Work (Descripfidn) (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. 7. Dimensions of existing structures, if any: Front Z-/7 - q Rear L/?_ q Height Number of Stories ,2_ 9. Size oflot: Front ¢/. X'2 10. Date of Purchase /)e~ oodd.g Dimensions of same structure with alterations or additions: Front Depth c/d-$- t. /o ~/o~-~Height. ~t~ ,bo Dimensions of entire new construction: Front c/ti. ~ , Rear Height $ / Number of Stories Rear )~,t/, c) ~ Name of Former Owner Depth Number of Stories l .Depth Depth l 1. Zone or use district in which premises are situated ~ ~ q ~ / 12. Does proposed construction violate any zoning law, ordinance or regulation? YES__ NO 13. Will lot be re-graded? YES __ NO V/Will excess fill be removed from premises? YES __ NO / 14. Names of Owner of premises ~ ~-t-beo ~- ~,,da,,) Address 299~-w*J/.r~,~ ~,4~tPhone No. ~3/ ~ ~ qL N~e of Architect ~ ~ , Ad~ess/~_?~/d/~ ~hone No~ Name ofCon~actor[~7~ ~ er~10~Address ~ ~ ~ /PhoneNo. ~/7~ q~/~ 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 cfa tidal wetland? * YES__ NO__ * 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 property? * YES __ NO ///px r~- t~ · IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF D ,_,J(~3C~,~,~') h ) ~ (--)C,['~'~ being duly sworn, deposes and says that (s)he is the applicant (Na~e of tndi,~'idual s~gning contrac~ above named, (S)He is the ~-~ ~ ~ - ' ['Contrictor, A~ent,'~orpomte 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. Sworn to before me this ~otaW Public Note~ Public. State of New York .o. n s9 22 atuWof AFpiicm OB~lified in $[lffolk,Cou~ .... BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 7360 DATE: JULY 21~ 2010 ISSUED TO: MATTHEW STANTON PROPERTY ADDRESS: 2725 WELLS AVENUE~ SOUTHOLD SCTM# 70-4-16 AUTHORIZATION Pursuant to the provisions of Chapter 275 and/or Chapter 111 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on July 21, 2010, and in consideration of application fee in the sum of $250.00 paid by Matthew Stanton and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits thc following: Wetland Permit to rebuild and construct an addition to the existing deck attached to the dwelling; and as depicted on the site plan prepared by Kenneth Babits, Architect, last dated June 20, 2010, and stamped approved on August 9, 2010. IN WITNESS WHEREOF, the said Board of Trastees hereby causes its Coqaorate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. Jill M. Doherty, President Bob Ghosio, Jr., Vice-President James F. King Dave Bergen John Bredemeyer Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0670C Date July 13,2011 THIS CERTIFIES that the reconstruction of existing 713 sfi deck with a 216 sr. addition At 2725 Wells Ave., Southold Suffolk County Tax Map #70-4-16 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 6/30/10 pursuant to which Trustees Wetland Permit #7360 dated 7/21/10 was issued and conforms to all of the requirements and Conditions of the applicable provisions of law. The project for which this certificate is being issued is for The reconstruction of the existing 713 sf. deck with a 216 sf. addition. The certificate is issued to MATTHEW STANTON owner of the_aforesaid property. A~rized Silatur~e Erosion,Sedimentation & Storm Water Run'Off ASSESSMENT FORM THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A DI,tHct Sec~on Blocl~ Lot STORM-WA1 ~, GRADINGr DRAINAGE AND EROSION CONTROL PLAN G~.~¥iFIED BY A DESIGN ~'AUe~aSIONAL IN THE STATE OF NEW YORK. Item Number: (NOTE: A Check Mark (4~ ) for each Question is Required for a Complete Application) Ye._~s N._~o Will this Project Retain All Storm-Water Run-Off Generated by a Two (2") Inch Rainfall on Site? (This Item will include all run-off created by site clearing and/or constructton activities as well as all Site Improvements and the permanent creation of impervious sudaces.) Does the Site Plan and/or Survey Show All Proposed Drainage Structures Indicating Size & Location? / ~ This Item shall include all Proposed Grade Changes and Slopes Controlling Surface WaterFtowl Will this Project Require any Land Filling, Grading or Excavation where there is a change to the Natural 'L~ n ~I Existing Grade Involving more than 200 Cubic Yards of Mstedal within any Parcel? ,~.~ ,~,,~ I~1 Wilt this Application Require Land Disturbing Activities Encompassing an Area in Excess of I I Five Thousand (5,000) Square Feet of Ground Surface? Is there a Natural Water Course Running through the Site? Is this Project within the Trustees Jurisdiction or within One Hundred (100') feet of a Wetland or Beach? 2 3 4 5 6 7 8 9 Will there be Site preparation on Existing Grade Slopes which Exceed Fifteen (15) feet of Vertical Rise to One Hundred (100') of Hodzonlal Distance? Will Driveways, Parking Areas or other Impervious Surfaces be Sloped to Direct Storm-Water Run-Off into and/or in the direction of a Town right-of-way? Will this Project Require the Placement of Material, Removal of Vegetation and/or the Construction of any Item Within the Town Right-of-Way or Road Shoulder Area? (This Item will NOT Include the Installation of Driveway Aprons.) Will this Project Require Site Preparation within the One Hundred (100) Year F oodp a n of any Watercourse? r~ NOTE: If Any Answer to Questions One through Nine 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 Permltl EXEMPTION: Does this project meet the minimum standards for classification as an Agricultural Project? Note: If You Anewered Yes to this Question, a Storm.Water, Grading, Drainage &'Erosion Control Plan is NOT Requlradl Ye__As N__qo STATE OF NEW YORK, ..~COUNTY QF .....~....~....~.[J~ ................. SS And that he/she is the ........................... ~~ ....................................................... Owner and/or representative of the Owner of Owner's, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements cone, fined in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed herewith. Sworn to before me this; ........................ C;~..~....~. .......... day of ......J..O~.. ~,. .................... ,20.~ Notary Public: ............. . .... FORM - 06107 N 141o1~ 00~ 69° SURVEY NIO/F o' 1 cHRISTINE ~$84'32'48'~E w~oo O~r~ 80* 34' AREA = 23,965 sq. ft. 00" W o. 9~ MAIN ROAD SOUTHOLD, IV. Y. 11971 90 - 313 PROPERTY A T SOUTHOLD ~ TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. 1000 - 70 - 04 - 16 Scale 1"= 30' - Dec. 20, 1990 ~ ~ June 28, ~91(foun~ loc.) ~ b% ~e LIA.L.S. ~d ~prov~ ~d ad. ted . . 1'~× LoT ~7 20.14×//Q? ' ~2x x~4x~ ~ ~ "k.%, x~v~y., / AREA= 2Z965.11 SO FT~ ~ ~ ~oo ~ x ~ ~ 0o ~ 0.55 ACNES ~ ~ % ~ ~ ~ ~ ~,,~ ~ 5 &0°34'00'' W 275. I 7 ~,'~ ~ ~ TAX LOT 15.1 ~ ENUE I I I I I I I I I 1 inch =30ft. GRAPHIC SCALE ( IN FEET ) QUAD MAP NUMBER= "FF59" LA T/LONG COORDNIA TES 41'03'30.5"N, 72'25'25.8'W ELEVAZTONS SHOWN REFER TO NGVD 1929 DATUM T. E,4SON [,AND SURVEYOR 304 HALLOCKAVENUE, PORTJEFFERSON STATION, N.Y. 11776 Phone (651)474-2200 /Fax (631) 899-9085 emai/TEAffONI~OPTONLEVE.~T TOPOGRAPHIC SURI/EY SURVEYED FOR: VINCENT LABATE M.,CP OF: DESCRIBED PROPERTY LOCATION: SOUTHOLD, SUFFOLK COUNTY ,NY CERTIFIED TO: VINCENT LABATE SUFFOLK COU2VTY DIS~. 1000 SEC. 70 BL~ 04 LOT 16 DATE; 7-08-10 [SCALE: 1"=30' PRO. IECTNUMBEiL. TEAlO-154 050452 ODUCER Timothy S Purdy 45 Rbute 25A suite D2 Shoreham, NY 11786 Joseph LaBate Dan LaBate DBA Labate Construction 9 Begonia Road j_Rocky Point NY 11778-9535 COVERAGES ~ THE POLICIES OF ~NSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE EOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTrFICATE MAY MAy PERTAIN THE INSURANCE AFFORDED SY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDI POLICrES. AGGREGATE LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS.OR CERTIFICATE OF LIABILITY INSU_RANC_E (631)82%2200 THIS CERTIFICATE '~ ISSUED ~-~ ~, MATTE,:,~ ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMENI EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POI CIES BELOW_._. INSURERS AFFORDING COVERAGE INSURER A: Farm Family Casualty Ins. co. NAIC # INSUR~ER ~j__The First Rehabilitation Life Ins. Co. GENERAL LIABILITY 3152x4074 03/15/1, 03/15/1' LIMITS Contractors GEN'L AGGREGATE LIMIT APPLIES p $ 5,000 INJURY 1,000 PRODUCTS. 1,000,000 PROPERTY DAMAGE GARAGE LIABILrTY (Per accident} $ ANY AUTO AUTO ONLY - EA ACCIDEN $ OTHER THAN EA ACC EXCESS / UMBRELLA LIABILITY AUTO ONLY: OCCUR ~ CLAIMS MADE tEXCLUDED7 EL. EACH ACCIDENT E.L DISEASE . EA OTHER DISABILITY APPLIED FOR ESC RIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ~arpentry ERTIFICATE HOLDER Town 'of Southold Bldg Dept. Town Hall Southold, NY 11971 -------__L ~-ORD 25 (2009101) CANCELLATION SHOULD ANY OF THE ABOVE SESCRIB ED POLICIES BE CANCELLED BEFORE THE EXP RATION ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WR TTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, SUT FAILURE TO DO SO SHALL '=/.:=O.==;=,O. ORL,A.,L,TYOEA.Y..DUPO...E,.SU.R..SAGE.TSOR G 1988-2009 ACORD CORP TION. All rights rese~ed, The ACORD name and logo are registered marks of ACORD STATE OF NEW YORK WORKERS' COMPENSATION BOARD CERTIFICATE OF NYS WORKERS' COMPENSATION INSURANCE COVERAGE la. Legal Name & Address of Insured (Use street address only) Joseph LaBate Dan LaBate DBA LaBate Construction 9 Bergonia Road Rocky Point, NY 11778 Work Location of Insured (Only required if coverage is specifically limited to certain locations in New Yorl~ State, L~, a Wrap-Up Policy) lb. Business Telephone Number of Insured 631-836-0294 lc. NYS Unemployment Insurance Employer Registration Number of Insured 2. Name and Address of the Entity Requesting Proof of Coverage (Entity Being Listed as the Certificate Holder) Town of Southold Bldg. Dept. Town Hall Southold, NY 11971 Id. Federal Employer Identification Number of Insured or Social Security Number 110484331 3a. Name of Insurance Carrier Farm Family Casuality Ins. Co. 3b. Policy Number of entity listed in box "la" 3101W 3c. Policy effective period 06/25/2010 to 06/25/2011 3d. The Proprietor, Partners or Executive Officers are included. (Only check box if all partners/officers included) all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box "3" insures the business referenced above in box "la" for workers' compensation under the New York State Workers' Compensation Law. (To use this form, New York (NY) must be listed under Item 3A on the INFORMATION PAGE oftbe workers' compensation insurance policy). The Insurance Cartier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box "2". The Insurance Carrier will also noti)~e the above certificate holder within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail..) Otherwise, this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent, or until the policy expiration date listed in box "$c", whichever is earlier. Please Note: Upon the cancellation of the workers' compensation policy indicated on this form, if the business continues to be named on a permit, license or contract issued by a certificate holder, the business must provide that certificate holder with a new Certificate of Workers' Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers' Compensation Law. Under penalty of perjury, I certify that 1 am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. (Print narnc Of authorized representative o~ licensed agent of insurance carrier) (S~gnature) '~ (Date) Title: Agent-Representative Telephone Number of authorized representative or licensed agent of insurance carrier: 631-821-2200 Please Note: Only insurance carriers and their licensed agents are attthorized to issue Form C-105.2. Insurance brokers are NOT authorized to issue it. C- 105.2 (9-07) www.wcb.state.ny.us STATE OF NEW YORK WORKER'S COMPENSATION BOARD CERTIFICATE OF INSURANCE COVERAGE UNDER THE NYS DISABILITY R;MFFITS LAW ~be c,.,,,~;Med by D;~;iI~ Benefits Carrier or Licensed InsuTance AgeM of Utat Carrier Ju~t=l"H I.ABATE & D.'~IIEL LABATE DBA I. ABATE CONSTRUCTION 9 BEGONIA ROAD ROCKY POINT, NY 11778 lb* Bu~n~ Tek~ Numb~ M Insured 631-836-0294 Id- Fed~al ~ IdemlfkMJen Nun~M M irmxed 110484331 TOWN OF SOUTHOLD BUILDING DEPT. TOWN HALL SOUTHOLD, NY 11971 DBL341611 06/25/2010 to 06/24/2011 & [] AIl efthemaployer'semployeesdJgibleundu theMewYMk Dl~bJlltyBeneflbLaw b.~] Only the fMlewtngda~sMrja~oflhem~Me3n(sMnptoyemc Tdq~mN~m~,. 516-829-8100 T~ Sr. Vice President PART 2. To be ~mpieted by NYS Werker'$ Compeflsatlon Board (Only if box "4b" of Pert I has ~ ~.~-- State of New York Worker's Comlxmsation Board TM~,~-~,~,~ Mumb~w Tit~ 0~-~.~ Additional Instructions for Form DB.120.1 By signing this form, the insurance carrier identified in Box '3" on this form is certifying that it is insorlng the ~usiness referenced in Box "la" for disability benefits under the New York State Disability Benefits Law. The ~nsurance ca'rier or Its ' licensed agent will send this Certificate of Insurance to t/ne erKIty listed as the certificate s~me~ ~ et me policy exp~rat~en dale listad in Box Please No~ff UlX~l the cancellation Of the d isability bermflts policy indicated cm this fo~rn, if the business continues to be named on a permit. I~w~e or correct issued by a certificate holder, the business must ~'ovide thai ce~iflcate holder with a new Certificate Of NYS Disability Benef'~s Coverage or other euth~xized proof thot the business is complying with the rnar~ato~j coverage requirements Of the New York St, ate Disability BenerRs Law. DISABILITY BENEFITS LAW (a) The head of state or municipal department, board, commission or office authorized or required by 'e~VJ~i~u,~e an2.~ ~o_r.~or. in ~c~. n, necti~n wl~ any work involving the ernployrnent of employees in r .~,,-.,,. ~ ,~=.,,.~u .~ m~s ar[tcte, ane notwithstanding any general or special statute requiring or authorizing the issue of such permits, shall not issue such permit unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair, that the payment of disability benefits for all employees has been secured as provided by this article. Nothing herein, however, shall be construed as creating any liability on the part of such state or municipal department, board, commission or office to pay any disability benefits to any such employee if so employed. (b) The head of state or municipal department, board, commission, or office authorized or required by !aw to enter into any contract for or in connection with any work involving the employment of employees ~n employment as defined in this article, and notwithstanding any general or special statute requiring or ~uthorizing any such contract, shall not enter into any such contract unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair, that the payment of disability benefits for all employees has been secured as provided by this article. DB-120.1 (5-06) Reverse PROOUCER Timothy S Purdy 4§ Rbute 25A suite D2 Shoreham, NY 11786 INSURED Joseph LaBate Dan LaBate DBA Labate Construction 9 Begonia Road .-[ Rocky Point NY COVERAGES CERTIFICATE OF LIABILITY INSURANCE DATE,M..D , (631)821-2200 THIS C~ERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # IRSURERA:?~arm Family Casualty Ins. co. iNSURERS: The First Rehabilitation Life Ins. Co. INSURER C: 11778-9535 INSURER D; 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 OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. GENERAL LIASILITY COMMERCIAL GENERAL LIABILI~( CLAIMS MADE ~ OCCUR Contractors OEN'L AGGREGATE LIMIT APPLIES AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS POLICY NUMBER LIMITS 03/15/10 03/15/11 5,000 PERSONAL & AD' 1,000,000 GSREraL ^GOrEGATE ___2,0~00,000 PRODUCTS- COMP/Dp AGO 1,000,000 COMBINED SINGLE LIMIT (Ea accident) SODILY ~NJURY [Per person) $ BODILY INJURY (Per accident) GARAGE LIABILITY ANY AUTO EXCESS I UMBRELLA LIABILITY I OCCUR ~ CLAIMS MADE DEDUCTIBLE _~ ~;~ABILITY APPLIED FOR 2arpentry PROPERTY DAMAGE (Peracc~ent) AUTO ONLY;EA ACCIDENT OTHER THAN AUTO ONLY; $ EACH OCCURRENCE $ AGGREGATE E.L. EACH ACCIDENT E.L. DISEASE - EA E.L. DISEASE - POLICY LIMIT ERTIFICATE HOLDER Town 'of Southold Bldg Dept. Town Hall Southold, NY 11971 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES GE CANCELLED BEFORE ~HE EXPIRATIOI DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL . 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. ;ORD 25 (2009/01) ) ACORD { All rights reserved. The ACORD name and logo are registered marks of ACORD RadianceRail' System · consult your local building codes for Visit www.timber tech.com/b~stallation to view 1imbed'ach installation videos, guard and handrail requirements. RadianceRail kits are available in 6' or 8' lengths. Measure Your Railing Area · Measurements are from center to center of post. Kits are produced to 6' and 8' to allow for finished end cuts and angles. · Determine how many 6' or 8' RadiaoceRail Kits you need and check to be sure you have all the components (and quantities) fisted in the chart and shown to the right. Important Information · RadianceRail 6' and 8' Kits are desiBned not to exceed 6' and 8' center of post to center of post, respectively. · For stair applicaUons maximum rail lenEttl must not exceed 9!" for residential applications and 87' for non-residential applications. · 4x4 lumber posts or'fimberTech post mount system should be installed plumb. · Cut slowly, using a fine tooth saw blade to avoid chipping. Component Dimensions Top Rail Tools Required · Miter Saw · Drill · 7/64" and 3/16" drill bits · Tape Measure Components Needed For Installing One RadianceRail System Components ! - Top Rail Included in 6' ! - Bottom Rail and 8' Kits 2 - Support Rails Foot Blocks - 1 in 6' Kits -2 in 8' Kits Square Balusters -13 in 6' kits -18 in 8' Kits Hardware Hardware Mounting Kit Included in 4 - Mounting Brackets 6' and 8' kits 4 - Support 8locks !2 - #8x3/4' Screws 6 ~ #8x2" Screws 16 - #8x3" Green Coated Screws *Support Block Mounting Templates Onlytwo support blocks are required for straight and angled sections. Four are required for each stair rail. Baluster Screw Baluster Screw Kit-6' Kits Kit-8' Kits 13 - #8x2" Coated 18 - #gx2" Coated Screws Screws 13 - #8x3" Coated 18 - #8x3" Coated Screws Screws T-20 torx driver bit Additional 2 - Post Covers Components 2 - Post Caps Needed for Each 2 - Post Skirts System PostCap (2) --~ Mounting Bracket (4~ Post Cover (2) Support Brock (4)* I I Post Skirt 'lop Rail. (!) = rr'-I support Ralt (2) ~ ~--- BaLuster Support Block MounUng Templates (1 ofeach) (Detach from carton) (18 in 8' kit) 03 in 6' kit) Bottom Rail (1) Foot Block (2 in 8' kit) (! in 6' kit) Railing Product Choices RAILING & Size RAILING ACCESSORIES RADIANCERAIL~ 6' RadiauceRait ~it-Squom Balusters 6' tength - 36" high X X X X X 6' ~ength - 42" high X X X X X 6' RadienceRail I~t-Square Balusters 8' length - 36" high X X X X X 6' length - 42" high X X X X X TOD Reit Balk Compenent 6' length X X X X X Bottom Reit Bulk Corspoeeat (no p~dril~ holes) 6' length X X X X X Supped Rail Rulg Component 6' length X X X X X Radiance Rail Baluster, Sand Square 12' ~eflgth X X X X X Hardware Mounting Kit Post Couer her 4x4 Post (use with 36" rails) 5' x 8"x42" X X X X X Post Cover for4x4 Post (use with 42" rails) i" x F'x ]2' X X X X X Past Cap and Pout Skirt ~A X X X X X OR#AM~A~ RAIL 6' Oreamee~l Rail Kit: g' length X X X 8' ~flamentai RaH Kit: 8' length X X X 6' 8alnetes Kit, ]6 Pre-Cut Sotid Square, 36"rad bt. ~3"x L3r'x 27" X X X B' 8aluste~ Kit, 20 Pre-Cut Solid Square, 36" reit hr. lYx i.Yx 27" X X X Post Cover for 4x4 Post 4.25" x 4.25' x 4' X X X 4.25" x 4.28" x ~2' X X X 8etustec Solid Square 13~'xl,Y xl2' X X X Past Cap enit Pout Skir~ i ~A X X X 8Ut~ERRAIL~- 6' BuiMerRail ~it: 6' length X X X Black C~esic Metal Balusters 38" high / 42" high 8' 8uilderRail I~: B' )ength X X X Black Classic Metal Balusters 38" high / 42" high 8' 8uildarRait Stair ~t: B' length X X X Black Classic Metal Balusters 38" high / 42" high RuilderRail Post Brackets 90° X X X BuitderRail $kair t25° X X X P~t Brackets RuitderBoard" Rails 6' or B' lengths X X X Post Cap and Past Ski[t N/A X X X * tJse Orsnamestal Rail Post C~s and Post Skirts with RaildesRail ADA #MD RAiL SYSTEM Grab Rail with Alursinurs tnnert ].5'OD x 104" X X A~umiflurs Joiner Kit !"OD x Inside/Outside Comer I-1/2"OD x 4"x 4" X X Iniine Waif Mount Bracket 3" X X Inside Comer 90° Standoff Bracket 6-1/4" X X End Cap 1-i/2' X X Raniticap Loop lB" x 12" x lB" X X Adjustable Internal Joiner 90° Return Bracket 3.75" x 3.5" X X External Swivel Connector X X Standoff Bracket 3" X X SECURE-MOUNT POST SYSTEM Souore-Mnent Post 36" - Adjusts to 42" high if needed Oecit ~untinit I(it (includes ~e~lieit Idt) Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631 ) 765-1802 Fax (631 ) 765-9502 BUILDING DEPARTMENT TOWN OF SOUTHOLD June 16, 2011 Matthew Stanton 2725 Wells Avenue Southold, NY 11971 TWO WHOM IT MAY CONCERN: The Following Items Are Needed To Complete Your Certificate of Occupancy: Application for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. ~ A fee of 50.00. Final Health Department Approval. Plumbers Solder Certificate. (All permits involving plumbing after 4/1184) ~J Trustees Certificate of Compliance. (Town Trustees #765-1892) __ Final Planning Board Approval. __ Final Fire Inspection from Fire Marshall. Final Landmark Preservation approval. BUILDING PERMIT: 35920-Z deck KENNETH BABITS-ARCHITECT 127 CAROLINE AVENUE PORT JEFFERSON, N,Y. 11777 631-331-1798 'x , ;/ /., / .. / . , · / , ,, / / /' / / / ,, , .. | . ., , / /' . .*" /X,;/ / . /' / / ,R RETAIN STORM WATER RUNOFF PURSUANT TO CHAPTER 236 OFTRETOWN CODE. APPROVEDAS NOTED DATE'/.~J/,,'m BP.# NOTIFY BUILDING DEPARTM' "~ 765-1B02 8 AM TO 4 PM FL,[ I FOLLOWING INSPECTIONS I FOUNDATION - TWO REO FOR POURED CONCRET[ 2, ROUGH-FRAMING, PLUMBiNG 't USE 18 UNLAWFUL , FINAL'CONSTRUCtION& ' ' ;L,r ALL CONSTRUCTION SHALL MF~ WITHOUT CERTIFICATE 0¢ OCCUPANCY REQUIREMENTS OFTHE CnDSC DESIGN OR CONS~UCtlON