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HomeMy WebLinkAbout36415-ZTown of Southold Annex 54375 Main Road Southold, New York 11971 7/15/2011 CERTIFICATE OF OCCUPANCY No: 35067 Date: 7/15/2011 THIS CERTIFIES that the building Location of Property: SCTM #: 473889 Subdivision: ADDITION/ALTERATION 1035 Calves Neck Road, Southold, Sec/Block/Lot: 63.-7-32 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 5/3/2011 pursuant to which Building Permit No. 36415 dated 5/24/2011 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: two dormers for unfinished attic and a replacement window. The certificate is issued to Fitzpatrick, Patricia (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit #: 36415 Date: 5/24/2011 Permission is hereby granted to: Fitzpatrick, Patricia 1035 Calves Neck Rd Southold, NY 11971 To: Additions to a Single Family Dwelling; Covered Front Porch, Dormers (2) & Window, as applied for. At premises located at: 1035 Calves Neck Road, Southold SCTM # 473889 Sec/Block/Lot # 63.-7-32 Pursuant to application dated To expire on 11/23/2012. Fees: 5/3/2011 and approved by the Building Inspector. CO - ADDITION TO DWELLING SINGLE FAMILY DWELLING - ADDITION OR ALTERATION Total: $50.00 $240.80 $290.80 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: 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 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 $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. 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. New Construction: Old or Pre-existing Bu~ Location of Property: !O2~ House No. Street Owner or Owners ofProperty: f~.t~_!_,r~ 'J~ I'~"-xt~'/t~' 'fh/-I~' Suffolk County Tax Map No 1000, Section ~/)5 Block Subdivision Permit No. Date of Permit. Health Dept. Approval: Planning Board Approval: (check one) Hamlet 7 Lot 27 Filed Map..~ ~-&at: ~ Appliea '~ ~~'/~, F ,~ {x Underwriters Approval: Request for: Temporary Certificate Fee Submitted: $ Final Certificate: (check one) TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ [ ] FOUNDATION 2ND [ [~ FRAMING/-~IAPPtN0~ [ [ ] FIREPLACE & CHIMNEY [ [ ] ROUGH PLBG. ] INSULATION ] FINAL ] FIRE SAFETY INSPECTION ] IIP.[ I~,~'I'~iT I~l~rRI/t~lOll [ ] FII~ RESISTANT PF. NETllATION REMARKS: DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH pLBG. [ ] FOUNDATION 2ND [ ] IN~J~TION [ ] FRAMING/STRAPPING [~]~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (R~_~_ [ ] ELECTRICAL (FINAL) R E MAR KS:/~ ~_~~~~_~ ~ T, OWN jOF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net I AY - 3 2011 BLDG. DEPT. TOWN OF SOUTHOLD PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Plamfing Board approval Survey_ Check Septic Form N.Y.SD.E.C. Trustees Flood Permit Storm-Water Assessment Form .... Mail to: Phorle: Building Inspector APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and sublnitted 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 wili issue a Building Permit to the applicant. Such a pem~it 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 fbr any pm'pose 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 alter 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 interinr, 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 lbr 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. ~ ~ (Sig~rporanon) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of'premises qS>/a~-"'~ kl~ '~']~f~-~ (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate ofricer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. l. Lgcation of land. on which proposed work wilt tlq?l House Number Street Hamlet County Tax Map No, 1000 Section ~.t~.~'-],'?-2~. Block Lot Subdivision Filed Map No. Lot 2. State existing use and occupancy of prem~es an~.;intende~t use and occupancy of proposed construction: a. Existing use and occupancy ~--'14-1~ fi/\ b. Intended use and occupancy ~--~lr'~.r,~v~['~ (2}4 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost ~ I~/~,//,, 5. If dwelling, number of dwelling units L If garage, number of cars Addition Other Work Fee Alteration'X,~ (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. Dirnensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height. Number of Stories 9. 10. Date of Purchase Dimensions of entire new construction: Front Height Number of Stories Size of lot: Front , Rear Rear .Depth Name of Former Owner [~.,~d~,[~-~[-O .Depth 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 14. Names of Owner of premises flJ/'I21t'~ '~glOlgtdress ~/-dq~t~ ~ ~Phone No.~} ' Name of Architect ~4.}aa::~b~ ,i~¢~_ Address ~'~1~,, Phone No~ Name of Contractor r-~O Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a fi'eshwater wetland? *YES~ NO __ * IF YES, SOUTHOLD TOWN TRUSTEE, S & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet ora 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', It' elleVati0n at any point o~n proferty is at 10 feet or below, must provide topographical~, data o~ survey. 18. Are thel~e~a~ay covenants and restrictions with respect to this property? * YES NO' * IF YES, PROVIDE A COPY. STATE OE.NEW YORK)' SS: COUNTY OF ) CONNIE D. BUNCH Notary Public, State ol New York No. 01BU6185050 Qualified in Suffolk County Comml~lon Expires April 14, 2~[~. being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to pertbnn or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his kmowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ~ '~2:~[-~( ,,clay of ~"g~,'&- _'~ 20JI Notary Public 'grgnature'o f-3;pp err 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 Permit No.: 7534A Date of Receipt of Application: April 4, 2011 Applicant: Patricia Fitzpatrick SCTM#: 63-7-32 Project Location: 1035 Calves Neck Rd., Southold Date of Resolution/Issuance: April 20, 2011 Date of Expiration: April 20, 2013 Reviewed by: Trustee Bob Ghosio Project Description: To add dormers and windows to the existing dwelling and add a covered porch over existing entrance. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the $outhold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the plan prepared by Chomo Associates dated April 4, 2011 and stamped approved on April 20, 2011. Conditions: A non-turf area between the two lower bulkheads to be planted with native vegetation. Inspections: Final Inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. Jill .~'~Doherty, ~ Bo~lrd of Trustees 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 # 0671C Date: July 15, 2011 THIS CERTIFIES that the addition of dormers and windows to the existing dwelling, add a covered porch over entrance, and a non-turf buffer area to be maintained between the two lower bulkheads At 1035 Calves Neck Road, Southold, New York Suffolk County Tax Map # 63-7-32 Conforms to the applications for a Trustees Permit heretofore filed in this office Dated April 4, 2011 pursuant to which Trustees Administrative Permit #7534A Dated April 20, 2011 was issued and conforms to ali of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the addition of dormers and windows to the existing dwelling, add a covered porch over entrance, and a non-turf buffer area to be maintained between the two lower bulkheads The certificate is issued to PATRICIA FITZPATRICK owner of the aforesaid property. BUILDING PERMIT EXAMINER CHECKLIST SCTM# 1000~ ~..,g ~ 7 m ~09_ Subdivision: Property Address: *Date Submitted: ,5--.3--}\ Date Reviewed: Estimated Cost: Zone: ~-¥o Conforming? City: ~ Pre COs? Building Permits (Open/Expired): BP__ -z / c/0 z- , Info: BP __-Z / C/0 Z-__, Info: BP -Z / C/0 Z-___, Info: BP __-Z / C/0 Z-__., Info: BP__-Z / C/0 Z-__, Info: __ Single & Separate Search Required? Y or'Determination: ' R.EQ. Lot Siz. e: ¢0/( ACT. Lot Size: ~'-~6 ~ (' K6'~),REQ. Lot Coy. D'~ ~t~ ACT; Lot Cov. REQ. Front_~__ A--C~.Front ?0q- REQ Side /5 ACT. Side om REQ. Re~-_.~'~ PROP. Rear ~ Waterfront~//or N? ¢ - f. .11 -~ w w v..~ .~.~ Ifyes, waterbody: ~7~t~z'-~-¢r~)/~-Zon~e.'X~~~ ADDITIONAL APPROVALS REQUIRED Suffolk County Health: Y o~ If yes, *Bed//: *Date: / / *Permit#: Town Septic: Y or }q - If no, certification required: Y or N Received: Y or N By: NYS DEC: ea~4mc 9a/Ts Y o~- Date: / / Permit #: or NJ Letter - Notes: Southold Trustees~)or N~ Date: /~/~a/I~ Pernfit ~: ~fl~or NJ Letter- Notes: Southold ZBA: Y o~ Date: / / Permit ~: - Notes: Southold Planning: Y o~- Date: / / Permit ~: - Notes: To~n Laqdmar[~ of A:y o~D~ k ./ / ~ o~ A a ~ CODE Compliance (page 2)~or N Fee Structure: Foundation: '"'- SF First Floor: 3 o SF Second Floor: 7~2-- SF Other: SF Total: [0o9.-- SF Calculation: I 0~ X $ ~ ~t°'=$ + Initial Fee: + Additional Fee ( ): SF X $ + Initial Fee: + Additional Fee ( ): TOTAL: $ q-o. o o, o o )-°Co,go NEW YORK STATE CODE COMPLIANCE CHECKLIST CLIMATIC/GEOGRAPHIC DESIGN CRITERIA: Grounll Snow Load: Weathering: Severe __ Frost Depth: 36"__ Design Temp: 11 __ · Ice Shield Underlay: YES . USE/OCCUPANCY CLASSIFICATION: HEIGI:IT/FIRE AREA: TYPE OF CONSTRUCTION: DESIGN CI~ITERL&: ENGINEERED/pREscR]I~TIVE FULL FRAMING DESIGN ELEMENTS: Y/N HEADERS: Y/N WALL STUDS: Y/N CEILING JOISTS: Y/N FLOOR JOISTS: Y/iN LU~BER SPECIES AND GRADE: Y/N Wind Speed: I20MPH__ Seismic Design Category/B . Termite: M-H Decay: S-M Flood Hazakds: GIRDERS: Y/N ROOF RAFTERS: Y/N W1NDOW AND DOOR SCHEDULE: ,MISSLE TEST REQUIREMENTS: Y/N EGRESS 5.7 S.F.: Y/N LIGHT 8%: Y/N '~rENT 4%: NAILING/CONSTRUCTION SCHEDULE: Y/N MEANS OF EGRESS: Y/N PLUMBING RISER DIAGRAM: Y/N LOCATION OF F[P,~ PROTECTION EQUiPMENT: Y/N TRUSS DESIGN: Y/N CERTIFICATION: Y/N ENERGY CALCS: Y/N TOTAL COMPLIENCE? Y/N (RETURN TO PAGE ONE) e Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C.T.M.~ THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A o~tr~ct S~_~io~ 7 ~- STORM-WATER~ GRADING, DRAINAGE AND EROSION CONTNOL PLAM ek~x ~ot G"k, ,rll:U BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUL,'t'ION rf~Vl # / WORKASSESSMFJWI' ] Yes No a. What is the Total Area of the Project Parcels? {include Total ^ma of all Parcels located within~_~t~I I Will this Prelect Retain All Storm-Wafer Run-Off the Scape of Wank for Propeaed Construction) .¥'t -- Genemteq by a Two (2') inch Rainfall on SRO? (S.F. t ~*) (This item will include all mn-off created by site '~ b. What is the Total Area of Land Cleating cleadng and/or construction acti'dties as well as all and/or Ground Disturbance for the proposed Site Improvements and the pennanerd creation of construction activity? impervious surfaces.) (S.F.,,~,) 2 Does the Site Plan and/or Survey Show All Proposed ~ PROVIDE BRIEF PROJ'ECTF DF~CRIFTION ~mv~ ~ Pages e~ Nee~ee) Drainage Structures Indicating Size & Location? This Item shall include all Proposed Grade Changes and ~[~[-~ -~__~_~.~__/ Slopes Controlling Surface Water Flow. · ~l;l.t~~ t~1~ t-l+v~ A6 Ukll' ~ ~,l~"9ok.~ 3 DoestheSitaPlanand/orSurveydescfihetheeresion~ and sediment control practices that will be used to - ' control site erosion and storm water discharges. This · ~[~ ~..~-~'1~ ~1; (~.lt~"y~ t~ ~ item must he maintained throughout the Entire '~, Co~stroction Pedod. 4 Will this Project Require any Land Filling. Grading or Excavation where there is a change to the Natural Existing Grade Involving more than 200 Cubic Yards~ __ of Material within any Parcel? S Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand (5.000 S.F.) Square Feet of Ground Surface? 6 Is there a Natural Watar C°urse Running threugh the I~! Site? Is this Preject within the Trustees jurisdiction ~eneral DEC 8WPpp Requir~ments: or within One Hundred (100') feet of a Wet/and or Submlsslo~ of a SWPPP ~ requited for all Co~strucSon activRles Involving soil Beach? 'disturbances of one (1) or more acres; including disturbances of less than one acre that 7Will there be Site preparation on Existing Grade Slopes ~ ~'~ am pa~t of a larger common plan that will u#imathly disturb one or mom acres of land; which Exceed Fifteen (15) feet of Vertical Rise to [ i irx~uding Construction activRies involving soil d~lurbancss of ~ess than one (1) acre where One Hundred (100') of Horizontal Distance? I~l -- the DEC has dethnm~ed that a SPDES permit is required for storm water dischargss. Nol&ry ruinr~, ~,, ,,, ........ STAIIE OF NEW YORK, No. 01806185050 COUNn_'Y OF ........................................... SS Qualified in ~uffotk County ,. Oomml~alon E~plre~ April 14, That I ................................................................................. being duly sworn, deposes and says that be/she is the applicant for Permit, And that he/she is the ............................................ (~;.'~ig{ 7~;17~i; ~.';'t~i ................................................................ Owner and/or representative of the Owner or Owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his 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 ............................................. day of ,X.,......~:..~..~ ........................ 20j.I. ,~,,~ ~ .,' Nto Pubhc.'' ~ "' /.~: 1....' 'k-__ ' x .................... ................ ................... : ................ (Signalu~e of Applicant) FORM - 06/10 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 OFSOUTHOLD June 30, 2011 Patricia Fitzpatrick 1035 Calves Neck Road 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 a~ter 4/1/84) Trustees Certificate of Compliance. (Town Trustees #765-1892) __ Final Planning Beard Approval. __ Final Fire Inspection from Fire Marshall. __ Final Landmark Preservation approval. BUILDING PERMIT: 36415-Z dormer additions and window ACO ZO CERTIFICATE OF LIABILITY INSURANCE [ oA.,. ,o6/19/2Oll THIS CERTIFICATE I$ I~UED AB A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the cenTiMe hol~er Is an ADDITIONAL INSURED, the policy(ins) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain pollcl~ may require an endomemenL A statement on thIs cerUflcote doe~ not confer rlghte to the certJflcote holder In lieu of such endomemeotis). PRODUC£R GEORGE FORMES NCO~N~AcT MANDI DINIZIO 1116 MAIN ROAD PO BOX 2336 AQUEBOGUE, NY 11931 RANDALL CLEMENT PO BOX 287 JAMESPORT, NY 11947 INSURED ~H~NNEo Ex~) 631-722~.100 ~.~C, ~.) 631-722~,500 ~ss: MAN DI_DINIZIO~FARMFAMILY.COM ~NSURER(S) AFFORDING C~R~E ~lC · INSURERA FARM FAMILY CASUAL~ INS CO 120 INSURER B: INSURER C INSURER D INSURER E iNSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT TH~ 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 TH~S CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. i GEN'L AGGREGATE LIMIT APPLIES PER: i i POUC¥ i JEST EXCESS UAB ) C~IMS-MADE j RETENTION $ OFF1CER~MEMBER EXCLUDED? 3101L7692 08/31/201C 08/3/2011 EACH OCCURRENCE [$ %000,000 i MEDEXp~ny~) m $ 5,000 ~ PERSO~L & ADV INJURY $ INCLUDED ; GENE~L A~RE~ $ 2,000,000 i P~OO~S C~.~ ~ 1,00b,~0O iEACH ~CURRENCE ~ A~RE~TE I$ 03/05/2011,03/05/2012i ) T~Y u~s E~ , ~ 100,000, 100,000 500,000 CERTIFICATE HOLDER CANCELLATION TOWN OF SOUTHOLD TOWN HALL 53095 ROUTE 25 PO BOX 1179 S©UTHOLD, NY 11971 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ~14E EXPIRAI~OR DATE THEREOF, NOI~CE ~ILL BE DEUVERED IN ACCORDANCE WIll THE POtJCY PROVpuONS. © 1988-20t0 ACORD CORPORATION. Alt Hghte reserved. ACORD 25 (2010/05) The ACORD name and logo am registered marks of ACORD SURVEY OF PROPER ..F PROPERTY LOCATED AT SOUTMOLO TOWN OF SOUTMOLO SUFFOLK COUNTY. NEW YORK S.C.T.M. # 1000-063-07-32 AREA = 24.6?9 SF. = 0.5666 ACRES SCALE: 1'=30' NOTE: THE EXISTENCE OF RIGHT OF WAYS. WETLANDS AND/OR EASEMENTS OF RECORD IF ANY. NOT SHOWN ARE NOT GUARANTEED. PROPERTY IS CLEARED IN ITS ENTIRETY (TO TIE LINES) LAND N/F HOLMAN CONC. TOWN CREEK N 21°55'55'E 8.94'~ 45.7' LAND N/F BJERKNES ~AY 2 0 2011 BLOC DEPI. TOWN OF SOUTHOEO PATRICIA FITZPATRICK LAWYERS TITLE INSURANCE COMPANY 2185 N 74 POLE 65.0 0.4D SURVEYED BY: STEVEN BARYLSKI N.Y.S. Lie. No. 858453 41 MEETING HOUSE LANE SOUTHAMPTON. N.Y. 11968 MAY 14, 2010 COMPLY W!TH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED AND CONDITIONS OF SOUTHOLD TOWN ZBA SOUTHOLD TOWN PLANNING BOARD SOUTHC[D TOWN TRUSTEES ~ o ' ~ PROVED AS NOTED ELECTRICAL ~/~/'__ -- /Bp# 3 ~/~z/~- INSPECTION REQUIRED :32' 8-AM TO 4 ~ F~ ~E , JW~NG INSPECTIONS: FOUNDATION - ~ REQUI~ FOR POURED CONCh/ qOUOH - F~I~, ~~ STRAPPING. ELECTRI~ ~ CAULKI~ ~.su~ ~ F,..L- CO.S~ ~Ca~ MUST ~ ~.~.C.p. ,LL c~~ ~ ~, REQU~REaENIS ~ ~ ~S YORK ~A~. ~~~ · t~ ! DATE: 4-4-11' FITZPATRICK RESIDENCE 1035 CALVES NECK RD SOUTHOLD NY CHORNO ASSOCIATES architects. SO~JTHOLD, NEW YOI~K