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Home My WebLink About36469-ZTown of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 3/7/2012 CERTIFICATE OF OCCUPANCY No: 35478 Date: 3/7/2012 THIS CERTIFIES that the building Location of Property: SCTM #: 473889 Subdivision: BASEMENT ALTERATION 175 The Cross Way, East Marion, Sec/Block/Lot: 30.-2-14 Filed Map No. conforms substantially to the Application for Building Permit heretofore 6/7/2011 pursuant to which Building Permit No. 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: Alterations to a Single Family Dwelling: Lot No. filed in this officed dated 36469 dated 6/10/2011 Finished Basement with Bathroom as applied for. The certificate is issued to Deluca, Robert & Lisa {OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 1/30/12 36469 12/16/11 Jr's Plumbing & Heating ~d ~ignature 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 #: 36469 Date: 6/10/2011 Permission is hereby granted to: Deluca, Robert & Lisa 175 The Crossway East Marion, NY 11939 To: Alterations to a Single Family Dwelling; Finished Basement with Bath, as applied for. At premises located at: 175 The Cross Way,East Marion SCTM # 473889 Sec/Block/Lot # 30.-2-14 Pursuant to application dated To expire on 12/9/2012. Fees: 6/7/2011 and approved by the Building Inspector. CO - ADDITION TO DWELLING SINGLE FAMILY DWELLING - ADDITION OR ALTERATION Total: $50.00 $502.80 $552.80 Building Inspector 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 ApprovaI 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, Cominercial $15.00 New Construction: Location of Property: Owner or Ownem of Property: Suffolk County Tax Map No 1000, Section Subdivision Old or Pre-existing Building: House No. Permit No..~, % 9 Date of Permit. Date. (check one) Street Block Hamlet Lot 2¥ Filed Map. Lot: / / Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Final Certificate: ~ (check one Applicant Signature Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Telephone (631 ) 765-1802 Fax (63 I) 765-9502 ro.qer, richert~,town.southold.ny.us BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION ssued To: DeLuca Address: 175 The Crossway City: East Madon St: NY Zip: 11939 ]uilding Permit #: 36469 Section: 30 Block: 20 Lot: 14 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Grove Electric LicenseNo: 48401-me SITE DETAILS Office Use Only Residential ~ Indoor [~ Basement ~ Service Only ~ Commerical Outdoor 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 3 ph Hot Water GFCI Recpt Main Panel NC Condenser Single Recpt Sub Panel NC Blower Range Recpt Transformer Appliances DrTer Recpt Disconnect Switches Twist Lock Other Equipment: Ceiling Fixtures ~[~[~ HID Fixtures Wall Fixtures Ill Smoke Detectors Recessed Fixtures CO Detectors Fluorescent Fixtur(~ Pumps Emergency Fixture Time Clocks Exit Fixtures I I TVSS 1-exhaust fan, 1 dead front GFCI, 3-ARC fault circuit breakers Notes: Inspector Signature: Date: Dec 16 2011 81-Ced Electrical Compliance Form CERTIFICATION (Please print) Plumber: (Plea~'l~rint~ I certify that the solder used in the water supply system contains less than 2/I 0 of I% lead. Sworn to before me this HILARY L. HOFFMAN NOTARY PUBLIC, STATE OF NEW YORK QUALIFIED IN SUFFOLK COUNTY REG. # 01 HO6234316 MY COMM EXP 01/18/2015 Notary Public, _._...~_~_~.~--01 ~ .County TOWN OF SOi~~~~~ BUiLDiNG DEPT. []FOUNDATION 1ST []FOUNDATION 2ND []FRAMING / STRAPPING []FIREPLACE & CHIMNEY 765-1802 I NSPEC/TiON [~,/] ROUGH PLBG. [ ]INSULATION [ ]FINAL [ ]FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: /~~- ~/~-~/~(~, ~'/~--~ INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-18O2 INSPECTION [ ] FOUNDATION 1ST [,~'"] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING / STRAPPING ] FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] INSULATION [~FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUC'nON [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRIPfAL (FINAL) REMARKS: DATE WN OF SOUTHOLD BUILDING DEPT. 765-18O2 INSPECTION ] FOUNDATION 1ST ] FOUNDATION 2ND ] FRAMING / STRAPPING [ [ ] FIREPLACE & CHIMNEY [ [ ] FIRE RESISTANT CONSTRUCTION [ ] ELECTRICAL (ROUGH) REMARKS: [ ] ROUGH PLBG. [ ] INSULATION ] FINAL ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION ~,~ELEC'fRICAL (FINAL) DATE INSPECTOR~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ] INSULATION [ ]FRAMING/STRAPPING ~FINAL ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION ] ELECTRICAL (FINAL) [ ] FIREPLACE & CHIMNEY [ [ ] FIRE RESISTANT CONSTRUCTION [ [ ] ELECTRICAL (ROUGH) [ REMARKS: DATE -~ '~ -/~''- INSPECTOR · TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork. net Expiration ?e~__ i/~) ,20 J,e'~ JUN - 2011 BLDG. DEPT, TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, betbre applying? Board of Health ~ 4 sets of Building Plans Planning Board approval '~ Survey Check ~.~_~(~ 4- ~ Septic Form N.Y.S.D.E.C. I rustees Flood Permit Single & Separate Stol'm-Water Assessment Form Building Inspector APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date {a .20i( a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector ~itb 4 sets of plans, accurate plol plan to scale. Fee according to schedule. b, Plot plan showing location of lot and of buildiags on premises, relationship to adjoining premises or public streets or areas, and waterways. c. Tire ~ork covered by this applicatioa may not be colnmenced before issuance of Building Permit. d. Upon approval of this application, tire Building Inspector will issue a Building Permit to the applicant, Such a permit shall be kept on the premises available for inspection throaghout tile work. e. No building shall be occupied or used in whole or in part tbr any purpose what so ever tmtil tire Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire i£tbe work authori:,ed has not commenced within 12 months after the date of issuauce or has not been completed within 18 months [?oln such date. If no zoning amendments or other regulations affecting the property have been enacted in tire iaterim, the Building Inspector may authorize, ia writing, the extension of the permit for an addition six months. Thereafter, a new permil shall be required. APPLICATION IS HEREBY MADE to tire Building Department for the issuance ora Bailding Permit pursuant to tire Building Zone Ordinance of the Town of Soutbold, 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. Tire applicant agrees to comply with all applicable laws, ordinances, bnilding code, housing code, and regulations, and to admit authorized inspectors on premises and ill building for necessary inspections. (Signature of applicant or name, ifa corpolation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder .( Nalne of owner of premises flog ~ (As on the tax roll or latest deed) If plicant is c p tion. sign ture of duly uthorized officer (Name and title .of comorate officer) Builders License No. ~t.~-,~ q, r - ~ Plumbers License No. _...~;~ 6£ ~ Oql0 Electricians License No. g,,it~,. ~t}.l ()the T ades L cense No. Location of land on Milch proposed work will be done: House Number Street llanllet County Tax Map No. 1000 Section .~'0 Block ~v,.~ Lot / Subdivision Filed Map No. Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy "~;w;~ ~o-Rmt. t ,~,o""/w- 3. Nature of work (check which applicable): Nexv Building Addition Repair Removal Demolition Other Work 4. Estimated Cost q~,~>O OO Fee Alteration~ 5. If dwelling, number of dwelling units If garage, number of cars 6. If business, commercial or mixed occupancy, spec'ify natui'e ~t extent~' each type of use. (Description) (To be paid on filing this application) Number of dwelling units on each floor 7. Dimensions of existing structures, if any: Front Height. Number of Stories Rear Depth Dimensions of same structure with alterations or additions: Front Depth Height_ Number of Stories Rear 8. Dimensions of entire new construction: Front Height Number of Stories Rear Depth 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO,~ 13. Will lot be re-graded? YES NO ~ Will excess fill be removed from premises? YES NO of premises~,~av[~:tl' "~.~. Address [ 71"~.t~$ ~,-'~%. Phone No./~'~ 7-~'0 '~ 14. Names of Owner Name of Architect ROJ-ke R'[- bO~l ~ Address one'" No Name of Contractor .~'ttt~¥ ~,-, ,~,t-e,.a.,~t]2~ PhoneNo. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWSXI TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet eta tidal wetland? * YES NO * IF YES, D.E.C. PERM1TS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate tbundation 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 ~' · IF YES, PROVIDE A COPY. STATE OF N~J~K) COUNTY OFt-_'~.~ [4/)l~ ZC[J,.O ~, ~ .~ !O h } &~/"----~ being du,~ swor,~, deposes and sa~s that (s)he is the applica,,t (NSaS'm~e (~f i~i~idu~ s~gning contract) above named, (S)He is the (Contractor, Agent, Corporate Officer? etc.) of said owner or owners, and is duly authorized to perfm'm 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 mauner set forth in the application filed therewid~. Sworn to before me this ~ 7 day of ~ [.1~ 20 // Notary Pd'61~' ~1;,~1~06190696 Qualified n Suffol~ ~un~, ~ ~mmission Exp res July 28, 20 ~ Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 REQUESTED BY: Company Name: Name: License No.: Address: Phone No.: Date: JOB$iTE INFORMATION: *Name: *Address': *C~et: (*Indicates required information) *Phone No.: · Permit No.: Tax Map District: 1 ooo Section: Block: *BRIEF DESCRIPTION QF WORK (Please Print Cleady) ~ Lot: (Please Circle All That Apply) *Is job ready for inspection: *Do you need a Temp Certificate: Temp Information(If needed] *Service Size: 1 Phase *New Service: Re-connect Additional Information: 3Phase 100 Underground YES / NO Rough In YES / NO Final 150 200 300 350 400 Other Number of Meters Change of Service Overhead PAYMENT DUE WITH APPLICATION 82-Request for Inspection Form , U LDING PERMIT EXAMINER CHECKLIST Applicant: SCTM# i000- gO Property Address: Building Permits (Open/Expired): BP__ BP -Z / C/0 Z-__., Info: *Date Submitted, ~- 6 --I I Date Reviewed: Subdivision: Info: -Z/C/0 Z- BP -Z / C/0 Z- ACT. Side Single & Separate Search Required? Y o~ Determination: REQ. Lot Size: ACT. Lot Size: REQ. Front ACT. Front REQ Side Estimated Cost: j~> ~ ~' ~- Zone: Conforming? City: ~~Pre COs? BP -Z / C/0 Z- , Info: BP __-Z / C/0 Z- , Info: REQ. Lot Coy. __ ACT; Lot Coy. __ REQ. Rear PROP. Rear REQ. Height. ACT. Height R E~. ~oTH SlO~5 A CT Project Descrintion:~, "~ ~ t~.__ ~~,~d ~--~~ d~--~--;' ' ~ Waterfront? Y o~ - ~ ~ ~ / ff Ify~, water body: Panel~ Flood Zone: BUl~ead/BluffDistance: ADDITIONAL APPROVALS REQUIRED pktl~/S(~r) $1,$w~-I).,..q,e'~/_[/~ SUeVe.¥ OR SITE PL.~N Suffolk County Health: Yor If yes, ~Bed#: *Date: / / ~Permit#: Town Septic: Y-hi - If no, certification required: Y or N Received: Y or N By: NYS DEC: PRE-DEC 9/I/75 Y or~- Date: Southold Trustees: Y 0¢- Date: / Southold ZBA: Y o~- Date: / / Southold Planning: Y o~_.~- Date: / / Town Landmark C of A: Y o~DTE: / Notes: / / Permit #: / Permit #: Permit #: Permit #: L I~BIL ~ TY or NJ Letter - Notes: or NJ Letter - Notes: - Notes: - Notes: *NYS CODE ~_ompliance (page 2): Y or N Fee Structure: Foundation: SF First Floor: SF Second Floor: SF Other: ~g~ 7.5-7 SF Total: SF Calculation: 7J-7 x$.qo4 3 o9., ¥o + Initial Fee: $ ~-~ 00, O O + Additional Fee ( ): $ SFX$, :$ + Initial Fee: $ ob" + Additional Fee ( ): $ C oF o F~~0,00 as 6UlLT re~ '---'- TOTAL:$ -~0g1''~7'0 NEW YORK STATE CODE COMPLIANCE CHECKLIST CLIMATIC/GEOGRAPHIC DESIGN CRITERIA: Grountl Snow Load: ~.0. Wind Speed: 120MPH Seismic Design Category." B . Weathering: Severe ~ . ·Frost Depth: 36" __ Design Temp: I 1 · Ice Shield Underlay: YES, USE/OCCUPANCY CLASSIFICATION: · HEIGIZlT/FIRE AREA: TYPE OF CONSTRUCTION: DESIGN CRITERIA: ENGINEERED/PRESCRIPTIVE FULL FRAMING DESIGN ELEMENTS: Y/N IlEAl)ERS: YfN WALL sTUDs: YfN CEILING JOISTS: Y/N FLOOR JOISTS: LUIM[BER SPECIES AND GRADE: YfN Termite: M~H' Decay: S-hi Flood Hazai'ds: GII-kD ERS: Y/N ROOF RA1TTERS: Y/N WI3qDOw AND DOOR SCHEDULE: · MISSLE TEST REQUIREMENTS: Y/N EGRESS 5.7 S.F.: Y/N LIGHT 8%: YIN 5qgNT 4%: Y/N NAILING/CONSTRUCTION SCHEDULE: Y/N MEANS OF EGRESS: Y/N PLUMBING RISER DIAGILAM: YfN LOCATION OF ItlP, JE PROTECTION EQUIPMENT: Y/N TRUSS DESIGN: Y/N CERTIFICATION: Y/N ' E ,n P. GY CALCS '4 TOTAL COMPLIENCE? Y/N (RETUI~N TO PAGE ONE) STATE OF NEW YORK WORKERS' COMPENSATION BOARD CERTIFICATE OF NYS WORKERS' COMPENSATION INSURANCE COVERAGE la. Legal Name & Address of Insured (Use street address only) SUNVIEW ENTERPRISE )NC 275 MAIN ST EAST SETAUKET, NY 11733 Work Location of Insured (Only required if coverage is specifically limited to certain locations in New York State, £e., a Wrap-Up Policy) 2. Name and Address of the Entity Requesting Proof of Coverage (Entity. Being Listed as the Certificate Holder) Town of Southold 53095 Route 25 Southold, NY 11971 I b. Business Telephone Number of Insured (631)872-3381 lc. NYS Unemploymentlnsurance Employer Regi~ration Number oflnsured 48854889 Id. Federal Employer Identification Number of Insured or Social Security Number 26 - 3406662 GUARD INSURANCE 3b. Policy Number of entity listed in box "la": SUWC241329 3c. Policy effective period: 04/01/11 04/01/12 _to 3d. The Propietor, Partners or Executive Officers are: ~ included. (Only check box if all parmers/ofricers included) [] all excluded or certain partners/officers excluded. This certifies that the insurance carrzer 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 of the workers' compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the en%ity listed above as the certi~cate holder i~ box "2". The Insurance Carrier will also not[Iv the above certificate holder within I 0 d~E~' IF a polk'y is canceled due to nonpayment qf premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the polity or eliminate the insured from the coverage indicated on this Certificate. (The.~e 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 I 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. Approved by: Joanne Swetman Approved by: (Print name of authorized representative or licensed agent of insurance carrier) 06/14/11 Title: (Signature) (Date) Director 877-266-6850 Telephone Number of authorized representative or licensed a~ent of insurance carr~er~ Please Note: Only insurance carriers and their licensed agents ar(, authorized to issue the C-105.2 form. Insurance brokers are NOT authorized to issue it. C-105.2 (9-07) www.wcb.state.ny.us STATE OF NL~V YORK WORKER'S COMPENSATION BOARD CERTIFICATE OF INSURANCE COVERAGE UNDER THE NYS DISABILITY BENEFITS LAW PART 1.To be completed by Disability Benefits Carrier or Licensed Insurance Agent of that Carrier Legal Nm~e ~d Addre~ of th~Jr~ (Use iu~el addres3 only) SUNVlEW ENTERPRISES CORP 561A LAKE AVENUE SAINT JAMES, NY 11780 lb. Business Tellphof~ Number of Iml~ 631-872-3381 1~. NYS Unemployment Inswam En~ieyer Regisirltion ld. Frei Employm' Identlfl~ati~ Numbe~ of Insured o~ Segial Security Nu~ 263406662 2, Name and Address of the Entity requesting Proof of Coverage (EMity being listed as the Ceftifloatl Holder) ~. Nm of It~mat~ge Ca~ie~ The First Reh~aUon Life range TOWN OF SOUTHOLD PO BOX 1179 SOUTHOLD, NY 11971 Comperty of ~ ;lb. Policy Numbe~ of Entity I~s~d in box"la": DBL322521 POliCy effegtiw NIod: 07113/2010 to 07/12/2012 4, Policy covers: a. [] All of the employ~"$ empleyee~ eligible undo' the New YO~ Disability Benefitl Law b. [] Only the following eli~ or oL~__~__ of the ~loy~'s ~ploy~: Undm- penalty of p*w, jury, I ;ettify that I am in authori~ r~p~sentltive ot l ioemad igent of the imrlm carrl~ rofe~nced abov~ .nd that ~he m~ed Ineur~l ha~ NYS Disability Benefits insurance ~ as cM~ribed ab~we. D~ Signed By Telep~me Number 516-829-8100 Title Chief Executive Officer PART Z. To be completed by NYS Worker's Compensation Board (Only if box "4b" of Per~ 1 has been checked) State of New York Worker's Compensation Board Dato Signed By Telephone Numl~r Titl~ Plesee N~te: Only in~urln;e earriers II;tn-,M to va*itl NYS Disability Be~ofits insurance poll¢let and NYS Li~ Int~w~ Agenu of those ir4ur~nee cart ler~ a~e authorized to issue F~nn DB.120.1. Im4wlnge brokm~ a~e NOT ~uthorized to isK~ thll form. DB-120.1 (5-06) Additional Instru=tions for Form DB.120,1 By signing this form, the insurance carrier identified in Box "3" on this form is certifying that it is insuring the business referenced in Box "la' for disability benefits under the New York State Disability Benefits Law. The insurance carrier or its licensed agent will send this Certificate of Insurance to the entity listed as the certificate holder In Box '2". T~lls ~tificate is vllid fl~ one year after this form il ~ by the tarrier or its lac em ed a~ent, or the p~fiey mq:lication date listed in Box Please Note: Upon the cancellation of the disability benefits policy indicated on this form. if the business continues to be rained on a permit, license or contrect J~sued by a certificate holder, the business must provide that ce~tificete holder with a new Certificate of NY$ Disability Benefits Coverage or other authOriZed proof that the business is compJying with the mandatory cover ~ge requirements of the New YOrk State Disability Benefits Law. DISABILITY BENEFITS LAW Section 220. Subd. 8 (a) The head of 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 employment of employees in employment as defined in this article, and 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 law to enter into any contract for or in connection with any work involving the employment of employees in employment as defined in this article, and notwithstanding any general or special statute requiring or authorizing 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 CERTIFICATE OF LIABILITY INSURANCE ~ATE ~ ~ AFFI~LY ~ NErViLY A~ND, EXTEND OR AL~R ~E C~E~ ~EO BY ~E P~CIE~ ~L~. ~ C~A~ OF IP~U~NCE D~8 NOT C~ A CON~ B~EN T~ ~ ~U~8), A~O~D ~P~E~A~ ~ PR~UCER, AND ~E C~A~ H~DER. 45 Ro~ 25A sure D2 ~: ladle ~bber~mtly.~m S~mham, NY 11786 ~)~Ne~ ~: Farm Fami~ CBEue~ Ins. ~. Sun~ Ente~ Inc, ~u~c: Po~ Jeffemon NY 11777 ~ ~: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO C=KHr¥ ~IAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTW~'H~i'ANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT wt'rH RESPECT TO WHICH THIS 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 MAY HAVE BEEN REDUCED aY PAID CLAIMS. A eE,m~LU~mU'rV 3152L9412 09/25/10 09/25/11 F. AC. OCCU~NCe $ 1,000,000 t c~lus-u~ ~ occu. ~.~u~s~s,~.o=.~-~) s 100,000 MED EXP IA~ ~ pe~*~) $ 5,000 X~ Contractual Liability ~.~SON~L & ^DY ~,~URy $ 1,000,000 -- C,;NERAC ^~EC~Te $ 2.000,000 GEN1. AGGREGATE LIM~r APPLIES ;ER: AROOUCT8 - COMP/DP ^GG $ 2,000,000 A ^~,~L~u~a~m, 3152C6729 11/25/10 11/25/11 CO~a.~OS~N;L=UU~' 1,000.000 ^ -- U~SU.~U~a L-~ OCCU. 3101El178 09/25/10 09/25/11 ~CHOCCUE~ENCE S 1,000,000 Sunroom, R~pl~cem~nt Window InStBIIBtion, O~rpentry -NOC CERTIFICATE HO{DER Town of Southold PO Box 1179 Southold, NY 11971 ACORD 25 (2010/05) CANCELLATION ~ 1988-2010 ACORD CORPORATION. All rlgl-~ r~erve<l. The ACORD name and logo are reglatered mark~ of ACORD REScheck Software Version 4.2.0 Compliance Certificate Project Title: DeLuca Basement Remodel Energy Code: 2007 New York Energy Conservation Construction Code Location: Su['folk County, New York Construclion Type: Detached '1 or 2 Family Heating Type: Non-Electric Glazing Area Pementage: Healing Degree Days: 5750 Construction Site; 175 The Crossway East Marion, NY 11939 Owner/Agent: Mr. and Mm. DeLuce 175 The Crossway East Marion, NY 11939 Compliance: 5,6/o Better Than Code Maximum UA: 179 Your UA: 169 Designer/Contractor: Brace Wholara Sunview Enterprise 561 A Lake Avenue St. James, NY 11780 631-872-3381 Ceiling 2: Flat Ceiling or Scissor T~uss 757 13.0 0,0 53 Wall 1: Solid Concrale or Masonry:interior Insulation 175 0.0 15,0 8 Window 2: Melal Frame with Thermal Break:Double Pane with 8 0.350 3 Low-E Door 1: Solid 19 0.350 7 Wall 2: Solid Concrete or Masonry:Interior insulation 175 0.0 15.0 10 Wall 3: Solid Concrete or Masonry:lnlerior Insulation 300 0.0 15.0 17 Wall 4: Solid Concrete or Masonry:interior Insulation 224 0.0 15.0 12 Window 1: Metal Frame with Thermal Break:Double Pane with 8 0.350 3 Low-E Ftoor 1: Structural Insulated Panels:Over Unconditioned Space 757 11.0 56 Furnace 1: Forced Hot Air 78 AFUE Air Conditioner 1: Elecldc Cenlral Air 13 SEER The proposed building represenled in this document is consislenl wit~v~;l~tions` and other calculalions submitted wilh this permll application. The proposed systems have been de~L~ . - . En~}rgy Conservation Construction Coda requirements. When a Registered Design Prolessional has ~'~.)g.[~. ~ ~ '~lky ~t:e attesting that to the best of his/her knowledge, belief, and professional jodgmenl, such plans or .,, ,' ., . - Name - Title t~~~ ~.,,~.~y/ . - Date Project Title: DeLuce Basemenl Remodel Report date: 05131111 Data flleceme: Unlitled,rck Page I of I ENGTNEERYNG DELUCA BASEMENT -PURCHASED THROUGH- SUNVIEW ENTERPRISE SHEET # G1 G2 G3 G4 G5 DESCRIPTION PLAN VIEW GENERAL ENGINEERING GENERAL ENGINEERING GENERAL ENGINEERING GENERAL ENGINEERING PLUMBING ALL PLUMBING WASTE & WATER LINES NEED TESTING BEFORE COVERING PLUMBER CERTIFICATION ON LEAD CONTENT BEFORE O ER TtFICA TE OF OCCUPANCY ,~OI. DER USED IN WA TER SUPPLY SYSTEM CANNOT EXCEED 2/10 OF 1% LEA[? NOTE: DIRECT VENT APPLIANCES AND APPLIANCES EQUIPPED WITH A COMBUSTION AIR KIT DO NOT REQUIRE ADDITIONAL COMBUSTION AIR. OTHERWISE, UNDER THE 2006 INTERNATIONAL FUEL GAS CODE ALL GAS-FIRED APPLIANCES (FURNACES, HOT WATER HEATERS, AND DRYERS) REQUIRE COMBUSTION AIR. COMBUSTION AIR SHALL BE HIGH AND LOW OPENINGS. ONE COMMENCING WITHIN 1 FOOT OF THE CEILING AND ONE COMMENCING WITHIN 1 FOOT OF THE FLOOR. LOUVERS MUST EQUAL 1 SQUARE INCH FOR EVERY 1000 BTU's OF ALL GAS FIRED APPLIANCES (METAL LOUVERS ARE CREDITED WITH 75% OF ITS TOTAL AREA). IF "UNFINISHED AREAS" CONTAIN FURNACE, HOT WATER HEATER, DRYER, ETC. THEN COMBUSTION AIR COMPLYING WITH THE ABOVE INFORMATION IS REQUIRED. NOTIFY BUILDING DEPARTMENT AT 8 AM TO 4 PM FOR THE 1 FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2 ROUGH- FRAMING, PLUMBING, STRAPPING ELECTRICAL ~ CAULKING 3 iNSULATION 4 FINAL - CONSTRUCTION & El FCTEICAL MUST BE COMPLETE FOR C.G. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESI~ FOR DESIGN OR CO~S1RtICl~)N ERRORS. COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED ~ / N~, ~C ELECTRICAL INSPECTION REQUIRED OCCUPANCYOR USEIS UNLAWFUL WITHOUTCERTiF!C~T~ OFOCCUPANCY NOTE: VENT OPENINGS SHALL NOT BE LESS THAN 100 SQUARE INCHES. THE ABOVE TABLE IS TO BE USED TO SIZE METAL LOUVER VENT BY SUMMING THE TOTAL BTU's AND THE CORRESPONDING VENT SIZE. Z z F:: _~ >-~ O7 o~ COVE SHEE' PLAN VIEW OUTSIDE 32" WINDOW 16'-8" UNFINISHEO AREA HVAC EXISTING STEEL POSTS AND BEAM ELECTRIC KEY: $ - SWITCH - LIGHT FIXTURE - RECEPTACLE SUOKE AC/DC 0 INTERCONNECTEO NOTE: ~tE MAIN CEILING HEIGHT SHALL BE NOT LESS THAN 7' (84"). PORTIONS OF THE BASEMENT THAT DO NOT CONTAIN "HABITABLE SPACE" (HALLWAYS, BATHROOMS, LAUNDRY ROOMS) SHALL HAVE A CEILING HEIGHT OF NOT LESS THAN 6'-8" (80"). BEAMS, GIRDERS, DUCTS OR OTHER OBSTRUCTIONS MAY PROJECT TO WITHIN 6'-4" (76") OF THE FINISHEO FLOOR. NOTE: IF A .3 WAY SWITCH DOES NOT EXIST TO ILLUMUNATE THE TOP AND BOTTOM OF THE STAIRWAY, ONE SHALL BE INSTALLED NOTE: ARTIFICIAL ILLUMINATION OF 6 FOOTCANDLES (65 LUX) OVER THE AREA OF THE ROOM AT A HEIGHT OF 30 INCHES (762 mm) ABOVE THE FLOOR LEVEL GFI 32" WiNDOW RATED DOOR b~ PROPOSED CLOSET NOTES: ALL WOOD FRAMING MEMBERS, INCLUDING WOOD SHEATHING, WHICH REST ON EXTERIOR FOUNDATIONS WALLS AND ARE LESS THAN 8" FROM EXPOSED EARTH SHALL BE OF APPROVED NATURALLY DURABLE OR PRESERVATIVE WOOD, INCLUDING LUMBER ON A CONCRETE SLAB. DRAFT STOPPING/FIRE STOPPING SHALL CONSIST OF MINERAL WOOL PLACED EVERY 10 FOOT ON CENTER OF STUD WALLS. MINERAL WOOL SHALL BE PACKED TIGHTLY tN BETWEEN STUD AND FLOOR .JOISTS. UNFINISHED AREA SHEET G1 FINIHSED CEILING HEIGHTN 2x6 CAF 2x4 BACKER GRASPABLE HANDRAIL MgO BOARD 5/4x5/4 BALLISTER __ 0 5" O.C. 4x4 NEWEL TYPICAL STAIR DETAIL FIRE RATED DROP CEILING 4'xB'xl/2" MAGNESIUM OXIDE BOARD FLOOR SECTION "B" JOISTS 25 GAUGE TOP & BOTTOM METAL TRACKS 4'x8'x1/2" MAGNESIUM OXIDE BOARD 3-1/8" POLYSTYRENE FOAM PLAS~C CORE METAL SILL Il --,,,~1~4' SPACE FIRE RATED OROP CEILING 4'xB'xl/4" MAGNESIUM OXIDE BOARD 3-1/8' POLYSTYRENE FOAM PLAS~C CORE SECTION "A" JOIST WAREWALL - TRACKS GAGE THICK 3 5/8" TRACK 4'x8'x1/4" MAGNESIUM OXIDE BOARD ~._3-1/8" POLYSTYRENE FOAM PLAS~C CORE JOIST ATTACHMENT WALL WAREWALL - TRACKS GAGE THICK 3 5/8" ~DE TOP TRACK 4'x8'xl/4' MAGNESIUM OXIDE BOARD '~___3-1/8" POLYSTYRENE FOAM PLAS~C CORE CONCRETE ATTACHMENT SHEET G3 WALL DETAILS TRIM OUTSIDE CORNER AFTER INSTALL WITH A ROUTER 2x4 INTO WALL PANEL WITH 1/8" EXPOSED FiLL WITH FIBER MESH THEN JOINT COMPOUND 5 COATS ELECTRICAL CHANNEL CORNER DETAIL MESH TAPE WITH 3 COTES [OF JOINT COMPOUND MAGNESIUM BISCUIT ..MAGNESIUM BOARD /- POLYSTRENE THERMAL CORE / ELECTRIC CH~,TNEL-~ MAGNESIUM BISCUIT NOTE: ALL SEAMS MUST HAVE A MINIMUM 1/8" GAP PANEL DETAILS · ~_ 1/8" SEPARATION REQUIRED / (~ 2x4 INTO WALL PANEL FiLL WITH FIBER MESH THEN JOINT COMPOUND 5 COATS PARTITION CONNECTION Q DRAGON BOARD 6MM FIBER REINFORCED MAGNESIUM-OXIDE-BASED PANEL Q ASHLAND AOHEISIVE :ISOGRIP 5050 Q POLYSTRENE THERMAL CORE Q DRAGON BOARD MAGNESIUM-OXIDE-BASED PANEL FIRE RATINGS - ANSI/UL 263 UL LISTING U055 ASTM El19 FIRE RATING ASTM E136 FIRE RESISTANCE AS~vl D5628 IMPACT TESTING ASTM 021 FUNGUS RESISTANCE ASTM E90 SOUND TRANSMISSION LOSS TEST e ASHLAND ADHESIVE ISOGRIP 5050 ESR-1140 : IN ACCORDANCE WITH ICC-ES ACCEPTANCE CRITERIA FOR SANDWICH PANEL ADHEISIVES e INSULATION CORP AMERICA POLYSTRENE FOAM PLASTIC CORE UL R9702 THE FINISHED WALL PANEL SYSTEM MEETS THE REQUIREMENTS FOR A CLASS A INTERIOR WALL FINISH IN ACCORDANCE WITH SECTION 805.1 OF THE IBC AND CONFORMES TO THE FLAME SPREAD AND SMOKE-DENSITY REQUIREMENTS IN SECTION R315 OF THE IRC WfHEN TESTED IN ACCORDANCED ~ITH ASTM E84. PANEL CROSS SECTION DRAGON BOARD BASEMENT WALL DETAIL SHEET G4 t NEW (2)2x10 HEADER JACK STUD EA SIDE DOUBLE INSULATED WINDOW WALL BUILDING LINE CLEAR LEXAN GRATE FINISHED GRADE LINE APPROX. 3" BELOW WELLSLOPE GRADE AWAY FROM WELL -~NDOW WELL LADDER (WHEN EXIT HEIGHT EXCEEDS 44") BASE WINDOW ELEVATION WITH ~/ELL DRAIN SYSTEM SECTION THRU, WINDOW WELL /(20" MIN. REQUIRED FOR EGRESS) ~"' NET HEIGHT = 45 3/8" NEW (2)2× o HEADER TB JACK STUD EA SID FOUNDATION LINE 61' WELL WIDTH ~-- DOUBLE INSULATED ~NDOW ~EGRESS ~NDOW WALL ~ESCAPE LADDER (WHEN EXIT HEIGHT EXCEEDS 44") PLAN VIEW WINDBW WELL 36' PRDJECTIDN REQUIRED FOR EGRESS