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HomeMy WebLinkAbout38082-Z Town of Southold Annex 10~ 11/19/2013 P.O. Box 1179 54375 Main Road Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 36610 Date: 11/19/2013 THIS CERTIFIES that the building RESIDENTIAL ALTERATION Location of Property: 1355 Deep Hole Dr, Mattituck, SCTM 473889 Sec/Block/Lot: 115.43-12.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 5/30/2013 pursuant to which Building Permit No. 38082 dated 6/10/2013 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: INTERIOR ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLLING AS APPLIED FOR The certificate is issued to Leone, Anthony & Leone, Angela (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 38082 09-26-2013 PLUMBERS CERTIFICATION DATED 11-08-13 Kenneth Zdanio~ 1 A ed ignatur- ~uF TOWN OF SOUTHOLD BUILDING DEPARTMENT r TOWN CLERK'S OFFICE $ SOUTHOLD,NY 2y ~n Safi 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 38082 Date: 6/10/2013 Permission is hereby granted to: Leone, Anthony & Leone, Angela PO BOX 1564 Mattituck, NY 11952 To: Interior alterations to an existing single family dwelling as applied for. At premises located at: 1355 Deep Hole Dr, Mattituck SCTM # 473889 Sec/Block/Lot # 115.-13-12.1 Pursuant to application dated 5/30/2013 and approved by the Building Inspector. To expire on 12/10/2014. Fees: SINGLE FAMILY DWELLING - ADDITION OR ALTERATION $200.00 CO - RESIDENTIAL $50.00 Total: $250.00 t Bu 2dingInspector 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 I. 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 $15.000 2 Date. J'D'1 , New Construction: Old or Pre-existing Building: (check one) ~1,~ Location of Property: I ~ ~5 Deep ~ o ~ r'- U / ( Z- 1cc4 House No. II ,m,, Street Hamlet Owner or Owners of Property: 4'W pt y Lco7 e Suffolk County Tax Map No 1000, Section J S Block _ 1 3 Lot J' Subdivision _ Filed Map. Lot: Permit No.Date of Permit. 6P-/O'/3 Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ App Iica ignature hO~~pF SO[/Tyolo Town Hall Annex Telephone (631) 765-1802 54375 Main Road T Fax (631) 765-9502 P.O. Box 1179 G Q Southold. NY 11971-0959 • ~O roger. riche rt(Q)town.so uthold. nV. us oou BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Leone Address: 1355 Deep Hole Dr City: Mattituck St: NY Zip: 11952 Building Permit 38082 Section: 115 Block: 13 Lot: 12.2 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Duffy Electric License No: 44991-me SITE DETAILS Office Use Only Residential X Indoor X Basement Service Only Commerical Outdoor 1st Floor X Pool New Renovation X 2nd Floor Hat Tub Addition Survey Attlc Garage INVENTORY Service 1 ph Heat Duplec Recpt 10 Ceiling Fixtures 2 HID Fixtures Service 3 ph Hot Water GFCI Recpt 2 Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures 8 CO Detectors Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances dw Dryer Recpt Emergency Fixture Time Clocks Disconnect Switches 9 Twist Lock Exit Fixtures TVSS Other Equipment: kitchen renovation, 1-exhaust fan, wall ovens (2) Notes: Inspector Signature: Date: Sept 26 2013 81-Cert Electrical Compliance Form.xls CERTIFICATION Date: 1143 Building P,e/rrmit, No. 3 ab yc~ Owner: d-W V e (Please printt) Plumber: Ve nne z i()- (Please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. p bers Signature) Sworn to before me this day of I 20 - - 11 I I _ Notary Public, A(Iatounty i Nov 15 2013 MARY MEDITZ~ Notary Public, State of New York No. OIME6055676 Qualified in Nassau County Commission Expires Mar. 5, 20. 1 L o~pf SO(/ly„ M" TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: DATE ~2j INSPECTOR f o~.~,OF Sol" y~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECT N [ ] FOUNDATION 1ST [ ROUGH PLEIG. [ ] FO DATION 2ND [ ] INSULATION [ - FRAMING / STRAPPING [ ] FINAL ( ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL UGH) [ ] ELECTRICAL (FINAL) REMARKS: E DATE 3 INSPECTOR I/ l ~ hO~,~,OF SOUTy06 TOWN OF SOUTHOLD BUILDING DEPT. 7654 802 INSPECT )ON [ ] FOUNDATION 1ST OUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ' [ ] ELECTRICAL (FINAL) REMARKS: ~7. XL 4~ ~i~a. n DATE ?//3 3 INSPECTOR 6 OF Op% A ~o TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [ ] INSULATION ( ] FRAMING / STRAPPING [ j FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) REMARKS: G/< DATE 3 INSPECTOR 'NL ~ ho~.~,OF 801/Tyo4~ TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [ ;],,,IXNLATION [ ] FRAMING / STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: DATE l~ INSPECTOR FIELD ON REPORT DATE CONDOMS FOUNDATION (1ST) O R- y FOUNDATION (2ND) 0 w . '004 "1 u 4, w OIL, y ROUGH FRAX VG & r PLUMING 013Z INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMNIENTS D 3c F5& o i u L-'Lem ' CC)(~ m z p 2. . C z _ b TOWN OASOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following, before applying? TOWN HALL Board of Health SOUTHOLD, NY 11971 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey SoutholdTown.NorthFork.net PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Examined , 20 Storm-Water Assessment Form Contact: Approved 20 Mail to: Disapproved a/c Phone: 31 q7.Z - t{ Ex n nn 20 .(2 art B ing Inspector AIAY 30 APPLICATION FOR BUILDING PERMIT BLDG. DEPT, Date 5 ' 3 d 20 TOW OF SOOTHOID 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 permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months 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. W W (Signature of applicant or name, if a corporation) ql (1tIQV1/ ~T~' /~qt OlsU~° (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Qeuew l Gt1` a dzr- Name of owner of premises A f 1i lry~ U (f L7-4 (As on the tax roll or latest deed) If applic j a rt < •on si tature of duly authorized officer (Name an title of corpora officer) Builders License No. 316?-3-7-4 Plumbers License No. / Electricians License No. - M it Other Trade's License No. 1. Location of land on which roposed work w)1II be dor~gg: House Number Street / Hamlet County Tax Map No. 1000 Section -Block 13 Lot ~ 2 - Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended usq and occupancy of proposed construction: a. Existing use and occupancy I^a_°7!~ i eki b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Addition Alteration V/ Repair Removal Demolition Other Work 4. Estimated Cost -af .,fiqt 32 • ©OO o Fee (Description) (To be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions 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 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 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 k Will excess fill be removed from premises? YES_ NO_ 14. Names of Owner of premises &PIddress 7 3Jr one No. ~ Jul Zd° X7jlf Name of Architect 1 Address Phone No Name of Contractor L fi it r i17~1 . Address hone No. 4. ' 2 i/' ' o 0 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 of a 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 * IF YES, PROVIDE A COPY. STATE OF NEW YORK) LL SS: COUNTY 017,01 o Y (,\r\av A S G~k I being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the Lp~~Os (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are 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 therewith. Sworn to before me this 9 day of 20)2) Notary Public Signature of Applicant WILSON SALAZAR NOTARY PUBLIC, STATE OF NEW YORK QUALIFIED IN SUFFOLK COUNTY REG.#01SA6224708 MY COMM. EXP. 07-12-2014 o~~ow: so~r~ Town Ha8 Amex Telephone (681) 7651804 54875 Main Road P.O. Box 1179 • ~er.rd rt(m OWn OUtt101tl nV us SouthoK NY 11971-0959 BUHZING DEPAMMrr TOWN OP SOUTHOLD APPLICATION FrOR ELECTRICAL INSPECTION/ REQUESTED BY: C.~~ `J w1 r Date: G 2 3 Company Name: Name: MCF7 License No.: Li l Address: OMC-vv Mi PL t (.A:: V111G N`! W'v1 Phone No.: S l 6- 3 O 6- S JOBSITE INFORMATION: (*Indicates required information) *Name: L Eo c *Address: \~SS OC~P ~~t~- ~R r1A \~Tv~ch E1952 `Cross Street: *Phone No.: Permit No.: _ Tax-Map District: 1000 Section: Block: Lot: *BRIEF DESCRIPTION OF WORK (Please Print Cleady) ' FA rAg N; mcc Cf_ z%.i!6 n vo r i Z\ j~o %J Cn (Please Circle All That Apply) *19 job ready for inspection: - YES I0 N Rough InI "Do•you need a Temp Certificate: YES! IOO LJ U 2013 U Temp Ittfarmation (!f needed) JUL - 1 *SerAoe Size: 1 Phase 3Phase 100 150 200 300 BLDG of "New Setvlce- Re-Connect Underground Number of Meters Change Servloe T of o Additional Information: PAYMENT DUE WITH AP Ll ATION - 1 1I NZ1WV tbu ~n 3 T\~ ec,~ 1 1V T a FJ \1 t9~ 82-Request for Inspection Form G 6 U TOWN OF SOUTHOLD PROPERTY RECORD CARD M a.~ VNER STREET S VILLAGE DIST. 666.- LOT )RMER OWNER NF, ( Dr e Ho I e GGr. La nc 5d S W TYPE OF BUILDING A, ~Jl 14 rc't SEAS. VL. FARM COMM. CB. MISC. Mkt. Value -AND IMP. TOTAL DATE REMARKS 2300 -2- 70 D ~~iv BS,ce aAI. b`9aod she»s~,' o LPm3) L 9z/i -1-T imp 3 boa as _ i Y s a _ ~ UJ ~-00 ~fl0V /1117 1 "'111f,? 8.? /a~~9 eonsf ad~f tic ~5~~OoD o jilge- 9*1 S - i rvunc~ PODI 4 -cence .Oc- 7 v s~ 86vo ~ DD(7 n &E 75uo B LDING/CONDlTI~ e NORMAL BE O A OV ` - #ao9a8- Bans duel/~n -G *A-5 06 )oo 7iov 8 00 A--9 a e7~e~Kco.aloµ We 000 <00 Soo' 3 9S # s Go. zble 0o goo 0 ho ible C3 J~2 O a t5-200 /O 1 dland npland FRONTAGE ON WATER hland FRONTAGE ON ROAD se Plot 11400 /090 ft DEPTH / _ i BULKHEAD r" DOCK OLOR RIM ,M1l f~i• u rat + Y115:13-12.1 3/06 Dinette BI `fi( 6 = 3.56 3Z7(o" Foundation C (jJ Bath lo-5 ;ensi Basement Floors 0 K K. -ension .Iyx~b r 1024 Z~ 21 It V t. Walls l4) y 0/ interior Finish ~f LR. / tension yk~` 8 3.a5 q r Fire Place,;, P. ( Heat g DR. Type Roof Rooms 1st Floor BR. 3 lc~ 1 k ~f a 3 ?~8 a 9 Recreation Roo Rooms 2nd Floo FIN. B. rch Dormer gae' a,y I 07T 0 Driveway I rtio B px -~f I~atS O `7~ a >tal a 7 g ,-1 p o t•4 V<J) FROM (TUE}JUN 11 20 13 10: 39/ST.10: 38/No,6660225827 P 1 91 Lakeland Avenue Patchogue, New York 11772 Office # (631) 2898450 Fax # ( 631) 218$811 fir TO: Town of Southold From: Barbara x 1005 Building Department Fa 631-7659502 Pages: 2 (including cover) x Datm June 11,2013 F&H Disability Certificate for Anthony CQ Leone *-MN barbard_sdbetta@lexoonslructl on.net Attached is the required disability certificate for the building permit we filed for: Anthony Leone 1355 Deep Hole Dr. Mattituck,NY 11952 Thank you, Barbara Scibetta Lex Construction Compliance pf SOUryOlo Town Hall Annex Telephone (631) 765-1902 54375 Main Road Fax (631) 765-9502 P.O. Box 1179 H ~ Southold, NY 11971-0959 o~yCOUNTi,~ BUILDING DEPARTMENT TOWN OF SOUTHOLD September 30, 2013 Anthony Leone PO Box 1564 Mattituck, NY 11952 RE: 1355 Deep Hole Dr, Mattituck TO WHOM IT MAY CONCERN: The Following Items (if Checked) Are Needed To Complete Your Certificate of Occupancy: Application for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. (Contact your electrician) A fee of $50.00. Final Health Department Approval. Umbers Solder Certificate. (All permits involving plumbing after 411/84) Trustees Certificate of Compliance. (Town Trustees # 765-1892) Final Planning Board Approval. (Planning # 765-1938) Final Fire Inspection from Fire Marshall. Final Landmark Preservation approval. Final inspection by Building Dept BUILDING PERMIT: 38082 - Interior Alterations 8i Development, Inc. 91 Lakeland Avenue, Patchogue, NY 11772 Phone: 631-289-6450 Fax: 631-218-6811 Licensed and Insured Suffolk Lic# 31237-H November 14, 2013 Southold Building Department PO Box 1179 Southold,NY 11971 Re: Building permit # 38082 To whom it may concern: We have an open building permit for: Anthony Leone 1355 Deep Hole Dr Mattituck,NY 11952 Enclosed please find the original Solder Certification from Z-Rite Plumbing, required by you to close the permit and issue the CO. Should there be anything else needed to close this permit, please contact me. Thank you, Barbara Scibetta barbara scibetta@Iexconstruction.net 631-289-6450 Ext. 1005 (8-2) Lex Construction Compliance G @00 5 noN I jl r, I l J FROM (TUE)JUN 11 2013 9:36/ST. 9:35/No.6660225626 P 3 New York State Insurance Fund Workers' Compensation & Disability Benefits Specialists Since 1914 8 CORPORATE CENTER DR, 3RD FLR, MELVILLE, NEW YORK 11747-3129 Phone: (631) 7564300 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE A A A A AA 542116284 LEX CONSTRUCTION & DEVELOPMENT INC TA LEXUS CONSTRUCTION & DEVELOPMENT 91 LAKELAND AVENUE PATCHOGUE NY 11772 POLICYHOLDER CERTIFICATE HOLDER LEX CONSTRUCTION & DEVELOPMENT INC TOWN OF SOUTHHOLD TA LEXUS CONSTRUCTION & DEVELOPMENT PO BOX 1179 917-14 & 917-15 LINCOLN AVENUE SOUTHOLD NY 11971 HOLBROOK NY11741 POLICY NUMBER CERTIFICATE NUMBER PERIOD COVERED BY THIS CERTIFICATE DATE 11319854-4 608783 04/18/2013 TO 04/18/2014 6/11/2013 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1319854-4 UNTIL 04/18/2014, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF SAID POLICY IS CANCELLED, OR CHANGED PRIOR TO 04/18/2014 IN SUCH MANNER AS TO AFFECT THIS CERTIFICATE, 10 DAYS WRITTEN NOTICE OF SUCH CANCELLATION WILL BE GIVEN TO THE CERTIFICATE HOLDER ABOVE. NOTICE BY REGULAR MAIL SO ADDRESSED SHALL BE SUFFICIENT COMPLIANCE WITH THIS PROVISION. THE NEW YORK STATE INSURANCE FUND DOES NOT ASSUME ANY LIABILITY IN THE EVENT OF FAILURE TO GIVE SUCH NOTICE. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. RICHARD SCHANDEL (PRES) OF LEX MILLWORK INC (ENTITY) ONE PERSON CORP THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE INSURANCE FUND J,e DIRECTOR,INSURANCE FUND UNDERWRITING This certificate can be validated on our web site at https://www.nysif.com/cerUcertval.asp or by calling (888) 875-5790 VALIDATION NUMBER: 389048568 U-26.3 FROM (TUE) JUN 11 2013 10:39/ST. 10:38/No. 6660225827 P 2 NOTICE LIANCE AVIEO OE CUMPLIMIENTO 1. If you are velars to bsamss of an Illinois or not I. bl uaad no Pisa geyr dwlao a a owasad a bow no Yr y or 's h mill fo ubnk s om r vablA 00" Mlw dww~o ¦ redblr aw BrW Fund for Dksm NO her Immummom @one%. or fmm bmmldms dd~"do w pol m o a a mw . 111 i a wp.w do able * pal ~ P~ BrleBdas prlnmpadd.d. jull 2, 2. 11 q 12 Him Ilr Iba, d.le d A..Idr~_ but a no aran rrlarw .a.. +S. come ie v a mss •s s BLI n ~>1FUais I as wsaa+fromsllon tlsa. MEN iMO M nrgur ala.M ds dW qa 7. Uss one d ma foalrwa g dslm anrw: Ua we a as It. 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Pan a Apmrirw f~rrM.ldw~abyfr o7lwN KMeral AaaollsyrMwamnwl EnvlwoIMl plml/gllr MW)~I/faU AII.ployrseyplte well New Yak Sum Dim iy Bawdw Low =ll LMY6+76y?m1 nor LNX CONSTlUCTION A DBVfltASM11MT WC. w1rNO°iWm 71oI1~. a DBALEXUSCONSMUI.TMAND NT N.nw d dr ) Two ¦ y~ A NOTICE ~IT11a 1-11 ww arse AlO1yT THE brebT "PIM xw7gmmft Yom. - m } W Z s t O N i % t p t0 O m -ri ~LL II Lo II n 4 I I KIT Ja qw2 ,J051" ~ Ltzr r_ rz aALL ' _ " ' R~rto G-I.ln~l- - 61~k' I(, _ • ~h~ ca ~ I~u~.Ir~Y - Q Z iZM CCU ~ , I - -7 T o COMPLY WITH ALL 43 'LY WITH ALL CODES OF - G~~ r I1~~ -Q U 41 NEW YORK STATE 3 RK STATE & TOWN CODES I - AS REQUIRED APo3-et IIRED A L U 4 • _S ;"d Z. Q~ S O L _ _ SO L~fBOARB • r - ~9 I l j f ~0 SO I J ' II - y I I ~ i l l N C I tc°~. L I N! N G 4Upie- - - L .41 I n 41 I I I I ~ ~ uorr_ I + -L IIo'! T e i~ ~Dp2 NC-W N k') T q WA L-1- W k ORon 1 7 x 12 N N ii i I I 1c, I I I x I x I I I ' 2Xfl GJ I -ohm II - of ~ - - ~f~l,?; it pp i- Pod ED AS NOT D}!ED AS NOTED ~ OCCUPANCY OR - l - { OATE:e I" 3 B.P. tk1Se ~ B.P. ° USE IS UNLAWFUL \ J FEE ~~BY WITHOUT CERTIFICATE N071 -Y BUILDING DEPARTMI DING DEPARTMENT AT 765-1802 8AM IU 9'v r.. FOLLOWING INSPECTIONS: ~I 1. FOUNDATION - TWO REOI INSPECTIONS: Ut Ut,l,Ul'H~VI,i ON - TWO REQUIRED FOR POURED CONCRETE RED CONCRETE FRAMING & PLUMBING 2. ROUGH - FRAMING & PLU 3. INSULATION nv ~~i55I~+{ot t~z. F'IAfT~Tuc k 7 4. FINAL - CONSTRUCTION IONSTRUCTION MUST OF NEWy - BE COMPLETE FOR C.O. 'LETE FOR C.O. IS RUCTION SHALL MEET THE y ~a I} .f I ALL CONSTRUCTION SHALL REQUIREMENTS OF THE CO[ INTS OF THE CODES OF NEW • 'p - - YORK STATE. NOT RESPO< F. NOT RESPONSIBLE FOR CONSTRUCTION ERRORS. DESIGN OR CONSTRUCTIOI 91O~~ 1GF1 404