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HomeMy WebLinkAbout38760-Z Town of Southold Annex 4/29/2014 P.O. Box 1179 54375 Main Road AL Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 36881 Date: 4/29/2014 THIS CERTIFIES that the building DECK Location of Property: 1820 Marlene Ln, Laurel, SCTM#: 473889 Sec/Block/Lot: 144.-2-33 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 3/13/2014 pursuant to which Building Permit No. 38760 dated 4/2/2014 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: 16.5'X 18'deck addition as applied for. The certificate is issued to Aylward, Rachel&Pigott,Ruthanne (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Aut ed ignat re fi 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#: 38760 Date: 4/2/2014 Permission is hereby granted to: Aylward, Rachel & Pigott, Ruthanne 406 2nd St Brooklyn, NY 11215 To: construct a 16.5' X 18' deck addition as applied for At premises located at: 1820 Marlene Ln, Laurel SCTM # 473889 Sec/Block/Lot# 144.-2-33 Pursuant to application dated 3/13/2014 and approved by the Building Inspector. To expire on 10/2/2015. Fees: SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $318.80 CO -ADDITION TO DWELLING $50.00 Total: $368.80 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 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$15.00 Date. New Construction: / Old or Pre-existing Building: _(check/ode) Location of Property: 1X,,2e t �r. ---- ,J f�' X-c- A House No. Streeeet Hamlet Owner or Owners of Property: Wv+ f e f Suffolk County Tax Map No 1000, Section I y y Block Z Lot 3 3 Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted:$ Applicant Signature 3- 8 7(e�0 rjf so TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION FOUNDATION IST ROUGH PLUMBING Ot ] FOUNDATION 2ND INSULATION FRAMING / STRAPPING FINAL FIREPLACE & CHIMNEY FIRE SAFETY INSPECTION FIRE RESISTANT CONSTRUCWN FIRE RESISTANT PENETRATION ELECTRICAL (ROUGH) ELECTRICAL (FINAL) CODE VIOL N CAUING REMARKS: DATE INSPECTOR \� v h l0 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUN ION 1 ST [ ] ROUGH PLUMBING [ IF NDATION 2ND [ ] 'INSULATION [ FRAMING / STRAPPING [ ] NAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: p DATE INSPECTOR �oF Soar pal► 'f'O coUNt'1, ` TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTIO [ ] FOUNDATION 1 ST [ ] ROU PLUMBING [ ] FOUNDATION 2ND [ ] I ULATION [ ] FRAMING / STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: /Xlk) DATE �� INSPECTOR r FIELD IlNSPEMN REP?URT DAU COMMENTS FOUNDATION(1ST) � O , Q�C FOUNDATION(2ND) i ' � z ROUGH FRAATINQ& � PLUMBING c' H INSULATION PEP,N.Y. � H STATE ENERGY CODE FINAL ADDZ'TIONAL COMMENTS o i f Lr r i TOWN OF SOUTHOLD 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 J1z 20_1_ Mail to: Disapproved a/c p J q Phone: J('19, Expiration y 20 Building Inspector PPLICATION FOR BUILDING PERMIT MAR 1 3 2014 ` 1 3 !3 ly !� Date ,20 -- - - INSTRUCTIONS L. a;This-applicatibn 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. (Signature f applicant or name,if a corporation) (Mailing address of applicant) State whether applicant is owner, lesse e, agent, architect, engineer, general contractor, electrician, plumber or builder e-" G /11 L- Name of owner of premises ✓`" � �'� x'7"7 ( s on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) cicer) Builders License No. 7 f7W ~1 Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on whic pr posed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section Block Lot Subdivision ` Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Qb. Intended use and occupancy /�e&,j –Oe.c 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost Fee (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 C�Timensions of entire new construction: Front Rear A6 6 Depth eight 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 Will excess fill be removed from premises? YES NO 14.Names of Owner of premises Address Phone No. Name of Architect Address Phone No Name of Contractor Address Phone No. 15 as Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO f— *�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) SS: COUNTY OF J) ) VIA n Ia+-r CC– (< y V l t c e– �� being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the loo,I" _/,r (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. SiT to before me this —day of 20 Notary Public CONNIE D.BUNCH Signelfure of Applicant Notary f'ubllo,State of Now York No.01 SU6186060 QualHlad in Suffolk County Commission Expires April 14,2-al\,0 Scott A. Russell James A. Richter, R.A. SUPERVISOR Michael M. Collins, P.E. SOUTHOLD TOWN HALL-P.U.Box 1179 53095 Main Road-SOUTHOLD,NEW YORK 11971 Telephone#: (631)-765-1560 Fax#: (631)-765-9015 MICHAEL.COLLINS@TOWN.SOUTHOLD.NY.US JAMIE.RICHTER@TOWN.SOUTBOLD.NY.US Office of the Engineer Town of Southold STORMWATER MANAGEMENT CONTROL PLAN REVIEW COVER SHEET ( TO BE COMPLETED BY THE APPLICANT ) PLEASE NOTE:All Contact & Project Information Requested by this FORM is Nessary for a Complete Application. ot,,~ee (Property Owner,D,,( Professional,Agent,Contractor,Other) -PANNEW (if Different from Applicant) NAME: R 'Pl,it 64- NAME: V11 t c e- ADDRESS: a IM 4 el-C Dr. ADDRESS: q 7 P&If fi _11712 Telephone Number: Telephone Number: —,6 Completed Applications can be picked up at the Engineering Department after being notified by the Department,or; it can be Mailed to the Applicant with the submission of a Self Addressed 8.5"x 11" Envelope& Appropriate Postage. DATE: -J? /'? /41 Property Address / Location of Construction Work: SCTM #: 1000 lqy 2-- District Section Block Lot Required Documents for Stormwater Review: Copy of Complete Building Permit Application. X Stormwater Management Control Plan. (2 Sets) Note: SMCP's are required whenever Grading or Excavations exceed 5,000 S.F,when New Impervious Surfaces are created,and/or when existing Roof Systems,Driveways,Patios or other Impervious Surfaces are Re-Surfaced. De Minimis Projects will NOT be Subject to the Submission of a SMCP During the Stormwater Review! Note: These Projects would be Limited to Interior Renovations, Replacement of exterior Doors&Windows,Deck Construction with Loose Fit Decking, Installation and/or Modification of Mechanical Systems or other similar Work. A Complete Description of the Scope of Work Proposed under the Building Permit Application A Completed Storm to Review Cheyklist. If No or NA are Indicated, Justification is Required. OR ENG 6 1 EP RTMENT USE ONLY Reviewed By: /"I- Date: 314211�( Appr Ved: n rn F-1 Addi on riformation Required: on of OCN U66K l - 1q0 F1_&J% 1F CHAPTER 236 STORMWATER MANAGEMENT CONTROL PLAN CHECK LIST -� DATE: 3 l3 APPLICANT: (Property Owner,Design ProfessiopaJ,.Arent,Contractor.Other) NAME: %? '�GG /� S C T M #: 1000 /yy 2 Z Telephone Number: District Section Block Lot S M C P - Plan Requirements: The applicant must provide a Complete Explanation and/or validation of all Information Required by this Checklist if it has not been providedi 1. A Site Plan drawn to scale Not Less that 60'to the inch MUST NA If You answered No or NA to any Item,Please Provide Justification Here! YES NO show all of the following items: If you need additional room for explanations,Please Provide additional Paper. a. Location& Description of Property Boundaries b. Total Site Acreage. 0 c. Existing- Natural & Man Made Features within 500 L.F. of the Site Boundary as required by§2,%-[7(0(2). d. Test Hole Data Indicating Soil Characteristics&Depth to Ground Water. O e. Limits of Clearing& Area of Proposed Land Disturbance. f. Existing& Proposed Contours of the Site (Minimum z Intervals) g. Location of all existing& proposed structures, roads, driveways,sidewalks,drainage improvements& utilities. h. Spot Grades& Finish Floor Elevations for all existing& proposed structures. 1. Location of proposed Swimming Pool and discharge ring. 0 j. Location of proposed Soil Stockpile Area(s). 0 / k. Location of proposed Construction Entrance/Staging Area(s). �O I. Location of proposed concrete washout area(s). 0 M. Location of all proposed erosion&sediment control measures. 2. Stormwater Management Control Plan must include Calculations showing that the stormwater improvements are sized to capture,store,and infiltrate O on-site the run-off from all impervious surfaces generated by a two(21 inch rainfall/storm event. 3. Details&Sectional Drawings for stormwater practices are required for approval. Items requiring details shall include but not be limited to: a. Erosion & Sediment Controls. b. Construction Entrance&Site Access. c. Inlet Drainage Structures (e.g.catch basins,trench drains,etc.) 0O +' d. Leaching Structures (e.g.infiltration basins,swales,etc.) FORM * SWCP Check List-TOS JAN 2014 DATE(MM/DONYYY) CERTIFICATE OF LIABILITY INSURANCE PJ26/2014 THIS CERTIFICATE IS ISSUED AS 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 Certificate holler is an ADDITIONAL. INSURED, the policy(les) must be endorsed. 0 SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER NA Automatic Data Processing Insurance Agency,Inc SAO?E AX 1 ADP Boulevard AC No Roseland,NJ 07468 ADOaESS: INSURER(S)AFFORDING COVERAGE NAIL! INBURERA:NorGuard insurance Company 31470 INSURED miceli contracing Co,.lnc. INSURER B: Patrick Miceli INSURER C: 47 Hill St East INSURER D: Wading River,NY 11792- INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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 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 BY PAID CLAIMS. SR T TYPE OF INSURANCE POLICY NUMBER M P LIMA GENERAL LIABILITY EACH OCCURRENCE i DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES Ea $ CLAIMS-MADE D OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPKOP AGG $ 17 POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL AUTOS OWNED SCHEDULED BODILY INJURY(Per accident) $ HIRED AUTOS AUTO NED Per soods $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIA6 CLAIMS-MADE AGGREGATE $ DIED RETENTION $ WORKERS COMPENSATION X WC STS OT R AND EMPLOYERS LIABILITY A ANY PROPRIETOR/PARTNER/EXECUTIVE Y N/A MIWC463662 6/1/2013 8MrA14 E.L.EACH ACCIDENT $ 100,0 OFFICERIMEMBER EXCLUDED? N (Mandam in NH) E.L.DISEASE-EA EMPLOYE $ 100: If yes, escribe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ 5W, DESCRIPTION OF OPERATIONS f LOCATKM I VEHICLES(Attach ACORD 181,Addllonal Remarks Schedule,N more apace In required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCR03ED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Southold ACCORDANCE WITH THE POLICY PROVISIONS. P.O.Box 1179 Southold,NY 11971- AUTHORIZED REPRESENTATIVE 0)1QRA-9n1n ArnRn rnRP()RATInN All rinhta rap awwrl III LIHdILI 1 T II IOURHIVVC 1 02/26/2014 THIS CERTIFICATE IS ISSUED AS 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 certificate holder is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER Phone: (631)2984700 Fax: (631)2983850 CONTACT Roy H Reeve Agency,Inc. ROY H REEVE AGENCY,INC. PHONE 631 298-4700 13 400 MAIN ROAD ""^'L "X�. (631)298-3850 PO BOX 54 E rhrd@royreove.com 13 MATTITUCK NY 11962 INSURER(S)AFFORDING COVERAGE NAIC r INSURER Main Street America Assurance Company 29939 INSURED MICELI CONTRACTING CO,INC. INSURERS 47 HILL STREET EAST INSURER WADING RIVER NY 11792 INSURER D: INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 51809 REVISION NUMBER: THIS IS TO CERTIFY THAT 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 BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CLUSIONS AND CONDITIONS OF S I! Ig"MITS SHOWN MAY HAVE BEEN REDUCED BY PAID INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFP POLICY EXP LIMITS A GENERAL LIABILITY MPUS463F 01/27/14 01127115 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAG R TED 60O 000 PREMISES fEe oocurerlce> $ , CLAIMS-MADE FK OCCUR MED.EXP(Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Me aoddenq $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED PUONEED CHED BODILY INJURY(Per•ooideM) $ AUTOS HIRED AUTOS S PROPERTY) $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I RETENTION$ $ WORKERS COMPENSATION MSTA LIMITS OTH AND EMPLOYERS' LIABILITY TORY ER ANY PROPRIETORIPARTNERIEXECUTIVE Y/N EL.EACH ACCIDENT $ (Mandatory In H) EXCLUDED? IF1 NIA E.L.DISEASE-EA EMPLOYEE $ (Mandatory in NH) If yes,desenbe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space,is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Southold THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 1179 ACCORDANCE V41TH THE POLICY PROVISIONS. Southold,NY 11971 AUTHORIZED REPRESENTATIVE Attention: ` ObC6241 Thomas A. Dickerson ern; 9.r,/gn1n/ns1 ©1988-2010 ACORD CORPORATION. All rights reserved. DEC-16-2003 10:10 REGAL TITLE AGENCY P.03 n-2% /V&302o' e" /¢5.040, .L'm o G ' � o D u N b 59.y' dg4Poi .� ur ira IV s + � y V .s a9�ao'.�•� w 1�s•.�o .Q f .Perms N Q'SI/�/wM -7LWC/400 As,c i qP'3!! WASNIsAVNT W LM ST"DiAQ T!R l7olreNCC os Rloia oP wwM ANDAR lAR[rCNif oP Nioop0.rI ANV. MO'f 0120dN ARS NOi GU WAN'fIID. TM Gumm0N0$Novo offs N,"M THE STRUd1 M TO T1IE PROPIRTT UHL AMC RM A SP£CIPIC PIIRPO.S!ONLY.THEY AMS NOT N'1OMMI TQ IS USED POS TM!MOTION OF PENOOC.STRUCTI IMPS 00 ANY OTHER IMPROVCMSW- YNAUTMOeix£D ALTERATION GUA*A c�•INDIOATM WIER"5M L P N ONLY oNLV COPICS peou TMII umal- oeAOQIT10NT0ASU71ver17AP To TNE [RSON Poe��py TMt EiI v£ Is PRe. aeAelNe A LNA wmv M O HAL Of THIS IVOVIV MA*KED PApMyB�cO�,I�AN�D!O7N MIS BEHALF TO�M56711LE Ca1A'{P7T�11NV, SUP,VSTOe'S UAL I!A VIOLA• WITH AN ORIGINAL OF TN! LfiT£D NENF'ON ESQ TO f US A901GN��OI•AMP LAND weVeroNS E MSOSSEO L Mre Yell TION OR SOCTION 7200,SUS• SEAL SMALL SE CONINDERlO IAMIIW6INVITRION. DIvimoN 16 OP TN£WSW YORK �1I ARASTIES ARS NOT TMAIW ER S�,ET�O ADOI- STATSfO11CA71ONLAW. T007;VAL*TPMC*ME.4 TINIALIIISTIIIfIKINOD111{IiSi�L,Nl OTYNeMS LAND . & PLAN stcTION BLOCK �'DATC j GUARANTEED TO nwTnrve/G I� � 1114116644 73VMI HIgTS01AVC• COUNTY POIIMP a.W.1Nf0 TaxwoNE 0o0M1.NL .A:I ASFw4m AgcApwc. Ord wA40 roo NO. InAIL:q�MSwMb wr„ iw�.wvc /�G�;T A.£^62 1.SA TOTPL. P.82 TnT01 p ai I � I I I 1 2X10 LEDGER CONNECTED ' TO HOUSE W/2-1/2" DIA v ; GALV.BOLTS W/WASHERS ; 1 1 , V 1 , Q 1 , � I , X 1 N , 1 1 1 ' I ' 1 (2) 2X10ACQGIRDER (2) 2X10ACQGIRDER ' I I 10"dia.CONC.PIER , UO T BELOW GRADE ON 1 - , � 1 I� 1 0 , 1 X 1 I z YY O 1 ' I 1 ' ' (2) 2X10ACQ GIRDER (2) 2X10ACQ GIRDER A 1 ' -- ----------------------- ----------------------- - V z 8'-0° a'-o" w W 1'-O" " 18'-0II 1'-O 181-011 0 0 Go FOUNDATION PLAN FLOOR PLAN a SCALE: 1/4" = V-0" SCALE: 1/4" = V-0" 0 1 [?r, M 5/4 DECKING 0–i , __ —m % 2X8 AC Dj @16"OC L ',!C (2) 2X10ACQGIRDER t7= %N �''F E F _� DRAWN BY: ]D �_._ 10"dia.CONC.PIER O (`NOTIFY BUILD1INIG M 755-1802 8 APu1 TO OF NE4'y 3/9/2014 F,;I_LOVVING INSP: :, �� S 1, DEF O,Q . FOUNDATION -TV",, Q� ��,* SCALE: 1/4" = 1'-0" FOR POURED 2. ROUGH-FRAMING.P! F.'_: m W CRO SS SECTION STRAPPING, ELECTRICAL SHEET NO: 3 INS'JLATiON 4. 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