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HomeMy WebLinkAbout39064-Z pt Town of Southold Annex 8/20/2014 P.O. Box 1179 54375 Main Road Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 37097 Date: 8/20/2014 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 365 Donna Dr, Mattituck, SCTM#: 473889 Sec/Block/Lot: 115.-16-3 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 6/24/2014 pursuant to which Building Permit No. 39064 dated 7/29/2014 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: "AS BUILT"ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR The certificate is issued to Depinto,Joseph&Depinto,Rose (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 39064 08-13-2014 PLUMBERS CERTIFICATION DATED 71Wed gnatu e 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#: 39064 Date: 7/29/2014 Permission is hereby granted to: Depinto, Joseph & Depinto, Rose 365 Donna Dr Mattituck, NY 11952 To: "As Built" Addition to an existing dwelling as applied for At premises located at: 365 Donna Dr, Mattituck SCTM # 473889 Sec/Block/Lot# 115.-16-3 Pursuant to application dated 6/24/2014 and approved by the Building Inspector. To expire on 1/28/2016. Fees: AS BUILT - SINGLE FAMILY ADDITION/ALTERATION $731.20 CO -ADDITION TO DWELLING $50.00 Total: $781.20 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$15.00 Date. (�V I New Construction: Old or Pre-existing Building: Y (check one) Location of Property:_ XLJ(p C7DNY•1/S� V14 0 j;�, HAI-MITU644- House No. Street Hamlet Owner or Owners of Property: L,7 - go:+ uA T+— , f1V ro Suffolk County Tax Map No 1000, Section �� Block 144 Lot Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted:$ pplicant W nature pF SOryol. Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O. Box 1179 roger.riche rt(aD-town.southold.ny.us Southold,NY 11971-0959 '�►O�� �� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Depinto Address: 365 Donna Dr City: Mattituck St: NY Zip: 11952 Building Permit#: 39064 Section: 115 Block: 16 Lot: 3 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: as built DBA: License No: SITE DETAILS Office Use Only Residential X Indoor X Basement Service Only Commerical Outdoor X 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition X Survey X Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt 9 Ceiling Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt 1 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 Dryer Recpt Emergency Fixtures Time Clocks Disconnect Switches F3 Twist Lock Exit Fixtures 11 TVSS Other Equipment: 1-paddle fan,----AS BUILT------ELECTRICAL SURVEY------ ------------NO VISUAL DEFECTS---------- Notes: Inspector Signature: Date: Aug 13 2014 81-Cert Electrical Compliance Form.xls oF so�jyolo Town Hall Annex Telephone(631)765-1802 54375 Main Road (631)765-9950 P.O.Box 1179 Q roger.richert(a�own soutno d ny us Southold,NY 11971-0959 y - �I�CpUNi`l,�'� BULC.DING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Date: Company Name: Name: License No.: Address: Phone No.. JOBSITE INFORMATION: (*Indicates required information) *Name: *Address: *Cross Street: *Phone No.: 2 f S- C3 — G� Permit No.: _ �g� . Tax Map District: . 1000 ection: Block: Lot: *BRIEF DESCRIPTION OF WORK(Please Print Clearly) LIS (Please Circle All That Apply) *Is job ready for inspection: YES / NO Rough In Final *Do you need a Temp Certificate: YES / NO Temp Information (If needed) '*Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other 'New Service: Re-connect Underground Number of Meters Change of Service Overhead Ndditional Information: PAYMENT DUE WIT H APPLICATION / 82-Request for Inspection Form i ti���Of SO(/l�Olo TOWN OF llTHOLD BU DEPT. 765-1802 [ ] FO NDATION IST [ ] ROUGH PLUMBING [ ) OUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIO ATION [ ] CAULKING REMARKS: rx L DATE © ( IN PECTOR i pF SO(/lyo� C� TOWN OF SOUTHOLD BUILDING DEPT. / 765-1802 �( INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLUMBING [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL )ROUGH) ELECTRICAL (FINAL) [ ) CODE VIOLATION [ ] CAULKING REMARKS: DATE �� INSPECTOR i �Y OF SO(/ryo TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPEC T ON [ ] FOUNDATION IST [ ] OUCH PLUMBING [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: D ATE NSPECTOR • couTdms I���L t '� _r ■rte •I . ✓.. � � ROUGH ee ���I PLUMING e STATE RNERGY CODE � r � 0 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. 90� Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Examined b4,20# r Storm-Water Assessment Form ontact: Approved 20�Y JUN 23 2014 Mail to: Disapproved a/c G ?. Phone: (� `— / Expiration ,20 ��1 —- 41 , Building Inspector APPLICATION FOR BUILDING PERMIT Date JUNK (� , 20 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. (Signature of applicant or name,if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises f�`-�� (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which roposed work will be done: �6� QoN�, V7fA_ vV1_ House Number Street Hamlet County Tax Map No. 1000 Section Block 16 Lot Subdivision Filed Map No. Lot . y 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy 510611L%i 1=AAi kL1y b. Intended use and occupancy 15AH4F,:, 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 t5 447-i I& If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. �j �. 7. Dimensions of existing structures, if any: Front *9511-014 Rear ��I'f� Depth Height -p It Number of Stories A Dimensions cif same structure with alterations 4 additions' Front 2�`._d" Rear Z�v'D h Depth - 7Height_ � � l 0 •b Number of Stories 1 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front Rear 110 r-r• Depth �7i • 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 V Will excess fill be removed from premises? YES NO F'&� �F�.�oP4A M 14. Names of Owner of premises V?� ViV:MO Address h'AA'UV-1c`-i 'N�Vhone No. Name of Architect A,►.7fi1•bt . Pte_ NEAR!►. Address G L+Ac1C�. LA _ Phone No Name of Contractor Address LAdCt- t0RdOL-t- Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO r✓ * 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 V/ * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ) 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 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 tobefore me this day o 20 ILa L-,, K Notary Public Notary Public,State of NeW1,Mure ofAlplicant No.01 BU6185060 Qualified In Suffolk County Commission Expires April 14,2c) Scott A. Russell a°SU '� STOIKIAWA\TIEIR, SUPERVISOR z 1\M[A\INAG 1EM1EN]F SOUTHOLD TOWN HALL-P.O.Box 1179 53095 Main Road-SOUTHOLD,NEW YORK 11971 IN Town of So u th o l d CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) DOES THIS PROJECT INVOLVE ANY OF THE FOLLOWING: Yes No (CHECK ALL THAT APPLY) ❑[g A. Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. ❑[�B. Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. ❑Q'C. Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. ❑[SYD. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. ❑[�'E. Site preparation within the one-hundred-year floodplain as depicted on FIRM Map of any watercourse. F. Installation of new or resurfaced impervious surfaces of 1,000 square feet or more, unless prior approval of a Stormwater Management Control Plan was received by the Town and the proposal includes in-kind replacement of impervious surfaces. If you answered NO to all of the questions above, STOP! Complete the Applicant section below with your Name, Signature, Contact Information, Date & County Tax Map Number! Chapter 236 does not apply to your project. If you answered YES to one or more of the above, please submit Two copies of a Stormwater Management Control Plan and a completed Check List Form to the Building Department with your Building Permit Application. APPLICANT: (Property Owner,Design Professional,Agent,Contractor,Other) S.C.T.M. #: 1000 Date: Q� n `/ District NAME: NAME: 7 OSf�P1,{ k JG rI I{••✓ � iw�/ (P-0 Section Block Lot FOR.BUILDING DEPARTNIE W USE ONLY Contact Information Relephme Numbed Reviewed By: c:-V Date: (�-tf�H Property Address / Location of Construction Work: —E— — — — — — — — — — — — — — — �(OJ �� �� Approved for processing Building Permit. J f / Stormwater Management Control Plan Not Required. ���A"`-n,-rLj6''� NOW �\ K ❑ Stormwater Management Control Plan is Required z (Forward to Engineering Department for Review.) FORM " SMCP-TOS MAY 2014 °m TOW kF SOUTHOLD PROPERTY RECORD CARD , OWNER S E -4 VILLAGE DIST. SUB. LOT L)71 Al A Ile 71 FORMER OWNER N E ACR. 3` 5 /2 Y Ylt 0:5 rZ)gvo Oct DI-5 W : S W TYPE OF BUILDING 004-4f.2 I've- RES. Z/O SEAS. VL. FARM COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKS ej " •--�G p .7 /7� 'Is va"raa, 8- v-s/-Ga-6Z-Gs� G�-G wi•vowaaas .mac. 4 ��S'( Sc�Lp 3S0o, ZNa !o %pc�3 a..�'k' 1�,7S WiNOW0 o Fs r` . In t'r�S �natS r � r c 11 !'? Ii l3� S t . '''e' eon - " 4 Art �P G 0 Q. j S/t {'f Q1ri'1�$ �uC �a R. S A Y d f'o U L O.� 4 VF j��'GI if J 15 a-4) A GI r G �'/ /Oa�,?f. L d• R a K o-T i v 1� C. � '0ebAS �. EB�.Zv ,. .ILDING� 1ONDITI N N BAB 6T 7,JEL I ° " t— i 13} �} - cru e��, -Eo Q - - l(o5, oDo FARM Acre Value Peraa l eel -7 og Tillable 2 Tillable 3 Woodland Swampland FRONTAGE ON WATER Brushland FRONTAGE ON ROAD House Plot DEPTH BULKHEAD Totat--- DOCK a� a.m s OMENMEMMMOM MENNINs MENNENtMOMENw�Uannim 0No MEN NoMEMO MMMMNMMMMMMMMMNMEMM Amari Deisgn Associates e ARCHITECTURE - SPACE PLANNING • INTERIOR DESIGN June 19, 2014 Town of Southhold Building Department Town Hall Southold,New York 11971 Re: Proposed Maintenance of Existing One Story Family Room Addition: DE PINTO RESIDENCE -365 DONNA DRIVE,MATTITUCK,NEW YORK To Whom it May Concern: Reference the above captioned project, we were retained by the Contractor for the Property Owner, Rose&Joseph De Pinto to prepare an architectural drawing depicting an existing one story wood frame addition proposed to be maintained at the above captioned property. In that regard, please find attached four(4) stamped and signed copies of same. Also attached are paperwork applications for a Building Permit, Storm Water Management worksheet, and Certificate of Occupancy application. The Contractor will also submit other paperwork documents as may be required by your office. As shown on our drawing, the subject one story wood frame addition is 18 feet x 23 feet in overall dimension and yields 414 square feet. The space is used as an open Family Room area. From our on-site visit to the residence on June 4, 2014, the existing work that we were able to observe in the Family Room addition appears to have been completed in accordance with applicable sections of the NY State Building Code as understood to apply to this particular structure. It is our intention that any upgrades or modifications to the existing construction, if they are required,be made to comply with code. If you have any questions regarding our drawing or the data contained herein, please give me a call at(631)467-3415 or e-mail me at abmarino(?i uno.com. Your help in expediting a Certificate of Occupancy/Completion for our client is very much appreciated. Thank you for your cooperation and kind consideration. Very Truly Yours, ANTHONY B. MARINO Registered Architect 6 LAKE LANE,LAKE GROVE,NEW YORK 11765 PHONE/FAX:(631)467-3415 Amari Design Associates �--- ARCHITECTURE • SPACE PLANNING • INTERIOR DESIGN July 23, 2014 ff Town of Southhold � � JUL 24 Building Department Town HallSouthold,New York 11971 70"J ` oF;'ou Re: Foundation for Existing One Story Family Room Addition: DE PINTO RESIDENCE -365 DONNA DRIVE,MATTITUCK,NEW YORK To Whom it May Concern: Reference the above captioned project,we were retained by the Contractor for the Property Owner, Rose&Joseph De Pinto to prepare an architectural drawing depicting an existing one story wood frame Family Room addition proposed to be maintained at the above captioned property. Our drawing and other related paperwork documents are currently under review by your office. Based upon our recent site visit to the residence, we observed a typical section of the cast in place concrete foundation structure provided. From what we were able to review, the foundation structure appears to have been built to the proper depth, and is of suitable quality to conform with applicable sections of the NY State Building Code as understood to apply to this particular structure. If you have any questions please give me a call at(631) 467-3415 or e-mail me at abmarinokiuno.com. Your help in expediting a Certificate of Occupancy/Completion for our client is very much appreciated. Thank you for your cooperation and kind consideration. Very Truly Yours, ED ApC ANTHONY B. MARINO e 'a Registered Architect (PA '9j• 171774 Q A F o� NE.`N 6 LAKE LANE,LAKE GROVE,NEW YORK 11755 PHONE/FAX:(631)467-3415 SUFFOLK COUNTY DEPARTMENT OF CONSUMER AFFAIRS HOMEIMPROVEMENT CONTRACTOR LICENSE NOM SALVATORE SQUILLACE This certifies that the amNmNAms bearer Is duly PRO SOURCE CONSTRUCTION LLC licensed by the County of Suffolk """�"�"°" 08111 D 35522-H x:3/11/2004 `XP "MN D"n 08/01/2014 SUFFOLK( COUNTY 13 OCCUPATIONAL LICENSE HOME 15 1mP.R,:0V- EMENT 16 17 verage/Compass - -Page : 002 yv "1 �Vu1ti1V1G U_ J•t)3J-Ot`5'jz U C Client#: 7751032 PROSOU51 ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS 4 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 certs of t holder is the terms and conations of tan ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WANED,subject to he 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 NTA CBS Coverage Group NAME: PHONE 516 938-9000 51693875 A Division of Assured SKCG Inc A1C,No,E.,): 11A1C,No E-MAIL 111 Express Street ADDRESS: Plainview, NY 11803 IN3URER(S)AFFORDING COVERAGE _ NAIC X INSURER :Main Street America Assurance C 29939 INSURED Pro Source Construction LLC INSURER B Salvatore Masonry Contracting INSURER C One Clare Court INSURER D Manorville, NY 11949 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. IN-BR ADDL UBR LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER POLICY EFF POLICY EXP — -- _ MMIDDIYYYY MMIDD/YYYY LIMITS A GENERAL LIABILITY MPU0540H 05/23/2014 05/23/201 EACH OCCURRENCE $1 000��� X COMMERCIAL GENERAL LIABILITY DAMAGE 7 RENTED PREMISES Ea occurrence E 500,000 CLAIMS-MADE OCCUR MED EXP(Any one person) $10 000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $2,000,000 -- AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT — ANY AUTO Ea accident ALL OWNED SCHEDULED BODILY INJURY(Per parson) $ AUTOS AUTOS BODILY INJURY(Per acadenl) $ HIRED AUTOS NON-OWNED AUTOS PROPERTY DAMAGE Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE $ --- 'AGGREGATE $ DED RETENTION$ — ------ WORKERS COMPENSATION } —____--- --- $ AND EMPLOYERS'LIABILITY WC STATU- I 0TH- ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NIA E.L.EACH ACCIDENT $ (Mandatory In NH) _ If yes,describe under E.L.DISEASE-EA EMPLOYEE $ DESCRIPTION OF OPERATIONS below ---- _ E.L.DISEASE-POLICY LIMIT 1$ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,II more space Is required CERTIFICATE HOLDER CANCELLATION Town of Soulthold SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Building Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 53095 Main Road ACCORDANCE NTH THE POLICY PROVISIONS. Southhold,NY 11971 AUTHORIZED REPRESENT ATIVE ~� a 1988-2010 A ORD ORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S281953/M281952 JDC 1`71 Ply k _ Jul 22 14 03:20p p 1 CERTIFICATE OF LIABILITY INSURANCE 17'11N"°°"ri'' 07/2212014 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 cordlicate holder is an ADDITIONAL INSURED,the P011ay(les)must be endorsed. If SUBROGATION!3 WAIVED,subject to the terms and conditions of the PDlicy, certain policies may require an endorsement.A statement on this certificate does not confer certificate holder M lieu of such endomement(s). rights to the PROOUCER SANDRA SIMPSON INSURANCE AGENCY INCDON ERRI O-OFFICE MGR 1268 WANTAGH AVE ft�M'ON 1 22 2 sfateFarm WANTAGH, NY 11793 N SIMPSONAGENCYINC.COAAF Nc 21 MSURERIS)AFFORDING COVEiUAOE MAIC 0INSURED INSUREtA:State Fern Fire and Casually Company PRO SOURCE CONSTRUCTION LLC INBURI3te: 43 1565 OCEAN AVE INSURIai C: BOHEMIA NY 11716-1917 INSURER D: INSURER E: COVERAGESNSURER F: CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT INDICATED. NOTWITHSTANDITHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD NG 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 CLARAS. I'IL18R TYPE OF INSURANCE POLICY NUMBER M LI U GENE RAL LIABILITY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CIMS-MADE 0 OCCUR PREMISE Ea occurrence $ MED EXP(Any one pennon) S PERSONAL 3 ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE E POLICY PRO. LCC PRODUCTS-COMP,�DP AGG $ AUTOMOBILE LIABILITY S ANY AUTO (EsaedWnU L S ALL OWNED SCHEDULED BOgLY IkJURY(Per person) ACOS AUTOS S HIREDAUTOS NDN-OWNED BODILY INJURY(Peraccidant) $ AUTCS PRO s UMBRELLA LIAB OCCUR S EXCESS LIAS CLAIMS.MADE I EACH OCCURRENCE S _ DEO RETENTIONS AGGREGATE y WORKERS COMPENSATION ---1— AND EMPLOYERS'LIABILITY x VCSTATU Try- S ANY PROPRIETO;VpARTNERlEXEC1ITIVE YIN1MY LIMITS OryIn N"EXCLUDED? NIA Y (M192-BX-AS9" @-L EACH ACCIDENT M unddescribe S and 08007/2013 08!07!2014 100,000 It teeONOFC)PERATmNA below er E.L.DISEASE-EA EMPLOYE t � 100,000 ❑ E.L.DISEASE-POLICY LIMIT $ 500,OD0 DESCFUPTON OF OPERAT7DNS!LOCATIONS)VEHICLES(Attach ACORD 101,Addtlonal Remwks Schedule,R more space Is r"ulred) CERTIFICATE HOLDER CANCELLATION ;-5513D95 N OF SOUTHOLD BUILDING DEPARTMENT SHOULD ANY OF THE ABOVE DESMSED]POLICIES BE CANCELLED BEFORE MAIN RITZ THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED INACCORDANCE WITH THE POLICY PROVISIONS.THOLD, NY 11971 AURE NTATIVE ^ ®1988-2 10 � � AGORD 25(201 0105) The AGORD name and 1090 are RD CORPORATION. AI!rights reserved. o$ registered marks of ACORD 1001486 132849.8 01-23-2013 I IX r -1•.,,�#`'1 tom.:.;. d ",'r' � YI 'k'-,.;•- `r �� h New �{ K E'NUE' ,o "DLXco rarY a c h DA��P !'6197& HUz '+. .• ,"7�b i UFA., ' K� , 'All 14 yF I �}th ¢ �°pVi «y '' LA7: ewK+4• >a96��?El^ r supply Mma i , uctlon htivq beer t Y 3 ,TvctE.d.by •,t�' I ep CO be sgLjCL yd°Dc13L07�AA a y1 �;p" d Icog tr ro fI. / of /92.00' . j h V �� VA i o w [i O N NZ 14 V 4.4k. Alo�.IOEE �l N b '. N.87°19 50--w 1 Lot 6'g u NorE: ; ■ s MONUMENT to O o STAIXE I ---- S(A90/VISION MRP P/LEO M TN£OPPICE ' Of THE CLERK OF SUFFOLK COUNTY ON ✓AN. 26,/965 AS PILE NO.-256. S`OtE OF NEk y ats", W Y O*t ME LOCRTLON OF WPLLS A"CESSPOOLS O O SLLOWNLLE9EIy AAE FL)0l1 FIELD OAZZAVATIONS . Z Amon(FEOIY DATE osTRINED I=oM OTRLSS .•� ....,,.,�.,..,.,..w,p�r..�..�.`p"����e"-'1F O r1 l�Ql.:n ati .'� ,,, �:'"'�=. �+y y2 4bSg5 NOV. 21,1978 400 OSTRANDER A`IENUE, RIVERHEAD, NEW YORK' MAY/2,1976 HOWARD-W,YOUNG 4N0 Sl'�� AL7EN W.YOUNG S PROPES910MAL ENGINEER AND LAND•URVLYCR -LAND MURV[YOR.ft.Y.S.LIC.NO.12842 N.`:.C.E.1C.NO.45E9] SURVEY FOR: unu THUR,:CO AETERATM OR ADG:TION TO Is SORVEY IS A VIOLATION Or SECrICN BEN MENDOZZA- 'iJ9 Cr THE TZW YORK SWE EOJCATION, - t_UT 70 :"DEEP HOLE .CREEK ESTATES " IES IF THIS SJRVEY NAP NOT CEARI" r .'^E r AND SURVEYOR''• INREC SEAL OR - cY .M?OSSEO 'EA: S"AL. NOT 9 =ONSIOEAEO /` - SE A';400 TRUE CCPV AT GUARATNT C' MA 1 TI TUCII ffD TO: Ra"rzt: HnIEAT. SOUTHOLDY SAVINGS BANK D"ERE°":HAEe.RUN GUARANTEED TITLE DIVISION Or 11 ...ERSO"'OR wl.cu 1" TOWN OF •,Fli /�( E� , I•;PRE I ARr].A'JO IN HIS RE"ALT SOUTHOLD � AM.R1 AN TITLE INSURANCE CO. { THE t It C::M.. .i,00'.r?NMENIAL 9Y :.Gr .YVII IENDI":.NSTI :ION L.STED /�//�� ^^tt �/ EON,4'.J 10*"E ASSICNEf.OF THE SUFFOLK CL., N. i. !. D� ­TITI;Ti•_:N GU...4TFES ARE j vdi ISANz:FRAG. TO AC01Y!ONAL SCALE: 11 ^of lD/�TE:/QCT. IO 1975 N' 7 ^CSE n STIP:T IO"S W 5JUSEOUENT ORRERS. 'Y 1) " f 1 r"81 17 11 ST v-71-09 13 BUILDING DEPARTMENT ISSUE GENERAL NOTES: 1 ) THIS DRAWING IS INTENDED TO INDICATE "EXISTING BUILT CONDITIONS" OF THE EXIST'MAIN HOU5E CONSTRUCTION SUBJECT RESIDENTIAL FAMILY ROOM ADDITION AS OBSERVED AND DATED ON THE PLANS. DONNA DRIVE N2°40'40','F- I 10.00' 2) ALL CONSTRUCTION WORK SHALL COMPLY WITH THE NEW YORK STATE BUILDING w CODE (LATEST EDITION), TOWN OF SOUTHHOLD ZONING ORDINANCE, AND ALL OTHER CODES HAVING JURISDICTION. 40'-0" 36-0" I � 3) ALL DIMENSIONS AND MEASUREMENTS SHOWN ON THE DRAWINGS ARE Z APPROXIMATE AND ARE SUBJECT TO VERIFICATION AT THE SITE. 01. 4) DIMENSIONS SHOWN ON THE SITE PLAN ARE TAKEN FROM LAND SURVEY AS ::•..;;EXI9TN6ONESTORI 27'-G" .FRAME RESIDENCE N.I.C. :'.:'.'.. PREPARED BY HOWARD W. YOUNG LICENSED LAND SURVEYOR DATED SEPTEMBER I G, 197G. EXISTING ONE STORY FRAME RES 1 D E N C E (N . I .C.) (+/-)27'-G° 8'-O" EXISTING I STORY FRAME EXI5T.MAIN Hou 5E CONSTRUCTION FAMILY ROOM ADDITION TO BE MAINTAINED BUILDING DEPARTMENT NOTES: TYPICAL I SECTION 23'-0" (+/-)19'-0" 1 ). THE EXISTING MAIN HOUSE CONSTRUCTION ILLUSTRATED ON THESE DRAWINGS HAS 2 BEEN PREVIOUSLY APPROVED AND IS COVERED UNDER A SEPARATE CERTIFICATE AB-I OF OCCUPANCY. Iv V C� 2). THE INTENT OF THIS DRAWING IS TO GRAPHICALLY REPRESENT THE FLOOR PLAN GARAGE KITCHEN / DINING I BEDROOM / BATHROOMS AND CONSTRUCTION MATERIALS USED FOR THE EXISTING ONE STORY ATTACHED WOOD WOOD STAIR WITH HAND FRAME FAMILY ROOM STRUCTURE SITUATED AT THE SUBJECT ONE FAMILY RESIDENTIAL RAILINGS EACH SIDE EXISTING BUILT-UP HEADER BEAM r WITH THRU-BOLTS PROPERTY SITE. -- -- - PROP05ED NEW(2)Ij"x 9&' (2)MICRO=LAM HEADER BEAM FULL SPAN TO REPLACE EXISTING Z'_9n ,•; NOTE: .: 3). IT IS THE INTENT OF THE PROPERTY OWNER TO LEGALIZE AND MAINTAIN THE SUBJECT 4rG"WOOD POSTS BEARING FROM UNDERSIDE OAK RAILING ' OF HEADER BEAMS DOWN 4"x 4"WOOD FAMILY ROOM AS PRESENTLY CONFIGURED AND SHOWN. TO CONCRETE FOUNDATION INTERMEDIATE 5 PO T WALL(TYPICAL-VJ.F) ,�4'-O" --T-1" F] - 4). THE SCOPE OF WORK FOR THE ARCHITECT IS LIMITED TO REPRESENTING THE EXISTING I �1'O"WxG-o"L� 1 THERM. IN5UL. FAMILY ROOM STRUCTURE HEREIN AS OBSERVED AT THE SUBJECT SITE . HE HAS NOT ELEV. I I UN FIXED ET 1 1 524o'4o"E i lo.00' BEEN RETAINED FOR SERVICES RELATED TO CONSTRUCTION UPGRADES IF THEY ARE , 1 1 FAMILY ROOM REQUIRED BY THE TOWN OF SOUTHOLD. AB-1 14'-9" L� EXI5T.ROCMADDITION L J (CERAMIC TILE OVER CONCRETE SLAB ON GROUND) p r­"�'\Existing Site Plan (N.T.S.) LU o N De Pinto Residence - 365 Donna Drive NOTE: N o U Mattituck,New York CONTINUOUS BUILT-UP WOOD HEADER CONTINUOUS WOOD FRAME BEAM 5PAN5 ABOVE GLA55 OPENINGS {PANEL BASE WALL 2 0— O" AND BEAR ON TWO END POSTS AND INTERMEDIATE 4NG"VERTICAL SUPPORT P05T5(TYPICAL ALL AROUND NEW FAMILY NOTE:TH15 15 A SITE PLAN, NOT A SURVEY. DIMENSIONS SHOWN ON THE 51TE PLAN ROOM ADDITION-V.I.F.) 0.. ARE TAKEN FROM LAND SURVEY A5 PREPARED BY HOWARD W.YOUNG, LICENSED LAND CONTINUOUS ALUMINUM FLASHING SURVEYOR DATED SEPTEMBER 16, 1976. UNDER ROOFING SHINGLES BETWEEN MAIN ROOF 4 ROOM ADDITION ARCHITECTURAL 5TYLE ROOFING SHINGLES (+/-) I G'-0" (+/-)23'-0" (+/-) 19'-O" LINE OF MAIN EXIST.ROOM ADDITION ELEV. HOU5E STRUCTURE ALUMINUM GUTTERS SET ON ALUM. CLAD WOOD FASCIA BOARDS 3 PAIR OF THERMALLY THERMALLY INSULATED GLA55 INSULATED FRENCH SLIDING CASEMENT WINDOW UNIT5 5ET ZONING DATA: GLA55 DOORS BETWEEN SOLID WOOD PO5T5 SET OVER CONCRETE BASE WALL Existing Room Addition Floor Plan 79--- E= �4"H VINYL SIDING fitELEV. N 1 ). EXISTING SITE AND REISIDENCE STRUCTURE EX15TINGGRADE (N.T.S.) IS LOCATED WITHIN THE TOWN OF SOUTHOLD. C r__ • NOTE: TM15 DRAWING DEPICTS EXISTING CONDITIONS OF APPROVED 2). EXISTING STRUCTURE IS A WOOD FRAME SINGLE Existing Left Side Elevation RESIDENTIAL STRUCTURE INCLUDING ATTACHED FAMILY ROOM FAMILY RESIDENCE. PROPOSED TO BE MAINTAINED AND LEGALIZED AS SHOWN ON THE PLANS. 3). ZONE DESIGNATION: RESIDENTIAL TYPICAL 4). SCTM NUMBER: SECTION: 1 15 BLOCK: 16 LOT: 3 SECTION 2 EL.EC RICAL AB- IN CT* ALL CONST " 'O,':'^,LL ' �!tl MAIN HOUSE STRUCTURE MEET THE REQS.8'-O" '-� THE EXIST.ROOM ADDITION (�� 4-5 MAIN ROOF E%ISTING BUILT-UP HEADER BEAM CODES OF I tl�¢�.,' j��,�)�)\y;��tiTc.. STRUCTURE WITH THRU-BOLT5 BEARING ON O,N D SOLID WOOD P05T5 EACH 51DE ,y R �{J (AUGN5 OVER CONCRETE FOUNDATION ALUMINUM GUTTERS SET ON ALUM. N 1` WALL BELOW(V.LF') THERMALLY INSULATED EXISTING MAIN HOU5E CLAD WOOD FASCIA BOARDS PROP05EO NEW(2)I+x 9k' OW ROOF RAF1 ER5 FIXED 5KY LIGHTS CONSTRUCTION(BEYOND) MICRO=LAM FULL SPAN HEADER BEAM AT G"o.c. ARCHITECTURAL STYLE ROOFING APPROVED AS (PROVIDE BEAR)NG EACH 5IDE OF BEAM{ AT CENTER POST,PROVIDE 51MP50N METAL SHINGLES FASTENERS TO ADJACENT STRUCTURAL ROOFING 5HING OVER. :-f MPLYWOOD EMBERS A5 PER CODE) VAPOF.BARRIER DN D A T F /�B-P # L—„0,-�/� 5HEA ING 5ATT5 BETWEEN INSULATION ETWEEN RAFTERS NEW SUFFOLK AVENUE (TYPICAU ELEV. ALUMINUM GUTTERS SET ON AWM. Tr 13/ p 8 O KITCHEN/DI ING CLAD WOOD FASCIA BOARDS AB-I y # '� G'_9” MIN.(3)2'xe'CONT. NOTIFY BUILDI� C, DCS fi HEADER BEAM YJ'� f��� � � I` 765-1802 8 ANI T G 4 �=,'" THE OAK RAILING THERMALLY INSULATED GLA55 " ' I A i6 FOLLOWING INSPECTIOI',"; 9'-2" THERM.IN5UL. 4"H VINYL SIDING CA5EMENT WINDOW UNIT5 U S E !2, U N LAl '. E(,nd FAMIL KOOM CA5EMENTWINDOW SET BETWEEN SOLID WOOD 1. FOUNDATION-T\PJO �.ED T-Q" UNITS . BA5E WALL OVERCONCRFTE " �" g , FOR POURED CONCkETE 2. ROUGH FRAMING,FLU'£1GI NG, L C.I.P.CONCRETE I BASE WALL ' .. L I.: STORAGE L CERAMIC TILE OVER CONTINUOU5WOODFRAME C.I.P.CONCRETE , ; - -•; d STRAPPING, ELECTRICAL&CAULKING CAB.'S BELOW CONCRETE SLAB ON GROUND {PANEL BASE WALL MAIN FLOOR LINE OF GRADE BASE WALL#FOUND. EXISTING GRADE �C.LP.f GRADE GRADETE 3. INSULATION 4. FINAL CONSTRUCTION &ELECTRICAL 3'-O" FOUNDATION WALL MUST BE COMPLETE BASEMENT (MIN.V.I.F.) W/FOOTING ALL CONSTRUCTION SHALL MEET THE SUBJECT SITE: REQUIREMENTS OF THE CODES OF NEW MAIN HOUSE - YORK STATE, NOT RESPONSIBLE FOR FOUNDATION WALL Existing Rear Elevation DE PINTO RESIDENCE DESIGN OR CONSTRUCTION � PORS. FOOTING 365 DONNA DRIVE R A5- 1 (N.T.S.) MATTITUCK,NEW YORK FED BApo M Cy 2 ExistingTypical Section Through Room Addition N �`� IT �0 0 A. Site Location Map (N.T.S.) NOTE: ALL CONSTRUCTION WORK FOR NEW ROOM ADDITION TO BE De Pinto Residence - 365 Donna Drive �'>► AS PER APPLICABLE N.Y. STATE CODE REQUIREMENTS. MattituCk, New York 4>� �7MA �O o EXISTING DOOM ADDITION TO BE MAINTAINED f N�vs Amari Design Associates DE PINTO RESIDENCE ARCHITECTS—SPACE PLANNERS—INTERIOR DESIGNERS ISSUE REVISED FOR REVIEW BY OWNER * BLDG. DEPT. (G. 19. 14) 6 Lake Lane,Lake Grove,NY 11755 (Na)&'-3415 365 Donna Drive, Mattituck, New York 1 SSUE FOR PRELIMINARY REVIEW (G. 1 1 . 14)