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Home My WebLink About39220-Z C"VO."v) Town of Southold Annex 11/25/2014 P.O.Box 1179 54375 Main Road Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 37286 Date: 11/25/2014 THIS CERTIFIES that the building ALTERATION Location of Property: 960 Pequash Ave, Cutchogue, SCTM#: 473889 Sec/Block/Lot: 103.-11-7 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 9/16/2014 pursuant to which Building Permit No. 39220 dated 9/29/2014 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: roof alteration to an existing one family dwelling as applied for. The certificate is issued to Mettham,Hugh&Ponzini, Suzanne (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED A o ' ed Signature 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#: 39220 Date: 9/29/2014 Permission is hereby granted to: Mettham, Hugh & Ponzini, Suzanne 13 Bar Beach Rd Port Washington, NY 11050 To: Alteration to an existing single family dwelling as applied for. At premises located at: 960 Pequash Ave, Cutchogue SCTM #473889 Sec/Block/Lot# 103.-11-7 Pursuant to application dated 9/16/2014 and approved by the Building Inspector. To expire on 3/30/2016. Fees: SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $200.00 CO -ALTERATION TO DWELLING $50.00 Total: $250.00 Buildin Inspec 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 ofOccupancyon 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. Z06O& New Construction: Old or Pre-existing Building: (chedone) Location of Property: /C% House No. cJ,/ Street (� Ha t Owner or Owners of Property: 11llq A �e� 4' (12/4n le PI 07-/n /, Suffolk County Tax Map No 1000, Section-7#1-- q-7 3 oo-9 7—Block Lot 7 Subdivision (� Filed Map. &` // Lomat: 7 Permit No. .3 2.2,o Date of Permit. Applicant: 4" ✓ ///��/"_ Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: IF 6/pp �Sign ure N • TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOU ATION 1 ST [ ] ROUGH PLUMBING [ ] F NDATION 2ND [ ] INSULATION [ FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: DATE Q INSPECTOR o��pf SO(/1�0 Q • �o TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROU PLUMBING [ ] FOUNDATION 2ND [ ] 1 LATION [ ] FRAMING / STRAPPING [ INAL [ ] FIREPLACE $ CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL(FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: It DATE INSPECTOR FIELD IIV'SPE=ON REPORT DATE COMMENTS 9 FOUNDATION(IST) cov> 1TN�PMN�KNrKN Yw FOUNDATION(2ND) VVV 1111 Vim/ CA ROUGH M01 NG& �� PLUMBING t� INSULATION PER N.Y. H STATE ENERGY CODE co FINAL A AA rn r 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 FFD E �� Septic Form N.Y.S.D.E.C. Trustees Flood Permit � Contact: Examined ,20 SEP 15 2014 � Storm-Water Assessment Form Cy � Approved l ,20B''' ,N r P" T -r� Mail to: WO'!' 01 PIJT'HOLD Disapproved a/c Cal Phone: Expiration Q ,20 /(. udy g Inspector CD 3 7�-7 l�17d r APPLICATION FOR RMIT Date , 20 /06 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. i atur o app icant or naine,if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder GJ Name of owner of premises (As on the tax rolf or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. 'ro( Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on proposed work will be done: House Number treet H County Tax Map No. 1000 Section Block � ' Lot Subdivision Filed Map No. Lot s ►+ r 'r1YR � y. do 2. 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 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 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 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 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 i * 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, CONNIE D. BUNCH Notary Public, State oe Ncv,'yotk (S)He is the No.01-IJE18r5u",J" Quaraled (Contractor,Agent, Corporate Officer,etc.) Commission Exi_'iroZ Ap,i1 `' 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. Sw_or o before me this I,,,� ' 15 M day of� 6'l 20_1_q_ Notary Public i ure o p scant Filed Map No. Lot Sf division 2. State existing use and occupancy of premises and intende se and occupancy of proposed construction: �`fe a. Existing use and occupancy b. Intended use and occupancy �S� r��/ ii `Ie�r� ✓ �/�'le ice`' Ji� e 3. Nature of work(check which aMlic le): New Building Addition Alteration Repair Removal a Demolition Other WoU �'�c7`� y,J/,j7,3�L(Description)/fc-t � ' 4. Estimated Cost `"/ "e 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— 4 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of ex's ' structures, if any: Front Rear 38 Depth 34"A /,7 � Height Number of Stories Dimensions of same structure with alterations or additions: Front X)f" Rear Depth .3q w /7 Heights Number of Stories 077c-,- 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 00 9. Size of lot: Front 70Rear ,7Depth o2 10. Date of Purchase 1-1 _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 Vl rillexcess fill be removed from premises?YES NO ,*51) /ne7'tA 'n', / 6N�cc h Rod- 14. Names of Owner of premises Address 3 A��'W,4sh.BUY I oPhone No. .5 Name of Architect Address Phone No Name of Contractor/AAu/- Address Jf' .-1�1R �N APhone No. 63/` 7p?7-670 y 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 1/ *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 osurvey. 18. Are there any covenants and restrictions with respect to this property? * YES NO * IF YES,PROVIDE A COPY. STATE OF NEW YORK) SS: r Scott A. Russell °su p ST01KMWAXIER. SUPERVISOR z IM[ANA\G]ENCENT SOUTHOLD TOWN HALL-P.O.Box 1179 0 53095 Main Road-SOUTHOLD,NEW YORK 11971 'kyto Town of So u th o l d CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) DOES TRIS PROJECT INVOLVE ANY OF THE FOLLOWING: Yes No (CHECK ALL THAT APPLY) A. Clearing, grubbing, grading or stripping of land which affects more ,..,.,/ than 5,000 square feet of ground surface. El[B B. Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. C_ Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. ❑ D. 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. #: 1 stn Date: f District ^-� NAME: V' I O3 HL / ��—� (PI Section Block Lot — o7'J� FORBt."I _D1Nta DI. PAR'1'M[-.',�i"1_ U. ONIN Contact Informati � Reviewed By: Date: Property Address/ Location of Construction Work: — — — — — — — — -- — — — — — — Approved for processing Building Permit. Stormwater Management Control Plan Not Required. ❑ Stormwater Management Control Plan is Required. (Forward to Engineering Department for Review.) FORM " SMCP-TOS MAY 2014 i TOWN OF SOUTHOLD PROPERTY' CORD CARD A - WNER STREET VILLAGE DIST. SUB. LOT 4 � ' `, u , (/e. 0W k,4 dq v e 1.2 toe-PC t-r 0111 04,1 -FORMER OWNS ' ( �fit-, N# fir} E ACR. µ. tl i-'aI a Q- P "1,,D # W TYPE OF BUILDING 0. z fp SEAS. VL. FARM COMM. CB. MISC. Mkt. Value f LAND IMP. TOTAL DATE REMARKSY � /r� •- o a 4 0 If&ALeY 4/ /fie g- ' Q Z, &'I`/4( .0 a.�+Ir,'A-e it a s- s— - - pc. on -L 14 — ' AGE BUILDING CONDITION , NEW NORMAL BELOW ABOVE -7 � Lia , -, -0 ��tr� 414 �rJ_ � a. FARM Acre Value Per Value Acre Tillable I Tillable 2 Tillable 3 Noodland swampland FRONTAGE ON WATER 3rushland FRONTAGE ON ROAD f� -louse Plot DEPTH *400, ' v BULKHEAD Total DOCK ONE MENNENNOOSEENOMM iY1MENEM IW■ EMENRIBM �MEMEMMMMMMYllp MONO EMMu FIZZUOGLIO CONSTRUCTION 19 INDIAN AVENUE FLANDERS,NEW YORK 11901 631-727-1970 631-740-9000 FAX PROPOSAL SUBIED TO : 8-25-2014 HUGH METTHAM 960 PEOUASH AVE CUTCHOGUE, NY 516-859-2776 RE: ROOF REPLACEMENT a 960 PEQUASH AVE REMOVE EXISTING ROOFING TO SHEATHING REPLACE&REPAIR ANY DAMAGED SHEATHING INSTALL ICE &WEATHERSHIELD ALONG EAVES AND PENETRATIONS INSTALL 30#UNDERLAYMENT INSTALL NEW PLUMBING FLASHINGS INSPECT AND REPLACE ANY DAMAGED OR DETERIORATED FLASHINGS INSTALL NEW GAF 30 YEAR ARCHITECTURAL SHINGLES ` HAUL AWAY ALL RUBBISH TEN YEAR WORKMANSHIP GUARANTEE EXTEND FACIA AND SOFFIT APROXIMATLY 8 TO 10 INCHES ON NORTH SIDE $7200.00 FABRICATE ANY REVERSE GABLE ON FRONT OF HOUSE TO MATCH EXISTING ROOFING AND SIDING ON GABLE INCLUDED $2,200.00 THIS IS A PROPOSAL ONLY. THIS IS NOT A CONTRACT. WE WILL ADHERE TO THIS PROPOSAL FOR 30 DAYS FROM DATE. THANK YOU pF SO!/ryQlo Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 G • Q Southold,NY 11971-0959 'Q �ycDUNTY,� ` November 17, 2014 BUILDING DEPARTMENT TOWN OF SOUTHOLD Hugh Mettham 13 Bar Beach Rd Port Washington NY 11050 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. A fee of$50.00. Final Health Department Approval. Plumbers Solder Certificate. (All permits involving plumbing after 4/1/84) 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. Final Storm Water Runoff Approval from Town Engineer BUILDING PERMIT — 39220 - Alteration r 1 k , d t r • A A `C 4 04,p �J f ' NYS BA FORM(1998;amended 9/25/00)-Heman to Mettham&PonzinI-10 SUFFOLK COUNTY DEPT OF LABOR, LICENSING&CONSUMER AFFAIRS f ` HOMEIMPROVEMENT i CONTRACTORLICENSE I N PAUL FIZZUOGLIO This certifies that the bearer is duly FIaUOGLIO CONSTRUCTION " licensedby the County Of Suffolk "'" Doi1iiui° 50921-H 12!27!2012 E""""°"°"h 12/01!2014 A� CERTIFICATE OF LIABILITY INSURANCE 09/15rM 2"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: H the certificate holder is an ADDITIONAL INSURED. the policy(les)must be endorsed. If SUBROGATION IS WANED,subject to the teens 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 JAMES KOWALSICK MIACT EILEEN CUSHMAN 1116 MAIN RD 5�•2Llp�L51.E,11:631-7224100 �X.NO)..631-722-4500 PO BOX 2336 ACDRESS. AOUEBOGUE.NY 11931 INSURER{S)AFFORDING COVERAGE NAIC0 INSURER A: FARM FAMILY CASUALTY INS.CO. 120 INSURED 04SURER 0 PAUL FIZZOUGLIO MISURER C r 19 INDIAN AVE INSURER D RIVERHEAD.NY 11901 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- -LLIMITS SHOWN SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE IN L SWVO. POLICY NUMBER IMPR I FYI (MMID Y P LIMITS A GENERAL LIABILITY 3101 X 1697 09/08/201009108/2015 EACH OCCURRENCE s 1.000.000 COMMERCIAL GENERAL LIABILITY R"E'AMI�.O(&a�ewr°e�oa) s _ 50.000 CLAWS-MADE OCCUR MED EXP(Any arra parson) s 5,000 XX CONTRACTORS PERSONAL d ADV INJURY S INCLUDED ADVANTAGE GENERAL AGGREGATE $ 2.000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG S 1,000,000 XX POLICY JECT LOC $ AUTOMOBILE LIAMMY ICFOOMB ;INGLE LIMITaccidentS ANY AUTO BODILY INJURY(Per paean) S Ath ffNED r�UHTStULED BODILY INJURY(Par accident S HIREDAUTOS AUTOSINNED (Per MS s - - UMBRELLA LIM OCCUR EACH OCCURRENCE s EXCESSLWB CLAIMS-MADE AGGREGATE S DED RETENTION S $ _ A WORKERS EMPLOYERS' LI A ILII 3101 W7532 09/08/2010 09/08/2015 XX TORY LIMITS ER AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNER IXECUTIVE Y/N MIA A E L.EACH ACCIDENT S 100,000 OFFICERIMEMBER EXCLUDED; - IWrlgail ry in Nit E L.DISEASE-EA EMPLOYEE S 100,000 IiIIescabe 4.11,10401' DYas�RR IPTION OF OPERATIONS ONow E L.DISEASE-POLICY LIMIT S _ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101.Addhiml Ren+arks Schedule,d nwre space Is repulrod) 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 53095 RTE 25 ACCORDANCE WITH THE POLICY PROVISIONS. POB 1179 AUTHORIZED REPRESENTATIVE SOUTHOLD NEW YORK 11971 /�� ®1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD f7- APPROVED AS NOTED _YC ,�`:'i s H ALL CODES OF DATE: Z-�I B.P.# NEW K SIATE & TOWN CODES FEE: �-�� BY: AS REQUIRED F NOTI Y BUILDING DEPARTMENT AT 765-1802 8 AM TO 4 PM FOR THE ARD FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED S FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING --- tt".Moll 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. - o�- I OCC �a UPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY 3 t X /57/SVG ��S i �F o,v7� C7 e v Yio t� . ��1,> j ��Q s �t 4v C- UJITN- tqLTrtA7)0 U i c'J' se NCO V'l� - ,�-- g` -- f7- 'fJq I'��aU* sue �I IT 1 4 341