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HomeMy WebLinkAbout34208-ZTown of Southold P.O. Box 1179 53095 Main Rd Southold, New York 11971 CERTIFICATE OF OCCUPANCY 4/15/2015 No: 37512 Date: 4/15/2015 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 1505 Naugles Dr, Mattituck SCTM #: 473889 Sec/Block/Lot: 99.-4-27.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/8/2008 pursuant to which Building Permit No. 34208 dated 10/8/2008 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: ACCESSORY IN -GROUND SWIMMING POOL AS APPLIED FOR The certificate is issued to Sessa, Leonard of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 4391 07-07-2008 Authoriz ignature FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 34208 Z Date OCTOBER 8, 20,4 01 Permission is hereby granted to: LEONARD SESSA 555 NORTHERN BLVD. GREAT NECK..NY 11021 for : CONSTRUCTION OF AN IN -GROUND SWIMMING POOL AS APPLIED FOR. THIS PERMIT REPLACES EXPIRED BP # 31388 at premises located at 1505 NAUGLES DR MATTITUCK County Tax Map No. 473889 Section 099 Block 0004 Lot No. 017 pursuant to application dated OCTOBER 8, 2008 and approved by the Building Inspector to expire on Fee $ 150.00 Rev. 5/8/02 ORIGINAL FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold,.N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 31388 Z Date AUGUST 24, 2005 Permission is hereby granted to: PETER & BARBARA SWAHN PO BOX 729 MATTITUCK,NY 11952 for CONSTRUCTION OF AN IN GROUND SWIMMING POOL AS APPLIED FOR at premises located at 1505 NAUGLES DR MATTITUCK County Tax Map No. 473889 Section 099 Block 0004 Lot No. 017 pursuant to application dated AUGUST 17, 2005 and approved by the Building Inspector to expire on FEBRUARY Q7. Fee $ 150.00 Autho ORIGINAL Rev. 5/8/02 )L d Signature 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 � 0 V New Construction: Old or Pre-existing Building: Date. 9 (check one) Location of Property: (� OS f 0,UO1,. S i MCk++1 fQ_d - fiy House No. 1 Street c A Hamlet Owner or Owners of Property: L e on a rd j Sok--- Suffolk County Tax Map No 1000, Section Block Lot Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept. Approval: Underwr Planning Board Approval: Request for: Temporary Certificate Final Certil Fee Submitted: $ v _06) SUFFOLK _BUREAU of . ELE.CTRI CAL INSPECT0RS,inc. 40 Nottingham Drive, Middle Island, NY 11953 Telephoner 63149.5 8136 n Fax: 631 980 6455 ■ E -Mail: SBEIGS@gmail.com CERTIFICATE OF ELECTRICAL COMPLIANCE Applicant: Kranz Electric Rough In Inspection Date: 3/27/2007 Application No,--. 4391 Suffolk County Tax Map N°: Final Inspection Date: 7/7/2008 Certificate .N°: ... 4.39.1 Building Permit N°: This Certificate of Electrical Compliance. is limited to the inspection and compliance of electrical equipment and/or work described below, installed by the applicant named above, located at the premise of and not after the final inspection date above: Owner: Sessa Address: 1505 Naugles Drive, -Mattituck, NY 11952 Address of Inspection Site: 1505 Na.ugles Drive, Mattituck, NY 11952 X Residential.. -X Indoors X Basement X Service Commercial X Outdoors X Ist Floor X Pool X New Renovation X 2nd Floor Hot tub Addition Survey X Attic X . Garage Inventory 4000G Service 10 -Oil Heat 123 Duplex Recpt 25. Ceiling Fix Service 30 Time Clock 91 Switches 49 Wall Fix 2-40ckt Main Panel Hot Water .6 GFCI Recpt 173 Recessed Fix 20ckt. Sub- Panel GFCI Breaker 4. Single Recpt Fluorescent Fix 2 Disconnects 2 Dryer Recpt Range Recpt 2 A/C Blower Transformers Exhaust Fan 11 Appliance 2 A/C Cond Twist Lock TVSS Heat Pump Electric Heat Other Equipment: 1 -Steam Shower, 1-]andy Pool Panel, 1 -Gas fired Pool heater. Shed Other: HID Fix 11 Smoke Det 2 Co Det . 3 Pump Emergency Fix* Exit Fix 1 Pool Luminaire. The electrical work and/or equipment described above were inspected and appear to be in compliance with ' local, state and national electrical code requirements and this office. {err, Applicant: Kranz Electric' - License No: 2800 -ME. 6 M+ _ <<�s' Inspected by` Gen R. SurdiDate of Certificate: 7/14/2008 k Signature: � fyp•4. .: J �.i ho��OF SOUryO� Comm TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION IST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ QCMAQVC■ ] FIRE RESISTANT PENETRATION DATE 3 �) �o —0 ? INSPECTOR FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION (1ST) y -------------------------------- FOUNDATION (2ND) r z ROUGH FRAMING & PLUMBING 0 a y Z- y INSULATION PER N. Y. STATE ENERGY CODE < r l'" y FINAL ADDITIONAL COMMENTS O z 1 t=i b O z y x d b H TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN W LI Ac SOUTHOTD.,-NY 11971 TEL:. 765-1802 Examined 120 Approved 2 , 20 Disapproved a/c a '-f I BUILDING PERMIT APPLICATION CRECKLIS'I Do you have or need the following, before applying Board of Health 3 sets of Building Plans .. Survey PERMIT NO. Check Septic Form Z . f` �„�"� fir' • ��. �fAsP <<,7 ° N.Y.S.D.E.C. Trustees Contact - Mail to: Phone: Building Inspector IN FOR BUILDING PERMIT Date ,INSTRUCTIONS 20 . NO -. a. This a`pplicatia � ST be completely filled in by typewriter Orin ink and submitted to the Building Inspector with 3 sets of plans, act. te,P of plan to scale. Fee according to schedule. b. plot plan, location of lot and of buildings on premises, relationship to adjoining premi es or public streets or areas, and waterways. c. The work covered by this application may not be comineiiced before issuance of Building Permit, issue a Building Permit to `the applicant. Such a permit d.. Upon approval of this application, the Building Iuspector .will shall be kept on the premises available for inspection throughoupt.the work- P ose what -so -ever until a Certificate of Occupant e: No building shall be occupied or used in whole or in art for an urp is issued by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant t, 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,, lterations or for removal or demolition as herein described. The applicant agrees to comply with all applicable laws, ordinaiices,: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) Q3SA -L ' (Mai g ss of applicant) it7b'z State whether applicant is. owner,, lessee; agent, atohitect,°engineer, general contractor, a"lectrician, plumber or.builder ., • (20A Pma Name of owner of premises � , (as on the tax roll or latest deed) If applicant ism corporation, signature of duly authorized officer (Name and title of Builders License No. Plumbers License No. dV Electricians License No. Other Trade's License No.�;�� i. Location of land on which proposed work will be done: House Number Hamlet ��/•''. - ` _.' �Iot,�s / � County Tax Map No . 9 Block 1000 Section Filed M No: Subdivision aP t L .A^T1 p) �q'3! IJP i �itl✓ Tr) 1 �7 �;7� �lf� {a�am•e !o'��a ���� J. rl .:'.. .. 1.7 l:_rv�r i _I � .-/ n?tw RON GIBBONS SWIMMING POOLS, Inc 2995 Sunrise Highway Islip Terrace, IVY 11752 August 15, 2005 Town of Southold Building Department 53095 Main Road PO Box 1179 Southold, NY 11971 "Three Generations of Experience" O#: 631-581-8258 Fax #: 631-581-8273 www.rongibbons.com RE: Leonard Sessa a ... 1505 Naugles Road Mattituck, New`York 11952' Sec: 99 B1k:04 Lot: 17 Swimming Pool Building Permit Application Enclosed is our complete application for a in -ground gunite swimming pool permit. The following documentation has been included: Two applications, two surveys, two set of stamped plans, insurance certificates, our Suffolk County License and the permit fee of $150. Th y u for your cooperation, (r' Peter Willstein Construction Coordinator. GENESIS1 ,mss All Th , sson0tion Or ZP) international° t$R lffi1ffl11 !SUM 817M fi 1 Aly 10 LAI r1_1 - � � rrxF�; o��OF SOUT,�O� h O Town Hall Annex 54375 Main Road P.O. Box 1179 G Q Southold, New York 11971-0959 0 �O BUILDING DEPARTMENT TOWN OF SOUTHOLD 1 st NOTICE September 23rd, 2008 Leonard Sessa 1505 Naugles Drive Mattituck, N.Y. 11952 RE: 1505 Naugles Dr. (In -Ground Pool) SCTM # 99.-4-17 Telephone (631) 765-1802 Fax (631) 765-9502 Dear Mr. Sessa, Please be advised that your Building Permit # 31388 issued August 24th 2005 has expired. According to the Code of the Town of Southold, a Certificate of Occupancy must be issued prior to use of the structure. To renew your Building Permit, please submit a fee of $150.00; at that time we can schedule an inspection by one of our Building Inspector's. If you have any questions, please call us at 631-765-1802. Respectfully, SOUTHOLD TOWN BUILDING DEPT. CC:RON GIBBONS SWIDDIING POOLS 2995 SUNRISE HWY. ISLIP TERRACE, N.Y. 11752 Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 March 23,2009 Mr.Leonard Sessa 555 Northern Blvd. Great Neck N.Y. 11021 BUILDING DEPARTMENT TOWN OF SOUTHOLD Telephone (631) 765-1802 Fax(631)765-9502 We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) OzNo Electrical Certificate on file / Inspector requesting Electrical Certification The Check is not on file - $ 25.00 No Final Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984) Certificate of Compliance from Southold Town Trustees. Approval of the Zoning Board of Appeals* Final Planning Board Approval BP# 34208 Inground Swimming Pool Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 November 9, 2011 Mr. Leonard Sessa 1505 Naugles Dr. Mattituck, NY 11952 pF SOUr�o CA � aQ y�4UNV BUILDING DEPARTMENT TOWN OF SOUTHOLD TO WHOM IT MAY CONCERN: The Following Item(s) Are Needed To Complete Your Certificate of Occupancy: Application for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. V�- A fee of $25.00. Final Health Department Approval. Telephone (631) 765-1802 Fax (631) 765-9502 Plumbers Solder Certificate. (All permits involving plumbing after 4/1/84) Trustees Certificate of Compliance. (Town Trustees #765-1892) Final Planning Board Approval. Final Fire Inspection from Fire Marshall. — Bob Fisher Final Landmark Preservation approval. BUILDING PERMIT: 34208 - Pool Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 March 20, 2015 Leonard Sessa 555 Northern Blvd Great Neck, NY 11021 BUILDING DEPARTMENT TOWN OF SOUTHOLD Re: 1505 Naugles Dr, Mattituck TO WHOM IT MAY CONCERN: Telephone (631) 765-1802 Fax (631) 765-9502 The Following Items (if Checked) Are Needed To Complete Your Certificate of Occupancy: �L/ Application for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. A fee of $50.00. Final Health Department Approval. Plumbers Solder Certificate. (AII 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. Final Storm Water Runoff Approval from Town Engineer BUILDING PERMIT — 34208 — Swimming Pool Suffolk County Executive's Office of Consumer Affairs VETERANS MEMORIAL HIGHWAY * HAUPPAUGE, NEW YORK 1 788 DATE ISSUED: 4/1/1983 SUFFOLK COUNTY No. 8391-H Home Improvement Contractor License This is to certify that RON A GIBBONS doing business as RON GIBBONS SWIMMING POOL INC having furnished the requirements set forth in accordance with and subject to the provisions of applicable laws, rules and regulations of the County of Suffolk, State of New York is hereby licensed to conduct business as a HOME IMPROVEMENT CONTRACTOR, in the County of Suffolk. NOT VALID WITHOUT DEPARTMENTAL SEAL AND A CURRENT CONSUMER AFFAIRS ID CARD Additional Businesses Director I This certifies that the bearer is duly licensed by the County of Suffolk i?l,a,& ,V Director SUFFOLK COUNTY EXECUTIVE'S OFFICE OF CONSUMER AFFAIRS HOMEIMPROVEMENT CONTRACTOR LICENSE NAME RON A GIBBONS BUSINESS NAME RON GIBBONS SWIMMING POOL INC Lice— Number 8391-H Date I,sueE 04/01!1983 EXPIRATION DATE 04/01/2007 J New York State Insurance Fund Workers' Compensation & Disability Benefits Specialists Since 1914 199 CHURCH STREET, NEW YORK, N.Y. 10007-1100 Phone: (888) 997-3863 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE RON GIBBONS SWIMMING POOLS INC 2995 SUNRISE HWY ISLIP TERRACE NY 11752 POLICYHOLDER CERTIFICATE HOLDER RON GIBBONS SWIMMING POOLS INC TOWN OF SOUTHOLD 2995 SUNRISE HWY P: O. BOX 11,79 ISLIP TERRACE ' NY •11752 SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER PERIOD COVERED BY THIS CERTIFICATE DATE G 785 065-4 248202 06/29/2005 TO 06/29/2007 8/10/2005 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 785065-4 UNTIL 06/29/2007, 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. IF SAID POLICY IS CANCELLED, OR CHANGED PRIOR TO 06/29/2007 IN SUCH MANNER AS TO AFFECT THIS CERTIFICATE, 30 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. THIS CERTIFICATE DOES NOT APPLY TO BUILDING DEMOLITION. 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. u_._.. .._, NEW YORK STATE INSURANCE FUND fj 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 U-26.3 VALIDATION NUMBER: 1008495734 New York State Insurance Fund Workers' Compensation & Disability Benefits Specialists Since 1914 199 CHURCH STREET, NEW YORK, N.Y. 10007-1100 Phone: (888) 997-3863 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE RON GIBBONS SWIMMING POOLS INC 2995 SUNRISE HWY ISLIP TERRACE NY 11752 POLICYHOLDER CERTIFICATE HOLDER RON GIBBONS SWIMMING POOLS INC LEONARD SESSA 2995 SUNRISE HWY 1505 N AUGLES ROAD ISLIP TERRACE NY 11752 MATTITUCK NY 11952 POLICY NUMBER CERTIFICATE NUMBER PERIOD COVERED BY THIS CERTIFICATE DATE G 785 065-4 248181 06/29/2005 TO 06/29/2007 8/10/2005 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 785 065-4 UNTIL 06/29/2007, 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. IF SAID POLICY IS CANCELLED, OR CHANGED PRIOR TO 06/29/2007 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 CERTIFICATE DOES NOT APPLY TO BUILDING DEMOLITION. 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. DIRECTOR,INSURANCE FUND UNDERWRITING This certificate can be validated on our web site at https://www.nysif.com/cert/certval.asp or by calling (888) 875-5790 U-26.3 VALIDATION NUMBER: 920802309 ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID RONGI-1 DATE(MM/DDIYY 08/09/05 PR0DUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Coverage Associates Inc 100 Comac Street, Ste 2 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. TYPE OF INSURANCE Ronkonkoma NY 11779 Phone:631-277-5700 Fax:631-277-5941 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: Lexington Insurance Company 19437 INSURER B: Merchants Mutual Insurance Cc 204 Ron Gibbons Swimming Pools Inc., etal. 2995 Sunrise Hwy 11752 Islip Terrace NY INSURER C: Scottsdale Insurance Co. INSURER D: State Insurance Fund EACH OCCURRENCE S1,000,000 INSURER E: First Rehabilitation Insurance rnVFRA[;FS 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATCE (,WDD/YY E ON POLICY(MM/DD/YY) LIMITS REPRESENTATIVES. AUT RIZED ESENT I GENERAL LIABILITY EACH OCCURRENCE S1,000,000 PREMISES (Ea occurence) $ 100,000 A X COMMERCIAL GENERAL LIABILITY 41LX6 4 3 7 9121 06/24/05 06/24/06 MED EXP (Any one person) $ Exc luded CLAIMS MADE[ OCCUR PERSONAL &ADV INJURY $1,000,000 X $2,500 PD DED. GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s2,000,000 POLICYFX PRO LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 B X ANY AUTO CAP9256058 08/15/04 08/15/05 (Ea accident) BODILY INJURY $ ALL OWNED AUTOS X SCHEDULED AUTOS (Per person) BODILY INJURY $ X HIRED AUTOS X NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY- EA -ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $1,000,000 C X OCCUR LICLAIMSMADE UNS0018045 06/24/05 06/24/06 AGGREGATE $1,000,000 $ $ 0 DEDUCTIBLE $ RETENTION $10,000 WORKERS COMPENSATION AND TORY LIMITS ER D EMPLOYERS' LIABILITY 785065-04 06/29/05 06/29/06 E.L. EACH ACCIDENT $ CERT TO ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. DISEASE - EA EMPLOYEE $ FOLLOW OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ FROM SIF OTHER E Disability Benefit DBLI08165 01/01/98 Satutory NY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION TOWNOFS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Town of Southold Town Hall IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Southold NY 11971 REPRESENTATIVES. AUT RIZED ESENT I ACORD 25 (2001/08) / / U © ACORD CORPORATION 1988 TEST HOLE DATA (TEST HOLE DUG BY McDONALD GEOSCIENCE ON DECEMBER 18, 1996) SURVEY OF PROPERTY ° SITUATED AT BROWN SILTY SANG SM MATTITUCK p 3 TOWN OF SOUTHOLD ° SUFFOLK COUNTY, NEW YORK • S.C. TAX No. 1000-99-04-17 •�. ' BROWN FINE SAND SP SCALE 1"=,30' AUGUST 24, 2004 JULY 8, 2005 ADDED PROPOSED ADDITIONS • JULY 22, 2005 ADDED S.C.D.H.S. DATA '•e' AREA = 27,374.38 sq. ft. 0.628 ac. 17' 0/F RSEN HOE TKPp NZ RSEN X25 00+ NOf ELEVATIONS ARE REFERENCED TO N.G.V.D. 1929 DATUM ge VpGp 6— EXISTING ELEVATIONS ARE SHOWN THUS:M _ EXISTING CONTOUR LINES ARE SHOWN THUS: — — —5— — — d F.FL - AW FLOW cwu FLOOR =I0 N 2. MINIMUM SEPTIC TANK CAPACITIES FOR B BEDROOM HOUSE IS 1,500 GALLONS. =12 1 TANK; 8' DIA., S' LIQUID DEPTH ++ c / // / / • %� _ _If6CP• 3. MINIMUM LEACHING SYSTEM FOR 5 BEDROOM HOUSE IS 4GO sq It SIDEWALL AREA. 1 POOL: 16' DEEP, 8' dla. 99y N �' STpP ' GOµtN� j�� ?? �J PROPOSED EXPANSION POOL PROPOSED LEACHING POOL .60 j / % / \ 0 j //� \ \ \ \ PROPOSED SEPTIC TANK `p /// // / / // /// // / \ 4 FT HIGH FENCE 'HE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD W/ SELF CLOSING AND LATCHING GATES IBSERVATIONS AND/OR DATA OBTAINED FROM OTHERS. TO NYS CODE � a�� i/�//ice,/i///� -- �\\ � ♦ \�\-\ \ CP•y/ ///� / j j� // — :;:::..` \\ \ \ �1 \ \\ \ ?9 CERTIFIED TO: /%% // ...: \ \ l \ \ \\ -a qc x LEONARD SESSA / / ..:r "'�L�. j�`, N3 \ \ O STG ASSOCIATES 10 j // // / j ///,,,. •� ••.•:`•.......... :' '�''".:a:`+`:•:;:""� \ \ \ \\ \JA �9 FIDELITY NATIONAL TITLE INSURANCE COMPANY OF NEW YORK 01 yc // // / /,•. °� ??:;v:r:...:.i::;:•:ri:\:;;;;mitt. \ \ \ 33A / f�,� '/ ; ..../ 05�•L"ti:C4i;': \ \\ \ \ \ \ \J? L 'fib \ xAU.......... .::. h :...................................... • •r'::•i:•ii, \ o,is y�.::.. 9::::::•::::::::::•:::::;:.:::. al \ 0 +s ON a ............... ::. N p;ir.,::SjGAy>i: ::,p . ;s.'•:; -i::;; ;s.'•;::;:;. \` �\ \ \ �� zu \ N A/ ,.. \ ' T� H S ++ a .� 8 73 4 109$ E �y t z 31.8 V J W VI O / G T K1 \ AIS �.a 0 0 \ \ \ \ ,D Cc Q�'Y¢S _ �Ax\ x `?s F \ ,.;;:. PF%°F / �• \ o\ \ \ °,`�o u e ` \ / EA Jg0\ \ \ \ \ �� Aux ;:I •/10 a" \e 'sLz\��\c1' \ \ \� w�1y � ,cy � J �4�°ew 100'Ar $R \ \ L L • . { < y / / lA. \ x 1 Ja ap QTc\5$� WMA p St`�Ng V e \ t9 TO �MG� �t \Gp` I \ \ \ GY1R 0 I y ss •." x"�y5: s e . JUX 4125, 4 N \ x 'e / ° x rs g ` U) x SO 5 ROp a 1•' 9. �0++ �, x q / / O 0 AD 1 638 p2 vfY �, 6 / j� {\ �) O• ' OT pl• • . • / A`/ IJP j/ f �NAU G / ���,,\N� IDIL WELL Owl\'\�\XAG PREPARED IN ACCORDANCE WITH THE MINIMUM STANDARDS FOR TITLE SURVEYS AS ESTABLISHED E L.IAL.S. AND APPROVED AND ADOPTED FOR H USE BY THE NEW YORK STATE LAND WELL 4 PIT S1 N.Y.S. Lic. No. 49668 UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. Seph A. Ingegno COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED Land Surveyor TO BE A VALID TRUE COPY. WELL CERTIFICATIONS INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND Title Surveys - Subdivisions - Site Plans - Construction Layout LENDING INSTITUTION LISTED HEREON, AND ' TO THE ASSIGNEES OF THE LENDING INSTI— TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE. PHONE (631)727-2090 Fax (631)727-1727 I THE EXISTENCE OF RIGHT OF WAYS AND/OR EASEMENTS OF RECORD, IF OFFICES LOCATED AT MAILING ADDRESS ANY, NOT SHOWN ARE NOT GUARANTEED. 322 ROANOKE AVENUE P.O. Box 1931 RIVERHEAD, New York 11901 Riverhead, New York 11901-0965 AP ROIVED AS NOTED DATE: FEE: P`' _- NOTIFY BULDINU T MENT AT 765-1802 8 AM TO 4 FM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - 7`110 REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 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. COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED AND CONDITIONS OF _ SOUTHOLD TOWN ZBA Sail a, -OWN PLANNING BOARD S36TPOLD TOWN TRUSTEES N.Y.S. DEC OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. ooD ZONE "J" — COMPLY WITH CHAPTER "46' FLOOD DAMAGE PREVENTION SOUTHOLD TOWN CODE. UNDERWRITERS CERTIFICATE Fc- ,._D S►zri CK) A b c o tr F G AtrA CAP. hutr tea. tr. n•►t,. ►� x �� r,cf-r-c. I'1 255 ,o 5' to C0? or, 10 t - a Q P-ex_9 l<<4rL - yam-• 17brrra 19' oc 14' oc 14 • o C G•Oc i?' OC EACN yltt? hutr rr•Au Au, K rwI'7N . 11ry 1,, m c1G'. c a rz-C-t jle� - -ri[G 07--Hf<u'.G 0I0'3 VA CIff;� h 10 Lie cA cr'rl r. r. WA U" UQeTAI Li -8 = G lM PLW t MZ; t • -vi vo CA. t.: CAr,-V_XJXVA • K 4 aPT1a1�1✓ �zt� t t. 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