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Home My WebLink About39820-Z I--'- � ��S�FFOI,��o Town of Southold 4/12/2023 at.� P.O.Box 1179 CM o • r 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 38403 Date: 7/22/2016 THIS CERTIFIES that the building ALTERATION Location of Property: 50 Lighthouse Rd, Southold SCTM#: 473889 Sec/Block/Lot: 55.-1-2 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 5/15/2015 pursuant to which Building Permit No. 39820 dated 6/1/2015 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: ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to Miller,Kirk&Ryan,Alice of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 39820 08-13-2015 PLUMBERS CERTIFICATION DATED Authori ed Signature ��FEot�,c TOWIV OF SOUTHOLD � a�� BUILDING DEPARTMENT TOWN CLERK'S OFFICE �, • �,��,�� SOUTHOLD, NY �� UILDING 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#: 39820 Date: 6/1/2015 Permission is hereby granted to: 10111i11er, Kirk & Ryan, Alice 333 E 9th �t Apt 4 New York, NY 10003 To: Alterations to an existing single family dv�relling as applied for. At premises located at: 50 Lighthouse Rd, Southold SCTM # 473889 �ec/Block/Lot# 55.-1-2 Pursuant to application dated 5/18/2015 and approved by the Building Inspector. To expire on 11/30/2016. Fees: SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $389.20 CO -ALTERATION TO DWELLING $50.00 Total: $439.20 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,properiy 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 Apri19, 195'n non-conforming uses,or buildings and"pre-existing" land uses: 1. Accurate survey of property showing all properly 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$15.00 _ Date. J� "� 5 �a�p-� ' New Construction: Old or Pre-existing Building: (check one) Location of Property: 7i7�� Q C� 1�� I�F� SDU-C1-b� House No. Street Hamlet Owner or Owners of Properly: �� -( � (�� Suffolk County Tax Map No 1000, Section �,� Block � , Lot- Z- Subdivision r��,� (�� Filed Map. Lot: Permit No. cJ�O°� Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: � Request for: Temporary Certificate Final Certificate: ec e) Fee Submitted:$ ,�� —� Applicant nature �� SOUrg,�l � o Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 G �� roqer.richert(a�town.southold.nv.us Southold,NY 11971-0959 � ��COU��,�� BUILDING DEPARTMENT TOWN OF SOUT�iOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION issued To: Miller Address: 50 Lighthouse Road City: Southold St: New York Zip: 11971 Building Permit#: 39820 Section. 55 Block: 1 Lot 2 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: OWeCI'S EleCtriC Irlc. �icense No: 3372-ME SITE DETAILS Office Use Only Residential X Indoor X Basement Service Only Commerical Outdoor 1st Floor X Pool New Renovation X 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt 12 Ceiling Fixtures 2 HID Fixtures Service 3 ph Hot Water GFCI Recpt 2 Wall Fixtures 1 Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel A/C Blower Range Recpt 40A Fluorescent Fixture Pumps Transformer Appliances DW Dryer Recpt 1-30 Emergency Fixtures Time Clocks Disconnect Switches 8 Twist Lock Exit Fixtures TVSS Other Equipment 1- Exhaust Fan, 1- Under Counter Electric Heater Notes: Inspector Signature: Date: August 13, 2015 Electncal 81 Compliance Form.xls ��°�_S°��'�a � , �,�, �o, Town Hall Annex ' '� Telephone(631)765-1802 = 54375 Main Road �-° � � �� - � - Fax(631)765-9502 P.O.Box 1179 y�� _ ._ _ _ � � '�` Southold,NY 11971-0959 p� � ��=,t�f , , .., p�f1z.�. . .� ... ��I@t •�� ;I `'' v; i - �� . o�.]e , BUII.DING DEPARTMENT � ` �� TOWN OF SOUTHOLD �:�-- ' 4}� �,:�� , i .: �� . . - , ¢,_ --i �'d� � �� , , ��''�-.�....-�^`�� `.,+ . f � CERTIFICA7CI�O.N � Date:��7 1 S� � Building Permit No. `3 �� Owner• �c f�-t,�— � `4 L l C� �t.j/LCG�� - � (Please print) ,� , � • _ � , _ Plumbei: �e.v�,��,-�, �e,ac�� .,��— ,�� , . � � , -, , . (Please print) `, � � � f .. -. . . , . I certify that the solder used in the water supply system contains Iess than 2/10 of 1% lead. (Plumbers ' ature) Sworn to before me this� day of_�,�`��U�� ` � � � Notary Public, S�A, I�"�ounly � �16z�bo�h f�, �'�n��r�ff� Notary publle, �fate af fVeW 1'ork , No.01 P�6�78628 � Qualific,�d in�uf6oik County Corrtmi§sion Expires �l�I I � 6 � ' _ ' ' ------_- ' �o��OF SO//ly�lo . � '� - � �' • �o - - � ��'Y�OUN1'I,��' � � . .TOWN �OF SOUTHOLD BUILDING- DEP�. _ ` 765-1802 _� � - 1 NSP�ECTION � � [ ] FOUNDATION 1 ST [ ] ROUGFI PLUMBING � [ ] FOUNDATION 2ND [ ] INSULATION - [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE � CHIMNEY . [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION � - ��] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) �r ` [ ] CODE VIOLATION [ ] CAULKING REMARICS: . �� - � �� ' � !� DATE ' 7 INSPECTOR . � � � �O��DP SOUTyOIo . � . � . V � � . . � • �o . ��'Y�OUMV,Oct� TOWN OF SOUTHOLD BUILDING DEPT:� 765-1802 - � 1 NSPECTI �N � � - - [ ] FOUNDATION 1 ST- [ ] R GH PLUMBING [ ] FOUNDATION 2ND [ ] SULATION � � [ ] FRAMING / STRAPPING [ FINAL :� [ ] FIREPLACE � CHIMNEY [ ] FIRE�SAFETY INSPECTION , [ ] FIRE RESISTANT CONSTRUC'TION [ , ] FIRE RESISTANT PENETRATION � [ ] ELECTRICAL (ROUGH) [ ] EI.ECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING � REMARKS: � - (''� - �. �� - R � � � � � ° � � -�� __ � � � ,. � � - . DATE � � INSPECTOR rjf so cou TOWN .OF SOUTHOLD BUILDING-DEPT. 765-1802 INSPECTION ' I FOUNDATION I ST ROUGH PLUMBING FOUNDATION 2ND INSULATION FRAMING /STRAPPING ] FINAL - FIREPLACE & CHIMNEY I FIRE SAFETY INSPECTION FIRE RESISTMT CONSTRUCTION ] FIRE RESISTMT PENETRATION ELECTRICAL (ROUGH) ELECTRICAL (FINAL) CODE VIOLATION CAULKING REMARKS: -ol DATE - INSPECTOR. i �� o��OF SO(/T�,olo �� # # , ' � • �o ��'Y�OUMY,Nc� TOWN OF SOUTHOLD BUILDING� DEPT.. . - 765-1802 � - INSPECT ON - ,� � � = [ ] FOUNDATION 1 ST [ ROUGH PLUMBING � [ ] FOUNDATION 2ND [ ] INSULATION - , . [ ] FRAMING /STRAPPING [ ] FINAL - [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION -- [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ � ] CODE VIOLA ION [ ] CAULKING REMARKS: � � � �'. d, . DATE �� '� INSPECTOR • - - Charles W. Southard Jr. Registered Architect 435 Bay Home Road Southold, New York 11971 Phone # (631) 471'-5228 cwsarchitect@optonline.net August 10, 2015 Town of Southold Building Department Town Hall Annex 54375 Main Road Southold, New York 11971-0959 RE: Renovations to Miller Residence, 2795 Lighthouse Road, Southold Dear Building Official I have examined the constructed "floor and wall framing" and the strapping and connection of all elements for compliance with the approved building plans and the New York State Residential Building Code, and find that all construction and devices have been installed correctly. If you require additional information, please contact me. Thank you, Charles W. Southard Jr. �o p,RCH�rFc Registered Architect �� 5�`THqqo�* p �� _ � � � � �}�� y�� ..'��. �' <,- � 0 Tq B�'fl��,��gpyl� TpRT1 O Charles W. Southard Jr. Registered Architect ' 435 Bay Home Road Southold, New York 11971 Phone# (631) 471-5228 cwsarchitect@optonline.net August 10, 2015 Town of Southold Building Department Town Hall Annex 54375 Main Road Southold, New York 11971-0959 RE: Renovations to Miller Residence, 2795 Lighthouse Road, Southold Dear Building Official �, I have examined the installed insulation and find that all of the elements for compliance � with the approved building plans and the New York State Residential Building Code, have been i installed correctly. . � � I If you require additional information,please contact me. �I Thank you, �p PRC��TF Charles W. Southard Jr. ��P SouTy,qR��. Registered Architect � �� -�� ,� � � ��a � j ��ya�. 1 � o � � , EO � � ��r�od� � � � �� . ��.��. � TC)��?k"�a�"J't'��.b� ' i I i i � ,I i i Ii ! 1 Q � � " � 11 1 {. - — --- — � - - - -- --- - , � 1 • ! � � "' � ` � � � . � � . � � � _. .. � � � -- — ��'� • � � ` • � � • . I1 � 1: I � � �, � - � � � � . .. � � � 1 � � � • r � - � � ��,�iGw�;wi��,� �^ � , � ��/��' � �:� '� ..�� :� �:.. �_,. 1� �� r I , � �� f � a-,. AE� � �'_� �...._� ♦ / .. � f . . , . .� / • _.��.a� w!s':w. ,'=._�i G.�L�./.f ' . I �`i��. .. - -- ' ' ��'..�0��/ --,��i�� ,i�in i �.;".-:..� � . � ��I� ��%-. � ��.�''..��% �►�` a �4�- -+�-�� _ � ,i�C.��'�� . '' �� ' ��'tir / . � � 6.�,.� ..,�� ..�t, ._ -� -- ---- �/.�..1, . r. �i'' • ' � • � ' , fi ' : � � . f' �,`�i_�� \- �� • � .��.1�1 � / . _ I, r%�l ' ? - Q � / ` / 1 - _ ' �-� ,� �' � ' � �� iu�u►.� ��►�` r� ��' � � , �, � � . . .. .. ,. - .. �, _ r TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWl�1 HALL Board ofHealth SOUTHOLD,11v11Y 11971 , , . , , . 4 sets of Building Plans TEL: (631) 765-1802 � Planning Board approval FAX: (631) 765-9502 � . - .�,,, Survey SoutholdTown.North�'ork.net PER1VdIT NO.�� Check , Septic Form ' N.Y.S.D.E.C. — , �, � , Trustees ' ' �� _� � �� ',� �,�� ;� C.O.Application ' !' � ' �Flood Permit�. Examined ,20 � � � j� � Single&Separate � � l�AY � � �� , � � Storm-Water Assessment Form ` � Contact: Approved ,20 6I,�G I::r^T Mail to � _ � Disapproved a/c �v�� l^ �'��-I�� n ��S t��' �fl�fZD �c►�L�v Phone: � ( Q-� �-�� Expiration � � �,� ,20 �� -� �3�1� � , Bui ' nspector aa��,�1�,.�� ' � �� APPLICATION FO BUI �T m-v_ Date �/r $ , 20 �� INSTI2UCTIONS 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. � „ �� £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 atithorize;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 applic L ws Ordinances or Regulations, for the construction of buildings, additions, or alterations or for re � o molit on e in described. The applicant agrees to comply with all applicable laws,ordinances,building co ,h usi de, r ions,and to admit authorized inspectors on premises and in building for necessary inspections (Signature of plicant or name,if a corporation) t �6)��—�'—`-E, �Fl�-:=°n=� . ��CJ V I GTU�1/ (Mailing address of appli ant) � State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ��i,`� � Name of owner of premises �i �-i�. �11 /—�� (As on the tax roll or la`test deed) � .. � . If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. �f'.3�6 '�� Plumbers License No. �3Gs�¢--Nt P° Electricians License No. .�3 7 z-- M� Other Trade's License No. . 1. Lo,cation of land on which proposed work will be done: �� ' o t-O N��.�'�. P�w J U wyl-�h� R�. ��'TNar,� � House Number Street Hamlet � -i.'�Sr�i4�i.� "`� )�' �� ^ 7 9 T»f 'C l County Tax Map No. 1000 Section �i � ��;=�L ` •f;�`-� -'••'��?�-t-''.�� B'Pock� = �� :��i:;i rr�:,Lot �� !� 1•';.Gt:;�c:' L�far.'.i�. `�t';�Il�:1J `+!�}~t=;f.�c'..S4's�.��3-f'•.5�=...N' ...._�','u:; :k•s�)i.4�i�R`�;::��:;,=.��:.'%3iivi14i�.�;� � J � . � L � ' � � 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 S/N�',G�' �",Q�c//G� �)sy��.vC— ' , ..� b. Intended use and occupancy ,�i•�E' fcaH�Gt/ D wc�"l.L�� 3. Nature of work(check,which applicable):New Building Addition Alteration Repair Removal Demolition Other Work - : " � (Description) 4. Estimated Cost �, �Z�• �� Fee � (To be paid on filing this application) . 5. If dwelling, number of dwelling units N��ir'�l�er;of dwelTing units on each floor If garage, number of cars �� "- 6. �If business,,�commercial or mixed occupanc.y, specify nature and extent of each type of se. ' , , , . � . . .', � - - - - i 7. Dimerisions�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 I 8. Dimensions of entire new constructiori: Front Y U._1 �y Rear � Depth Height Number of Stories � 9. Size of lot: Front ��7� Rear �� ' Depth �776 '�� '��s � � , . - 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, ordiriance or regulation?YES �O� �13. Will lot be re-graded? YES NO ,�) Will excess fill be removed from premises? YES NO''� z� r o�.o � � 14.Names of Owner of premises ��'K ��" Address .� 9,r►/v�� Phone No. _ . Name of Architect � Address Phone No Name of Contractor/'3�.two�+��AE�rr�" �� Address oe.-c�� ✓3L✓-DPhone No. Z �-7�z'� ' e,a.�.o . , 15 a. Is this property within 100 feet of a tidal wetl'and or a freshwater wetland? *YES NO� ` * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED I , . 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�� ) _ � ' g duly sworn, deposes and says that(s)he is the applicant (Name of individua signing contract)above named, - , , , (S)He is the (Contractor,Agent, Corporate Officer, etc.) , ' . . ,,'. . d-, , of said owner or owners,and is duly authorized to perform or have performed the said wo"rk arid 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 perf�rmed in the manner set forth in the application filed therewith. ' Sworn to before me this ,�n ' I � —� � }�,�day of I"1 G�. � 20,�t�, �� ' . , ., , , � . � . ,-�� ' � ., L. DWYER pp�i ant Notary Public NOTARY PUBLIC,STATE OF NEW YORK Signature of A , �NO.01 DW6306900 ' � �UALIFIED fN SUFFOLK COUf�T1( � COMMISSION EXPIRES JUNE 30,2Q�S � . , - ��oF so�Ty�� ; � o � Town Hall Annex 1�( � Telephone(631)765-1802 _ �' 54375 M�R�a� �, � " 3i)�7o�0a2 i=_' �; ,,i r i� ; P_O_Box I179 �, Q ro er.richert �Qcn��.southold{r� .us ,J� r i Southold,MC 11971-0959 pl ~ �� 1 � ;� ; I � ��OUN�!`(,�� ' '�' � '? , ' � ' . ��I, ;� 3UN i 5 ��5 � �� i . �`.w.�: . BLIILDI�IG DEPA.RTMENT _ , --, � TOWN OF SOUTHOLD s;.u�� oF��i 1 APP�ICATlON FQR ELECTRICAL 1NSPECTiO(�! � ' '�`�`'`cF i01;?'+�>>_�� " - . I - REQUESTED BY: � ��P, �- �� . Gompany Name: ' ( . � _ - �- Name: rn � - "- � '.� L�cense No.: � � Addr.ess: (�'p�. �le.��a��, V�,J�- e�c� � �� ' Phone No.: " �3 1 �-`E— �2� ' . . JOBSlTE fNFOR�IlATf4(�I: (*indica�es requ�red informat�on} - �Name: _ ' '�Addr-ess: �c� S �-- -- - - - *CGoss Streef: �� . ' _ - '�Pfione No_: • • ' _ Pennit�lo.: _ �C��2� . - Tax•Map Districf: � 'tOflO Secfian: - Btock: Lot: � � *BRIEF D�ESCRiPTiON OF WORK(Please F'rint Eleariy) � . _ . � � tcn� �'bo O'V'�. ' - • - - (Piease Circle All That Apply) � . � ' *I�job ready for inspectfion: � - � NO. augh !n Final *Do-you need a Temp Certtficate: _ YES!� _ ' - Temp Infarmation (If needed} � �� ^ • - - �Set�ice S�ze: 1 Phase 3Phase 10Q 150 200 300 350 400 Other '�New Service: Re-connect" Underground Number of Mefers Change of Service Ove�head . '-. Additionat lnformation_ PAYMENT DUE WiTH APPL1CATfON � . �. i - � , I 82-Reques!for fnspecfion Form ,�/�� 'J ; d�� l � > � �l4 v��/�/�S" ��OF SO(/�.��! � o Town Hall Annex Telephone(631)765-1802 54375 Main Road � � Faac(631)765-9502 P.O.Box 1179 � • @ Southold,NY 11971-0959 'rQ � ��COU��,�� August 11, 2015 BUILDING DEPARTMENT TOWN OF SOUTHOLD Kirk Miller 333 E 9th St, Apt 4 New York NY 10003 Re: 50 Lighthouse Rd, Southold TO WHOM IT MAY CONCERN: The Following Items(if Checked)e�re iVeeded To Complete Your Certificate of Occuparscy: Mote: All work needs to be certifipd �y archite t or engineer for this building permit, see attached inspection ticke4 dated 08/10/2015 ��SD�� <<- .� Application for Certificate of Occupancy. (Enclosed) � (` � �� /�� t!�Electrical-�erwrifers Certificate. � �� A fee of$50.00. � � /'��j'5�,�� Final Health Department Approval. "�� , , PIUCTIbeI'S $Oldel' C�I�ilf Cat@. (All permits involving plumbing after Trustees Certificate o¢Compliance. �Town Trustees#�ss-�as2� Final Planning Board f�pproval. (Planning#765-1938) Final Fire Inspection �rom Fire Marshall. Final Landmark Pr�:��ation approval. Final inspection by Qu;lding Dept. Final Storm Water Kunoff Approval from Town Engineer �UILDING PERIVIIT — 39�2� = Alterations � �� r �,, .�.� . � c� r."'. �� ' � .'� . ;�, 4p . .y� 1' � 1: }� . � � r.. .� �: � � i � � � v � �F - I h `,, . � � �� i _ ,; �, I c � F . , � , � e , $ yt , 6 4 " s . t ` �$. s � ) , �� 7 _ �` • g ", e �----� ,� � ._,,��... ., ...ic._' _ 1 1 � A S 4 ' �� x,— �� n�__ ^, . a New York State Insurance Fund Workers'Co»tpensation&Disability Benefits Specialists Si�ce 1914 8 CORPORATE CENTER DR,3RD FLR,MELVILLE,NEW YORK 11747-3129 Phone:(631)756-4300 . CERTIFICATE OF WORKERS' COMPENSATION INSURANCE, � ^^"^^" 462113642 BOSWORTH 8�EDGEIT CONSTRUCTIOId CORP , �5035 PECONIC BAY BLVD. LAUREL NY 11948 � POLICYHOLDER CERTIFICATE HOLDER BOSWORTH&EDGETT CONSTRUCTION CORP TOWN OF SOUTHOLD BLDG 5035 PECONIC BAY BLVD. DEPT LAUREL NY 11948 TOWN HALL ' SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER PERIOD COVERED BY THIS CERTIFICATE DATE 12360 730-2 780902 05/08/2015 TO 05/08/2016 5/13/2015 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO.2360 730-2 UNTIL 05/08/2016, COVERIPIG THE ENTIRE OBLIGATIOfd 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 05l08/2016 IN SUCH MANNER AS TO AFFECT THIS CERTIFICATE, 10 DAYS WRITTEN NOTICE OF SUCH CANCELLATION WILL BE GNEN TO THE CERTIFICATE HOLDER ABOVE. NOTICE BY REGULAR MAIL SO ADDRESSED SHALL BE SUFFICIENT COMPLIANCE WITH THIS PROVISION. THE NEW YORK STATE IfdSURANCE FUND DOES NOT ASSUME ANY LIABILITY IN THE EVENT OF FAILURE TO GIVE SUCH NOTICE. , 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 AMEIdD, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. , NEW YORK STATE INSURANCE FUND . d-a�,�� U 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 ' VALIDATION NUMBER:476186452 U-26.3 �� BOSWO-2 OP ID:GS ACORO° CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYY1f1� �� 05/13/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHT3 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 CONSTITU7E A CONTRACT BE7WEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificabe holde�is an ADDITIONAL INSURED,the policy(ies)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 certiflcate does not confer rights to the certiflcate holder in lieu of such endorsemen s). PRODUCER � �ME�T John M Titolo John M Titolo,inc ' 990 South 2nd Street,Suite 4 �i ac°N o�c:866-484-8656 ac No:631-585-3171 Ronkonkoma,NY 11779 ' Aop��,John itoloagency.com John M Titolo INSURE S)AFFORDING COVERAGE NAIC# �Nsu�Ra:Kingstone Insurance Co. 13668 INSURED Bosworth�Edgett Construction INSURERB: Corp 5035 Peconlc Bay Blvd; �Nsur�c: � Laurel,NY 11948 � INSURERD: � INSURER E: li INSURER F: COVERAGES CERTIFICATE(dUMBER: REVISION NUAPIBER: THIS IS TO CERTIFY THAT.THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. IdOT1MTHSTANDING ANY REQUIREMENT,TERM OR CONDRION 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 INSR TypE OF INSURAPICE POLICY NUMBER ��Y EFF M�p P uM� LTR A X COMMERCIAL OENERAL LIABILJTY EACH OCCURRENCE $ ��OOO,OO CLAIMS-MADE a OCCUR I X CP5008213 02I2812015 02/28/2016 pREMISES Ea oaurrence S 50�00 MED EXP(Any one person) S 1,�� i PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER I GENERAL AGGREGATE $ Z�OOO�OO POLICY��EC7 �LOC � PRODUCTS-COMPlOPAGG $ 1,000,00 OTHER. $ AUTOMOBILE LIABIIJIY COMBINED SINGLE LIMIT $ Ea acadent �A�� BODIIY INJURY(Per person) $ AUT08�E� AUTOSULED i BODILY INJURY(Peracadent) S HIREDAUTOS p�NpSWNED I Pe�axRdeTMrKDAMAGE $ , $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ IXCESS LIAB CWMSMADE AGCaREGATE S DED RETENTION$ $ WORKERS COMPENSATION ANDEMPLOYERS'W181LITY y�N'; 9TATUTE ERH ANY PROPRIETOR/PARTNER/EXECUTIVE �N�A E L EACH ACCIDENT $ OFFICERlMEMBER EXCLUDE6? (Mandalory In NH) E L DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below I E.L DISEASE-POLICY LIMIT $ i II - DESCRIPiION OF OPERAi10NS!LOCA710N5!VEHICLES(ACORD 101,Additlonal Remarks Schedute,may be attached if more space is required) Carp entry-Certiflcate holder is listed as Additional Insured with respect to the Liability Policy listed herein as required by written contract � . CERTIFICATE HOLDER ! CANCELLATION TOWNSH2 � �� SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Southold TMe EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN I � ACCORDANCE IMTH THE POLICY PROVISIONS. Building Department � PO Box 7179 auTt+oR¢en Rer�s�urarn� 53095 Route 25 ' - Southold,NY 11971 � �� J�� I � O 1988-2014 ACORD CORPORATION. All righfs reserved. ACORD 25(201M07) i The ACORD name and logo are registered marks of ACORD � � � - i ;' �_ - , � s , . f - .. t �, N/F MURRAY i,_'i:�-" ' �� N�54'S7'10"E 346.00' .�E��< <o��a� �a��w�� , W �CV�' � �' YpxVY[M �_:.' ._ . ' . ��-�-�_ HORM Y SOUl11 '. F - � I ( ''' � I I ' �, -.� � . I I I I . I I I r _ I I I ' _ I I ' � ! � I -'� � I I r^ _ I I v/ z - REMNANCE OF W000 FENCE THIS AREA I 1V � '.-_ _"'� � � a, ' � ` � ca, N - ` , � lo o . ' � I rri � ::.f, � I - { ' � , �. � � `y= ' I ' I -f, .k: j _ , i ' �-�+ -.'��;: 9.9• � � � . � � s B'�N/OU,T BUlLDING I I � , : 5.6`,' I z.s A L ^ ----------------� � l � '��t' � --�B� P�'9 '' _�t � O .� , I � ' 'S � '•�' I s a � ; , z 0 , J 2 ' N . ' i � �p.� � :: � �J i' , - . , i � W _ w �I - a a' 'A � _ ��I BNICN PAIp , ' �� V � � �B' V O ., .• n' WOOD FRAME (tp � "''��- RESIOENCE H' 4 � ..,..a..�.�. _�,._;..a:ca c=- ..�,W.uxe..^�=a��F:ec��G.�,�,:s��.c.'�e�^:a<-��.,^°'y. .:d!..G--. „_.�.e.....=q�::.._�r-;-'=_�`��"�t.��.%_ c...,""a:.,,.,�`y�"`'=°_ =i•-- - W"�" -- �. _. �3 — - -- ,u: .._�.__ .___ . . ___ ._-- • -:-- ��- - , _ ,. � � 5 k�C � " ' axex � � � 54 ,. . V �$ 5 .r W ' L t�� ' � I �C' � � urm vwc • S 54'47 00 W 264.70 ', NOR`�I� ROAD � i SURVEY OF ti+� �000—oss—o,—ooz DESCRIBED PROPERIY , - , siruarE SOUJTH,OLD, TOWN OF .SOUTHOLD : ., , � ' SUFFOLK COUNTY, N.Y. , U4R�NTEEO TO• - SURVEYED FOR: KIRK STEPHEN MILLER SURVEYED, 7 SEPTEMBER 200� IiIRK STEPHEN MILLER � . aucE Rr•aN . � ALICE RYAN SCALE �"= ao' COMMONWEALTH LAND TITLE.INS. Cq � JP MORGAN CHASE BANK, jN.A: F AREA = 114,565 S F '� OR ' � „ 2.fi30 ACRES JARA�ITEES fN01CA1E0 NERE ON SHALL RUN I�^ vL Y i0 lHE PERSt7N FOR WHOM ME SUR 4£Y PREPAREO,ANO ON HIS BEHALF i0 1HE ' SURVEYED BY ' iLE COMPANY,`COVERNMENiAL ACENCY, STANLEY J. ISAKSEN� �IR NDING'INSI1lUDON,If 1lS7F0'NfRfON, AND � ) iN£ASSIGNEES OF'JHE LENOlNC IN57IiUA0N. ' /ARANiFES ARE NOT IRAMSFERA81f TD � P.O� BOX Z94 )DIAONAL�NSIliUA0N5 OR SUBSEOUENT OWNfRS , NEW S FOLI<. N Y. 1 1956 VFUTHJRIZEO ALlEFAAON OR A00/lION TO THIS � 631-7 4-5835 ;nVE1'IS A NOLATION OP SECTION 7209 OF � :e NEII'1'ORK SlA/E fOUCATlON L11V I . I � 7°iE5 0!MIS SURY£1'A/AP NOT BEARINC ' �e[ANO SUR�y0F5£AfBO55ED SEAL SHALL CENSE �D URVEYOR ]7 EE CONS�OEP,£0 TO B£A VAGD TRUf i '�r �NYS Lic. No. 49273 07R1619 , b 07 CORRECT SPELLING (LIGHTHOUSE, SOU7HOL0) 1 18 SE __� ._ ^c:r�.. ....._ , � • - F;(+'�i'`_ �li. s�..:i-' - � ,�''��!,�F �,i .i r,� . , ..� � . ' � DEFLEGTION LIMITS Gharles W. 5outhard �r — ��N�i�� NOT��: Minimum Unfformly Distributed Live Loads I. Gontractor shall verif conditions and dimensions and notif Architect /� � � �1 I -r � � (in pounds/sc�uare foot) of inconslstencies, rior to roceedin with an work. y t"�� T-T GONSTRUGTION L S OR W D + L Section R301 Table R301.4 p p g y ROO� MEMBERS L/360 L/360 L/240 US� Live Load �. The �4rchitect is not responsible for construction supervision unless SUPPORTING PLASTER GLG. L/240 L/240 L/180 specified by written contract. �xterior Balconies 6O 435 Bay Home Road SUPPORTING NONPLASTER GLG. L/180 L/180 L/120 Decks � 40 3• All work shall be done In accordance with all �ederal, Residential Gode �LOOR MEMB�RS L/360 L/240 of New York 5tate, W�GM, � local Building Godes 5outhold, New York II�f71 Passen er vehicle ara es # �� 4. P�II electrical work shall be done in accordance with the National �XT. WP�LLS � INTERIOR Pf�RTITION Attics without stora e ! 10 Electrical Gode, the Board of �ire Underwriters, and Res(dential Gode of N1'S, Phone (631) 4�71-5228 WITH BRITTL� �IN15HE5 L/240 Attics with stora e 2O Part �/III, chapters 33-42. WITH FL�XIBLE �INISH�S L/120 cwsarchitect�optonline.net � ?�ttach to structure wi�h 3/8" lag bolts Rooms other than slee in rooms 40 5. �II plumbing work shall �omply with the Residential Gode of NYS, Part VII, chapters 25-32. �24" O.G. Slee in rooms 30 6. Do not scale these drawings. Refer to written dimensions. � Attach to Gon�rete with 3/8" masonary Stairs 40 7. All glazing shall have a minimum classification rating in accordance table R308.3 Anchors �24" O.G. from the Residentlal Gode of N.Y.S. Windows � Glass doors shall be in accordance with Section R613. # Elevated �loors shall su ort 2000#/20 s fn. Guardrails and handrafls 200 pp �' And designed with exterior wind pressur� based on 120 m.p.h. winds. ! No storage with roof slope of less than 3/12 8. Handrails shall be provided on at least one side of each stalrway with two or more risers Handrail height, measured above stafr tread nosings, shall not be less than 34 inches and not more than 38 inches. a. Provide stairway illumination directly over ea�h stairway section in accordan�e with the Residential code of NYS sectlon R303.6 � �� 10. ?�II "Treated" lumber to be pressure preservatively treated and naturally resistant wood. Pressure preservatively treated wood and naturally termfte reslstant wood shall not be used as a Physfcal barrier uniess a barrier can be inspected for termite shelter tubes as per R320.1 of RGNYS _ - Insulate all exterior walls to � ' '_ ' " - '_ " receive new gyp. bd. with NE R-13 batt insulation . (4 2 x210 doub e ng � . � EW x he der � �� , �� - - - , � N � . . �-, Existing � � �-' � O ( �� I � � � p � � ��Y''��. t. KI GH N (no work) ',.f� : �____f,�,� ry /\(��4_F'�r�*`{; -�(, . � NEW I/2�� g p. O jr'•/' j P` `\ � � _ 0 _. .4V -� ��;G � Wa �s � Ge I ing �� . C� � �- ,r F, ��, - � �� , '� r ,,�� (2 2xiz h ad r }�� . , , r =-- __- ----- -_-__= , � �j�- - ,%',:� �.; EW 2x4 stu w II Insulate all exterior walls to -----�v`' �'� �W�� n I 2" yp. bd oth sid s receive new bd. with y � � gyp Insulate all exterior walls to � R-13 batt insulation _ � 5heet Title I I I I � I � I I I I ( I I receive new gyp. bd. with , , � R-13 batt insulatian y'"` "�'� " �. r°�r° � r�. e �U Pn..i.: _ ,_.� .„ . o �..�8 .� c,a�r�-�,� � �7� e.�.�� = o � � '1 � 2U � , X � �`�� .��, C1Y:`'��-�J!'�—__. ��`- � � �UILCI'd;:.� �J�F'r�T,�T�,�`,r��' AT N DI ING RO M DEN I LIVING ROOM 7�5��?,�2 8A`f" i0 4P"v! rc�� T}�,� � � I`l�� 2 JJI_' r-�i (ti'� (` 'J�' ��n �� z c� EW /2" 9yp. NEw I/2" gyK�• r�.�i_.�,�'�va ��v�, r_CTIO.��J: �Y Q� ,. i=�\��4,��T��rJ . �`�� 7^ USE IS UNLAl�'�UL I I I I I I �a�►S� � c�e��Ig I I I r�,r' ' �,�� ccn�c�r��:H�° NEW 3/4" plywood glued NEW 3/4" plywood glued = _ � a�i �CU,�,�� r 2. 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Gonnectlons Rec�uired) Uplift connectors as rec�uired Reframe w II for window � oint "?." 5ee Desi n "Notes sheathe wi h I/2" plywood p 9 ----- ------- ----------- -------------------ins�l�e c� �ns�_�in�lor��i�h------ ---- ---------------------------- ----- ------ For windspeed" �or applicability spray foa insulation HeaderStuds ------- ------ ------------- ---- ---------------- � � � ------ ------- -------�r- ------,-�--------T,---------�T------ � � � � � � � � � � � � � � � � ----- � � � � � � � � � � ; No ;Uplift � � ; j � ' Go�nhector ' ' I I ' ' � � I I I I I I I I I I ' ' Relc�uired � I � I rer�'�ove wir�dow � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 1 I � I 1 � I I Patch sic�'r��atch e i ting � � � � � � � A � � � � � � � ?� � � � � � � � � Open inc� �ram inG �et�i � Sca le: I/2"=I'-O" �O�'t�l ��Y��10�1 ,-`.t��'cf,�,,. I�l��. SGG1�Pi ��4�� _ ��-�ii �C�%'�:;C�t17'Fr ��r� C��;I� '"`�',� ��v`� U, r_� , �`'-v �. �'_ a� �_ , ,'�: .: I. The window sizes and styles shown on these drawings refer to "Anderson Gorporation "Series 400 products. ,� 4,,;, ` � �. • This is for the purpose of illvstration only. � � �� / ;� 2. The connectors rec�uired or shown on these drawings for Hurrlcane Resistant Residential Gonstruction sl-�all ��'° �;�' Y r�` ' � , meet or exceed the design rec�uirement as shown on these drawings and shall be installed in accordance with the `'` the manufacturers rec�ufrements. The contractor may used any product whlch wlll provide these design specfficatlons. Products as manufactured by "Simpson Strongtie" are shown for the purpose of illustration and compllance only. 3. These construction documents have been prepared by or under the dire�tion of the Architect whose seal and signature 5heet Title have been affixed upon these documents. Any addition, deletion, or revision to these documents or the work performed in a�cordance with these documents, is in violation of the New York 5tate Licensing Law, and anyone who directs these additions, deletions or revisions will be held responsible. - Pro�e�t Name Gl�ent Old North Road 5outhold, NY I1a71 SGTM # 1000-055-OI-002 May 15, 2015 ------ --- ------- --------------------------------------------- ----------------------- ------- � �� OUt�I �I�VC1tlo�1 scale I/4" = I'-O" of 4 Gharies W. Southard �r G01��l��UG�ION 1�OT��: � i� � �I I � � � I. All footings shall bear on undisturbed soil of I I/2 ton bearing capacity. 435 Bay Home Road 2. Gon�rete for footings and foundation walls shall be 3000 psi � 28 days and have between 5� and �� air entrainment by volume Southold, New York Ila�l 3. P�II concrete slabs shall be placed on clean fill, compacted to 95% density. 4. Goncrete for garage slabs, and concrete expcsed to the weather shali be Phone (631) 471-5228 3500psi � 28 days and have between 5� and 7� air entrainment by volume cwsarchitectc�optonline.net 5. All lumber shall be construction grade, �+em-�ir, S�O psi strength. 6. Double framing around all openings. --------- - ------------------------ ----- --------------------- - -------------------- 7. Double floor �oists under ail partitions. ________ __________ _________ _____ _________ ________ _____ _____ 8. Headers over all openings shall be (2)2"xS" unless otherwise noted. �i. Double 2"x4" posts under each end of all headers and girders. 10. Provide metal �oist hangers where all members meet flush headers II. Firestopping is rec�,vired at all concealed spaces within wall, partition, floor, stair, attic, or cornice construction, and around chimney, pipe and duct openings. Such constructlon shall be fire-stopped or fllled with non-combustible materlal, Refer to to Resi�ential Gode of NYS Section R602.8 12. Geiling ffnishes shall be in accordan�e with section R805 Residential code of NYS � 13. Insulation shall be in a�cordance with sectfon R316 Residential �ode of NY5 14. Wall coverings shall be in accordance with section R700 Residential code of NYS ��5� ��V��IOf� = Y� a{zc��T. sca l e I/4" = I'_O" ` `^ R\�" �.;.our� ��, r� a� '� �`�i� It% l� .�`�t°` �';..� c` * <<i r�--� f�, � ' ��11��- �' , 'i,�� i - �`�,,� T� 7 1 ��: �, E � �,, - � Sheet Tit�e � � B�DROOM B�DROOM B�DROOM �� J �� _� _� Pro�ect Name Glient � ' Old North Road dn 4 ri e s Southold, NY II�i71 SGTM # I000-0�5-0 I-002 May 15, 2015 ,_ �� _ �� ond �loor �I�� scale I/4" = I'-O" of 4