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Home My WebLink About40329-Z �� o�OSUFFO�'��oGy Town of Southold 8/9/2016 � � P.O.Box 1179 � � � ' S3095 Main Rd - ��.��1 ��o�� Southold,New York 11971 � CERTIFICATE OF OCCUPANCY No: 38436 Date: 8/9/2016 THIS CERTIFIES that the building ALTERATION Location of Property: 550 Old Salt Rd, Mattituck SCTM#: 473889 SecBlock/Lot: 144.-5-11 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 12/3/2015 pursuant to which Building Permit No. 40329 dated 12/7/2015 ' ._. 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: KITCHEN ALTERATION TO AN EXISTING ONE FAMII.,Y DWELLING AS APPLIED FOR The certificate is issued to Techet Joan R Revoc Trust of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 40329 03-31-2016 PLUMBERS CERTIF'ICATION DATED 04-09-2016 John McLoughlin � • , � Autho ' Signatur ��ol�, TOWN OF SOUTHOLD �,��° �aG� BUILDING DEPARTMENT . �- $ TOWN CLERK'S OFFICE o� • 4�� SOUTHOLD, NY �ial � .�� 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#: 40329 Date: 12/7/2015 Permission is hereby granted to: Techet Joan R Revoc Trust C/O Valerie Jeter Thetford 5516 Falmouth St Ste 300 Richmond, VA 232301819 To: construct a kitchen alteration to an existing single family dwelling as applied for. At premises located at: 550 Old Salt Rd, Mattituck SCTM # 473889 Sec/Block/Lot# 144.-5-11 Pursuant to application dated 12/3/2015 and approved by the Building Inspector. To expire on 6/7/2017. Fees: SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $398.80 CO -ALTERATION TO DWELLING $50.00 ELECTRIC $90.00 Total: $538.80 � -B, ilding 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: ]. 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 fonn). 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 iri 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. Q�1�t�� 1� -_� New Construction: Old or Pre-existing Building: � (check one) • _ Location of Property: �xS� �`� �'��-'� �'� - �(!-��TL3�� House No. Street � Hamlet Owner or Owners of Property: c�Sf��'� '� �� -�t�� Suffolk County Tax Map No ]000, Section �� Block � Lot �� Subdivision ��C�7 C,-� � Vl L�A� �� Filed Map. (��a Lot: � PermitNo. �lYj�-� DateofPermit. Applicant: (11�C-1(�(,1.��P�ASI �b'� �ST. Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (/ (check one) pa Fee Submitted: $ �� c��e�� Applicant Sig ture �O��pF SO(/lyOlo Town Hall Annex Telephone(631)765-1802 54375 Main Road � � Fax(631)765-9502 P.O.Box 1179 c � � roaer.richertC�a.town.southold.nv.us Southold,NY 11971-0959 �` � O��coUNT`I,�� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION issued To• Techet Address: 550 Old Salt Road City: Mattituck St: New York Zip: 11952 Budding Permit#: 40329 Section: 144 Block: 5 Lot: 11 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE contractor: �Ba: Darling Electric License No: 38041-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 13 Ceiling Fixtures 2 HID Fixtures Service 3 ph Hot Water GFCI Recpt 5 Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures 21 CO Detectors Sub Panel A/C Blower Range Recpt 40A Fluorescent Fixture Pumps Transformer Appliances DW Dryer Recpt Emergency Fixtures Time Clocks Disconnect Switches 31 Twist Lock Exit Fixtures TVSS other Eqwpment: 1- Exhaust Fan, 1- Electric Oven (40A), New 200A Main Panel Notes: Inspector Signature: � Date: March 31, 2016 Electrical 81 Compliance Form.xls ff,��or- so�;r;�,l..� , �,,� Town Hall Annex �p� ;. ��,r,,�� Telephone(631)765-1802 54375 Main Road N ' � �' Fax(631)765-9502 P.O.Box 1179 � � k ,��"- Q �� souuoia,NY 11971-0959 ��Q�� • \��5� ;�,��UN1�I,e ��f �``�"�crr��tl BUILDING DEPARTMENT TOWN OF SOUTHOLI3 C�RTIFICATION Date: �� l Z C��(�. Building Permit No. �� ,� Owner: �.� �, �1� � � ' (Please print) Plumber:� t��+1, � ��C¢cs'1/l.�„-v . (Please pr t) I certify that the solder used in the water supply system contains less tlian 2/10 of 1% lead. � r " � � (Plumbers Signature) Sworn to before me this �� REGINALD LEDAf� day of �i � , 20 �� Notary Public-State of Nev�d YorK N0.01LE6293930 Qualified in Nassau County ' My Commission Expires Dec i 6,2017 � �"�:�'�°.�r- Wr � ,� Nota.ry Public, _�cc�{"o�� _ C:o�mty 1 � �� Of SOpjyo ti� lo # #� � • �Q . o�yCO�� TOWN OF� SOUTHOLD BUILDING DEPT. � 765-1802 � . IIVSPECT -ON -� - [ ] FOUNDATION�iST [ ROUGH PLUMBING [ ] F NDATION -21ND [ ] INSULATIOM � . [ FRAMING / STRAPPING [ ] FINAL � :' [ ] FIREPL.ACE & CHIMNEY [ ] FIRE SAFET'Y INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATIO [ ] CAULKING RE RKS: �lC� � �. � , DATE �� 2-' l� INSPECTOR � - � �OF SOUT D� o`� y�! - • � o � # # � • �o ��y�OUN('l,�`� TOWN�OF SOUTHOLD BUILDING �DEPT. 765-1802 1111SPECTION _ [ ] FOUNDATION 1 ST [ ] ROUGH PLUMBING ' [ ] FOUNDATION 2ND [ ] IN LATION, � [ ] FRAMIRIG / STRAPPING [ FINA'L [ ] FIREPLACE � CHIMIdEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSYRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: � �. G, - , � ' �Q ' � . , . DATE O3 3� 6 INSPECTOR ` � -- - - hO��OF SOUr�,�lo � . - /, �� - V� � � yQ ��'Y�OUPti`I,�� . ` TOWN OF SOUTHOLD BUILDING DEP'1'. 765-1802 � � INSPECTION � � [ ] FOUNDATION 1 ST . = [ ] ROUGH PLUMBING [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL � [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION - � [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION � [ ] ELECTRICAL (ROUGH) �J ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: ��r� � � �r� ,� �� DATE � �� INSPECTOR � �i 1 j ' i O • � e � . r 1 /� -- � -- --- - - • � \ . • � • • � ` � � � ' • � • • � � .a/� Mifr'.11�7.� �'�u�� __ _.�. ��.'" � ��--�, � M � � I �:4` ..i � . . � o . . �i ♦ " �: I \ � .. � � � � . • • � � . ' • r r � C�-- � � c l _ � - �� I� ''� /'/L.J r ,�`f:��.;�_ � ,..r.P%aiAl` :... � , �� . .� �:►�� w ., .. .� /. � ��//?. .��"� � ' ••`� _/ t. �___ �--_ _� � � I = ��• / � � � i� �� I.�.r��....rnd..� :Y_' i�.:.. _ _ �``' � .�/.�... / �i ar_= / _/ � / �� / �- � . �,� �`�/ � ,�ir�� ' f� I r° ' -- 6i Rl��E �;V�y�' '�� -- -- \ ,, i� s / � ►!�� '� .� _ �� I - � • �/ /J. 1� ' ��. m ��1��i ' c (� 1 .�.�.! � � r `1/L��`"/�..�^ � ''.�.�� .... �1_i. � �Ir / �" � ' �-�' � ---: _ / --�..rl.w 3..�,...�. - - - =.. -�; ' ' r� r / � - �- - �� 1 / � L'Z7j�� ." i � �— �►- '� i . � � ,�'./1� ✓ _ •�� ,.� _ .. , � �. . .. r ��► n r TOWN OF SOUTHOI.D BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applymg? TOWN HALI, Board of Health SOUTHOLD, NY 11971 . 4 sets of Building Plans TEL: (631) 765-1802 ' . Planning Board approval FAX: (631) 765-9502 n ��-r- s Survey SoutholdTown.NorthFork.net � PERMIT NO. v d— z� � Check ' Septic Form , N.Y.S.D.E.C. ' ' � Trustees . C.O.Application Flood Permit Examined ,20 Single&Separate � � Storm-Water Assessment Form /J Contact: Approved ,20 Mail to: Disapproved a/c ��ne: Expiration ,20� � � (� �� I_�� _�� rx.r �� --n---' Building Inspector �'��I1 I� �� `II I� ,� �I D � � I�'APPLICATION FOR BUILDING PERMIT � m 1� 'I —r�l- �- �� 20 ; Date �D��-� , 20 1S - -_--_----- � INSTRiJCTIONS �3Li)t; CiFPI a. This�a"" 1'ICa ��'TLI��i9.u.�il�be-eompletely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets o pla 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 inay 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 lcept 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 worlc 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 Pennit 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. �� - ��,�� f�l��} C�►.�i c7�rc-� (Sig ture of applicant or name, if a corporation) �'�2�►rr+�r�,�v�-��.I��►,��- I�� (Mailing address of applicant) � State whether applicant is owner, lessee,3agent,�ar,chitect, engineer, general contractor, electrician, plumber or builder �' ��l_/l/��("71�1 �-'J ,`��ai��'+'.�� .�. - ��} „ •�. _ < YS`�� _' r�� . �� ' ' � ,• �-,t .'•'llq� -.7 `�,�'-,�<�� Name of owner of premises 1�1/`��°- �� `�`�-�� (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. (o��'d-� Plumbers License No. �0�� r-(�(�� Electricians License No. ��8�� -- M� Other Trade's License No. N�� 1. Location of land on which proposed work will be done: �O ��,�" � 11'I-� (lcc�C,�, - � � . House Number Street Hamlet ' ^ County Tax Map No. 1000 Section ( �'�0 Block S Lot �� Subdivision '�S�-�L� IL� vlL(�A�C�� Filed Map No. �3J(� Lot � �� 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy �1� �� Iolr10�.,C� �J��C� ► b. Intended use and occupancy ��-� /bN� �'19�.LQ �^��--a�� 3. Nature of work(checic which applicable): New Building Addition Alteration Repair Removal Demolition Other Work ��IT��1"-� ��6V�� (Description) 4. Estimated Cost ��L��, ��•� 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 l �� r�qe-� , 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 ;;;�;: � .� :�•�� u ,.i.� 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�WiII excess fill be removed from premises? YES NO 14. Na�nes of Owner of premise� C� o-A� ��Address �S-G ��-T�• Phone No. �g�`1 ��r d 77� —� Name of Architect Address Phone No Name of Contractor l�� 'S�l�-f.�C�c� Address f9-��s��`�•g�• Phone No. �� O-�'�l�' N�1.�-T N�tc7 � 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 ' * IF YES, PROVIDE A COPY. CONNIE D.BUNCFi STATE OF NEW YORK) No4gry Public,Stete of Nauv York S : Ido.01�U6185050 . . Qualif�d fn�uNoHc County COUNTY OF�I� �ommisslon E�ires April i4,2Q� being duly sworn, deposes and says that(s)he is the applicant (Name of individual sib ing 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 worlc will be performed in the manner set forth in the application filed therewith. S orn to before me t is �� • day of �/-�LvvC 20 � � ��P � ��_ Notary�Public ' iature of�pp icant - d�`�� C'�0�][��1t��A\�C']E]E� Scott A. Russell a � � SUPERVISOR �,. - I��/][A\1�A\(Gr]EI��/][�E1�7C' .� SOUTHOLDTOWNHALL-P.O.Box 1179 � � Town of Southold 53095 Main Road-SOUTHOLD,NEW YORK 11971 'y� �- lp,� �i.,��-v rs CHAPTER 236 - STORMWATER MA.NAGEMENT yVORK SHEET ( TO BE COMPLETED BY THE APPLICANT) . - -- - - �� x� ��' ��[,�� ' �'�� t,�,��: Yes No (CHECK ALL THAT APPLIn : ❑ A. Clearing, grubbing, grading or stripping of land which affects more � � than 5,000 square feet of ground surface. ' ❑ B. Excavation or f illing 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-FI�M-l�Iap- af-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 lnformation, 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 wiih your Building Permit Application. APPLICAN7 (Property Owner,Design Professional,Age t,Contractor, ther) S.C.T.M. #: 1000 Date Dutnct NAME. �I G!-��t��-��•�� ( / ( � � I I �I �► 2�I S . �e,�� Section Block Lot LQ�/�'G�X� �,g�,��,<, .<":.- ��OR E�L�iLT�1:��; DE��'�ftT:�iL�i"f 1��1: �)_'�L�' .�`. Contact Information ( �� '��`�� p � n// .r�i��i�an.��,�a /p L <,� /:(/a � Reviewed By: (�a a►�.`p �►�i\ — — — — — — — — — — — — — — — — — — Date• �J��1 � Property Address /Locat�on of Construct�on Work: — — — — — — — — — — — — — — — — — �� c n r..�� Approved for proce5�ing Bwld�ng Perm�t. ��-�-�� Stormwater Management Control Plan Not Required — — — — — — — — — — — — — — — — — ��A�� Stormwater Nlanagement Control Plan i�Peyuired (Forw�rd io Engineenng Depariment for Review.) FORM " SMCP-7�OS MAY 20]4 ' �;� I ��' . - � � , � �� - � . ��yOF SO�l�,Q� : o �-._� ;a-�----- ---- --- - - ; Town riall Aiu�ex ' � ' �4 �S , � i Teiept�one(631)763 l`180 �� 54375 n�t�;R itead �, � I �� "ar.-{o3�i-1�a�-��Z � � p.o_Bo� ti�9 � �, � o �C er_rich�r� town_sout �cl.n .us Southold,LVY 1197LA959 '�p � I � �y�oUt,t�,��, ��' �_� JA N 1 2 2016 (,� � . i � �. BUILDII�G D�PARTIv1�NT ';l n�' ��`I I�.e e= I _ . . . (�; �ni i;, ,�! 7[`OWN ��S��J.TJE��I�— - APPLIGATfON FOR ELECTRICAL INSPECTiO[� - ' - _ � . 7 - REQUES�ED BY_ �-(��-c�t� �.-��1�� Qa�P: � 12 ��301� ; : : �Company Name= ��e_.t,t�(�`�d��1�(� ��A � ��►� i � t�a m e: � ��}� �PsQ-c�11� _ -_ �- _- License No.: �� - (�(1� � _ � - Addr.ess_ p� � t�p ,- �--�� j � .- 1 �_- " Phone�No_: " " _ !"_ JOBS(TE [(�iFOR�(1liATI4t�i: ('�{ndica�es requ�r-ed informafion - � t � � � , � • � Narree: �� - _ - _�•� . '�Addr-ess: ��1� � `�� '• - �CTI�T�� ! - - I �C�oss Streef: • - . '�Pfione No__ � �� ('p'� � �, � ' f - ; Permit�fo.: , � �� q - . Tax-MapD�sfrict: - 1000 Secfian: Iy� - B�oc[c�_ Lofi: !� � ' . � *BEZ[EF D�ESCRiPTION OF WORK tP{ease Prin��leariy) _ . . � _ I��N ��ic�t� . _ _ � - o - � �{P[�ase Circle e4([Tha�e4Pp1y) _ � 1,1�11.,��. �(A - t(� "ob read for ins ecfion_ � ' � �I b � Y , p . YES NO Rough [n Fina( � *Do-you need a Temp Ce.rFf�icate_ YES/ f�d0 - - - � . _ _ � TerYtP tnfarmation ([f needed� � ' � ; ` �SerriiceS[ze: 1 Phase 3Phase �f00 'i5Q 200 300 350 400 Ofher I . . i -. '�New Service: Re-connect Underground (�fumber of Mefers Change of Service Overf�ead Additiona[ lnformation: � PAYMENT Dl1E WITH APPUCAT(ON � _ �.�C �� c.��[P--eC� L c�� °� ' � z c��cU ' �,',�' �� . � � � �� I'�� 82-Request for tnspecfion Form � �� " � _ � �� _,�, � `�rw+�� .�hr„� f. , ` .� ��. ; , y=.,,� . � _, � . r �� --»�-... �_ � � � , . � ; ��:.�.,��. �Aq.....,,, _ '°��""""''��, ....�, I�,.� ��"�� . ---... � < � . - ;/� �...� , . .. • � ' ti�� y`_++. 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SMITHTOWN NY 11787 631,366-2774 iNSURERS AFFORDING COVERAGE NAIC# wsur�o DARLING ELECTRIC CORP INSURER A MERCHANTS ' 7 OLD POST RD EAST wsuReR e• HARTFORD wsuReR c: GUARDIAN PORT JEFFERSOtV,-NY 11777 INSURER D: INSURER E: COVERAGES THEPOLICIESOFINSURANCELISTEDBELOW HAVEBEENISSUEDTOTHEINSUREDNAMEDABOVEFORTHEPOLICYPERIODINDICATED.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 INSURANCEAFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECTTOALLTHETERMS,EXCLU510NSANDCONDITIONSOF SUCH POLICIES.AGGREGATE LIMITS,SHOWN MAY HAVE BEEN REDUCED BY PAID CIAIMS. INSR - pp{��y NUNIBER P�CY EFFECiiVE POLICY DIPIRA710N �� - CaENERAL LIABILRY EACH OCCl1RRENCE $'I OOO OOO A X X COMMERCIAL GENERAL LIABILIIY BOPI060484 07I17/2015 07/17t2016 ��GE TO RENTED $�OO OOO cwnes�oe XO occuR MED EXP «� rsoo s 5 000 PERSONAI$ADV INJURY 'I OOO QOO GENERALAGGREGATE 2 O�O OOO GEN'LAGGREGATE LIMIT APPLIES PER• PRODUCTS-COMP/OP AGG 2 OQO OOO , POLICY PRa LOC AUTOMOBILE LIABILITY COAABINED SINGLE LIMIT a ANY AUTO (Ee acc3denq AlL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (�� $ HIRED AUTOS BODIIY INJURY S NON-0WNED AUTOS (Per satdeM) PROPERiY DAMAGE a � (Parecadenq QARAGE UABILITY AUTO ONLY-EA ACGDENT ANY AUTO OTHER THAN �A� $ AUTO ONLY: � AGG S EXCESS f UMBRELLA LWBILITY EACH OCCURRENCE OCCUR �CWMS MADE AGGREGATE $ _ $ DEDUCTIBLE � RETENTION S - WORKERS WMPENSATION X WC STATU- OTH- AND EMPtAYERS'LIABILITY B ANY PROPRIETORlPARTNERfEXECUTIV� '�Z��Q�997 03/20/2015 03/20/2016 E.L EACHACCIDENT S�Q��0 OFFICER/AAEMBER EXCLUDED? (M811dEtOry III NH) E L DISEASE-E4 EMPLOYEE $'I OO OOO ' Ityes,desrnbe under P PR 51 N below � E L DISEASE-POLICY LIMIT $5OO OOO OTHER C NY DISABiLITY 881855-001 0312012015 03/20I2016 NY5 LIMITS DESCRIPTION OF OPERATIONS 1 LOCAT10N3!VEHICLEB/EXCLUSIONS ADDED BY ENDORSEMENTI SPECWL PROVISIONS CERTIFICATE HOLDER CANCELLATIOPI _ $HOULDANYOFTHEABOVEDESCRIBEDPOL1CtESBECANCELLED6EFORETHEEXPIRATION Town of Scuthold ' oa�ni�oF,THE ISSUING INSURER WILL ENDEAVOR 70 MAIL�Q_DAYS WRITiEN 54375 Main Road , Nonce To TMe c�rrnFlca�Ho�o�waraeo ro nie�r,BUT FAILURE TO DO SO SHALL PO Box 1171 IINPOSE NO OSLIGA710N OR LIABILITY OF ANY 0(IND UPON iHE INSURER,1TS AGENTS OR Southofd,NY 11971 ��s�ramres. � AUTH�D REPRESENTATtVE ACORD 25(2009/01) O 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD =�, x" ��:.,y S�FFOLK C4UNTY'DEPT OF LABOR. ;'�-; ' ��,:� L10EN51tJG�S CQNSUNIER AFFAIRS ` � HOME iMPRi7VEMENT ��. �`',:,`s�:�„_': �,:� CONTRACTOR ��+�,�c , �yi��,, �, �j6'Y ?tl::C.,}e;d��_..:.'��:ytl !' ? � " f� �I.i:.'�"� .. j°�:,7 �'� ' EDNtUND L ROWLAND JR �� This Ce�tiftes ih'at'the NDA CONSTRUCT#ON INC DBA ' bearer is duly , . . licerised tiy the ��,�,,,� p„�„„„, County of Suffotk � . 03/01/1982 / 6658=H r�Ma�fl..�-�v 1 comm+.ua�.r ��""t"nO"O"'� 03f0112035 � i � New York �tate Insurance Fund Workers'Compensation&Disability Bene,ftts Specialists Since I914 199 CHURCH STREET,NEW YORK,N.Y.10007-1100 Phone:(888)997�863 _ CERTIFICATE OF WORKERS' COMPENSATION INSURANCE "^^"^^ 113044811 N D A CONSTRUCTION INC 192 SMITHTOWN BLVD NESCONSET NY 11767 POLICYHOLDER CERT{FICATE HOLDER N D A CONSTRUCTION INC TOWN OF SOUTHOLD BUILDING DEPT . 192 SMITHTOWN BLVD 57375 MAIN ROAD NESCONSET NY 11767 PO BOX 1171 SOUTHOLD NY 11971 PpLICY NUMBER CERTIFICATE NUMBER PERIOD COVERED BY THIS CERTIFICA7E DATE � G 709 348-7 94350 06/29/2015 TO 06/29/2016 11/6/2015 TH1S IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 709 348-7 UNTIL 06/29l2016, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT 70 ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF IVEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF SAID POLICY IS CANCELLED,OR CHANGED PRIOR TO 06/29/2016 IN SUCH MANNER AS 70 AFFECT 7HIS CERTtFICATE, 10 DAYS WRITfEN NOTICE OF SUCH CANCELLATION WILL BE GIVEN TO THE CERTIFICATE HOLDER ABOVE. NOTICE BY REGULAR MAIL SO ADDRESSED SHAl.L 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 POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE IIdSURED CORPORATION. , EDMUND ROWLAND JR. , � _ PRESIDENT AND SOLE OFFICER OF N D A CONSTRUCTION INC THIS CERTIFICATE IS ISSUED AS A MATfER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURARICE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. ' � NEW YORK STATE INSURANCE FUND . �Qy� , U DIRECTOR,INSURANCE FUND UNDERWRITING This certificate can be validated on our web site at https:/lwww.nysff.com/certicertval.asp or by calling(888)875-5790 VALtDATION NUMBER:387013474 U-26.3 -/�1 NDACO-9 OP ID:JA � �''��`�'� � CERTiFlCATE QF LIABtLI`i'Y INSURANCCE DATEjMMlDWYYYY) 11/06I2095 THIS CERTIFICATE IS ISSUED AS A NlATTER OF lNFORMATiON ONLY AND CONFER3 NO RIGWTS UPON'PHE CERTIFICATE HOLDER,THIS CERTIFlCATE DOES NOT AFFlRdAATl1lELY OR NE6A71VELY AMEND. E7CfEND OR ALTER 7HE COVERAGE AFFORDED BY THE POLICIES BEL�W. 7HIS CERTIFICA7E QF INSURANCE DOES NOT CONSTl7UTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCBR,AND THE CERTIFtCATE HOLDER. IAAPORTANT: if the certificate holder is an AODI'i'IQfVAL INSURED,the poiicy(ies)must be endorsed. [f SUBROGATION iS WAIVED,subject to the terms and condidons of the poticy,ceriain poltcles may require an endorsement. A siatement on this certificate does not co�er rights to the certiflcate hoider in lieu oP sach endorsemen s. PROAUCER Phone:631-589-5100 NqµE�T Jasmine Arettines FOLKS 1NSURANCE GROUP PHONH 33 nAAIN 3TREET Fax:631-589-3335 No E,,,:631-589-5100 N,;631-5893335 WES7 SAYVILLE,NY 11796 A�� .'arettines folksins .com JAME3 M.FOLKS JR • MSUR 8 AF60RQWGCOYER1tGE NAICg INSt)RERA:Wesco{nsurance Co �Nsu��o idDA Constructlon,Inc. ,r,s��e: 192 Smithtown Bivd. ,�rs�Rc: Nesconset,NY 7'1767 INSURER D• IHSURER E• - INSURER F• COVERAGES ' CERTIF[CATE NUAABER: REVl510N NUMBER: � THIS IS TO CERTIFY THAT THE FOLICIES OF INSURAt3CE LIS7ED BELOW HAVE BEEN 1SSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIQO INDICATED, NOTWITH5TANDING ANY REQUIREMEiVT,TERM OR CONDITION OF ANY CON7RACT OR OTHHR DOCUMENT WRH RESPECT 7'O WHICH THIS CERTlFICATE MAY BE ISSUED OR MAY PERTAIN,THE iNSURANCE AFFORQED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CON�1TIOiVS OF SUCF{POUCtES.41MITS SNOWN MKY HAVE BEEN REDUCED BY PAID CIAIMS. INSR TYPEOfWSURANCe POUCYNUMBER k�AAfuDDY� MMIPD LtlAiTS e�r►�uaswrv �,cH occuRR�ce a l,OOO.aO A X COr�AErtCuu.GEt�Ewuunaiu�rr PPl149809 4M3012015 OAI3012016 P��se�ee a 900,00 .cLnu�s.�aoE Qx occur� M�o aw�n�y o�cerso�� s s,00 PERSOMAL 3 ADV INJURV a 1,000,00 GENERAI AC�GREGATE 3 z��OO�{W CiEN'L A(iGREGATE LIM1T APPLIE$PER: PRODUCTS-GOM%OP AOG S 2,aoo�QD POLICY PRa LOC S � �� Ee aBIN S W GLE LINu7 � rr en ANY AUTO BODILY tNJURY(Pef persp�) 6 VTOYS1RdED AS�C�Na ULED BODFLY ttJJURY(Per ac�Edent) S NON•OWNED PRO ERTY U 1iIREC AUTOS AUTOS � ��;�� S S �8�� OCCUR EACH OCCURRENCE i S EXCE33IJAB C��q�pE AGGRECATE �S EO RE7ENTION S g �W�RKERS COMPENSA7tON � 1NC STA7U• OiH- AND EMPLOYERS WlB1UTY I ANY PROPRIETORIPARTNERtBXECUTiVE Y�N � E.L EACH ACCIDENT S OFFICERtMEMBERD(CCUOED? � N!A (Mandatflry fn NH) EL DISEASE-FA EMPI.OYE S flyes,descnbe under DESCRiPTION OF OPERATION treiow E.L OISEASE-POLICY UM�f 5 � DESCRIP7ION OF qPERATIONS/LOCATIONS!VEHICLES(AttacA ACORD 101,AAClticnal Remuks Schedui¢,If more apace Is reqWmd} CERTIFICA7E HOLbER CANCELI.ATION ' SHOULD ANY OF THE ABQVE DE3CRlBED POLlCIE3 BE CANCELLED BEFORE THE EXPIRA7)ON DATE TMHREOF, NOTICE WILI. BE DEi.iVERED IN Town of Southold ACCORDANCE WITH TFEE POLICY PROVlSIONS. Buiiding Departrnerrt pUTFi0R2ED REPRESENTATNB 57375 Main Road PO Box 1lT7 ��'�y�� Southold NY 17971 z O 9988-2010 ACORD CQRPQRATION. AI!rights reserved. ACORD 25(2010lOS) , 7he ACORD name and logo are registered marks of ACORD 5TATE OF NEW YORK WORKER'S COMPENSA710M 80ARp CERTIFICATE OF IfVSURANCE COVERAGE UNDER TNE NYS DISABILI'fY BENEF{TS L/AW PART 1.To be completed by Disability Benefits Carrier or Licensed Insurance Agent of that Carrier � 1a.Legal Name arM qddress of Insured(Use street address only) � 1b.Busin�s Telephone Number of Insured NDA CONSTRUCTION INC 631-360-3818 - 7c.NYS Unemployment lnsunnce Employer Registration ATTN: LUCILLE ROWLAND Numberoflnsured 192 SMITHTOWN BOULEV ARD ' NESCOI�SET, NY 1'1767 1d.Federal Employer ldeMifleatlan Num6er of lnsured or 5oclal Seauiry Number 113044811 2.IVame and Address of the Entity requasting Proof of Coverage 3a.Rfame of I nsurar�ce Carrier (Entity being�isted as the Certificate Holder) ShelterPoint Life Insurance Company Town of Southold 3b.Policy Numher of Entity listed In box"1a": Suilding Department DBL404114 57375 Main Road ac.Poncy efire�uve per�od: PO Bax 1179 04/01/2015 � 43/31/2017 Southoid ny 11971 , � � 4.Policy eovers; a•� All of tlsg employer's employees eligible under the New York pisability Benefits Law b.� Only the following class or Wasses of the empioyer's employe&s: Under penalty of perJury,!certify that i am an authorized representative or licensed agant of the insuranee carr�er referer�! above and that the named insured has NYS Disabitity Beneftts insurance coverage as described above. Date STgned l i/6/2095 gy 1,��'ilSh�Ul� (Signatura of insunnce prriefs authprtz�represeMetive�NYS Lieensed Ins�aance Agent oi th�t ituuranee eartierj Telephone Number 516-829-81 QO ru�e Chlef Executive Offieer � IMPORTAR1T:If box"Ga"is eleedked,ana this torm is signed by the inwranoe wrriw's authorized representative or NYS Lieensed Inwranoe Agent , of that earrier,this cettfffeate is COMPLETE.Mail it directly W tho eeniflrate hoider. If box•4b"is checkaa,this certifirate is NOT COMPLETE fpr the purposes of$ection 22p,Subd.8 of the Oisability Bene�ts Law. � It must be mailad for oompletion to the Waker's Campensation Bnard,DB Plons Axepiarwo Unit,328 State Stree4 Schenectady,NY 12305. PAR7 2.To be completed by NYS Worker's Compensation Board{Only ii box"4b"ot Fart 1 has been checke� State of New York Worket's Compensation Board Aaording to iMormatian ma4ltairted by ehe NYS Worker's Compensation Board,the above-named e�nployer}�as ewnp�Ied with tho Nys Disability Benelits Law wiq�rbspect to aH of his/her empEoyees, Date Signed gy � (Signature of NYS Worker's Compensation Board Employeo) � Telephone Number Titte Pleas�Note:On1y insiaance carriers liee�ed to write NYS Disabifity Benefits insurarrce policies and NYS Llcensed Insurance Agents of fhoss insurance carriars are authorized to issue Form QB.120.7.Inwrance brolcers are NOT authorized to issue th15 form. DB-120.1(]2-13) - � New York State Insurance Fund � m R'orkers'Compensation&Disability Benefits Specialists Sic�ce 1914 199 CHURCH STREET',NEW YORK,N.Y.10007-1100 Phone:(888)997-3863 CERTIFICATE OF W012KERS' COMPENSATION INSURAI�CE ' ' ^^^"^" 913044811 � N D A CONSTRUCTION INC 192 SMITHTOWN BLVD NESCONSET NY 11767 POLICYHOLDER CERTIFICATE HOLDER N D A CONSTRUCTION INC TOWN OF SOUTHOLD BUILDING DEPT 192 SMITHTOWN BLVD 57375 MAIN ROAD NESCONSET NY 11767 PO BOX 1171 SOUTHOLD NY 91971 _ FOLICY NUMBER CERTIFICATE NUMBER PERIOD COVERED BY THIS CERTIFICATE DATE G 709 348-7 94350 06/29/2015 TO 06/29/2016 11/6/2015 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLtCY NO_ 709 34&7 UNTIL O6/2912016, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLpER 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, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF SAID POLICY IS CANCELL�D,OR CHANGED PRIOR TO 06/29/2016 IN SUCH MANNER AS TO AFFECT THIS CERTIFICATE, 10 DAYS WRIT7EN 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 IP! THE EVENT OF FAILURE TO GIVE SUCH NOT{CE. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATlON. EDMUND ROWLAND JR. PRESIDENT AND SOLE OFFICER OF N D A CONSTRUCTION INC THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION aNLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPOiV THE CERTIFICATE HOLbER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. ; NEW YORK STATE INSURANCE FUND . �� DIRECTOR,INSURANCE FUND UNDERWRITING This certificate can be validated on our web site at https:llwww.nysif.com/certicertval.asp or by calling(888)875-5790 � VALIDATION NUMBER:387013474 U-26.3 �1 NDACO-i OP ID:JA � '4�R�� CERTiFICATE OF LiABtLITY INSURANCE �A�IMINIDDMfYY) 11f06/2015 THIS CERTIFIGATE IS ISSUED AS A MATTER OF(NFORMATlON ONLY AND CONFERS NO RIGWTS UPON YHE CERTIFICA7E HOLDER.TliIS CERTIF{CATE DOES NQT AFFIRMAT(VELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE CflVERAGE AFFORDED BY THE POLICiES BHLOW. THIS CHRTIFICATE OF INSURANCE DOES NOT COAISTITU7E A CONTRACT BETWEEN THE IS�UtNG INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFlCATE HOLUER. IMPORTANT: If the certiflcats holder is an AOD171QNA! I1dSURED,the pollcy(ies)must be endorsed. if SUB6tOGAT10N 1S WAIVED,subject to the terms and conditlons of the policy,certain policies may requlee an endorsement A stateraeM on this certiflcate does twt confer rights to the eertificate holder in lieu of such endorsemen s. PRODUCBR Phone:631-589.5t40 ryp�E�T Ja6mine Arettines FOLKS iNSURANCE GROUP .639-589-5100 N,:631-589-3335 33 NWIN STREET Fax:631-589-3335 PHON o RAx WEST SAYVILLE,NY 1'1796 anaRess•� rettine folksins .eom JAMES tVl.FOLKS JR INSU 8 AFFORd1NG COYERAt3E NAIC� RJSURERA:Wesco[nsurance Co iasu�o NDA Constractlon,inc, n�sua�e: 192Smithtown Bivd. ��: Nesconset,NY 11767 INSURER D• MISURER 8: INSURER F• COVERAGES CERYfFICATE NUMBER: REV1510N NUMBER: THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN 1SSUED TO THE INSURED NAMEO ABOVE FOR 7HE POLJCY PERIOD INDICATED. NOTWITHSTANDING ANY R£QUtREAAENT,TERM OR CONDRION OF ANY CONTRACT dR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES QESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS ANQ COND{TIONS OF SUCH POUCIE3.UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR L TYPE OF INSURAtdCE PpLICY NU1118ER MM CCD� M D P LiMIT3 cEN�ru►�uaswTv eacHOCcue�n►ce s 9,000.00 A X conw��cuu.GewEsn�uneiurr PP1149609 � 44/30/2015 04/30/2016 P isE ��„� $ 106,00 •c�nuas•n�aDE QX oCcuit nneo pw Ina,v o�e ae�or+l S 5,00 PERSONAL&ADV INJURV s 1,000,00 GENERALAGGREGATE S Y�OOO,OO GEML AtiGRECiATE UMNT APpL1ES PER: PRODUCTS-COMPIOP AGG S Z�OOO�OO POUCY PRa LOC S AUTOMOBiLB�1ABILITY ECOMB�I,Nd�SIP1GLE LI 17 S ANY AlJrO BODILY INJURY(Per p�) 6 AllfOS � AUTOSu� BODILY INJURY{Per acadmt) $ NON•OWNEQ PROP R D A � HIRED AUTOS p�pg Per aedde S �� OCCUR EACHOCCURRENCE f S DCCESS LIAB C��E AGGREGATE S DEO RE7ENTION S • . S WORKER3 COMPENSATlON WC STATU- OTH- AND EMPtAYERS UABtL.ITY Y�N ANYPROPRIETORlPARTMEWEXECU'RVE E.LEACHACC�DENF S OFF{CER/AfEMBER IXCLUDED? � N!A {MandaWry(n NN) E L DISEASE-EA EMPLO ' S Ityee,desufbe under ESCRIPTI F PERATIOkS below EL DiSEASE-POUCY LIMCf $ DESCRIPTiON OF OPERATIOfdS/LOCp'IIONS/VEHICLES(Attaeh ACORD 101,qtlCtNonal Renftrks Schedulq ff moru apace ts requlrod) CERTiFICATE HOLDER CANCElU4TtON SHOULD ANY OF THE ABQVE DESCRtBED POUCIE3 BE CANCELLED BEFORE 7HE EXPiRATiON DATE TNEREOF, NOTICE WILI BE DELIVERED IN TOWn Of$OUthOld ACCQRDANCE WffH TIiE POLiCY PROVl510NS. Building Department - nurHor�o aePReseMra�mre S73T5 Main Road � PO Box 1771 ��' , � outhold NY 11971 O 9988-2010 ACORD CQRPORATION. All righffi reserved. ACORD 26(2090105) �The ACORD name and logo are registered marks of ACORD STATE OF NEW YORK WORKER'S COMPENSATION 80ARD CERTIFICATE OF INSURANCE COVERAGE UNDER THE NYS DISABIUTY BENEFITS!AW PART 1.To be carrepleted by Disability Benefits Carrier or Licensed Insurance Agent of tG�at Car�ier , � 1a.Legal Name and Address of Insured(Usa street address oniy) � 1b.Business Telephone Number of Insured NDA CONSTRUCTION INC 631-360.3818 7c.NYS Unemploymant Insurance Employer Registration ATfN: LUCILLE ROWLAND Nuinberoflnsured 192 SM[THTOWN BOULEV ARD N ESCONSET, NY 11767 �a.Federal Employer ldeMificaUon Number of lnsured or Social Sectsiry NumDer 113044811 2.Name and Address of the Entity reyuestin9�f��►�S� 3a.Name of I nsurar�e Cerrier (Entity being lisbed as the Ctrtificatt Hoider) Shelteri�oini Life Insurance Company Town of Southold � 3b.Po{iey Numder of Entity Eisced in box"1a": Building Departrnent DBL404114 57375 Main Road �c.poi�cy e�Pec�ve�riod: PO Box 1179 04/01/2015 � 03I31/2d17 Southoid ny 11971 , i 4.Poticy coverx ' � a.� All of the employer's employees eligible uruler tha New York Disabillty Benefits Law b,� Oniy the following class or elasses of the empioyer's employees: � Under penalty of pe Jury,t eertify Utat i am an authorized representative orlicensed agent of the insurance carrier Pefererec�d above artd that the named insured has NYS Disability Benefits insurance saverege as described above. Date Signed i 1/6l2015 g� ��;��Q G�� (Sigreawra of insuranee carrier's anthoriz�represenmtive or NYS Licensed IMura�es Agent of th�t ir�vrance earrier) Telephone Number J�'I 6-829-8100 nt�e Chief Executive Officer IMPORTANT:!f box"4a"is eher3ud,and tnis torm is signed by 1he inw►anw carrier's authorized representative er NYS Licensad Insuwnu Agem Of U72L terrieY,this certi�itete i!COMPLETE.Mail lt direcify tu tho mrtifleate holdc+r. ' iP box'4b'is ehecked,t�is�efitifleate is NOT COMPLE'fE fDr the purposBs of Section 2?A,Subd.8 of the Oisahility BeneFits Law. -It must be maitod for eompletion to ifte Worker'S Cempensation 9oard,DB Plans Aaeptatke Untt,328 State Street,Schenectady,HY 12305. PART 2.To be compteted by NYS Worker's Compensation Board(Qnly if box"4b"of Rart 1 has been checked} . Stat�of New York Worker's Compensation Board According to information maimal�ed by the i11YS WorkeYs Compensation Board,tha above-nam�d¢mployer has eomplied with the NYS Disability Benefts Law with respe�t to all of hiSJher emplpyees. , Date Signed gy , (Signaque of MfS Workers Compensation Board Employea) Telephone Number Titie Please Note:Oroy insurance can-fers Iice►ued to wrlie NYS Dtsability BeneFits insurance policies and 11fYS LicenSed Insurance Agents of those insurarue carriers are ainhorized to issue Form DB•120.7.Insuranca broken are NOT authorized M issue this form. DB-120.1'(12•13) - �;�r;•a•:: ,'#i-^^�*z;-. .. �i` - _ '• , ,. , " -�+ � = , ..y,�b:.c^;:,,`5.`�C.. �.' �' Y e`e�: � .'.ro ^ Y 5;:,�' .�x. ,z^»�L•,.�;.�.•£�i,";�,`',r .. , e��.+. ` .:i� e:.i"ti � ��<tl -SUFFOLK COUIVTY'DEPT�C?F' . "'« x� •�. �s'.�;� E - :�, , R�F ��'�- „M� I G 8� �C ON5U � NS . .+� �lt� E N . . C �� x ,,,, - - ` � �� ;, - - y�,.,. ,MAS,TER � =°�� a '-' 'ds 'S". � �; ' � . . ' 7ar � � �"'�~� ' -'`-� - "�`PLUMBER; , . �-� : . �: y�� :�� : _ . _-_- - a`�- - � ':;�: . . � :�� :�� _ _�:T:`.,,a- :__�� _ �s; . _ a ,.k f�'.i�'� Y�.�d.� �,,, �r _. .. , _ � I �'.`Y - _ t'1{�C. � �~ `•'f�.a ,��+„1�:`iri. "j�. .v: " ��(.{ JOF�� LO�UGHLIN��"�`�' : � Y �V " . � .. '_ '°`=*; ' ' ` � .This certifies�tfiaf tfie, �°``�r,:' � .. -:;��-�;�T.� -:�:: ��. '_ _ � `,� ;. . � . : ._,•_. . -. - . Cn��e:�E�ttVPL'UMBffVG:��HEATfIVG`1NC.�:., : ; � ;Eiearer is;.diaty � . � - �� ;., �� -"`iicenseci�oy zne� � - �� '`°��`"�°'..: ;;� t,_ ` " ^'. -' ' � L`tce�so 2lumber ", i' Dsi�lasusd__ �,? :�•' t.= �; , w .`Cou�nty:of Suffolk - � - ��-� �-- � � . � .r , - ..� �� . - , - _ .3� 1:0-M P _ V�-2io"iFr��:, � ..�� n:��,i � � . � - . _ �` � �`�_ ��'' - f.. 4.AYd /,/I � Conv�iaaiofttlr', - . : , •_L-XPIRATION S7ATE - .{,r�;�1/•��:y:�`•j i ;��-+�^a , ' - •e; ?y - � ' _ '� . , =1=Gl.V��L��LJ�,.,. t r`. . . _ �-. .� =.- - - _ _- - �.��,: ��.., [ New York State Insurance Fund Workers'Conepensatio�dc Disability Benefets Spec�alrs�s Since 1914 8 CORPORATE GEFlTER dl�,3RD FLR,MELVILLE,NEW YORK 11747-3129 Phane:(S31}756-4300 CERTIFICATE OF WORKERS' COMPEIdSAT10N IIVSURAN�E ^^^^" 371437748 , CRESNiEW PLURAgING�HEATING iNC 7 COLUMBINE LANE K1fVGS PARK NY 11754 POLICYFiOLDER CERTiFICATE HOLDEI2 CR�SNIEW PLUMBING&HEATING iNC TOWN OF SOUTHOLD 7 COLUM81idE LANE 53495 AAWN ROAD KINGS PARK NY 11754 P.4.BOX 1179 SOU7HOLD NY 11971-1150 PQUCY NUMBER CER'P1�ICATE NUMBER PERIOD COVERED BY THIS CERTiFlCATE DATE 12270 3fr6-4 87708 04h012Q15 TO 04110/2016 11/9/2015 UND'UN ER�POUCY NOT 2 0 366-4 YUPiTIp fl4/1�0/2016, CSOVERWG'THERENT RE BLIGATEON OF 7H$S POLlCYFiOD R FOR WORK�RS' COMPENSATION UNpER TH� NEW YORK WORKERS' COMPENSAT{ON LAW W�TH RESPECT TO ALL OPERA7I�NS IN TH�STATE OF NEW YORK. E)CCEPT A5 iNDICATED BELOW, AND, WI7H RESPECT TO OPERATIONS OUT5IDE OP NEIN YORK, TO THE POLICYH�LDER'S REGULAR NEW YORK STATE EMPLOYEES Ot�tY. IF SAID POLiCY IS CANCELL.ED,OR CHANGED PRIOR TO�4N0/2016 iN SUCti MANNER AS TO AFFEC� Tt{!S CER71FtCATE, 10 DAYS WRITTEN NDTICE OF SUCH CANCELLATION WIl.L B� GIVEN TO THE C�RTIFICATE HOLDFR ASOVE. f�OT10E BY REGULAR MAIL SO AUDRESSED SHALI. BE SUFFiCtENT C�MPLU4NCE WITH TNIS PROVISION. THE N�W YORK STATE INSURANCE FUND DOES�10T ASSUME ANY UABILITY IN THE EVENT OF FAII.URE TO GIVE SUCH NOTICE. THIS PaUCY DO�S N�T COVER CLAIMS OR SUITS THAT ARISE FROM BODILY iNJURY Sl}FFEFtED BY�HE flFFiC�RS OF THE INSURED CORPORA710N. JOHN hACLOUGLIN(PRES)OF CRESNIEW P�UMBlNG�HEATING INC ONE PERSON CORP THIS GERTI�ICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CER7IFICATE HOLD�R. THIS CERTIFICATE QQES NOT AMENR, EXTEND OR AL7ER TFiE COVERAGE AFFORDED BY 7HE f'OUCY. i I I NEW Y�RIC STATE INSURANCE FUNC � � � � DIRECTOR,INSURANCE FUND UNQERWRITING This certiflcate can be validated on our web site at https:llwww•nysif.comlcerticertval•asp or by calling{888)875-5790 VALIpA710N NUMBER:10277445 i�_oa z �'� �c�RD• CERTIFICATE OF LIABILITY 1NSURANCE DA1EtMMlDWYYYYI � �� „rvs►zo�s PRODUCER THIS CERTIFIC�ITE 13 ISSUED AS A MA7TER OF INFORMATIOId Takach b Assoclabea,Inc, ONLY AHD C�NFERS NO RIGHTS UP�M THE CERTIFtCATE HOLDER. THIS CERTtFICATE DO�S HQT AMEND, EXTEND OR 112 Terry Road ALTEIt 7l1E COVERAGE AFFORDED BY Ti1E POLIClES BELOW. Smithtov�m NY 11787 INSURERS AFFORDINQ COVERAGE NNC# iasur�o JOHN MCLOUGH�IN INSURER A UTlCA FIRST INSURANC�CO CRESNiEW PLUMBING�HEATIFIG fNC iNSURER 8. 7 COLUldBINE LANE lttSURER C KINC�S PItRK NY 11T54 INSURER O• INSURER E COVERAGES 7HE POLICIES QF INSUJiANCE LISTED BEi.OW HAVE BEEN(SSUEO 70 THE lNSUREO NAAIEDABOVE FOR THE P�UCY PERIOD INDICATED.NOTYVITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER QOCUMEN7 WiTH RESPEC7 TO WHICH THIS C£RTIFICATE MAY BE SSSUEO OR MAY PERTAIN,TH�INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,F�tCLUSIONS ANd CONDITIdNS OF SUCH POUCIES.AGGREGATE UMITS SHOWN MAY HAVE BEEN REOUCED BY PAID CCAlMS. INSR D�' - PQLICY NUMBER POUCY EFFE YE POLICY EXPIRATION LIAAll9 GENERALLIABILIIY �A(�10CCURRENCE S 1.�,� pANfAGE TO RENTEO A X COMMERCIRLGENERALLIABWTY ART 723475fi1Z 0913WY0'E5 U9l30t2016 s 500Q0 CUUMS MADE a OCCUR MED EXP one r6on S 3�� PERSONAL 8 ADV INJURY S�.�� GENERAL AGGREGATE S �� GEN'LAGGREGATELIMITAPPUESPER PROOUCTS-COMPIOPAGCi OOO.00O PULICY PRO- L� AUTOM�BILE UABRJ7Y � CWu181NFA SINGLE UMIT g (Ee aeridenh ANY AU70 - ALL OWMEG AUTOS BOOILY INJURY S tPerveraoni SCHEDIf LED AIJ�OS HfftEO AUTOS BODILY INJUItY s (P�e�dmit) NON-04VNED AUi05 . ' � PROPERTY DN�AAC3E s � (Per oxidenU AUTO ONLY-EA ACC�E 3 GARAGE L1A811t7Y ANY AUTO 07HER THIW �ACC S qlJT90NLY A,� EXCESSIUY9RaLA UABILTY H OCCURRENCE OCCUR ❑CV�ASMAUE AGGREGAiE S s DEDUcnBLE i RETENTION S s WC STATU- OTH- WORKERS COAIPEN9A710N AND ENPLOYERS UA�LIY1' Y I N E L EACH ACCIOENT S ANY PROPRIETOfilPARTNBiIEXECUTN�( OFFICERIMEI�ER EXCL110EU9 V E l AISEASE-EA EMPLOYE i I (M�ndatory in NH} If yes,deftrbe Wder E L 6ISEASE-POLIGV LMIT S SP � � 07MER I � DESCR1P110N OF GPERA710N5I LOCA71ONS!YEWCL.E�!F]fCLiJS1ANS AD�ED BY QIDORSEMENT 7 SPECUL PR01flS10NS Cettificate Holder fs named as additional insured in regsrcis tu the Ganeral Lfabilily►pollcY when required by written wntrace. CERTIFICATE HOLDER CANCEI.LA'T�ON . • SlIdULO ANV OF TNE ABOV�DESCRIBED POi.ICOESBE CANCELLED BEFORE�HE EXPIHRTION � TOWN flF SOl1THOl.� DA7E 7}IEREDF,TNE ISSUING INSURER WILL£HDFJ�YOR TO NA�4�5 DAYS WRITTEN 53095 MAlN RQAfl N0710E TO Tf1E CERflf�CATE HOLDER NA11ED TO THE lEif.811T FAILUR£TO 00 SO SHAL� P.D. BCIX'I1T9 - I�Ipp$E HD GBUGATION OR LiRBIUTY OF ANY�IND UPON THE�NSURER,ITS AGENTS�R SOUTHOLD,NY 11971 REPREBEWiATIVES. �p AUT}iORQEA pEPRE9E}lTATN�� m 9888•2009 ACORD C�RPORATION. All rights reserved. ACORD 25(2009101} The ACORD name and logo are registered marks of ACORU ` ' � STATE OF kEW YORK � � WORKER'&COMPENSATION BOARD . � CERTiFICATE OF ItJ�URANCE COVERAGE UNDER THE NYS DISABIL{TY BENEFITS LAW PART 1.To be corn leted Disabil' Benefita carrier or Lioensed Insurance A errt of thai Carrier la Lega!Name and Address of Insured(Use sireet address only) - 16.Business Telephoiee N�unber of lnsnrcd . � . (631)724-5817 _ John MeLonghtin Ie.NYS Unempinyment Insurence Employer Registratian restview Plumbing&Hesting INC Number of[nsurcd Columbine Lane ' gs Pai'k,NY 11754 ' ld.Federal Employer 1�niiGeation Number of lnsurcd orSocial Sscuriry Numbu � 37-1437748 .Neme and Address of�he Entity requesting Pcoof of Coverage 3a Name of lnsutaoce Cturier Entiry lxiag listed as the Certificete Holder) GUARDU►N LI�E INSURANCE CO OF AMERICA 3b.Policy Numberof Entity Us[ad io box"la' own of Southold 92b355-0080 3Q95 MBin Road 3e.Poiicy affective pttiod: .O.Box I179 Juiv 1� To Julv].2016 outhold,NY, 11971 .PoGcy covers: a. �Al1 of the employer's ecnployces eligible under tt�e New Yartc Disability Benofits Law b. ❑Only the following class or classes of the employer's employe�s. nder peaalty of per,}ury,I ce�tify thec I am an aathoriud represeatative or licea�agent af the insurance cartier refe�enced bove and that the named insured has I�f S Disability beneGts insuance e ag d�cri ve- - . Q� ��.'�w at�Signed November 9 20]5 By - (eigoawrc ofirtwrmco ss�ie�s�admrrad rep�e�e�ativaor NYS hcoaaad lnsurana AgentN'�h�inewanm wnu) elephone Number f6311366-2774 Title_ Presids^t i PORTANf: lf box"4a is�hackod.�d Utis fam ie sip�ed by tbt i�u�ca��'s�°n�nP��ve ar AIYS Liceased insur�m Agrnt of tlret . � er.this cau8c�e is COMPLEfE. Mul it�cectlY to thecac�6eae Aoldc. f box"4b is chsciced,tirie eerti6cae i�N4T COMP'LETE fu►tLe PwPus�s of Saiou 22Q,Subd.8 of Disa6iltty Benefits iaw.lt muk 6e ma�7ed for comDletioo to the arkei s Comprns+fioa Soad,DG Pians Aoocptana ilni;7A Pah 5teot,Alhuiy NY f72D7. PART 2.To be completed by NYS Worker's Com nsaiion Board(Onl if box"4b"of Part 1 has been checiced) � Stpte oT New York - ' Worker's Compe�eatioo Board cc�ording to ioformatioa msintained by tha NYS Worlcer's Compensetion Boud,the above-named employer has wmpliad witB the NYS I isability Senefrts L.aw with rcspocc to�Il ofhisliter employees. ( ate Signed Novernber 9 2015 BY - I � (sigvanra of NYS Wodcer's Cnmpenss+ilnn 8uard Emplcyee) . , elephone Number Tide ' Please Note:Only insurance curiers 1�censad to write NYS Disability Bcrcfits iaswana polic�es and NYS Licensed lns�aance Age�ts of � ��a�iers ere a�t2prized to issue Far DB-120.!.ltiswance broktrs are NOT author¢ed to issue this form. DB-120.1{5-05) J � �� :t.,x�, ..�, ,. r .,a...,�� „.,„ >-:,.�; ,; ,. ...ae :� . r r ,— 3 y, �� ..��: � .. . �` " '�R�� -�.. .._ ,� �.. � ir � by: � i G � k � � r � - {i � � , .n;'-{ . ^ s � ��' :'�.� . . . : ,�, �� '��. �" � ��, �`;: s' p Q�` _ � x.,�`.'� �z . W�; °: ��;:. 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' 3z.(.p = . ..�. ' Note:This drawing is an artistic � Designed: 10/2/2015 interpretation of the general i��,i.��icc�;� Prin[ed: 11/6/2015 appearance of the design.It is not meant to be an exact rendition. 4883 TECHET(REV 10-1-1 5) A❑ Drawing#: 1 ~I ��,., , jt1 .. "' . . .�� u�F7 ,� � `'�." '` . .-� f� ��. �:..,v.�,a..z�._.,., ,.��.�. . . _ . � � � � � � � — - � � �. -. ��``" . � ,, � , _ _ � _ — � - �, ��- '�' `� �``�� "��"�.. ,w ,,, ,, ��°�, ,�� '/� '`'r � d T__- � v � � ; \„4„ '___'_ '_ ._.�.� ____ _"_._____— .--.'�r � ` 1 i s,^� � 8' -�Y .N �' .Y's 4 } _ § I � � I � �`Y �I � �� . I 4� ba,by` � II � � \ �� I� _ � I I ""4,. �P � �'� ,.<, 'I.� � •..« �'�� "i"v''� q f F,� II! �t _ ,�,:, � Y^� '� . .. . E � � ��i•�P,y �i � I I � � i I ,� � � �� I �i� � i'� !i � I � � r �I g , , _ i �, � , � . � I � -_ �i ��;��` � � -- ( _ �irr�r�r�i�� C � Q� '' _ -- j � — � �� I � � �� , , �. ,a , .. _ �,r� i �� E .� 'I, ,� - � � t �� ; �_u w`a`''� I , __ . � i_ ------ . � __ _ _ ._� ,_--- i _ Note:This drawing is an artistic 7f1' ��;� Designed: 10/2/2015 interpreta�ion ofthe general �,v iccics� �'rinted: 11/6/2015 appearance of the design.It is not meant to be an exact rendition. 4883 TECHET(RGV 10-1-15) All Drawing#: 1 �� , ; �:� �� "�� `��, �� °r ��"�� _ � � � g �,�� `��,�k � y P � € � � ,�,-:==�� i„, iz r,kex.M .�; vl ;.i.+x:�na�xy°"rN/"�,-a � � '} t ^"s^'^ } .�� Z,. ��x�'d�w�^��~A�xr+r""M..r, � �� Mr..w��3 �mx�.w.r.r+�•vN':.aw+�'uw �� w� . - S,` C '., :�.. � �� _�.�;,,_,r-':' '"�- '^„� ' �` _ } , __ _ (rtT�"n i 1� � I� � r I�� E ��. , �. . � � � '� � �✓ � � -.� t '' '� � ' � , - ;-� �, , � E� l � � � ; � �� , �; � � , I f � �€ � '� i� � . j � � `� � _- - f� �. { �; - _ -� � - �, .� � - r`�" �, �� - � �. � � � � � � � ,-- ____ . � m � � ;. - ' �-.a.._„f �, ' � ��r � , --� � � , ,�- � ��tll1 � - --t� _ _ � - � � �.-�,- �� .�, � � u.� - � .�..,�-- j _,.�;.---�, _. � " � � �' f � ; -� �' �:..�.-. d.,,� � I � � ; �, 4 � �; ! � �I � � 3- � 1 m �� ( � �4. { �.�� '� 3 5 � . � i, � . . . - _ � � . . � f k. � e 3 � � . �. i ..... �. �1 I � ��. . -- 1 t� .� ' � ; a_' --- � �E�� j i t � :i � � _ ., ^�.... . _._� i�� __� ; �_ -x S � '�-� , �� '��.'. , j _,._ ti _ e � � �'�-- �� ,,,n,,,�. : . _,� ,� �`� �__ � __� , : , .- -_.._ �s �._ " - ---- � . :; ..�-,..� . � - --- � . . W�� -— — -_- -.�.�- � �i ��..r.^'�� - .._- — T � � '�' . �..,�_'_---« �- _-- � --.,_ � _ --_�_ .� � ,�>; ' - __ -__ � _�` „>� .,,:,. ... „ �a�T ,s . . � .-.. ..,. � . — ' �`"'--�_. .W' _"--�-- _ , g�� - ..�.. �. .. ., ..., i"'-+^-...,� � ;�� .�.�, ,- , u.su�...- ' " - . -�- . .. Note:This drawing is an artistic �' Designed: 10/2/2015 interpretation ofthe�encral rccnraoiccics� Printed: 11/6/2015 appearance of the design. It is not meant to be an exact rendition. 4883 TECHET(REV 10-1-15) All Drawing#: 1 � i a'?� 4 _"'�.„�ry�� . � � � , .� , � �� I � . . � . f ��^'�.. � , _ ''L..��,�M ^, I K � �� , a .. 'a..�... �.-:. �� i „ �.• 12.� �. .�. . s. , �. . . � � � � •, ` ' '. '. � I � ' �� _��,.....».w^^'9 f � :�" ��`' � j � r �;g k= �� i � � ' ' ,�� ; � �k� � � ' �,. a E a 4 � 3 � � � �' � ! � we � � $= ��,� � ��°�� ' � ` �� `"�` [ F �g � . � �� 4�; �, i s ��ya,�:. ... � � �. }..�: 3 '! . . . . .. . . .. � ' ' .. . � : x � � -m��, �T �_.,� :. . _ -,�; ��.� �.,.� __ � �--� : �,� �„�. _ < _. m .r ._ �� -� � �..n�� _ „ r, _—,---�� M �__.. _— --. .... _ � , � —�— � < ��; � -�-�-�. � I ��- _� , �� -� i , � � ., � � � �� ,t � � �. ; � ; �� ('' � �`� ' � �(� � � �{� � � �� [[[ q j{ 3 .. . . i�l " 9 �f:. � j{ � j k � I � I r i {{ j , : .. �� 4,- j:�`�- �� . 1 7 � � �' �� I I' : �'� � l: i � ��. �' �� j � ; �� iF �� E�� ,;� , �, , i �-.�---�--�-- � � � , , , __r.--- �.,.� � �; �{ l i � ----�=��::-' � � I ^,e....�� ^�^aw.. { � � w�«.: ti � �_- -- �_ �� -— » .��: �.: i � � Y�; � , � � �., ,»...�, .o- _..r _�.r'� ,.,.�^\ . , 9 ..: � . __..J— . , r__..r . � __ �...� �: �.., . .:.�� _ — . .. ,a, �.,;.._r � .:: - �..; '= � . ' .,.'y � ' �� .� .,�,: � � ,�-;;.�.,_ ':: �'. . v� �• �. �i . ,._ .. - . ��z�'i?. �._ .. "'&� . �.m � . �Note:T'his drawing is an artistic � " � Designed: 10/2/2015 intcrprctationofthegencral r��,�N�,io�i�� Printed: Il/6/2015 appearance of the design. It is not meant to be an exact rendition. 4883 TFCHET(REV 10-1-15) All Drawing#: 1 �-. �„a.,,.�,..�.. � , m,.. � � E """^",,,,��. � � r � ' r:.. -�... �-"'"'.,,,,','""""�-.. t , � � ,. . . . . � . i p. � . �.-_ . � . .. � . �, � , .. � '' ; ' � � �,�;r,t,..+•^r"' ..x-u^ 7. . � �, }} � ~��yy� " 8 . � �.F � �a�� —'� �a� e� I �. � � iWry �tl ...' pg l � � f' "� { : ~o�.'-.,.� . , � �'.� �4 1 � � . ... � �. . ",'�,:�",��a �� . � : � �d�"",. . . .. � r r,�.yz ,� , . y jI. '--�-��, t p a � s �''' i ,� s , � � E �� _ � � x �'"�� a y � ,� "�`�m� �a� � � % i � �1- �� . � ! { I � �f . �, i� � ; n , . ... E, . � i ;:�.� _ +��. e < x. » ;'� y .�., u � � �.. . . . . .. . ,..._.�_ _.. � ��..�� .__ �u9� , � l d` . ..e— {:'". : .. � ,. `= - ___ . _. _ , . �°3 �� i �" � I �t . � {�� ', ._� �� -�--"� �,_.,— .� � € ' , E� ,�,.. ( � � ; �� ,I �� E�� i �k �� ; , � � - � � � � i # � �� ; � i �� 1:' r` , . . ��k�� 9F�. � � ' [ � � I '3 �� I, � ,€ � � � � -�� `(( �{{ j � � 1 � . > — I . �. > �, �� , � I � � � i � . . . __ -� I � �:�j. ,' 6� � ll� j � _ - � � � � # � �� ti.:�,,,.,.�� '- t��: I �� ' i E, f � i � � t.----- � � _�-----�-'�-� n';°'�'"""�;`:�-,.�� a �"� ; � �� _� � M_.�-•- � I � Y: � � �. � __ , .,,.T,,, _�- �� , .�„„„ _ - � -- � � ..� �. � �--�--'�" - � V..� - � _ , � � � . � � �:— _ � _�. �- ° -- � � _� ��_� __—- y.� � � � �-- � � � � � �, �� : :.�< � � �� , .� � �� . � � ' �� .. ' .... � � �„ � .,. � �� -..: � , - � � _ � ; �,,� � ��. � �g � Note: 1'his drawing is an artishc 7f"1 ` � Designed: 10/2/2015 intcrpretation of the gcneral ��iccies� printed: 17/6/2015 appearance of the design. It is not meant to be an exact rendition. 4883 TECHET(REV 10-1-15) All Drawing#: 1 r , � FtEScheck Softvvare i/ersion 4.6.2 Compliance Certificate Project Techet Energy Code: 2010 New York Energy Conservation Location: Suffolk County, New York , Construction Type: Single-family , f , Project Type: Alteration ' Climate Zone: 4 (5750 HDD) � Permit Date: " Permit Number: Construction Site: Owner/Agent: Designer/Contractor: 550 Old Salt Road Joan &Steve Techet NDA Kitchens Mattitck, NY 11952 550 Old Salt Road 192 Smithtown Blvd. Mattituck, NY 11952 Nesconset, NY 11767 631-360-8949 . . Compliance: 0.0%Better Than Code Maximum UA: 33 Your UA. 33 The%Better or Worse Than Code Index reflects how close to compliance the house is based on code trade-off rules. It DOES NOT provide an estima[e of energy use or cost relative to a minimum-code home Envelope Assemblies . . . Wall 1:Wood Frame, 16"o.c. 251 15.0 . 0.0 0.077 19 Ceiling 1: Flat Ceiling or ScissorTruss 396 30.0 0.0 0.035 14 , Floor 1:All-Wood Joist/Truss:Over Unconditioned Space --- --- --- --- --- Exemption: Framing cavity not exposed. Compliance Statement: The proposed building design described here is consistent with the building plans,specifications, and other calculations submitted with the permit application.The proposed building has been designed to meet the 2010 New York Energy Conservation Construction Code requirements in REScheck Version 4.6.2 an ly with the mandatory requirements listed in the REScheck Inspection Checklist. �RE� A(�C �yne-Title Sig �Q�,M. Rq�y �� Date , \I �' �� "' " —"�� o� �' �� /"' ' � � � F�.s ,� r � f � j �'9T� � i OF N� � Project Title: Techet Report date: 03/31/16 Data filename: C:\Users\dreinhart\Dropbox\NDA\Techet.rck Page 1 of 6 , , REScheck Software 'a/ersvon 4.6.2 Inspection Checklist Energy Code: 2010 New York Energy Conservation Construction Code Requirements: 0.0% were addressed directly in the REScheck software Text in the "Comments/Assumptions" column is provided by the user in the REScheck Requirements screen. For each requirement, the user certifies that a code requirement will be met and how that is documented, or that an exception is being claimed. Where compliance is itemized in a separate table, a reference to that table is provided. - Sectian ' �. ' � °. ' ' � ' Pla"nsUerified °Fieid Verified h � � � � � � � � � . #' Pre-Inspection/Plan Review . � °Complies? � �Comments7Assumpti�ns,. & Req.ID � Value � . Value ,-� , . 103.2 ;Construction drawings and "( � ;� � � ❑Complies ; 1 ('.;.,.°F f. .. , ,� , ,e � ! [PRl]1 �documentation sufficiently k, � ,� � 'w,.f, ,, , • ;'r�Does Not ; � � ;demonstrates energy code ;; �,� , : ;� ., � � ;compliance for the building ` . , , - ; � µ •❑Not Observable � ;envelope. i � ' ;' " .' ° ❑NotApplicable ; 103.2, ;Construction drawings and ,", , . ; � : � �� „}�Complies ; 403J Idocumentation sufficiently � � ' ' `, �^i,,.� ' , � �❑Does Not � [PR3]i ;demonstrates energy code � " ' . � �'`r,- � • � ��j ;compliance for lighting and ;`� � � ` ; , ' 'I r �❑Not Observable � �mechanical systems.Systems �' k, ' ; i " , " � `�NotApplicable ; ;serving multiple dwelling units ` " .. �- �' ;�� • �� ;must demonstrate compliance �. , • �.,� � , ; �with the commercial code. i� ° ` ` ; � 403.6` Heating and cooling equipment is; Heating: ; Heating: ;❑Complies ; [PR2]?;' �_ �sized per ACCA Manual 5 based � Btu/hr � Btu/hr ;❑Does Not ; ,� �� on loads per ACCA Manual J or � Coolmg: � Cooling: � � . , ,�other approved methods. � Btu/hr � Btu/hr ;❑Not Observable � � °� ; ; �❑Not Applicable ; , � , , � � . , � � � � , � � � � � � � � Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Techet Report date: 03/31/16 Data filename: C:\Users�dreinhart�Dropbox\NDA�Techet.rck Page 2 of 6 Section � . ,. . �, ., ,- .. ., , . , . . ; h , , �# ' . ,Fouitiiiation.lnspection , • Comp9ies?`. . �� Comments%Assumptions_,�� ' � "&�Req:ID � . a f• , . . , . , . . 303'.2.1 ,�- Exposed foundation insulation ;❑Complies ; [FO1,1]?. ~ protection. ;❑Does Not ; s�i •v �, �`� ;❑Not Observable; ;❑Not Applicable ; 403.8 ��Snow melt controls. ;�Complies ; [F012j?, , � ;�Does Not ; �� '. � ;pNot Observable; � ;❑Not Applicable ; Additional Comments/Assumptions: 1 High Impact(Tier 1) �.2 Medium Impact(Tier 2) 3, Low Impact(Tier 3) Project Title:Techet Report date: 03/31/16 Data filename: C:\Users\dreinhart\Dropbox\NDA\Techet.rck - Page 3 of 6 � � 1 Section � � "- p�ans Verified •Field Verified � � > # Framing�-!Rough-In Inspection. Complie's? CommentslAss'umptions,;� & Req.ID � , � ' � Value �Value ,. � . � �. 402.4.4 ;Fenestration that is not site built � ' , � � ;� `� � � t❑Complies ; [FR20]1 �is listed and labeled as meeting � , , � f❑Does Not � ,J �AAMA/WDMA/CSA 101/I.S.2/A440 ` - � ; � � ;or has infiitration rates per NFRC � � ; . �i❑Not Observable � �400 that do not exceed code � " ; � . �❑Not Applicable ; �limits. � � • . ' s ` ° - ; 402.4.5 ' IGrated recessed lighting fixtures� �- ; - ;`, .- . - ,;+ ❑Complies ; [FR16]? sealed at housing/interior finish � _ � � � � . , ❑Does Not ; ,� �and labeled to indicate&It;= 2.0 � . � _ ❑Not Observable ' �cfm leakage at 75 Pa. � - , ;. , ; ; „ - ❑Not Applicable ; 403.2.2 ;All joints and seams of air ducts, ; , . � ; � {{OComplies ; [FR13]1 �air handlers,filter boxes, and � " ` � � k' .• ' �: ��Does Not ; ,J �building cavities used as return �"� , _ � " , � 'ducts are sealed. C � � '❑Not Observable ; ; � ; ;❑Not Apphcable ; 403.23 'Building cavities are not used as � . � - . ;❑Complies ; [FR1513 iducts or plenums. � � � r � . • - ' .;j❑Does Not ; ��J ! w -�' � � '• '` � n " � �❑Not Observable ; � �'" � � � � ; � = - � - -��; �� 1 - , T.;ONot Apphcable ; 403.3 HVAC piping conveying fluids ; R- ; R- ;❑Complies ; [FR17]z above 105°F or chilled fluids � � �❑Does Not � � � � � �� , below 55°F are insulated to R-3. � � ;❑Not Observable ( � ; ; ;❑Not Applicable ; 403.4' Circulating service hot water ; R- ; R- ;❑Complies ; [FR1'8]2 pipes are insulated to R-2. � � ;�Does Not ; U ; � ; ; ;❑Not Observable ; ; ; ;ONot Applicable ; 403.5 ;Automatic or gravity dampers are�- � - ,., ' - � �� ❑Complies ; [FR19]? 'mstalled on all outdoor air !`' . � ` � . ' `� ❑Does Not ; �� intakes and exhausts. � - � " � ° y ' �❑Not Observable ; ' � � ; , - ��Not Applicable ; Additional Comments/Assumptions: 1 High impact(Tier 1) ,2_ Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Techet Report date; 03/31/16 Data filename: C:\Users\dreinhart�Dropbox�NDA\Techet.rck Page 4 of 6 � , , Section - ' # Insulation Inspection Complies? Comments/Assumptions & Req.ID � 303.1. All installed insulation labeled or ;❑Complies ; [IN33]z �'3 mstalled R-values provided. ;❑Does Not ; '.� " � � ;❑Not Observable; � ;❑Not Applicable ; Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title:Techet Report date; 03/31/16 Data filename: C:\Users\dreinhart\Dropbox\NDA�Techet.rck Page 5 of 6 � . � Section . Plans Verified ��F,ield Ve�ified, ' # '; Final lnspection P`rovisions . Complies?- • Comments/Assumptions & Req:ID . •Value � '_Value � . � . , , 402.4.2, 16uilding envelope tightness ; ACH 50 = ; ACH 50 = ;❑Complies ; 402.4.2.1 �verified by blower door test resultl � �❑Does Not � � � � [Fi17]1 �of&It;7 ACH at 50 Pa.This � � � � �} ;requirement may instead be met ; � 10Not Observable ; ivia visual inspection, in which 1 ; ;❑Not Applicable ; �case verification may need to � � � � ;occur durmg Insulation ; ; ; ; �Inspection. � 1 � � 403.2.2 ;Duct tightness via post- ; cfm ; cfm ;OComplies ; [FI4]1 �construction with maximum � � �❑Does Not � ;leakage of 8 cfm to outdoors, or � � � � `'�`� ;12 cfm across systems. For ; � aONot Observable � +rough-in tests,verification may � ; ;ONot Applicable ; �need to occur during Framing � � � � ;Inspection,with maximum ; ; ; ; �leakage of 6 cfm across systems � � 1 � ;and 4 cfm without air handler. ; � ; ; 403.1.1 Programmable thermostats , ; " � µ � ' � ❑Complies ; [•FI9]?' installed on forced airfurnaces. ��-�� >. � • '� '�" � ," , ❑Does Not ; V . ;''-• , . -- ";; "<� �,;' `..-; �:ONot Observable ; � � ; . #❑Not Applicable ; 403.1.2 Heat pump thermostat installed ,, _ _ ; : ' . ' ❑Complies ; [FI10]?� on heat pumps. � � ,�� ; � ..��Does Not ; .L� • � ' � � ,,.',�: " � � : ,.';�❑Not Observable ; . � , ;�� ° � - ❑Not Applicable ; 403.4 Circulating service hot water � ; ❑Complies ; [FI11]? systems have automatic or � � . ❑Does Not ; accessible manual controls. � � '�J � , � ; , �- ❑Not Observable ; ' ; ;,pd; � �❑Not Applicable ; 401:3 . Compliance certificate posted. � , ^ • � ; � ,.. . � , ❑Complies ; [F17]?' � � , �� -' �Does Not ; Q1 ; ; - . ❑Not Observable ; , � � .❑Not Applicable ; 303.3 �Manufacturer manuals for �; , , � , :, ' ; �.,;❑Complies ; (FI1813 mechanical and water heating R'�; _�, `� . ' . �� " , �'-❑Does Not � �equipment have been provided. �. ' � ; `' ; � � � ` ❑Not Observable , � � � � ; ❑Not Applicable ; Additional Comments/Assumptions: 1 High Impact(Tier 1) `�2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title:Techet Report date: 03/31/16 Data filename: C:\Users\dreinhart\Dropbox\NDA\Techet.rck Page 6 of 6 0' - • � 20'� � New Yo��C Energy Co�aser�rat�on Co�str�ct�o� Code Energy Effocve�cy Ce��f�cate . . Above-Grade Wall 15.00 Below-Grade Wall 0.00 Floor 0.00 Ceiling / Roof � 30.00 Ductwork (unconditioned spaces): a.. . . Window Door . . .. . . . Heating System• Cooling System: Water Heater: Name: Date• Comments � 28'-18° II° 2'-6° 4'-9' '¢S 2'-6° 2'-4° 2�'�¢� 5'-IOg° I'-II�° 5'-8S" 10�° 5'-10g° 5�� EXISTING WINDOW STAY5 DOOR 5TAY5 FWHZ768 5TAY5 EXISTING G35 WINDOW 5TAY5 EXISTING FWG-6068 5TAY5 EXI5TING G335 WINDOW STAY5 u ii ; i; i i i ii � i � � ' ' �EXI5T.HVAG EXlST.HVAG �' _ � I� i i i ;� i r-�+------ � FL.00R REG. ^ PLoOR REG. - „ --------- � � , � �� IL_ I �I I ____'_ . ' I I I� � � I 111 � II I �I I r 1 I �I I � 111 � � �� 1 1'-C__'"" '_":^'7 I I� � III Q F -� �L_______L________ L_______-___J_____l II I ' � %11 ln N II __________P L__________'_____ ___ + � /ll 'I ii �________________�I Ij j � lU � ��. �� g� Ig� t¢� g�, ,.'L_____ � '�r'47�°�+.� k�.� �i4��@,.i ;i I I i; r---------------- --5�� ii I� � i � _ ii i� � I i�---___----h i -7------t� ;�ATE: � _� g o,�� I I �; � EXI5TIN6 104"X 87"TRAY TOP iGIGK � �� ;— —•� �� , � �� ct� �-- ;; � �I ;; I GEILING WITH GROWN 5TAY5. �'15T� I i� � � '� � � ' ��i iCITGHEN m � --F �� 'c 1 ' ' LL-----------�-1--------J J I R E M O V E G O V E L I 6 H T I N 6 O N L Y I �� 4 I �� 1;1 v 1D ��P,V � � I I � I ii '�`--_ :i i� i � i �u 3'Ib SC�tF �X��5�Tp.1'1p1/�AG ..�.n..�.a..-�t�. I I � _ I I , L-__-_lU �w f�I�L V. � v i�Y c u i�c�.,�� r." ,4 R T��n�a;r �i� � � , __ . � � � �o��s ,v� � �- � � h I 1 i� ;'+r�- • i � �-. n �ii . . i ii i I u I I �r.�Ji',��r� d`ti � �f �•1L' �.��t��J �� I i� d 1 i� i i 765-18d2 8 A1V1 '10 Q PM �C�RI TH� �CI5TING DROP � � @�' ` ��,^,;-:�� +-}^t� T r � � I �; � � ;I i T �"� 6UT EXISTING KITGHEN TO FRAMIN6 � � G a ; i � IVEL�� .J��;t J 1}f i�r � OWiJ CODES ii ` � ii i i �ii � FOLLOWIfvG I�ISPECTfON,.:, }�qp�� -�` I � , , � � �� -�rR-y IT •'lA C � ii----=—=----� i � iii AHD 51�F�OOR 1. FUI�idDf�TICN - TWU RE,t�`�! E+ ; ARGHWAY 5TAY5 � � �i�' R�QJ+�j1�V ��`� �"-. , I i� �i i ' � �1� FOR POUREU C�NCRETE= i i ( IN�LUDIN� � � i �� ;� f; ; �,�-----1� � ., � ' , _ �oc�oN i i ��.�SOU`�; I� ' ','! Z5A �� n ;, 2. RUUGH - FRAi�iIN(a a PLU«f�I�G` � K I T U�E N 5 1 D E � � � I ; j ;I ;; ; � - �r 3. INSUL A T I O N a- I I � 5��:;�1! '; r;t��ni oi , i � ��__________�=�--J , 4. FlNAL - COP��STRU�'B T� N � �T � � � ' � I I i ; ' � �- � � , i BE CONiPLETE FO�,A�2 P A�E A � j �.�., �,;V:r.,,��_�� I;;�f��;v i� ��e� �—; �12�•� E X I ST I NG P I N E 6 U T KITGHEN TO I � � ; ( o A L L C O N S T R U C T I O N j p(��n �p�P�T T H E ��5 T A Y 5 � �F R A M I N 6 A 1 d D1e4�� 1;,=a,,``, ^�,^, � I � � ;'fl REQUIREMENTS OF THE CODES OF N�VII � �� ; � � � � � , n YORK STATE. ��T��S��°Si€�-�K�(g�{'� � � � � i ( � C' E T � I L---------------------------� nn Iii �D DE�IGN OR CONST H�,��3 i ��i n'�JRS. � � _ �-------��rl_______� ;-� -------- ----------- �-___--------�- r_ __ � rt.________JL��______.fi ' �--- ------------ � �------------ � ------------- - - -- ----- -------- r- l r-------------y _ _ t=---------_-___-_ ------------yi i ii -----------�� ir � ..-�. .�_�. .._ ---------- - ------------- C-----� r------------------------------ 11 I I i�'Y. /� �n N v< I II II �� f_______________T_____________-_ ii I � i ii i i i� i �� i �i i n n i i� i ,i ii ii i ,i n �� ii �� u i u u �i ii i u I I �� , � ,r�� ,r�,.� .r�� n u �� ,� � ii � � ;i ii i ' �� u �i ii i i i � � i i i F-------------i--k;�_��,:=:.c—i------------------------------- n n �i i� ----------� 7i ir------I �----- +--------------- n n i i i ii i! ii i � i i ��Gjk�� i i u ii i i n n u ii i� i u i u u ii ii i i i ---- ------� i i i u n i i i i i ��`�� t��=a�� ;; � ir----------- i � PANTRY � � i_LQI�LCLIt1`L'J_ � �� -----� � � � ,, �`` 13 5QF FRAME OUT �i � �� ' ' � � � � , . --- ' EXI5TING i�EMOVE FLOORING FOR NEW � I ; 1 '� GUT ROO TO -——— " `-- J � 2468 DOOR �REMOVE Y'41RE 2068 DOOR � � � ' �� FRAMING AND � s�vir�w ---- STAYS �, -----� EXIST6.2668 � �-------------� SUBFLOOR � � ' DOOR 5TAY5 ,- l d�N��1 in EXISTIN6 a00 AMP �� --- �XISTG.LOW ( �� U�� ---�-0 - HVAG 5TAY5 �� `� PANEL APPROX S REMOVE �iGET DOOR '`s— l` 50'AYVAY �� p� � � ` � --_ - l� �___�_�,— ;.� �� ' - o � 2'�," 2p 3-2 �ING -----5-�� —__ I n I � 5�� 3p � a � 3�� r 8-48 � � � 4-10� 14-9� 3� ��. d A GENERArL NOTES: - �' ""�"`�"�'� - EXISTING Iq20s EXPANDED ONE STORY GOTTAGE APPROVED BY: COMPANY REPRESENTATIVE: - EXISTING OPEN BASEMENT AND GRAYVI_ SPAGE - EXISTING 24 X 12 STAGGERED ASB�STOS SHINGLE SIDING --- --- --- - EXISTING 200 AMP PANEL. APPROX. 50' �ROM KITGFfEN EXI5TING BIFOLD DOORS — - DEMOLITION NOTES: STAY JOAN TECHET NDA REPRESENTATIVE - LAUNDRY Homeowner - f'REPARE 51TE FOR DEMOLITION. FIANG PLASTIG OYER OTHER ROOM OF'ENINGS -Kitchen Co.- pA�. A5 A1�GE55ARY. PROT�GT�LOORS �5 NEGE55ARY. 192 Smithtown Blvd.Nesconset NY 11767 - REMOYE EXISTING P?�NTRY WIRE SF{ELVING 631.360.8949 DESIGNED BY: ED ROWLAND 10/12/15 _ �MOYE EXISTING POWDER ROOM POGKET DOOR STEVE TECHET Vis�t us on ihe web at wvuw.NDAKITCHENS.Com Homeowner DRAWN BY: CARMEN ZARATE DRAWING:4883 _ �p� FLOORING IN HALLYVAY AND PANTRY Designing with you in mind since 1980 DEMOLITION PLAN SHEET� O A � - GUT EXISTING KITGHEN TO FRAMING AND SUBPLOOR - TRAY GEILING STAYS. DATE: SCALE: 3/8"=1'-0" j - GUT �XISTING POWD�R ROOM TO FRAMING AND SUB�LOOR. �8�-28 �XISTING EXISTING WINDOW FXI5TIN6 DOOR FNW2768 EXISTING G35 WINDOW EXISTING FYVG-6068 EXISTING G335 WINDOW 0 � 0 � -- __—_-=-_-- . o '" � RELOGATE EXISTING FNAG � � i I �-------------- ----------� TOE KIGK RE615T�INTO � I i I � I NEW GA6INET TO�KIGK - I I � EXI5TIN6 104°X 8'1° TRAY � v I I � GEILIN6 WITH GRONW � _ , � II � � z � ! II I I N < i ' � I I � � � ' PJCISTIN6 DROP IlEXI5TIN6 I I i ��_ � ; HP/1D�'tRUE � ( �RYWALL I I � � � , � ,�+w,aY i i oN i � KITGHEN � �i � � � � �� i i I I I I 376 5QF *; ;' ' I I I I IOI?5°AFF N � [_' � � � � — < i ' I I � � I I ' I I -�q. `° I I I I � I I I I I I ,tl�, - I I I I DIMENSIONS ARE FROM FRAN� I I I I I I � � , BAR AREA i i i i I2I5GtF � � �---------------------------� 101?5°AFF I I � I I EXI5TIN6 2-3/8°YB.LOW PINE I I FLODRIN6 I I 4'-2° �OF HOOD 5'-I�° I I �'' � PANTRY N =, � 2o saF — — GUT AND GAP EXISTING , " � ' ' POYV�R ROOM PLUhBIN6 ———— NFJ'V 2068 DOOR � �n (2'-2"X 6'-IO°RO) � � ST.LOW FRAt� IN POGKET PRAME NENI O� �� HVAG DOOR OPENIN6 4'-II� -------- �r - GONSTRllGTION NOTES: APPROVED BY: �--- COMPANI' REPRESENTATIVE: - ��''�E IN POGKET DOOR OPENING - FRAME NEW 2068 INTFRIOR DOOR OPEr11NG � - {=RAME NEW DROP HEADER AGR055 HALLWAY I NTO LAUNDRY AREA --- --- --- - PLUMB,LEYEL AND P1ANP ALL KITGHEN GABINET WALLS A5 AlEGE55ARY �cISTING BIFOLD nooRS JOAN TECHET NDA REPRESENTATIVE _ LEYEL ALL KITGHEN GEILINGS AS NEGE55ARY -Kitchen CO.- Homeowner - ROUGFi OUT FOR NEW PLUMBI►JG AND EI..EGTRIGAL LAYOUTS LAUNDRY 192 Smithtown Blvd.Nesconset NY 11767 �A�' - SUPPLY AND INSTAU.. NEW RI3 FIBERGLA55 INSUI..ATION IN GUTTED PJCfERIOR WALLS - 631.36�.8949 DESIGNED BY: ED ROWLAND 10/12/15 - SUPpLY AND INSTALL NEW R30 FIBERGI..A55 INSULATION IN GUTTED GEILING Visitusonthewebat www.NDAKITCHENS.Com STEVE TECHET DRAWN BY: CARMEN ZARATE DRAWING:4883 - ��i'LY AND INSTALL NEW I/2" DRYWALL,TAPE 5EAM5 AND APPLY THREE GOATS OF Homeowner Designing with you in mind since 1980 FRAMING PLAN SHEET 2 o f 5 .101NT GOMf'OUND DATE: SCA�E: 3/8"=1'-0" ' �T � �x� wITH INLINE BLOWER LOGATED IN ATTIG AND YENT ON PRONT ROOF 28��0 II■ �1 GB A1�A4 �1�`tl �1 All Zt�p ��I�� I��"7� ��'VS� �VAp ��'�ya, tl •.TJ '7�'1 -�I �T T CJ '7 �J •r CJ PXISTING EXISTING WINDOW EXI5TIN6 DOOR FWH2'168 EXI5TIN6 G35 WINDOW EXISTING PWG-6068 EXISTING G335 WINDOW ----------- --------- --_------------- ------ - , „ , - ---�. . � „ � � � � ��:t�� u' � � --- -„----�-------�- — -- -L----�---- ---------------------� , � �� , , �;�- f � � � EXIST.HYAG � ' �� i i � i i `��`:��:� � FXIST.FNAG\—NEJN�I/4°PRIMED GOVE � �, PLOOR REG. MOULDIN6 ON RISER WITH _� � - i ii �D�� '-------� � � \,`�iii r NOSE A1dD GOl/E 1�1ROUMD I � - PIAOR REC. � ---�---------- ��ry p�V (V j i �v_________J____________1________ ______ ' 3�'I � LI`IIfW I��T� � � ' _L______� 31j1 � � ^ V ' ' � RELOGATE �`:• iii� i � z . . � i �-----ii%�r-------------- �: •" ��'' � '-----------• � ' I I � "� ' ----------�HYAG TOE . �� } �,-------------j-� � z� �''� , � EXISTIN6 104"X 87°TRAY� �iCIGK �-�---------'�N � � � , � o �i I i i � ii ; � GEILIN6 WITH GRONW AND ��15� i�� iii r i i ; ' �, � �� , ,_ �� '� in �{ I i ( p ii � GOVE 1..161-IT�N6 I i s iii i � i t � ii I i � �15 u. � I �-----------�ii i i i i � i ni� �i ii i i i � W BAR AREA �� , � � e=====_______--'� ' ! � � �r------------ -� _____�______� � � ' ' � 1215QF � ' � � , � o � � � I I � ' � � � ` -i r i 101?5 AFF i EXI5TING I I � � � ;j � � ! � ---------- � � � � DROP � I � � , � � ; , � � � EXI5TIN6 23/8'YELLOW PINE ' � , � � ; ; ; ;� F1.00rztHs. � ,��+y��,�i i , � i ; � i { i , ` u . ; � BLEND IN FLOOR FINISH B�ORE ; I I � , I � � ; 42 X 60 ,__ I — ,�i DINItd6 ROOM AR�IYVAY � j BL�ND ROc�R FINISH �I � ; � � I E � I �`� KITGHEN _rAsl�_ �orz r�� ', ' � � ( � j j € ` j ' j � , I ' 3'16 5QF I ( , � �. 4 ' � ��.?5�AFF , � � � , I I ,INSTALL NEyV Y�OOD FLOORIN6 TO � � � I I 'MATGH A5 GL�A5 P0551BLE I �LY AND INSTALL NEW WOOD FLOORING — - � I I � I I TO MATUf AS GL05E AS POSSIBLE � � � ` - --- � I �r=====_�_____ } --;--s------�; I I � .fl i � � , I � �� ----------- _—___—.�_ __ ---J �—__—__—�n—_ . � I � � � �j —� 1 '� I II ; i � � p �r-------------- ------------r— --------------1f'-------- -------------{I o-----------------r------------f-- i ` -�r— —{' ii ----� �� 18�� L------ii ii ------i _� i � -- ------ ------ -------- .i ; " REFiZ16ERATOR ;FR�R u � u i--- � ��-----------� �__ � � 36'X 18"X 24°55 � � � ' - --. � � ' � HOOD WITH INLINE i MIGROWAVE � 1 : ' , � , ' �'9------------------- -i' -" BLOV�R --------------1--------- � . 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NEYV 3-I/4" GUSTOM POPLAR GA51NG Exlsrlr�elFoln pooRS JOAN TECHET NDA REPRESENTATIVE _ r.,�PpLY AND INSTALL NEW BASE MOULDING E1ND SHOP TO MATGH EXISTING AS LAUNDRY Homeowner —Kitchen Co.— pA� GLOSE A5 P0551BLE 192 Smithtown Blvd.Nesconset NY 11767 - SUPPLY AND INSTAL.L NEW rl/4" PRIMED GOVE MOULDING ON RISER WITH 631.360.8949 DESIGNED BY: ED ROWLAND 10/12/15 �yp� A�yp �,py� AROUND ENTIRE KITGHEN vis�tusonthewebat www.NDAKITCHENS.com STEVE TECHET DRAWN BY: CARMEN 7ARATE DRAWING:4883 - FABRIGATE AAID IN5Tf1LL �DGE BANDED BIRGH PLYWOOD PANTRY SHELYING Homeowner � � Designing with you in mind since 1980 FlNISH FLOOR PLAN SH�3 of 5 _ �OGATE EXISTING HYAG RE6151'ER INTO NEW GABINET TOE KIGK DATE: SCALE: 3/S"=1'-0° - SUPPLY AND INSTALL NEW GRANITE GOUNTERTOPS AND BAGK5PLA5H TILES u�° �° �' - �e STER�O GOMPONENTS I62° � I6�° 'd,• MASTER SPEAKBZ ON ' TOP SHPLF --------- ---------------- ------- - i ---= ----- �V ii i i i i ~ . �`.�� QDO 20'��2° � i �� TF03�96 �i MIX�R i DI5HWA51$(ii � i e�¢° `�� - '•, ��`•,.� X 29-13/Ib° ' . ; c�i� �� 81953�4l.. ; ; B5G3334 i81D�135' �O s�yz, , �� . ,` _ ;� � ��2F OESP-L� PPIP � +__LF-^� � OBPW � e �q ��a�l; - i� =1�t ~ BF0334, ii � r --,�-------'--- 7 i �ii i y � v____ _—__J____________1___--_ ________L_ ` � /`��1�Ij N _—__ �Q- 'o � ♦�.�C� � ' i�l�� i a � � �F � MI�LIFT WITH �w+�vAc s�o3�a ,c� ' � 'F RE1(-A-SF�LP � `• s� '�'� ' '°� ; i i ii i r------- ---------------------'1 `�� t � ��i'�m = `---------' ' i�i � �1 o ii i i � TOE KIGK I ��----�N 0�= �� ----- ��------------�•� N cn IL iE i� � 50FT GL05E REGISTER � BF0334 i_ �� m�ii�i cy � i � GlDO 18-15/16° ii i i $J iE„ � RA.rML-FfD�.�G � QDO 14-1/8tl i� s ��ii c�y Xr - i i ' , ■ i i i � ik i � � i hi�- X 24-13/Ib ,�826.?534-IS?5� � � � �� X 2q-13/I6" � .;�' � ' ' , i i ik i � f ,�----------- ii � i i MDY'� �� LF ORrI �� 0 �� ! �FRB0434-241y ' I , �r------------- ------�______'� BOFD`{34 =____-__- � 9�34 (?a QDO 13 3/16"XI i C�DO 26-I/4° , 29-13/16°(HDY�1 I I X 24-13/Ib° �-��----- ' i r � � , - I i � � � � I I ' � � � I I I I -� 42°X 60" �_ I i TASLE I � �--------� I I 26�' - I I I i (?a GtDO 13-3/16'X � � _, 29-13/16°MDY'�I BF0334 j i 4=====_�=====F =------------� I I � � � i B26.7534-15 u �------------ -35°-SpTv'-Riql�g--- ;ct`�� ;� LF OR5-L �' QDO 15-II/Ib"X S�O�� 34 �� 0334 ° �N� ��+'.�- " 29-13/I6°�HDVV� �-------------- - ----------- -------- -----d�'----a--- --------------� �---------------r--------------- �� GU�4'7-I/2 X 10 �� p ., p)REV-A-51�.F 24 i m� '� --------- � ii B3D2834 �n �°E8D2834 PLGI850-34,,�I p,G� BID2?34 LP u u $ID3034 ; SID3034 I � 5USAN ON GABINET � -� I T ��i �� RF OESP-R � '�i � (2IODI OESP-L�� I 2)ODI R�OESQ-R; (?a ODI FLOOR LD-4NW-0DI-24B-I � =rt � � � BFRBI53�1--24 � ,�-----'�---� � PD �p> ; - 2F OGD-I 'XI8°V�6lO� Y V 2 82540 REFRI6ERATOR I�ofi�ZC-ii MI�"�2�� NBO�iO BP0334� � ' �, + _ `" OESP-R YV/INLINE BLON�t 06D-I RF ---------------�-------- LF OFSP-L RP OESP-R N6040 _ „ -------------------- . - ii�24°REFRI6J;$IDI534; qjDs4'� ; -� � �F0334 � QDO 2411/16° �� R/ � OBPW � �'�' ,� �� THERMADOR INLINE BLOY�R IN r X 2q-13/16° ii i IGP MA!'�ER ; � ; '�. , ';' N ATI'IG,VENT T}iROU6H FKONT 51DE �� WITH P/4NEL � �� •--- „� � ��O3�q64 32° . 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SPRAY FAUGET wsit us an the weh at www.NDAKITCHENS.com STEVE TECHET DRAWN BY: CARMEN ZARATE DRAWING:4883 HARDWARE: AMEROGK WESTERLEY WITH STAINLE55 ST�L PINISH Homeowner Designing with you in mind since 1980 CABINET PLAN SH�4 of 5 ��21-GIO DOORS AND SMALL DRHYVERS 50AP DI5PEN5ER: (I) GROFfE,GON7'EMPORARY SOAP DATE: SCA�E: 3/8"=1'-0" 53'722-GIO SINGLE ON BIG DRAVVERS (24"W+) ONLY DISPENS�R WITH REAL STEEL FINISH TO PORGH TO TWD S�TS 5TERC-O GOMPONENTS GEILIN6 PAN EXISTING EXT�RIOR �.�� LIGHT FIX111RE5 TO EXISTIN6 GONTROLS ON TOP I j !� SP�OT LIGHT5 SHELF 1 I HI6H S�iIND N � \ � --------- ---------------- ------ - ----------- - i \ � �� u i i i �\ �/ � ' �— -��t- - —�----�--- ----�--�6FJ `t - ---------- i � `� iir/-/ \.y �_— i �� i i / -�� ` ---------; i i ��—� i�' / i i � � i � .��;�;` � --------- ' i �y— � -� i i i s�- \`:�• :� � i �� / R90 � ii iT�iO�� i -- -Ra0 �+�i�� TR3p � � �. �, , / u ��'---}� ��4i r i � \ � i ii i DISH�--,'--------'----7 i � �hi i � ' v_________J____________1____ _______L______{� ' , !�i' i � ______ ♦ . 1I 1 ' I I �_''�1, � , `��♦ j�lj ! � i ; I I � 4 i r________________ __ _--� ��` ' �{. 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' � � i .-�-'-- �� -- ------- ' �• ' ' � I �� BLOM�R -�� ---------------L-------- 6F ' � 6FI --------- �`�- �i ir ' ^, { i . \ �� i \\ � i�i / i i � � �—� �---'-�� i �� .1. ; � . � � / \� j �� -f;f}-� � �' . ��;'� � tz�o I I � , � 1 SPEAKER GONTROL , ( � ;;; I �T�� ' ;� �-- , PHNEL FOR KITGHEN � " ' ��; � � � -- . : i �� "� � �-----�% ----- ; � ; ---�� ———— ----- � � ' I ---- � � i � �e ( i REMOYE�CISTING KITGHEN SPEAKER5 ; ; AND REINSTALL IN NEW LOGATIOM � �-------� � r F - LEGEND: APPROVED BY: COMPANY REPRESENTATIVE: � 51NGLE POLE SWITGH � DUPLEX OUTI.ET �� 5°,R30 INSULATED HIGH HAT WITH LED TRIM KIT T �° DIMMER SWITGH `��i GFI PROTEGTED DUPLEX OUTLEI' �-� PPNDANT LIGHT FIXIIJRE JOAN TECHET NDA REPRESENTATIVE Homeowner THR� WAY SWITGH � LED UNDER GABINET LIGHT � GEILING LIGHT PIXNRE -Kitchen Co.- DATE: �g �� 192 Smithtown Blvd.Nescanset NY 11767 631.360.8949 DESIGNED BY: ED ROWLAND 10/12/15 sD __ STEVE TECHET � TFiR�WAY DIMt�R SWITGH � LED LIGHT IN51DE GABINET — LID ROPE LI6HT Ysftusonthewebat www.NDAKITCHENS.com - Homeowner DRAWN BY: CARMEN ZARATE DRAWING:4883 Designing with you in mind since 1980 DATE: SCALE:I 3/8"--�1'-0° SH�� O f � � -5��N1R�OL PA1JE1. � PHONE JAGK -a GA81.E.1AGK r 0 •O y �•� O � �d SUR�EY OF PROPERTY 0 �.... � ;��U� SITUATE N/��F UGHLIN = m TERENCE J• McLAUGHLIN � �. r 1vIAT T I T U C K gc SALLY L� � �+ �••a � 61 .57 � �oN�MON. 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No. 50467 ." g t� / e r°1,nm ::: W�� 14� 6` � UNAUTHORIZED ALTERATION OR ADDRION TO THIS SURVEY IS A VIOLATION OF W i o�� J SEC170N 7209 OF THE NEW YORK STATE � � v� .:.:.m �� '�`'L� EDUCATION LAW. ��n �� CO��I� III ! .�v ';•:.� NS i "p y r+� :�:.�^ N pPRE�0 Q`�' L ■ ■ y COPIES OF THIS SURVEY MAP NOT BEARING W m� '`. � � �� THE LAND SURVEYOR'S INKED SEAL OR � �� :A �� p9� 2�� Lal'1CI SurV�y�Or� N j\��P�ON /, o�� EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. 80�. � �SE. •NP�'R i�/ p�y � CERTIFICATIONS INDICATED HEREON SHALL RUN 1• N� N��N�� y -(� y ONLY TO TNE PERSON FOR WHOM 7HE SURVEY B�� g�KN' i r� IS PREPARED, AND ON HIS BEHALF TO THE �ON�' 0 aE' � °� 3� TITLE COMPANY, GOVERNMENTAL AGENCY AND �12 � LENDING INSTITUTION LISTED HEREON, AND Tifle Surveys - Subdivisions - Site Plans - Construction Layout Qa�� TO THE ASSIGNEES OF THE LENDING INSTI- S �jV �O TUTION. C ERTIFl CATI ON S AR E NOT TRANSFERABLE. �� PHONE (631)727-2090 Fax (631)727-1727 THE EXISTENCE OF RIGHTS OF WAY OFFICES LOCATED AT MAILING ADDRESS AND/OR EASEMENTS OF RECORD, IF 1586 Main Road P.O. Box 16 ANY, NOT SHOWN ARE NOT GUARANTEED. Jamesport, New York 11947 Jamesport, New York 11947