Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
40387-Z
Town of Southold ` 10/12/2017 0 P.O.Box 1179 co 53095 Main Rd ©4% Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39285 Date: 10/12/2017 THIS CERTIFIES that the building FOUNDATION Location of Property: 2665 Jackson St.,New Suffolk SCTM#: 473889 See/Block/Lot: 117.-9-31 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 1/5/2016 pursuant to which Building Permit No. 40387 dated 1/5/2016 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: FOUNDATION UNDER AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to Maul, George of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 40387 07-25-2017 PLUMBERS CERTIFICATION DATED 07-25-2017 RqbNI H. Gramman r ut o ' ecrSignature TOWN OF SOUTHOLD ao oay� BUILDING DEPARTMENT co TOWN CLERK'S OFFICE o • SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 40387 Date: 1/5/2016 Permission is hereby granted to: Maul, George PO BOX 635 New Suffolk, NY 11956 To: Alterations (foundation work for flood compliance) to an existing single family,dwelling as applied for with flood permit. Replaces BP# 39002 At premises located at: 2665 Jackson St., New Suffolk SCTM # 473889 Sec/Block/Lot# 117.-9-31 Pursuant to application dated 1/5/2016 and approved by the Building Inspector. To expire on 7/6/2017. OO. Fees: Total: $0.00 r l� Building spector " TOWN OF SOUTHOLD �gUFFO(p- �� BUILDING DEPARTMENT TOWN CLERK'S OFFICE �y • oR SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 39002 Date: 7/1/2014 Permission is hereby granted to: Maul, George PO BOX 635 New Suffolk, NY 11956 To: Alterations (foundation work for flood compliance) to an existing single family dwelling as applied for with flood permit. At premises located at: 2665 Jackson St, New Suffolk SCTM # 473889 Sec/Block/Lot# 117.-9-31 Pursuant to application dated 6/4/2014 and approved by the Building Inspector. To expire on 12/31/2015. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $399.20 CO -ALTERATION TO DWELLING $50.00 Total: $449.20 Buildin ecto Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings,property lines,streets,and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building,industrial building,multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings(prior to April 9, 1957)non-conforming uses,or buildings and"pre-existing" land uses: 1. Accurate survey of property showing all property lines,streets,building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant.If a Certificate of Occupancy is denied,the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy-New dwelling$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00, Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,Businesses$50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15.00, Commercial$15.00 Date. `3 New Construction: / Old or Pre-existing Building: JJ�� V (check one) Location of Property: 6 �s 6�Sa'� S� c)� k House No. Street x,� I Hamlet Owner or Owners of Property: ��2-0 V�� l"`a \ Suffolk County Tax Map No 1000,Section l Block q Lot Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: -Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted:$ Applicant Signature pF SOUr�®l 0 Town Hall Annex Telephone(631)765-1802 54375 Main Road N Fax(631)765-9502 P.O.Box 1179 c roper.richert(aD_town.southold.ny.us Southold,NY 11971-0959 NTI,�� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: George Maul Address: 2665 Jackson Street city,New Suffolk st: New York zip: 11956 Budding Permit#: 40387 Section: 117 Block. 9 Lot: 31 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Mr. Sparky Electric License No: 58213-ME SITE DETAILS Office Use Only Residential X Indoor X Basement Service Only Commerical Outdoor X 1st Floor X Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph 150A Heat Duplec Recpt Ceding Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors Main Panel 150A A/C Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks Disconnect 150A Snitches Twist Lock F1 Exit Fixtures TVSS Other Equipment: Move Service Due To House Being Raised. Notes: Inspector Signature: Date: July 25, 2017 0-Cert Electrical Compliance Form.xls so Town Hall Annex ,r7b f� Telephone(631)765-1802 54375 Main Road °� Fax(631)765-9502 P.O.Box 1179 Soufliold,NY 11971-0959 eou T`1;�� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Date: Z Building Permit No. 15-103 Owner: (P ase print) Plumber: mur- l 4-2e ,,nznA-d (Please print) I certify that the solder used in the water supply system contains less than 2/10 of I% lead. (Plumbers Signature) Sworn to before me thisas� a day of 20/1 7. Notary Public, County JUL 31 2017 0 BUMDING DEFE NOMMAXIEpuwic.STOW of mow TOWN OF SO>I THOLD Al®.47,M116" 00awled j►Wee"a aeurav SO�Tyo cDUN1Y,� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ FOUNDATION 1ST [ ] ROUGH PLRG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FIN ) REMARKS: i� O V- 7 19-94ft✓ 12X ep-v( cm,--+-ei vL JA^DATE INSPECTOR �Of SO//ly �o� olo i O o�y 0 lm,� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION /] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL,(ROUGH) [ ] ELECTRICAL (FINAL) REMARKS. 0��/ wm( �A%/ ov-/ 06WI&A .�-- DATE 41 l a A' INSPECTOR / v zf SOI/ly� couNril TOWN OF SOUTHOLD BUILDING-DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUND ATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICA _(FINAL) REMARKS: �N( bhl I Q/ m << . mp,(4 r)I " DATE I INSPECTOR :7000, f SOUlyO UOUPli'I,� TOWN OF SOUTHOLD BUILDING DEPT. 765-1602 INSPEC 1 ® N [ ] FOUNDATION 1ST [ ROUGH PLEIG. [ ] UNDATION 2ND [ ] INSULATION [oma] FRAMING / STRAPMG [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICA (FINAL) REMARKS: A,1 J av `�eyq i Q V/ veto 'eAv��_u �t DATE P ' 4'_ INSPECTOR on - a0F SOUIy hod olo TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLSG. [ ] OUNDATION 2ND [ ] INSULATION [ FRAMIN / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] EL EC RICAL (FINAL) REMARKS: - VMh�k d vl(/Iovv"o (a) 400,11 M-�V, gow�> ;.v/ tA bak V11�1v - ; DATE INSPECTOR W4 o l � o o�y00UM'1,�� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] F NDATION 1ST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL ( ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) EMARKS: fA-hd o �dV ✓ b� lvkIV DATE INSPECTOR tl ��pF 50Ulyo TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ 71] F UGH PLEIG. FOUNDATION 2ND [ ULATION FRAMING / STRAPPING [ INAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: I JIB fn tft air&(M4 OA 064 SYS • fe SMA Cav f Lv, 4f t ief.fel V-0A - w� mqjAz cq go,1(*A w w 1 � ou b D� � I • DATEA ?iOl�' INSPECTOR OE SO(/Tyolo 46 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [� ELECTRICAL (FINAL) REMARKS: DATE z INSPECTOR 3�� �pE SOUTy YCOUNI TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]XSULATION [ ] FRAMING / STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) MARKS: f /I qVI KSDa/ CAmn - (a R 1 ,YJ• tV4 o�C DATE Y INSPECTOR S OUjy� couto,��' ,TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] NSULATION [ ] FRAMING / STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] -FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARK L e4A) s Ir DATE lf INSPECTOR 1883 Veterans Memoriat Higrhway, Suite 45 Hauppauge, Mew York 11788 LanyA. ,Rubinson,P.E. (631)969-8535 Michael L. Williams, P.E. Fax(631)969-8618 April 25, 2017 Croundbreakers Contracting Ino. X s Riad ® C��GOd[ Westbury, New York 91590 D Att: Mr. Kevin Muro, President L 19 209 Re: Gaul Residence 266 Jackson Street; New Suffolk DIIILDING DEPT. Helical Pili: installation Certification TOWN OF SOUTHOLD Mr. Muro: To the best of my knowledge, the work presented in the documents submitted"for review is accurate and in conformance with the.applicable codes at the time of submission and has been prepared in conformance with customary standards of practice. Documents reviewed by our office include the following: 1, Architectural plans prepared by PKAD Architecture & Design .{drawing Numbers A-100 and A-1 101 dated 07109116. The plans depict the installation of 24 helical plies, 18 of which are shown as being ,pnder the perimeter foundation of the structure and 6 supporting house interior piers. 2. The"Helical Pile Specifications"and details on drawing Number A-1 10 lists the following design parameters: Minimum installation depth - 15 feet Minimum load capacity - 20 trans ultimate load (10 ton working) Minimum lead section length _ 7 feet Minimum extension length = 6 feet Helices arrangement = 8"110" 8. Helical Pile installation log presented by Groundbreakers Contracting Inc.for Maul Residence. The pile log indicates a round shaft 2-718 inch triple helices (8"/10"/ 12")with one 7 foot lead section. Our review of the pile log indicates the following: Minimum installation length = 7 feet Minimum installation load achieved - 11.61 tons Maximum installation working load achieved - 18.90 tons �1 Groundbreakers Contracting lnc. Maul Residence Foundation Helical pile Installation certification April 25,2017 Page 2 of 2 Swed on the information presented above, we certify the installation of the helical piles exceeds the minimum ultimate load specified by the engineer. This certification is limited to the helical pile installation and does not provide an opinion or certification as to the adequacy of the design or installation of the pile caps,grade beam or other structural cornponents�tthe,found tiona •d�Wilding structure. I ddition, R&W assumes no€responsibility for the design of the helicalices the design itdb�t�ty falls;solely-..withe �ctrtect of record. p ro�4t^i & Should you have any e-questions, please contact our office, mr j"-3lVery truly yours, R w licha , P.E. Principal wJ encl. ALUL RESIDENCE 7' LEAD - 2-7I6"-8xI OxI 21 RS7.DRIVE;HEAD E29 Pressure In Pressure Out Difference Tonaue 1 7ft below grade 1400 320 1080 14.58 2 7ft below grade 1300 $50 840 12.60 3 7ft below grade 1200 320 880 11.88 4 7ft below grade , 1200 320 880 11.88 '6 7ft below grade 1200 340 860 11.61 6 7ft below grade 1200 320 880 11.88 7 7ft below grade 1200 320 880 11.88 8 7ft below grade 1200 320 880 11.88 9 7ft below,grade 1300 320 980 13.23 10 7ft below grade 1400 360 1040 14.04 11 7ft below grade 1300 340 960 12.96 12 7ft,below grade 1300 320 980 13.22 13 7ft below grade 1200 320 880 11.88 14 7ft below grade 1200 320 880 11.88 -15 7ft below grade 1200 320 880 11.88. 16 7ft below grade 1300 340 960 12.96 - 17 7ft below grade 1500 360 1140 . 15.39 18 7ft below grade .1600 340 1260 17.01 19 7ft below grade 1600 320 1280 17.28 20 7ft below grade 1300 380 920 12.42 21 7ft below grade 1700 300 1400 18.9 22 7ft below grade 1 300 300 1100 14.86 23 7ft below grade 1200 340 860 11.61 24 7ft below grade 1200 340 850 11.61 • O�N� LEE 062 l a 1STf1TEIJ ltd NYS 408.2 THERt I E 4"WASTE TO SEPTIC mm MAINMING'WATERp0R VENTILATION ARE NOT FLOOD VENT NOTES: 03v,22Enclosed,,"below c: ar r, :, (i �¢ JnctUding crawspaces,U7di art lei 2.Be OtWided wiltillood open ", .. i; i. _... EX, -T ? 2-1.There shad be a minimurri 3 Q _rr_ 3 m F - t •'' ..V :,> a enclosed area,,if a buldin fra: design flood etevatton,each as 22.The total not area of all op mm2)for each square toot(tl-C w is shall be-designed mid the cont that the design and invialtalion flood forces on exter3orv+ails ti \ .: —r• eY r iq r �, I co floodwaters. 2.3,The bottom of each openir A �. __ "' :'" ,': r r m adtacentgroundlevel. 2. ishe!l he at feast' 2.55 Any Any louvers, ers screens 9r or 1(2)2'k8"AC6 2 r j L� ; i J`%' j -, flow of floodwaters Into and ou 2.6.Opeiritigs instated in door FJ. through- - EX through 2.5,are aoceplatrie;he �' t p openings 00 not moet The requ tu # LU ca ibIds r 1 i Q ( SCRAWL SPACE,:"• { t { . Ta' - 2"x8"ACQ LED 627 S.F,/2+00 S.F.PER VENTS - SEE ATTACHED SECTION AT =MlN,(o}VENTS REQUIREDt INTERIOR GIRDERIPIER y DWAE Tit WITH BEL "jg w iF 1 " I. ! / + SEE ATTACHED.SECTION AT CENTER I :~ �yEXTERIOR GIRDE R!F'IER TW ACC - - '`) , '_ '. "Xg"AGC )_ i l R4SSSE _ f - -- ACG!STEPS. CCTIO DECK AND RAILINGS t -- GAS METER ___ ----- — ACO STEPS,C f unentc,c,,,n,v vvuc c vn, \4\ ( i,-11 ! 4"WSTE TO SEPTIC INCOMING WATERFORSTAED TI PI TI 4ds.2 E NO T F€lR VEN7CLA7it}N RRE NOT MAIN € FtOODV�NTNOTES. R324.2.2 Enclosed area below including crzM spaces,that art ', « f i ✓"1 t.Be used solely far a paon a 2.Be provided with Hood open , 11 shag enclosed areaiha building ha: _EX-F.J. . ¢;- .W `i_ .1 _€ inimum a' _,. _ ._ _ : _'_ ! design flood elevation,each ar 2-2.The total net area of all op .-. „. M.._._, mm2 for each square foot(ox _ kw OEX.F.J. €_ _. <- - -- ._,.. « shaft ba designed and dta cans "ryrywthat the design and installation flood forces on exterior vralls b __ _._. . . `� ' floodwaters. 1 `! 2,3.The bottom of each openit adjacent ground level. w2.4.Openings shad be at least 2,5,An louvers,screens or of Y_ flour of ftoedwaters into and ou (2)2-x8-ACO£ ! - [_ Q ! .. r_ « } ? 2.6,Openings Installed in door F.J. �: :# N ; Y _. EX.F.J. - \ openthrouings da not meeare acceptable; the lrrsqu ` XEX.F.J __.,...: ,. _ .. ."., .�. .�.cH�CRAWLSPACE- � .,.. ».�.. ! t � 2"x8"ACCt IJ=Q 627SFt2t?DS.F.PER VENTS-, "SEEATTACHEDSECTION AT �t iMIN.f4, E.N,.TS REQUIRED",I , INTERIOR GIRDERIPlER ; I' _.... TV,_�7 Ir DIAME - if M I WITH BEl W (2)2"x8"A- SEE ATTACHED SECTION AT CENTER[ f ;iEXTERIOR GIRQERIPIER' 6x8"ACC 2"W ACG V@ 16"O.0 r� RO' S SECT10 ACCT STFPS C — ACO STEPS.l7ECK AND RAILINGSGAS METER I Ii I 1 0 • ' — • 1 1. ly ------ - - Pam;r`go, � ► � �� � �►�� � 11 . � NOW n I I • AApqp:. _SEE JJJU M . ..d :i�;�r 1 STATE ENEROY CODE �.'► M WAS ���.� .. ���"'�►' ,`moifA I NO WNW. W- 74 NOW MOB C'l>J TOWN OF SOUTH r I BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPAR T ON 1 N — 4 nn1 A Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD,NY 11 71 BLDG DEPT 4 sets of Building Plans TEL: (631) 765-1802 TOWN OF SOUTHOLD Planning Board approval FAX: (631) 765-9502 Survey SoutholdTown.NorthFork.net PERMIT NO. � Check T Septic Form N.Y.S.D.E.C. Trustees Flood Permit Examined ,20 Storm-Water Assessment Form Contact: f Approved ,20 Mail to: Disapproved a/c Q 6o Phone: � 2 Expiration � Z � C ,20 1 ui Inspe APPLICATION FOR BUILDING PERMIT n Date , 201y INSTRUCTIONS a.This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accurate plot plan to scale.Fee according to schedule. b.Plot plan showing location of lot and of buildings on premises,relationship to adjoining premises or public streets or areas, and waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application,the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e.No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f.Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim,the Building Inspector may authorize, in writing,the extension of the permit for an addition six months.Thereafter, a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County,New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings,additions, or alterations or for removal or demolition as herein described. The applicant agrees to comply with all applicable laws, ordinances,building code,housing code regulations,and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant or name,if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder 0 W K_Q Name of owner of premises (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: 66 House Number Street Hamlet County Tax Map No. 1000 Section 11_7 Block ® q Lot _31 Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and inte}}��ded use and occupancy of proposed construction: a. Existing use and occupancy V-e-3i d'1�51LILC-0 b. Intended use and occupancy reSJebl-C'e-- 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost 1 0 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 tl oV7 e- 6. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front c�V Rear oma? Depth 3 d Height "'a L Number of Stories Dimensions of same structure with alterations or additions: Front O Rear a Depth 13 b Height 9F, —Number of Stories a 8. Dimensions of entire new construction: Front N Rear Depth Al 4 Height ktjq e Number of Stories 9. Size of lot: Front 5 C7 Rear 5 0 Depth �S C-) Cs axis 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated HOW ll� �t�S l liter Ss 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded?YES NO Will excess fill be removed from premises?YES NO;X 14.Names of Owner of premises 6 -,- � a66s �a�(c�o�s� lVehws,�-�, 7O3S Address Pone No. '7 3 z1 Name of Architect �J`oL.L,\ C du o Address 17-'Z--s(-7s&e/� Phone No d-79 l l F6 Name of Contractor �- K-,-( Address MS tr`t` `Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO_,><-/ --*-IF YES,-D.l✓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 ) being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, CONNIE D.BUNCH Notary Public,State of New York No.01 BU6185050 (S)He is the 01 islified in Suffolk Cour (Contractor,Agent, Corporate Officer,etc.) Commission Expires April 14,2 of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief;and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this q—day of n 20� Notary Public ----Signature of Applicant Scott A. Mussell ZI Su p STOIKIMMATIE]E, SUPERVISOR SOUTHOLD TOWN HALL-P.O.Box 1179 p 53095 Main Road-SOUTHOLD,NEW YORK 11971 �O TO Q t919N 4 9n9� CHAPTER 236 - STORMWATER MANAGEMENT WO ( TO BE COMPLETED BY THE APPLICANT ) iv OF SOUTHOLD JUN 0 5 2014 DOES THIS PROJECT INVOLVE ANY OF THE FOLLOWING: NG: Yes No (CHECK ALL THAT APPLY) ❑[B A. Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. ❑r7vl B. Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. ❑p C. Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. ❑ D. Site tlands, beach, bluff or coastal er slon azar area. E. Site preparation within the one-hundred-year floodplainrsepi ed of any watercourse. F. ns a a ton o ne ouare t Ii feet or more, unless prior approval of a Stormwater Management Control Plan was received by the Town and the proposal includes in-kind replacement of impervious surfaces. - ---- ------------------------------ — _ --- - - -- - - -- - If you answered NO to all of the questions above, STOP! Complete the Applicant section below with your Name, Signature, Contact Information, Date & County Tax Map Number! Chapter 236 does not apply to your project. If you answered YES to one or more of the above, please submit Two copies of a Stormwater Management Control Plan and a completed Check List Form to th4?Building Department with your Building Permit Application. Date:APPLICANT. (Property Owner,Design Professional,Agent,Contractor,Other) S.C.T.M. #: 1000 `Q 6V l n 1 t District / NAME. .J[ (,/� ,mi Sect ton Block Lot "'FOR BUILDING DEPARTMENT USE ONLY Contact Information du)-, lCrdcptwn<NumberlV ,�- ^Reviewed B : , V�IJ Date: Property Address / Locatio of Construction Wor : — — — — — — — — — — — — — — — — — r �� b ® Approved for processing Building Permit. �j ( St rmwater Management Control Plan Not Required. l�L� Stormwater Management Control Plan is Required (�c (Forward to Engineering Department for Review.) FORM # SMCP-TOS MAY 2014 6 O tT APPLICANT S.C.T.M. 100-0 - a�� @� CHAPTER 236 (Property Owner,Design Professional,Agent,Contractor,Other) - • ---- -- tri 0 q _ Stormwater Management Control Plan CHECK LIST NAME: � D'a� Sect)on Biock Lot S M C P -Plan Requirements: Provide ONE copy of the Building Permit Application. 3 ��3� Date: X01 �k The applicant must provide a Complete Explanation and/or Reason for not providing Td h L4all Information that has been Required by the following Checklist! Signa Rirr ep,one NumEn I. A Site Plan drawn to scale Not Less that 60' to the inch MUST YE If You answered No or NA to any Item, Please Provide Justification Here! show all of the following items: NO NA If you need additional room for explanations, Please Provide additional Paper, a. Location & Description of Property Boundaries b. Total Site Acreage. c. Existing-Natural & Man Made Features within 500 L.F. of the Site Boundary as required by §236-17(C)(2). A A-:a,— , a d. Test Hole Data Indicating Soil Characteristics&Depth to Ground Water. ()( L ') - 1 ti is ce e. Limits of Clearing & Area of Proposed Land Disturbance. VftP ' f. Existing & Proposed Contours of the Site (Minimum2'Intervals) 1A,0G g. Location of all existing & proposed structures, roads, gholl inelude but Re-t be 4-m-4-ad toO driveways, sidewalks, drainage improvements & utilities. !i. Spot Grades & Finish Floor Elevations for all existing & Wive Backed gilt Fencing, stabilization &v proposed structures. ESeetling of Up sed and/ow inactive soils 1. Location of proposed Swimming Pool and discharge ring, 0 A v e ao/ j. Location of proposed Soil Stockpile Area(s). 00 oil o� tie k. Location of proposed Construction Entrance/Staging Area(s), ® I. Location of proposed concrete washout area(s), lil o I a aY m. Location of all proposed erosion&sediment control measures. �'lwl n v)oBt.Ge w )u ZKVIC e -} _ at 1 2. Stormwater Management Control Plan must include Calculations showing 1C ('-d that the stormwater improvements are sized to capture,store,and infiltrate , .1-V 1-5kw 6.o e'l. Duvt 1 o w Wl on-site the run-off from all Impervious surfaces generated by a two V)inch ® ke 0 C.,kf�/Md w .¢ 5 2 K rainfall/storm event. •e v- �u >2�e-Qir, 3. Details&Sectional Drawings for stormwater practices are required for approval. Items requiring details shall include but not be limited to: ProVe0%tje'v- g w a, Erosion &Sediment Controls, r w b. Construction Entrance & Site Access. /W11 vbzka2 w1 iw �- Q�ctg�i wal , c. Inlet Drainage Structures (e.g.catch basins,trench drains,etc.) e'-'rk Aa I-., d. Leaching Structures (e.g.inflltratlon basins,swales,etc.) A ee in I C)I ENGINEEf N a DEPAR USE ONLY*"** Additional Information is Required. Reviewed & 1 ® Stormwater Management Control Plan is Not Complete, Approved By — — — — — — — — — — — — — — — — — — — — — — — — Stormwater Management Control Plan is Complete. Date: ! SMCP has been approved by the Engineering Department. d FORM * SWCP Check List-TOS MAY 2014 Verity, Mike From: Richter,Jamie Sent: Wednesday,July 19, 2017 3:16 PM To: Verity, Mike Cc: Collins, Michael Subject: SCTM # 117 - 09 - 31 Attachments: Inspection Report 7 19 17.pdf Michael I had a visit from the contractor who raised the building to meet flood zone requirements in new Suffolk by the boat ramp. I do not know which inspector reviewed the project for completion but; The building department inspection report referenced compliance with stormwater management Chapter 236. 1 did an inspection myself and found the perimeter drainage satisfactory but two main items are required for final approval. As you can see from the enclosed,erosion control has not been provided. This must be established around the entire house and maintained until at least 80%Germination of grass. The driveway apron must also begin with an asphalt pavement section a minimum width of 4. 1 will call the contractor and let him know that these items must be completed before I can sign off on the SWMP. Thank you for your assistance with compliance for Chapter 236. Jamie James A. Richter James A.Richter, R.A. Stormwater Manager Office of the Engineer Town of Southold, New York Stormwater Management Control Plan Website: http://www.southoldtowmy.gov/index.aspx?nid=l 95 Office: 631-765-1560 CONFIDENTIALITY NOTICE: This communication with its contents may contain confidential and/or legally privileged information. It is solely for the use of the intended recipient(s). Unauthorized interception, review, use or disclosure is prohibited and may violate applicable laws including the Electronic Communications Privacy Act. If you are not the intended recipient, please contact the sender and destroy all copies of the communication. o, 1 MimppPF ILI Ie f i1i.�' ...���.+m'• ^^"` _ _..- � ....._ .a _. —. ,...fir. - ,w t • W _ - jam-`► - Y " • • 3 - • _ _�. .�.-� •�r"S' _�, •�fM+*• � y, ` + �'!r w���63i�� moi' o � _ _ vim. "\,"` � ` "� ,ir•k. ♦,}` ' .�:�. r• - .ra'� � ,` _ - , * •- _`� T•'r. ���y.1,�,� `.. �,is PROJECT LocnTl°N - wrrrncr I ContadTI°N: s.C.T.M. : 1000 ENGINEERING DEPARTMENT - (Properly Owner,Design Professlonai1l,Agent,Contractor,Qtber) ��� o.��- b,`Je -k [NAME- - e � f U� Section Block �Lo� z � �- . • - SITE INSPECTION REPORT FORM Picnic Pnnt Inspection Date: '' E-Mad Addrw TelcpM1orc dumber t - 1.- ' Subdivisions, Site Plans, Stormwater Improvements-& Other Installations DESCRIPTION OF REQUIRED SITE WORK YE MNOT�A NOTES- Incomplete Site Work a. Maintenance of Erosion&Sediment Controls F--1, _ h. Limits of Clearing&Area or Proposed Land Disturbance. - c Condition of Stockpiled Soils. ] d. Verif icat ion of Size&Depth of`Leaching Pools. e Verification of Drain Pipe Installation/Concrete_Parging_ _,iQl f. Driveway Installation within the Town ROW-Highway Specifications V - 1's'3 , g Final Site Grading-Effect on Adjacent Property - - - - - `- h. Inspection of Gutter&Leader System-Drainage Piping i. Instalation of proposed Swimming Pool and discharge ring. - j. Inspection of Construction Entrance/Staging,AreaW.. 0 _ k.Location of proposed concrete washout area(s) �1 I. OTHER-EX lanation'Required L__J —m OTHER=Explanation Ee wired _ A Final Inspection Report must be certifieded prior to issuance of Certificate of Occupancv. Three options for certification are as follows:_ OPTION 1, Certification of Drainage Installation with As-Built drawings prepared&-Sealed by a Registered Design Professional Licensed in the State of New York. OPTION":2. Photographs showing placement of all drainage structures with appropriate background indicating location of all structures and drainage piping. OPTION":3. Site Inspection of open excavation prior to complete backfill and a written inspection report from the Town Engineering Department. a TOS Review NOTES: QS Qv4 51�'0r6ilTl 'T9®L, 1sTt -- --r'T 'Lis 11.6D, V' fi a�c�t KIM,it ,o -oF � 7i' � 1w°� r' ;�'a ` v "� n. r= - - s ENGINEERING INSPECTIO' _ :REPORT'-. �----�--�----. -' _ Additional Work Is Required for Final Approval. Reviewed /-Inspected ® SITE WORK Is Not Complete. (See Notes Above) — — — — _ — — — — — — — ,ry ire- rteA et by me r e & _ ng - artm�nt.Date. 7 Inspection ® Cy / FORM ENGINEERING Inspection Report Form-TOS May 2015 w t L . APPLICATION a ' PA(,E I of s TOWN OF SOUTHOLD I,LOODPLA.IN DEVELOPMENT PERMIT APPLICATION i I This form is to be filled out in duplicate_ I SECTION 1° GENERAL PROVISIONS (APPLICANT to read and sign): 1. No work may start until a permit is issued- 2- The permit may be revoked if any false statements are made herein- 3. If revoked, all work must cease until permit is re-issued. f d- Development shall not be used or occupied until a Certificate of Compliance is issued- S. The permit will expire if no work is commenced within six months of issuance. 6. Applicant is hereby informed that other permits may be required to fulfill local,state and federal regulatory requirements. 7. Applicant•hereby gives consent to the Local Administrator or his/her representative to make reasonable inspections required to verify compliance. 8. 1,THE APPLICANT,CERTIFY THAT ALL STATEMENTS HEREIN AND IN ATTACHMENTS TO _ THIS APPLICATION ARE,TO THE B KNO,,VLE E,TRUE AND ACCURA (APPLICANTS Sf-6-*ATURE) DATE i SECTION 2° PROPOSED DALOPMENT(To be completed by APPLICANi-1 NAME ADDRESS / ( cJ TELEPHONE / ; APPLICANT (�U�`'`" y BUILDER ` 73-Y D3 C-, IL�1.56 i ENGINEER ��� ����� / �S � �•� � (�C 4�� p PROJECT LOCATION: • To avoid delay in processing the application, please provide enour-b information to easily identify the project location. Provide the street address, lot number or legal description (attach) and, outside urban areas, the { distance to the nearest intersecting road or well-known landmark. A sketch attached to this application showing i the project location would be- helpful. � I FDP(93) 4 APPLIC41'I0n PAGE 2 OF 4 --- DESCRIPTION OF WORK (Check all applicable boxes) A. STRUCTURAL DEVELOPMENT ACTIVITY STRUCTURE_ TYPE ❑ New Structure Residential (1-4 Family) ❑ Addition ❑ Residential (More than 4 Family) ❑ Alteration ❑ Noo-residential (Floodproofiog? ❑ yes) ❑ Relocation O Combined Use (Residential & Commcrdal) ❑ Demolition P ❑ Manufactured (Mobile) Home (10 Manu- AX Replacement factured Home Park? ❑ Ye-S) 011) 0a � ESTIMATED COST OF PROJECT S 1 I B. OTHER DEVELOPMENT ACTIVITIES. I TJ Fill ❑ Mining ❑ Drilling O Grading ❑ Excavation (Except for Structural Development Checked Above) O Watercourse Alteration (Including Dredging add Channel Modifications) O Drainage Improvements (Including Culvert Work) ! O Road, Street or Badge Constroctiou I ❑ Subdivision (New or Expansion) O Individual Water or Sc sr System O Other (Please Specify) After completing SECTION 2, APPLICAW should submit form to Local Administrator for review. ECTION 3: DPLAIN DE'T'ERMINATION o be com feted by LOCAL ADT�iIM ROTOR The proposed development is located on FIRM Panel No.S6L Dated a loa.G Tbc Proposed Development: I 0 Is (iceT located in a Special Flood Hazard Arca (Notify the applicant that the application review is complete and NO FLOODPLAIN DEVELOPMENT PERMIT IS REQUIRED). ! O Is located in a Special Flood Hazard Arca- FIRM zone designation is 100-Year flood elevation at the site is: Ft. NGVD (MSL) O Unavailable O The proposed development is located in a floodway FBFM Panel No. Dated O Sec Section 4 for additional instructions I DATE SIGNED APPLICATION a. _ PAGE 3 OF a SECTION d ADDITIONAL INFORMATION REQUIRED (To he completed by LOCAL ADMINISTRATOR) The applicant must submu the documents checked below before the application can be processed- ❑ A site plan showing the location of all existing structures, water bodies, adjacent roads, lot i dimensions and proposed development. r ❑Devclopmcnl plans,drawn to scale,and specifications,including where applicable:details for anchoring structures,proposed elevation of lowest floor(including basement),types of water resistant materials used below the First floor,details of floodproofing of utilities located below the fust floor and details of enclosures below the First floor. Also r ❑Subdivision or other development plans(If the subdivision or other development exceeds 50 lots or 5 acres,whichever is the lesser, the applicant must provide 100-year flood elevations if they are not otherwise available). I, ❑ Plans showing the extent of watercourse relocation and/or landform alterations. ❑Top of new Fill elevation Ft. NGVD (MSL). O Flood proofing protection love] (non-residential only) Ft:NGVD (MSL). For i flo Woofed structures, applicant must attach certification from registered engineer or architect. � ❑ Certification from a registered engineer that the proposed activity in a regulatory floodway will not result in any increase in the height of the 100-year flood. A copy of all data and calculations supporting this finding must also be submitted. ❑ Other: I i SECTION 5 PERMIT DETERMINATION fTo be completed by LQCAL ADMINISTRATOR) I I have determined that the proposed activity.A.O Is t B.O Is not in conformance with provisions of Local Law # . 39 The permit is issued subject to the conditions attached to and made part of this permit. SIGNED , DATE If BOX A is checked, the Local Administrator may issue a Development Permit upon payment of designated fee. If BOX B is checked, the Local Administrator will provide a written summary of deficiencies. Applicant may revise and resubmit an application to the Local Administrator or may request a bearing from the Board of Appeals. I i i. l 4 ' APPLICATION a PAGE a 0F ,1 APPEALS Appealed to Board of Appeals? ❑ Yes O No Hcarmg date: Appeals Board Decision --- Approvcd7 ❑ Yes ❑ No Cooditioo_s SECTION 6: AS-BUILT ELEVATIONS (To be submitted by APPLICANT before Certificate of Compliance is issued The following information must be provided for project structures. This section must be completed by a registered professional engineer or a licensed land surveyor (or attach a certification to this application) Complete I or 2 below. 1. Actual (As-Built) Elevation of the top of the lowest floor,including basement(in Coastal High Hazard ca , bottom of lowest structural member of the lowest floor, excluding piling and columns) is: FT. NGVD (MSL). i 2. Actual (As-Buil() Elevation of floodproofing protection is FT. NGVD (MSL). NOTE: Any work performed prior to submittal of the above information is at the risk of the Applicant. ,SECTION 7• COMPLLINCE ACTION (To be compieted by LOCAL ADMINISTRATOR) I The LOCAL ADMINISTRATOR will complete this section as applicable based.on inspection of the project to ! ensure compliance with the community's local law for flood damage prevention. I INSPECTIONS: DATE BY DEFICIENCIES? O YES O NO DATE BY DEFICIENCIES? O YES ❑ NO DATE BY DEFICIENCIES? ❑ YES ❑ NO 5E,CTION $ CERTIFICATE OF COMPLIANCE(To be completed by LOCAL ADMINISTRATOR] Certificate of Compliance issued: DATE: BY: f i r i t ; - t i Attachment B t SAMPLE ' CERTIFICATE OF COMPLIANCE A�- for Development in a Special Flood Hazard Area i i i i i 1 i I i Y 1 • TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE FOR DEVELOPMENT IN A SPECIAL FLOOD HAZARD AREA (OWNER MUST RETAIN THIS CERTIFICATE) I i I PREMISES LOCATED AT: PERMIT NO. PERMIT DATE i I OWNERS NAME AND ADDRESS: CHECK ONE: Cl NEW BUILDING ❑ EXISTING BUILDING ❑ VAC .N T LAND • i s THE LOCAL ADMINISTRATOR IS TO COMPLETE A. OR B. BELOW: A. COMPLIANCE IS HE, CERTIFIED WITH THE REQUIREMEN'T'S OF LO CAL LAW # , 19 SIGNED: DATED: B. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 19_, AS MODIFIED BY VARIANCE # DATED SIGNED: DATED: f i f i t • C/C(93) U.S. DEPARTMENT OF HOMELtinv SECURITY - �+`.I Federal Emergency.Management Agency lex i�ation Date: N vember 30,2 18 National Flood Insurance Program ELEVATION CERTIFICATE OCT - 6 2017 Important: Follow the instructions on pages 1-9. Copy all pages of this Elevation Certificate and all attachments for(1)community official, (2)insurance agent/corr�latWi-14idWb 'I IRTbwner. :ii Aw SECTION A-PROPERTY INFORMATION FOR�lYSJ6PAKff E Al Building Owner's Name Policy Number. Cs c RA&W— A2. Building Street Address(including Apt., Unit, Suite, and/or Bldg. No)or P.O. Route and Company NAIC Number: Box No. City State ZIP Code aEvt SudFoLL 9 `[ZoZr, ICK,(V A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.) �uF i-IC couec ►AX' DE--JGA1�71(X.1- blsmct (W<0o l M EILML9 LQT 3l A4. Budding Use(e.g., Residential, Non-Residential,Addition,Accessory,etc.) 11�(1�L- A5 Latitude/Longitude: Lat.Alga-S9-���n Long.iJjt-2i�-1c).<" Horizontal Datum. ❑ NAD 1927 [NAD 1983 A6. Attach at least 2 photographs of the budding if the Certificate is being used to obtain flood insurance. AT Building Diagram Number -Zk A8. For a building with a crawlspace or enclosure(s). a) Square footage of crawlspace or enclosure(s) �Daat- sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s)within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b sq in SI:r C&-WC-A( 15!1�1c1d Ok� iFjaC d) Engineered flood openings? ❑Yes ❑ No A9. For a building with an attached garage- a) Square footage of attached garage Al/A sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade Al 1A c) Total net area of flood openings in A9.b AJ,/A sq in d) Engineered flood openings? ❑Yes ❑ No SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1. NFIP Community Name&Community Number B2. County Name B3. State 1OVa OF Sc��e7H -� '�IFbSP-3 SIIFfo `E B4. Map/Panel B5. Suffix B6. FIRM Index 87. FIRM Panel B8 Flood Zone(s) B9. Base Flood Elevation(s) Number Date Effective/ (Zone AO, use Base Revised Date Flood Depth) B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9. ❑ FIS Profile [FIRM ❑ Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 [NAVD 1988 ❑ Other/Source: B12 Is the building located in a Coastal Barrier Resources System (CBRS)area or Otherwise Protected Area(OPA)? ❑Yes [?(No Designation Date: ❑ CBRS ❑ OPA FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 1 of 6 ;fes`' L ;� 1 OMB No. 1660-0008 n LEVATION C5R IFjCATE Expiration Date: November 30,2018 IMPORTANT: In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE j);13uilding Street Address(including Apt, Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No. Policy Number city State ZIP Code Company NAIC Number (wy, SECTION C—BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on. F] Construction Drawings* ❑ Building Under Construction* dFinished Construction {ye'1 Anew Elevation Certificate will be required when construction of the building is complete. • dr C2. Elevations—Zones Al—A30,AE,AH,A(with BFE),VE,V1—V30,V(with BFE),AR,ARIA,ARAE,AR/A1—A30,AR/AH,AR/AO. Complete Items C2.a—h below according�to the building diagram specified in Item A7. In Puerto Rico only,enter meters. Benchmark Utilized. SS �wc-GJSv i`. Vertical Datum: Mit i) Indicate elevation datum used for the elevations in items a)through h)below. t D' NGVD 1929 5NAVD 1988 D Other/Source: Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. a) Top of bottom floor(including basement, crawlspace, or enclosure floor) [�feet ❑ meters b) Top of the next higher floor r i pS-C I% � l. feet ❑ meters c) Bottom of the lowest horizontal structural member(V Zones only) ❑ feet ❑meters d) Attached garage(top of slab) Ja ❑ feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building j� . Kfeet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent(finished)grade next to budding(LAG) [/Meet E] meters S 7S' g) Highest adjacent(finished)grade next to building(HAG) Fr feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including At A ❑ feet ❑ meters structural support SECTION D—SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer, or architect authorized by law to certify elevation information. 1 certify that the information on this Certificate represents my best efforts to interpret the data available.1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Sectio,n1�001. �, Were latitude and longitude in Section A provided by a licensed land surveyor? l�'Yes ❑No ❑Check here if attachments. Certifier's Name License Number Title I-lceW545D 1A14P S(G1OVEy®p, rJ jr� Company Name ,� '�T a �• _�. �� s r Address 11';x=, $;• I r r City State ZIP Code 111k, � Sign ture Date Telephone ` + '7m Ir- 201 �/(o &- 179& py all pages of evation Certificate and all attachments for(1)community official,(2)insurance agent/company,and(3)building owner. Comments(inc uding ty e of equipment and location, per C2(e), if applicable) G P� M��ACrSG �`C(3k of P-0IL Z�4 N�i1 l��lEl fF.>i' EL_= ��.y`� S`i\AA$2 WW I5LO-51t{H A P--aflbw OF 6LJ5CTXV--P'WQ—EL- /4.e\ sa F�t. PEZ-Var( Faz A-f-u[A.LGaJ8ZA6✓ C. AWLS 53UAM F-3!�Ma yr FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 2 of 6 OMB No. 1660-0008 ELEV aTiON CERT CATS Expiration Date. November 30,2018 IMPORTANT:In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address(including Apt, Unit,Suite, and/or Bldg. No.)or P 0.Route and Box No. Policy Number: City State ZIP Code Company NAIC Number nlCG�1 SutFc�al� AILI-tl.yc0X_ 1IgW SECTION E—BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFE),complete Items E1—E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B,and C. For Items E1—E4, use natural grade, if available. Check the measurement used.In Puerto Rico only, enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade(HAG)and the lowest adjacent grade(LAG). a) Top of bottom floor(including basement, crawlspace, or enclosure) is ❑feet ❑meters ❑above or ❑below the HAG. b) Top of bottom floor(including basement, crawlspace,or enclosure)is ❑feet ❑meters ❑above or ❑below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages 1-2 of Instructions), the next higher floor(elevation C2 b in the diagrams)of the building is - ❑feet ❑meters ❑above or ❑below the HAG. E3. Attached garage(top of slab)is ❑feet ❑meters ❑above or ❑below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ❑feet ❑meters ❑above or ❑below the HAG. E5. Zone AO only. If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F—PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A(without a FEMA-issued or community-issued BFE)or Zone AO must sign here.The statements in Sections A, B,and E are correct to the best of my knowledge. Property Owner or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑Check here if attachments. FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 3 of 6 OMB No. 1660-0008 ELEVATM GER` HCATE Expiration Date: November 30,2018 IMPORTANT: In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address(including Apt., Unit, Suite,and/or Bldg. No.)or P.O. Route and Box No. Policy Number: 2l�l0� 3ALY_SC>j,1 s, I--f City State ZIP Code Company NAIC Number ��a1 SLI�(OL l� k1 / yofzlL 119 S10 11 SECTION G—COMMUNITY INFORMATION(OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C(or E), and G of this Elevation Certificate. Complete the applicable item(s)and sign below. Check the'measurement used in Items G8—G10. In Puerto Rico only,enter meters. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer,or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2 ❑ A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE) or Zone AO. G3. ❑ The following information(Items G4—G10)is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate of Compliance/Occupancy Issued G7 This permit has been issued for ❑ New Construction ❑ Substantial Improvement G8. Elevation of as-built lowest floor(including basement) of the building: ❑ feet ❑ meters Datum G9. BFE or(in Zone AO)depth of flooding at the building site: ❑ feet ❑ meters Datum G10. Community's design flood elevation: ❑feet ❑ meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments(including type of equipment and location,per C2(e), if applicable) ❑ Check here if attachments FEMA Form 086-0-33(7/15) Replaces all previous editions Form Page 4 of 6 BUILDING PWOTOGRAPHIc OMB No. 1660-0008 ELEVATION CERTIFICATE See Instructions for Item A6. Expiration Date: November 30,2018 IMPORTANT: In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address(including Apt., Unit,Suite, and/or Bldg. No.)or P.O. Route and Box No. Policy Number: ZlotoS TACKSOXl, s�a-- City State ZIP Code Company NAIC Number Irl EW 4J1 F FvUG. All-A•`(dr- 11 q�(P If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken; "Front View"and"Rear View'; and, if required,"Right Side View"and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents,as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. LJ I Hu ?� Clltl c Photo One Photo One Caption �� I _ y Photo Two Photo Two Caption j� Sj �(��(� /7 tot FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 5 of 6 r EULDING G HOTOGRAPH%( OMB No. 1660-0008 ELEVATION CERTIFICATE Continuation Page Expiration Date: November 30,2018 IMPORTANT:In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address(including Apt., Unit, Suite,and/or Bldg. No.)or P.O. Route and Box No. Policy Number: City State ZIP Code Company NAIC Number If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and 'Rear View'; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents,as indicated in Section A8. I QIpU - �T Illllll�l i�llllllll '�� I lllllllllllllill =_ � Phcto One Photo One Caption (D /7 Zpl ;r , ;. } ,�7" IIII�II�nIII e Photo Two Photo Two Caption C qtCV6 10 ll nll FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 6 of 6 r i U.S4DEPARTMENT OF HOMELAND,SECURITY Federal Emergency Management Agency -E $#iMI) v bZ0,2 8 National Flood Insurance Program ELEVATMA CIE Important: Follow the instructions on pages 1-9. J U L 1 9 2017 Copy all pages of this Elevation Certificate and all attachments for(1)community official, (2)insurance agent/company, and 3 buildg owner. SECTION A—PROPERTY INFORMATION F CSE Al. Budo ic Building Owner's Name Py Num er G.1-7 - 1 -- A2. Building Street Address(including,Apf.,`Unit, Suite,and/or Bldg. No or P.O. Route and Box No. Company NAIC Number, City State ZIP Code )JE-14 ) !6,J y6eL A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description, etc) N STIW JM;b SW 1 Qd I)7 1: 1. 3 C L C( LIST 3� A4. Budding Use(e.g., Residential, Non-Residential,Addition,Accessory, etc.) RZE.sit�asro L A5. Latitude/Longitude: Lat.A� a'-SQI'ZJ,.q" Long MV_2.$-19•S" Horizontal Datum. ❑ NAD 1927 KNAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number,,29k A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) : _7 sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s)within 1.0 foot above adjacent grade _3- c) Total net area of-flood openings in A8.b 3 sq in d) Engineered flood opehings? [Yes ❑ No A9 For a building with an attached garage: a) Square footage of attached garage Al /A sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade AJ/A c) Total net area of flood openings in A9.b )V/ sq in d) Engineered flood openings? ❑Yes ❑ No SECTION B—FLOOD INSURANCE RATE MAP(FIRM) INFORMATION B1 NFIP Community Name&Community Number B2. County Name B3. State lowed Or 50�1_.D sllFFdL-- A2At \lam B4.Map/Panel B5.Suffix B6. FIRM Index B7. FIRM Panel B8. Flood Zone(s) B9. Base Flood Elevation(s) Number- Date Effective/ (Zone AO, use Base Revised Date Flood Depth) 31�1�3Ca�� Nil !`2��7�`� AE B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 139- ,,r 11, 9•;0,FIS Profile [FIRM ❑ Community Determined ❑ Other/Source. B11. Indicate elevation datum used for BFE in Item 139: ❑ NGVD 1929 [NAVD 1988 ❑ Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS)area or Otherwise Protected Area(OPA)? ❑Yes [(No Designation Date ❑ CBRS ❑ OPA FEMA Form 086-0-33(7115) Replaces all previous editions. Form Page 1 of 6 L OMB No. 1660-0008 ELEVATM CERT CATS Expiration Date, November 30,2018 IMPORTANT: In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Budding Street Address(including Apt, Unit, Suite, and/or Bldg. No.)or P 0. Route and Box No Policy Number City State ZIP Code Company NAIC Number A-16- Ll ALL-0 yWic- I)R;[o SECTION C-BUILDING ELEVATION INFORMAT90N (SURVEY REQUIRED) C1. Building elevations are based on. ❑ Construction Drawings* ❑ Building Under Construction* M/Finished Construction *A new Elevation Certificate will be required when construction of the building is complete C2. Elevations-Zones Al-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,ARAE,AR/A1-A30,AR/AH,AR/AO. Complete Items C2.a-h below according to the building diagram specified in Item A7. In Puerto Rico only,enter meters. Benchmark Utilized- SU.rr6LIC_GILD( Vertical Datum: Indicate elevation datum used for the elevations in items a)through h)below. ❑ NGVD 1929 [iaNAVD 1988 ❑ Other/Source: Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. a) Top of bottom floor(including basement, crawlspace, or enclosure floor) [feet ❑ meters b) Top of the next higher floor FI1?s( FLozR-- I �� [f feet ❑ meters c) Bottom of the lowest horizontal structural member(V Zones only) -) ❑ feet ❑meters d) Attached garage(top pf slab) _ ❑ feet ❑ meters e) Lowest elevation of machinery or equipment servicing the budding �� �7 M"feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent(finished)grade next to budding(LAG) 4 . [feet ❑ meters g) Highest adjacent(finished)grade next to building(HAG) !3 . 7! []feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including VA ❑ feet ❑ meters structural support SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION This certification is to'be signed and sealed by a land surveyor, engineer,or architect authorized by law to certify elevation information. I certify that the information on this Certificate represents my best efforts to interpret the data available. /understand that any false statement may be punishable by fine or imprisonment under 98 U.S. Code, Section 900 Were latitude and longitude in Section A provided by a licensed land surveyor? RrYes ❑No ❑Check here if attachments. Certifier's Name License Number L 4v�c� Al- YIJES �o i 25 Title �¢ L I G4g52!JP 44,kii? SvP-Y�t- OP— �.- Company Name�� IAC L� !-�CY•<1�5 / 1.117 sv,�Zv.�yO/2.5 i`� �. � ' ' `` d, s, Address � 3"Y P, t'I�� e �zr H 1 City State ZIP Code Sign ture Date Telephone %s�i" y a I pages of is on Certificate and all attachments for(1)commlinity official,(2)insurance agent/company,and(3)building owner. Comments(include g type of equipment and location, per C2(e), if applicable) POffO)k OF P.x31 L64 A4(ZK KIM&- ggm a�-- 1.4-7 301 ialk OF Fl Fcp4c Pnua- i�L= '�- �IC�"f5 ,►�F'G SIv1�I�Flt.� M��t- IS�o-�(� V,-Ci 1 A, (0,LE2A E of zz;z-�, C- .L G FEMA Form 086-0-33(7/15) Replaces all previous editions Form Page 2 of 6 f t ELEVA�f➢®� ����������� OMB No 1660-0008 Expiration Date November 30,2018 IMPORTANT: In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address(including Apt, Unit, Suite, and/or Bldg No.)or P.O. Route land Box No. Policy Number: City State ZIP Code Company NAIC Number ,G d S� rot `1�1L 119 S(o SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFE), complete Items E1-E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B,and C. For Items E1-E4, use natural grade, if available Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade(HAG)and the lowest adjacent grade(LAG). a) Top of bottom floor(including basement, crawlspace, or enclosure)is ❑feet ❑meters ❑above or ❑below the HAG. b) Top of bottom floor(including basement, crawlspace, or enclosure)is ❑feet ❑meters ❑above or ❑below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages 1-2 of Instructions), the next higher floor(elevation C2.b in the diagrams)of the budding is ❑feet ❑meters ❑above or ❑below the HAG. E3. Attached garage(top of slab)is ❑feet E]meters E]above or ❑below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ;` ❑feet ❑meters ❑above or ❑below the HAG. E5. Zone AO only: If no,flood depth number is available,is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A(without a FEMA-issued or community-issued BFE)or Zone AO must sign here.The statements in Sections A, B, and E are correct to the best of my knowledge. Property Owner or Owner's Authorized Representative's Name ------------ -------------- - --- ------ --- ------- ------ -- - - Address City State ZIP Code Signature Date Telephone 1 Comments A ❑Check here if attachments. FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 3 of 6 1 _l EL[ VAT�®� ����������� • OMB No. 1660-0008 Expiration Date- November 30,2018 IMPORTANT: In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Budding Street Address(including Apt, Unit, Suite, and/or Bldg No.)or P.0 Route and Box No. Policy Number. 2-�v�� J�C-iCSOJI�- ���T City State ZIP Code Company NAIC Number SECTION G—COMMUNITY INFORMATION(OPTIONAL) Flocaloffflicial who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete C(or E), and G of this Elevation Certificate. Complete the applicable item(s)and sign below.Check the measurement G8—G10. In Puerto Rico only,enter meters. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer,or architect who is authorized by law to certify elevation information.(Indicate the source and date of the elevation data in the Comments area below.) G2 ❑ A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE) or Zone AO. G3. ❑ The following information(Items G4—G10)is provided for community floodplain management purposes G4. Permit Number G5. Date Permit Issued G6. Date Certificate of Compliance/Occupancy Issued G7. This permit has been issued for. ❑ New Construction ❑ Substantial Improvement G8. Elevation of as-built lowest floor(including basement) of the building. ❑ feet ❑ meters Datum G9. BFE or(in Zone AO)depth of flooding at the building site: ❑feet [] meters Datum G10. Community's design flood elevation. ❑feet ❑ meters Datum r Local Official's Name Title Community Name Telephone Signature Date Comments(including type of equipment and location, per C2(e), if applicable) JA, ❑ Check here if attachments. FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 4 of 6 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE See Instructions for Item A6. Expiration Date: November 30,2018 IMPORTANT:In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address(including Apt., Unit, Suite,and/or Bldg. No.)or P.O. Route and Box No. Policy Number: 2-WA- s-ZEEZ-t City State ZIP Code Company NAIC Number AIEW SL1FFo� K"y 19 If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken;"Front View"and"Rear View"; and,if required,"Right Side View"and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents,as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. ( fliflff��ffffi .�' III�IIIIIIII Illlliiliillllll - I _ XN _�inuununu numnu ._.. � ,p. k Pno[o One Photo One Caption VII�sA4 to 11 ZaX f _ rnoto Iwo Photo Two Caption v,( (p' 17 Z 111 FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 5 of 6 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE Continuation Page Expiration Date: November 30,2018 IMPORTANT:In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No. Policy Number: 2Udl 1 AUC5zXA City State ZIP Code Company NAIC Number )1t7ic1 �Jw cLtL A16kL— I I%'Iv If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and 'Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents,as indicated in Section A8. V ® t5ylje 1 Photo One Photo One Caption LSC FAOA& (DI) Z�11 ,I "IIII�IIIIIIIIIIIIIIIIIIIIIIIII Photo Two Photo Two Caption PJGLV( SIDE FA41",J& FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 6 of 6 'OF SOLI Town Hall Annex Telephone(631)765-1802 54375 Main Road g 02 P.O.Box 1179 G Q ro endchertoW l.so6 5M.n .us Southold,NY 11971-0959 �O j ly�4UNi`1,�� BUaDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: ����o,�,s, Mc - Date: S— o— \- Company Narne: Name: ���� '- License No.: Address: 3S �S �o�wSbv� S�v - Cs2orS `� \\S—f Phone No.: 5-1-�Z) O I JOBSITE INFORMATION: (*Indicates required information) *Name: *Address: *Cross Street: *Phone No.: Permit No.: E Tax Map District: 9000 Section: Block: Lot: _ I *BRIEF DESCRIPTION OF WORK(Please Print Clearly) (Please Circle All That Apply) f *Is job ready for inspection: YES kNjo Rough In Final *Do-you need a Temp Certificate: ES NO j Temp information (if needed) 'Service Size: Phas 3Phase 700 150 200 300 350 400 Other l *New Service: Re-connect Underground Number of Meters% Change of ServiceOverhead Additional Information: PAYMENT DUE WITH APPLICATION i 82-Request for Inspeefion Form I � (n l �� . 90 f N/F VICTORIA ` I j • S 83°51'E 50.7/ CM Fd. N - NZ , o . h • o 8.2 173 STUCCO STRUCTURE 13.5 25.6 W 74-� 262 17 I 0 1` WOOD FRAME Y 3 BUNGALOW U (ELEVATED ON 23.2 W O BLOCKS) tt = W J = 0 p -f--17.4 CL W 14.0 �27 16.2 LU O �0 71 .o a M N h sz Ci W O 2 STORY a y 4 a ti WOOD FRAME a ul '�' RESIDENCE U) O 30.3 62 (P) CELLAR Q I P Ftl ENTRANCE — N 830 51' W 50.66 Guarantees indicated hero on Shan rtri only to the person for whom t°9i a survey is prepared„ and on his behalf to the JACKSON S TREE title company, C overwental Agency, lending insfiktion, if listed hereon, and to the assignees of the lending institution. Guarantees are not transferable to additional imatutions or subsequent owners. TM 1000-117-09-31 - MAP OF SURVEYED 27 APRIL,1991 SCALE 1" = 20` CM Fd = Concrete Monument DESCRIBED PROPERTY : Found t'�authcr;z�e: o!7�r.Nficn or addition to this I P Fd = Iron Pipe Found SITUATE 3L'rny i5 a vicicsri:n of Section 7209 of HAMLET OF NEW SUFFOLK tl:® Now York State Education Law. TOWN OF SOUTHOLD, SUFFOLK COUNTY, N.Y. SURVEYED FOR: GEORGE 4 LAURA MAUL GUARANTEED TO COpies of this survey map not bearing SURVEYED BY STANLEY J ISAKSEN, JR GEORGE LAURA MAUL the Land Surveyors embossad seal shall P•0. BOX 294 TICOR TITLE GUARANTEE Co. not bo considered to be a valid fru® N FOLK, N.Y., 11956 TOWN OF SOUTHOLD COPY. -5835 LIC D LAND RVEY R N.Y. LIC. NO 49273 91 R 456 DIST: 1000 SECTION: 117 BLOCK:' 9 TAX LOT: 31 SURVEY NO. 80686 TITLE NO. THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPER+!LINES TO THE STRUCTURES. ARE FOR A SPECL^C PURP05E AND USE. THEREFORE THEY A<E NOT INTENDED TO MONUMENT THE PROPERTY LINES OK TO GUIDE THE ERECTION OF FENCES. ADDITIONAL STRUCTURES OR ANY OTHER IMFROVEV,ENT O C� Z LO 30305PE m 50. 71 , J w in O + FE. 3'-0'+ o FRAME 6� — 3HED 4._1 E J 12' w w w �1 `J O 7'-32 25--1 2T o 0 w 2 STORY= zSTUCCO m Z ILI LL- FRAME- () i 71-104° LQ LQ WOOD RAMP 1 71-1 4 z 'a,' R OZ - I STORY g FRAME m F.FL.EL=7.45 a (POST OFFICE) W 7-2Z' 20-22° W " J O U� O a N 71-0 '1 EL=4.75 141 o Zm EL=4.90 7'-0 Cn O.H. o I6'-O° Ln O STORY FRM.-, z 2 DWELLING o 0 in F FLEL=1 1.29 N WOOD U RIDGE EL=38.10 PLAT WOOD 30-I hT. 5'-7° (-Y LOG HT. 51-2" _I'Tl EL=4.85 EL=4.8561-22 q I 1 II II 11 t - w w EL=4.70 50.6E 1 EL=4.97 ~ N83°51 ' W TCEl=4.85 EDGE OF ROADWAY EL=4.35 5CEL=4.30 +EL=4.10 CL + EL=4.05 CL JACKSON STREET MAP OF PROPERTY ISLAND WIDE LAND SURVEYORS SITUATE AT j` D �05 NF 5UF�0`�K 199 LAFAYETTE DRVE5Y0 ET, NY11791 TOWN OF SOUTHOLD tNE: I-866-808-5500 FAX: 5 16-496-1 DD 792 SUFFOLK COUNTY, N. Y. J U L 1 9 2017 RECORDS OF WALTER I.BROWN,GUSTAVE A.ROULLIER ,ROBERT A-HAYNE5 UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY 15 A VIOLATION OF { 't SECTION 7209 OF THE NEW YORK STATE 5URVEYED : JUNE 17, 2017 �T �� �DEW. " •� EDUCATION LAW COPIES OF TH15 SURVEY MAP NOT BEARINGB,]� +T THE LAND 5URVEYOR'5 INKED SEAL OR GUARANTEED TO �� 9 1 �C Tj� � � EM5055ED SEL SHALL NOTBE CONSIDERED _ TO BE A VALID TRUE COPY. '' '-GUARANTEES OR OR CERTIFICATIONS INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY 15 PREPARED, AND ON H15 BEHALF TO THE TITLE COMPANY, - GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON, AND TO THE LOT NUMBERS: ASSIGNEES OF THE LENDING INSTITUTION -' `_"• ' " GUARANTEES OR CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR 5UB5EQUENT OWNERS DRAFTED BY BRIAN G. `" D15T: 1000 SECTION: 1 17 17377 9 TAX ITT: 31 SURVEY NO. 60686 TITLE NO. THE OFFSETS OR DIMENSIONS 5HOWN HEREON. FROM THE PROPERTIUNES TO THE STRUCTURES. ARE FOR A 5FECI--C FURPOSE AND USE THEREFORE THEY 4ZF NOT INTENDED TO MONUMENT THE PROFERTY LINES OR TO GUIDE THE ERECTION OF FENCES. ADDITIONAL STRUCTURE5 OR ANY OTHER IMPROVEN,ENT O Z 5 5305 VELo m 50. 71w + FRAMME a, 12' w w I' 1 w Q^I u3 Q 17'-3 " 25'-14.. o O O z 3TU�O9 Q °- FRAME- 7-104 LQ, LV k WOOD RAMP 1 1 Z J QVI I STORYoZ M1,' � Ju FRAME m s F.FL.EL=7.45 ca (POST OPFICt 7'-22' 26'-22 w " d U p O EL=4.75 14`-�14° EL=4.90 O.H. O 10-0" 7LO' :;rLn Q O Q) 2 STORY FRMS` z DWELLING o g N FFL.EL=11.29 WOOD RIOGE EL=38.10 PLAT WOOD 30-]-.4L' HT. 5'-7'PLA HT. 51-2" EL=4.85 EL=4.85 , I, m mm 6-22 u� v FE. 1'-2" _ U U �• Lu ro EL=4.70 50-661 EL=4.97 ~ N83°51 ' W - EDGE OF ROADWAY TCEL=4.85 EL=4.35 BCEL=4.30 + EL=4.10 CL + EL=4.05 JACK50N STREET MAP OF 'MAT PROPERTY ISLAND WIDE LAND SURVEYORS r SfTUATE ATF _ V EW 5 u0 FOLK PROFESSIONAL LAND�CITY SURVEYORS �� 199 LAFAYETTE DRIVE,SYOSSET, N.Y. 11791 D PI10NE: I-866-808-5800 FAX: 516-496-1792 roWN o�Sourllolo � RECORDS OF WALTER 1.BROWN,GUSTAVE A.ROUWER SUFFOLK COUNTY, N. Y. ry q JUL L 1 9 201 7 ROHERT A.HAYNE5 UNAUTHORIZED ALTERATION OR ADDITION F• '` SECTION 209OFITHE NEWYORKSTATE SURVEYED JUNE l7, 2017 �pr�y EDUCATION LAW - BUILDING DEP ge •ti r COPIES OF THI5 SURVEY MAF NOT BEARING �• -��r THE LAND 5URVEYOR'5 INKED SEAL OR GUARANTEED TO TOWN'��' ®�'�` ®y"D EM 5055ED A SHALL NOTE°CONSIDERED TO BE A VALID TRUE COPY — - GUARANTEES OR CERTIFICATIONS INDICATED HEREON SHALL RUN ONLY TO THE PER50N FOR WHOM THE SURVEY 15 FREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING , INSTITUTION LISTED HEREON, AND TOTHE LOT NUMBERS: ASSIGNEES OF THE LENDING INSTITUTION. - _ GUARANTEES OR CERTIRCATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR 5U55EQUENT OWNERS. _ DRAFTED BY BRIAN G. L-2 TOWN OF SOUTHOLD PROPERTY RECORD CA-RD OWNER,-, STREET VILLAGE DISTRICT SUB. LOT S77— )Ve V 7a: F'ORMED OWNER N E ACREAGE T S 1 W TYPE OF BUILDING loo7 /10-�,4 KJ, J 4 4XA 6 0- VL. FARM comm. IND. CB. MISC. Est. Mkt. Value LAND IMP. TOTAL DATE REMARKS // d C, r-4-- 041(Z 24U FCFL 7 b (j Y,r!t x I- 34 0 P Cl VJ1 o. )-I I all 4,ag- .1, (El r,2 P' //Asbt2 (000s� Ue-vnior'?5 / f ✓ 7 o o 21700, Z )-(i DO 17 19.�,-)3 P c-,o k,S4, L--(-p va� 00 31900 9 27o S 7(� uj) 7,00 1 ov)4 -74;C, 1,4 AGE BUILDING CON .Ecj nn /ITIq - 19 �Z-�, f--�w% W7 00 0 90"< CC - 'cM4 NEW PM%o BEL ABOVE FRONTAGE ON WATER Pt v a a ivre, -rf Form Acre Value Per Acre Value FRONTAGE ON ROAD % ,oN Tillable I BULKHEAD t - Tillable 2 i OC 111Rkn 0*33567 &P; 3i31N Tillable, 3 10b&/(9-7-L- 125F5D 0?)-/- -nifilif -4-0 qlau( (C- vVoodland re,010,ce-s 803361z 'e" 57 Swampland ol nh-q,-6 37,T'10 -"if-vloce5,:746: �W,? / Hou.m. Total say...,?,.a ,'a� !� 1 � -r _- � ` � , 1 '?,�t�} �t�l }!tl .rT�S; '`�' 3.��-e. - - ,■■.■■�_.■ t gy MOEN %t moommommmmmmmmoom low REMOMMEMEMEM ., . EMEM■■■■.■.■■■■■■ ■■■■■■■■■■■■■■■■■ ONE -- i®Esmmm®mm■ •• e BR • t • ' � t D [EC[EoV[E DD JAN 2 7 2017 BUILDING DEPT. TOWN OF SOUTHOLD 7� L VO a vi' It �3l G$S6¢897 12/22/20 GERTIF'ICATE OF LIABILITY INSURANCE I' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE; DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BV THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BEYWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the Policy((es)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the poricy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the Certificate holder in lieu of such endorsentud(s). OONTACT PRODUCER NAM Lorraine Bruno W-N. Tuscano Agency Inc. PHONE 631-864-0363 alc No 631.864274 p0 Box 1027, 950 gi.ghland Ave, Ibruno.bagat01@Ins remail.net GREENS13URG PA 15601 AD >ass INSURER($)AFFORDING COVERA08 NAIQS INSURERA:Essex Insurance Company 39020 INSURED INSURERS:Philadelphia Indemnity Insurance Company 12537 Advanced Builders & Land INSURERC! Development Inc. INSURERD: 400 Oser Avenue HAUppAUGE NY 11788 INSURERE INSILRFR F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE I'OLWCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY RI=QUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER poCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICES DESCRIBED HEREIN IS SUBJECT T4 ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POUCIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSK 7ypeOFRCAXV OE sR POLICY NUMBER MMID MID L ' GENERAL LIA LITY x 3EGS631 11106/2016 9'1 1pBJ2017 EACH occuRRENCE S1,000,000 A 1C CQMMERGIALGENERAL LIABILITYP DAISES oocunaL- $100,000 MED EXP CLAIMS-MADE L,-,OCCUR (An One Pacson $5,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2, 0 0 0,0 0 0 PRODUCTS-COMP)OPAGG $2,000,000 GFN L AG43REGATE LIMIT APPLIES PER- $ X p0lICY0 LOC M61NE NGLELI T AUTOMOBILE LI)WILITY BODILY IN.IURY(Pe*Parson) $ ANY AUTO BODILY INJURY(PemccidenQ $- ALLOWNED SCHEDULED AUTOS Na"vovuNED PERTY AMAGE S ra HIRED AUTOS AUTOS S uMBR��A LIAR X OCCUR PuB561654 11106/2016 11/06120171 EACH occuRRswm 3,0 001000 aGORE6ATE 53,000,000 B X E7CCE95 LIA9 CLAIMS•MA135 S DED Ft1+fENTIONS WCSTATU- OTH- WORKERS COMPENSATION AND EIAPLOYERS U45M Y YIN EL.EACH ACCIDENT $ ANY OFFlPCERlME!DF�O R EXCLUDED? E EINE❑ N 1 A E L DISEASE EA E7w1PLD $ (Mandatory in Eyyaaeede��,e � EL.DISFASE-POLIGYLlMTf 3 DESCRIFnONPERATIONS ba$Pw pE3CR1PnON OF OPERATIONS I LOCATIONSr VOIICLES(Attach ACORD 101,Addldonal Remarks sagdula,tP more epaci!is reQu'ned) Contractors - Executsve Sts.or Executive $uperintendents. products-completed operations are subject to rhe General Aggregate Llmlt. As pertains to insureds OE bjectnto the terrmsfandtconditionssofithedpooli_cyaitional Insured P CERTIFICATE HOLDER CANCELLATIOtIF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE ExpIRATION DATE THEREOF, NOTICE WLLL BE DELIVERED IN ACCORDANCE WITH THE POLICY PRo1RSIONS- TOWN OF SOUTHOLD 53095 ROUTE 25 AUTHOROWREPRESENTATM ,, P-0. BOX 1179 SOUTHOL , NY 11971 chi 1988,2010 ACORD CORPORATION. All fights reserve< ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD i ENew 'York State Insurance Fund Workers'Compensation A Disability Beneflis Specldists Since 2914 iI a CORPORATE CENTER DR,3RD FLR,MELVILLF,NEW YORK 11747-3129 1 CERTIFICATE OF WORKERS'COMPENSATION INSURANCE (RENEWED) i AAAA"" 203591812 OAK �fr 0 TINGO INSURANCE AGENCY INC • 3771 NESCONSLT HWY STE 210 L SOUTH SETAUKET NY 11720 , Soan to Validate POLICYHOLDER CERTIPICATE HOLDER ADVANCED BUILDERS AND TOWN OF SOUTHOLD LAND DEVELOPME=NT INC 53095 ROUTE 25 400 OSER AVENUE SUITE 2300 P.O.BOX 1179 HAUPPAUGE NY 11786 SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DAT1= 12194025-9 56087 02112/2017 TO 02!12/2018 1!?_312017 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO, 2194025-9, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, ANO, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY, IF YOU WISH TO RECENE NOTIFICATIONS REGARDING SAID POLICY.INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS:IAAMAN.NYSIF•,COWCERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS THIS CERTIFICATE IS ISSUED A$ A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE INSURANCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER:938715804 U-25.3 Yi7 workers' CERTIFICATE OF INSURANCE COVERAGE STATE Compensation UNDER THE NYS DISABILITY BENEFITS LAW Board PART 1. To be completed by Disability Benefits Carrier or Licensed Insurance Agent of that Carrier 1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured ADVANCED BUILDERS&LAND DEVELOPMENT INC. 6317750405 400 OSER AVENUE,SUITE 2300 HAUPPAUGE,NY 11788 1 r.NYS Unemployment Insurance Employer Registration Number of Insured PENDING Work Location of Insured(Only required if coverage is spe0cally limbd to id.Federal Employer Identification Number of Insured or Social Security certain locations in Nero York State,i.e.,a Klap-Up Polito Number 20.3591812 2,Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Standard Security Life Insurance Company of New York TOWN OF SOUTHOLD 53095 ROUTE 25 3b.Policy Number of Entity Usted In Box"1 a" P.O.BOX 1179 1101312-000 SOUTHOLD,NY 11971 3c.Policy effective period 1/1/2014 to 1 212112 01 7 4.Policy covers: QX A.All of the employer's employees eligible under the New York Disability Benefits Law B.Only the following dans or classes of employer's employees: Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carder referenced above and that the named Insured has NYS Disability Benefits insurance Coverage as described above. AA- Date Signed 12/22/2016 BY (Sisaamre of insurance camel's autltorin4 resp at&or NYS Lieeased Insurance Agent of that insurance ounce) Telephone Number (212)355-4141 Title SUPERVISOR-DBL/POLICY SERVICES _ IMPORTANT: if Sox'49"is Checked,and this form is signed by the insurance carrier's authorized representative or NYS Licensed Insurance Agent of that carrier,this certificate is COMPLETE.Mail 4 directly to the certificate holder. If Box 411"is checked,this certificate is NOT COMPLETE for purposes of Section 220,Subd.a of the Disability Benefits Law.It must be mailed for Completion to the WodkenO Compensation Board,DB Plaits Acceptance Unit,328 State Street,Schenectady,NY 12305 PART 2.To be completed by the NYS Workers'Compensation Board (Only if 13ax'14b"of Part 1 has been checked) State of New York Workers' Compensation Board According to information maintained by the NYS Workers'Compensation Board,the above-named employer has complied with the NYS Disability Benefits Law with respect to ad of his/her employees. Date Signed _ By - Signature ofNYS Woftre Compmwtioo hoard rmproycc) Telephone Number Title Please Note: Only insurance carriers licensed to write NYS disobiflty benefits insurance policies and NYS licensed insurance agents of those insurance carriers are authorized to issue Form DB-120.7_ Insurance brokers are NOT authorized to issue this forret. DB■120.1 (94 5) Additional Instructions for Form D13a120.1 By signing this form, the insurance carrier identified in box"3"on this form is certifying that it is insuring the business referenced in box"1a"for disability benefits under the New York State Disability Benefits Law,The Insurance Carrier-or its licensed agent will send this Certificate of Insurance to the entity listed as the certificate holder in box 7'. Will the carrier notify the certificate holder within 10 days of a policy being cancelled for non-payment of premium or within 30 days if cancelled for any other reason or 9 the insured is otherwise eliminated from the coverage indicated on this certificate prior to the end of the policy effective period? ©YES , ONO This certificate is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend, extend or alter the coverage afforded by the policy listed,nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Disability Benefits contract of insurance only while the underlying policy is in effect. Please Note:Upon the cancellation of the disability benefits policy indicated on this form,if the business continues to be named on a permit,license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of NYS Disability Benefits Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Disability Benefits Law. DISABILITY BENEFITS LAW §220. Subd. S (a) The head of a state or municipal department, board, commission or office authorized or required by law to issue any permit for or in connection with any work involving the employment of employees in employment as defined in this article, and not withstanding any general or special statute requiring or authorizing the issue of such permits, shall not issue such permit unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair,that the payment of disability benefits for all employees has been secured as provided by this article. Nothing herein, however, shall be construed as creating any liability on the part of such state or municipal department, board,commission or office to pay any disability benefits to any such employee if so employed. (b)The head of a state or municipal department, board, commission or office authorized or required by law to enter into any contract for or in connection with any work involving the employment of employees in employment as defined in this article and notwithstanding any general or special statute requiring or authorizing any such contract, shall not enter into any such contract unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair,that the payment of disability benefits for all employees has been secured as provided by this article. DR420.1 (9. 6)Reverse G956469Y�r,r� � �#I�ORI� CERTIFICATE OF LIABILITY INSURANCE 017/20/2016 THIS CERTIFICATE IS ISSUED AS A UATTI:R OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR'ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES KUY CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder la Rn ADDITIONAL.INSURED,the policy(fes)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain potldas may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CON NONE Lorraine Bruno 1027, W.N. x Agency Inc:. RIONN 631-864-0363 x 631.864.8274 Po sox oz� 950 Highland ave- GREENSBURG PA 15601 ,oM6 IbrUno.ba at01 Q Insuremail.net INSURERS AFFORDING COVERAGE MAIC-4 INSURER A.ESSOX Insurance Company 39020 INSURED INSURER B-Philadelphia Indemnity Insurance CDmpany 12537 Advanced Builders & Land Development Inc. INSURER C. 400 Oser Avenue INSURER D; HAUPPAUGE NY 11788 INSURERE; INSURER F; COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LIS'T'ED$FLOW HAVE BEEN ISSUPA TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,TM15 INSURANCE:AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH PQUCIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID OLAIMS. NVFR SRYYPEOFINBURANCE POLICYNUM Ot MMI D!Y LIMITS UL 01JOK GENERAL UABILITY X $EG8631 11/06/2018 11108t2017 EACH OCCURRENCE $1,000,000 A 7G COMMERCIAL GENERAL LIABILITY PRaism IE. urmni 1 $100,000 CLAIMS-MADE I A I OCCUR MED Imo.'(Any cine man) s5,000 PERSONAL&ADV INJURY $7.,000,000 GENERAL AGGREGATE $21000,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS.cOMPIOP A8G s2,000,000 X POLICY PRO LOC $ AUTOM0315 LIABILVY art ANY AUTO BDDILY INJURY(Pei pefBon) $ ALL AUTOS OWNED AUTOSULSD BODILY INJURY(Pet acddert) S FARED AUT05 ANWrPW@ra'YnlDlAMAM a S UMBRELLA LIAB $ OCCUR PU6561654 11/06/201811108/x017 EACH OCCURRENCE 63,000,000 S X EXCMUAS CLAIW-MADE AGGREGATE $31000,000 DED I I RETENTIONS i VIORKERS COMPRNSATtONTyffAlIr AND EMPLOYIRS LIABILITY YIN ANY PROPRIETOR]PARYNEREXECUTIVENTA EL.EACH ACCIDENT S QFFIC(MandE>fty In NM)EXCLUDED? E L.DISEASE-EA EMPLOYEE S If yes,dwuW under DESCRIPTION OF OPERATIONS below EL.DISEASE.POLICY LIMIT $ DESMPTION OF OPERATIDNS]LOCATIONS]VEHICLES(Alf2eh ACORD 101,Addidennl Remefke Sebedule,Mnee lefequlmd) Contractors - Execgtive Supervisors or Executive Super znTendehts. Products-completed operations are subject to the General Aggregate Limit:. As pert:ai4a to insureds opergtions, the certific to h Jdgr is listed a Additional insured ae per written contract, subject to the terms and conditions of the policy. Job Looation-2665 Jackson St, New Suffolk, NY 11956 CERTIFICATE HOLDER CANCELLATION SHOULDANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE Wl" Ill; DELIVERED IN Town of SOUthhold ACCORDANCE WITH THE POLICY PROVISIONS. 653905 Rout®5 AUTHORIZEDREPRESENTATIVE P4Box 1179 Southold f1JY 11971 (D1988,2010 ACORD CORPORATION, AN rights reserved. ACORD 26(2010105) The ACORO name and logo are registered marks of ACORD ADVAND5 OP ID:LB �►( R'�� CERTIFICATE OF LIABILITY INSURANCE R �27jzo�s I THIS CERTIFICATE 15 ISSUED AS A MATT'tER OF INFORMATION ONLY AND CONFERS NO RkGHTS 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 CONSTIYUr A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED _ REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an AD017IONAL INSURED,the policypes)must'be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the•polley,certain policies may require an endorsement A statement on this certificate does not confer rights to the certtticate holder In lieu of such endorsement(s). PRODUCER NtQT MEA Iia atta Associates,Inc, 9a atta Associates,Inc, P9099 63i 8134-1111 A No,:631.964-8274 823 W Jericho Turnpike Ste 1A C Smithtown,NY 11787 ADDRESS: watta Associates,Inc, INSU S AFFORDING COVERAGE NAIC 0 I INstNRENaA:The Usli companies INSURED Advanced Builders and Land MUMS: Development Inc t*URERI:: 400 Oser Ave Hauppauge,NY 11788 Lus(raea°7 INSURER E: r =REB P: COVERAGES CIERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFYTHAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED 70 THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTM RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN is SUBJECT TO ALL THE TERMS, EXCLU$ICNSAND CONDITIONS OF SUCK POLICIES.LIMITS SHOWN MAYHAVE BE9N REDUCED BY PAID CLAIMS. -POLICY EXP NPE OP INSURANCEAu" POLICY NUNWR MMlDD JqMIDONYYYIL1NRB 99MNERCIAL GENI=RAL LIABILITY EACH OCCURRENCE S CL14IMS•MAOE MOCCUR PREMISEQe S MED M(Any ane Parson S PERSONAL&AOV INJURY $ GEMLAGGREGATE LIMIT APPLIES PER: 6ENERALAOOREGATE S PCUCY 17 Toe a LOC PRODUCTS-COMPIOPAGG- E OT)JER• $ AUrOMOSILELIABILRY -d6mimm Sl S Ea arddent ANY AUTO BODILY INJURY(PIWOF1001 S NOO SCHEDULED @DOILY INJUtRY(Por taaenO S AUTOS UOp �D PHIASOAVr0s AM7 S _ s X UMaAMJ A LID$ X OCCUR EACH 00CURRENCE t 5,DOO,D00 A EXCESS CLAIMS-MADE L157R Oli1D8IZD16 06(OB1Y017 AGGREGATE S 5,DOO,DO DEp RETENTION S S WGRKERS COMPENSATION STA UTE ER Are]EMPLOYERS'LUIBILITY TF AW PROPRIETDRIPAMMWENECUTIVE YIN NJA EL.EAC;HACCIDENT S (MICEPiMeAm x d dwy E ,UI>kD9 G.L.DISEASE-EA EMPLOYEE s I�yyaa=,dapmhpundar DESCAIPTIONOFOPERATIONSbelow HL.ONSEASEE-POI CYUNIT t DESCRIPTION Or OPERATIONS ILOCAMONSIVIACLE8CACORD 101,Aftflooaf"Llke Schedule,way b.aftdchod R mors spies Is riqukod) .lob Locaiton:2665 Jackson Sk Now Suffolk,NY 11956 As pertains to Insured's operations,the certificate holder Is listed as additional insured as per written contract,subject to the terms and conditions of the policy. CERTIFICATE CANCELLATION TOWNS01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIt38 OR CANCELLED$EFOI2E THE EXPIRATION DATE THEREOF, NOTICE WILL Be PKIVERIED IN Town of Southold ACCORDANCE WITH INE POLICY fROVIs14NS. 53095 Route 25 PO Box 1179 AUTHORIYED REPRESENTATIVE Southold,NY 11971 1999-2014 ACORD CORPORATION. All rights reserved, ACORD 25(2014101) The ACORD name and logo aro registered marks of ACORD New Roark State Insurance Fund • Workers'Comperrsatio�x sPc Alspbll/ty,BQ�efifs�peclarltSfs SY►tCe I9I� 0 CORPORATE CENTER DR,3RD FLR,MELVILLE,NEW YORK 11747-3129 CERTIFICATE OF WORMERS' COMPENSATION INSURANCE . E wAAAAA 2p3591B12 TINGO INSURANCE AGI=NCY INC 3771 NESCONSEf HWY STE 210 SOUTH SETAUKETNY 11.720 Scan to Validate POLICYHOLDER CERTIFICATE HOLDER ADVANCED BUILDERS AND GEORGE MAUL LAND DEVELOPMENT INC 2865 JACKSON ST 400 OSER AVENUE SUITE 2300 NEW SUFFOLK NY 11956 HAUPPAUGE NY 11788 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE 12194 M-9 9185559 02/12/2016 TO 02/12/2017 12127/2016 THIS 1S TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO, 2194 025-9, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSA110N 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 YOU WISH TO RECEIVE NOVFICATIONS REGARDING SAID POLICY,INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS:INWVW.NYSIF.COWCERT/CERTVALASP.THE NEW YORK STATE INSURANCE FUND 13 NOT LIABLE IN THE EVENT OF FAILURE 70 GIVE SUCH NOTIFICATIONS, THIS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER, THIS GEIRTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE INSURANCE FUND U DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER:437124385 U-26.3 e"NEW VOR Workers' CERTIFICATE OF INSURANCE COVERAGE Board ars Compensation UNDER-THE NYS ,DISABILITY BENEFITS LAVH B ' PART 1. To be completed by Disability Benefits Carrier or Licensed Insurance Agent of that Carrier 1 a.Lagal Name&Address of Insured(use street adolms only) 1b.Business Telephone Number of Insured ADVANCED BUILDERS&LAND DEVELOPMENT INC. 6317750408 400 OSER AVENUE,SUITE 2300 HAUPPAUGE,NY 11788 1c,NYS Unemployment Insurance Employer Reglstration Number of Insured PENDING Work Location of Insured(Only regcdmd it Coverage is speciNcally 11adied to 1tl Federal Employer Identification Number of Insured or social Security certain locatioes M New York State,i.e.,a Wrap-Vp Poiky) Numtrer 20.3591812 2.Name and Address of Entity Requesting Proof of Coverage 391,Name of Insurance Canter (Entity Being Listed as the Certificate Holder) Standard Security We In5uraftm Company of New York GEORGE MAUL 2565 JAGKSON ST 3b,Parry Numbar of Entity Listed in Box"1a" NEW SUFFOLK,NY 11856 Rb7312-000 3c.Policy effective period 1/112014 (a 1212812017__ 4.Policy covers: Q A.All of the employees employees eligible under the New York Disability Benefits.Law S.Only ft fogoW ng class or classes of employer's ernpWpes- Under penalty of padury,i certify that I am an authorized representative or licensed agent of the insurance carrier raferenced above and that the nanmetl Insured has NYS Disability Benefits Insurance coverage a6 described above. Date Signed 12127/2016 BY AA- a. (9igaatin of fiam=oe auniere au*ocim nTrwBn a or NY9 Lieeoaed[nsaroaee Agent ofthet insurance canna). Telephone Number (212)855-4141 Title SUPERVISOR-DBUPOUCY SERVICES IMPORTANT: If Box°4a"Is checked,and this form la signed by the insurance caulaes authorized representative or NYS Licensed Insurance Agent of that carrier,this certificate Is COMPLETE Mail it dint, to the certificate holder. If Bmr 114b"is checked,this certificate Is NOT COMPLETE for purposes of Section 220,Subd.8 of the Disability 8anefdo Law,N must be mailed for coriVletloon to ft Workers'Compensation Board,D8 Plans Acceptanoa Unit,328 State Street,Schenectady,NY 12306 PART 2.To be completed by the NYS Workers'Compensation Board(only it Box 114b"of Part 1 has been checked) State of New York Workem' Compensation Board According to information maintained by the NYS Workers'Compensation Board,the above-named employer has complied with the NYS Disablity Benafrts Law with respect to all of his/her employees. Date Signed ay gipstuco of NYS Warkete Compowhoa aoctit Fmpleyes) Telephone Number Tiuo Please Note:Only Insurance canters lkensed to write NYS disability benaft insurance policies and NYS lkensed insurance agents of fhoso insurance carriers are authorized to issue l=ean OB-120.1. firsumace brokers are NOT authorized to Issue this form. 176120.1 (8.16) - Ilii\r' _"4m49 ef . � s 3 �°@ eo r u uAa b� fir. a �nb ��s •a. ..p„r @ ° �" esr� 5�s t ah B ���3 �r, 1' 0 S� r7,p 'p r „�Gntn-^�ils:,�Yr.�4� ,,..mdns3".r,."s;,�,��a>:D �.-e�v;,-, ;� i •i. t �, ,.-•—,=-�..� �i r,�� :,�-...;,� /�' ' 1�1'`' rte. {1��\�`�,�, `S9 .o"q�3i«fiSY�tx'£a),F4 .R"z^,3�TtlX7S:5¢L55e_itCl.°2'i;' t�Al�x•Y'2�2'q.9t^avJ?a`x�,`�zg;�n7z2d�a55off+&Y��•��'G,SSAtats'CtuLVS�v rJ�SSt2�,'2.'4:1RA.fiJR.�LLY�I�T�;nsCd�b\'�2�'t2�:`".;+,. 5�".sK•ftp+x'T°�'"�A;!fi�'65TGe�;C�:'L�v+"S'�?.x36���sM.�xx"G�.. .44ersl.3i^:tEe.'97^,�'.y, f�?, h;±I, r � f- Suolk Count f Department o Labor/ iiLcensn & t Ba;do ff eo s� a�Y Consumer Affairs rvs �t VETERANS MEMORIAL HIGHWAY * HAUPPAUGE, NEW YORK 11788 }' DATE ISSUED: 3/13/2017 `'�• No. 58213-ME SUFFOLK COUNTY f' Master Electrician License �B This is to certify that WILLIAM C MURDY doing business asa arc' MRS21 CORP DBA .;\ ., • .: having given satisfactory evidence of competency, is hereby licensed as MASTER ELECTRICIAN in accordance with and subject to the provisions of applicable laws,rules and regulations of r the County of Suffolk, State of New York. @ Additional Businesses �" 6 ' - MISTER SPARKY (: NOT VALID WITHOUT yy `` DEPARTMENTAL SEAL AND A CURRENT J u gr CONSUMER AFFAIRS ID CARD Commissioner Pilr t goX�p r 7 b@�.�i f Y. �3,{ ,fi= �t�'.AEa�'^it8Xf7�LX45i,Sfi2drit2MS;uY••'USi`F 'N'XFfi"u7A�i1iFP�P`?;.i.c' X�ei,'X^i„�f1Yt}5ka�7iM3iu"'$Ra.eYSReGxYiAh.4.0 `bXi+Y�Ythk'EV/.+7kt/A)�$e"nl`hi:•/d:;�z" '3'"—;"i,•3d)IYdA${%��1VPS3.[GSl7.l,Sir,`V�3�fr3fd`si$.S�SR�fiMu"•�(ll4i n'.itS;i@+5'fi'.fCv'C- X�5'ulr� s�Ca�ivvrl'J`.�Y�f�ki Tf2'a"i W� YiG'64+d7ctb'V%is inXa"ln�unLaiAS'�`,�S`'> } '"3`5 _ r ry, °� 4�F�� `i,`_"'� �};yF°�w �s c��, ,,. ,���„ey>�y-4 i{e� 5y Lid �'+�i^''':Z� i' `i,. � ,.,t��!}(' 'tom"' ,+t ~� �• •�+��V r�.Y '' ' i�,'+��"i �RAY!% '�k ,�-�2•�� vrv�r'r"` M = 1 v�^rmn .a-��^;° ...,,.,,,or ��'Q�„�, .>, �.,� , y., i'�,, a C+xa e: A •P I` '$ !u?; 11. °a+>°•.,�.'� 4 hi°b '�I. �<+ 1 ra MURDELE-01 LLEVY AC�JR® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YWY) 05/31/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED f' REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. ' IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or 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 certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NRACT T Filos Agency Inc. PHONE FAX 814 W.Eseech Street (A1C,No,Ext)'(516)897-4546 (A1C,No)•(516)897-8920 E-MAIL tom filosa enc inc.com Long Beach,NY 11561 4 ADDRESS: .0--_-----g .-.Y.-_ _ _ ___ ----7 __ __ _ _ - I INSURER(S)AFFORDING COVERAGE —� NAIC# INSURER A Citizens Ins.Co of America 131534 INSURED INSURER B Wesco Insurance Co 125011- L----=- — - ---- ----—--- ------ - - - Murdy Electric Co.Inc.&MRS21 Corp.T/A Mister Sparky I INSURER Cs 3525 Lawson Blvd INSURER D' Oceanside,NY 11572 j INSURER E' (INSURER F. COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MM YY MMIDDIYYW A I X 'COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE is 1,000,000 CLAIMS-MADE X OCCUR ZBY 8920455 07 11/01/2016 11/01/2017 DRMAGETO RENTED i 100,000 X PREMISES(Ea occurrence) S 4 X Per Project Aggregat MED EXP(Anyoneperson) I s 10,000 PERSONAL&ADV INJURY_ I S 1,000°000 !GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE i S 2'000'000 POLICY 1 dECT !�LOC PRODUCTS-COMPJOP AGG I S — 2'000'000 i OTHER II ;S B [,A=LE LIABILITY COMBINED SINGLE LIMIT 1,000,000 UTO MPP1164079 02 11101/2016 11/01/2017 BODILY INJURY(Per person) )S OWNEDX SCHEDULED AUTOS ONLY AUTOS BODILY INJURY_(Per accident $ EE NN pp EEpp PROPERTY AMAGE (XZMA ONLY X AUR ONLY (Per ace dent — S �------ - UMBRELLALIAB '.'OCCUR EACH OCCURRENCE 'S ,EXCESS LIAB CLAIMS-MADE ! AGGREGATE S I DED I RETENTION$ Is WORKERS COMPENSATION1 AND EMPLOYERS'LIABILITY STATUTE EERH ANY PROPRIETORIPARTNERIEXECU I[VE Yi I EL EACH ACCIDENT Is OFFICERIMEMggER EXCLUDED? N f A i -- -- --------- -- ---- ---- (Mandatory in NH) E.L DISEASE- If yes,describe under -'- "EA EMPLOYEE S- '--' —T DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT 15 .y' I DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Advanced Builders&Land Development Inc.and Mr.George Mau(are named as additional insured as required by written and executed contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE of Southold THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town TownMain Road ACCORDANCE WITH THE POLICY PROVISIONS. Southold,NY 11971-0959 AUTHORIZED REPRESENTATIVE ��'�j' ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 4v 3 e New York State Insurance Fund Workers'Compensation d Disability Benefits Specialists Since 1914 199 CHURCH STREET,NEW YORK,N.Y.10007-110 CERTIFICATE OF WORKERS' COMPE N SATION INSURANCE �, p AAAAAA 112166032 �J - MURDY ELECTRIC CO INC � 3525 LAWSON BLVD OCEANSIDE NY 11572 Scan to Validate POLICYHOLDER CERTIFICATE HO DER MURDY ELECTRIC CO INC TOWN OF SOUHOLD 3525 LAWSON BLVD 54375 MAIN ROAD OCEANSIDE NY 11572 SOUTHOLD NY 11971-0959 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOb DATE G 539 671-8 104960 11/01/2016 TO 111/01/2017 5131/2017 yr" THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 539 671-8, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY,INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS://WWW.NYSIF.COM/CERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE INSURANCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER:423739371 U-26.3 13'-92" 16'-0" IIQ I Srart Vent II--- ----- --------1 1 I1 1 I ----- ------------------- 11 rnU (� 1 1 = I I Simpson TA18 M"'� 1 ear?Pocket 0 Pocket 1 1 Zo = I r--------- --- -------1 1 �' ° 1 1 tbN 1 I eam Rocket I I 1 W 1 11 I I I I --- -------1 I L_ 7'-32' -� I 1 1 Notes: II I I _ —J —ICMI I A The contractor is to verify all measurements in the field to assure that the new 7'-0" I M ' I I foundation walls will align with the building walls. Simpson LT 5 ( I earn Pocket I I p5„ g„ ,- 1„ I I 1 -All concrete 3,500 psi after 28 days minimum. Simpson BP I I ' 7016 7 216 8 O$ I Smart Vent 1 I I ' ' Smart Vent I I 2-All rebar ASTM A-615 Grade 60. 1 2'x2'x10" _(_ 3- Footings are to be installed at the same or deeper elevation qas existing on New 8"O Anchor Bolts I 1 I I 1 I 0 I I °' S-1 undisturbed virgin soil. Typical Wall and 5"OC in 8' End Zones 1 1 —— —-+-— t" Sill Strapping 29"OC in Interior Zones ``' I _I- Q I X x 3'x 10" I I 4- Rat slab is to be sloped to assure water drains to to nearest slab drain opening. Detail New 2x6 ACQ Sill& to I I 1 —— 112"x 12"Pier — , _ /w No. 5 Rebar 2'x 2'x 10" ( I Drain openings are to be 4"in diameter. C pper Termite Shield r I I 9"OC I I I I 1 1 5-All snap off form ties are to be removed and remaining openings are to be Fl r in � __ 12"x 12" Pier S Sao Proposed FF El. 8.8' —-- -- —-- -- -- --— y kcal sealed/grouted. ' E , 51 2' Freeboard ( I L— 50.71� -f-—--I I I 6 -The foundation contractor shall coordinate with the plumbing and electrical -- -- - -- -- -- -- -- -- I 112"x12" Pier contractors relative to installation of sleeves and other penetrations prior to pouring I I I I Existing FF E1. 7.2' -- -- -- ea - -- -- -- -- I 1 earn Pocke I I concrete. I I 2"Rat Slab Slope L—————————— —————————————J I 7-Foundation excavation is not to be back filled prior to lowering the building onto the - -------- -------- ° ° C? to Drains See Plan I I 0 BFE EI. 6 -- ° -- - -- -- -- -- --— ————————————————— ——————— ————————————————— 8- Backfill along foundation walls is to be clean sand material and is to be mechanically The foundation is to be backfilled 30'-1" compacted in 6" lifts to 95%of maximum dry density. with clean sand and vegetated t Stucco assure minimum erosion. - Smart Vent Access Opening $"Q)Anchor Bolts 25"OC Wood Framing Structure Grade El. 4.6 - - . -- — n 8' End Zones 29"OC in ubbase-Compactable Fill 1.All lumber is to be No. 2 or better Douglas Fir Larch (N)with the following minimum ° \ / I / nterior Zoes specifications: 8" �/ Mil Vapor Barrier 4' psi 825= Expansion Joint Fb p /\ and Joint Sealer Existing 2 x 8 xisting 2 x 6 Sister with 2 x 8 Fv= 95 psi --- --- Fc perp=625 psi �co / E = 1,600,000 psi o. � �, \\ ompacted Fill (3)2 x 1� Smart Vent New x6 ACQ Sill & p x \ Copper Termite Shield 2.All pressure treated lumber is to be ACQ No. 2 or better Southern Yellow Pine. E w M \ ° a 2" Rat Slab Slope ca ca O "' to Drains See Plan � `� � No. 5 Rebar ' Wood Framed / 48"5 2 x 6 ACQ z 3 .All beams fabricated with multiple lumber boards are to be nailed/bolted in Bungalow CopperTermit ° G ° accordance with the Wood Frame Construction (Manual. Beams are nailed with two rows Shield ° 12" Maxof 20d nails-one row near the top edge and the other near the bottom edge. Nails in CD a a \, _ each row are spaced 32 Inches apart.(D ° 4.All straps, connectors, plates, bolts, nails, etc. are to be galvanized or stainless steel. Designated connectors, strap etc. on these drawings are made by Simpson unless W !n " 3" 2) No5 Rebar ° ° Indicated otherwise.All connectors, straps etc. are to be nailed/bolted In accordance 10 . with the manufacturer's specifications. t0 LL 3,. 16�� < 6 0 L -d e a \\ o Foundation Section C ° , Notes: Z o A o .X � � a � &n scale Y"=r-0" - E ih a ° '�. *The foundation is to be backfilled with clean 2 Story � m o c sand and vegetated to assure minimum erosion. Wood Framed p Residence FF EI-7.2' SMART VENT as * E1-4.6' MODEL 1540-510 ° FLOOD VENT INSULATED d N830 51' W 50.66' SILICONE/POLYURETHANE Flood Zone OCATION STRAP SLOTS USE Foundation Section at Vent AE Elevation 6.0 TWO TOP AND 3' C * rL EI-4.0' (FLANGE) TWO BOTTOM a Scale Yz"=1'-0" 161/4 R/O a . Pad Footing & Pier Detail Jackson Street F_ B Scale Yz"=1'-0" Surve b Q 1 ----------------------� yy ° Stanley J. Isaksen Jr. = TRAPS Elevations by VENT m I P.O. Box 294 I (— � -- P.O. I New Suffolk NY 11956 Nathan Taft Corwin DOOR I 00 I N U X I 1 I I rn� ------------ April 27, 1991 I I e I 1 c u_ - N I I I --------- I I Elevation Reference a a - I m N I I I NAVD 1988 Datum VENT LOAT SLOTS 12"MAX FROM I �- FRAM SCTM# 10001-117-09-31 E STRAPS INSTALLED: FINAL GRADE as I I W I I I 1 ( I I Existing 2 x 8 FJ 1 1 1 TWO ON TOP TWO FIGURE 1 — ————— 1 -- , I I _� ON BOTTOM Front View I 1 I L_________J I I I Scope of Work 17111. FIGURE 2 �______—___i i L_' r I I I Side View FIGURE 3 * Disconnect water, waste, and electrical connections to the Side View I I ( I ( I I building. I I I I * Demo east and west entry steps and landings and cellar access. TEETH MUST CLICK 800 I I BEND TO WALL VENT INSTALLATION INSTRUCTIONS IN TIGHT TO TW I I * Mechanically lift the existing building to an elevation that will INSURE SECURE I 1 I I I Q I O B 9 INSTALLATION. BEND PAST 90° Existin 2 x 8 FJ Exi�ti——�6 FJ facilitate demolition of the existing foundation and construction of 1 — FOR SPRING 1. Remove vent door from vent frame. (Tum upside down, rotate bottom of door outward and slide ( F——� X I I a new raised foundation. BACK out) I O O i I I I I I � I iN o0 * Demolish existing foundation and footings and properly dispose I I L——j c i I ^ I I STRAP DETAIL. 2. Prepare a CLEAN 16.25 wide by 8.25 high rough opening (approx. 1 block wide X 1 block high) I I 00 �— —I ( M I I of all debris. for each vent. Ensure the bottom of the rough opening is no more than 12"above the finished grade. I I I X IN I I I I *Construct a new foundation and footings as shown in the plans. c) I ( ( I I I I 3. Apply a bead of silicone or polyurethane caulk around the back of the flange on the vent frame. I 1 I * Lower building onto new foundation walls and secure with new (FIG. 2) L J _ _ I I anchor bolts as shown in the plans. I 1 4. Bend the 4 steel straps to the thickness of the wall measuring from the end with the teeth (see * Reconnect water, waste and electrical connections to the STRAP DETAIL) building. Vent Sizing 5. Insert the top straps into the top two strap slots about two clicks. ILU IJILI UA * Backfill around existing foundation. r rk Smart Vent Model 1540-510 Certified Coverage=200 Sq Ft. 6. Insert the vent frame in the cut opening. The bent strap ends go in then up behind the inside of the _ *Reconstruct steps and landings at east and west entrances wall. Push the frame tight against the face of the wall. Ensure the frame is flush and square in the Building Footprint=628 Sq. Ft. opening. (FIG. 3) Framing Plan 7. Reach through the vent opening and click the two straps in while holding the front of the vent ESSRONP�' Total Vents Required=628/200=3.14 against the wall face. The sharp point of the straps should not extend past the front of the vent face. scale "=1'-0" Total Vents to be Installed =4 Install the two remaining bottom straps and click into place. t �4 ��, J 1� �Ca �'��f �:l lel�� 8. Re-check that frame is square and slots are clear of debris, and caulk. �au�� � � � F� C�� Scale: 1/4" = 1'-0� Condon En ineerin , P.C. EROSION A SEDIMENT CONTROLS 9. Install the door into frame by grasping the bottom of door(with float pins down)and front(weld � � Maul Residence APPROVAL OF STOR ATER FAANAGEIVIENTShall include but not be limited to: marks back). Slide door into frame and rotate until it is latched. Plans are prepared by Condon Engineering,P.C. It is a violation of the New York State Education Law,Article 145,Section 7209,for any person unless acting under the direction of a licensed Drawn by : JJC 1755 Si sbee Road CONTROL PLA t -T n code c apt �6 9 2665 Jackson Street A well maintained Construction Entrance, 10. To open the door insert two credit cards into the float slots as shown in the diagram.This will Professional Engineer,Architect,or Land Surveyor,to alter item in anyway.If an item bearing Mattituck New York 11952 Date: 4'' C `- Wire Backed Silt Fencing,,stabilization& g the seal of an Engineer,Architect,or Land Surveyor is altered,the altering Engineer,Architect,or � Approved by: ��j unlatch the door for removal and cleaning. Land Su Date : 6-4-2014 New Suffolk, New York Surveyor shall affix to the item his/her seal and the notation'Altered by'followed by his/her (631 298-1986 Seeding of exposed and/or inactive soils. signature and the date of such alterations,and a specific description of the alteration. ` 7r--- t4 D�� r 13'-92n � � / ��, NOTED COVPLY 1 !ITH ALL CODES OF r------------- 16-0 O� D `°� NEW YOPK STATE & TOWN CODES I 1 „ I S art Vent DATE:_ ]` B.P. ' -_ AS REQUIRED A4 -E99t OF I r-- ------ --------I I FEF . -�% Esti sck Jr. I_ cm 0 S11 I MN i — -------, IPC ;IFY 6UILDiiJG DEPARTMENT AT I - ` I r V.am I locket Se�l�, , t Simpson TA18 PktiE 102 8 AM TO 4 PPFOR THE I I FOU_O��"11NG INSPECTIOPJS: SOI+ __ ,�`.'.' tS I w I I I I 1. FC)UNDATION - TA10 REQUIREDN _ I L_-- ----- I 7'_32" I I I Notes: FOR POURED C��;'>>RETE --" I L ------ --� I I 1 2. ROUGH - FR!,%-1dNG & PL UP.9DING _, I I I I I • ---- p— 3. INSULATION �, �{(' R ; ( L—— ———————— —J -M I I A The contractor is to verify all measurements in the field to assure that the new 4. FINAL - CONSTRUCT!OIJ MUST 0OCUPANCY O' ` - foundation walls will align with the building walls. BE COMPLETE FOR G.O. USE IS UNLAWFUL Simpson LT 5 I I earn Pocket I I ALL CONSTRUCTION SHALL P. EET THE p 1 I 5 9 1 I I 1 -All concrete 3,500 psi after 28 days minimum. REQUIREMENTS OF THE CODES OF NEW WITHOUT CERTIFICATE Simpson BP ( I 7_16' _ _ 7�-216�� 8'-08" I YORK STATE. NOT RESFO`vcIDLE FOR I I r -1 1 I 2-All rebar ASTM A-615 Grade 60. Smart Vent 1 I I I DESIGN OR CONSTRUCTION ERRORS. •' `` ``�``� �•� 2'x 2'x 10" � Smart Vent I I OF O'CCUPAICY' � : :,. . . Contact t�� 1.. too ir1U at 765-1560 bccioP,e I I-- --I I_ _I_ B 3- Footings are to be installed at the same or deeper elevation qas existing on Backfill,OR Provide Engineer's Certification New 5'0 Anchor Bolts I I I I I 1 ' that the drainage has been installed to Code. Typical Wall and 5"OC in 8' End Zones S-1 _ I I _ L_ ( I r' undisturbed virgin soil. —+— I I Sill Strapping 29"OC in Interior Zones ti� I I _ Q 3'x 3'x 10" I I 4- Rat slab is to be sloped to assure water drains to to nearest slab drain opening. I I I I Drain openings are to be 4"in diameter. , . �. :.k Detail New 2x6 ACQ Sill& 1 1 --J12 x 12 Pier _ _ /w No. 5 Rebar 2'x 2'x 10" " �+` r � C pper Termite Shield I ( I 9"OC I I RETAIN STORM WATER RUNOFF C �,1°°v�3:"y i�dl°i`�,' �� ZFie r rjain 5-All snap off form ties are to be removed and remaining openings are to be I w�� �, Proposed FF El. 8.8' --- -- -- -- --- t-- --I 12"x12" Pier I I PURSUANT TO CHAPTER 236 S 830 F:•,t�+� ,; K> 'l `(„ ;�, I y kcal 1 1 I I sealed/grouted. 51 E SOgsI 1t :p'�1',tr,'I�i c L_t_J OF THE TOWN CODE. } 2' Freeboard I I 6-The foundation contractor shall coordinate with the plumbing and electrical -- -- - - - -- -- � j 12"x12" Pie r contractors relative to installation of sleeves and other penetrations prior to pouring 1 1 I I Existing FF El. 7.2' --— ( ( earn Pocke — —————— I I concrete. _H 2"Rat Slab Slope ;——————————— —————————————.__I I 7- Foundation excavation is not to be back filled prior to lowering the building onto the — -------- "? to Drains See Plan IU LiI BFE EI. 6 • ————————————————— 8- Backfill along foundation walls is to be clean material and is to be mechanically -- - - - -- -- -- -- - - -- --- ----------------- -------- 30'-1” compacted in 6" lifts to 95% of maximum dry density. Stucco Smart Vent ccess Opening $'�O Anchor Bolts 25"OC Wood Framing Structure Grade El. 4.6 - - - -- --— n 8' End Zones 29"OC in 1. All lumber is to be No. 2 or better Douglas Fir Larch (N)with the following minimum ubbase-Compactable Fill Interior Zo es specifications: 8" �/ Mil Vapor Barrier —4' \ \\ Expansion Joint Fb= 825 psi /\ and Joint Sealer Existing 2 x 8 Existing 2 x 6 Sister with 2 x18 Fv= 95 psi • a / - - - - ---- - - - Fc perp= 625 psi om acted Fill E = 1,600,000 psi o CD = o \\ P (3)2 x 1� Smart Vent New x6 ACQ Sill & p X a / \ Copper Termite Shield 2. All pressure treated lumber is to be ACQ No. 2 or better Southern Yellow Pine. W \ e d ' E &_ M 2 Rat Siab Slope (a ° ° "' to Drains See Plan a) �° \ No. 5 Rebar ' Wood Framed a / 48" 5 2 x 6 ACQ & a • M 3 . All beams fabricated with multiple lumber boards are to be nailed/bolted in Bung4. Copper Termit d accordance with the Wood Frame Construction Manual. Beams are nailed with two rows ,�•, \ Shield . . 12"Maxof 20d nails-one row near the top edge and the other near the bottom edge. Nails in • - each row are spaced 32 inches apart. (D ° d • e ........................... . (� • 4. All straps, connectors, plates, bolts, nails, etc. are to be galvanized or stainless steel. • / / / Designated connectors, strap etc. on these drawings are made by Simpson unless 4.a a \ \\ \ Indicated otherwise. All connectors, straps etc. are to be nailed/bolted In accordance LLl 10" 3" 2) No. 5 Rebar • � with the manufacturer's specifications. LL3,. 1 g�� to IV" a \ \ 0 0 3 ('�) Foundation Section 4 Q- r_ Scale Yz.=1'-0" W00 2 Story 0 W c>s o Wood (Framed 0 a Residence W FF El-7.2' SMART VENT d * EI-4.6' MODEL 1540-510 FLOOD VENT INSULATED N83°51' W 50.66' SILICONE/POLYURETHANE d Flood Zone STRAP SLOTS USE Foundation Section at Vent AE Elevation 6.0 OCATION TWO TOP AND T C * El-4.0' (FLANGE) 16 1/4" wo TWO BOTTOM a'a a Pad Footing & Pier Detail se:aleY"-''-0" Jackson Street n Scale Yz"=1'-0" Survey by 0 I ----------------------� " � STRAPS ( Stanley J. Isaksen Jr. •,� P.O. Box 294 Elevations by VENT ao j r — New Suffolk NY 11956 Nathan Taft Corwin DOOR I x r 00 I ( f-------------- ----------- April 27, 1991 ( I °'-' O p r x I I I 1 ----------- a I c ti = i--------- ; I I NIL Elevation Reference a A 1 P m N ( I I NAVD 1988 Datum VENT \---FLOAT SLOTS-/ 12" MAX FROM I r FRAME STRAPS INSTALLED: FINAL GRADE as I I w r I I I ( I I I SCTM# 1000-117-09-31 TWO ON TOP TWO FIGURE 1 d I L___ —____ ,Existing 2 x 8 FJ I I I I I ON BOTTOM Front View Scope of Work FIGURE 2 '-----------i Side View FIGURE 3 " Disconnect water, waste, and electrical connections to the Side View I I ( ( I I I building. 11 9110 F I I I I 1 1 r r r I I * Demo east and west entry steeps and landings and cellar access. TEETH MUST CLICK IBEM�w800 IN TIGHT TO�' VENT INSTALLATION INSTRUCTIONS I 1 r 1 r 1 I r l " Mechanically lift the existing building to an elevation that will INSURE SECURE I I r I I Q r Q B BEND PAST 90° Existin 2 x 8 FJ Exiti—— 6 FJ I S-i facilitate demolition of the existing foundation and construction of INSTALLATION. 1. Remove vent door from vent frame. Tum upside down, rotate bottom of door outward and slide I ——, — I I a new raised foundation. BOACK SPRING out) ( P 1 I Q 1 r I r x00 1 I I r I r� x I I ' Demolish existing foundation and footings and properly dispose STRAP DETAIL. 2. Prepare a CLEAN 16.25"wide by 8.25"high rough opening (approx. 1 block wide X 1 block high) j L �J f — —I ( M I I of all debris. for each vent. Ensure the bottom of the rough opening is no more than 12"above the finished grade. 1 I r x I I r •Construct a new foundation and footings as shown in the plans. 1 1 I? I r I r I 3. Apply a bead of silicone or polyurethane caulk around the back of the flange on the vent frame. I I I * Lower building onto new foundation walls and secure with new (FIG. 2) L i J I I anchor bolts as shown in the plans. I I 4. Bend the 4 steel straps to the thickness of the wall measuring from the end with the teeth (see I 1 r I I I 1 ,OE EIEi$+ yo STRAP DETAIL) I r r ' I I '��' >i. co R7 * Reconnect water,waste and electrical connections to the I e--------- r building. 5. Insert the top straps into the top two strap slots about two clicks. ——————————— —————————— ————— —————J i 6�a oar Vent Sizing W Lu " Backfill around existing foundation. 6. Insert the vent frame in the cut opening. The bent strap ends go in then up behind the inside of the Smart Vent Model 1540-510 Certified Coverage=200 Sq Ft. "` Reconstruct steps and landings at east and west entrances wall. Push the frame tight against the face of the wall. Ensure the frame is flush and square in the "'' _N�� opening. (FIG. 3) Building Footprint=628 Sq. Ft. Framing Plan 5��84 P 7. Reach through the vent opening and click the two straps in while holding the front of the vent '�aFESS10NP Total Vents Required =628/200=3.14 against the wall face. The sharp point of the straps should not extend past the front of the vent face. scale ^=1'-0" Total Vents to be Installed =4 Install the two remaining bottom straps and click into place. 8. Re-check that frame is square and slots are clear of debris, and caulk. Scale: 1/4" = 1'-0" Condon En ineerin P C 9. Install the door into frame by grasping the bottom of door(with float pins down)and front(weld g g P.C. Maul � marks back). Slide door into frame and rotate until it is latched. Plans are prepared by Condon Engineering,P.C. It is a violation of the New York State Education IYI a u I Residence Road sbee JJC 1755 Si Law,Article 145,Section 7209,for any person unless acting under the direction of a licensed Drawn by : g 2665 Jackson Street 10. To open the door insert two credit cards into the float slots as shown in the diagram. This will Professional Engineer,Architect,or land Surveyor,to alter any item in anyway.If an item bearing in the seal of an Engineer,Architect,or land Surveyor is altered,the altering Engineer,Architect,or Mattituek, New York 11952 unlatch the door for removal and Cleaning. Land Surveyor shall affix to the item his/her seal and the notation'Altered by'followed by his/her Date : 5-18-2014 (631) 298-1986 New Suffolk, New York signature and the date of such alterations,and a specific description of the alteration. V COMPLY WITH ALL CODES OF 13'-92" NEW YORK STATE & TOWN CODES ---------------------- 1 6v-0" A P P1,11 0 El AS V E D AS REQUIRED AN I Sr art Vent 711 ji� B.P. -- ------ ------- DATE: r -,e -A r T;)� S�O�T�,AN',7_ . . I ------ ---------------------- FE2:L_t!!)_ SOUTHOLD TOWN PLANNING BOARD r,l I I U_ NOTIFY BUILDING DEPARTMENT AT Simpson TA18 .5; -0 0 rL-------1 I MZ���ES b eagPocket r_________ MA eam I locket 765-1802 8 AM, TO 4 P!`,," FOR THE X FOLLOINING INSPECTIONS: W 1. FOUNDA 1 I0N-_T" ------- 711 31'1- WO REQUIRED Notes: FOR POURED CONCRETE LI )I 2. ROUGH - FRAMING & PLUMBING ---- ATION C�04 I If I 3. INSUL 7'-0" rA The contractor is to verify all measurements in the field to assure that the new 4. FINAL - CONSTRUCTION iMUST OCUPANICY OR i. 0) foundation walls will align with the building walls. BE COMPLETE FOP, C.O. earn Pock., uNLAWFUL Simpson LT ALL CONSTRUCTIOIN SHALL MEET THE USE IS 5 911 All concrete 3,500 psi after 28 days minimum. REQUIREMENTS OF THE CODES OF NEW UT GERTIFICATE Simpson BP 71-0-1146" 7'-2i-6 8,-0-8L., YORK STATE. NOT RESPONSIBLE FOR VVITHO nX I Smart Vent- F_ 2-All rebar ASTM A-615 Grade 60. DESIGN OR CONSTRUCTION ERRORS. OF OCCUPANul 2'x 2'x 10" r---i Smart Vent I I 1 -1— 1 3- Footings are to be installed at the same or deeper elevation qas existing on New 5" 0 Anchor Bolts I , I N I 8 0 _1 0 5"OC in 8' End Zones I - I L_� Typical Wall and I - undisturbed virgin soil. Sill Strapping 29"OC in Interior Zones 0 Xx X 10" 4- Rat slab is to be sloped to assure water drains to to nearest slab drain opening. Detail New 2x6 ACQ Sill& LO I I ---1 12"x 12"Pier /w No. 5 Rebar Drain openings are to be 4"in diameter. Aper x 2'x 10" RETAIN STORM WATER RUNOFF r Termite Shield PURSUANT TO CHAPTER 236 91,0C o in 2"x 12"Pier 5-All snap off form ties are to be removed and remaining openings are to be OF THE TOWN CODE. Proposed IFF El. 8.8' --- FI r D l!ia sealed/grouted. t It the dr- n e e r's Ce t i t S 830 E Ty z)lcal 50.711 2' Freeboard- 12"x 12" Pie 6-The foundation contractor shall coordinate with the plumbing and electrical contractors relative to installation of sleeves and other penetrations prior to pouring 4 Existing IFF El. 7.2' concrete. "y -�j -1 earn Pocke g TER 14,11 _H 2" Rat Slab Slope r.,i,r I i--------- -------- 7- Foundation excavation is not to be back filled prior to lowering the building onto the C? to Drains See Plan -------- _j I t ; r, BFE El. 6 ---- ------------ ----------------- 8- Backfill along foundation walls is to be clean material and is to be mechanically —30'-l"- compacted in 6"lifts to 95% of maximum dry density. Stucco Smart Vent/ Access Opening Wood Framing . . .................... 5'0 Anchor Bolts 25"OC 8 Structure Grade El. 4.6 -in 8' End Zones 29"OC in 1. All lumber is to be No. 2 or better Douglas Fir Larch (N)with the following minimum ::.::\:::s ubbase-Compactable Fill Interior Zo les 8" Mil Vapor Barrier 41 specifications: r- \ \�\/\ Expansion Joint Fb= 825 psi /\ and Joint Sealer Existing 2 x 8 xisting 2 x 6 Sister with 2 x 8 Fv= 95 psi a / Fc perp=625 psi E = 1,600,000 psi CL \\ ompacted Fill I (3)2 x CO rL.0 Smart Ven New Jx6 ACQ Sill& W X W Copper Termite Shield 2. All pressure treated lumber is to be ACQ No. 2 or better Southern Yellow Pine. WO - E L_ Cr) 2" Rat Slab Slope (a 0 4 Wood Framed No. 5 Rebar C? to Drains See Plan 48"OC 2x6ACQ & A 3 . All beams fabricated with multiple lumber boards are to be nailed/bolted in Bungalow Copper Termit 4 accordance with the Wood Frame Construction Manual. Beams are nailed with two rows Shield 12" Max of 20d nails-one row near the top edge and the other near the bottom edge. Nails in .................................. 0 .......... each row are spaced 32 inches apart. 4 U- ................................ ............... ................. ............................. .. Pier '>3 Rebar 2 9 ocke --------------j 3'- X ' �_l 4 .............. . ...... 4. All straps, connectors, plates, bolts, nails, etc. are to be galvanized or stainless steel. 10 d // Designated connectors, strap etc. on these drawings are made by Simpson unless LU 10" -k32) No. 5 Rebar indicated otherwise. All connectors, straps etc. are to be nailed/bolted in accordance 0 with the manufacturer's specifications. 611 to 3 IV- 0 \/\ CID 0 � � ° \\ �Foundlation�Sec�ttion. C) Ln (1) X a) �� 'I LO a) Uj \ \ 2 Story 0 E _0 C.0 cn Wood Framed CD W 0 � - /\ Resiidence co FF' EI-7.2' SMART VENT M \ E1-4.6' MODEL 1540-510 FLOOD VENT INSULATED N830 51 50.66' Flood Zone SILICONE/POLYURETHANE STRAP SLOTS USE AE Elevation 6.0 OCATION TWO TOP AND Foundation u�ndd ati�on�Se cti�on attVv Vent OU El-4.0' (FLANGE) 16 1/4" R/O A TWO BOTTOM A S le Y2 Pad Footing & Pier Detail Jackson Street r— I (:B� Scale Y2'._=01'_0" 0 r---------------------- Survey by I ' I Stanley J. lsaksen Jr. Elevations by VENT TRAPS 0 1 P.O. Box 294 00 F_ —:: ------ --------1 1 NTft co ------------------------- athan aCorwin DOOR New Suffolk NY 11956 ------------------------- ............. X DO April 27, 1991 pzq CN 0 X 0 tm) 0 0 C14 Elevation Reference r U_ -------- 4------------ VENT -'q I -I I NAVD 1988 Datum FI OAT SLOTS-/ 12"MAX04 FRAME STRAPS INSTALLED: X SCTM# 1000-117-09-31 FINAL GRADE 4" W 11 0 ON TOP TWO FIGURE 1 a I L__ Existing 2 x 8 FJ 4- ON BOTTOM Front View 4------ L----------J Scope of Work FIGURE 2 —————— ---� I I I I j ------ _--1 Side View FIGURE 3 1 _j A Disconnect water,waste, and electrical connections to the Side View building. � I � r I ( I I • Demo east and west entry steps and landings and cellar access. TEETH MUST CLICK 800 F__ -7 1 BEND TO WALL IN TIGHT TO nw, I -800 VENT INSTALLATION INSTRUCTIONS TO • Mechanically lift the existing i building to an elevation that will INSURE SECURE 'T a - n 11 If �B facilitate demolition of the existing foundation and construction of BEND PAST 900 Existin 2 x 8 FJ 0 1 0 ff INSTALLATION. 1. Remove vent door from vent frame. (Turn upside down, rotate bottom of door outward and slide Exi i _�ISFJ a new raised foundation. FOR SPRING r -1 L_ 4�L �t- BACK out 0 1 1 X DO • Demolish existing foundation and footings and properly dispose I 1 0 04 X L j of all debris. STRAP DETAIL. 2. Prepare a CLEAN 16.25"wide by 8.25"high rough opening (approx. I block wide X I block high) for each vent. Ensure the bottom of the rough opening is no more than 12"above the finished grade. I X cr) •Construct a new foundation and footings as shown in the plans. C-4 3. Apply a bead of silicone or polyurethane caulk around the back of the flange on the vent frame. • Lower building onto new foundation walls and secure with new (FIG. 2) I I r L anchor bolts as shown in the plans. 4. Bend the 4 steel straps to the thickness of the wall measuring from the end with the teeth (see STRAP DETAIL) NEW • Reconnect water,waste and electrical connections to theyp building. i--•-------- -----------r -- ----- 3. C LU Vent Sizing 5. Insert the top straps into the top two strap slots about two clicks. :A I I - LU Uj * Backfill around existing foundation. Smart Vent Model 1540-510 Certified Coverage 200 Sq Ft. 6. Insert the vent frame in the cut opening. The bent strap ends go in then up behind the inside of the L------------------------------------------------- * Reconstruct steps and landings at east and west entrances wall. Push the frame tight against the face of the wall. Ensure the frame is flush and square in the opening. (FIG. 3) Building Footpri68 nt=628 Sq. Ft. 7. Reach through the vent opening and click the two straps in while holding the front of the vent Framing Plan 51 Total Vents Required =628/200 3.14 against the wall face. The sharp point of the straps should not extend past the front of the vent face. Scale 1'-0" Total Vents io-be Installed =4 Install the two remaining bottom straps and click into place. 8. Re-check that frame is square and slots are clear of debris, and caulk. 9. Install the door into frame by grasping the bottom of door(with float pins down)and front(weld Scale: 1/4" = 1'-0' Condon Engineering, P.C. marks back). Slide door into frame and rotate until it is latched. Plans are prepared by Condon Engineering,P.C. It is a violation of the New York State Education I Maul Residence Law,Article 145,Section 7209,for any person unless acting under the direction of a licensed Drawn by : JJC 1755 Sigsbee Road 10. To open the door insert two credit cards into the float slots as shown in the diagram. This will Professional Engineer,Architect,or Land Surveyor,to alter any item in any way.If an Rem bearing 2665 Jackson Street M unlatch the door for removal and cleaning. the seal of an Engineer,Architect,or Land Surveyor is altered,the altering Engineer,Architect or Mattituck, New York 11952 Land Surveyor shall affix to the Rem his/her seal and the notation"Altered by'followed by his/her Date : 5-18-2014 (631) 298-1986 New Suffolk, New York signature and the date of such alterations,and a specific description of the alteration. 3"x3"x1/4"GALV. WASHER PROJECT ISSUE 7/9/16 REVISIONS (2)3"x12"ACID. GIRDER WHERE FLOOR PACKAGE IS NEW: No. Description Date SIMPSON HURRICANE CLIPS (2) -FINISHED FLOORING-3!4"PLYWOOD SHEATHING AT EACH JOIST GIRDER CONNECTION -2"x8"F.J. @ 16"O.C. -R-19 FIBERGLASS BATT. INSULATION REINSTALL APPROXIMATELY 2'-0"BAND -6 MIL VAPOR BARRIER OF SIDING AFTER STRAPPING INSTALLATION ADD R-19 BATT INSULATION TO FLOOR REFER TO STRAPPING INSTALL DETAIL .� FOR STRAPPING UP STUDS AND UNDER Q SILL PLATE U) z C7 z CL \ a- -- . . -- ADD R-19 BATT INSULATION TO FLOOR o - u- C9 VAPOR BARRIER Z 0 U) w O GALV. GIRDER SEAT LU NN ° d d °° UNLESS AIOCT�ING UNDER THE RECTION OF THE LAW TO OF A ANY SON, LICENSED ARCHITECT ENGINEER TO ALTER IN ANY COPPER TERMITESHEILD °.` a dee° ° WAY ANY ITEM ON THESE DRAWINGS. IF AN ITEM VAPOR BARRIER . 4 4' .e.. d , - BEARING THE SEAL OF AN ARCHITECT/ENGINEER IS ALTERED,THE ALTERING ARCHITECT\ENGINEER ACQ.PLATE PER MODULAR COMPANY s ' _ la d 5 REBAR SHALL AFFIX TO HIS/HER ITEM THEIR SEAL AND THE NOTATION"ALTERED BY"FOLLOWED BY HIS/HER COPPER TERMITE SHEIL ° a (3)#4 each way ^°° d°� a . d° SIGNATURE AND THE DATE OF SUCH ALTERATION, d d °° AND A SPECIFIC DESCRIPTION OF THE ALTERATION d d °1 d ANCHOR BOLT.REFER TO MODULAR ° d ( �, I ° ° ° ° d DESIGN FOR SIZING AND SPACING �. ON THE DRAWING. ""THE PLANS AND 1 dl SPECIFICATIONS HEREIN ARE INTENDED FOR THE PROVIDE FOAM SILL SEALER d d d d SUBJECT PROJECT ONLY AS A RESULT OF 1 ,a `A. ° CONTRACTUAL NEGOTIATIONS BETWEEN THE OWNER AND PHILIPP E. KAMPF. THESE PLANS AND 1 SPECIFICATIONS WILL BE THE SUBJECT OF A ° 5 REBAR ° ° COPYRIGHT PETITION AND MAY NOT BE REVISED OR REUSED BY ANYONE WITHOUT THE WRITTEN AUTHORITY OF PHILIPP E. KAMPF." d d. ..a ° °y °d •,d. OPTIONAL 8"CONCRETE FOUNDATION WALL °� °a l d A F2 C H I T E C T U R E Sc D E S I G N a'° WITH C 3T5 TOP AND eOTTOM ,m PHILIPP E. KAMPF d i d °1 a PHONE: 631-943-1081 1 �/� r�G G' 4 d°I Z�✓/vo rJl P�.RAT.NAe I ° a I ° 107 CENTER STREET • Id ° d d ° SAY SHORE, N.Y. 1 1 706 EMAIL: PHILIPPKAMPF@Q PKAD.NET a. d ° i a --I° ° 100 01 d 1 I a (2)#5 DOWELS la • d ° GRADE _ _ _=III= ° e °�` ° ° TYPICAL @PILE CAPS -I I I-I I IEI I I-1 I IEI I °i ° 1=1I I-I 11=1 11=1I I-II I-III-III= d ° I I=1 11=1 11=1 I IEI I IEI 11=1 11=1 ° -III-III-1 I IEI I I-I 11=1 11=1 I I-III 1, I I I=1 11-I I_I-I 11-I I IEI 11=1 I 2�3500 PSI P.C.RAT SLAe 1=1 I IEI 11=1 11=1 11=1 11=1 11=1 11= I-0 11=1 I I-1 I i=1 I I-1 I I-1 11=1 11=1 d l I -I I 1=III-III-IIIEI II-III-III-III ° d I i I-III-III-III-III-III- (2)#5 DOWELS °° • 1=1 I El I 1=1 11El I 1=11 I-1 I I-1 11= a l 1 a .. (1=III=III=III=I I = —�-1 TYPICAL @ PILE I° ' =1 11=1 11=1 I I_I I I_I I I-III I I I_I I i I I I=1 11=1 - I 1=1 I-I I I CAPS ° d 1=1 11=1 11=1 11=1 11=1 I-1T_I-1 11= • a 1 ° 11=_=1 I I-1 I IEI I IEI I i-1 ° . ° 1 a 11=1 11-III-I I I-III-III-III -III-III-I I i-I 11-III-I 11 1 I I IE1 I IEI I IEI I I=i 11=1 11=1 11=, ° I IEI I IEI 11=i 11 ° 1° i d° ' ° =1 11=1 1=1 11=1 I I=1 I-III-III-III d I I I-III-III-I 11'I I f=111=11 1=1 11=1 11=1 11=1 11=1 11=1 11=1 11= 1 .°.' I I-1 I I-1 11=1 11=1 I I-1 11=1 11-1 -°° °° 11=1 11=1 11=1 11=1 11=1 11=1 1=1 I I d al I 1511 1=1 I IEI I 1=1 11=1 I 1=1 i1=1 I d ° I I I I I i I ° . 1 d -1 I I=III=1 I 1=III=1I 1=1 I I-III- e ( e I IEI 11=1I 1= I IEI I I-III _ I III III III III III III I l I III III III I , _ _ _ _ _ _ I I I-1 I IEI I IEI I IEI I 1=1 ° El I 1=1 11=1 I -1 I IEI I 1=i I I-1 I I-1 I I-1 I-1 I'-"�''' 11= -I I F1I1=1 11=111=III=1 11=III a ° �► I I I-III El I i-I 11-I 11-III-IV _ _ _ I ° �I° � ° fl-=-M-(2)#5- DOWELS- _ -111=1I1=111=1I1=III=III= ° ) °: ° =1I1=III=1I1=1I1=I11=III=1 HATCH oNAL \METER -I11=1I1=1IIEIII-III=1I1=III-III-III-III=1I1=III d d ° 11=III=1I1=III=——_—_ _ =111-1 I =III=II1=111=111 _ 11-11 1=1 C�Y5 REaaR 1=1 11=III I I I=1 I I Ill I I I Ill I I I-I 11-I I I=1 I i-I g I-1 11=1 11=-- =l 11=I I I=1 11=111=I 11=]TYPICAL @ PILE: ' I I-III=III=III=III=III=III=I FOW RATION WALL AeovE .III=1 11=I 11=1 11= 3)#4 each wa I _ -- I=1 I I , 1 ° ° == I=III=III=III=I 11=III=III=I 11=CAPS\1=1 I1=1 11= M I I-III-IIL-III_III-III- ° ° _ -I I I-III III-11� t y I - -II- I-I d�'1 a s.1 d -II-III-I I i-i I i-I I I_I I -111-III-III-III_\ I_lll-III-I I I- _ i I I I-111-III =1 I I=1 1=1 11=III=111=111=III=111=111=III=III= III=III=111=III=111=III=1 11=111=III=111=III=III=111=III= -I 1 I-III-1 _�=III=11 I 1 11=III=III=11 IEIII=111=1 I 1=1 I 1 °° e d 1=111-I 11=I 1 I=III=III=III=111=1 I 1=1 1=III=III=III=111=III= ° n .. . III-III-_III -III-III-I l I-Ill-I I -I l-I I I-III-III-I I i-I I l-I I i ° 1 ° 11 I_T-III-III-i I l-I I -i 11-1 I I-I -I l I-III- IIII=III=III=III=111=111=III=111=1 I-I °. d 1=111=III=III=II1=1 ——_ =111=III=III= d III—III—III 1 , °d °n d ° : I=1 i =1 i I=1 =111=111=1 11=III=III=111=III=111=IIIEl I IEI 11=I111=III=III=III=III III=1 I 1=1I1=1 - - 1=111=III=111= r _ - _ - _ _ d ° =11�=III ° . .. .. ° d. . "a.d °. I I I=11►=1►1 1_I 1 I_II� I l l i 11_I 11_I►IEI 11_1 I I_I I IEI 1 IEI I IE I-11�=IIS-I 11-1 1111 I-Iii-I 11=1►I- - 1=II�_11�=1 11=1 I►_ -1 I IEl 11= `ml 3500 95I P,G PILE cAP/GRAVE 5FAM =I 1=I I I I i I I I=T=1 11=1 11=III=1 I I=III=III=III=III - I IEI 1=1 I I-1 I-1 1=1 I I-1 I I-1 I I-1 I I I i I-1 11=1 11=1 I I-1 I I=- 1=1 11=1 I I .� °_ J • L ° _ d I 1=1 11=1 I X-01 WIDE x s'-#r DEEP.REFER To I_I I I_o I I I_I 11=1 11=1 11=1 11=1 I IEI 11=1 11=1 11=1 °���° . d 1=1 11=1 11=1 1=1 I I I 1=1 11=1 11=1 I I_I I_I I I I I I=1 11=1 11=1 I i- 4 -1 11=1 I I- a d ° " 1=1 11=1 I I; Fa�DATION a aN -I I I_I I I , I I_I I I-III-I I i-III-i I I-1 I I-I I I-III-III d I I III-III-III-III III-I►I-III-III-III-I 11=1T_I=1 I I=1 I -III- i-I I IEI I i III-III- I-1 11=M I l i-1 11=1 =1 a -1 11-1 11=1 11= 11=11_IEll IE1 I IEI I IEI I I-1 I l=1 I I- d II-III-III= I I - - - - - - - - - - - d - - - =T= - -= - - - - - -I I IEI I I-III , d 111-11 I ° • a ° _ I I -0 .d RF,eARs CONTINUE AT °d 11=1I1=1I I- ° i -° e'.. ° • I1=111=1I I� ° ° 6RAVE 5W M(r d 11=III=111 II-111=111 1 1 1 i - - - - - - - - - - - - - - - - - - - - ° -- - - - - - - - - - - - - - - d'° ° E ° d ° i� I I ° I I-III I I I-I i I-III 1=1 I I I_I I i-III-1 11=1 I i- 11=1 0 -111= 1 I=111-111-1 -III=11�=111-1T1-IT- III- - " - ° 1 ° ° .d (#r#EACH WAq AT HELICAL.PILES i MAUL RESIDENCE (MOR EAG\t WA4 AT NE!-ICAC PILES ° ° ° d TOP AND BOTTOM - 1 TOP AND BOTTOM ° ° a y .d �° 1 d — — — — — — — — — — — — — — � ° ode. 1a �. ° —d— °— —.e— .•� .� �. �. — .,r d ° I ° _ _ r r d 0 -3 °T A. "4* a III=111=III=1 I I 111=►11=TI =1 l ►=11 I-IT=1►1=1►1=►►1111-I 11=1 11=1 I I- 266 JAC K S O N A'. -III-iI I-I 11=1 11=1 I I-ITI=1 I =11 I-1 11=1 I I-I 11=1 I III-1 I I-1 I-1 I I "`f°OTH �- I I I-1 I►-I I IEI I I I I I=1 I -1T_I III-I 11=1 I I =1 11=1 I I-I 11= " -1- -° ° � -t- ed` ' eOUNDARDk of -111-111-111=►1 I-►►I-I►I-►► _ 1=III=111=1 I I- 11=111=111=111 HELICAL PILE.REFER TO NOTES FOR ° ^.° ° PILE CAP I I El I I1=1I1=1II III=IIIEll I== -_=I11=1 1=III=111 Ill ,,,=I,I=�,= STREET N E W ADDITIONAL INFORMATION -I 1 I-I i-III-I i -1 11-III-1 I III-I 1=1 11-1 I I-I 11-I i I-1 11 1 1=111=1 I o d grade beam per foundation plan III=1 I I=I 11=1 I IEI I I-I I I-III I I=1IEll I I=1 I El I El I I I 11=1 El I I=1 I I- rade beam SUFFOLK, N Y 11 56 ° . -III-I 1-11 El 11=1 11=1 11=1 I - 1=1 1 1El 11=1 11=l I I= 11=1 11=1 I I g per foundation plan III-III-III=1I_I III-III-III -III-III=III III=III III-III= ° l HELICAL PILE -III-III-I 1=1 I-I I -I I I-I I I-_ -I I I-1 I I-I 11-I I I-I I I-I I I I F I I I ° I I =1 I I-1 I I-III i I I=1 11=1 11=111== I I-1 I I-1 I-1 11=i I I-1 I I I I-1 11-1 -�= 3500 PSI Pc.PILE cAPi6RAVE eEAM a ° -1- ° =1 I 1-1 I 1=1 I El I IEl I El I 1=1 I =111 _III-III- -MEI I I-I I IE111=111El I I-1 I I V-0"'WIVE><1�-N1 SEEP.REFER To IT_I-1 11=1 i-III I I I=1 11=1 I =1 11=1 11=1 I -_=1 I I t 1=1 11=1 11=1 11= FOrINVArtoN a,AN W d .' '1° ° ° °d . ` ' _III-Ill-111-I I-III-III-I I -Ili _ I IEI I I-III-I I I_I I I -I l�-iI I-III III-III-I 11 El-I i -I 11-I I _-I 1 1=111-II__I- C//}'r//EACH WA�r AT HELICAI.PILE5 --''''II HELICAL PILE.REFER TO NOTES FOR a � •_°° TOP AND eOTTOM I I I—III-I I —III—III—III= _ I1—III-111-1 IIIE= _ =fll� ADDITIONAL INFORMATION -111-III III-111-ill- -I = I-III-I I I-III-III-III III-III-111-III= I-III-I 11-111-111=1 I I I I=111=1 11-1 11-i 11-111-I I I-III-I I I-III �I�IIIII�IIIIIIIIII�IITIIIII 1111111�11�1ITIIIIIIIII�IIIIIIIIIIIIII SECTIONS -III=1 I I III-►►I-I►,- - ►I=1 11=►I i=►i► 1 I 1=1 I I-III=1 I I- � I 1 I ►=1111 I I I=►�I I�TI=11= __ III-ITI=►�1=1,I-►11=i 1 I-111-11►=ITI-111 r-o° 11 IEI I- III - I I=1 I►=1 l IEI 11-1 1 I-II I 111=1 I IEI► III 1 I= (3 I I 1 I I-III=III=III=III-II - = I-IIIEI II=III=III=III=III=111 -111-I I I I I I-I I I-I I I I I -I I I-I I I I IEI 11=1 I IEI 11= I i 1 I H�fP0T1 tETIGAL. 111=1 I El I IE1 I IEI I -I I I =1 I -1 I l=l I IEI 11=l 11=1 11=1 11- I i =1 1=1 I I I I I=1 I I-I 11=1 I =1 11=1 I I-1 -I I i-III III-I 11=1►1- sTAMP AREA eOUNDARV�f OF PILE CAP -1 I I=1 11=1 11=1 I I_- =1 I I-I 11=1 I I-IIIEI II- 1=1 I-iII i I I=1 I I-f f -III-III I I IEl 11=1 I DATE: 7/9/16 -III-IIIEI II=IIIEI II=III=III=III=III=III=III=I I IEI I I=III=III=III=III- PLAN V1 1Y I IEI 11=1 I I I I El I I-I I -I 11=1 11=1 11=1 I IEI I IEI 11=1 11=1 1 1El I I I 1 1EI 11=1 I �,�, /' --.. PROJECT -III=111-I I-III=111-III-iII=III=1 I I=1 I =1 I =III=III=1 I =1 I =1 f l=1 I I- �� `� NUMBER: 42858 -III=111-III III-III-\V=IIIEI IIEI II=III=IIIEI IIEI II-III=III IIIEI II=11 �- KA C 1=1 11=1 1=1 1=1 11=1 I I-1 11=i_I I-111.2,_''6;11 IEI III=1 I I-1 I -i I -1 I IEE f IEI J A PJ 3 0 2017 �`� Q M°� -'�' D RAW I N G BY: P E K :III-I i-I I = - - - - - - - I 1=1I -I I .e c -I I I-III I-- -_ -III=III= a� ' CHK BY: P E K i 1=1 I Ell T_ 1=1 1=ITI= =1 11=1 11=1 I_I=1 11=1 I i=1 1=1 11=1 1=1 1=1 1=1 I IEI I ` �1' i I A _ZZ 'I I-1 11=1 I I-III-III-III-III-III-III-I 11=1 11=1 I I-1 1=1 1=1 I I-I 1=1 i' ENDING DE'T. `u ; a SECTION @ EXT GIRDER/PIER SECTION @ INT GIRDER/PIER W/GRAD \=1 I1-111-111-111-111-1I 1-111-111=111-111-1I 1-1I I-1T TOWN O SOUTHOLD � o t� DWG No: M 0 A-201 00 5 W/GRADE BEAM n BEAM - �_ 11 � 29�``' -� � �TqT p CAD FILE NN 42858 U °0 1 PROJECT ISSUE 7/9/16 TABLE 8301.2(1) /� TT j��j /� /� �/( REVISIONS CLIMATIC AND GEOGRAPHIC DESIGN DETAIL DIAGRAM No. Description Date GROUND WIND SEISMIC SUBJECT TO DAMAGE FROM: WINTER ICE SHIELD SNOW DESIGN FROST LINE DESIGN UNDERLAYMENT HAZOARDS FREEZING MODEL 1540-510 LOAD SPEED (MPH) CATEGORY WEATHERING DEPTH TERMITE DECAY TEMP. REQUIRED INDEX Smart VEIMT MODERATE- SLIGHT- o PER CODE PER CODE DUAL FUNCTION FLOOD AND VENTILATION VENT 20 110 C SEVERE 3'-0" HEAVY MODERATE 7 YES OFFICIAL OFFICIAL 877= 441 = 8368 CONNECTOR COMPATABILITY NOTES: www.smartvent.com16 1 /4" R/O H'0T L\,'ANIZ`Els '�� 'i E ,T�: `.;, NUT-y, ''NASHERS. , & F,A`.:TEI`tiElrt:;. HUT DICT LIVITE: T';a STRAP SLOTS USE TWO h `�_: t` {` ti 1 + 1 5 t } � I \} r+� t z y � . � '`) LSC-`-:' H'OLP_� .rFE 11,;E-..,�.'IF.EL) F01 �..i`,Y I;��\1(.'. -�'ETE �;f�,�lPJE�.TI..+r��� OP, ' F:E�.TEL' LUt�.�IH ti TOP AND TWO BOTTOM 1 ' i'V (�!1 Y JL5K Y J: ti1 .tI lr,' 4� +K`t ra ■ rk, w� 5.+ „'ENT—, l� - 1 14 M.I '✓ I ! I T I t R C N I f � X 1 '„F l�' 1. �+ Imo' f i {'Y+ 9'h .-7 4l ti1 ALL '.rTH E' E.� ��'i�. Tf ErTEt.+ L.1 o':I I E' � " LL TI- E�TEl1 LI.� ,r1 C3E Cx, 'wt. Er T':.,' O k-E-4,N -.ALT A II, Vfl LL �E': U I RE ❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑ ❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑ BEHIND THE RODENT SCREEN, LOUVERS TA --TEEL ”, N; t� t�H�, NUTS, '',;�`, -sr. ;,- �,, ti . �, ,, � I;+. �? '{ A :3, `3C:IiE4'`,':: �'�;: c� 1t� t, ❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑ �- '7--TEEL 'r I `E�:,: It�.�:LU111 lta I.'IJT i��.�T LI Y.ITE:1 T�) �,.• IL L .� H LT AUTOMATICALLY OPEN AND CLOSE WITH 00000 TEMPERATURE.TEMPERATURE. NO ELECTRICITY IS NEEDED 81 /4 ❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑Iuuc�❑❑❑❑ ❑�❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑;�❑❑rte❑u_�❑�❑❑ RIO ❑ ❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑o❑❑❑❑❑❑❑�u�❑d❑❑u❑❑ ❑❑❑❑❑❑❑❑❑❑❑❑❑❑�❑I,_l:�❑❑❑ ❑I�❑❑❑�❑❑❑❑❑❑❑❑❑❑❑ SILICONE/POLYURETHANE ❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑p❑r�❑_❑❑❑n❑�❑❑❑❑❑❑❑❑❑❑❑❑❑ ADHESIVE LOCATION ® ❑❑❑❑❑❑❑❑o❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑ (FLANGE) ❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑a❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑ "IT IS A VIOLATION OF THE LAW FOR ANY PERSON, Q UNLESS ACTING UNDER THE DIRECTION OF A FLOAT SLOTS 4 a LICENSED ARCHITECT ENGINEER,TO ALTER IN ANY WAY ANY ITEM ON THESE DRAWINGS. IF AN ITEM BEARING THE SEAL OF AN ARCHITECT/ENGINEER IS 0) ALTERED,THE ALTERING ARCHITECT(ENGINEER SHALL AFFIX TO HIS/HER ITEM THEIR SEAL AND THE NOTATION"ALTERED BY" FOLLOWED BY HIS/HER SIGNATURE AND THE DATE OF SUCH ALTERATION, FIGURE 1 AND A SPECIFIC DESCRIPTION OF THE ALTERATION STRAPS INSTALLED: TWO ON THE DRAWING. ""THE PLANS AND ON TOP TWO ON BOTTOM o SPECIFICATIONS HEREIN ARE INTENDED FOR THE Front `�T SUBJECT PROJECT ONLY AS A RESULT OF VENT / �011" �� vv / / CONTRACTUAL NEGOTIATIONS BETWEEN THE DOOR OWNER AND PHILIPP E. KAMPF.THESE PLANS AND SPECIFICATIONS WILL BE THE SUBJECT OF A COPYRIGHT PETITION AND MAY NOT BE REVISED OR REUSED BY ANYONE WITHOUT THE WRITTEN `VENT AUTHORITY OF PHILIPPE. KAMPF." (FRAME STRAPS FIGURE 2001" ft a a a Side View12" MAX FROM ARCHITECTURE & DESIGN FIGURE 3 FINAL GRADE Qa Side ♦ iewPHILIPP E. KAMPF Q 107 CENTER STREET PHONE: 631-943-1081 TCY X_::�( BAY SHORE, N.Y. 1 1706 EMAIL: PHILIPPKAMPF@PKAO.NET EXISTING SEPTIC TANK SMART VENT Foundation Flood Vents STRAP DETAIL. 80O �/ 450 AndBro Dr.Suite 2B TOLERANCES UNLESS Pitman NJ 08071 BEND TO WALL OTHERWISE SPECIFIED SMART VENT TEETH MUST CLICK IN TIGHT TO INSURE THK. XX XXX +loos DUAL FUNTION FLOOD SECURE INSTALLATION(. X•� +/-0.005 877-441 —8368 AND VENTILATION VENT BURIED 2" ELECTRICAL CONDUIT — — — — — BEND PAST 90° FOR WWW.SMARTVENT.0 OM MODEL 1540-510 8"3000 PSI P.C. FOUNDATION WALL[1/22" TO BE TRACED DE-ENERGIZED AND SPRING BACK THE INFORMATION CONTAINED IN THIS DRAWING SIZE DWG NO. REV IF USED IN PROJECT,CHANGES TO DRAWING A 1540-510 B REMOVED I IS THE SOLE PROPERTY OF SMART VENT,INC. EXISTING 3X4X4 DRYWELL 1 I ARE PROHIBITED WITHOUT THE WRITTEN TO BE REMOVE WITH EXISTING FOUNDATION DUAL ACTION FLOOD/IAIRVENT I PERMISSION OF SMART VENT,INC. DATE, 5-15-09 SHEET 1 OF 2 AND REPLACED WITH NEW MIN. 5'-0"OFF 20 SMART VENT MODEL VENT 10 HOUSE PIPE TO NEW AS REQUIRED.ALL WORK AND LOCATIONS 200 S.F.COVERAGE PER VENT SHALL BE TO CODE 1 l 13'-9 1/2" 7' 16'-0" I I 7'-0" 6'- 1 1/2" 7 - 11 1/2" 7'-0" 8'-4 1/4" L- - - - - - - - -- NOTE: ABANDOND WATER MAIN CALCULTATION FOR FLOOD VENTING PROVIDES FOR I I GREATER THAN CODE COMPLIAMCE FOR VENTILATION 1 4"WASTE TO SEPTIC INCOMING WATERSTATED IN NYS 408.2 THEREFORE SEPARATE CALCULATION S i I MAIN FOR VENTILATION ARE NOT REQIUIRED. 1 I FLOOD VENT NOTES: — — — — — R324.2.2 Enclosed area below design flood elevation.Enclosed areas, including crawl spaces,that are belom the design flood elevation shall: 1.Be used solely for parking of vehiccles,building access or storage. 0 2.Be provided with flood openings tlhat meet the following criteria: 1 — — — — — — — — — — — — — — — — 2.1.There shall be a minimum of two openings on different sides of each {� enclosed area;if a building has more than one enclosed area below the EX. F.J. I 1 c i design flood elevation,each area shlall have openings on exterior walls. co 2'-0"41;7— Q I �° 2.2.The total net area of all opening-s shall be at least i square inch(645 C'1� 11 N I 1 — — — — — — mm2)for each square foot(0.093 m:2)of enclosed area,or the openings X N io (o shall be designed and the constructicon documents shall include a statement NSEX. F.J. I I ( o I I I 1 that the design and installation will provide for equalization of hydrostatic " — — — — flood forces on exterior walls by allovMng for the automatic entry and exit ofG PROJECT floodwaters. 2.3.The bottom of each opening shall be 1 foot(305 mm)or less above the I i I io adjacent ground level. l — — 2.4.Openings shall be at least 3 inches(76 mm)in diameter. MAUL RESIDENCE 01 F — d I I 2.5.Any louvers,screens or other opening covers shall allow the automatic 2"x8"ACQ LEDGER PER DETAIL I (2)2"x8"ACQ GIRDER U U flow of floodwaters into and out of the enclosed area. Q I I Q I 2.6.Openings installed in doors and windows,that meet requirements 2.1 N i I � EX. F.J. EX. F.J. Q through 2.5,are acceptable;however,doors and windows Without installed 2"x6"ACQ. F.J. 10 1 I X 1 �— x I l I m openings do not meet the requirements of this section. @ 16"O.C. 1 N I I N 1 EX. F.J. 0 l W I 1 _ CENTER LANDING ON DOOR / I " I N I I r 266 JACKSON W EFI 1 _?1I il) cO q I "; o} N CRAWL SPACE N 2"x8"ACQ LEDGER PER DETAIL STREET, NEW co 12"DIAMETER P.C. PIER (F) b 0 1 I 1 IN S.FJEN S.F.PER VENTS SEE ATTACHED SECTION T WITH BELLED FOOTING N 1 (MIN.(4) VENTS REQUIRED I INTERIOR GIRDER/PIER SUFFOLK, NY 11956 LO 1 x 12' DIAMETER P.C. PIER `t WITH BELLED FOOTING 6"x6"ACQ POST I I I l i I I rc? (2)2"x8"ACQ GIRDER 00 SEE ATTACHED SECTION AT _ _ CENTER LANDING ON DOOR Z EXTERIOR GIRDER/PIER '� I I I I I I I "' io " 1 1 6x6 ACQ POST FOUNDATION PLAN REMOVE EXISTING DRIVEWAY AS REQUIRED AND REPLACE IN KIND 2'W"ACQ.F.J.. AND DETAILS — — � — — — — — @ 16"O.C. CROSS SECTION ACQ STEPS , DECK AND RAILINGS GAS METER 1 ( ACQ STEPS , DECK,AND RAILINGS PER CODE 1 1 A-200.00 PER CODE 6'- 10" I 7'-3" 7'- 8'-41/4" 01 STAMP AREA: DATE: 7/9/16 7 -0 — — 301- 1-1 ►K C 1, PROJECT �� Y, MI> r�' � NUMBER: 42858 PROVIDE 36"WIDE � Q F �e DRAWING BY: PEK ACCESS PANEL FULL EXISTING BILCO DOORS TO BE REMOVED CO °\ x ,''_\ Y HEIGHT OF CRAWL SPACE co �r ~�� � CHK BY: PEKLul � .>. a 1 FOUNDATION PLAN o DWG No: 1/411 = 1'-Of' Co 1c 0 -Z9 s A-100.00 to �T CAD FILE N CD 42858 PROJECT ISSUE 7/9/16 REVISIONS No. Description Date HELICAL PILE SPECIFICATIONS: QUANTITY 1.ALL PILES SHALL BE PATENTED HELICAL PILES AND APPURTENANCES RATED @ 20 ITEM NO. DESCRIPTION PART NO. CAT.NO. TON (40K)ULTIMATE CAPACITY(F.O.S. =2.0)AS MANUFACTURED BY chance AND A B C D E FURNISHED EXCLUSIVELY BY PREMIUM TECHNICAL SERVICES(1-800-282-7453). ALL P16052 >D660S0608 1 HELICAL PILES ARE TO BE INSTALLED BY A FACTORY CERTIFIED INSTALLER, 1. D6 SHAFT,1-1/2"RCS 60" 318"x 6"-8" OTHERWISE A CERTIFIED TECHNICIAN FROM PREMIUM TECHNICAL SERVICES MUST BE 2. D6 SHAFT,1-1/2"RCS 60" 3/8"x 8"-10" P14394 >D660S0810 1 ON SITE AT ALL TIMES TO WITNESS PILE INSTALLATION.MANUFACTURER TO HAVE IN 3. D6 SHAFT, 1-1/2"RCS 60",3/8"x(10"-12") P116775 >D660S1012 1 EFFECT INDUSTRY RECOGNIZED WRITTEN QUALITY CONTROL FOR ALL MATERIALS AND MANUFACTURING. ALL WELDING TO BE PERFORMED BY WELDERS CERTIFIED UNDER SECTION 5 OF THE AWS CODE D1.1. PART NO. NEW CAT.NO. ITEM "HS" "HD" OLD CAT. NO. DIA,("HD") 2. PRIOR TO INSTALLING ANY PILES, PILE CONTRACTOR SHALL INSTALL(2)TEST PILES AS SHOWN ON PILE PLAN TO VERIFY SOIL CONDITIONS,TORQUES,AND DEPTH OF PILE F722742 D660SO608 A 18" 6",8" REQUIRED TO ACHIEVE FULL LOAD RATING,AS DIRECTED BY THE EOR. F724315 D660SO810 B 24" 8",10" 3" 3/8" 3. HELICAL PILE LEAD SECTIONS SHALL BE MODEL 150-1012-7'LG WITH A 1.5"SQUARE SHAFT AND A 8"& 10" F724794 D660S1012 C 30" 10",12" N-6203-0026S -� DIAMETER HELIX. LEAD SECTIONS SHALL BE 7' LONG. HELIX PILE EXTENSION MAY BE 5, 7 OR 10'LONG DEPENDING ON VERTICAL CLEARANCE. TORQUE STRENGTH RATING-6,000 FT-LB 4. HELICAL PILES, EXTENSIONS AND APPURTENANCES SHALL BE HOT-DIPPED ULTIMATE CAPACITY-60 KIPS WITH A TORQUE FACTOR(Kt)=10 ALL HELIXES FORMED BY PRESS DIE GALVANIZED STEEL IN ACCORDANCE WITH ASTM A153(LATEST REVISION). 3/8"HELIX ULTIMATE STRENGTH-6",--KIP;8",30 KIP;10",28 KIP;12",26 KIP;14",24 KIP, FORMED VIEW 5.ALL PILE INSTALLATION OPERATIONS SHALL BE SUPERVISED BY A LICENSED ACTUAL BEARING LOAD IS DEPENDS ON SOIL CONDITION AND OVERBURDEN PRESSURE. ( ) ULTIMATE TENSION STRENGTH-70 KIP WITH COUPLING BOLT. ENGINEER. THE INSPECTOR SHALL KEEP A COMPLETE RECORD OF THE PILE INSTALLATION OPERATION . 6. HELICAL PILES SHALL BE INSTALLED TO A MINIMUM DEPTH OF 15'AND A MINIMUM TORQUE OF 2000 FT-LBS. SUBJECT TO THE FOLLOWING PROVISIONS: A)IF THE MINIMUM TORQUE REQUIREMENT HAS NOT BEEN SATISFIED AT THE MINIMUM DEPTH LEVEL, THE CONTRACTOR SHALL HAVE THE FOLLOWING OPTIONS: a) INSTALL THE PILE DEEPER USING ADDITIONAL EXTENSIONS UNTIL THE SPECIFIED TORQUE LEVEL IS OBTAINED. b) REMOVE THE EXISTING PILE AND INSTALL A PILE WITH LARGER AND/OR MOREIT IS A VIOLATION OF THE LAW FOR ANY PERSON, HELICES. THE REVISED PILE SHALL BE INSTALLED BEYOND THE TERMINATION DEPTH ,UNLESS ACTING UNDER THE DIRECTION OF A OF THE ORIGINAL PILE,AS DIRECTED ENGINEER. LICENSED ARCHITECT ENGINEER,TO ALTER IN ANY c) ADD ADDITIONAL PILES AS RECOMMENDED BY ENGINEER. WAY ANY ITEM ON THESE DRAWINGS. IF AN ITEM B) IF THE MAXIMUM TORQUE RATING OF THE PILE AND/OR INSTALLING UNIT BEARING THE SEAL OF AN ARCHITECT/ENGINEER IS HAS BEEN REACHED PRIOR TO SATISFYING THE MINIMUM DEPTH REQUIREMENT,THE ALTERED,THE ALTERING ARCHITECT\ENGINEER 24"SQR(POURED CONCRETE PILE CAP CONTRACTOR SHALL HAVE THE OPTION TO INCREASE THE TERMINAL TORQUE TO A SHALL AFFIX TO HIS/HER ITEM THEIR SEAL AND THE WITH(5) #5 EPDXY COATED MAXIMUM OF 5500 FT.LBS. (5000 FT.LBS. WITH PORTABLE EQUIPMENT.),AFTER NOTATION"ALTERED BY" FOLLOWED BY HIS/HER REBAR IEQL SPCD E/W&NEW CONSTR CONSULTING WITH THE ENGINEER OF RECORD.THE CONTRACTOR MAY REDUCE THE SIGNATURE AND THE DATE OF SUCH ALTERATION, BRACKET(PTS MODEL#NCB-6-6-2H- SIZE OF THE HELIX AS REQUIRED TO ACHIEVE THE MINIMUM DEPTH WHILE STILL ANDA SPECIFIC DESCRIPTION OF THE ALTERATION RCS ACHIEVING THE MINIMUM TORQUE. W/3"COVER1s'o" 7. HELICAL PILES SHOULD BE INSTALLED AS SHOWN ON THE ENGINEER'S PLAN.ALL ON THE DRAWING. ""THE PLANS AND MINIMUM SPECIFICATIONS HEREIN ARE INTENDED FOR THE PILE DEPTH CHANGES IN PILE LOCATION MUST BE APPROVED BY THE ENGINEER. SUBJECT PROJECT ONLY AS A RESULT OF NOTE:ALL REBAR FOR THIS PROJECT 8. IF UNDERGROUND OBSTRUCTIONS ARE ENCOUNTERED DURING INSTALLATION,THE CONTRACTUAL NEGOTIATIONS BETWEEN THE S/B ASTM GR60 HD GALV OR EPDXY CONTRACTOR SHALL HAVE THE OPTION OF REMOVING THE OBSTRUCTION IF POSSIBLE OWNER AND PHILIPP E. KAMPF.THESE PLANS AND COATED OR RELOCATING THE PILE WITH THE ENGINEER'S APPROVAL. THE LATTER OPTION MAY SPECIFICATIONS WILL BE THE SUBJECT OF A REQUIRE THE RELOCATION OF ADJACENT PILES. COPYRIGHT PETITION AND MAY NOT BE REVISED OR 9. THE HELICAL PILE SHALL BE CONNECTED TO THE STRUCTURE USING A PTS REUSED BY ANYONE WITHOUT THE WRITTEN APPROVED STEEL BRACKET OR SLAB-SUPPORTING CHANNEL AS THE CASE MAY BE-AS AUTHORITY OF PHILIPP E.KAMPF." HELICAL PILE RATED @ SHOWN ON ENGINEER'S PLAN. THESE CONNECTION DEVICES SHALL BE CAPABLE OF 20 TON ULTIMATE LOAD SAFELY TRANSFERRING THE STRUCTURAL LOADS TO THE HELICAL PILE. (10 TON WORKING LOAD) 10.WRITTEN INSTALLATION RECORDS SHALL BE OBTAINED FOR EACH HELICAL PILE. &NEW CONSTR BRKT BY THESE RECORDS SHALL INCLUDE, BUT ARE NOT LIMITED TO THE FOLLOWING: PTS a) PROJECT NAME AND/OR LOCATION. b) NAME OF CONTRACTOR'S FOREMAN OR REPRESENTATIVE WHO WITNESSED THE INSTALLATION. A P C H I T E C T U R E & D E S I G N 1 TYPICAL PILE DETAIL c) DATE AND TIME OF INSTALLATION.d) LOCATION AND REFERENCE NUMBER OF EACH PILE. NTS e) DESCRIPTION OF LEAD SECTION AND EXTENSIONS INSTALLED. PHILIPP E. KAMPF fl OVERALL DEPTH OF INSTALLATIONS REFERENCED FROM BOTTOM OF GRADE BEAM OR FOOTING. 107 CENTER STREET PHONE: 631-943-1081 g) TORQUE READING FOR THE LAST THREE FEET OF INSTALLATION IF PRACTICAL. IN BAY SHORE, N.Y. 1 1706 EMAIL: PH ILIPPKAMPF@PKAD.NET LIEU OF THIS REQUIREMENT,THE TERMINAL TORQUE SHALL BE RECORDED AS A Will MINIMUM. h) ANY OTHER RELEVANT INFORMATION RELATING TO THE INSTALLATION. 11 PILE MFG; PREMIUM TECHNICAL SERVICES 2487 NORTH JERUSALEM ROAD EAST MEADOW, NY 11554, WWW.PREMIUMTECHNICAL.COM CONTROLLED INSPECTION REQUIREMENTS TEST PILE INSTALLATION..................................................EOR PILE INSTALLATION................................................................EOR CONCRETE MIX CERTIF..........................................................EOR REBAR PLACEMENT AND FORMWORK..............................EOR NOTE: TIMBER POST&UPLIFT CONNECTION INSTIL...........EOR CONTRACTOR TO PROVIDE SIMPSON H2.5 CLIPS NOTE: EOR RETAINED BY OWNER NOT GC OR PILE CONTRACOR. ON ALL BEARING WALLS WHERE FLOOR JOISTS MEET NEW GIRDER. 1-vr 1.1@" 1" 13/16"IDIA.HOLE 0 STEEL STENCIL 55" - 0�� 0" TYP PROJECT 3"TY . 1-1/2"X 60"D6 HELICAL LEAD MAUL RESIDENCE TYPICAL PILE DETAIL (20 TON ULTIMATE CAPACITY) 266 ,JACKSON 2 NTS STREET, NEW SUFFOLK, NY 11956 -- r1,z y 1i4 ITEM# DESCRIPTION PART NO. DWG.NO. QUAN. A 6 1. PIPE SHAFT,2"SCH 80 X 6" 304028 M-1986 1 2. PLATE,112 X 6"SQ. 304108 M-2762 1 HELICAL PILE NOTES INFORMATION 1.HOT DIP GALV.PER ASTM Al 53, AFTER FABRICATION. 2"SCH 80 CATALOG N0. PART PIPE N-6401-0081 A STAMP AREA: DATE: NEW CONSTRUCTION BRACKET 7/9/16 FOR 1 112&13/4 ROD PROJECT 'r�, NUMBER: 42858 TYPICAL FOUNDATION BRACKET DETAIL �� Q K�MpF °� DRAWING BY: PEK t � NTS �Lij �� � a z CHK BY: PEK nx.�~R` h �� Q o DWG No: co Jr- co co 0.PIN � A-110.00 STS?-E OF ��� CAD FILE N N 42858 co