HomeMy WebLinkAbout42570-Z c��Ft1F Town of Southold
2/27/2019
( = a P.O.Box 1179
53095 Main Rd
Southold,New York 11971
7
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CERTIFICATE OF OCCUPANCY
No: 40231 Date: 2/27/2019
THIS CERTIFIES that the building IN GROUND POOL
Location of Property: 1005 Mason Dr., Cutchogue
SCTM#: 473889 Sec/Block/Lot: 104.-5-36
Subdivision: Filed Map No. Lot No.
conforms,substantially to the Application for Building Permit heretofore filed in this office dated
4/9/2018 pursuant to which Building Permit No. 42570 dated 4/16/2018
was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy,for '
which this certificate is issued is:
accessory in-ground swimming pool as applied for.
The certificate is issued to Schneider,Kenneth
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 42570 11/1/2018
PLUMBERS CERTIFICATION DATED
ut o ' ed Signature
•
TOWN OF SOUTHOLD
u .°•:. �v:: BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, NY
y`iYi-•ar=-`�{r
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#: 42570 Date: 4/16/2018
Permission is hereby granted to:
Schneider, Kenneth
1005 Mason Dr
Cutchogue, NY 11935
To: construct accessoryinround swimming-g g pool as applied for.
At premises located at:
1005 Mason Dr., Cutchogue
SCTM # 473889
Sec/Block/Lot# 104.-5-36
Pursuant to application dated 4/9/2018 and approved by the Building Inspector.
To expire on 10/16/2019.
Fees:
SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00
CO - SWIMMING POOL $50.00
Total: $300.00
Buil spector
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.
New Construction: Old or Pre-existing Building: (check one)
Location of Property: Mets O1 J N- L) 610
House No. Street Ha t
K'e V .
Owner or Owners of Property: AI V� d i C-1/__
Suffolk County Tax Map No 1000, Section ly4 _/QV Block Lot 3(P
Subdivision Filed Map. Lot:
Permit No. S Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ 5,0
x
'pplicant Sinale
Town Hall Annex _ Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 =-
,•.ti; roper.richert(_town.southold.ny.us
Southold,NY 11971-0959 r"
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Kenneth Schneider
Address: 1005 Mason Dr City: Cutchogue St: New York Zip: 11935
Building Permit* 42570 Section 104 Block: 5 Lot, 36
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Eastern Electrical Cont. License No: 5089-ME
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service Only
Commerical Outdoor X 1st Floor Pool X
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt 2 Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks 1
Disconnect Switches 1 Twist Lock Exit Fixtures TVSS
Other Equipment: In ground swimming pool to include, bonding, control panel, 2-GFCI circuit breakel
2-pool lights,pool cover motor,gas pool heater,pool pump.
Notes.
Inspector Signature: - Date: November 1 2018
81-Cert Electrical Compliance Form.xls
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* TOWN OF SOUTHOLD BUILDING DEPT.
courm��'' 765-1602
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)
[ ] CODE VIOLATION [ ] CAULKING
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REMARKS. `/ M 5'T-c>P- viorK
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DATE f(�/1���� INSPECTOR
�o�aOF 50Ulyo�
# # TOWN OF SOUTHOLD BUILDING DEPT.
`ycou765-1802
[NSPECTION -
FOUNDATION
1ST [ ] ROUGH PLBG. Z 7
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) r] ELECTRICAL (FINAL)
[_ ] CODE VIOLATION [ ] CAULKING
REMARKS:
f- --�PLJ L4
DATE / > INSPECTORc�C c
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soulyolo
# # TOWN OF SOUTHOLD BUILDING DEPT.
°�courm e�' 765-1602
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] SULATTIO
[ ] FRAMING /STRAPPING [ FINAL ;
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION - _ „ [-_] CAULKING
REMARKS::' ...-
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DATE INSPECTOR OA fl
FIELD INSPECTION REPORT DATE COMMENTS
FOUNDATION(1ST)
-------------------------------------
'FOUNDATION (2ND) t�
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ROUGH FRAMING& t�
PLUMBING
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INSULATION PER N.Y: H
STATE ENERGY CODE
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FINAL
ADDITIONAL COMMENTS
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BIUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL Board of Health
SOUTHOLD,NY 11971 !4 sets of Building Plans
TEL:(631)765-1802 Planning Board approval
FAX:(631)765-9502 —Survey
IT NO.
Southoldtownny.gov PERMCheck
Septic Form
NYSDEC
Trustees
--C O Application
qh Flood Permit
Examined 2 Single&Separate
D Truss Identification Form
-
� "Storm-Water Assessment Form
Contact: \- r
Approved 20� �Iefatf-taJ�Y11n Nlbq-6 Pv&)
Disapproved a/c _
�wN�F S� Phone 1��1 1 ILO
Expiration 20
Build gctor
APPLICATION FOR BUILDING PERMIT
13 Date L4 /0p
20 W
INSTRUCTIONS
a This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
sets of plans,accurate plot plan to scale.Fee according to schedule
b.Plot plan showing location of lot and of buildings on premises,relationship to adjoining premises or public streets or
areas,and waterways
c The work covered by this application may not be commenced before issuance of Building Permit
d.Upon approval of this application,the Building Inspector will issue a Building Permit to the applicant Such a permit
shall be kept on the premises available for inspection throughout the work.
e No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector
issues a Certificate of Occupancy.
f.Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date.If no zoning amendments or other regulations affecting the
property have been enacted in the interim,the Building Inspector may authorize,in writing,the extension of the permit for an
addition six months.Thereafter,a new permit shall be required
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold,Suffolk County,New York,and other applicable Laws,Ordinances or
Regulations,for the construction of buildings,additions,or alterations or for removal or demolition as herein described.The
applicant agrees to comply with all applicable laws,ordinances,building code,housing code,and regulations,and to admit
authorized inspectors on premises and in building for necessary inspections.
(Signature of appis t or name,if a corporation)
(5 (-ardenil-i Hve /�✓j �� /�
(Mailing address of applicant)
State whether Tlicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder
Name of owner of premises ke r-\ I cJ�rZ e i'A-41-e-
(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:
House Number Street Hamlet `I /
County Tax Map No. 1000 Section Block Lot 26
Subdivision Filed Map No. Lot
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy
b. Intended use and occupancy
3. Nature of work(check which applicable):New Building Addition Alteration
Repair Removal Demolition Other Work peg Lo3 i
(Description)
4. Estimated Cost a�52 , p C7 Fee
(To be paid on filing this application)
5. If dwelling,number of dwelling units Number of dwelling units on each floor
If garage, number of cars
6. If business,commercial or mixed occupancy,specify nature and extent of each type of use.
7. Dimensions of existing structures,if any:Front Rear Depth
Height Number of Stories
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction:Front Rear Depth
Height Number of Stories
9. Size of lot:Front Rear Depth
10.Date of Purchase Name of Former Owner
11.Zone or use district in which premises are situated
12.Does proposed construction violate any zoning law,ordinance or regulation?YES_NO
13.Will lot be re-graded?YESNOWill excess fill be removed from premises?YES_�< NO_
14.Names of Owner of premises Address l OOS Mc-g a 0/' Phone No.
Name of Architect Address Phone No
Name of Contractor Address Phone No.
15 a.Is this property within 100 feet of a tidal wetland or a freshwater wetland?*YES NO
*IF YES,SOUTHOLD TOWN TRUSTEES&D.E.C.PERMITS MAY BE REQUIRED.
b.Is this property within 300 feet of a tidal wetland?*YES NO
*IF YES,D.E.C.PERMITS MAY BE REQUIRED.
16.Provide survey,to scale,with accurate foundation plan and distances to property lines.
17.If elevation at any point on property is at 10 feet or below,must provide topographical data on survey.
18.Are there any covenants and restrictions with respect to this property?*YES NO
*IF YES,PROVIDE A COPY.
STATE OF NEW YORK)
} cu SS:
COUNTY OF516, /()
Q Z�` 0— L)O�1,y'� Yin Qom-&vz' being duly sworn,deposes and says that(s)he is the applicant
0 x d
0 (Name of individual signing contract)above named,
W meaCL
-u « N L'U (S)He is the G
Qco
v co (Contractor,Agent,Corporate Officer,etc)
J —C��
p, of said owner or owners,and is duly authorized to perform or have performed the said work and to make and file this application,
(L z E that all statements contained in this application are true to the best of his knowledge and belief,and that the work will be
OU performed in the manner set forth in the application filed therewith.
Z2 Swom,t9 before me this
day of 20IA_�A' 'V* -, r) � n
/!
Woubl Signature of Applicant
Town Hall Annex Telephone(631)765-1802
54375 Main Road t + } Fax(631)765-9502
;3
P.O.Box 1179
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLI)
STOP WORK ORDER
TO: Kenneth & Cheryl Schneider
1005 Mason Drive
Cutchogue, New York 11935
YOU ARE HEREBY NOTIFIED TO SUSPEND ALL WORK AT:
1005 Mason Drive, Cutchoque, New York
S.C.T.M. 1000-104-5-36
Pursuant to Section 144-8 of the Code of the Town of Southold, New York, you
are notified to immediately suspend all work and activities until this order has
been rescinded.
BASIS OF STOP WORK ORDER:
Construction without a Building Permit. BP 42570 issued 4/16/2018 has not been
paid for. $300.00 is due for this permit.
CONDITIONS UNDER WHICH WORK MAY BE RESUMED:
When the fee for the Building Permit has been paid.
Failure to remedy the conditions aforesaid and to comply with the applicable
provisions of law may constitute an offense punishable by fine or imprisonment
or both.
DATED: 10/15/2018
Lester Baylinson
Ordinance Inspe t
(Cert. Mail)
1 -
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 ,
Southold,NY 11971-0959
jam' :., ;jlk�(�•; t•. C�:
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
VIOLATION NOTICE
TO: Kenneth & Cheryl Schneider October 19, 2018
1005 Mason Drive
Cutchogue, New York 11935
PLEASE TAKE NOTICE there exists a violation of Southold Town Code and
New York State Code
At premises hereinafter described in that:
Construction of an in around swimming pool without a valid Building Permit is a violation
of Southold Town Code(1448). Building Permit 42570 was issued on April 16 2018.The
fee due for the Building Permit is$300.00. This fee has not been paid therefore there is not
a valid Building Permit on file for the swimming pool.
The premises to which this ORDER TO REMEDY refers are situated at:
1005 Mason Drive, Cutchogue, New York
SUFFOLK COUNTY TAX MAP:
#1000-104-5-36
Failure to remedy the conditions aforesaid and to comply with the
applicable provisions of law may constitute an offense punishable by fine
or imprisonment or both.
zk��—a
l
Authorized Signe
Lester Baylinso
Ordinance Inspector
r"
Scott A. Russell ,��° � STO]KAWWA' IER
SUPERVISOR ( �T
I��1[A\1�A\ G�]EMUE1�`]C'
SOUTHOLD TOWN HALL-P.O.Box 1179
53095 Main Road-SOUTHOLD,NEW YORK 11971 ti� Town of So u th o l d
CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET
( TO BE COMPLETED BY THE APPLICANT )
DOES THIS PROJECT INVOLVE ANY OF THE FOLLOWING:
Yes No (CHECK ALL THAT APPLY)
❑� A. Clearing, grubbing, grading or stripping of land which affects more
than 5,000 square feet of ground surface.
❑ B. Excavation or filling involving more than 200 cubic yards of material
within any parcel or any contiguous area.
❑W C. Site preparation on slopes which exceed 10 feet vertical rise to
100 feet of horizontal distance.
❑[p D. Site preparation within 100 feet of wetlands, beach, bluff or coastal
erosion hazard area.
El V3 E. Site preparation within the one-hundred-year floodplain as depicted
on FIRM Map of any watercourse.
❑[�, F.- Installation of new or resurfaced impervious surfaces of 1,000 square
feet or more, unless prior approval of a Stormwater Management
Control Plan was received by the Town and the proposal includes
in-kind replacement of impervious surfaces.
If you answered NO to all of the questions above, STOP! Complete the Applicant section below with your Name,
SignattifE,-Contact Information,_Date & County Tax Map Number! Chapter 236 does not apply to your project.
*J If you answered YES to one or more of-the.above, please submit Two copies of a Stormwater Management Control Plan
and a completed Check List Form to the Building Department with your Building Permit Application.
APPLICANT- (Property Owner,Design Professional,Agent Contractor,Other) S.C.T.M. #: DOOic Date
NAME 04
( u 4Secti Block Lot
kI OR BUILDING DEPARTNIEN71- UISE ONLY *�*`
f -7���/�
Contact Information tt /// ggg
rd,phun,Numt ri
' Revie\�ed By: LLA-kk
— — — — — — — — — — — — — — — — — —
I Date. Cb
Property Address / Location of Construction Work: — — — — — — — — — — — — — — — —
1,
o .,! A-Z900 , I Approved for processing Building Permit
Stormwater Management Control Plan Not Required
E] Stormwater Management Control Plan is Required.
/ (Forward to Engineering Department for Review)
FORM SMCP-TOS MAY 2014
offOl'i[tco_.. BUILDING DEPARTMENT-Electrical Inspector
a TOWN OF SOUTHOLD
y.' ,. Town Hall Annex - 54375 Main Road - PO Box 1179
• Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX (631) 765-9502
roper richertCa�t'ownaouthold:ny::us:
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: ttft�ax I �� Stnq - Date:, - j�
Company Name: s_ ir /� �yppg p 9y� ��{
� I
Name: Ichcle-fl LA�
License No.: —- - - - - - ema"il: SI 'e� s+,, �r4r,c�
- - - � �• t�� y._
- - - -
Address: y�.o, 9O)KC tAwn %nk At q(P
Phone No.: _ Iv3�_ ��� __ 11 0-0 _ -CP I l 03 -7liq I -
JOB SITE INFORMATION: (All Information Required)
Name: Kp-n 5Chae—o f-C - - -
Address:
Cross Street: Irco d war 3 Drt V t- _,-
Phone No.: Col 6__ `1NA®� d --
Bldg.Permit#: �}a �� - - email: y
Tax Map District:_ 1000 Section: 9 O Li Block: _ _ _ Lot: -?)(p-
BRIEF DESCRIPTION OF WORK(Please Print Clearly) _ ?6o1 wtrn
Circle All That Apply:Is job ready for inspection?: YES NO Rough In Final
Do you need a Temp Certificate?: YES / O Issued On _
1Temp Information. (All information required)
Service,Size 1 Ph 3 Ph A # Meters,-_ _ Old Meter#
11ew Service- Fire Reconnect- Flood Reconnect- Service Reco -Underground - Overhead
- #Underground Laterals__ 1 2_ H Frame Pole Work done on Service? _ Y
Additional Information:- _ 3 i oo ,O O
--- - ---- - - - -
- - PAYMENT..DUE WITH APPLICATION CD _
®0
® I a° ®A
82-Request for Inspection FormAs . )�, � ��
HM ENGINEERING P.C.
3 CHERRYWOOD DRIVE
EAST NORTHPORT,NY 11731
TEL:516-476-5392
EMAIL:HMARNIKA@OPTONLINE.NET
March 25, 2018
D
Town of Southold
Building Department TOWN OF SOUTHOLD
Town Hall
Southold,N.Y. 11971
Dear Sir/Madam:
This is to certify that the drainage facilities to be used exclusively for the construction of a swimming pool
on the premises of:
Schneider Residence
1005 Mason Drive
Cutchogue,N.Y. 11935
will not require draining because the pool is of gunite construction. The pool water will be continuously
recirculated through the filter and will be reused from year to year. The drainage from the filter backwash
is nominal and will not interfere with the public water supply, the existing sanitary facilities or public
highways.
Sincerely,
HM En ineering P.C.
feoj
/ti
a P.E.
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From: Michael Single <mike@easternelectrical.com>
Sent: Thursday, November 01, 2018 10:13 AM
To: Dwyer, Tracey
Subject: 1005 Mason Drive Cutchogue
Michael R Single
Eastern Electrical Contractors Inc.
1 Jackson Avenue South
Hampton Bays NY 11946
Office 631728-1100
Fax 631728-1101 mikea easternelectrical.com
Begin forwarded message:
From: Jeff<jsin leg 2502optonline.net>
Date: November 1, 2018 at 7:54:44 AM EDT
To: Mike<mike e,easternelectrical.com>
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SUFFOLK COUNTY DEPT OF LABOR,
LICENSING & CONSUMER AFFAIRS
HOME IMPROVEMENT
CONTRACTOR
LICENSE
NAME
MYKHAYLO ABRAMCHUK
This certifies that the BUSINESS NAME
AQUA COASTAL INC
bearer is duly
licensed by the
License Number Date Issued
County of Suffolk
//f / 43470-H 09/19/2007
,7Q tl+P /1Q tQ��r'
on mi ssioner E XPRATION DATE 09/01 /2019
New York State Insurance Fund
Workers'Compensation&Disability Benefits Specialists Since 1914
8 CORPORATE CENTER DR,3RD FLR,MELVILLE,NEW YORK 11747-3129
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE (RENEWED)
2 0
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A A^AAA 202506176 '
PROACTIVE BROKERAGE INC
926 SUNRISE HIGHWAY
WEST BABYLON NY 11704
SCAN TO VALIDATE
AND SUBSCRIBE
POLICYHOLDER CERTIFICATE HOLDER
AQUA COASTAL INC TOWN OF SOUTHOLD
P 0 BOX 226 53095 ROUTE 25
ISLIP TERRACE NY 11752 SOUTHOLD NY 11971
POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE
11415789-5 362831 04/01/2018 TO 04/01/2019 3/19/2018
THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE
FUND UNDER POLICY NO 1415 789-5, 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:INUWW.NYSIF.COM/CERT/CERTVAL.ASP.THE NEW
YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS.
THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE
INSURED CORPORATION
MYKHAYLO ABRAMCHUK(PRES)
OF ONE PERSON CORP
AQUA COASTAL INC
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 STATEINSURANCEFUND
U
DIRECTOR,INSURANCE FUND UNDERWRITING
VALIDATION NUMBER:730676488
U-26 3
TE(MM/DD/YYYY)
A�®® CERTIFICATE OF LIABILITY INSURANCE
F73/19/2018
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: 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 CONTACT
NAME:
PROACTIVE BROKERAGE INC PHONE 631 482-1860 Fn c No): 888 859 6455
926 Sunrise Highway
E-MAIL info@ roactivebro.COM
West Babylon,NY 11704 INSURERS AFFORDING COVERAGE NAIC#
INSURERA Atlantic Casualty Insurnace Co
INSURED Aqua Coastal Inc. INSURER Progressive Insurance
INSURER C
INSURER D
PO BOX 226 INSURERE'
Islip Terrace NY 11752 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 EFF POLICY EXP LIMITS
LTR POLICYNUMBER MM/DD/YYYY MM/DDlYYYY
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
DAMAGE TO RENTED
CLAIMS-MADE FX1 OCCUR PREMISES Ea occurrence) $ 100,000
MED EXP(Any one person) $ 5,000
A Y L035013818 7/30/2017 7/30/2018 PERSONAL&ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000
POLICY[X]jE O LOC PRODUCTS-COMP/OP AGG $ 1,000,000
OTHER $
AUTOMOBILE LIABILITY EO aBIINdEeDtSINGLE LIMIT $ 1,000,000
ANY AUTO BODILY INJURY(Per person) $
OWN
B AA OS ONLY X AUTOSULED 03861607-1 7/22/2017 7/22/2018 BODILY INJURY(Per accident) $
HIRED NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY Per acadent
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LIAB HCLAIMS-MADE AGGREGATE $
DED I I RETENTION$ $
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS'LIABILITY Y/N STATUTE ER
ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? N/A
(Mandatory in NH) E L DISEASE-EA EMPLOYE $
If yes,describe under
DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if mon:space is required)
The following are included as additional insured required by written contract subject
to the terms and conditions of stated polices:Town of Southold
CERTIFICATE HOLDER CANCELLATION
Town of Southold SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
53095 Route 25 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Southold NY 11971 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
I 88-z2001 5-ACOND CORP16RA11URVAII rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
S.d.D.H.S. REF. NUMBER R10-00-0215
NG G SURVEY OF PROPERTY
s cAMpBEvu �� OSO
AT CUTCHOO UE
RINE J A BvG pro
P`0 WN OF SO UPHOLD
N/o/F A uNG ,�� p� O SUFFOLK COUNPY, X Y.
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AREA=26,463 80. FT': sod •�Sir i; o,�� P �z
'i=MONUMENT
r=PIPE
ELEVATIONS REFERENdED TO N.A.V.D. CD*,J-XNG `' b
l am familiar with th6 STANDARDS Fd_R APPROVAL ��
AND CONSTRUC77ON dF SUBSURFACE SEWAGE tAND
DISPOSAL SYSTEMS FOR SINGLE FAM1L Y RESIDENCES - LIC. NO. 4961 -
and will abidd by the conditions set forth therein and on the ANY ALTERA170N OR A00I77ON TO THIS SUI;VEY IS A WOLA TION IP CON/C`S WYORS; P.C.
permit to coristruct. OF SECTION ;r2090F THE NEW YORK STATE EDUCA77ON LAW. (631) 765-50 0-FAX (631) 765-1797
EXCEPT AS PER SEC77CN 7209-SUBDIVISION 2. ALL CER7If7CA77ONS P.O. BOX 909
HEREON ARE VALID F(* THIS MAP AND COPIES 774ERtOF ONLY IF
The location of public water,Wells and cesspools shown hereon ore SAID MAP 09 COPIES BEAR tHE IMPRESSED SEAL OF THE SURVEYOR 1230 IRA l/ELEft' STREE' 12-L119
from field observations and or from data obtained frdm other's. WHOSE SIGNATURE APPEARS HERk7ON. SOUTHOLD, N. Y. 11971
I.
APPROED AS NOTED 2
DATE:42_ 6�,"'04�
BP:B � � ZFEE:_ RETAIN STORM WATER RUNOFF
BY: PURSUANT TO CHAPTER 236
NOTIFY,BUILDING DEPAR AT - OF THE TOWN CODE.
765-1802 8'AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
-FOR POURED CONCRETE
2. ROUGH-- FRAMING & PLUMBING
3. INSULATION ELECTRICAL
4. FINAL - CONSTRUCTION MUST INSPECTION REQUIRED
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS.
kElC:dr'a .•'^r-7?=fig_° 4"--? ^+'?-- u''i-,_/4�',�. ;i�;��`a_ --,
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POOL NOTES: \
1.POOL AND PROPERTY TO CONFORM TO 2017 NYS UNIFORM CODE,THE
POOL DECK TO 12" 2015 IRC,2 nd PRINTING,AS AMENDED BY THE 2017 NYS UNIFORM CODE
PUMP STAIRS SHALL BE OF SLOPE AWAY FROM SUPPLEMENT,2017 SUPPLEMENT TO THE NYS ENERGY CONSERVATION
POOL 2%MIN. WATER LEVEL 3" CONSTRUCTION CODE,TOWN OF SOUTHOLD CODE AND 2014 NATIONAL
FILTER NON-SLIP DESIGN COPPING POO FROM TOP OF ELECTRIC CODE.
SUCTION SKIMMER . 11 ' + 2.POOL SHALL CONFORM TO ANSI/NSPI STANDARDS R326.3.1.
BENCH (3) #4 BARS '' a e .. 6" FROST PROOF TILE BAND 3.SECTION R326.7 POOL ALARM REQUIRED.
CONTINUOUS GRADE .' 4.ENTRAPMENT PROTECTION REQUIRED SECTION R326.6.
BEAM ALL AROUND At • , '. ,, Si POOL SHALL COMPLY WITH BARRIER REQUIREMENTS SECTION R326.5.
TIES 12" D.C. PNEUMATICALLY APPLIED CONCRETE 6.POOL SHALL COMPLY WITH INTERNATIONAL ENERGY CONSERVATION
CODE SECTION R403.10:
y4 BARS 0 12" O.C. a T, POOLS AND PERMANENT SPA ENERGY CONSUMPTION(MANDATORY).
VERTICAL AND HORIZONTAL '
SWI . SECTION R403.10.1 HEATERS
RETURN WHTE MARBLE DUST a�WALL THICKNESS , a. DIRECTIONAL INLET 2.5' SECTION R403.10.2 TIME SWITCHES_ 3.0 THROUGHOUT R403.10.3 COVERS
�fT VARIES 6" TO 8" �f 1
(MIN.) 648$F, 18� 6"(MIN.) .. �.a 7.THE DESIGN IS BASED ON A DRAINAGE SOIL WITH<10%SILT.GROUND
WHITE MARBLE DUST FINISH WATER SHALL NOT EXIST WITHIN LIMITS OF THE EXCAVATION.IF GROUND
DUAL MAIN DRAIN , y ; RADIUS VARIES
WITH STRAINER VGB 'a' WATER EXISTS WITHIN 6'BELOW GRADE SPECIAL DEWATERING FACILITIES
1' RADIUS ROUNDED CORNERS
( r WILL BE REQUIRED.WATER DISPOSAL IS LIMITED TO OWNERS PROPERTY.
SAFETY ACT #4 BARS ®6" O.C. IN RADIUS :�+ (SHALLOW END) ,
moposm
APPROVED DRAINS) AND VERTICAL WHEN WALL 5.5' (MAX.) RADIUS ROUNDED 8.NO SURCHARGE ALLOWED WITHIN 4 OF SHALLOW END AND 6 OF DEEP
HEIGHT EXCEEDS 5' ''i ' CORNERS (DEEP END) END.
36' (ALTERNATE BARS) n t, X14 REBARS - 12" ON 9. THE PNEUMATICALLY APPLIED CONCRETE(GUNITE)SHALL BE 4,000 PSI
! , CENTER EACH WAY @ 28 DAYS.
', • (FLOOR) 10.REINFORCING STEEL SHALL BE INTERMEDIATE GRADE BILLET STEEL
M WITH A MINIMUM LAP OF 30 BAR DIAMETERS.
d!A +
11.REBAR SHALL BE 3"MIN.CLEAR TO EARTH.
ALL CORNERS FORMED 12.POOL WATER SUPPLY BY OWNERS GARDEN HOSE.POOL TO BE KEPT
3" TO 6" CLEARANCE POOL PLS, FULL DURING EMPTY POOL IN EE HOURS.
WEATHER.PUMP CAPACITY TO BE SUFFICIENTTO
BY INTERSECTION OF 6.5"
BETWEEN POOL LADDER NOT TO SCALE WALLS AND FLOOR 6 SLAB
AND WALL SHALL BE ROUNDED 13.LOCATION OF PROPOSED SWIMMING POOL AND POOL EQUIPMENT BY
TYPICAL WALL SECTION OTHERS AND SHALL COMPLY WITH ALL LOCAL ZONING REQUIREMENTS.
NOTE: 14.ALL DRAIN COVERS TO MEET ALL REQUIREMENTS OF THE VIRGINIA
THIS IS A NON-DIVING POOL. NOT TO SCALE GRAEME BAKER(VGB)POOL AND SPA SAFETY ACT.
15. NO DIVING EQUIPMENT PERMITTED.
FILL SPOUT AS 16.CONTRACTOR SHALL VERIFY SOIL BEARING LOADS PRIOR TO
REQUIRED INSTALLATION OF POOL.
SKIMMER INLET PROVIDE SEALING 17.SLOPE PATIO SURFACE 1/4"PER FOOT AWAY FROM POOL.
BULLNOSE COPING (TYP•) (TYP•) AT DECK COPING 18. THIS PLAN IS FOR CONSTRUCTION ON PROPERTY AT 1005 MASON
(TYP.) LADDER WATER LEVEL 19.DRIVE,CUTCHOGUE,N.Y.11935 ONLY.
19.HM ENGINEERING,P.C.SHALL NOT BE RESPONSIBLE FOR
CONSTRUCTION MEANS,METHODS,TECHNIQUES OR PROCEDURES
O ®O UTILIZED BY THE CONTRACTOR,NOR FOR THE SAFETY OF THE PUBLIC OR
3.5GRADE BEAM CONTRACTOR'S EMPLOYEES,OR FOR THE FAILURE OF THE CONTRACTOR
UNDERWATER 8.0` (�.) TO CARRY OUT THE WORK IN ACCORDANCE WITH THIS PLAN.
LIGHT
(OPTIONAL)
6" THICK
CONCRETE (TYP.) 1 1/2" TO WASTE
HAIR & LINT STRAINER
0.50' 36' 0.50' PUMP
DUAL MAIN DRAIN WITH FOR POOLS CONSTRUCTED ON VIRGIN FILTER AUTO SKIMMER
HYDROSTATIC VALVE AND SOIL, COMPACT BASE TO 95% MODIFIED
COLLECTOR TUBE IN PROCTOR. FOR POOLS CONSTRUCTED ON
GRAVEL BASE BACKFILL MATERIAL, POOL CONTRACTOR DUAL MAIN DRAIN
POOL PROFILE TO INSTALL 6" COMPACTED GRAVEL BASE ) It POOL v LT�HYDRDOSTA71C
NOT TO SCALE POOL BACKTO COLLECTOR TUBE IN
PREPARED FOR: GRAVEL BASE
SCHNEIDER RESIDENCE
1005 MASON DRIVE SCHEMATIC PIPING ARRANGEMENT
CUTCHOGUE, N.Y. 11935 NOT TO SCALE
DATE: 03/25/2018
NOTE: 4 HM ENGINEERING P.C. SCALE: ASSHOWN
THESE PLANS ARE AN INSTRUMENT OF SERVICE AND ARE THE PROPERTY OF HM ENGINEERING P.C..UNAUTHORIZED /O SHEET: 1 OF 1
ALTERATIONS OR ADDITIONS TO THESE DOCUMENTS ARE A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE " 3 CHERRYWOOD DRIVE EAST NORTHPORT,NY 11731
EDUCATION LAW.INFRINGEMENTS WILL BE PROSECUTED. Tel:(516)476-5392 Fax:(631)980-7671 www.hmarnika@optonline.net RESIDENTIAL GUNITE
VOID WITHOUT RAISED SEAL AND BLUE SIGNATURE SWIMMING POOL PLAN
CAST IRON FRAME & COVER
IF UNDER PAVED AREA] FINISHED GRADE
8' MIN. - 12' MAX, ���� 24' r;���ti
BRICK LEVELING COURSE MIN_
CONCRETE COVER 27' zo NOTES:
PRECAST CONC. COLLAR MAX
AS REQUIRED 1. UNSUITABLE MATERIAL SHALL BE REMOVED UNDER LEACHING POOL
PRECAST UNTIL 6' MINIMUM PENETRATION INTO VIRGIN STRATA SAND AND
REINF. CONC. GRAVEL AND BACKFILLED WITH SAND AND GRAVEL TO BOTTOM OF
DOME BASIN.
4'0 PVC 2. AS AN ALTERNATIVE TO THE DOME TOP, A FLAT SLAB CAN BE
MIN. SOPFOOT ® ® ® ®❑ SUBSTITUTED WITH APPROVAL OF THE ENGINEER.
PERINVER ® ® ®o 3. LOCATION OF DRAINAGE POOL TO BE DETERMINED BY OTHERS.
NON-SHRINK Nu
GROUT ED❑ 4. ALL DRAINAGE PIPES MUST BE PROVIDED WITH A MINIMUM 2'-0"
3' MIN. SAND COVER.
m ❑ AND GRAVEL -i
a COLLAR (TYP) a 5. COLLAR IS NOT REQUIRED WHEN RATEABLE MATERIAL EXISTS FOR
w ALL AROUND H a FULL DEPTH.
m W
PRECAST REINF. m
CONC. LEACHING - 6. THE MATERIAL USED FOR COLLARING SHALL BE COMPRISED OF
�- RINGS cz W SAND AND GRAVEL CONTAINING LESS THAN FIFTEEN (15) PERCENT
v
C3 w w FINE SAND, SILT AND CLAY. SILT AND CLAY FRAC11ONS ARE NOT
\v, W TO EXCEED (5) PERCENT.
�
: 4' DIAMETER
wa
Z� pRY
' -ELL CALCULATION:
BACKWASH FROM POOL 70 GPM @ 4 MIN.'= 280 GAL. (37.4 CF)
DRYWELL CAPACITY = 327 GAL. (43.8 CF)
e '2!3 o-•' •.'• •.•ooeo•••�l�
XZ -6' MIN. PENETRATION
Fu a INTO VIRGIN STRATA Q
GROUND WATER
at OF SAND & GRAVEL
DRAINAGE POOL DETAIL
NOT TO SCALE
PREPARED FOR:
SCHNEIDER RESIDENCE
1005 MASON DRIVE
CUTCHOG,UE, N.Y. 11935
NOTE: /
THESE PLANS ARE AN INSTRUMENT OF SERVICE AND ARE THE PROPERTY OF HM ENGINEERING P.0. J7�/v HM ENGINEERING, P.C. DATE: 03/25/2018
UNAUTHORIZED ALTERATIONS OR ADDITIONS TO THESE DOCUMENTS ARE A VIOLATION OF SECTION 7209 OF THE / J SCALE: NOT TO SCALE
NEW YORK STATE EDUCATION LAW. INFRINGEMENTS WILL BE PROSECUTED ` SHEET: 1 OF 1
3 CHERRYWOOD DRIVE EAST NORTHPORT,NY 11731
VOID WITHOUT RAISED SEAL AND BLUE SIGNATURE Tel:(516)476-5392 Fax:(631)980-7671 www.hmarnika@optonline.net DRYWELL DETAIL