HomeMy WebLinkAbout43496-Z Fac,f Town of Southold 9/17/2019
P.O.Box 1179
53095 Main Rd
P44 pti Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40698 Date: 9/17/2019
THIS CERTIFIES that the building IN GROUND POOL
Location of Property: 500 Four Winds Ct, Southold
SCTM#: 473889 Sec/Block/Lot: 88.-6-13.38
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
2/13/2619 pursuant to which Building Permit No. 43496 dated 2/26/2019
was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for
which this certificate is issue&"is:
IN-GROUND SWIMMING POOL,FENCED TO CODE, AS APPLIED FOR
The certificate is issued to Zatcoff,Adam&Shira
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43496 07-24-2019
PLUMBERS CERTIFICATION DATED
Signature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
v • 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#: 43496 Date: 2/20/2019
Permission is hereby granted to:
Zatcoff, Adam
34 Joyce Ln
Woodbury, NY 11797
To: construct accessory in-ground swimming pool as applied for.
At premises located at:
500 Four Winds Ct, Southold
SCTM # 473889
Sec/Block/Lot# 88.-6-13.38
Pursuant to application dated 2/13/2019 and approved by the Building Inspector.
To expire on 8/21/2020.
Fees:
SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00
CO - SWIMMING POOL $50.00
Total: $300.00
Building Inspector
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. For new building or new use:
1. Final survey of property with accurate location of all buildings,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. - o2— L)-15
New Construction: ✓ Old or Pre-existing Building: (check one)
Location of Property: _ 500 RA �C1•J QL Q
House No. Street Hamlet
Owner or Owners of Property: &WA-r b 1
Suffolk County Tax Map No 1000, Section Block Lot 13,38
Subdivision Filed Map. Lot:
Permit 140. Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
-Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $
s<�
Applica it Sig ature
f �
Town Hall Annex /sem® Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 • y®� sear.devlinatown.southold.ny.us
��C®UIQ 1
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To Adam Zatcoff
Address: 500 Four Winds Ct city Southold st: NY zip: 11971
Building Permit* . 43496 Section- 88 Block: 6 Lot: 13.38
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Emerald Electric Inc. License No: 4868-ME
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service Only
Commerical Outdoor X 1 st Floor Pool X
New X Renovation 2nd Floor Hot Tub
Addition Survey X Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt 1 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 2
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks 2
Disconnect Switches Twist Lock Exit Fixtures TVSS
Other Equipment: Salt generator, Switch for heater, Heater, Pump main, Pump booster, Bonding,
220 GFCI breakers for pumps-2, 115 GFCI breaker for heater/ lights
Notes,
Inspector Signature: Date: July 24, 2019
S.Devlin-Cert Electrical Compliance Form.xls
oFso�lL4 1�
Ll 9 (o (rods)
# TOWN OF SOUTHOLD BUILDING DEPT.
cou765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY- [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING-
REMARKS:
DATE 41 INSPECTOR ( 07�D
SO(/ly0
# # TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION ,
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ rSULATON
FRAMING /STRAPPING [ NAL of
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
nrl �Vlkt W4
LAO) ir-damL-, mL&A-
-�06
DATE INSPECTOR
OF SOUTyO
* # TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION ,
[ ] FOUNDATION 1ST [ ] ROUGH PLSG.
[ ] FOUNDATION 2ND [ ] *SULAT"N
[ ] FRAMING /STRAPPING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFE INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
DAT INSPECTOR
FIELD INSPECTION REPORT DATE COMMENTS
FOUNDATION (1ST)
' H
i ----------------------------------
'FOUNDATION (2ND)
" � O
ROUGH FRAMING&
PLUMBING H
INSULATION PER N.Y-. y
STATE ENERGY CODE
�0 { AJC •
vl
idi
FINAL
ADDITIOIJAL COMMENTS
z
z
TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CICKLIST
BUILDING DE9PsARTIVIEN�" 4;
Do you Have or need the following,:before applying?
TOWN.HALL,, Board of Health
SOUTHOLD,NY 11971
3 sets of Building Plans
`TEL:-765-1802
rJ Survey
PERMIT NO: J Check
Septic Form
N.Y.S.D.E.C.
Examined 9X ad ,20Contact:Trustees
_ -
Approved d ,20 Mail to:
Disapproved a/c
S(/ 6 Phone:
DBu ector
-X FEB 1 3 2019
APPLICATION FORZUILDINGrPERM-JT
15UILD!iTC D��I%T r
TOWN OF SOUTHOLD INSTRUCTIONS- Date- , 20 19
a.This application MUST'be completely filled in by typewriter or,in ink and submitted to the Building Inspector with 3
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 orpublic 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- pur'po'se what-so-ever until a Certificate of Occupancy
is is suped by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zon&Ordinance�of he-Town ofFSouthold •Suffolk;County;New'York,and other applicable Laws;bidiifances 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,•bufldmg code,housing,code, ,regulations,rand-to admit
authorizdd7inspecf6rs on premises,apdf in building for necessary-inspections.
(Signator of applic t r came;if a corporation)
q)Oi kt- )-S-A 411& Pbu 11L,11170V
(Mailing address of applicant),- -
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber;or,builder
j.
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. 3b HT
Plumbers LicenseNo.
Electricians License No. 430y A-- 1-4�=
Other Trade's License No.
1. Location of land on which proposed work will be done:
500 ",FAIR kAm" 0*
House Number Street Hamlet t
County Tax Map No. 1000 Section BlockLOt ,�8
Subdivision NS'geL wS Filed Map No. 7Zc Lot : )I�
(Name)
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 ocouparicy QP�IW/VAt. Kw) r1i1NA)I-
3. Nature of work(check which applicable):New Building Addition Alteration
Repair Removal- Demolition Other Work=„)J" Vlnv� '�1^prnV19AJ,I,
4. Estimated Cost 141000- Fee (Description)
(to be paid on filing this application)
'S: ` 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 . i Rear
Height Number-of Stories IQi,,�
. .-, 4
Dimensions of same structure with`',alterations or-additions:Front Rear
Depth Height Number of Stories .
a � i
8. Dimensions of entire new construction: Front o Rear Depth T12-
Height Number of Stories
9. Size of lot: Front I 10 Rear ' Depth 300
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:
n N
13. Will lot be re-graded PQX Qf-eA d�,fZ� Will.excess,fill be removed from,premises YES, 'NO
]19-1k
14. Names of Owner.of.premises &whto -rwe-kiAd'dresssoc) �wwos ct- Phone'N6. 631- S �
Name of Architect`Ji ONAS b fie%It C Adiiress/4 kec 4i /,AilPhone''No b3)420— 5746
Name of Contractor tz�A tos c.S Address q 1,91 Pk2�A Ptllzc_ Phone No. 631-NN 7lao�F
15. Is this4property within-1 00'-feet-of atidd1 wetland? *YES NO
® IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE FUIR.ED
Q�
16. Provide survey,to scale,with accurate foundation plan and distances to property lines.
17. If elevation ut any point on property is at l 0`feef or below,must provide topographical data on survey.
STATE OF NEW YORK)
SS:
COUNTY OF,�IRU-L- )
being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)He is the &Jka'+L'��-.
(Contractor,Agent, Corporate Officer,etc.)
of said owner or owners,and is duly authorized to perform or have performed the said work and to make and file this application;
that all statements contained in this application are true to the best of his knowledge and belief; and that the work-will be
performed in the manner set forth in the application filed therewith.
Sworn to before me thi
day of 20�q�_
r
of Public a e of licant
MARGAREr A. KIDNE
g Notary Public-State of New York
No. 01 K160211 11
Qualified in Suffolk County
My Commission Expires March 8,20J3
Scott A. Russell ®su '�� STO]RMWA\T]EIR.
SUPERVISOR MA�NA\G]EM1EN1F
SOUTHOLD TOWN HALL-P.O.Box 1179 °
w
53095 Main Road-SOUTHOLD,NEW YORK 11971 Town of Southold
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)
®ffA. Clearing, grubbing,,grading or stripping of land which affects more
than 5,000 square feet of ground surface.
®[3"/B. Excavation or filling involving more than 200 cubic yards of material
within any parcel or any contiguous area.
1:1 13/c Site preparation on slopes which exceed 10 feet vertical rise to
100 feet of horizontal distance.
0[3'/D. Site preparation within 100 feet of wetlands, beach, bluff or coastal
erosion hazard area.
❑
d E. Site preparation within the one-hundred-year f loodplain as depicted
ori FIRM Map of any watercourse.
®dF. Installation of new or resurfaced impervious surfaces of 1,000 square
feet or more, unless prior approval of a Stormwater Management
Control Plan was received by the Town and the proposal includes
in-kind replacement of impervious surfaces.
If you answered NO to all of the questions above, STOP! Complete the Applicant section below with your Name,
Signature, Contact 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 the Building Department with your'Building Permit Application.
APPLICANT: (Property Owner,Design Professional,Agent,Contractor,Other) S.C.T.M. #: 1000 Date.
Q' District
NAME: �iI ?" �tJ J I
Section Block Lot
,�,�/�� (j **** FOR BUILDING DEPARTMENT USE ONLY
J ****
Contact Information P`� "TKi 1
(Tdep6oiu Number) �J
Reviewed By:
— — — — — — — — — — — — — — — —
— —/Approved
— — — — Date_ �i
Property Address/Location of Construction Work: _ _ _
for processingBuilding Permit.
Stormater Management Control Plan Not Required.
— — — — — — — — — — — — — — — — —
® Stormwater Management Control Plan is Required.
(Forward to Engineering Department for Review.)
FORM * SMCP-TOS MAY 2014
� FFpI�� BUILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
Town Hall Annex - 54375 Main Road - PO Box 1179
o • Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX (631) 765-9502
roger.richert(@-town.southold.ny.us
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: - - Date: / 1p
Company Name: 1v,g&-�aE � i^i✓C.
Name: ^MAIXG 9r✓Z 2/r`
License No.: - Q email: 3-1
Address: -0 D>< Rd �� 1,172-
Phone No.: J7(P - 5-ZS
JOB SITE INFORMATION: (All Information Required)
Name: A6104
Address: Soo L&Lwlnvo s C:�-- vl�
Cross Street:
Phone No.:
Bldg.Permit#: C�3C��(P email:
Tax Map District:, 1000' Section: �' Block: Lot:
BRIEF DESCRIPT N OF WORK (Please Print Cl rIY)
i tj &V I, O0 l
Circle All That Apply:
Is job ready for inspection?: YES / NO Rough In Final
Do you need a Temp Certificate?: YES / NO Issued On
Temp Information: (All information required)
Service Size 1 Ph 3 Ph Size: A # Meters Old Meter#
New Service - Fire Reconnect- Flood Reconnect- Service Reconnected - Underground - Overhead
# Underground Laterals 1 2 H Frame Pole Work done on Service? Y N
Additional Information:
PAYMENT DUE WITH APPLICATION
Request for Inspection FormAs l
ry
4
FOR SCDHS USE: NOTES. PARCEL AREA:45,861 SF or 1.05 Ac. }
THE PROPOSED RESIDENCE IS TO CONTAIN 5 BEDROOMS.
PROPOSED SANITARY TO CONSIST OF.
1500 GAL.SEPTIC TANK&(5)4'E.D.X V DIA.LEACHING POOLS }� GARAGE AREA=667 SQ.FT.
ELEVATIONS ARE NAVD 1988 O^ 1 ST FLOOR AREA=1723 SQ.FT.
THERE ARE NO SURFACE WATERSIWETLANDS WITHIN 300'OF PROPERTY AS DEPICTED /�
2ND FLOOR AREA=2174 SQ.FT.
TESTHOLE #2
a
LAND NOW OR FORMERLY OF JVOIq
OFTHOMPSO
OP
PUBLIC WATERN (RESIDENCEe EN�O @q j"
J �U
C
8 /V
35
o2 40„ C Res IFN F�ppORMERC,
\ ` UBC/CN
x 9.6 91 ® wATeR
_z x 9.7 \ 9�349�/ NF Ow
OOR
TEST HOLE INFORMATION: E�f�ENT �\ Res�OeAC�<<e FORME
LAND NOW OR FORMERLY p� Q x F/C \ pOUN�\ E-pU�Cp RCy
OF LOVERICH g x 10.4 10.0 �E S W
RESIDENCE-PUBLIC WATER LO x101 x 113 \p� Tqk f 11 ® greR
TESTHOLE #2 MAP OF ANGEL 102 x9'7 x10.2 c NSP
SHORES MAP # 9729, 8/23/95 ® 10.8 11.1 x ,o Ts' E DRi �seo v CEAt
x ¢� oar h Ay �� 50 DSS
FE O. v_ C 0 4
Nc 05 �o o h � gE1BA W /
0' 0.7'N x 11.0 ZOp��Ury�O 3 0 4i FAR'q o r / / L
xa p N Ts. / 13.4 ,
LAND NOW OR FORMERLY N 0 Ano Q•63 Ory 3e 13 2 /
RESIDENCCEOF?PUITS L0 LU BLIC WATER ^ C x 1 0 1 x 6,0 "�Q�' �p ^i o / / � ^ LAND NOW OR FORMERLY
LOAM ca 121 ? 2 S sx 13.6 10 F�N O OF CASTLENUOVO
LU PROPOSED /
OL x ?�' o , 13.4 . �o RESIDENCE-PUBLIC WATER
� � /
STORMWATER D - ST Ip EX / TC=13.33
Y PROPOSED 11.7 DRYWELL II�JJ �p Lp BC=13.07
4' DEEP s / �' DP
o x B' DIA X 8' E.D. (2X) LP /
� 8' DIA. PROPOSED LPR=50.0' TC=13.4
DRYWELL&OOL EQUIP. PROPOSED WATER SERVICE o PROP. EX x13.6 TC=13.20 BC=13.16
DD Ki (1500 GAL BC=1288 L=108.26
-5' EZ, PROPOSED SEPTIC TANK
11.7 11.7 121 129 U.G. UTILITIES CATCHBASIN WATER
FE 13.5 1 .4 13.6 STAKE 13 .. RIM = VALVES (EXISTING 6"FOUR
®�®TER MAIN) p
0 5'N S 15°03378 FOUR V� I N®S C®tom RT
SAND '52" W 265.82' TC=1 .
AND BC=12.93
GRAVEL LAND NOW OR FORMERLY OF ROGAN TC=13 27
SP RESIDENCE-UNDER CONSTRUCTION
PUBLIC WATER
® SITE PLAN
-10' PROFILE NOT TO SCALE �+ SITUATED IN of:m P yo
GROUND WATER ( ) SOUTHOLD rc
INV=14.0
FINISHED FLOOR 16.5 INV=13.4 TOWN OF SOUTHOLD,COUNTY OF SUFFOLK,STATE OF NEW YORK
FIN. GRADE 15.5 FIN. GRADE 15 0 �wO
®®Con nor ® Petito, L. L. G.
4' sdr SEPTIC LEACH. 003
TANK POOL 27 Forest Avenue AtA
O V�
BASEMENT FLOOR 7.0 Land Surveying Locust Valley, NY 11560 ANO
'UNAUTHORIZED
ED VIOLATIONR ADDITION TO A SECTION 7 09 OF THE NEW YOMAP REPA ED AND
BY A LICKED �D INV=13.6 INV=13.2 3' MINIMUM CMI Engineering g g (516)676-3260
'COPIES FROM THE ORIGINAL OF THIS SURVEY MAP NOT MARKED WErH AN ORIGINAL OF THE LAND SURVEYOR'S
INKED SEAL OR HIS EMBOSSED SEAL SHALL NOT BE CONSIDERED A VAUD TRUE COPY." "CERTIFICATION GROUNDWATER 5.0 MAP ANGEL SHORES,MAP No 9729,8/23/1995 DIST.1000 SEC. 88 BLY- 6 LOT 13.38
INDICATED HEREON SIGNIFY THAT THIS SURVEY WAS PREPARED IN ACCORDANCE WITH THE EXISTING CODE OF
PRACTICE FOR LAND SURVEYS ADOPTED BY THE NEW YORK STATE ASSOCIATION OF PROFESSIONAL LAND REVISED: MAR.3,2018
SURVEYORS. SAID CERTIFICATIONS SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED, DATE: DECEMBER 3,2017 ADD POOL,REVISE HOUSE SCALE: 1"=60' SHEET: 1 OF 1
-
#:�bi�
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:�,tr.- �'""I r;l - - � - f - �.--- - - f�- �y.r..•- -- 6��� - __ _ "r r.'�a• - \ q- _ -- -- �'��—'�-'�'�.fG-',~ '�R'{.+;�
3
Suffolk County Department of Labor, -Licensing & -ki
Consumer-Affairs
-> VETERANS MEMORIAL HIGHWAY * HAUPPAUGE,NEW YORK 11788 E
a6` DATE ISSUED: 0701/1978 No. H-4436 Y
Tart � 'P
s; &� Suffolk County <, a
Home Improvement Contractor License :''
fF This is to certify that ARTNTTR J- FDD RWR
doing business as ARTHUR J_ EDWAR_DS'MASON CONTRACTING CO 1NC'1i8A`(1 SUPPL_ F;y VV
{ having furnished the requirements set forth in accordance with and subject to the provisions of applicable laws,rules - e
and regulations of the County of Suffolk,Mate of New York is hereby licensed to conduct business as a HOME
"$ IMPROVEMENT CONTRACTOR, in the County of Suffolk. `
License Category
%'' NOT;VALID:WITHOUT Additional Businesses R;
DEPARTMbiTAL SEAL- - H26-POOLS&SPAS%CERTIFIED
`n ANp ACURRENT ARTHUR EDWARDS POOL& H3-POOLS/SPAS
=gf
CONS UIyIEk AF'I_;'AIR.S SPA CENTRE HI-GC _M V
ID'CARD y _
Suffolk County Dept of
j Labor-;Licensing&Consumer Affairs °
�Iti
HOME IMPROVEMENT LICENSE Commissioner
Name
` ARTHUR J.EDWARDS
Business Name r '
ARTHUR'EDWARS,MASON _ v
,C = CONT.CO INC DBAg
This certifies that the
e, l5�r I is duly licensed License Number H-4436
' Dy ine County of Suffolk 07/01'/1'978
w ;> Issued:
Expires: 07101!2020
`' Gommisswner 1_l(p ,�� s,,�P.� �•�" �,gx� �. " ;� �" _' „- _ Y ` r,, �� r
- _ _ `•y; "?� �"� :S' u- i��,Y� �- �� � y���-.t"Pr4riX°'s Fp� i�.�•�^ �__&"�+��`k'
,
New York State Insurance Fund
199 CHURCH STREET,NEW YORK,N.Y.10007-1100
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
All A A A A 112377925 Q
LEVITT-FUIRST ASSOCIATES LTD
520 WHITE PLAINS ROAD,2ND FL
TARRYTOWN NY 10591
SCAN TO VALIDATE
AND SUBSCRIBE
POLICYHOLDER CERTIFICATE HOLDER
ARTHUR J EDWARDS MASON TOWN OF SOUTHOLD
CONTRACTING COMPANY INC P.O.BOX 728
929 RTE 25A SOUTHOLD NY 11971
MILLER PLACE NY 11764
POLICY NUMBER I CERTIFICATE NUMBER POLICY PERIOD DATE
G 2438 491-9 765253 06/29/2018 TO 06/29/2019 06/12/2018
THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE
FUND UNDER POLICY NO. 2438 491-9, 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.
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
—4„ lj
DIRECTOR,INSURANCE FUND UNDERWRITING
VALIDATION NUMBER: 195404147
111110100000000000059nn10,MT�TI,N,10m�68427���71111jjI�1IJI
Form WC-CERT-NOPRINT Version 2(02/29/2016)[WC Policy-24384919] U-26.3
74 [000000000000S9684277][0001-00002438491911##G][14901.06][Cert NoP-CERT_11[01-00001]
SUFFOLK COU
NtY DEPT OF LABOR,
p�.
UCENSING&CONSUMER AFFAIRS
MASTER
ELECTRICIAN
CALOGERO G BRUTTO
This certifies that the �'�a""'�
bearer is duly STANDARD ELECTRIC CORPORATION
licensed by the
County of Suffolk
!�3098-ME 07/19/1007
o ��R euouun°v VAM 07/01/2019
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APPROED AS NOTED/
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DATE: B.P.# 34'T�
FEE: 5 1 BY:
NOTIFY BUILDING DEPARTME T AT
765-1802 8 AM TO 4 PM FOR THE OCCUPANCY ®�
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED USE IS UNLA��F° `�
FOR POURED CONCRETE WITHOUT CERT I r p
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST OF OCCUPANCY
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET TH
REQUIREMENTS OF THE CODES OF NF',
YORK STATE. NOT RESPONSIBLE F!
DESIGN OR CONSTRUCTION ERRORS
'RETAIN STORM WATER RUNOFF
PURSUANT TO CHAPTER 236
OF THE TOWN CODE.
COMPLY WITH ALL CODES OF
NEW YORK STATE & TOWN CODES
AS REQUIRED AND CONDITIONS OF
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SIZE AB C D E F G H AREA CAP. b o
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16X32' 16' 32' 8' 14' 6' 4' 4' 8' 512 19,000 ���� 500 Fa)q 14 a�n S Ct
16'X36' 16' 36' 12' -14' 6' 4' 4' 8' 576 21,600 &S)�A C> E
PERMACRETE WALL SYSTEM[
18'X36' 18' 36' 12' 14' 6' 4' 5' 8' 643 24,300 929 Route 25A Miller Place ICY 11764cfiF
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20'X40' 20' 40' 16' 14' 6' 4' 6' 8' 800 30,000 (631) 744-7185 FAX (631) 744-0174 ��Jr 4q'7 I��I
w 24'X44' 24' 44' 18' 14' 8' 4' 6' 10' 798 30,000 Suffolk lAcense #4436—H1
2448' 24' 48' 20' 16' 8' 4' 6' 10' 900 30,000 Nassau JAcense #H174450000