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Sa flF t& Town of Southold 7/30/2020 0 P.O.Box 1179 C* 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 41302 Date: 7/30/2020 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 7540 Main Bayview Rd., Southold SCTM#: 473889 Sec/Block/Lot: 78.-7-48 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 11/19/2012 pursuant to which Building Permit No. 41337 dated 2/1/2017 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 fenced to code as applied for. The certificate is issued to Gould, Susan of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 41337 7/20/2018 PLUMBERS CERTIFICATION DATED / IVAu o e ature SU �Kc TOWN OF SOUTHOLD ��oti° any BUILDING DEPARTMENT TOWN CLERK'S OFFICE oy-• 4� 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#: 41337 Date: 2/1/2017 Permission is hereby granted to: Zakarin, Gary 185 E 85 St Apt 35B New York, NY 10028 To: Construct an inground swimming pool, fenced to code as applied for. Replaces BP# 37665 At premises located at: 7540 Main Bayview Rd., Southold SCTM # 473889 Sec/Block/Lot# 78.-7-48 Pursuant to application dated 2/1/2017 and approved by the Building Inspector. To expire on 8/3/2018. Fees: PERMIT RENEWAL $125.00 Total: $125.00 Building Inspector o�SUFFtoo TOWN OF SOUTHOLD BUILDING DEPARTMENT s TOWN CLERK'S OFFICE y • � ,fi SOUTHOLD, NY o . 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 #: 37665 Date: 12/3/2012 Permission is hereby granted to: Zakarin, Gary &Zakarin, Eileen 325 E 79th St New York, NY 10075 To: construct an in round swimming g pool, fenced to code as applied for At premises located at: 7540 Main Bayview Rd, Southold SCTM # 473889 Sec/Block/Lot# 78.-7-48 Pursuant to application dated 11/20/2012 and approved by the Building Inspector. To expire on 6/4/2014. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE V2 $250.00 CO - SWIMMING POOL �d,--VA--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. New Construction: Old or Pre-existing Building: (check one) Location of Property: -1 5qD MaLn y iP w aa �5 o-11-1 D I House No. Street Hamlet Owner or Owners of Property: \j la� r Suffolk County Tax Map No 1000, Section Block 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 SO!/r�,ol 0 Town Hall Annex Telephone(631)765-1802 54375 Main Road cis Fax(631)765-9502 P.O.Box 1179 G Q Southold,NY 11971-0959 •� • �o roger.rich ert(a�town.southoId.ny.us 0.'�COUNrI BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Gary Zakarin Address: 7540 Main Bayview Road city,Southold st: New York zip: 11971 Building Permit#: 41337 Section: 78 Block: 7 Lot: 48 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Beach Electric of Quogue License No: 4025-E SITE DETAILS Office Use Only Residential X Indoor Basement Service Only Commerical Outdoor X 1st Floor Pool New 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 1 Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks 1 Disconnect Switches Twist Lock F1 Exit Fixtures �] TVSS Other Equipment: "AS BUILT" - "ELECTRICAL SURVEY" - "NO VISUAL DEFECTS" Notes: Inground Swimming Pool to Include: Bonding, 1- Pool Light, 2- GFCI Circuit Breakers. Inspector Signature: Date: July 20, 2018 0-Cert Electrical Compliance Formas opF Sol/ �o� olo o�'YOOUM'�?cam TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [ ] DdSULATION [ ] FRAMING / STRAPPING [VrFINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELEC RICAL (FINAL) REMARKS: D Ilr cin4& 6v�[L' 04, oL2 IS j 44 1 r DATE INSPECTOR SOUryo H �O cou TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND 9SULATION [ ] FRAMING / STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT-PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: iii/ 14 1 DATE INSPECTOR ' pF SOUIyo� * # TOWN OF SOUTHOLD BUILDING DEPT. °`ycourm,N�'' 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) [ ] CODE VIOLATION [ ] CAULKING REMARKS: DATE INSPECTOR c ql a0f SO(/ly # TOWN OF SOUTHOLD BUILDING DEPT. °`ycouHty e�' 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I LAT N G S FRAMING /STRAPPING G� [ ] RAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: S JroY DATE INSPECTOR FIELDSPEQN REPORT DATE COMMENTS 'OUND�iON(18T) L C\) FOUNDATION(2ND) � ROUGH FRAAIINQ& y PLUAMING y INSUL•ATION PER N.Y. STATE ENERGY COME -k (P 'N4t iti t` 10 I's 17 wt 6 FINAL q• 4of 24►'� St v� 1 - N ADDITIONAL COMMENTS —�Na•P �� Q 'r Z e TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD,NY 11971 1 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 r Survey SoutholdTown.NorthFork.net PERMIT NO. 7� lJ Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Examined 20 � { Storm-Water Assessment Form `I �lQ 1 9 2012 'r� �n act: Approved �� 20 U Mail to: i e &/�dl' &— Disapproved a/c BLDG DEPT. Expiration L 20 TOWN OF SOUTHOLD Phone: Bui din spector APPLICATION FOR BUILDING PERMIT Date 4) , 20 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 four flflnecessary inspections. OCCUPA 9 96tl7eM,EDIATE6Yoi �S I a (Signature of applican or name,if a corporation) ENCLOSE POOL TO CODE- � ��� UPON COMPLETfOId 'ITHODUT CERT IFI T ® I� OX I-13 CP -- - OX ,U `'BEFORE,"WATE.7 (Mailin address of a hcant OF �� UI NO"s� �° APPROV A Vf ) I laL42— State whether applicant is owner, lessee, agent, architect, engineer, general contra to , electrician p or builder iDATE 2— B P Aaw–r �i� Poo 1 Scrui C.— Name of owner of premises Irk, NOTIFY BUILDING DEP RTI�ENT AT G�ly� I 765-1802 8 AM TO 4 PM FOR THE (As on the tax roll&ghtQM T�S If applicant is a orporation, signa f duly q*orized fficer �. FOUNDAT®N-TWO REQUIRED r FOR POURED CONCRETE r(AVV2. ROUGH-FRAMING,PLUMBING, (Name and title of corporate officer) STRAPPING, ELECTRICAL&CAULKING 1 -l co g g 3. INSULATION Builders License No. 4. FINAL-CONSTRUCTION &ELECTRICAL Plumbers License No. MUST BE COMPLETE FOR C.O. Electricians License - - � � ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW Other Trade's License No. > > 'R` PORK STATE, NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS, 1. Location of land on which oposed work will b done: ISL40 Nimn t5a%,.1yicW ' 1-�oarl. SDUAbOIOL House Number Street Harr> TAIN STORM WATE 9A1 r%nmr-476 FF PURSUA�T TO CHAPCounty Tax Map No. 1000 Section Block Subdivision Filed Map No. o ' 2. State existing use and occupancy of premises and intended se and occupancy of proposed construction: a. Existing use and occupancy re-S 1 d ,-h a_ b. Intended use and occupancy S' X L' Q 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition Other WorkS W 1 rn M I n q RX= (De ption) 4. Estimated Cost 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 10 13. Will lot be re-graded? YES NO Will excess fill be removed from premises?YES NO_g,, 14. Names of Owner of premises 7-oLKIrt 0 Address 3Q 5 E 7 9+41 Phone No. C1 I 1 dS 14 133(10 Name of Architect Address r IQ C- to-'��Phone No Name of Contractor CrjM_)arA SiLlhMay" Address il90 Avziu 1-73b Phone No. (P31-US3Al L86 &_Q " AqI 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) SS: COUNTY OF SO %I &y-A &u Inn mo,,r being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is thef N:' 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. SwoNQ,before me th'KIMM f►'1 day of 20 MALLORY C LESCENSe NOTARY UBLIC tart'Public -STATE OF RtW YORK Signature of Applicant No. O1 LE6266195 Qualified in Suffolk County My Commission Expires July 23, 2016 J Town of Southold - Chapter 236 - Stormwater Management w sol SWPPP - Storm Water Pollution Prevention Plan Assessment Form GENERAL INFORMATION: (All Requested Information is Required for a Complete Application) APPLICANT NAME: Owner-Agent Consultant-Contractor orQthe (Circle one) Property OWNER: Different then Applicant) G-dvialnd � P ri� gaol�vl S �_ r l�VZ� I Address: uX � S� �l✓ Address: j 7SLJ'C7 tl a c b .. o 0 Q Telephone#: (051-653 Fax#:�-a1`US3 a� Telephone'N-1 r,-5a,f—qm(p Fax#* E-Mail: lf1J'� iX.� E-MaEI: I J "J/ om Property Address: Brief Description of Construction Activity,Proposed Structural BMPs,Soil S.C.T.M.#: Stabalization BMPs,Project Scope and/or Sequence of Construction Activity 1000 (Provide Additional Pages as Needed) Dlsfrie! Setlion Slotk Lo! � NseofContractorandlorContaot ersonrisponsiblef>orlmplementationofSWPPP: �� � l --� �J_—_---^,_--�. 11AeAt ( 'L. 00 v AddID e� ii l3cp 1lfl e 7e ee#:(92 I l,j/ Fax#-(031-(96-3 1/ 6 V 9 �CL ,..� I C �._�� �.,_t/.►... G ._ ___^__ E-Mail:- --------------------------------------------- Name — _-.-_..,_Name of Persons Responsible for Installation&Maintenance of Erosion Control Practice: --------------------------------------------- Address: Telephone#: Fax M. E-Mail: Total Area of All Total Area of land Clearing ----------------------------------- Project Parcels: andlorGroundDisturbance, ,__—_____ is F.I Aries) (S.F./Acres) ProjectDuration: StartEnd —�--.------.------.--______-._—_.._____--------..___-- (Anticipated) Date: Date: (Number crCWwdaroays) ----------------------- Will ....,.—_Will this Project Disturbe five(5)or More Acres at Q -'�-'-� -v� ------ "-`---- .____.----_-_ Any One Time During the Proposed Development 7 Yes No ----------------------------------------------- IfYES:Please AnswertheFollowingl _. m ,_ ,,,. ,. --------- _,..--- ---------- a. Does the Applicant have a Qualified Inspector On Q Q Staff To Conduct the Required Inspections? Yes No b. Does the SWPPP Indicate How Frequently the Site O = List the NAMES ordeseription of all Potentially Impacted Waterbodtes andlor Wetlands: Inspections will Occur and for What Period of Time? Yes No c. Does the SWPPP Adequately Identify All Temporary Q = and/or Permanent Soil Stabalization Measures? Yes No ____,_______________.,_ d. Does the SWPPP Adequately Identify a Complete 0 = ""'------___.._'---------- --------------____________ Project Phasing Plan? Yes No Status of Impacted Waterbody:(eq.TMDt.,303(d)Listed,Impalred_) e. Does the SWPPP Indicate Additional Site Specific Practices that Will be Utilized to Protect Water Quality? Yes No f. Has the Applicant Submitted a Completed DEC Notice Type of Impacted Waterbody:leg.Lake,Creek,Bay,Pond,Sound,FreshwaterWetiand.) Of Intent and SWPPP Acceptance Form for Review r__1 Q by the Town of Southold? Yes No NFW S1'ATF.O'F�COUNIY OF......... 11 .......SS That I,...."- W.o d........ .� U ......being duly sworn,deposes and says that lie/she is the applicant for Permit, (Name of individual signing Document) Andthat he/she is the ................................ .........� � .....................................................................................:.................. (Owner,Contractor,Agent Corporate Officer,etc.) Owner and/or representative of the 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 b 'ef;and that the work will be performed in the manner set forth in the application filed herewith. Sworn to re me this; kv .......................... ....... .. d ............AtIIFYY C LE SKI Notary Publi .. ........ /�NOTARY..P.11k11C-STATE. !N ......... ............................... No. OILE626 95 (signal eofAppGcant) SWPPP Assessment FORM: P3112 ®uolitied in Suffolk County My Commission Expires July-23, 2016 Town Hall Annex,:; �,;,�. ;, Telephone(631)765-1802 54375 Main Road _. • A 01(631)raQeGrlche o[d. ny l!s_ Southold;MY ftVf,- 959 - I. BUI W.WG DEPART ffM TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION [Address: QUESTED BY: L Lo -s S,�r lmc� Date: �- Z mpany Name: i me: l i. ense No,: s one No.: a 23t Cv5 3� ,JOBSITE INFORMATION: (*Indicates required information) *Name: Oi G. L I *Address: 4v t ( v t 11 *Cross Street: *Phone No.: C ( I s7[ 4 Permit No.: Tax-Map District: 1000- Section: 9 Block: ® -7 Lot: *BRIEF DESCRIPTION OF WORK(Please Print Clearly) (Please Circle All That Apply) *Is job ready for inspection: YES/ O Rough In Final *Do you need a Temp Certificate: YES 7 NO Temp Information(if needed) *Service Size:" 1 Phase 3Phase 100 950 200 300 350 400 Other *New Service: Re-connect Underground Number of Meters Change of Service . Overhead Additional Information: PAYMENT DUE WITH APPLICATION 82-Request for Inspection Form :q•r �.;, �;,11j,'i+J. .....��iiSu..$��,lr��:, .\Lt ..r:•r7;1�/ 'ri:t',•• c'47:?.� / 'tf'"U'',y., .�:7rti, �,yr,�:rx. %'ct" ,,,,";a�' ,'•t �' ':,d• v•.:. '�'' .Ilf•.i %,:• .%31••:•.x;.1' :.(.• /^-..r.s..-•.•,. ..i�1.' �:j. :/i,^-. y:ff;•:)r t�:;::v:�'=:;(r r? ;f ,/j t , -Mfr+.:. _ i's%!�. ;s. .;n;• ...�':+J,•..,• ..�''g•.,,.p ..rCn�+� '�' S• /._ `-:• :,-,,,, ! c, �! ,',1 ;ii. J;� .hal'. t�.-, y:\.. :?{..•..;�. : ..•--:•. v.� n I',°.'!:?'� !4• "•"�- ,ya::}: t r: Wit" � g J._ SSC` • ~• • _ ^1 r•' • a 3� :P .S• S 1 ilii l•' l Ill. •( •t{t-;z,_�>; •I a• l'P •,1.. 1., .�aU' 11•' tts,;'r%'- lf:y%t •�i}.'V-4 , "•1:f' t '}• '� r !��• :•/• •1• r(.+.F,. nY% 34 ,yT,., +.5.: •y, ......... L2:i'1:i1:•n'l,GS: D:;•: 1+��15.��:{tA• •GL;A•A•hA'ii''' '•�''A'S:'7tit\r��..:d:d"��Zr'_2'7.�lr6".,.T•R"::,•A•1•A•1'.-.:: :T, rp.'. ..�.,....•.. - • ... ,t t..,.t,5.. .]•h.,:\�r„srti{;1�c3tr1LL�J+,�'r,,•e•r,•:SC•t..�•l� • Southampton Town LicenseReviewBoard • 116 HAMPTON ROAD SOUTHAMPTON,NY 11968 fi> 1. L990089 DATE r� ISSUED: 12012 Home Improvement License 4' This is to certify that Edward W Summar Jr. w•, i �: doing businessPool �' .c� •t it �_ • Yhaving furnished the requirements set forth in accordance with and subject to the provisions of the applicable regulations rules and • on, n _a censed to conduct business under the provisions of the Home Improvement Contractors Law, Chapter 143. THIS LICENSE EXPIRES April 11,2013 ANTHONY WITALIA,JR. Chairman License Review Board ! • �C?`;::t.,.%`;-t''F"- ::'i:�:!:V`y,`,:t`'t'.i�T...l�-;7C�:1':tnT.t'�t.t,:-st.n„r<C•;-rTL:t.•T• -;w.F _ T� �. - �f. • :•t'•t•t'd.,::7•'-!•CtBC1•: tyy. .,im'y1'Pl”.tLVSYS'.'�N:�t�^-:`^."-G11y�t�'6'..N�;+lv`J:•1•}-l-:n?1!�;r.C•Gn;Z>.`7•`,:I•C'?r.,.ifs•:•i3;^T•r,,,�'�-•'.r�''rs;;Zi`r,T•r'.l•' �_.'}'t� ''.�' ''�•,F.i` �i•;�/!O Rl`,f"Uf�" V,\�' •'`li?" t• t'' li�tt,'lJ'- Ii -�� _ „ _ • ''✓.-;.� r IIiI. \ ..;` Lj't';: .�Ff,"L ``��__ i,t1 '•j!1 .:•.,•�t• - •��(• ��}ie ..y• .(.i �-.t' 1!. .y.�".,: '%' ;,'t'� .'!tr, �fI11' �l.• •.r:•. t •:P;l, _7.;:.� � :_U �Y!, i •f•-_^ ,tt, .� ,t .- t it 'i' ,[r.. :,1 ,�ll �, ';CC' 'jyl 1, :t�,,L `� ,j1 t •,.-(' '• .•:: "•h• 'jl 'T �ttrs•;.• 1 ���_.,.7.'�'1.. ..: �,: �����, ,� :r l tl' 'al•'' q i:�r1�! _B�, i1�t �1� t• i:' �� ;/�tI(,v. •v '*.. .l•. ! Vic:� '•1 �• �: �:t< it •QJt^' ...'_. .r:. :.� ��+'?.r. 'ti`t`le"• .F �?�^... lar`i.�„ "'+�l v �•:F'v ,..t.:: ,/, .'f 7 "�T,' ';h•: .;;�"! .•'v.•� �. :1rr ::R• rlla'. �;�-'. '�,"• - �"-r:.;:. •rh•r •.I' .I`j•��+��:'�`\•�. :.ji :'� 'I' `:�tiM.r./ ! „ '-.�.. ../'tiy:•: tiy::tiv r r• •'f.,i ,,i:� +'..11',-i-•`�.•'•.^�1 Ya #r:117 �.1yv II�iJ�,I.. /��il:!`I �gt '�-�nJ �i7 fJ� I stl� / r/•'•!^•.gti���,�;.-•,.';,'`;,\yam/ i', `,•1 I:,,��:.�titiy:./r .; ••%' 1 b 0 New York State Insurance Fund Workers'Compensation&Disability Benefits Specialists Since 1914 8 CORPORATE CENTER DR,3RD FLR,MELVILLE,NEW YORK 11747-3129 Phone:(631)756-4300 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE NA A^A A 113390743 SUN BRITE POOL SERVICE INC PO BOX 1736 EAST QUOGUE NY 11942 POLICYHOLDER CERTIFICATE HOLDER SUN BRITE POOL SERVICE INC TOWN OF SOUTHOLD PO BOX 1736 53095 RTE 25 EAST QUOGUE NY 11942 P O BOX 1179 SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER PERIOD COVERED BY THIS CERTIFICATE DATE 11452742-8 276279 04/24/2012 TO 04/24/2013 11/8/2012 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1452 742-8 UNTIL 04/24/2013, 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 SAID POLICY IS CANCELLED,OR CHANGED PRIOR TO 04/24/2013 IN SUCH MANNER AS TO AFFECT THIS CERTIFICATE, 10 DAYS WRITTEN NOTICE OF SUCH CANCELLATION WILL BE GIVEN TO THE CERTIFICATE HOLDER ABOVE. NOTICE BY REGULAR MAIL SO ADDRESSED SHALL BE SUFFICIENT COMPLIANCE WITH THIS PROVISION. THE NEW YORK STATE INSURANCE FUND DOES NOT ASSUME ANY LIABILITY IN THE EVENT OF FAILURE TO GIVE SUCH NOTICE. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. EDWARD SUMMER(PRESIDENT)OF SUN BRITE POOL SERVICE INC (ONE OF ONE) 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 This certificate can be validated on our web site at https://www.nysif.com/cert/certval.asp or by calling (888)875-5790 VALIDATION NUMBER:279289901 '4 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD 11/14/2012012 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 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 Jennifer Reutter Maran Corporate Risk Associates, Inc. PHO'ICNE (631)283_8000 A No: (631)287-2207 300 Hampton Road E-MAILE ADDRSs•7 m reutter@mcrainsurance.co INSURERS AFFORDING COVERAGE NAIC# Southampton NY 11968 INSURERA:Hartford Casualty Ins Co 29424 INSURED INSURER B. Sun-Brite Pool Services, Inc. INSURERC: P O BOX 1736 INSURER D: INSURER E: East Quogue NY 11942 INSURER COVERAGES CERTIFICATE NUMBER:12/13 GL 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 ADDL SUBR EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MM DDY/YYYY MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES(Ea occurrence) $ 300,000 A CLAIMS-MADE D OCCUR 12UUNQY2797 /24/2012 /24/2013 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) '$ ALL OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( ) HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS Per.ccdent $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ RIEXCESS LIAB CLAIMS MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- I JOTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS I I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $ OFFICERIMEMBER 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 (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN The Town of Southold ACCORDANCE WITH THE POLICY PROVISIONS. 53095 Rte 25 PO BOX 1179, NY 11971 - AUTHORIZED REPRESENTATIVE B Gardner, CPCU, AAI/ ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS026(201005)01 The ACORD name and logo are registered marks of ACORD STATE OF NEW YORK WORKER'S COMPENSATION BOARD CERTIFICATE OF INSURANCE COVERAGE UNDER THE NYS DISABILITY BENEFITS LAW PART 1.To be completed by Disability Benefits Carrier or Licensed Insurance Agent of that Carrier 1a.Legal Name and Address of Insured(Use street address only) 1b.Business Telephone Number of Insured SUN-BRITE POOL SERVICES INC. 631-653-8788 1c.NYS Unemployment Insurance Employer Registration P O BOX 1736 Number of Insured EAST QUOGUE, NY 11942 528705 1d.Federal Employer Identification Number of Insured or Social Security Number 113390743 2.Name and Address of the Entity requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity being listed as the Certificate Holder) The First Rehabilitation Life Insurance Company of America 3b.Pol icy Number of Entity listed in box"1a": TOWN OF SOUTHOLD DBL143610 PO BOX 1179 3c.Policy effective period: SOUTHOLD, NY 11971 03/01/2012 to 02/28/2014 4.Policy covers: a. ❑✓ All of the employer's employees eligible under the New York Disability Benefits Law b.❑ Only the following class or classes of the employer's employees: Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has NYS Disability Benefits insurance coverage as described above. Date Signed 11/14/2012 By 4441011,hf (Signature of insurance carrier's authorized representative or NYS Licensed Insurance Agent of that insurance carrier) Telephone Number 516-829-8100 Title Chief Executive Officer IMPORTANT:If box"4a"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 it directly to the certificate holder If box"4b"is checked,this certificate is NOT COMPLETE for the purposes of Section 220,Subd.8 of the Disability Benefits Law. It must be mailed for completion to the Worker's Compensation Board,DB Plans Acceptance Unit,20 Park Street,Albany,NY 12207- PART 2.To be completed by NYS Worker's Compensation Board (Only if box "4b" of Part 1 has been checked) State of New York Worker's Compensation Board According to information maintained by the NYS Worker's Compensation Board,the above-named employer has complied with the NYS Disability Benefits Law with respect to all of his/her employees. Date Signed By (Signature of NYS Worker's Compensation Board Employee) Telephone Number Title Please Note:Only insurance carriers licensed to write NYS Disability Benefits insurance policies and NYS Licensed Insurance Agents of those insurance carriers are authorized to issue Form DB-120.1.Insurance brokers are NOT authorized to issue this form DB-1201 (5-06) tai ,.5unb P I OOS Construction—Maintenance—Marble Dusting—Masonry—Renovations-Saltwater Pools Pool Package: $22.295.00 - Excavation- Backfill&Rough grade 5' around pool - Pool- 18'x 40' Rectangle Poured concrete walls - Extrusion -Top mount - Liner- 20 Mil - Coping- 2"x12"Thermal bluestone treads - Padding- '/a"Wall foam - Plumbing- 2"Schedule 40 rigid pipe w/ schedule 80 unions &valves - (1) Step -9' Vinyl overlay corner step - (2) Skimmers - Hayward 2" - (2)Returns - Hayward wall fitting - (1) Vac Sweep - Hayward wall fitting - (2)Main Drains - Hayward 2"equipped with VGB covers - (1) Equipment Pad-4"poured concrete - (1) Filter- System 3 cartridge filter - (1) Pump - Pentair 3.0 HP pump w/SVRS +VS ($200.00 LIPA rebate available) - (1) Hayward automatic chlorinator - (1) Drywell - Cultec 415 gallon - (1) Ladder- 3 tread stainless steel (1) Light-400 Watt(Includes I5'of V pvc conduit and 50'cord,($12 95 per additional ft) (1) Vac Kit-Rope &floats, vac pole, hose, net,brush, vac head&test kit www.sun-br ools.com P.O. Box 1736—East Quogue,NY 11942 Office: 631-653-8788—Fax: 631-653-8915 Southold Town Building Department �gOFfU(K�o P.O.Box 1179 Permit#: 37665 4 G y 53095 Main Rd Cm Southold,New York 11971 Permit Date: 12/3/2012 (631)765-1802 Expiration Date: 6/4/2014 Parcel ID: 78.-7-48 BUILDING PERMIT RENEWAL LETTER Dated: 5/13/2015 Applicant: Sun-Brite Pool Services Location: 7540 Main Bayview Rd, Southold Work Description: IN GROUND POOL construct an inground swimming pool, fenced to code as applied for A FEE OF $125.00 IS REQUIRED TO RENEW THIS BUILDING PERMIT. Owner: Zakarin, Gary&Zakarin, Eileen Address: 325 E 79th St New York,NY 10075 The permit listed above has expired. No work is permitted or authorized beyond the expiration date. Please submit the above fee made payable to the Town of Southold. Mail to the Town of Southold Building Department, P.O. Box 1179, Southold, New York 11971 THANK YOU, SOUTHOLD TOWN BUILDING DEPT. Southold Town Building Department P.O.Box 1179 Permit#: 37665 53095 Main Rd Co • Southold,New York 11971 Permit Date: 12/3/2012 yfjQlao�. (631)765-1802 Expiration Date: 6/4/2014 Parcel ID: 78.-7-48 BUILDING PERMIT RENEWAL LETTER Dated: 1/9/2017 Applicant: Sun-Brite Pool Services Location: 7540 Main Bayview Rd, Southold Work Description: IN GROUND POOL construct an inground swimming pool, fenced to code as applied for A FEE OF $125.00 IS REQUIRED TO RENEW TRIS BUILDING PERMIT. Owner: Zakarin, Gary&Zakarin, Eileen Address: 325 E 79th St New York,NY 10075 The permit listed above has expired. No work is permitted or authorized beyond the expiration date. Please submit the above fee made payable to the Town of Southold. Mail to the Town of Southold Building Department, P.O. Box 1179, Southold, New York 11971 THANK YOU, SOUTHOLD TOWN BUILDING DEPT. OF SO!/p�ol � o Town Hall Annex Telephone(631)765-1802 54375 Main Road y 4W Fax(631)765-9502 P.O.Box 1179 G Q Southold,NY 11971-0959 '® COUNTY,N BUILDING DEPARTMENT TOWN OF SOUTHOLD August 28, 2018 Gary Zakarin 185. E 85 St Apt 35B New York NY 10028 Re: 7540 Main Bayview Rd, Southold TO WHOM IT MAY CONCERN: The Following Items(if Checked)Are Needed To Complete Your Certificate of Occupancy: NOTE:7PeTmmit=isrequiredrfor'th e=hot}tub-befdtd C of-'O can be=issued. Electrical Underwriters Certificate A fee of$50.00. Final Health Department Approval. Plumbers Solder Certificate. (All permits involving plumbing after 411/84) Trustees Certificate of Compliance. (Town Trustees#765-1892) Final Planning Board Approval. (Manning#765-1938) Final Fire Inspection from Fire Marshall. Final Landmark Preservation approval. Final inspection by Building Dept. Final Storm Water Runoff Approval from Town Engineer BUILDING PERMIT — 41337 —Swimming Pool i • nE 40 S �� Y •. /�� P/ J P!/F ZE9ROSKl O Pe- 2�,��0 e A YV I�J/�j COMPILATION MAP o S 64'03'10'E f �AD DESCRIBED PROPERTIES o 0 SITUATE Mh,°�' h 120.43' BAYVIEW, TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y.- °9• O P/Pf ss UTILITY PREPARED FOR: GARY ZAKARIN " W000FRA�1E o o coNc POLE EILEEN ZAKARIN o ! RES BLUESTONE PTFE o9h /Df�CE RWq(�"/"0 DRIVEWAYLO \ ?D.01 5 ' o. WOOD STEPS I 7 O /RNt1N0S N WOOD 4 T O V � SFAT/�1L/NGS N 2 ®S t � S•8• i o � � J O Z � ZAKARIN, REPUTED OWNER W ' z TM# 1000-078-07-048clq 3d—'�N N W 7 � 64'03,10»W p0 E O 0 __. 00 A/Ory aa. . Al 64'o3,10,,W :�: 13.28' Z N 6403 10 W 0o 64-03, 110.0 1 p'E 1166, \ "°" L.Oj'(b:� N/F CLEMENS o PIPES 26*52',50»w N N'' 23.0$' � n • 0 15'0 -54.2' cNi ;5.0' 0 � 0 RTLVP 8146;NC ENV /' �' 15.01 z SCOP Ts 0 1 E " ^ N NI" CAROFOLO cs � a o cq M # 000-087 s'0 35.0' N R�-15 �4� 14 m SURVEYED: 3 MAY 2007 N �h W SCALE I"= 30'. a 534900'Fy / Q AREA = 25,920 S.F. >>' OR 3 0.595 ACRES GUARANTEES INDICATED HERE ON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY \� IS PREPARED, AND ON HIS BEHALF TO THE 777ZE COMPANY, GOVERNMENTAL AGENCY, SURVEYED BY LENDING ASSIGNEES IF LISTED HEREON, AND STANLEY J. ISAKSEN, JR. TO THE ASSIGNEESEES OF THE LENDING INSATUDON. 2`?p0 i GUARANTEESR£ OT ANo" TRANSFERABLE >b P.O. BOX 294 AD0I710NAL INS777U77ONS OOWNERS.R SUBSEQUENT 6 692' NEW Slf FOLK. N.Y. 11956 \ UNAUTHORIZED AL 77ON OF E 770V 7 0 TO THIS 6 31 —7" 4-5835 SURVEY IS A V10CA710N OF SECTION 7209 OF / THE NEW YORK STATE EDUCATION LAW. . i COP/ES OF 7N1S SURVEY MAP NOT BEARING • THE LAND SURVEYORS EMBOSSED SEAL SHALL t ,NOT BECONSIDERED TO BE A VALID TRUE roPY L SE D UR R - - NYS Lic. N0. 49273 7R 1582R20AUG07 - '�)"I (D�,5 MIIV /�� -�Z�Y�x-�� ry-` cC � n� tK�NMER w00 %RAIN V RAIN 5 '- •TYP1cAL V-44-Ll s PLAN VIEOF POOLA44MIpD�.t - W i t'/z" z+p wALT'� r, 10ii � . Eil N • - 7 f.INO Oo T rON-Tit;.�rCO- Pcx�t... - f,Qoctto � To LONGITUDINAL SECTION vc 0lF NF'yjy t.itlts-�t=PT1 i of t=cam_ t^o� Dt=C�C L.�-vL _.blVt►.�GOA��� 'TO nmE=E=T N•s+F. RE:"'mT t RO r J ® of .Mt►J ►►.�v M AT 8'-�" CID EP< 04747c C7 ��'�ROFESS40OW f v SECTION G106 PMOL AND PROPERTY 'IO OO[Q-Ml Tb N.Y. STATE RESIDENTIAL UTI'RAPMEW PR(YT'ECTION REQUIRED CODE APPaUIX G 2010 EDITION SECTION G107 POOL TO Oa*X)P-- 'Iri NNSI/NSPI STAI`>DARL6 AL:103. 1 (POOL ALARM REQUIRED