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HomeMy WebLinkAbout45755-Z �guEF01 `a Town of Southold �o �cooy 6/11/2021 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 42079 Date: 6/11/2021 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 2415 Cox Neck Rd,Mattituck SCTM#: 473889 Sec/Block/Lot: 113.-7-10 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 1/14/2021 pursuant to which Building Permit No. 45755 dated 1/28/2021 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: accessoryground swimming pool fenced to code as applied for. The certificate is issued to 153 Herricks LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 45755 4/22/2021 0-1 PLUMBERS CERTIFICATION DATED tho ' ed Signature TOWN OF SOUTHOLD �o aye BUILDING DEPARTMENT C x TOWN CLERK'S OFFICE Wo • 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#: 45755 Date: 1/28/2021 Permission is hereby granted to: Tsounis, Nicholas & Thomas 57-17 256th St Little Neck, NY 11362 To: construct an inground swimming pool as applied for. At premises located at: 2415 Cox Neck Rd, Mattituck SCTM #473889 Sec/Block/Lot# 113.-7-10 Pursuant to application dated 1/14/2021 and approved by the Building Inspector. To expire on 7/30/2022. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO- SWIMMING POOL $50.00 Total: $300.00 Building Inspector ®��oF sovey®l Town Hall Annex ® Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 �. • �o sean.devlinCab-town.southold.ny.us at�c®UNTY,�� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: 153 Herricks LLC Address: 2415 Cox Neck Rd city.Mattituck st: NY zip: 11952 Budding Permit#: 45755 section: 113 Block: 7 Lot: 10 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Pro-Line Electric License No: 32279ME SITE DETAILS Office Use Only Residential X Indoor X Basement Service Commerical Outdoor X 1 st Floor Pool X New X Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures 2 Smoke Detectors Main Panel A/C Condenser Single Recpt I Recessed Fixtures CO2 Detectors Sub Panel A/C Blower Range Recpt Ceding Fan Combo Smoke/CO Transformer UC Lights Dryer Recpt Emergency Fixture Time Clocks 1 Disconnect Switches 4'LED Exit Fixtures Pump 1 Other Equipment: Intermatic Pool Tranny, 2 Lights, Pump on 220GFI Breaker, Pool Heater Notes, Pool Inspector Signature: Date: April 22, 2021 S.Devlin-Cert Electrical Compliance Form As OF SObTyo� Ll 57 J j'` �L-4 15 Co � B f # TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 ANSPECTION- FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] -FIREPLACE & CHIMNEY [ ] FIRE'SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: Td 0 >,-- ��� i_,-I) �t DATE .2 INSPECTOR # # TOWN OF SOUTHOLD BUILDING DEPT. �`ycoum � 765-1802 - INSPECTION [ ] FOUNDATION 1ST . [ ] ROUGH PLBG. [ ] FOUNDATION 2ND = . [ ] INSULATION/CAULKING [ ] FRAMING/STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ h] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) [ ] CODE VIOLATION [/ ] PRE C/O REMARKS: �s DATE hl/ INSPECTOR �aof SO(/j�° # TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [ ] SULATION/CAULKING [ ] FRAMING/STRAPPING [ FINAL fwl� [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: `V A Y W - i Ia'✓ C:e'�t�� DATE INSPECTOR k2 �a0f solyt, h� 'o # TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATI,O,NN/CAU G [ ] FRAMING/STRAPPING [v/FINAL Pot, V�p� [ ]- FIREPLACE & CHIMNEY [ ] FIRE SAFETY-INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT-PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: gg CO& -To ful �eJ Ing DATE INSPECTOR — O X R d f iR n1 Pause 0.-0 M. w O lift 1!� X-11 1; 06 = 1 CACEr ,. ;�,. r -� M ? ti, .may � � � ' � ► � ` 1 ,, ,� rt. �• � 3, 'fit` w.o RAY DOVER,ARCHITECT ARCHITECTURAL DESIGN INTERIOR DESIGN PLANNING&DEVELOPMENT RESIDENTIAL-COMMERCIAL.-INDUSTRIAL 95 RICHMOND AVENUE S.AMITYVILLE,NEW YORK 11741 Phone/Fax: (631)6914718 EMAIL:RDARCHITECT@YAHOO.COM May 14, 2021 Southold Building Department 54375 Rte. 25 Southold,New York 11971 RE: CERTIFICATION of POOL RE-BAR 2415 Cox Neck Road, Mattituck. BUILDING PERMIT NO: 45755 To Whom it May Concern: This Letter is to Certify that as per My Inspection All Re-bar was installed to the Walls and `Floor' of the In-ground Pool before the Pouring of Concrete. I Acknowledge that the Southold'Building Department is relying on this Affidavit to issue a Final Certificate of Occupancy for the above ConstR�on. Sincerely, NED) Ray Doner, Architect. 024���0�� OF N EW FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION(IST) 6' -''z ---------------------------------- ;r FOUNDATION(2ND) R v' ROUGH FRAMING& PLUMBING y eCr' INSULATION PER N.Y. y STATE ENERGY CODE 51, Ji2 ' FINAL F �. Irv: r : I ADD ON COMMENTS Af e Zs at �P e. y b��St�f We off, TOWN OF SOUTHOLD —BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 https://www.southoldtownny-gov Date Received APPLICATION FOR BUILDING PERMIT "a For Office Use Only � �,� J PERMIT NO. Building Inspe or: AN 1 4 2021 -Applied'tions_and`foi•ms musttbe#il(ed=out,in thei�'enti�e Incom+let`e`Y` _ _- -_= `��'r'--'' ` '� :, - - ��� :applications will:no"t_fe accepted:Wfie�e the Applicant is=not=tlie`ouiner,'ari = ;,; Date: f /3 2 `t6WNER - - - S Name: 153 -� �' 2l_C�S_L L C SUM#s000- //3 - 07=- to Physical Addresss:- 2(,r j S Cox A eqt __ cl Phone#: Email: Mailing Address: 8F/2 CT E - - - - - _ 011L AC�:P� - T RS- =-- - Name: 214 �J / V O_f2_ _ Mailing Address: 2) '7 SA lJ 'J Phone#: (,t (,t 3 Email__ S -Rol DE51GN PROFESSIO AL� fF - - - - N IN ORNIp►T-IONc - - - -- Name: � - Mailing Address: 73 -tf _Ea� Q �� Phone#: ' 2 8- _ �3 � Email: j s,- "CO TRACTOR`INFORMATION:�� Name: V' .Ift-S— Mailing Addres - - — Co --ta A I E- (2--v VF----- Phone#: 1V Email: N Q � TjPOSED -Q- NSTRU,C'�CTODPR0 - - - - _ - EJ New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: ❑Other 20' x �0 I 1700L $ C2(2 --- __ Will the lot be re-graded? Yes El No Will excess fill be removed from premises? MYes ❑No 1 E AfYINFOR q Existing use of property: f('o Intended use of property: 1AeG*614?11 Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? [Aes ❑lyP IF YE4, PROVIDE A COPY. f,cz�,- V,­ h-6ck,gd)(Aftdt-',Rciadihg:,'-The owner/eciiitiact6r/disign'O'&feiti4h-al'is�iit0br(s'lblk' ra age'andst;')' Tin water iiiiii' ,Xhapter 236 of the-Town Code.-APPLICATION IS HEREBY MADE 1:6-thcguildirig 09partment for theOssuanco of a,Building Perm.itpurs 1 11 a -of Southold,Suffolk,C66rity,Ne i cI bidii:iinie�oi thifown Regulations; _V­ 'na- uil I ina rL housing code and admit ecte ir rsonperipm O�--pecqssary.-insplictiori�.-Falie statements i eanor purstidnt t6S64ti6n,21-0.,45�6ftW4--�i�vYork-Stati eniii Liii4z abk�4_cloi_ OT Application Submitted By(printnarne): tu OAuthorized Agent 601caner Signature of Applicant: . Date: ///3/�� — -- STATE OF NEW YORK) SS: COUNTY OF S VFFOL C _a7 f—(A 'y CO/V t 0 P_ being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)he is the F fZ__ (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/her knowledge and belief; and that the work will be performed in the manner set forth in the application file therewith. Sworn before me this day of A-N U/4 P_Y 20 2, Notary Public Monika Majewski YORK 92440 JH Mk' r NOTARY 11LIBLIC,Wn OF NEWYORK Ismu PROPERTY OWNER AUTHORIZATION Register No.OIMA6392440 r Q C ty n (Where the applicant is not the owner) QualifirA in Sju�ffolk COOV ou Commission Expires 051 10 ommisgon Expites 0512812023 residing at do hereby authorize to apply on my behalf to the Town of Southold Building Department for approval as described herein. Owner's Signature Date Print Owner's Name 2 j 1 .,BUILDING DEPARTMENT- Electrical Inspector 0 2021 TOWN•OF SOUTHOLD Town Hall Annex -54375 Main Road - PO Box 1179 - Southold, New York 11971-0969 =;' ' ?`-t ' 6 xTetephone (631) 765-1802 - FAX (631) 765-9502 rog6 r(@_south0' ldtow' nny.gov - sea nd(cD-southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: , 2— C 2 . Company.Name: ,=tai`" a - _ -_ _fit �• Name: Pl C/4 l . ;License No.. 22: L` email: � E6D Phone No:' . 2. [/]i request'an ernait copy of Certificate of Compliance Address.. f13, - 0IN U-If { )"YS JOB SITE INFORMATION` (All Information Required) _ Address: Cross,Street: Phone Nq:. ; BIc1g:Permit .f=1 - =Tax Map.District: 1010 n. }1 BlQok: Lot: BRIEF DESCRIPTION OF. �,NORK (Please Print Clearly) j/��': J�"a,e f ot" ' Check All That Apply:. . i Is jeb ready for inspection [jRougti In []Firial = i e , .D6you-need a Temp Certificate?: YES NO .- .. -- _ -� _ � ` Issued On •X0/7 � • Ten o linformati (AII information required) Service Size 1 Ph Ph Size:. A #Meters Old Meter# iEl aNew Service D Service Reconnect° UndergroundOverhead #,Underground Laterals 01 02 2 Frame QPoleWork done Ely Service? Y I_JN Additional Information: PAYMENT DUE WITH`APPLICATION QN, Electrical Inspection Form 2020.XIsx 6Y Q` PERMIT# Address: Switches Outlets GFI's Surface Sconces HH's UC Lts Fans fridge HW Exhaust - Oven Dryer. Smokes-., Serrrice; Car=ooh-. - _� -" -- ., -- •. - _� �Mcr�z�" � � . - � -•- . . "- -. - ; � . , -� , - Ger�ertor: Cortrbo- ;- . -'• - . -_ - -•_`-: .-, - ;- -- --,-- -:--�aca�tc� - -- , -----•-•------ •-,- ---•- --------,-- -----Tr- - ------ : ----------•-- -------------- " ansfer i AC AH Mini- - Special: Comments. • CONSULT YOUR LAWYER BEFORE SIGNING THIS INSTRUMENT-THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY THIS INDENTURE,made thel'3 day of w.�� 2021 BETWEEN NICHOLAS S. TSOUNIS(98% INTEREST), THOMAS A. TSOUNIS (1% INTEREST), and CHRISTOPHER TSOUNIS(1%INTEREST) 57-17 256th Street,Little Neck,N Y.11362(NICHOLAS S TSOUNIS) 162-31 91h Avenue,Apt.8A,Whitestone,N.Y.11357(THOMAS A.TSOUNIS) 80 Ketchams Road,Hicksville,N.Y.11801 (CHRISTOPHER TSOUNIS) party of the first part,and 153 HERRICKS LLC 87 Sandy Court Riverhead,KY 11901 party of the second part, WITNESSETH,that the party of the first part,in consideration of Ten($10.00) dollars paid by the party of the second part,does hereby grant and release unto the party of the second part,the heirs or Successors and assigns of the party of the second part forever, SEE THE ATTACHED SCHEDULE A The Grantors herein being the same parties as the Grantees of the same premises as described in a deed dated June 18,2012 and recorded at the Office of the Suffolk County Clerk on June 27,2012 in Liber 12697 Page 639. TOGETHER with all right,title and interest,if any,of the party of the first part in and to any streets and roads abutting the above described premises to the center lines thereof,TOGETHER with the appurtenances and all the Estate and rights of the party of the first part in and to said premises; TO HAVE AND TO HOLD the premises herein granted unto the party of the second part,the heirs or successors and assigns of the party of the second part forever. AND the party of the first part covenants that the party of the first part has not done or suffered anything whereby the said premises have been encumbered in any way whatever,except as aforesaid. AND the party of the first part,in compliance with Section 13 of the Lien Law,covenants that the party of the first part will receive the consideration for this conveyance and will hold the right to receive such consideration as a trust fund to be applied first for the purpose of paying the cost of the improvement and will apply the same first to the payment of the cost of the improvement before using any part of the total of the same for any other purpose. The word"party"shall be construed as if it read"parties"when ever the sense of this indenture so requires. IN WITNESS WHEREOF,the party of the first part has duly executed this deed the day and year first above written. NICHOLAS S. TSOUNIS IN PRESENCE OF. 0 r THOMAS A.TSOUNIS L VRISTOPHER T UNIS Standard N.Y 8 T.U.Form 8002-Bargain and Sale Deed,with Covenant against Grantors Acts—Uniform Acknowledgment Form 3290 a ` TO BE USED ONLY WHEN THE ACKNOWLEDGMENT IS MADE IN NEW YORK STATE State of New York,County of ss. State of New York,County of qs�0.550-v ss: On the day of in the year 2021 On the O% day of,)l I t7o-VT- in the year o0 2.[ before me, the undersigned, personally appeared Nicholas S. Before me,the undersigned,pers nally appeared ti�Ckiotck,s Tsounis,Thomas A.Tsounis,and Christopher Tsounis �; rkTnp � -Tsourv,s Personally known to me or proved to me on the basis of personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s)whose name(s) is satisfactory evidence to be the individual(s)whose name(s)is (are)subscribed to the within instrument and acknowledged to (are)subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their me that he/she/they executed the same In his/her/their cepacity(Jes), and that by his/her/their signature(s) on the capacity(es), and that by his/her/their signature(s) on the instrument,the individual(s),or the person upon behalf of which instrument,the individual(s),or the person upon behalf of which the individual(s)acted,executed the instrument the in ' id�acdtedd the ins ment. L7�e--O!offfc�ei rJ king acknowledgment) (signature and office of individual takin acknowledgment) No.011AMSM11143 Common d tEVIres�teni y 21,,�( untY TO BE USED ONLY WHEN THE ACKNOWLEDGMENT IS MADE OUTSIDE NEW YORK STATE State(or District of Columbia,Territory,or Foreign Country)of ss: On the day of December in the year before me,the undersigned,personally appeared personally known tome or proved to me on the basis of satisfactory evidence to be the individual(s)whose name(s) is(are) subscribed to the within Instrument and acknowledged to me that he/she/they executed the same in his/herRheir capacity(les),and that by hls/hbr/their sighature(s)on the instrument,the individual(s),or the person upon behalf of which the mdnriduai(s)acted, executed the instrument,and that such individual made such appearance before the undersigned in the in ` (Insert the City or other political subdivision) (and Insert the State or Country or other place the acknowledgment was taken) (signature and office of individual taking acknowledgment) DISTRICT 1000 BARGAIN AND SALE DEED SECTION: 113.00 WITH COVENANT AGAINST GRANTOR'SACTS BLOCK: 0700 2415 Cox Neck Road LOT: 010.000 Mattituck, N.Y. Title No, -15079/Abstracts Incorporated COUNTY OR TOWN 11952 NICHOLAS S. TSOUNIS, THOMAS.A. TSOUNIS, Suffolk/Southold AND CHRISTOPHER TSOUNIS STREET ADDRESS, TO Recorded at Request of 153 HERRICI(S LLC ABSTRACTS,INCORPORATED RETQRN BY MAIL STANDARD FORM OF NEW YORK BOARD OF TITLE UNDERWRITERS , " DlstnbtAed by Commonwealth Ar vwA.cu .t . COMMONWEALTH LAND TrrE INSURANCE COMPANY i T- ABSTRACTS, INCORPORATEC" RasidanLial 6&Commercial Title Insurance since l 584 as agentfor First American Title Insurance Company SCHEDULE A DESCRIPTION Title Number: 563-S-15079 Page: 1 ALL that certain plot piece or parcel of land, situate, lying and being in the Town of Southold, County of Suffolk, and State of New York at Mattituck, described as follows: BEGINNING at a point on the westerly side of Cox Neck Road, distant 551.56 feet southerly from the corner formed by the intersection of the westerly side of Cox Neck Road with the southerly side of Bergen Avenue; RUNNING THENCE along,the westerly side of Cox Neck Road, South 15 degrees 43 minutes 30 seconds East, 126.50 feet; THENCE South 74 degrees 16 minutes 30 seconds West, 153.85 feet to land of Mendozza; THENCE along said land of Mendozza, North 14 degrees 45 minutes 50 seconds West, 126.52 feet to land of Sheldon; THENCE along said land of Sheldon, North 74 degrees 16 minutes 30 seconds East, 151.73 feet to the westerly side of Cox Neck Road at the point or place of BEGINNING. i i' ACORDT. CERTIFICATE OF LIABILITY INSURANCE DATE(MIVI/DD/YYYY) 10/30/2020 PRODUCER 516-564-5656 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION NORTH FRANKLIN BROKERAGE INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 13 N FRANKLIN ST HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. HEMPSTEAD, NY 11550 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA AMERICAN EUROPEAN INSURANCE CUBIAS CONSTRUCTION CORP INSURERB 76 GARDNER AVE INSURERC HICKSVILLE, NY 11801 INSURER D. 4 INSURER E COVERAGES 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 AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L POLICYEFFECTIVE POLICY EXPIRATION LTR INSRC TYPEOFINSURANCE POLICY NUMBER DATE MM DD DATE M DD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A ✓ COMMERCIAL GENERAL LIABILITY DAMAGETOR NTED PREMISES(Ea occurence $100,000 CLAIMS MADE [—&/]OCCUR MED EXP(Any one person) s5,000 SKP2007842 10 10/21/20 10/21/21 –PERSONAL&ADV INJURY $ 1,000,000 GENERALAGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OPAGG $2,000,000 VI POLICY PRI- J C LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANYAUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULEDAUTOS (Perperson) $ HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTYDAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EAACCIDENT $ ANY AUTO OTHERTHAN EA ACC $ AUTO ONLY AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR FICLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION ANDWCSTATU- OTH- EMPLOYERS'LIABILITY TORYLIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACHACCIDENT $ OFFICER/MEMBER EXCLUDED? EL DISEASE-EA EMPLOYEE $ Ifyes,describe under SPECIAL PROVISIONS below EL DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS According to policy terms and conditions certificate issued for proof of coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town Of Southold DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN 53095 Route 25 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL PO Box 1179 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Sothold, NY 11971 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE 7in;�7� I ACORD 25(2001/08) ©ACORD CORPORATION 1988 YoeK workers' CERTIFICATE OF INSURANCE COVERAGE STATE I Compensation Board DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW PART 1.To be completed by Disability and Paid Family Leave Benefits Carrier or Licensed Insurance Agent of that Carrier 1 a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured CUBIAS CONSTRUCTION CORP 516-439-3670 76 GARDNER AVENUE HICKSVILLE,NY 11801 1c.Federal Employer Identification Number of Insured Work Location of Insured(Only required if coverage is specifically limited to or Social Security Number certain locations in New York State,i.e.,Wrap-Up Policy) 114786049 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) ShelterPoint Life Insurance Company Town Of Southold 53095 Route 25 3b.Policy Number of Entity Listed in Box"1 a" Po Box 1179 DBL605178 Southhold,NY 11971 3c.Policy effective period 12/18/2019 to 12/17/2021 4. Policy provides the following benefits: ® A.Both disability and paid family leave benefits. B.Disability benefits only. F1 C.Paid family leave benefits only. 5. Policy covers: ® A.All of the employer's employees eligible under the NYS Disability and Paid Family Leave Benefits Law. E] B.Only the following class or classes of employer's employees: Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance camer referenced above and that the named insured has NYS Disability and/or Paid Family Leave Benefits Insurance coverage as described above. Signed 10/6/2020 By V4 d hf (Signature of insurance carrier's authorized representative or NYS Licensed Insurance Agent of that insurance carrier) Telephone Number 516-829-8100 Name and Title Richard White, Chief Executive Officer IMPORTANT: If Boxes 4A and 5A are 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,4C or 5B is checked,this certificate is NOT COMPLETE for purposes of Section 220,Subd.8 of the NYS Disability and Paid Family Leave Benefits Law.It must be mailed for completion to the Workers'Compensation Board,Plans Acceptance Unit,PO Box 5200,Binghamton,NY 13902-5200. PART 2.To be completed by the NYS Workers'Compensation Board(Only if Box 4C or 5B of Part 1 has been checked) State of New York Workers' Compensation Board According to information maintained by the NYS Workers'Compensation Board,the above-named employer has complied with the NYS Disability and Paid Family Leave Benefits Law with respect to all of his/her employees. Date Signed By (Signature of Authorized NYS Workers'Compensation Board Employee) Telephone Number Name and Title Please Note:Only insurance carriers licensed to write NYS disability and paid family leave 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-120.1 (10-17) llf Illi�!''1°�1°1°0°111°°('10�-111)°�I�� /Pk\ N Y S ' F New York State Insurance Fund 8 CORPORATE CENTER DR,2ND FLR,MELVILLE,NEW YORK 11747-3166 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE D D ^^A"^" 461989045 NORTH FRANKLIN BROKERAGE , 13 NORTH FRANKLIN STREET N HEMPSTEAD NY 11550 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER CUBIAS CONSTRUCTION CORP TOWN OF SOUTHOLD 76 GARDNER AVE 53095 ROUTE 25 HICKSVILLE NY 11801 PO BOX 1179 SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE H2462 539-4 656200 01/24/2020 TO 01/24/2021 10/6/2020 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2462 539-4, 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:/NWIW.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. PRESIDENT NOEMI LOPEZ TORRES CUBIAS CONSTRUCTION CORP ONE PERSON CORPORATION THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE INSURANCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 190125258 U-26.3 SURVEY OF PROPERTY SITUATE MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000- 113-07- 10 /001 IF) LITEg LOT COVERAGE SCALE 1 "=40' AgREN gINDERLITER 1,g1'3, // 15.5 ��� DESCRIPTION AREA X LOT COVERAGE SEPTEMBER 17, 2020 PROPOSED HOUSE DECEMBER 5, 2020 ADDED PROPOSED POOL 'S �fi z 2,058 s ft. 10.6% DANA DWs"GWA'SR / D� & PORCHES q' & usQ c / / //� 10 C ' 924 s ft. 4.8% PROPOSED POOL PLT & COPING q' yap�� TL •�6'3��� / ��pt1�i/ / ��/ WL` S�tY ON TOTAL 2,982 sq. ft. 15.4X ILA �� AREA = 0.444 a�. ft. �5 . >..v,. 0 .Z ? ` v 25' RIGHT OF ' / TEST HOLE DATA ELEVATIONS ARE REFERENCED TO N.A.V.D. 1988 DATUM •„ �,_/,.,,gy�pp QOM :�:�::. .• •• Q EXISTING ELEVATIONS ARE SHOWN THUS:�x --- X. i �1" � 'cCti rt o o (TEST HOLE DUG BY NATHAN T. CORWIN III. L.S. ON SEPTEMBER 20, 2020) EXISTING CONTOUR ONES ARE SHOWN THUS:----� O / n 2. MINIMUM SEPTIC TANK CAPACITIES FOR A 4 BEDROOM HOUSE IS 1,250 GALLONS. LTVfir' 1 TANK; 8' DIA. 4' UQUID DEPTH y O / �� OyN EL' 12'2' O, q ft 3. MINIMUM LEACHING SYSTEM FOR A 4 BEDROOM HOUSE IS 300 s SIDEWALL AREA. 3 POOLS: SOXDFUNRE EXPANSION POOL O 0:.: .�.: :: Gf BROWN SILTY SAND (SM) n v�C1 c Qp Y'': '0 J Z� 4• ®PROPOSED 8' DIA.X 4' DEEP LEACHING POOL rn ,� ;::;; f PROPOSED 1,250 GALLON SEPTIC TANK to a O H ::.;,0,::: Z Pt"'• (J� 12.0 A c "' "' �'` PALE BROWN FINE TO MEDIUM SAND SP 4. THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD O to �.;;.':;:.;2p"•i:•i' T1t "� 1r ( ) OBSERVATIONS AND/OR DATA OBTAINED FROM OTHERS. DRAINAGE SYSTEAf CALCULATIONS: r� W il9 DRIVEWAY AREA: 7000.1 = 11 EL. 4.7' 700 aq. it. X 0.17 = 119 cu. ft. d QIL�W $TJ 7.5' 119 cu. ft. / 42.2 = 2.8 vertical ft. of 8' dia. leaching pool required y�L/1 y(OGK W 1rJ3' HIGHEST EXPECTED GROUND WATER a N'y yp�L TEST WELL No. USGS 405924072321501 S 39269.1 ROOFOVIDE (i 950 dia } 3' high STORM DRAIN POOLS EL 1.7' 10.5' 1,950 sq. ft. X 17= 332 cu. ft. WHO u / TEST HOLE GROUND WATER 332 cu. H. / 42.2 = 7.9 vertical ff. of 8' dia. leaching pool required / y"G WATER IN PALE BROWN PROVIDE (2) 8' d1o. X 4' high STORM DRAIN POOLS i ��� ut � / D�BUC WAS TO MEDIUM SAND (SP) USES 0/F S PROPOSED e' DIA. X 4' DEEP DRYWELLS FOR ROOF RUN-OFF ARE SHOWN THUS: N�FDTAKI KIS `-' - PROPOSED 8' DIA. X 3' DEEP DRYWELLS FOR DRIVEWAY RUN-OFF ARE SHOWN THUS: €:: $ogN9LI FFoTAgiS r:. MAR PROPOSED SEPTIC SYSTEM DETAIL E HOUSE (NOT TO SCALE) F FL 18.0' ♦ TOP BURIED 4' DEEP max. FINISHED GRADE PRECAST REINFORCED CONCRETE COVER //j!Z4 - `� FINISH GRADE BURIED 1' DEEP min. 2' DEEP max. dia. LOCKING. WATERTIGHT & INSECT PROOF ELEV, 14.0'T IRON COVER TO GRADE LEANOLU 20'mIn 20'min. MIN. 4'dia. t TOP EL 12.4' 3 __ _ TOP ELEV.4; APPROVED PIPE TO BE USED WHERE TOPSOIL IS NECESSARY FOR NOTES. - -fH FTS "L-- PITCHED 1/8"/1' 8" a :r 1. AREA CHOSEN FOR STOCKPILING OPERATIONS ro o - REGRADING & VEGETATING DISTURBED AREAS. � MIN. 4" dia. S' GLEX, SHALL BE DRY AND STABLE. INV. EL' _ 4' dia.' TEMPORARY STOCKPILE STABILIZATION MEASURES INCLUDE APPROVED PIPE 3 .° SAND 2. MAXIMUM SLOPE OF STOCKPILE SHALL BE :1. 12.4' PITCHED 1 4 1 INVERT ?rn °° a CROSSOVER COLOR VEGETATIVE COVER, MULCH, NONVEGETATIVE COVER, AND 3. UPON COMPLETION OF SOIL STOCKPILING, EACH / "/ ELEV. 121' INVERT PIPE ° ° PERIPHERAL SEDIMENT TRAPPING BARRIERS. THE Ems• 11.8' > PILE SHALL BE SURROUNDED WITH EITHER SILT• 3 FLOW +' STABILIZATION MEASURE(S) SELECTED SHOULD BE FENCING OR STRAW BALES, THEN STABILIZED WITH ' BAFF n APPROPRIATE FOR THE TIME OF YEAR, SITE CONDITIONS, VEGETATION OR COVERED. e ro AND REQUIRED PERIOD OF USE. i 4. i STABILIZE ENTIRE PILE 2 SLOPE OR LESS I g' -{ W W W W W W I _ . 3HIGHEST EXPECTED GROUND WATER SEPTIC TANK .WITH VEGETATION OR COVER LEv. Ile Al! 1. MINIMUM SEPTIC TANK CAPACITIES FOR A 1 TO 4 BEDROOM HOUSE IS 1,250 GALLONS. W W W W W W W 1 TANK; 8' DIA., 4' LIQUID DEPTH I W W W W W W 2. CONCRETE SHALL HAVE A MINIMUM COMPRESSIVE STRENGTH OF 3,000 psi AT 28 DAYS. LEACHING POOLS -3� 3. WALL THICKNESS SHALL BE A MINIMUM OF 3', A TOP THICKNESS OF 6'AND A BOTTOM THICKNESS OF 4'. 1. MINIMUM LEACHING SYSTEM FORA 1 TO 4 BEDROOM HOUSE IS 300 a ft SIDEWALL AREA ALL WALLS, BOTTOM AND TOP SHALL CONTAIN REINFORCING TO RESIST AN APPUED FORCE OF 300 pal'. 3 POOLS; 4' DEEP, 8' dia, q w W W W W .V W W W W W 4. ALL JOINTS SHALL BE SEALED SO THAT THE TANK IS WATERTIGHT. v W W W W W 5. THE SEPTIC TANK SHALL BE INSTALLED AT LEVEL IN ALL DIRECTIONS (WITH A MAX. TOLERANCE OF ti/4') 2. UEACHING POOLS ARE TO BE CONSTRUCTED OF PRECAST REINFORCED CONCRETE (OR EQUAL) ON A MINIMUM 3"THICK BED OF COMPACTED SAND OR PEA GRAVEL LEACHING STRUCTURES, SOLD DOMES AND/OR SLABS. y 41 J y y ,y ,y 6. A 10' min. DISTANCE BETWEEN SEPTIC TANK AND HOUSE SHALL BE MAINTAINED. 3.ALL COVERS SHALL BE OF PRECAST REINFORCED CONCRETE (OR EQUAL). 4. A 10' min. DISTANCE BETWEEN LEACHING POOLS AND WATER UNE SHALL BE MAINTAINED. 5. AN B' min. DISTANCE BETWEEN ALL LEACHING POOLS SHALL BE MAINTAINED. 6. AN 8' min. DISTANCE BETWEEN ALL LEACHING POOLS AND SEPTIC TANK SHALL BE MAINTAINED. STRAW BALES OR SILT FENCE TYPICAL STORMWATER UNIT STORMWATER MANAGEMENT NOTES: SOIL STOCKPILE (TOPS TO BE TRAFFIC BEARING) 1. ANY WORK OR DISTURBANCE, AND STORAGE OF CONSTRUCTION (NOT TO SCALE) (NOT TO SCALE) MATERIALS SHALL BE CONFINED TO THE LIMIT OF CLEARING AND/OR GROUND DISTURBANCE SHOWN ON THE APPROVED PLANS. CAST IRON INLET FRAME & COVER (FLOCKHART J63518 TYPE 6840) 2. PRIOR TO THE COMMENCEMENT OF ANY CONSTRUCTION ACTIVITIES, FINISHED GRADE OR 6'THICK REINFORCED CONC. COVER A CONTINUOUS LINE OF SILT SCREEN (MAXIMUM OPENING OF 8'TRAFFIC BEARING SLAB 1'-0' U.S. SIEVE 20 SHALL BE STAKED AT THE LIMIT OF CLEARING 36" HIGH POLE (FCST max.) �' ) STEEL OR WOOD fCST AND GROUND DISTURBANCE SHOWN ON THE APPROVED PLANS. THE SCREEN SHALL BE MAINTAINED, REPAIRED AND REPLACED AS FLOW PIPE FROM ROOF GLITTERS OFTEN AS NECESSARY TO ENSURE PROPER FUNCTION, UNTIL ALL DISTURBED AREAS ARE PERMANENTLY VEGETATED. SEDIMENTS 50' MIN. TRAPPED BY THE SCREEN SHALL BE REMOVED AWAY FROM THE OR TO BE SUFFICIENT TO PREPARED IN ACCORDANCE WITH THE MINIMUM SCREEN TO AN APPROVED UPLAND LOCATION BEFORE THE KEEP SEDIMENT ON SITE * CRUSHED 3/4" - 1-1/2' STONE STANDARDS FOR TITLE SURVEYS AS ESTABLISHED SCREEN IS REMOVED. HAY BALES AND/OR ALL AROUND BY THE L.I.A.LS. AND APPROVED AND ADOPTED 3. PRIOR TO THE COMMENCEMENT OF ANY CONSTRUCTION ACTIVITIES, SILT FENCING \ c^;;?; ~ FOR SUCH USE BY THE NEW YORK STATE LAND A CONTINUOUS ROW OF STAKED STRAW OR HAY BALES SHALL a i 0 LEACHING RINGS TITLE ASSOCIATION. BE STAKED END TO END AT THE BASE OF THE REQUIRED SILT o . ' REINFORCED PRECAST CONC. SCREEN AT THE BASE OF THE REQUIRED SILT SCREEN. THE BALES W 4" x 6' TRENCH 3 4000 PSI O 28 DAYS ° SHALL BE MAINTAINED, REPAIRED AND REPLACED AS OFTEN AS IS " I �A W/ COMPACTED aat a 8p NECESSARY TO ENSURE PROPER FUNCTION, UNTIL ALL DISTURBED p y (min.) r S1`:!•j C 0 -------- -------------- '- AREAS ARE PERMANENTLY VEGETATED. THE AVERAGE USEFUL LIFE Q - BACKFILL (min.) 4' ---- OF A BALE IS 3-4 MONTHS. SEDIMENTS TRAPPED BY THE BALES O I o TRENCH DETAIL SHALL BE REMOVED AWAY FROM THE BALES TO AN APPROVED N UPLAND LOCATION BEFORE THE BALES THEMSELVES ARE REMOVED. I (NOT TO SCALE) o r1 { 4. STRAW BALES SHALL BE RECESSED TWO TO FOUR INCHES INTO THE GROUND. I E 5. SILT SCREEN SHALL BE RECESSED BY TRENCHING SIX INCHES INTO THE GROUND. v F, $ 6. LEADERS AND GUTTERS THAT EMPTY INTO DRYWELLS SHALL BE INSTALLED I STEEL OR WOOD GROUND WATER ON THE PROPOSED RESIDENCE. ExTRA STRENGTH FILTER FABRIC POST(TYP•) ,y ` ' :41> 7. ALL PROPOSED SWIMMING POOL DISCHARGES SHALL BE DIRECTED TO DRYWELLS. I SILT FFEENCCINC D/OR REQ'D. WITHOUT WIRE MESH SUPPORT �;„ ti 8. PROPOSED DRIVEWAYS MUST BE CONSTRUCTED OF PERMEABLE MATERIALS 10' MAX. O.C. SPACING ' `•4 ..�'.•''' ' 0- ' OR IF PAVED, BE EQUIPPED WITH DRAINAGE SUFFICIENT TO PREVENT RUNOFF W/WIRE SUPPORT FENCE ' "` N.Y.S. Lic. No. 50467 FROM BEING DISCHARGED ONTO THE ROAD OR OFF-SITE. PLAN VIEW 6' MAX. O.C. SPACING " - W/O WIRE SUPPORT FENCE •. •• '`�*.,,, •'''"''-' 9. ALL AREAS OF SOIL DISTURBANCE RESULTING FROM THIS PROJECT SHALL BE :d.•v - UNAUTHORIZED ALTERATION OR ADDITION SEEDED WITH AN APPROPRIATE PERENNIAL GRASS, AND MULCHED WITH STRAW TO THIS SURVEY IS A VIOLATION OF IMMEDIATELY UPON COMPLETION OF THE PROJECT, WITHIN TWO (2) DAYS OF ,.;.j;: �.,�..� ' F,aR SECTION 72LA OF THE NEW YORK STATE Nathan Taft Corwin III FINAL GRADING, OR BY THE EXPIRATION DATE OF THE BUILDING PERMIT, IXISnNG GRADE � "' EDUCATION LAW. WHICHEVER N FIRST. MULCH SHALL BE MAINTAINED UNTIL A SUITABLE ROAD + '"i`:' VEGETATIVE COVER IS ESTABLISHED. IF SEEDING IS IMPRACTICAL DUE TO ..•,., COPIES D THIS SURVEY MAP NOT BEARING HAY BALES AND/OR •'�:: .•• `' `, TIME OF YEAR, TEMPORARY MULCH SHALL BE APPLIED AND FINAL SEEDING SILT FENCING z ATO UP FILTER 1'A9RIC SECURELY THE LAND SURVEYOR'S INKED SEAL OR Land Surveyor ��or PERFORMED AS SOON AS WEATHER CONDITIONS FAVOR GERMINATION I CONSTRUCTION CE BASE OF TO UPSTREAM SIDE OF POST EMBOSSED SEAL SHALL NOT BE CONSIDERED AND GROWTH. COMPACTED 3/4 STONE BLEND TO BE A VALID TRUE COPY. OR N.Y.S. D.O.T.APPROVED R.CA 10. SUITABLE VEGETATIVE COVER IS DEFINED AS A MINIMUM OF 85% AREA FILL TO 18' MIN. ABOVE EXISTINGGRADE TO ALLOW FOR DRAINAGE SILT FENCE DETAILS CERTIFICATIONS INDICATED HEREON SHALL RUN VEGETATIVE COVER WITH CONTIGUOUS UNVEGETATED AREAS NO LARGER NOT TO SCALE ONLY TO THE PERSON FOR WHOM THE SURVEY THAN 1 SQUARE FOOT IN SIZE. IS PREPARED, AND ON HIS BEHALF M THE Successor To: Stanley J. Isaksen, Jr. L.S. 11. ALL CONSTRUCTION ACCESS WAYS SHALL BE RAISED SUFFICIENTLY AT THEIR CROSS SECTION TiTLE COMPANY, GOVERNMENTAL AGENCY AND y SITE ACCESS LOCATIONS WITH THE EXISTING ROADS, TO PREVENT RUNOFF NOTES SILT FENCE SHALL BE PLACED PARALLEL TO SLOPE CONTOURS TO LENDING INSTITUTION LISTED HEREON, AND Joseph A. Ingegno L.S. TEMPORARY CONSTRUCTION ENTRANCE MAXIMIZE PONDING EFFICIENCY. INSPECT AND REPAIR SILT FENCE AFTER TO THE ASSIGNEES OF THE LENDING INSTI- OF WATER, SILTS AND SEDIMENTS FROM BEING DIRECTED OR DISCHARGED ONTO EACH STORM EVENT AND REMOVE SEDIMENT WHEN NECESSARY. REMOVED TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE. Title Surveys - Subdivisions - Site Plans - Construction Lc THE ROAD. A NON-LOAM BASE MATERIAL, SUCH AS CRUSHED STONE, GRAVEL, (NOT TO SCALE) SEDIMENT SHALL BE DEPOSITED TO AN AREA THAT WILL NOT ALLOW OR RECYCLED CONCRETE BASE, SHALL BE PLACED ACROSS THE DRIVEWAY OR OFF-SITE TRANSPORT. CONSTRUCTION ACCESS WAY AT THE ACCESS POINT ALONG THE ROAD. PHONE (631)727-2090 FOX (631)727-1 THE EXISTENCE OF RIGHTS OF WAY OFFICES LOCATED AT MAIUNG ADDRE! AND/OR EASEMENTS OF RECORD, IF 1586 Main Road P.O. Box 16 ANY, NOT SHOWN ARE NOT GUARANTEED. Jamesport, New York 11947 Jamesport, New Yol 4C 0 0 APPROVED AS NOTED DATE: l 'Z�t I ( B.P # Luj o B F ?b BY _c= .- O a ti NO -IFY BUILDING �,EPARTMENT Al U) o 33'-8" 765-1802 8 Ari TO q PNI FOR THE ¢ 5.: lo FOLLOWING INSPECTIONS: 00 Z 0" 321_011 ®" 1. FOUNDATION - TWO REQUIRED w FOR POURED CONCRETE I0 2. ROUGH - FRAMING & PLUMBING 12'-0" lo'-��� 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ® F _ — _ - - - - - i _ _ _ _ _ _ _ _ _ _ i _ _ _ _ _ _ _ _ _ _ _ ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW RE IRK RETIR4 I I YORK STATE. NOT RESPONSIBLE FOR I I DESIGN OR CONSTRUCTION ERRORS. 211-011 z COMPLY WITH ALL CODES OF w z NEW YORK STATE & TOWN CODES z I AS REQUIRED AN -CONBi-T-I OF W 3 - w a I v I I SOUTHOLD TOWN ZBA z �.� Nt ¢ 0 I I DRAIN ® ® oN��a I SOUTHOLD TO LANNING BOARD N U I I ® 16 -m X 32'-0" ���5p� I I 'OUT TOWN TRUSTEES l.S.DEC I DRAIN W N Q) a Evo �� � RETAIN STORM WATER RUNOFF I I PURSUANT TO CHAPTER 236 w W z OF THE TOWN CODE. c ami =c"" i t0 u z0-4 LIGHT LIGHT I I - 0 E N uw t; SKI R SKI ER I ��O� ,��OF NF C!l w Lit- ® — - - - - 11 - - - - - - - - - - - - - I. �' - - — —I ,`� GO .�P — — = — — — — — rUn 0 Ijolt 32--011 0itcl o. A S99O5 �OFEssvA -�' - V) z OCCUPANCY OR USE IS UNLAWFULPOOL NOTES WITHOUT 1-ALL GUNI[E MALL HAVE A MIN.28 DAY STRENGHT OF 4,500 PSI. Q F *I " I T H O OT O E T9 FI OAT 3-WELDED WIRE FABSM RIC REINFORCEMENT SIIALL BESHALL BE GRADE 60 yCOLD DRAWN FORMING TO CO FORMING TO AST 185 o O I I� - o � OCCUPANCY B 7-ALL WORK SHALL BE IN ACCORDANCE WITH THE LATEST ACI CODE 8- LEGS OF REBAR ACCESSORIES SHALL PLASTIC TIPPED.ALL SNAPTIES AND WALL SCALE: 1/4" I'-0 PENETRATIONS 9-SHALL BE CLEANED&GROUT REPAIRED TO PRELUDE CORROSION > 10-ALL DIMENSIONS GIVEN SHALL B CONSIDERED A MIN. CONTRACTOR MAY INCREASE TO PROVIDE FOR DRNNS&COPING 11-ENGINEER CONTROLLED INSPECTION REQUIRED d Adlarm&. 0 z ---------------------------;, Off TOP OF WATER Ilk LLj LL CVO C14 0 U) CD POOL < I6'-01, x 32,-0" > z 2 .... .....777 77 7 < U) z < 0 0 cr) P > w Lu U) III-a" 0 00 x 0 LU LU 0 1011 0 Lr) z 0 C'4 12" COPING 10 12" COPING SAND OR SAND OR CLEAN FILL 5X5 TILE 5X5 TILE CLEAN FILL A TOP OF WATERt , ,"" 101, x 101, P.C. 04 REBAR FOR *4 RE5AR FOR 101, x 101, P.C. U BEAM WIDTH OF POOL WIDTH OF POOL BEAM fn mcn " �: q E a- q�Z 04 REBAR 1@ 12 C C. 04 RE15AR 's 12" O.C. w ui V� co co it MARBLE DUST fp ® ® L MARBLE DUST 0 u z0 ol 0 uj D (n (Y E uj LL: (o u') < 7 GUNITE zo 7 GUNITE -c Lu e oF N& 0:3 31 0 U) D co MAIN ': cn DRAIN STONE OR SAND BASE STONE OR SANE) BASE j - 777 /11, N., P'Essl 'Esslo 0 V POOL NOTES w 1-ALL GUNITE SHAL HAVE A MIN.28 DAY STRENGHT OF 4,500 PSI. 2- STEEL REINFORCEMENT SHALL BE GRADE 60 CONFORMING TO ASTM A615 3-WELDED WIRE FABRIC REINFORCEMENT SHALL BE COLD DRAWN CONFORMING TO AST 185 7-ALL WORK SHALL BE IN ACCORDANCE WITH THE LATEST AC(CODE 8- LEGS OF REBAR ACCESSORIES SHALL.BE PLASTIC TIPPED.ALL SNAPTIES AND WALL PENEIWONS 9-SHALL BE CLEANED&GROUT REPAIRED TO PRELUDE CORROSION > w 10-ALL DIMENSIONS GO SHALL BE CONSIDERED A MIN. CONTRACTOR MAY INCREASE TO PROVIDE FOR DRAINS&COPING 11- ENGINEER CONTROLLED INSPECTION REQUIRED