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HomeMy WebLinkAbout46673-Z TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE 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 #: 46673 Date: 8/10/2021 Permission is hereby granted to: Koff, Howard 630 E 72nd St Apt 19C .._ _._._... ..... New York, NY 10021 To: Construct partially in-ground gunite swimming pool with deck surround as applied for, and with Trustees #9440 At premises located at: 1380 Oakwood Dr., Southold SCTM # 473889.................................... ��nnn _-__..__......................................._.. _..........._.._...........................­.. ...... Sec/Block/Lot# 70.-12-32 Pursuant to application dated .__6/7/2021 and approved by the Building Inspector. To expire on 2/9/2023. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO - SWIMMING POOL $50.00 SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $566.00 Total: $866.00 Building Inspector Town Hall Annex 51375 Main Road P. 0. Box 1179 Southold,NY 11971-0959 Telephone (631) 765-1 Fax ( 31) 765-9502 Date Received APPLICATION FOR BUILDING PERMIT For Oce Use Only �� Building Ins� ert � w............ PERMIT . ..m,..��..._._ ......... .w�.____..w_._.._ ..... Applications an forms must be filled out in their entirety.Incomplete J 1. N � ' �'�1 applications i not be accepted. ere the Applicantis owner,an Ownees Authorizationr )shall be completed. Da te: OWNER(S)®qat PERTY: _............ _. _w .._..... 32 Name: Lisa L . . rojec ress: Drive, g ...-�._..._ Phone ai :._www lkoff@paulweiss.com lkol MailingAddress: ., 01 CONTACT PERSON: Name: Michael R. Inzerillo Mailing Address: 623 Medford Avenue, Patchogue, NY 11772 � ....�,� Phone#I: ............ E ail: PROFESSIONALDESIGN . Name: Swimming Pools by Jack Anthony MailingAddress: 623 Medord Avenue, Patchogue, NY 11772 Poe ail: _,.....y-._.--.._...w�..w�. �,.. CONTRACTOR INFORMATION: ..---l-1-................ ...... Mailing Address: _,,._ _....___....__w... _ Poe ail: ._. .._.._......_.._._....�.. DESCRIP71ON OF PROPOSED CONSTRUCTION EINewStructure ElAddition ElAlteration ❑ e air ElDemolition Estimated Cost of Project: � CD ter In round Pool w 150,000.00 Will the lot be re-graded? ...,'Yes ❑No Will excess fill be removed from premises? R Yes El No 1 PROPERTY INFORMATION Existing use of property: Single Family Dwelling intended use of property: Single Family Dwelling Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to i R40 this property? E]Yes iiNo IF YES, PROVIDE A COPY. Check Box After Reading: The owner/contractor/design professional is responsible for all drainage and storm water Issues as provided by Chapter 236 of the Town Code. 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,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 buildlng(s)foir necessary inspections.False statements made herein are, punishable as a Class A misdemeanor pursuant to Section 210A5 of the New York State Penal Law. Application Submitted By(print name): Michael R. Inzerillo giAuthorized Agent ElOwner Signature of Applicant: Date: STATE OF NEW YORK) SS: COUNTY OF Suffolk Michael R"h. inzerillo being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the Contractor (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 f 2q ...... IST 'FE OF 0 COUNTY PROPERTY OWNER AUTHORIZATION (Where the applicant is not the owner) Lisa L. Koff A&'1d'td ' "I residing at 1) 1 )f Z -1��'�'0 'L(zLL)1 L�' ") C -- , Al,""o H L�12 7--,- Michael R. Inzerillo authorize, to apply on o hereby aut my behalf to the Town of Southold Building Department for approval as described herein. Z /2 I LI ' 1wner's Signature-"r�e Date Z /!"77c, Z - k'(') Print Owner's Name 2 Clien : 10246 SWIMP001 ACORD - _ .. .. ... oae - DAE(M /DD 122 1 IS CERTIFICATE IS ISS S A F INFORMATION L A F TS T FIC L THIS CERTIFICATE T AFFIRMATIVELY NEGATIVELY E E LT COVERAGE FF F Y T POLICIES BELOW.THIS CERTIFICATE INSURANCE ES T CONSTITUTE CONTRACT BETWEEN T ISSUING INS (S),AUTHORIZED REPRESENTATIVE PRODUCER,A THE CERTIFICATE HOLDER. ... . .. - � . . ..._._ _.-..MICR A1T:I thechol. r 1rADDITIONALI5 the Qlc (Ie� must have ADDITIONAL INSURED revisions or 1e endorsed. T I SUBROGATION IS WAIVED,subjecttot the terms and conditions a policy,certain policies ayr require a endorsement.A statement ois not c m(s). PRODUCER Q 31 a er A(ADlvO Naa Fi) rtl_flcarlal Support Edgewood Partners Ins. _ _tA ' Marcus rive N*I 31'3 90-9790 tooSTarcoa3r Floor _...... .., mNsaJRER(S)AFrOWJ qtN Co.........C' ,. .. NAIc# Melville,NY 11747 !NSRF#R A:Hartford Fire Insurance Co...,R. an 82 INSURED -------- INSURER I URER . B:Trumbull Insurance Company 271 Swimming ols By Jack Anthony,Inc INSURER C 623MedfordAvenue Patchogue,NY 11772 INsaaara D; I1CSk!RER E NSURER F: COVERAGES CERTIFICATE E SI NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BE11 LOW HAVE BEEN I 11 SSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED- NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF Y CO CT OR OTHER DOCUMENT WITH RESPECT TO ICH THIS CERTIFICATE Y BE ISSUED OR Y 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. tNStI (OL Pa ACY EFF EXP L dl TYPE of INSURANCE INS Atte .... 5 2021 IPOLICYr I LIMITS wtaR 0. PQ v uta a A COMMERCIALGE 1L 1 2/0 021051202 EACH OCCURRENCE $1,000,000 n . p CLAIMS DE II occuR I i I s a s 3011 000 t u^u .gur�aaa) S10 000 PERSONAL&ADV INJURY $1,0010,0001 GEN°L AGGREGATE LIMIT APPLIES PER. GENERALAGGREGATE_.. 52mw,,000 000 PFO- . ..._._.. ... . .. ...___...POUCY . JECT P, .,J LOC PRODUCTS CCbIIrII IP"AGG S2 t� �l 000 _.... ... ......... ___._w.. .... .. �_._._„ O�EIPcIt: a .. .. $ AUTOMOBILE LIABILITY 12 4 ... .......e, ..... 2J051 021 02/05(202 CO , - ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED L........ ,,, .. ..,.,,, ,.,_...........AUTOS ONLY _........... AUTOS BODILY INJURY(Per accident) .$ ---- ... __ ..®....,. x HIRED AUTOS ONLY AUTO ED ' CPi"CTI 1 TA'il'w A rB. , I P Auros ONLY ( pa ara.uulaku�a),. $ _,..... _EXCE ........_ _..,, &I al ..... UMBRELLA L C9 ,RENCE o-aArolCLAI &MADE S1 ...... . ... DEDd RETErr"ONS WORKERS COMPENSATION,.,. II I AND EMPLOYERS*LIABILITY vfN .. ....SIJIF IEPITRN, ANYITaPRlPWLER1EXECrrfVF - Or Ib EN„itwtEIABr R I XC�LUbE1 N/A E.L.EACH AI CIDFNT (Mandatory in NH) ��_w .._ I4"..L.ClI' .A m :enMa La.'byP r,S' I.I..DISEASE-POLICY LIMIT u �re�Saa uDu�laur IaEil l IcN Oar r yPe PIAS tN --- DESCRIPTION OF OPERATIONS I LOCA71ONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be affached it more space is required) CERTIFICATE HOLDER CANCELLATION Town of SoutholdSHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE E EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 375 Route 25 ACCORDANCE WITH THE POLICY PROVISIONS. PID Box 117 Diol ,NY 1171 AUTHOR2ED REPRESENTATIVE ®1988.2015 ACORD CORPORATION.All rights reserved. ACGR 25(2015103) 1 of 1 The ACORD name and logo are registered marks of ACORD #S2912755/M2912623 CPRAV NEW Workers' Zil_\YNARTAF Compensation CERTIFICATE OF INSURANCE COVERAGE 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 rrier�­' ......... ...............— ......a,_........... ................ ,"' ­­ ---------- 1.. .L_.- egal Name&Address of Insured(use street address only) 71b�Business Telephone Number of Insured SWIMMING POOLS BY JACK ANTHONY INC 631-878-7665 623 MEDFORD AVENUE PATCHOGUE,NY 11772 1c.Federal Employer Identification Number of Insured Work Location of Ins (ofirnitedonly required if coverage is specifically tor Social Security Number ured certain locations in New York State,i.e.,Wrap-Up Policy) 113041142 2,Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) ShefterPoint Life Insurance Company Town of Southold 54375 Route 25 !3b.Policy Number of Entity Listed in Box"l a" PO Box 1179 DBL66700 Southold, NY 11971 3c.Policy effective period 12113/2020 to 1211212021 4. Policy provides the foliog benefits: R] A.Both disability and paid family leave benefits, E] B.Disability benefits only, [:] 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. B.Only the following class or classes of employees employees: ........... ....... Under penalty of perjury,I certify that I am an authorized representative or licensed agent oft insurance carrier referen ...w above and—that the named insured has MYS Disability and/or Paid Family Leave Benefits insurance coverage as described above. 3/29/2021 By d�ht Date Signed (Signature of insurance carrier's authorized representative or NYS Licensed Insurance Agent ofthat insurance carrier) Telephone Number 516-829-8100 Name and Tale Righard White Chief Executive Officer IMPORTANT: If Boxes 4A and 5A are checked,and this form is signed by the insurance carriers authorized representative or NYS Licensed Insurance Agent of that carrier,this certificate is COMPLETE. Mail it directly to the cerfificate holder. If Box 4B,4C or 5B is Ghecked,this certificate is NOT COMPLETE for purposes of Section 220,Sub .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 I has been checked) State of New York Workers' Compensaflon Board According to information maintained by the NYS Workers'Compensation Board,the above-named employer has complied vAth the NYS Disability and Paid Family Leave Benefits Law virith 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 IVYS disability and paid family leave beneft insurance policies and NYS licensed insurance agents of those insurance carriers are authorized to issue Form DB-120.1.Insurance brokers are NOTauthorrized to issue this fonn. DIB-120.11 (10-17) Ikris120.1 I I0_I17 ) 17--oq*-1\1 I IN, NYSIF New York State Insurance Fuad 8 CORPORATE CENTER DR,3RD FLR,MELVILLE,NEWYORK 11747-3129 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE AAAAAA 113041142 EPIC INSURANCE BROKERS CONSULTANTS MCA 40 MARCUS DR 3RD FLR EL LLE NY 11747 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER SWIMMINGPOOLS BY JACK ANTHONY INC TOWN OF SOT LD 623 MEDFORD AVENUE 54375 ROUTE 25 PATCHOGUE NY 11772 PO BOX 1179 SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE 12432495-6 2 12/01/2020 TO 12/01/2021 1 /2020 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2432 495-6, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR RES' COMPENSA71ON UNDER THE NEW YORK S' COMPENSATION LAW WIT RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK EXCEPT AS INDICATED LO , AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES LY. IF YOU WISH TO RECEIVE N071FICATIONS REGARDING SAID POLICY,I L , OR TO VALIDATE THIS CERTWICATE,VIISIT OUR WEBSITE AT HTTPS-IfWWW.NYSW.CONUCERTICER-IVAL-ASP. STATEYORK INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE FIC I S. THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS O RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER_ THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEWYORK STATE INSURANCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION BER:687621772 U-26.3 Suffolk County Dept.of ' Labor,Licensing&Consumer Affairs HOME IMPROVEMENT LICENSE Name MICHAEL R INZERILLO This certifies that the Business Nara bearer is duly licensed SWIMMING POOLS BY JACK ANTHONY INC by the County of suffolk License Number:H-24507 Rosalie Drago Issued: 03/07/1997 Commissioner Expires: 03/01/2023 Q s 50rs North Road S06054'30"E 275' �o o O, El 1:1 ( \ xisting Septic Sy tem , Doors with access to the pool rea are to be equipped with C � /( E udlble alarms 8" High Chain Link Fence 0 Self los ng and Latchi g Gate N e r CP ® Latcl i or Interior Side f Fence ood Existing Deck New Wood Pool W Deck IO 0 2 Story Resi nce co EM Po I Equipmen C) O M 00 Z (2P , o 'ask,6'0 x 2' Deep Pool Equipment Cj Leaching Pool O 1 11 N 06 54 30 W 232.041 Scale: I" = 10'-0" P� � '•; TIN - 7 2021 51684 - SSW) 1684 SSW) = Plans are prepared by Condon Engineering,P.C. It is a violation of the New York State Education Scale: 1" 10'-0" Condon Engineering, P.C. Koff Residence Law,Article 145,Section 7209,for any person unless acting under the direction of a licensed Oft A Professional Engineer,Architect,or Land Surveyor,to alter any item in anyway.If an item bearing Drawn b . JJC 1755 Sigsbee Road 1380 Oakwood Drive the seal of an Engineer,Architect,or Land Surveyor is altered,the altering Engineer,Architect,or y Land Surveyor shall affix to the item his/her seal and the notation'Altered by'followed by his/her Mattituck, New York 11952 Southold, New York signature and the date of such alterations,and a speck description of the alteration. (631) 298-1986 Date : 5-25-2021 Enclosures As shown on the attached survey the area around the pool will be enclosed with a 48 inch high chain link fence. The maximum size of the chain link shall be not more than 2 a". The gates to the pool area are to be self closing with latches '71 located on the interior side of the gate at least 40 inches above �.oe grade. All gates are to be equipped with locks that will prevent access when the pool is not being used. I / I / I Doors in the building that provide access to the pool area are No. 3 Rebar to be equipped with audible alarms which will be activated 12 OC Bot 12" when the door or screens are opened Ways 8 amp 2 Pool q K / � Main Drainslwith o Pneumatically installed concrete (Gunite). The mix proportion BO Hydrostatic V41ves �' a ' used for guniting are 1:3 and 1:4:5. This will generally have a water cement ratio of 0.30. A 1:3 mix will attain a strength of 70 MPa in the 7th day after application. I I • ' = The walls and floor are to be reinforced with No. 3 Grade 60 �` \ j ' ' •'' ' :' Deformed Bars Conforming to ASTM A615. The rebar is to be instalI `` ' • a . ; . „ of 121ed riches on(ly and center The floor'isn the tobe installedalls with a spacing 36'-0" �\ I 10 front to back and side to side 12 inches on center. The pool is to be finished with a pool plaster finish. Color is to be specified by the owner. Pool Plan � Section Details Scale "=1 1-0" Scale: 1/4" = 1'-0" 36'-0" eck Elevation ater Elevation Skimmer kimm r I I 2" �� pprox. Grade Elevation /�' I Three Way Valves 1 • x.; �bao 8 1„ 13 • amp I ' Three Way Valves LO — - - - - - — — — — - - - - - - - - � heck Valve •' ::'' '`: • K Main Drainslwith Lim: •L l-i�F' •- I `� Pum Hydrostatic heck Valve 1 `. I Filter Heater Longitudinal Pool Section Scale: 1/4"= V-0" All Pool plumbing is to be 1 2"0 Schedule 40 PVC pipe Pool Plumbing Plan Scale: 1/4" = 1'-0" •� ," ;,` =' 1684 •�^. ES$t0�a�' Plans are prepared by Condon Engineering,P.C. It is a violation of the New York State Education Scale: 11" = 10'-0" Condon Engineering, P.C. Koff Residence Law,Article 145,Section 7209,for any person unless acting under the direction of a licensed Professional Engineer,Architect,or Land Surveyor,to alter any item in anyway.If an item bearing Drawn by : JJC 1755 Sigsbee Road 1380 Oakwood Drive the seal of an Engineer,Architect,or Land Surveyor is altered,the altering Engineer,Architect,or y Land Surveyor shall affix to the item his/her seal and the notation'Altered by'followed by His/her Mattituck, New York 11952 Southold, New York signature and the date of such alterations,and a specific description of the alteration. (631) 298-1986 Date : 5-25-2021 z 3 5"0 Gave Lag Bolts 16" OC Staggered i Simpson 4 Graspable Hand CQ4.62-5.506SD ZMax " ` Rail > 1 4"0< 2"0 x 6 MCQ Posts a° impson CCQ4.62-5.506SDS ZMax x 6 MCQ Posts 10" impson ABU66 ZMax 4. lo j impson ABU66 ZMaxlo 1. .� - - - - - - - - - - - - 11" 41 : d �— •'.• .j ' G '� •d ♦ •' •. •. d... e C d... / 811 lard • `• ..••• '•. • .•. • d •� a �� •_! 11 li:l.lf''.• y •• l•• !i:laf'. Y. L• AA j i• Section Detail 16" • d A Section Detail © •'1 ' Scale 1/2"=1'-0" " Zh • O Scale 1/2"=1'-0" : • C Stair Detail D Hand Rail Detail Scale 1/2"=V-0"" O Scale 1/2"=1'-0" 5!-5f }—41_6 101 61-94-1.'4 211 11 5, 11 6 �~ 12'-11 5y11 I ---------- � 1-411 g 30"0 Sonotube 30"0 Sonotube 24"0 notube o 'o 24"0 Sonotui e I I i x x N N 04 I 1 , (3) 2 x 10 MCQ �\ % �\ ( 2 I `--' --' '1' 1M I vzImt - I 30"0 onotube x 6 MCQ Posts U- I C100 U I T l \t r`>lao °° 1 �\\ o co x 1(212 1 I N I o coU 18"0 Sonotube N v I 1 2 x 8 MCQ Bolt d 16"OC Staggered (2 2 t 12 MPQ I I B Notes: 309 0 on)tut a ,� S-1 / All measurements are to be verified in the 1 field and any discrepancies are to be brought to the attention of the Engineer. g U) * Design Loads: 1 2 x 8 MCQ FJ Concrete used for footings is to be 4,000 psi am afts C) i - 16"OC _ er 28 da Y minimum. Deck - LiveLoad-40 Dead Loadp 15 psf m o 0 1 *All pressure treated lumber is to be MCQ No. 24" Sonotu e m 2 or better Southern Yellow Pine. Design Criteria- c� toe i \1 I * Decking planks on decks are to be 4 x 4 Epe. * NYS Residential Code R301.1.1 and utilized the methods ,� °x° and procedures stipulated in Chapter 2 Engineered Design ----------------- --- A `�' ------------------ \ ------------ * Stair treads are to be 2 x 12 Epe and risers and Chapter 3 Prescriptive Design in the 2015 American – Forest and Paper Association Wood Frame Construction i \\ are to be Cedar. Manual (2015 WFCM)for One and Two Family Dwelling Units ti–' // \\ and ASCE 7. * Railing balusters are to be #2 Cedar, with 2x d \\ horizontal supports, and 2 x 6 Epe top caps \\ 1 X o ; \\\ *All nails, bolts, nuts and washers are to be ✓ r.a , o / \ x ; `� hot dipped galvanized. 2412 Sonotube ; \\ I '" i \\ *Joist hangers and post bases are to be 30010on toe �/ Simpson ZMax corrosion resistant / \ / \ All screws used to secure framing and decking planks are to be stainless steel. ------------------------------ I ------------------------------------- *All steps are to be equipped with round Mahogany railings with outside diameters of Z0 _ not more than 2" as shown in the drawings. o) , 1 00 I i 18"3 Sonotbe 8"0 Sgnot be I %77+ a _� U s� X V-411 aFESS14 .•� N --D— -----moi— -------- S-1 C 511 S-1 i I i Plans are prepared by Condon Engineering,P.C. It is a violation of the New York State Education Scale: 1 10'-0" Condon Engineering P.C. Koff Residence Law,Article 145,Section 7209,for any person unless acting under the direction of a licensed Deck Framing P I a n Professional Engineer,Architect or Land Surveyor,to atter any item in any way.If an item bearing Drawn b . JJC 1755 Sigsbee Road 1380 Oakwood Drive Deck Foundation Plan the seal of an Engineer,Architect,or Land Surveyor is altered,the altering Engineer,Architect,a Y Scale: 1/4"= 1'-0" Land Surveyor shall affix to the item his/her seal and the notation"Altered by'followed by his/her Mattituck, New York 11952 Southold, New York Scale: 1/4"= 1'-0" signature and the date of such alterations,and a specific description of the alteration. Date : 8-6-2021 (631) 298-1986