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Home My WebLink About42467-Z g11EfQL�- Town of Southold ��otiv �vGy; 6/29/2021 a P.O.Box 1179 0 ca, 53095 Main Rd oy o� Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 42122 Date: 6/29/2021 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 825 Horton Lane, Southold SCTM#: 473889 Sec/Block/Lot: 63.4-3.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 3/8/2018 pursuant to which Building Permit No. 42467 dated 3/19/2018 was issued,and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: accessory in-ground swimming pool fenced to code as applied for. The certificate is issued to Elliston,N A Cifarelli&Ano. of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 42467 5/24/2018 PLUMBERS CERTIFICATION DATED th r'iFeaiSignature sU rn��c TOWN OF SOUTHOLD oG 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#: 42467 Date: 3/19/2018 Permission is hereby granted to: Elliston, N A Cifarelli 825 Horton's Ln Southold, NY 11971 To: construct accessoryinround swimming-g g pool as applied for. At premises located at: 825 Horton Lane, Southold SCTM # 473889 Sec/Block/Lot# 63.-1-3.1 Pursuant to application dated 3/8/2018 and approved by the Building Inspector. To expire on 9/18/2019. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO - SWIMMING POOL $50.00 Total: $300.00 i Buil I ector 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. I New Construction: Old or Pre-existing Building: (check one) Location of Property: ,�&,0� �� r�,o�a�—� House No. Street Hamlet t Owner or Owners of Property: Suffolk County Tax Map No 1000, Sectio Plock Lt 3- 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: $ L Applicant Signature sovey®l Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 ® �Q roger.richert(-town.southold.ny.us Southold,NY 11971-0959 Q lyc®U�9T°I,� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Elliston Address: 825 Horton Lane city.Southold st: New York zip: 11971 Building Permit#: 42467 Section: 63 Block: 1 Lot: 3.1 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor DBA: James Dougherty Electric License No: 33397-ME 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 Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt 1 Ceiling Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt 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 4 Twist Lock Exit Fixtures �] TVSS Ll Other Equipment: Inground Swimming Pool to Include: Bonding, 1- Salt Generator, Gas Pool Heater, 4- Pool Lights. Notes: Inspector Signature: Date: May 24, 2018 0-Cert Electrical Compliance Form.xls CQ a0f SOUTy h� `o Ag TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ FOUNDATION 1ST4P� ROUGH PLEIG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: 3 (A S Q Sh DATE INSPECTOR BOE SOUTy couff v TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION AOL,- /3FOUNDATION 1 ST ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) MARKS: &i�' m. `Ili DATE BINSPECTOR g 50UTyo� # TOWN OF SOUTHOLD BUILDING DEPT. `ycou765-1802 t INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) [ ] CODE VIOLATION [ CAULKING REMARKS: DATE INSPECTOR-z��qC2E2 gfsou �o�a Tyo� * # TOWN OF SOUTHOLD BUILDING DEPT. cou765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND XSAULA N FRAMING /STRAPPING NL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: -h Ulu -J DATE INSPECTOR �E SOUTyOIo # TOWN OF SOUTHOLD BUILDING DEPT.- 765-1802 EPT.765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] " SULAT :Z�LKING [ ] FRAMING /STRAPPING [ FINAL [ ] 'FIREPLACE & CHIMNEY [ ]- FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: DATE INSPECTOR FIELD INSPECTION REPORT DATE COMMENTS I l% l .div✓ 1 FOUNDATION(1ST) �S -------------------------------------- FOUNDATION (2ND) z 0 ROUGH FRAMING& � y PLUMBING i c INSULATION PER N.Y. y STATE ENERGY CODE G FINAL ADDITIONAL COMMENTS �✓ 4-G V rx t 'aon p. O ,�3 H x d Ot H 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 44 ets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 'arvey Southoldtownny.gov PERMIT NO. Check Septic Form N.Y.S.D.E.C. Xees st Application Flood Permit Examined ,20 �(�(� /�� Single&Separate 0 1� Truss Identification Form MAR _ 8 2018 St -Water Assessment Form Contact: Approved ,20_[r Disapproved a/c TOS OVA®SOLD ? Phoke: 9�— Expiration ,20 i BViUjn ZJdspector APPLICATION FOR BUILDING PERMIT Date 3 , 2014�$ INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application,the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim,the Building Inspector may authorize, in writing,the extension of the permit for an addition six months. Thereafter, a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County,New York, and other applicable Laws, Ordinances or Regulations,for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant-o-r-nmrie, if a corporation) -S 1 e��r�� VN, SOI)t \ a N1 11�� ) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder Name of owner of premises (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. 977 -- d Plumbers License No. -Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: House Number Street Hamlet �"�►'2 X44 � 2' @�� - - 2 County Tax Map No. 1000 Section Block , Lot J Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work(check which applicable):New Building Additio Alteration Repair Removal Demolition Other Work ' S ' ' (De ri tion) 4� Estimated Cost V1 -onca Fee --(To-be paid on filing this application) If dwelling, number of dwelling units ; 4 ifI�Tumber of dwelling units on each floor If garage, number of cars A � 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 Dimensions of entire new construction: Front Rear Depth p Height Number of Stories Size of lot: Front Rear Depth 1(�. Date of Purchase Name of Former Owner _1111. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded? YES NO Will excess fill be removed from premises? YES NO 14. Names of Owner of premises Address Phone No. Name of Architect Address Phone No Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY$E REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? * YES NO__;?�, * IF YES, PROVIDE A COPY. _ STATE OF NEW YORK) SS: COUNTY OF 1 nti mc being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)He is the (Contractor,Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this �rth day of M(rC h 2011—ibEpACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK NO.01 DW6306900 Ulotary QUAtIF ED IN SUFFOLKGOUNTV Public COMMISSION EXPIRES JUNE 30,�A Signature of Applicant i L� 0.°SUFFa�� 5T(01R,1\ [WA�T1E1K SCOL L1. Russell � y SUPERVISOR 0 � MANA(Gl]EIMUENT SOUTHOLD TOWN HALL-P.O.Box 1179 v" N 53095 Main Road-$OUTHOLD,NEW YORK 11971 'kj�O - Town of Southold f i CHATTER 236 - STORMVVATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT) DOES THIS PROJECT I1'gVOLVE ANY OF THE FOLLOWING: Yes No (CHECK ALL THAT APPLY) ❑ A. Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. EP B. I�Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. ❑P-C. Site preparation on slopes which exceed 10 feet vertical rise to ; 00 feet of horizontal distance. ED. Site preparation within 100 feet of wetlands, beach, bluff or coastal _ !erosion hazard area. t E E. Site preparation within the one-hundred-year floodplain as depicted on FIRM Map of any watercourse. E� F. Installation of new or resurfaced impervious surfaces of 1,000 square feet or more, unless prior approval of a Stormwater Management Control Plan was received by the Town and the proposal includes-kind replacement of impervious surfaces. you answered NO to all of the questions above, STOP? Complete the Applicant section below with your Name, ignatulle,rconuct-Infannation,-Date-&-Count-}LT•ax-Map-Number Cbapte"36-does-not-app4Ao-your-prO*t_ If you answered YES to one or more of the above, please submit Two copies of a Stormwater Management Control Plan and a co�pleted Check List Form to the Building Department with your Building Permit Application. / APPLICANT: (Property erty Owner,Design Professional,Agent,Contractor,Othei� S.C.T.M. 1000 Date ( District i NAME: Section Block Lot , OR Blili_�1\u DEP�r?"l'�-t�_NT I G tiL i + t Contact Information: .7c1.y1✓}, i unGr � - Reviewed By: - - - - -! - - - - - - - - - - - - - , � 2)-5-/R — Property Property Address / Location of Construction Work: I' — — — — — — — — — — — — — — - - — Approved for processing Building Permit. 0�S �s�_ 1' — — Stormwater Management Control Plan Not Regwred. i f Stormwater Management Conlrol Plan n,Required. (Forward to Engineering Depat tment for Review) FORM St-y1CR- TOS MAY 2014 �,. �Z L o�g�FPOt,�coG BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD Town Hall Annex - 54375 Main Road - PO Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 roger.richert(aD-town.southold.ny.us APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Date: /49 Company Name: L3 1, h-0, " ° eu C � Name: License No.: email: -e �,�� 5' Address: J Q�6� h L T- JOB Phone No.: 31 � L f SITE INFORMATION: (All Informations Required) ` Name: Address: S Q Vq I (� Cross Street: Phone No.: �, Bldg.Permit#: email: Fp�j�� e,��' per: JCp Tax Map District: 1000 ection: Block: Lot: BRIEF DESCRIPTION OF WORK (Please Print Clearly) Pool Circle All That Apply: Is job ready for inspection?: YES NO Rough In Final Do you need a Temp Certificate?: YES / NO Issued On Temp Information: (All information required) Service Size 1 Ph 3 Ph Size: A # Meters Old Meter# New Service - Fire Reconnect- Flood Reconnect- Service Reconnected - Underground - Overhead # Underground Laterals 1 2 H Frame Pole Work done on Service? Y N Add ® fon: MAY _ 8 2018 AYMENT DUE WITH APPLICATION 82-Request for'f F E B 1 3 2020 , ACC31MY CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 03,0512078 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 C NTA T RTS Specialty,LLC NAME Vincent R Pesce Agency LLC dba VRP insurance Agency ty, PHONE FAX 6456 Transit Road E-MAIL F"t' (631)738-7300 (A,C,No.(631)738-7382 ADDRESS: Oepevr,NY 14043 INSURER{SI AFFORDWG COVERAGE y J NAtC it INSURERA:COLDNY INSURANCE COMPANY 35993 INSURED Hampton Elite Swimming Pools INSURER B 89 James Hawkins Road INSURER C: Moriches,NY 11955 INSURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION Or ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT T'O 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 CLAIBAS 1NSRR TYPE OF INSURANCE I pOLICY NUMBER POD Y EFF POLI Y EXP LIMITS A X COMMERCIAL GENERAL LlABtL.ITY x IGL410E784 12.11912017 17JISJ2018 EACH OCCURRENCE 5 1,000,000 CtJiIMS-lMDE OCCUR DAMA-E PREMISES Ea occaaenca S 100,000 61ED EXP(Any one p rwn) ,5 5,000 PERSONAL EAOVINJURY S 9,000,000 GEN L AGGREGATE LIMIT APPLIES PER, GENERAL AGGRFGATE S 2,000,000 POLICY❑JEST LOC PRODUCTS-COMPIOP AGO S 1,000,000 OTHER. S AUTOMOBILE LIABILITY COUNINEOSINGLE LIMIT S _(Ea acadsM) ANY AUTO SWILY INJURY(Per person) S ALL OWNED SCHEDULED AUTOS AUTOSBODILY INJURY(Peracddent) S I NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS �PeraacdPnt $ S UMBRELLA LWU OCCUR EACH OCCURRENCE S EXCESS LU lB CLAIMS-MADE AGGREGATE � S DED RETENTION$ S WORKERS COMPENSATIONPER OTH- AND EMPLOYER$'UABtLITT Y t N BTATUTE ER ANY PP.OPRtETMPARRJETIIP>(ECLMV£ EL EACHACCIDENT 5 OFICERIMEMBEREXCLWED7 NIA (Mandatary m NH) E L DISEASE-EA EMPLOYE• S It yes,desmba under — --_— DESCRIPTION OIOPERATIONS oa:ow E L.DISEASE-POLICY LIANT $ I DESCMf'nON OF OPERATIONS FLDCATtOtdB)VEHWAt ES(ACORD 101,AddAi nal Remadts Scheduts,may tsa agached if nwrespaoe i. c T imd) Certificate holder is included as additional Insured CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 6EFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of Southold AUTHOWEO REPRESENTATWE 54375 Main Road 5OUTHOLD,NY 11971 CI 1986-2014 ACORD CORIHORATION. All rights reserved. ACORD 25(2014161) The ACORD name and logo,are registered marks of ACORD New York State Insurance .Fund Wor"rs'Compensation&Disability Benejft Speciatisa Since 1919 8 CORPORATE CENTER DR,3RD FLR,MELVILLE,NEW YORK 11747.3129 CERTIFICATE OFWORKERS"COMPENSATION'INSURANCE A A A A A A 205422045 HAMPTON ELITE SWIMMING POOLS INC 89 JAMES HAWKINS ROAD MORICHES NY 11953 EMIG SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER HAMPTON ELITE SWIMMING POOLS INC TOWN OF SOUTHOLD 89 JAMES HAWKINS ROAD 54375 MAIN ROAD MORICHES NY 11955 PO BOX1179 SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBERPOLICY PERIOD DATE 62 114 092-6 315655 08/2412017 TO 0812412018 3!5!2018 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER, POLICY NO. 1462092-6 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 TFIIS CERTIFICATE,VISIT OUR WEBSITE AT H'ITPS:i .NYSIF,COPA/CERT#CIzR7vAL.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. ROBERT DISTEFANO(PRES)OF HAMPTON ELITE SWIMMING POOLS INC ONE PERSON CORP 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, EXTENT? OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE INSURANCE FUND CJ DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER 865817733 U-26.3 I SURVEY OF DESCRIBED PROPERTY SITUATE AT L NIP JOHN L. CONWAY SOUTHOLD 010V� �,� � ,.� � e TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK N 39'20"E 28 00' ;a FE. CONC. SCALE " = 40' DATE. SEPTEMBER 21, 2006 a. 6 COR. MON. POST & FIRE FE. 1.0N 0.6's 10 FE. COR. FE. 12• 0 4 0.5N GE HEDGE HESE S.C.�.11l. DIST. 1000 SEC. 63 BLK. 1 LOT J. 1 1.4'S 0.2'S � — , 1.0' 1.2E .�Q D►' ILAPLDA I;D� NC. 0.4 W EASEMENTS AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED 01 SHED PAD i"' ►{i w ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE p, .---_— O TIME OF THE SURVEY GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON(S) FOR IA�`U, WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE TAR£ COMPANY, i �\ a, CONC i� l GOVERNMENTAL AGENCY AND LENDING INSTITUTIONS LISTED HEREON, AND TO / i� \ q0 THE ASSIGNEES OF THE LENDING INSTITUTION. GUARANTEES ARE NOT 01 9.8' 7yELli / �\ 1 pQ ONE CO�xDETACHED TRANSFERABLE TO ADDITIONAL /NSTM)77ONS OR SUBSEQUENT OWNERS THE "4 x 26.5' C 1 / \ (BRI�CrK STY WOOD DECK OFFSETS (OR DIMENSIONS) SHOWN HEREON FROM THE STRUCTURES TO THE i.2�`w A I 1 I W""" _4.2'0' 8.5'x9.0') PROPERTY LINES ARE FOR A SPECIFIC PURPOSE AND USE AND THEREFORE FR. '`t TWO �j A CON . I ARE NOT INTENDED TO GUIDE THE ERECTION OF FENCES, RETAINING WALLS, I GAS ' 245' SHED ``��-� "y STORYr! z k \ CO I TAN '; T fYO i� POOLS, PATIOS, PLANTING AREAS, ADDITIONS TO BUILDINGS AND ANY OTHER Q, FR. c*� O \ \\ I TAL O m STOkY ' ALL LOCATIONS OF AND DISTANCES TO WELLS AND CESSPOOLS ARE BY NIP MARTLNE BASCHNONGA BARN \\ �� TOWER 7.2'ONE;FR. *G - 14.6' \ O STY. ! 31. LOCATIONS FROM HOMEOWNERS, FIELD RE NOT WSIB AND/OR INFORMATION OBTAINED FROM 07HERS. SINCE MOST ARE NOT VISIBLE THESE LOCATIONS AND -'-ca \� 1 +�, �� 0 \41.8 ' DIMENSIONS CANNOT BE CERTIFIED. .y ONE \ 1 +Q� UNAUTHORIZED ALTERATION OR ADDMON TO THISSTY. SURVEY IS A VIOLATION OF �+ A w SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS 12.1 �� I i" SURVEY MAP NOT BEARING THE LAND SURVEYORS SIGNATURE AND RED INK OR EMBOSSED SEAL SHALL NOT BE CONSIDERED A TRUE VALID COPY. FILE NO. 50669 ,T f '� ?� \\ \� a ' �/y 9 i o U.P. REVISIONS: DILAPIDATED ,��OF N �,Y Z30.3' y� i P SEC C 4 5.2'x5.3' W `D FR. SHED W FR. HED3. GE FR. NYT-7 Q O FE. END O.i N 1�,t; GARAGE _ —%'' 0.2'Nn ry r, — 107.0 2.7E 7k 0.5E '` — CONC. FE. 1.4N FE. COR. ! CON ' MON. FR. 1.4N MON. 0.3'E S 7228'50"W m SHED 270.00' r ry 1.1 S v 1 `()SND N/F DANIEL PETER GRATTAN, JR & ROBERTGRATTAN N/F ROBERT G. MALONE CERTIFIED TO: V CCOVV Fy ROBERT L. ELLISTON 41 rh i t-LIPAT T. SECCAFI CO PROFESSIONAL LAND SURVEYOR, P.C. 107-5 W. Montauk Highway 328A Main Street I Hampton Bays, NY 11946 Center Moriches, NY 11934 V _ PHONE.- (631) 728-5330 PHONE: (631) 878-0120 _ FAX. (631) 728-6707 FAX: (631) 878-7190 S UNNYSIDE ROAD , N.Y.S. LIC. NO. 049287 AREA: 38,148 Sq-Ft. = 0.875 Ac. COPYRIGHT — 2006 PAT T. SECCAFICO P.L.S., P.C. D� j%Rql, VED AS NOTED DATE- B.P.# LFEE: bD BY: eA��e NOTIFY BUILDING DEPARTMENT AT ENCLOSE POOL TO CODE 765-1802 8 AM TO 4 PM FOR THE UPON COMPLETION FOLLOWING INSPECTIONS: 'REFORE "WAT ER'- 1. FOUNDATION -- TWO REQUIRED FOR POURED CONCRETE 2. ROUGH_=FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST ELECTRICAL BE COMPLETE FOR C.O. INSPECTION REQUIRED ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK ,STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED AND CONDITIONS OF J U P RD SEES OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY RETAIN STORM WAFER RUNOFF PURSUANT TO CHAPTER 236 OF THE TOWN CODE. BY OTHERS COPINCs SCONE WASTE ILTER ,_< , •~ AIR t LINT CATCHER 8 - ° "" WAIN �� WATE INE 6x6 TILE SKIMMER a a ° FACING i.+ o 04 BARS DONT. ® Q BOND BEAM K1 U Vi" RETURN ALL AW.XXM Ik LIES 12 , TO INLET MAIN DRAIN 14 PLAN a SCALE: N.TS QFINISH N LE Dusr a e ae d SATE! HIIf filTlY3 e 80 TO B VARIESDIUS o 24" SHALLOW PIPIN6 SCHEMATIC END TO BE 25" PLUS SCALE: N.T,S E e 04 STEEL REINFORCEMENT SECTION 5 DEPTH <51-0" X51-0" C SCALE: N.T.S HORIZ SPACING 12"O.G. 12"O.C. SECTION ,4 GENERAL NOTES: VERs SPACING 1z"o�c. 6"ojC. FLOOR 12" OZ.(EACH WAY OR SCALE: KT.S L DESIGN IS BASED ON A DRAINAGE SOIL WITH LESS THAN 1096 SILT. MESH EQUIVALENT) SIZE(FT) A 8 C D E F G AREA GAL. 2. GROUND WATER SHALL NOT EXIST WITHIN THE LIMITS OF THE SQ.FT. CAPACITY EXCAVATION. IF GROUND WATER EXIST WITHIN 6'-0" BELOW GRADE 18x42 18 42 5 19 18 3.5 8 156 SQ_T. 30000 SPECIAL DE-WATERING FACILITIES WILL BE REQUIRED.WATER DISPOSAL IS LIMITED TO OWNERS PROPERTY. 3. NO SURCHARGE ALLOWED WITHIN 4'-0" OF SHALLOW END AND 6'-0" ON CODE NOTES: DEEP END. 1. ALL CONSTRUCTION TO BE IN ACCORDANCE WITH 2015 IRC,LOCAL ZONING AND BUILDING CODE AND REGULATIONS,2015 IFGC, 4. THE PNEUMATICALLY APPLIED CONCRETE GUNITE SHALL BE A 04 MIX 2015 IECC. WITH A MAXIMUM OF%"GALLONS OF WATER PER SACK OF CEMENT. 2. IN-GROUND POOLS SHALL BE DESIGNED AND CONSTRUCTED IN CONFORMANCE WITH ANSIRNSPI-5. 5. REINFORCING STEEL SHALL BE INTERMEDIATE GRADE BILLET STEEL 3. AN OUTDOOR SWIMMING POOL SHALL BE SURROUNDED BY A TEMPORARY BARRIER DURING INSTALLATION OR CONSTRUCTION WITH A MINIMUM LAP OF 30 BAR DIAMETER AND SHALL REMAIN IN PLACE UNTIL A PERMANENT BARRIER IN COMPLIANCE WITH SECTICN 832653 IS PROVIDED, 6. POOL WATER SUPPLIED BY OWNER'S GARDEN HOSE. 4. TOP OF THE TEMPORARY BARRIER SHALL BE AT LEAST 48" ABOVE GRADE MEASURED ON THE SIDE OF THE BARRIER WHICH 1. POOL TO BE KEPT FULL DURING FREEZING WEATHER- FACES EATHERFACES AWAY FROM THE SWIMMING POOL. 8. PUMP CAPACITY TO BE SUFFICIENT t0 EMPTY POOL IN 24 HOURS. 5. TEMPORARY BARRIERS SHALL BE REPLACED BY A COMPLYING PERMANENT BARRIER WITHIN W DAYS OF THE DATE OF ISSUANCE OF THE BUILDING PERMIT FOR INSTALLATION AND/OR CONSTF41CTION OF POOL OR W DAYS OF THE DATE OF COMMENCEMENT OF THE INSTALLATION OR CONSTRUCTION OF THE SWIMMING POOL. [Proje Contractor. Date: ?- 6. PERMANENT BARRIERS SHALL BE AT LEAST 48" ABOVE GRADE,WITH A MAX.2" CLEARANCE BETWEEN GRADE AND BOTTOI"'I OL HAMPTON ELITE SWIMMING POOLS INC. �c+C-D R C' OF FENCE AND MAX.CLEARANCE BETWEEN THE TOP OF POOL STRUCTURE AND THE BOTTOM OF THE BARRIER SHALL BE //�s�o n 89 JAMES HAWKINS ROAD A. ,� Scale: NOTED ONLY 4". vv ,G MORICHES,NY 11955 Drawn B SAS 1. OPENINGS IN BAWER SHALL NOT ALLOW THE PASSAGE OF A 4"0 SPHERE. to Y/)�7 Project No:2018 005 GATES SHALL COMPLY WITH THE REQUIREMENTS OF SECTON 832653 OF THE 2015 IRC. 9. SUCTION OUTLETS SHALL BE DESIGNED TO PRODUCE CIRCULATION THROUGHOUT THE POOL AND SHALL BE PROTECTEDGIZENTIZ��AGAINST USER ENTRAPMENT. Drawing No: 10.ALL SWIMMING POOLS AND SPAS INSTALLED, SHALL BE EQUIPPED WITH AN APPROVED POOL ALARM.POOL ALARMS SHALLAj C-HIRCTUIZE & 0DICN. P.Q.COMPLY WITH ASTM F2208. Iq QJREENTREE VF. ' 0398111. POOL ALARMS SHALL ACTIVATE UPON DETECTING ENTRY INTO THE WATER AT ANY PONT ON THE SURFACE OF THE POOL. QAKDALE NY If769 FOF N�� S P-- 1 12. ALL UNDER KOUND PIPING SHALL BE IN CONFORMANCE WITH 2015 IFGC AND 2015 IFGC AND 2015 IECC. PH.516ho7439 EMAIL. QREENTREW@a-1A1LCOM