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HomeMy WebLinkAbout44729-Z 4SUEF04 Town of Southold 7/21/2021 P.O.Box 1179 0 M 53095 Main Rd W �a,%t io 0 Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 42183 Date: 7/21/2021 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 1535 Park Ave,Mattituck SCTM#: 473889 Sec/Block/Lot: 123.-2-31 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 2/18/2020 pursuant to which Building Permit No. 44729 dated 2/25/2020 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 Opisso,Ami&Matthew of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF]HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 44729 7/20/2021 PLUMBERS CERTIFICATION DATED t oriz d ignature S F QF TOWN OF SOUTHOLD of BUILDING DEPARTMENT y z TOWN CLERK'S OFFICE o • 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) J Permit#: 44729 Date: 2/25/2020 Permission is hereby granted to: Opisso, Ami 1535 Park Ave Mattituck, NY 11952 TO construct an in-ground swimming pool as applied for. At premises located at: 1535 Park Ave, Mattituck SCTM # 473889 Sec/Block/Lot# 123.-2-31 Pursuant to application dated 2/18/2020 and approved by the Building Inspector. To expire on 8/26/2021. Fees: SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $250.00 CO- SWIMMING POOL $50.00 ota : $300.00 a s 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, dditions to dwelling$50.00, Iterations 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. bJ � �2o New Co �f nstruction: Old or Pre-existing Building: (check one) Location of Property: 163-5 P(i l - � V� � v A W Jl House No. Street Hamlet --- Owner or Owners of Property:_ Iv/^,�� 0 4) Suffolk County Tax Map No 1000, Section —Block �— Lot 3 I 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: $ A plicant Sig at e Building Department Application AUTHORIZATION (Where the Applicant is not the Owner) 1, residing at �� -ParL_A—,. (Print property own is name) (Mailing Address) `D �rdo hereby authorize I (Agent) S 1� pply on my behalf to the Southold Building Department. A 'Z' � (O ner s S' nature) (Date) /� (Print Owner' Name) OF 50U��®� Town Hall Annex a ® Telephone(631)765-1802 AL 54375 Main Road jr Fax(631)765-9502 P.O. ox 117 Southoldd,,NY 11971-0959 ® sean.devlin(a)-town.Southold.ny.us �` � BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Ami Opisso Address: 1535 Park Ave city:Mattituck st: NY zip. 11952 Building Permit#: 44729 Section: 123 Block 2 Lot: 31 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE contractor: DBA: Mike Smith & Sons Electric License No: 42078ME SITE DETAILS Office Use Only Residential X Indoor Basement Service Commerical Outdoor X 1st Floor Pool X New X Renovation 2nd Floor Hot Tub Addition Survey X Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan Service 3 ph Hot Water GFCI Recpt 2 Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors Sub Panel X A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO Transformer UC Lights Dryer Recpt Emergency Fixtures Time Clocks Disconnect Switches 4'LED Exit Fixtures Pump 1 Other Equipment. Pump 220GFI, Salt Generator, Pool Lights Push Button Switch 120GFI, Pool Cover Key Locked Switch 120GFI Notes. " AS BUILT NO VISUAL DEFECTS " Did Not See Bonding - Pool Inspector Signature: Date: July 20, 2021 S.Devlin-Cert Electrical Compliance Form As --- # * TOWN OF SOUTHOLD BUILDING DEPT. courm '' 765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ rFINAL SULATION/CAULKING FRAMING /STRAPPING [ ZL--� [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ PRE C/O REMARK_ S: Qvfu z o m DATE 0 i0 INSPECTOR a SoblyO * # 'TOWN OF SOUTHOLD BUILDING DEPT. co765-1802 - INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND i [ ] I ULATION/CAULKING [ ] FRAMING /STRAPPING [ FINAL I� Ag.",, [ ] FIREPLACE & CHIMNEY- [ '] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: T CP je�" (i)NAM, VK be-,ZK 040tyl SeA. in A 001 I 0knS"dXoMwv\ Aq, 6-oV DATE INSPECTOR 6 # # TOWN OF SOUTHOLD BUILDING DEPT. G _ 765-1802 INSPECTION [ " ] -FOUNDATION 1 ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATIOWCAULKING- [ ] FRAMING/STRAPPING [ ] FINAL [ ] "FIREPLACE & CHIMNEY [ ] 'FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) [ ] CODE VIOLATION ] PRE C/O REMARKS: TOO L- m:> Li DATE INSPECTOR � �-`� a I SSM ..-Mar. 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RQ2b1.763$: fwrr y+va/�I•++r.�'e``4`1��w MIM s f - Jw 6 ' y � E ` —D INSPECTIOr;REPORT F-DATE COMMENTS ° — FOUNDATION (1sT) H ----------------------------------- FOUNDATION (2ND) o ROUGH FRAMING& PLUMBING r INSULATION PER N.Y. , STATE ENERGY CODE C114W '4V\ • m �n � ' FINAL flint a � noWA ADDITIONAL COMMENTS �r o-ab a _ �� � #ally • , Z m z • d • • r 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 4 sets of Building Plans TEL: (631)765-1802 Planning Board approval FAX: (631)765-9502 OM � Survey Southoldtownny.gov PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined 0on 20 Single&Separate } - E E B 1 8 2020 Truss Identification Form Storni-Water Assessment Form jZ v Contact: Approved 20 Mail Disapproved a/c V11, ce Phon Expiration ,201 m � !7)J � /® Building Inspector APPLICATION FOR BUILDING PERMIT P INSTRUCTIONS Date 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 flew 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. he applicant agrees to comply with all applicable laws, ordinances,building code,housing code,and r lation and admit authorized inspectors on premises and in building for necessary inspections. (Sign r of applicant ename,if a corporation) I' 41br, hf� (Mailing dddress of applicant) t engineer,mgen contracto trician lumber or builder State whether applicant is owner, lessee, agent, architec , e g ,plumber lNameAl Al-- Name of owner of premises (A81 on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of�grpor�telofficer) Builders License No. �,r �. d Plumbers License No. Electricians License No. Other Trade's License No. 1. Locay ai on which pose work N11' done: 1 House Number Street J a Hamlet County Tax Map No. 1000 Section Block 2— Lot 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 •fro (� P �� I Z� k �-�� b. Intended use and occupancy r 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work (Description) 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 C30 Rear Q9Depth 10. Date'of Purchase Name of Former Owner 11. Zone oruse 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 etx►ise I S5 tress M 94i,f LJ. Phone N Name of Archite t K Address 3 ' 'sn5,-We-Phone No�1 Name of ContractorV4-AAAL4'T Addr6ss 1 j'on1e No. Lp?)I lcYz 15 a. Is this property within 100 feet of a tidal wetland or a freshwater�d? *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 ) fu 601. S being duly sworn, deposes and says that(s)he is the applicant (Na e m ividual si ning contract)above �named, (/ (S)He is the V ►boU' (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 tha�� �A }�is knowledge and belief; and that the work will be performed in the manner set forth in the application filed� th. N/i/V Swo t eforeme th' c���Q� •••'•�6- day ofT�b 20 =m?o °�J : 47 Notary ublic *s °•.�'J O\p�� Signatur of Applicant -N1ii SS ������� = �nnmu► Scott A. Russell ��-°SU �� ST0RIA�I WA\T]Elk SUP'ER`lIS®R AWA\N A\(GrIEI�MUENIF SOUTHOLD TOWN HALL-P.O.Box 1179 53095 Main Road-SOUTHOLD,NEW YORK 11971 0 Town of Southold 1 Y+ CHAPTER 236 - ST®RMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) DOES THIS PROJECT INVOLVE ANY OF THE FOLLOWING: Yes VO (CHECK ALL THAT APPLY) ❑ A. Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. ® B. Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. E]R C. Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. ® D. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. ❑Q E. Site preparation within the one-hundred-year f loodplain as depicted []4on FIRM Map of any watercourse. 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 in-kind replacement of impervious surfaces. If you answered NO to all of the questions above, STOP! Complete the Applicant section below with your Name, Signature, Contact Information, Date & County Tax Map Number! Chapter 236 does not apply to your project. If you answered YES to one or more of the above, please submit Two copies of a Stormwater Management Control Plan and a completed Check List Form to the Building Department with your Building Permit Application. APPLICANT: (Property Owner,Design Professional,Agent,Contractor,Other) S.C.T.M. #: 1000 Dale Du t NAME �� — �3 ! Section Block Lot yl FOR BUILDING DEPARTMENT USE ONLY**** Contact Info mattoa ,i.mc Numtr,l Reviewed By: — — — — — — — — — — — — — — — — Date: Property Address/Location of Construction Work: — — — — — — — — — — — — — — — — — Approved for processing Building Permit. Stormwater Management Control Plan Not Required. / — — — — — — — — — — — — — — — — — ® Stormwater Management Control Plan Is Required. (Forward to Engineering Department for Review) FORM # SIVICP-TOS MAY 2014 at/( BUILDING DEPARTMENT- Electricals l � �`3 - TOWN OF SOUTHOLD 1 •, o Town Hall Annex - 54375 Main Road 1 Bo aj17 -4o Southold, New York 11971-0959 ��' 0 2020 p� Telephone (631) 765-1802 - FAX (631) 765-9502 roaerr arsoutholdtownny.gov seandCa�southold�i >a t APPLI.CAT`ION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Inform tion Required) Date!'IffiTA I - Company Name: ffli Name: License No.: email: pe—a Ab Address: Phone No.: _:t6 ea- 35�5,57 U 000 JOB SITE INFORMATION (All Information Required) Name: QN - - - - -- Address: Cross Street: Phone No.: Bldg.Permit 44 email: _ Tax Ma__District1000- Section: --_ - - _ - Block: = BRIEF DESCRIPTION OF WORK(Please Print Clearly WI Circle All That Apply: Is job ready for inspection?: YES 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: � #Meters Old Meter#: New Service- Fire Reconnect- Flood Reconnect-Service Reconnected- Underground -Overhead #Underground Laterals 1 2 H Frame Pole Work done on Service? Y N -'Additional Information: -PAYMENT.-DUE-WITH_ APPLICATION o . Request for Inspection Formats �O n� t 0' PERMIT# Address: Switches Outlets GFI's I Surface Sconces H H's UC Lts Fans Fridge HW Exhaust Oven Dryer Smokes DW Service Carbon , Micro Generator Combo Cooktop Transfer AC AH Mini Special: Comments* MJOY �� .S, -� w� i I YORK Workers' CERTIFICATE OF STATS Compensation 'NYS WORKERSCOMPENSATION INSURANCE COVERAGE Board � 1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured 631-744-8100 Fence King of Rocky Point,Inc. Dba Swm King Pools&Patios 471 Rt.26AUnemployment 1c.NYS Unem to ment Insurance Employer Registration Number of Rocky Point,NY 11778 Insured I I Work Location of Insured(Only required/f coverage Is specifically limited to 1 d Federal Employer Identification Number of Insured or Social Security certain locations In New York State,I.e.,a Wrap-Up Policy) Number 113008276 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certlflcate,Holder) Everest Indemnity Insurance Co. Town of Southold 3b.Policy Number of Entity Listed In Box"1 a" 53095 Rt.25 SW5WC00205191 PO Box 1179 Southold NY 11971 3c.Policy effective period 11/05/2019 to 11/05/2020 3d.The Proprietor,Partners or Executive Officers are Included.(Only check box If all partners/officers Included) E] all excluded or certain partners/officers excluded. This certifies that the Insurance carrier indicated above in box"3"insures the business referenced above In box"1 a"for workers' compensation under the New York State Workers'Compensation Law.(To use this form,New York(NY)must be listed under Item 3 on the INFORMATION PAGE of the workers'compensation Insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2". The insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy Is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate.(These notices may be sent by regular mall.)Otherwise,this Certificate Is valid for one year after this form is approved by the Insurance carrier or its licensed agent,or until the policy expiration date listed In box"3c",whichever Is earlier. This certificate Is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend, extend or alter the coverage afforded by the policy listed,nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note: Upon cancellation of the workers'compensation policy Indicated on this form,if the business continues to be named on a permit,license or contract Issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Workers'Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. 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 the coverage as�de/picted on this formes. 1 Approved by: NAi autoauto1/ ,d1/- (Print nAre of authm7dyresentative or licensed agent of Insurance carrier) Approved by: Underwritineov'ice President Offlp I o (Signature) (DatA) l/l Vv VPTitle: Telephone Number of authorized representative or licensed agent of insurance carrier: Please Note:Only Insurance carriers and their licensed agents are authorized to Issue Form C-105.2.Insurance brokers are NOT authorized to Issue It. C-105.2(9-17) www.wcb.ny.gov YORK Workers' CERTIFICATE OF INSURANCE COVERAGE STATE 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 1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured SWIM KING POOLS 71 ROUTE 25A ROCKY POINT,NY 11778 1 c.Federal Employer Identification Number of Insured Work Location of Insured(Only required if coverage is or Social Security Number specifically limited to certain locations in New York State,i.e., 113008276 2.Name and Ad ress 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 3b.Policy Number of Entity Listed in Box 1 a" 53095 Rt 25 P O Box 1179 DBL37154 Southold, NY 11971 3c.Policy effective period ----- --- ----- - .- - - - 02/01/2020 to 01/31/2021 4. Policy provides the following benefits* © A.Both disability and paid family leave benefits. B.Disability benefits only. E] 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 employer's employees. Under penalty of pequry,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 and/or Paid Family Leave Benefits insurance coverage as described above. Date Signed 2/7/2020 By " (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 (110-17) I�j111111°��° °°11°1°�����l1°°1°11°°��'1111111 VtJM i it m: 5O � H ' --/� N 1 L p closest neighboring W E SUFFOLK , Septic IT SURVEYED 05-21-02 AMENDED II-08-06, OI-10-200-1 S e SUFFOLK COUNTY DEPT. OF HEALTH SERVICES REF # RIO - O6 - 0103 SUFFOLK COUNTY TAX # 1000-123-2-31 CERTOM M kramyHmmm Land Now or Formerly of: pweilinq TaumMudbon Oammmwa]�Land TlitlehmavoeCompmnY Land Now or Formerly of: Gordon J. Hass Septic 150+ ml Alfred Bariatti B Shirley Bariattl pwelling - Dwellingq Septic 15U F w S el•10' i 5! k Vt^.GD O BVI` t i 1 1 150' TO 5EPT1GJl VML ' -- O Y tAr r -n-i_ c D TE-5T HOLE i Q McDONALD GE05GIENGE o c3o al �� o DARK BROWN co VI 7 I, OL SANDY LOAM o `�� -- 4 To BROWN CLAYEY fl coo 2 C� Q%� 0 o 41 5G SAND "-m N 9 3 `. PALE BROWN f o FINE SAND To—,\ BE ABANDONED MR 17' 5P 5GD415 STANDART� ���•, \ c� sr G E deck • ® _ • ---- ('®a EXISTIN(5 5EPTIG TO 2 Story �l BE ABANDONED PER 8 cp �l � - 5GDH5 sTANDARD� o e House —y'A � Ib' ppoPOSeD nd__ ; u p Wolk 5 T. Q e ExfStN►g�be rel Ved n t n �� a,Pholt lirWeway �. } t -------------- � 385.00' - 5�b .aU •.. Dark Avenue �'`=� ` fit • 1, ' -- -- -- -- -- - -- -- -- - s NOTES; MONUMENT FOUND EXISTING SEPTIC SYSTEM TO BE vacant 100' + -a , ABANDONED IN ACCORDANCE WITH dwelling e 5CDH5 5TANDARD5. " b ll"pro0 h.%W W. f►O•p�pq ELEVATIONS REFERENCE SUFFOLK a b dfrrq o COUNTY TOPO MAPS AREA = 25pOO 5.F. or 0.5-1 ACRE JOIN C. EHLERS LAND SURVEYOF 6 EAST MAIN STREET N.Y.S.UC.NO.50202 ,?APHIG 5GALE I"= 30' '"�` RIVERHEAD,N.Y. 11901 369-8288 Fax 369-8287 REF.1\Compagserverlpros\02\02 269 updated 09-28- 1 ---•---- • - - -- • - --- - - - - -- - -- - - . _.._---••--• - AP q OVED AS DATA® S.P.4 FEE: �5�- EY( -`--� CC; ;PLY WITH ALL CODES OF NOTIF BUILDING Dp�,*ITNIENT AT NIL---'VV YORK STATE & TOWN CODES 765-1802 8 AM TO PM FOR THE AS REQUIRED FQLLUWING INS _ -f,,,NO REQUIRED 1, FOUNDATION SGu-,O�D T0'N%ZBA FOR POURED CONCRETE SOUTHOLDTOW NNINGBOARD 2. ROUGH - FRAMING & PLUM ftBING SOUTHO OWN TRUSTEES 3. INSULATION 4. FINAL - CONSTRUCTION MUST I '. .DEC BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENT S OF THE CODES OF NEW FOR YORK STATE• NOT F ON TERRORS BLE DESIGN OR CONST E L INSPECTION REQUIRED 'USE IS UNLAWFUL \NI TROUT CERTIFICATE OF OCCUPANCY p6'�N9�®Ii4TELY" �, ENCLOSE POOL TO CODE, UPON COMPLETION - DEFORE-"WATER", 10" 40' 101 12 NOTES ttWATER LINE � = - 0 1 NO 501L SURCHARGE PERMITTED WITHIN 4 FEET OF EXCAVATION AT THE SHALLOW END,OR 6 FEET OF EXCAVATION ATTHE DEEP END t/l a 2 THIS POOL MEETS THE REQUIREMENTS OFANSI/NSPI-5 "AMERICAN NATIONAL STANDARD FOR RESIDENTIAL INGROUND SWIMMING O POOLS"AND1996BOCACODE-5ECTION421 DIVING EQUIPMENT ISALLOWED DIVING BOARD AND INSTALLATION TO CONFORM WITH {— ANSI/N5PI-5-03 STANDARDS FOR RE5IDENTIAL INGROUND SWIMMING POOLS FORA TYPE If POOL A)FRAMES ARE MADE OF190"O.D x MIN. DIM.SECTION A 065WALL ALL BENDS ARE 6"RADIUS FRAMES ARE DRILLED TO ACCOMMODATEJg"OREINFORCEDRODS. REAR STAND HAS(2)7'HOLES C1 DRILLED ON 12"CENTERS FOR D B ANCHORING B)COMPRESSIVE STRENGTH OF CONCRETE SLAB FOR DIVING BOARD TO BE 3500 PSI OR }� A H2O�y H2O SVNDECK O 15' GREATER. t/l 8'-D"^ 3'-6' co .J Cp WATER LINE 3, SWIMMING POOL SHALL BE COMPLETELY AND CONTINUOUSLY SURROUNDED WITH A BARRIER CONSTRUCTED LAW REQUIREMENTS OF SECTION 8326 5 3 OF THE INTERNATIONAL RE5IDENTIAL CODE(2016)AND IN CONFORMITY WITH ALL SECTIONS OF THE SOUTHOLD 0 TOWN CODE ACCESS GATES SHALL COMPLY WITH SECTION 8326.5 2 OF THE IRC AND BE SELF CLOSING,SELF LATCHING AND BE SECURELY Q i LOCKED WHEN POOL 15 NOT IN USE OR SUPERVISED ALL GATES ARE TO OPEN AWAY FROM THE POOLAREA 11 p V a :7 4 DURING CONSTRUCTION THE CONTRACTOR,SHALL EP ECTA TEMPORARY BARR IER AROUND THE EXCAVATION 1AWTHECODEOFTHE a Q TOWN OF SOUTHOLD. Z Z 0 3'-9" v N 6•_ 5 POOL MUST BE EQUIPPED WITH AN APPROVED POOL ALARM CAPABLE OF DETECTING A CHILD ENTERING THE WATERAND SOUNDING v CONC WALLS AN AUDIBLE ALARM WHEN DETECTED THAT IS AUDI BLEAT POO[SIDE AND ATANOTHER LOCATION ON THE PREM15E5 WHERE THE POOL B IS LOCATED. THE ALARM MUST BE INSTALLED,MAINTAINED AND USED IN ACCORDANCE WITH THE MANUFACTURERS INSTRUCTIONS. MIN. DIM. SECTION /B\ THE ALARM MUST MEETASTM F2208 "STANDARD SPECIFICATION FOR POOL ALARMS THE DEVICE MUST OPERATE IN DEPEN DENT(NOT °C PLAN ATTACHED TO OR DEPENDENTON)OF PERSONS. NTS 12 6 POOL SUCTION FITTINGS(EXCEPT FOR SURFACE SKIMMERS)MUST BE PROVIDED WITH A COVER THAT CON FORMS TOASME/ANSI WATER LINE A11219 BM ORA MINIMUM 18"x 23"DRAIN GRATE OR A CHANNEL DRAIN SYSTEM. POOL CIRCULATION SYSTEM MUST BE EQUIPPED WITH 20'VINYL COVERED CONCRETE STEPS SUNDECK ATMOSPHERIC VACUUM RELIEF IN THE EVENTTHE GRATE COVERS LOCATED WITHIN THE POOL BECOME MISSING OR BROKEN. SUCH , VACUUM RELIEF SYSTEMS SHALL CONFORM WITH A5ME A1121917 OR BE A GRAVITY SYSTEM APPROVED BY THE TOWN OF SOUTHOLD POOL SHALL BE PROVIDED WITH A MINIMUM OF 2 SUCTION FITTINGS OF THE ABOVE MENTIONED TYPE THE SUCTION FITTINGS 5HALL BE r q SEPARATED BY A MINIMUM OF 3'AND MUST BE PIPED SUCH THAT WATER 15 DRAWN THROUGH THEM SIMULTANEOUSLY THROUGH A " VACUUM RELIEF-PROTECTED LINE TO THE PUMP(OR PUMPS) VACUUM/PRESSURE CLEANING FITTINGS SHALL BE IN AN ACCESSIBLE MIN DIM. SECTION POSITION,MINIMUM OF6'ANDNOGREATERTHAN I2"BELOW THE MINIMUM OPERATIONAL WATER LEVEL OR BE ANATTACHMPNTTO q THE SKIMMER/SKIMMERS �2'TO 4'SAND BOTTOM V 7. ALL ELECTRICAL WORK SHALL COMPLY WITH THE REQUIREMENTS OF NFPA 70(NEC)PRINCIPALLY ARTICLE 680 AND THE IRC SECTIONS _ 4201 THROUGH 4206 ALL ELECTRICAL DEVICES MUST BE APPROVED BY UNDERWRITERS LABORATORIES AND BE PROTECTED BYA v SECTION A GROUND FAULT CURRENT INTERRVPTERCGFCI) CURRENT CARRYING ELECTRICAL CONDUCTORS EXCEPT FOP,TH05E PROVI DING POWER e TO POOL LIGHTING AND POOL EQUIPMENT SHALL MEET THE SEPARATION REQUIREMENTS OF TABLE E42035 ALL METAL ENCLOSURES, N T.5 F°vECR M nn"E` FENCES OR RAILINGS NEAR ORAWACENTTO THE SWIMMING POOL THAT MAY BECOME ELECTRICALLY CHARGED DUE TO CONTACT v Ln WITH AN ELECTRICALCIRCUIT5HALL BE EFFECTIVELY GROUNDED �O O sm snnmE _ � 3/8°O REINF W/MIRPOR FlNISH CJ } WAi ER LINE 10P OF WALL ROPs WP PONEB Ov EM ❑ O > coNc slnx � PONE OVOlHERS 8. WATER SOURCE FILLING THE POOL SHALL B..EQUIPPED WITH A BACKFLOW PROTECTION DEVICE TAW NYS PLUMBING CODE 608. p En Q Z (d WIPE MINT Ly ' b w �� 9 ALLPIPINGI5DIAGRAMMATICUNLESSOTHERWISESTATED. _U ) U Z" 12• q• +. N ry V vs -V 10 WALKS IF PROVIDED SHALL BE NONSLIP AND SLOPE AWAY FROM POOL EDGE v p QJ III, M 2'-8' 1'-8' O O � d 4 .� 11, A MEANS OF EGRESS FOR DEEP AND SHALLOW ENDS MUST BE PROVIDED TAW AN51/NSPI-5 SECTION 6. ~ 12 CONTRACTOR TO PLACE THE POOL IAW TOWN OF SOUT-tOLD CODE SETBACKS. DIVING BOARD DETAIL 13. ALL DRAINAGE FROM THE POOL SHALL BE MAINTAINED ON THE 5UB)ECTPROPERTY O SECTION BN 15. THE DESIGN 15 BASED ON A DRAINAGE\501L WITH 410%SILT GROUND WATER SHALL NOT EXIST WITHIN THE EXCAVATION IF GROUND O NTS WATER EXISTS WITHIN 6'-O"FROM GRADE,DEWATERING FACILITIES WILL BE REQUIRED N 16. ALL GAS AND OIL HEATERS(IF INSTALLED)FOR THE INGROUND SWIMMING POOL SHALL BE NATIONAL APPLIAN CE ENERGY CONSERVATION ACT(NAECA)COMPLIANT. POOL HEATERS SHALL BE TESTED IAW AN51 22156 AND SHALL BE INSTALLED IAW MANUFACTURERS SPECIFICATIONS OIL FIRED POOL HEATERS SHALL BE TESTED IAW UL726 POOL HEATERS SHALL BE LOCATED OR U GUARDED TO PROTECT AGAINST ACCI DENTAL CONTACT OF HOT5URFACE5 BY PERSONS. POOL HEATERS SHALL BE PROVIDED WITH ^ t` CHECK VALVE TEMPERATURE AND PRESSURE-RELIEF VALVES FOR HEATERS NOT PROVIDED WITH AN INTEGRAL BYPASS SYSTEM A BYPASS LINE SHALL 0. 00 00 BE INSTALLED FROM INLET TO OUTLET TO ADJUST WATER FLOW THROUGH THE HEATER POOL HEATERS SHALL BE PROVIDED WITH THE 00 PUMP FROM SKIMMER FOLLOWING ENERGY CONSERVATION MEASURES (� F Z-2' 161 AT LEAST ONE THERM05TAT5HALL BE PROVIDED FOR EACH-iEATING SYSTEM Z ~— COPING AND WALKWAY 10" 16 2 ALL POOL HEATERS SHALL BE EQUIPPED WITH AN ON-OFF SWITCH MOUNTED FOR EASY ACCESS TO ALLOW SHUTTING OFF THE a (BY OTHE85) OPERATION OF THE H EATER,WITHOUT AD)USTI NG THE THERMOSTAT SETTING AND TO ALLOW RESTARTING WITHOUT RELIGHTIN G THE W drz TO DISPOSAV GRADE PILOT LIGHT W Q-co cop a DRYWLLL WATER LINE 16.3 HEATED SWIMMING POOLS SHALL BE EQUIPPED WITH A POOL COVER(EXEMPTED FROM THIS REQVIREMENTARE OUTDOOR POOLS 8 DERIVING 20%OF THE ENERGY FOR z HEATING FROM RENEWABLE SOURCES AS COMPUTED OVERAN OPERATING SEASON) ED / 16.4 TIME CLOCKS SHALL BE INSTALLED SO THE PUMP CAN BE SETTO RUN DURING OFF-PEAK ELECTRICAL DEMAND PERIODS AND CAN BE SET 3 of CD Qm a. a DIVERTER J TO RUN THE MINIMUM TIME NECE55APY TO MAINTAIN THE POOL WATER IN A CLEAN AND SANITARY CONDITION TAW APPLICABLE E^^o VALVE UNDISTURBED EARTH o ca ca a �o O SANITARY CODE OF NEW YORK STATE i`, m Y e cu 3500 PSI POURED CONC a n \ iv 17 THI5 DRAWING 15 FOP,STRUCTURAL SHELL ONLY ALL ACCES50RIE5AND APPURTENANCESARE DEFINED BYOTHERS N FILTER 3/8"REBAR 2)TYP \/ 18 BACKFILL WITH CLEAN EARTH,FREE OF ROOTS AND DEBRIS DO NOTALLOW THE HEIGHT OF BACKFILL TO EXCEED THE HEIGHT OF THE ✓' a°~ a VINYL LINER WATER IN THE POOL BY MORE THAN 6", OR THE WATER TO EXCEED BACKFILL BY MORE THAN 8" r a ®d N EVV O 2"TO 4'5AND 19 PLACE CONCRETE ON SANDY TO LOAM SOIL. REMOVE ANY CLAY DEPOSITAND REPLACE W/COMPACTED CLEAN BACKFILL PV y j� ., k, T HO / 20. THERE IS NO MAIN DRAIN IN THI5 POOL. SUCTION FOR POOL WATER CIRCULATION 15 PROVIDED BY THE SKIMMERS ONLY THIS MEETS =' i, REQUIREMENTS OF THE IRC-SECTION 8326 6 FOR ENTRAPMENT PROTECTION \ 21 THE POOL WAS DESIGNED IAW THE FOLLOWING: 'C t TO RETURNS 211 THE INTERNATIONAL RE5IDENTIAL CODE(IRU .15 -CHAPTER 42 C2016) r1 S ll�� I m w 21.2. THE INTERNATIONAL ENERGY CONSERVATION CONSTRUCTION CODE-SECTION 8403.10(2015) �\\ I CHECKVALVE VERTICAL3118' 21.3. THE I NTERNATIONAL FUEL GAS CODE(2015) s `+n s, s-d Z/ (NOTSHOWN) -214 THE NEW YORK STATE CODE SUPPLEMENT-SECTION R326 (2017) ,\i��, ��` 215 THE NEW YORK STATE SANITARY CODE. 216. ANSI/NSPI-5 STANDARD FOR RESIDENTIAL IN-GROUND SWIMMING POOLS 08 41'J PLUMBING SCHEMATIC WALL SECTION 217 CODE OFTHETO HOFS 218. CODEOFTHETOWNOFSOVTHOLD A�OfiESStiONP� 22 ALL BACKWASH TO BE SELF-CONTAINED ON-SITE, NTS NTS