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HomeMy WebLinkAbout44829-Z =2'=� S�ffDLI- �otio cpGy� Town of Southold 7/18/2021 0 P.O.Box 1179 ce .1 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 42171 Date: 7/18/2021 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 550 Mt Beulah Ave, Southold SCTM#: 473889 Sec/Block/Lot: 51.-3-2.6 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 3/13/2020 pursuant to which Building Permit No. 44829 dated 6/3/2020 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: accessoryground swimming pool as applied for. The certificate is issued to Pantelides,Harry&Michelle of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 44829 2/2/2021 PLUMBERS CERTIFICATION DATED 0 or' ed Signature �SUFFo��co TOWN OF SOUTHOLD BUILDING DEPARTMENT 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) Permit#: 44829 Date: 6/3/2020 Permission is hereby granted to: Pantelides, Harry 526 E 19th St Brooklyn; NY 11226 To: demolish existing rear deck addition and reconstrust an accessory in-ground swimming pool as applied for. At premises located at: 550 Mt Beulah Ave, Southold SCTM #473889 Sec/Block/Lot# 51.-3-2.6 Pursuant to application dated 3/13/2020 and approved by the Building Inspector. To expire on 12/3/2021. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO - SWIMMING POOL $50.00 DEMOLITION $149.50 Total: $449.50 uilding Inspector '• e 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, lterations 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$15.0 Date.v i New Construction: Old or Pre-existing Building: (check one) Location of Property: (� House K. Street Ham t Owner or Owners of Property: " L 51 Suffolk County Tax Map No 1000, Section , Block _. Lot Subdivision Filed Map. Lot: e Permit No. Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: ,/ Request for: Temporary Certificate Final Certificate: " (check one Fee Submitted: $ ) Applicant S'g ature ®��oF sorry®� Town Hall Annex ® Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 ® �� roger.riche rtla'�.town.south old.ny.us Southold,NY 11971-0959 ®l�c4UIVT�,� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Harry Pantelides Address. 550 Mount Beulah Ave City: Southold St: New York Zip: 11971 Building Permit#- 44829 Section: 51 Block: 3 Lot. 2.6 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Big Bear Electric License No: 43841-ME SITE DETAILS Office Use Only Residential X Indoor Basement Service Only Commerical Outdoor X 1st Floor Pool X 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 3 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 Fixtures Time Clocks 1 Disconnect Switches El Twist Lock Exit Fixtures TVSS Other Equipment: In ground swimming pool to include, control panel, bonding, time clock, 1-switch, 3-GFCI circuit breakers, 1-pool pump with 20a GFCI circuit breaker,gas pool heater,salt generator,low vltage pool lights. Notes: Inspector Signature: Date: February 2 2021 81-Cert Electrical Compliance Form.xls Building Department Application AUTHORIZATION (Where the Applicant is not the Owner) (Print property owner's name) (Mailing Address) L do hereby authorize a6l vyt- V4 f-0 �D' 0 LS (Agent) to apply on my behalf to the Southold Building Department. ( wner's Signature (DA) iA6.1 le. f)a-n+.e-1 ,4,45 (Print Owner's Name) f 4w -- oe souTyolo * TOWN OF SOUTHOLD BUILDING DEPT. `y�ourmN�'' 765-1802 g I L z' INSPECTION [ ] FOUNDATION 1ST [ ] 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: G� DATE INSPECTOR �-( ll # # TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 - INSPECTION , ]- FOUNDATION 1ST [ ] ROUGH PLBG. [ ] 'FOUNDATION 2ND., [/] FIN NSULATIOWCAULKING [ ] FRAMING /STRAPPING [ AL Povi.,00- FIREPLACE & CHIMNEY [ '] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: fo i, 4AZ DATE t INSPECTOR qOF SO # TOWN OF SOUTHOLD BUILDING DEPT. `�courm '` 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND ° [ ] rULATIOWCAULKING [ ] FRAMING/STRAPPING [ FINAL-l [ ] FIREPLACE & CHIMNEY [ -1- FIRE-SAFETY INSPECTION [ ] -FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION I [ ] PRE C/O REMARKS: I6&p./ &hv t)(V-/ ll_)t - Irr-D&Bin Lvlve� DATE INSPECTOR IIr�(�� C l' FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION(1ST) — H ------------------------------------ FOUNDATION(2ND) O � ROUGH FRAMING& y PLUMBING r INSLLATION PER N.Y. H STATE ENERGY CODE �AI►V�1 S t �• �m FINAL d!f✓ +h/ S - I As 0•4b CA V S ADDITIONAL COMMENTS \ --2 -,2 1 Doi AfOAri'c, I co oro r °-4 ' -o m r a 1U z x e b H TOWN G^F SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BU4ILDING 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 Survey Southoldtownny.gov PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined ,20� ` Single&Separate Truss Identification Form MAR 1d�' 2 20 Storm-Water Assessment Foran Contact: Approved r Approved ✓ 20 � Ma to. O hkqa' Disapproved a/c Phone: Expiration ,20 LP I B n inspector g p APPLICATION FOR BUILDING PERMIT f Date a , 2 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 reguJati ns,and to admit authorized inspectors on premises and in building for necessary inspections. r/ ignature of apoicant or name,if a c rporation) 52_�o &_65+1 q'+" ��e_ t { t ; I ai address of applicant) State wheth `gyp 1/}'ca^nt iwner, lessee, agent, architect, engineer, g4neral contractor, electrician,plumber or builder 6!/LJ 1'U Name of owner of premises Aimn the tax ro 1 or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of r to f cer) Builders License No. Plumbers License No. y Electricians License No. Other Trade's License No. 1. Loca ' o d on hi ropose work 'll be done: �. House umber Street Hamlet County Tax Map No. 1000 Section Block Lott- o ,SubdMsion Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed constriction: a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work(check which applicable): New Building _ Addition i AlterAoR Repair Removal Demolition Other Work 701 (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 constriction: Front Rear Depth Height Number of Stories 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed constriction violate any zoning law, ordinance or regulation?YES NO 13. Will lot be re-graded?YES NO Wil excess fill be removed from premises?YES NO �"U /�/�' i.� {� ) 14. Names of Owner o •rewileg �Ci (� �1i1 d Phone N' P Name of Archite Addres4M 01 one N(U'3 t U Name of Contractor — ress q-'71 S a Phone No.�E3 i � 1 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetl nd? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY 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 ^ ^ ) ( ��L Llr�_"b f; eing 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 appli5 ' k {l+64e%ewith. Swo before me this - day of (� =24M16231sUr8�r:• a LK COUNN ro otaryPublic %is+l•,•. PUg��GQ�`� Si gnatur of Applicant ���� �F/OF1 N;� ,``\�� Scott A. Fussell ,��°Su �� STO>RMWA\T]E]k SUPERVISOR MA NA\cGr]EM]EN`]F SOUTHOLD TOWN HALL-P.O.Box 1179 0 Z 53095 Main Road-SOUTHOLD,NEW YORK 11971 Town of Southold CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) DOES THIS PROJECT INVOLVE ANY OF ')(')H[lE 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. ❑ B. Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. ❑ 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. ❑ E. Site preparation within the one-hundred-year floodplain as depicted on 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 Date B 1 Distric NAME t`'lI I �c� i ac-'s 1121 (Pt tion Bloc �4 t' FOR BUILDING DEPARTMENT USE ONLY**** Contact Information (rdR7s.rc hwn6nl Reviewed By: — Property Address/Location of Construction Work: _ _ _ _ _ _ _ Date: — — — — — — — — — D Approved for processing Building Permit. Stormwater Management Control Plan Not Required. Q ❑ Stormwater Management Control Plan is Required (Forward to Engineering Department for Review.) FORM # SMCP-TOS MAY 2014 i qs,. 4 Fpj� BUILDING DEPARTMENT- ElectricaLlh` ...� spe'ctdf O ���✓�� TOWN OF SOUTHOLD C Town Hall Annex - 54375 Main Road - PO Bd�t"T1�N 1�95 Southold, New York 11971-0959 �. u � 9 Telephone (631) 765-1802 - FAX (631) 7659502' ' rogerr(ab-southoldtownny.gov — sea nd(@.southol'dl'ovi`r hV.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: 1/21/21 Company Name: Big Bear Electrical Contracting Name:Harry Pantelides- License No.: ME-43841 email: bigbearelec@yahoo.com Phone No: 6317601997 ❑✓ I request an email copy of Certificate of Compliance Address.: 550 Mount Beulah Ave., Southold NY 11972 JOB SITE INFORMATION (All Information Required) Name: Harry Pantelides Address: 550 Mount'Beulah Ave., Southold NY 11972 Cross-Street: Old North Rd Phone No.: 6317601997 Bldg.Permit #: 44829 email: bigbearelec@yahoo.com Tax Map District: 1000 Section:51 Block: 3 Lot: 2.6 BRIEF DESCRIPTION OF WORK (Please Print Clearly) Pool Inspection Pool Inspection Pool Inspection Check All That Apply: Is job ready for inspection?: ✓❑YES ❑NO ❑Rough In ❑✓ Final Do you need a Temp Certificate?: ❑YES ❑✓ NO Issued On 1/21/21 Temp Information: (All information required) Service Size ❑1 Ph ❑3 Ph Size: A # Meters Old Meter# ❑New Service ❑ Service Reconnect ❑ Underground ❑Overhead # Underground Laterals ❑1 ❑2 ❑H Frame ❑Pole Work done on Service? ❑Y ❑N Additional Information: PAYMENT DUE WITH APPLICATION L MoD Electrical Inspection Form 2020 xlsx � op® C�G1 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) 1 b.Business Telephone Number of Insured FENCE KING OF ROCKY POINT INC.DBA SWIM KING POOLS&PATIOS 471 ROUTE 25A ROCKY POINT,NY 11778 1 c.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) 113008276 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier ShelterPoint Life Insurance Company Town of Southold 3b Policy Number of Entity Listed in Box"1 a" 53095 Rte. 25 DBL37154 P0. Box 1179 Southold, NY11971 3c.Policy effective period 02/61/2020 to 01/31/2021 4. Policy provides the following benefits: ® A.Both disability and paid family leave benefits. 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 employer's employees: Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has NYS Disability and/or Paid Family Leave Benefits insurance coverage as described above. Date Signed 2/7/2020 By ah Ud (Signature of insurance carrier's authorized representative or NYS Licensed Insurance Agent of that insurance carrier) Telephone Number 516-829-8100 Name and Tide 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 i 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) IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII(IIIIIIIIIIIIIIIIIIIIIIII Morlt'p ' CERTIFICATE OF nsatinrt gcrard NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1 a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured Fence King of Rocky Point,Inc. 631-744-8100 DBA Swim Kings Pools&Patios 471 Route Rocky Point,NY 11778 1c.NYS Unemployment ment Insurance Employer Registration Number of Insured Work Location of Insured(Only required if coverage Is specificallyllmlted to 1d.Federal Employer identification Number of Insured or Social Securitycertain locations In New York State,l e.,a Wrap-Up Policy) Number 11-3008276 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Everest Indemnity Insurance Company Town of Southold 53095 Rt.25 PO Box 1179 3b.Policy Number of Entity Listed In Box"1a"Southold,NY 11971 SWSWC00205181 3c Policy effective period 11/05/2018 to 11/05/2019 3d.The Proprietor,Partners or Executive Officers are QX Included.(Only check box If all partnerslofficers Included) F] 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'1a"for workers' compensation under the New York State Workers'Compensation Law.(To use this form,Now York(NY)must be listed under Item 3A 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 mail.)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'Compensetlon Coverage or other authorized proof that the business is complying with the mandatory coverage requlrefiients of the New York State Workers'Compensation Law. Under penalty of perjury,I certify that I am an authorized representhtive or licensed agent of the Insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Kevin White (Print name laulhogrr ntattva,or licensed agent of Insurance caller) �F Approved by: 11-07-18 ( qn ure) (Date) Underwriting Vlce Pro sident Title: _ Underwriting Assistant Telephone Number of authorized representative or licensed agent of insurance carrier:714.371.9612 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) yvww.wcb.ny.ggv Labor, Licensing&Consumer Affai HOME IMPROVEMENT LICENSE jName I RANDY RODECKER { Business Name FENCE KING OF ROCKY POINT INC i This certifies that the bearer is duly licensed License Number H-21412 by the County of Suffolk Issued: 06/01/1992 'b Commissioner p Ex ires: 06101/2020 I l r ma A - - - Y0 UNT BEULAH(so'wiD-F) A VENUE - -- - MIX ar Anwar mcr ,w .c> y g 421.00' ! N 1'55' 10" W 221.00' N 1'55' 10" w LA b 50.00' 041 111 rod- o z o b .. pr.wrDr �-' 9=3y i z b -: :2''ST.ORY;FRA•�E:BUILDING Co coCb co C13 n ►.. .. Q. .: rWC:S7NlC1WX o CA CD n C t- 01 F�`•`rt'-H_ ,�H car � O y o � mC. Vyy H O o jv m 1 O ulr ,r wo�aoE>r a �s'� i-c' co CA i _qrAfti PM my Q%X*o mew . 44 n AK S?m P z " S 00.48'50"E 221.04' N 001148's 0jw1s Uria 50.01 r- lawn- MM ! 10" 44' 10• i N OTES A�� 1 NO SOIL SURCHARGE PERMITTED WITHIN 4 FEET OF EXCAVATION AT THE SHALLOW END,OR FEET OF EXCAVATION AT THE DEEP END BENCH I � O 2 THIS POOL MEETS THE REQUIREMENTS OFAN51/NSPI-5 'AMERICAN NATIONAL STANDARD FOR RESIDENTIAL INGROUND SWIMMING O POOLS"AND 1996 BOCA COPE-SECTION 421. DIVING EQUIPMENT 15NOTALLOWED I- - PPROVEDASNOTED 3. SWIMMING POOL SHALL BE COMPLETELY AND CONTINUOUSLY SURROUNDED WITH A BARRIER CONSTRUCTED IAW REQUIREMENTS OF SECTION 8326 5 3 OF THE INTERNATIONAL RESIDENTIAL CODE(2016)AND IN CONFORMITY WITH ALL SECTIONS OF THE SOUTHOLD TOWNCODE ACCE55 GATES SHALL COMPLY WITH SECTION R326 5 2 OF THE[PC AND BE SELF CLOSING,SELF LATCHING AND BE SECURELY DATE: B.P.# ( H2O LOCKED WHEN POOL 15 NOT IN VSE OR SUPERVISED. ALL GATES ARE TO OPEN AWAY FROM THE POOL AREA, N_I H2O iv 8'-D" CO 3,_6" 4. DURING CONSTRUCTION THE CONTRACTOR SHALL ERECTA TEMPORARY BARRIER AROUND THE EXCAVATION IAW THE CODE OF THE Q r FEE: ��® BY: TOWN OF50UTHOLD NOT[ BUILDING DEPARTMENT A 5 POOL MUST BE EQUIPPED WITH AN APPROVED POOLALAKM CAPABLE OF DETECTING A CHILD ENTERING THE WATER AND SOUNDING } 765-18 2 8AM TO 4PM FOR THE AN AUDIBLE ALARM WHEN DETECTED THAT 15 AUDIBLE ATPOOL5IDEAND ATANOTHERLOCATION ONTHE PREMISES WHERE THE POOL v 3 FOLL ING INSPECTIONS: IS LOCATED. THE ALARM MUST BE INSTALLED,MAINTAINED AND USED IN ACCORDANCE WITH THE MANUFACTURERS INSTRUCTIONS. a THE ALARM MUST MEET ASTM F2208 "STAN PARD SPECIFICATION FOP POOLALARMS THE DEVICE MUST OPERATE INDEPEN PENT(NOT z QZ 1. FO DATION - TWO REQUIRED \ o ATFACHEDTOORDEPENDENTON)OFPERSONS w c FO POURED CONCRETE `CONCWALLS g b. POOLSVCTIONFITTINGS(EXCEPT FORSURFACE SKI MMERS)MUSTBEPROVIPED WITH ACOVER THAT CON FORMS TOASME/ANSI A112198MORA MINIMUM 18"x23"DRAIN GRATE ORA CHANNEL DRAIN SYSTEM POOL CIRCULATION SYSTEM MUST BE EQUIPPED WITH ��T 2. RO GH -_ FRAMING & PLUMBING ATMOSPHERIC VACUUM RELIEF IN THE EVENT THE GRATE COVERS LOCATED WITHIN THE POOL BECOME M1551NG OR BROKEN SUCH p 3. INS LATION PLAN VACUUM RELIEF SY5TEM5 SHALL CONFORM WITH A5ME A1121917 OR BEA GRAVITY SYSTEM APPROVE[)BY THE TOWN OF 5OUTHOLD v d POOL SHALL BE PROVIDED WITH A MINIMUM OF 2 SUCTION FITTINGS OF THEABOVE MENTIONED TYPE THE SUCTION FITTINGS SHALL BE 4. FIN L - CONSTRUCTION MUST N T5 SEPARATED BY MINIMUM OF3'AND MUST BE PIPED SUCH THAT WATER 15 DRAWN THROUGH THEM SIMULTANEOUSLY THROUGH A 2O'VINYL COVERED STEPS VACUUM RELIEF-PROTECTED LINE TO THE PUMP COR PUMPS) VACUUM/PRESSURE CLEANING FITTINGS SHALL BE IN AN ACCESSIBLE BE OMPLETE FOR C.O. POSITION,MINIMUM OF 6"AND NO GREATER THAN 12"BELOW THE MINIMUM OPERATIONAL WATER LEVELOR BE AN ATTACHMENTTO ALL C NSTRUCTION SHALL MEET TFIE rHESKIMMER/SKIMMERS. REQUI EMENTS OF THE CODES OF NEW ^ 7 ALL ELECTRICAL WORK SHALL COMPLY WITH THE REQUIREMENTS OF NFPA 70(NEC)PRINCIPALLYARTICLE 680 AND THE IRC SECTIONS QJ 4201 THROUGH 4206 ALL ELECTRICAL DEVICES MUST BE APPROVE[)BY UNDERWRITERS LABORATORIES AND BE PROTECTED BYA V YORK TATE. NOT RESPONSIBLE FCRGROUND FAULT CURRENT INTERRUPTERCGFCI) CURRENT CARRYING ELECTRICAL CONDUCTORS EXCEPT FOR THOSE PROVIDING POWER C 2'TO 4'SAND BOTTOM v TO POOL LIGHTING AND POOL EQUIPMENT SHALL MEET THE SEPARATION REQUI REMENTS OF TABLE E42035 ALLMETALENCLO5URE5, QJ DESIG OR CONSTRUCTION ERRORS. FENCES OR RAILINGS NEARORADJACENTTOTHESWIMMINGPOOLTHATMAYBECOMEELECTRICALLYCHARGEDDUETOCONTACT WITH ANELECTRICALCIRCUIT SHALL BEEFFECTIVELY GROUNDED 3 Q1 � MPLY WITH ALL CODES OF SECTION A TS OCCUPANCY ®R 8 WATER SOURCE FILLING THE POOL SHALL BE EQUIPPEDWITHABACKFLOWPROTECTIONDEVICEIAWNYSPLVMBINGCODE608 vs NEVYORK STATE & TOWN CODESOPOFWALL WATERLINE 9 ALL PIPING IS DIAGRAMMATIC UNLESS OTHERWISE STATED ti �_—�� AS EQUIRED AND CONDITIONS OF i 4' 74' ; EIS UNLAWFUL 10 WALK5IFPROVIDEDSHALLBENONSLIPANDSLOPEAWAYFROMPOOLEDGE QJ m } N q F Z A ITHOUT C E RT I F I�,AT 11 A MEANS OF EGRESS FOR DEEP AND SHALLOW ENDS MUST BE PROVIDED IAW AN51/NSPI-5 SECTION 6 O O 12. CONTRACTOR TO PLACE THE POOL IAW TOWN OF 5OUTHOLD CODE SETBACKS .2' tl QJ BOARD OF OCCUPANCY a c L ° 13. ALL DRAINAGE FROM THE POOL SHALL BE MAINTAINED ON THE SUBJECT PROPERTY SO�IOMIOWN-TRUTEES SECTION B 15 WATER EX STS BASED AS DN N ODRAII MAGE SOIL WITH<105 SI T GROUND WATEWILL BE R SHALL DOT EXIST WITHIN THE EXCAVATION IFGROVND EC _ N T.5 16 ALL GAS AND OIL HEATERS(IF INSTALLED)FOR THE INGROUND SWIMMING FOOL SHALL BE NATIONAL APPLIANCE ENERGY NO CONSERVATION ACT(NAECA)COMPLIANT. POOL HEATERS SHALL BE TESTED IAW ANSI 22156 AND SHALL BE INSTALLED IAW MANUFACTURERS 5PECIFICATION5 OIL FIRED POOL HEATERS SHALL BE TESTED IAW UL726 POOL HEATERS SHALL BE LOCATED OR 2'-2" GUARDED TO PROTECTAGAINST ACCIDENTAL CONTACT OFHOT SURFACES BYPERSONS POOL HEATERS SHALL BE PROVIDED WITH N TEMPERATURE AND PRE55URE-RELIEF VALVES FOR HEATERS NOT PROVIDED WITH AN INTEGRAL BYPASS SYSTEM A BYPASS LINE SHALL COPING AND WALKWAY 10" BE INSTALLED FROM INLET TO OUTLET TO ADJUST WATER FLOW THROUGH THE HEATER POOL HEATERS SHALL BE PROVIDED WITH THE (BY OTHERS) - FOLLOWING ENERGY CONSERVATION MEASURES GRADE u �n WATER LINE 161 AT LEASTONE THERMO5TATSHALL BE PROVIDED FOR EACH HEATING SYSTEM t` CHECK VALVE $ 16.2 ALL POOL HEATERS SHALL BE EQUIPPED WITH AN ON-OFF SWITCH MOUNTED FOR EASY ACCESS TO ALLOW SHUTTING OFF THE 00 FROM SKIMMER n / OPERATION OF THE HEATER WITHOUT AD)USTI NG THE THERMO5TAT5ETFING AND TO ALLOW RESTARTING WITHOUT RELIGHTING THE o PvMP O \// PILOTLIGHT Q UNDISTURBED EARTH / 16.3 HEATED SWIMMING POOLS SHALL BE EQUIPPED WITH A POOL COVER(EXEMPTED FROM THI5 REQUIREMENTARE OUTDOOR POOLS r.. \\ DERIVING 20%OF THE ENERGY FOR HEATING FROM RENEWABLE SOURCES AS COMPUTED OVER AN OPERATING SEASON) y 3500 PSI POURED CONC n n / R. \ iv 16.4 TIME CLOCKS SHALL BE INSTALLED 50 THE PUMP CAN BE 5ETT0 RUN DURING OFF-PEAK ELECTRICAL DEMAND PERIODS AND CAN BESET TO 1) OSAU 3/8"REBAR 2)NP \/ 'd' TO RUN THE MINIMUM TIME NECESSARY TO MAINTAIN THE POOL WATER IN A CLEAN AND SANITARY CONDITION IAW APPLICABLE w Q �m q a DRYWELL� a \\ SAN ITARY CODE OF NEW YORK STATE y VINYL LINERto W •a 17 THIS DRAWING 15 FOR STRUCTURAL SHELL ONLY ALL ACCE55ORIE5AND APPURTENANCES ARE PER NEDBYOTHEPS lU F_� 3� a DIVERTER 2"T04"SAND VALVE O a \// �j = Err d w /\ 18. BACKFILL WITH CLEAN EARTH,FREE OF ROOTS AND DEBRIS DO NOTALLOW THE HEIGHT OF BACKFILL TO EXCEED THE HEIGHT OF THE ��1 .M m U / WATER IN THE POOL BY MORE THAN 8", OR THE WATER TO EXCEED BACKFILL BY MORE THAN 8" W Im. c:::� g O FILTER /\\//\\//\\//\\//\\//\\//\\/ //\\//\\// 19. PLACE CONCRETE ON SANDY TO LOAM SOIL. REMOVE ANY CLAY DEPOSIT AND REPLACE W/COMPACTED CLEAN BACKFILL N Co r 20. THERE 15 NO MAIN DRAIN IN THIS POOL SUCTION FOR POOL WATER CIRCULATION 15 PROVIDED BY THE SKIMMERS ONLY THI5 MEETS o REQUIREMENTS OF THE IRC-SECTION 83266 FOR ENTRAPMENT PROTECTION, TO RER/RNS VERTICAL 3/8T L "REBAR@ 3'0 C 21 THE POOL WAS DESIGNED IAW THE FOLLOWING m 0 F / (NOTSHOWN) CHECK VALVE) 21.1. THE I NTERNATIONAL RESIDENTIAL CODE(IRC)-CHAPTER 42(2016) �'" pr R THO� PLUMBING SCHEMATIC 212 THE INTERNATIONAL ENERGY CONSERVATION CONSTRUCTION CODE-SECTION 840310(2015) C) - 21.3 THE INTERNATIONAL FUEL GAS CODE(2015) N TS WALL SECTION 214 THE NEW YORK STATE CODE SUPPLEMENT-SECTION 8326 (2017) 21.5, THE NEW YORK STATE SANITARY CODE N T5 216 ANSI/NSPI-5 STANDARD FOR RESIDENTIAL IN-GROUND SWIMMING POOLS. fa r� `�°�° " 21.7. BOCA CODE-SECTION 421 -,I�•e p'�blb1 �n 218 CODE OF THE TOWNOF50UTHOLD -.�I� 1, °ENG'-I= �^E �OOL TO C! DO®I :l_ 22 ALL BACKWASH TO BE SELF-CONTAINED ON-SITE. ELECTRICAL x j' v'��.n�8475 ,UPON COMPLETION � � : `� � -,BEFORE"WATER"; INSPECTION REQUIRED oNP Fessio.�