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04v"-� �o�OS11fFt1L�'p` Town of Southold 10/9/2021 y� P.O.Box 1179 o • $� 53095 Main Rd 4�,�! �aor Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 42444 Date: 10/9/2021 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 180 Summit Ln.,East Marion SCTM#: 473889 See/Block/Lot: 38.-7-10.5 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 4/1/2016 pursuant to which Building Permit No. 46282 dated 5/20/2021 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: accessory in-ground swimming pool fenced to code as applied for. The certificate is issued to Capobianco,Neil&Brandeis,Laura of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 43021 12/23/2020 PLUMBERS CERTIFICATION DATED 14/1+ized hignature I S�fpp� TOWN OF SOUTHOLD BUILDING DEPARTMENT y z TOWN CLERK'S OFFICE 15, 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#: 46282 Date: 5/20/2021 Permission is hereby granted to: Capobianco, Neil 16 Sutton PI 2A New York, NY 10022 To: Construct accessory in-ground swimming pool as applied for. Replaces BP#43021 At premises located at: 180 Summit Ln., East Marion SCTM # 473889 Sec/Block/Lot# 38.-7-10.5 Pursuant to application dated 5/20/2021 and approved by the Building Inspector. To expire on 11/19/2022. Fees: PERMIT RENEWAL $125.00 Total: $125.00 ___>X- Building Inspector F TOWN OF SOUTHOLD SUFFnIk BUILDING DEPARTMENT ' TOWN CLERK'S OFFICE y 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#: 43021 Date: 9/10/2018 Permission is hereby granted to: Capobianco, Neil 250 W 89th St Apt 2M New York, NY 10024 To: Construct accessory in-ground swimming pool as applied for. Replaces BP#40598 At premises located at: 180 Summit Ln., East Marion SCTM # 473889 Sec/Block/Lot# 38.-7-10.5 Pursuant to application dated 9/10/2018 and approved by the Building Inspector. To expire on 3/11/2020. Fees: PERMIT RENEWAL $125.00 Total: $125.00 Bui i ector 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#: 40598 Date: 4/7/2016 Permission is hereby granted to: Capobianco, Neil 250 W 89th St Apt 2M New York, NY 10024 To: construct accessory in-ground swimming pool as applied for. At premises located at: 180 Summit Ln, East Marion SCTM # 473889 Sec/Block/Lot# 38.-7-10.5 Pursuant to application dated 4/1/2016 and approved by the Building Inspector. To expire on 10/7/2017. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO - SWIMMING POOL $50.00 Total: $300.00 Buil 'ng 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- $100.00 3. Copy 6f Certificate of Occupancy-$.25 - 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15.00, Commercial$15.00 Date. 41- 1" ,2014v New Construction: ��pp Old or Pre-existing Building: [' (check ones) IO Location of Property: ® S /W/-//� L!/1/ /2/oAl House No. Street Hamlet Owner or Owners of Property: Suffolk County Tax Map No 1000, Section aj j Block - / Lot /C). J� 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: $ Applicant Signature rq SO(/��®l 0 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Q Southold,NY 11971-0959 ® s �® sean.devlin(Qtown.southold.ny.us c®UNTY,� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Neil Capobianco Address: 180 Summit Ln city:East Marion st: NY zip: 11939 Budding Permit#: 43021 section: 38 Block 7 Lot. 10.5 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Luna Electrical License No: 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 A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO Transformer UC Lights Dryer Recpt Emergency Fixtures Time Clocks 1 Disconnect Switches 1 4'LED Exit Fixtures Pump 1 Other Equipment: Pool Heater, Pump, Salt Generator, Pool Cover w/ Key Switch Notes: Pool Inspector Signature: �. Date: December 23, 2020 S Devlin-Cert Electrical Compliance Form.xls �Of 30 ® c00Ni`4,� TOWN--OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION FOUNDATION IST- [ ] ROUGH PLUMBING [ ] 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: G DATE INSPECTOR soul yO�o TOWN OF SOUTHOLD BUILDING DEPT. courm 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] MULATION [ ] FRAMING /STRAPPING jV(FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION ] CAULKIN A."',c REMARKS: oq"l-cG, 9 42AA p DATE ` l INSPECTOR �O�apF SOOlyolo L-4 e;5 0 2,1 l ba * # TOWN OF SOUTHOLD BUILDING DEPT. ��courm e�' 765-1802 _INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING/STRAPPING [ ] FINAL [ ] - FIREPLACE & CHIMNEY'- , [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION ELECTRICAL (ROUGH) ELECTRICAL (FINAL) [ ] CODE VIOLATION C y PRE C/O REMARKS:., As� -�3 o f t_-r U� e DATE 112,14C.i INSPECTOR aZapf SOG,yO # * TOWN OF SOUTHOLD BUILDING DEPT. co 765-1802 INSPECTION , [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ']= FOUNDATION 2ND [ ] SULATIO CAULKING [ ] FRAMING /STRAPPING [ FINAL Pwtllo [ ] FIREPLACE &CHIMNEY [ ] -FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] 'FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL-(FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: 0+4Ag6 ()v J s DATE °�3 �►O . INSPECTOR ti / / i 0 ' • " 1 • 1 /� -r..film ' - • S t: t -r •rIS 7, MIN/� r Will _w 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)765-1802Planning Board approval FAX:(631)765-9502 Survey SoutholdTown.NorthFork.net PERMIT NO. Check Septic Form N Y.S.D E.C. Trustees C.O.Application Flood Permit Examined 20 Single&Separate Storm-Water Assessment Form 4ContacK: t /I•� Approved 020� Mail to: V Disapproved Ede —17 Phone �(� 3 O Expiration 20 _" DD APPLICATION FOR BUILDING PERMIT APR - 1 2016 INSTRUCTIONS Date o�/V// 20/& a.This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 BtJffglot plan to scale.Fee according to schedule. T �, location of lot and of buildings on premises,relationship to adjoining premises or public streets or ��ar1eias�and at ayri� s�• 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. �c (Signature of applicant or name,if a corporation) (Mailing address of applicant) State whether applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder Name of owner of premises /4G/G Za,&OA IAAlr-0 (As 6n 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. Plumbers License No. Electricians License No. Other Trade's License No. 1. Loc o of land on which pro sed work will be done: House Number Street Hamlet County Tax Map No.1000 Section Block al Lot /0- 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 Addition Alteration Repair Removal Demolition Other Work W11Vq///d 45V (Des iption) 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 Rear Depth 10.Date of Purchase Name of Former Owner 11.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 regraded?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 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(Su � V; kY (5c(c n-5ku j being duly sworn,deposes and says that(s)he is the apTRAGEY L. DWYER (Name ofindivid signing con act)above named, NOTARY PUBLIC,STATE OF NEW YORK NO.01 DW6306900 (S)He is the QUALIFIED IN SUFFOLK COUNTY 16 (Contract r,Agent, orporate Officer,etc.) COMMISSION EXPIRES JUNE 30,2D� 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 St day of � 20JI,_ '�g` acw AU A �( Notary Public Signature of Applicant Scott A. Russell 6;°su p 9T0IKMWA.]r1E1K SUPERVISOR co AWAN A\IGJEMJEN T SOUTHOLD TOWN HALL-P.O.Box 1179 ts" 53095 Main Road-SOUTHOLD,NEWYORK 11971 Town of Southold CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) DOES THIS (PROJECT INVOLVE 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. ®[21 B. Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. ❑Er c. Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. 09D. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. ❑Ej E. Site preparation within the one-hundred-year f loodplain 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 Tag Map Number! Chapter 236 does not apply to your project. �C 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 Oitner.Design Professional,Agent,Contractor,Other) S.C.T.M. : 100 Date. D � � /, nirlct Section Block Lot ✓(/ '- "" ' ****FOR BUILDING DEPARTMENT USE ONLY**** Contact Information ar,Reviewed By: R'rLphoce n"cnhrt) — — — — — — — — — — — — — — — — Date: / Property Address/Location of Construction Work — — — — — — — — — — — — — — — — 8Q Approved for processing Building Permit. o SU (� I Stormwater Management Control Plan Not Required. 60 Stormwater Management Control Plan is Required. (Forward to Engineering Department for Review.) FORM * SMCP-TOS MAY 2014 oF sntryo - Town Hall Annex 54375 Main Road Telephone 16310�7gg65QQ122802 P.O.Box 1179 G� 0 roaer.rlCheftfC eox(6 SOUtl101tl nV US , Southold,NY 11971-4959 Q 'N�U � � 220 BURRING DEPARTMENT 'OWN OF SOUTICOLD APPLICATION FOR ELECTRICAL INSPE �• M.; ;,``x ' CTION - _,ar REQUESTED BY: __tf AT Date: Company Game: _LLLjq. Name: A/A7 ( A-f,(1,f ks71ri2.A License No.: Address: 7 6mv i(l cril n/c kJ /Su P AN _J/ 1? Phone No.: C�3l X35- 9�i JOBSITE INFORMATION: (*Indicates required information) *Name: A PO_T�I A 0 CO *Address: I RO L.ta►�1E. E Y`(1p,�2��l►J *Cross Street: _ M� *Phone No.: Permit No.: Tax•Map District: 1000 Section:_�,f- Block: 08 Lot: /0.5 *BRIEF DESCRIPTION OF WORK(Please Print Clearly) l��cJ f OL (Please Circle All That Apply) *Is job ready for inspection: (�al NO. Rough In Final *'Do•you need a Temp Certificate: YES 16O Temp Information Of neededi Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other *New Service: Re-connect Underground Number of Meters Change of Service Overhead Additional Information: PAYMENT DUE WITH APPLICATION B2-Request for Enspeclion Form Town Hal!Annex 54375 Main Road Telephone(631)765-1802 P.O.Box 1179 �Q roQerrichert(aoia`wn i 75 svola,NY 119X-0959 ' +`yp .;ouia4dnv us_,, r� • � � ;, BUR DING DEPARTMENT [J" -NOV 2 0 2020 z TOWN OF SOUTHOLD AERLICATIQN FOR ELECTRICAL INSPECT ' REQUESTED BY: Date: �vo d 20 "Poo'2�o ae7 Company Name: NA F&GC L o� Name: , A7 CA N k 16-IP Z�► License No.: Address: IZ MP<_ n!c 1A I kS u p Phone No,: ( 3 336- 9q 7 JOBSITE INFORMATION: ,(1nd-icates required information) *Name: dAPUPW A I�C 0 *Address: (go_ fSu_ 'y\"Xk-r �1Ie_ *Cross Street: R O im�Ci nC J 'Phone No.: (1p31 335-(�,9q� Permit No.: Tax-Map District: 1000 Section: �3� - Block: 08 Lot: /0.s' ----- *BRIEF DESCRIPTION OF WORK(Please Print Clearly) 0 (Please Circle All That Apply) *Is job ready for inspection: (;i�,/ NO. Rough in Final *Do-you need a-Temp Certificate: YES Ig Temp Information(If needed} 'Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other *New Service: Re-connect Underground Number of Meters Change of Service Overhead Additional Information: PAYMENT Dt1E-WITH APPLICATION a. X82-Request for Inspecf;on Forfr, PERMIT# Address: Switches Outlets ` GFI's 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: g� A Comments v �� te _ Southold Town Biulding Department 046fF0j1r411�- , P.O.Box 1179 Permit#: 40598 53095 Main Rd o _ Southold,New York 11971 Permit Date: 4/7/2016 . y' Laos (631)765-1802 Expiration Date: 10/7/2017 Parcel ID: 38.-7-10.5 BUILDING PERMIT RENEWAL LETTER Dated: 8/10/2018 Applicant: Capobianco,Neil Location: 180 Summit Ln, East Marion Work Description: IN GROUND POOL construct accessory in-ground swimming pool as applied for. A FEE OF $125.00 IS REQUIRED TO RENEW THIS BUILDING PERMIT. Owner: Capobianco,Neil Address: 4, ��q �or�k�10 a ` r) Sc�7Z 7�G/r Pe:,cC�e The permit listed above has expired. No work is permitted or authorized beyond the expiration date. Please submit the above fee made payable to the Town of Southold. Mail to the Town of Southold Building Department, P.O. Box 1179, Southold, New York 11971 o 1EC[E0V[E DD AUG 3 1 2018 BUILDING DEPT. TOWN OF SOUTHO7LD THANK YOU, SOUTHOLD TOWN BUILDING DEPT. Young & Young N 400 Ostrander Avenue, Riverhead, New York 11901 �� 631-727-2303 4z \, Howard W. Young, Land Surveyortl �j Thomas C. Wolpert, Professional Engineer Robert C. Tast, N Architect ti0� �ryb \ Ronald E. Pfuhl, Landscape Architect 6q�1c Douglas E. Adams, Professional Engineer ! W _ E ow g , 0 ARI=A = 41,542 50. FT. i Wil- NV. (1�a ` • SUBDIVISION MAP - "SUMMIT ESTATES, SECTION 2" FILED IN THE } ` oG}'l Q\� �°' / BOO O,5 / OFFICE OF THE CLERK OF SUFFOLK COUNTY ON MAY 21, 2002 A5 1 \ �� kea O9/ 6 FILE NO. 10768. N 10 41 Q $, w ho" dR 3, F '0' E %t <0 5URVEYOR'S CERTIFICATION FpJ2 Naa Id� •' ,�,l �� • AE HEREBY CERTIFY TO CHRISTOPHER CAPOBIANCO, �� . ����' CP Lot{�7' ` k�0• Lot Iq es p,�, ``+ Y NEIL CAPOBIANCO Sc FIRST AMERICAN TITLE i N S U RA N C E C O M PANY THAT THIS SURVEY WA5 PREPARED r�TC� :��G • , ' "�s� -p �� =_ I IN ACCORDANCE WITH THE CODE OF PRACTICE FOR LAND `•,,VO y� �\ `Y� " ^�_ SURVEY5 ADOPTED BY THE NEW YORK STATE G OF PROFF-55IONAL LAND SURVEYORS. • ' ',-N 17 - / �, s 12.4' Z ee "r �, o Q z 2 STOFtrHOAARO W. YOUNG, N.Y.S L.S. NO. 45883 L�� '5 E 9 O �' ifl ¢i ' mV j �'.�I - Na;.5 ry 1 SURVEY FOR IS1 p o CHRISTOPHER CAPOIBIANCO o 4 N =I L CAP051 AN0O c ryt� .4° F = =T LOT Iq "SUMMIT ESTATES, SECTION 2RATWt " � � ! RIS At East Marion, Town of Southold S1 =to 00: Suffolk County, New York -7 LF,125 R=17 .Op, �0� � (ALSO �(��� County Tax Map District I000 Section 35 eiock 08 Lot 10.5 L ,od >p`_- - -N'4sFI c NAL �RV�Y � ��'�,, •,,tija$ SANITARY MEASUREMENTS A B S.T. 24' 98' FINAL SURVEY DEG. 211, 2005 90, G.P. 1 22' 411' FOUNDATION LOCATION A & 29, 2005 ���� G.P. 2 94' 4a' SURVEY MAP COMPLETED JAN. 15, 2005 � �F FIELD SURVEY COMPLETED JAN. 19. 2005 ^ 3 e•� SCALE: 1"=50' � JOB NO. 2005-0011 ' ET 0 -Mommxr ram A.eTAKE ser �•5t,Kc ram Ro-ROOF ov>s<t s•sTum c•0HIr4&Y DWG. 2005-0011—P• 'Ila i iJJFFOLK COUNTY DEPT OF LABOR. LICENSH�4G & CONSUMER AFFAIRS HOME IMPROVEMENT s CONTRACTOR NAME KRZYS TO F ZEBROWSKI ' � W, a ,, a . This certifies that the ° `""` bearer is duly FLANDERS RENOVATIONS INC iicensed by the L!C#nM Number Date Issued County of Suffolk 54181 -H 10/02J2014 New York State Insurance Fund Workers'Compensation&Disability Benefits Specialists Since 1914 8 CORPORATE CENTER DR,3RD FLR,MELVILLE,NEW YORK 11747-3129 Phone-(631)7564300 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ^^A A" 203592246 FLANDERS RENOVATIONS INC 286 FLANDERS BOULEVARD FLANDERS NY 11901 POLICYHOLDER CERTIFICATE HOLDER FLANDERS RENOVATIONS INC TOWN OF SOUTHOLD 286 FLANDERS BOULEVARD 53095 ROUTE 25 FLANDERS NY 11901 SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATENUMBER 7T PERIOD COVERED BY THIS CERTIFICATE DATE 12172435-6 337493 11/25/2015 TO 11/25/2016 3/31/2016 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO.2172 435-6 UNTIL 11/25/2016, 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 SAID POLICY IS CANCELLED,OR CHANGED PRIOR TO 11/25/2016 IN SUCH MANNER AS TO AFFECT THIS CERTIFICATE, 10 DAYS WRITTEN NOTICE OF SUCH CANCELLATION WILL BE GIVEN TO THE CERTIFICATE HOLDER ABOVE. NOTICE BY REGULAR MAIL SO ADDRESSED SHALL BE SUFFICIENT COMPLIANCE WITH THIS PROVISION THE NEW YORK STATE INSURANCE FUND DOES NOT ASSUME ANY LIABILITY IN THE EVENT OF FAILURE TO GIVE SUCH NOTICE. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. KRZYSZTOF ZEBROWSKI, PRESIDENT OF FLANDERS RENOVATIONS 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, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE INSURANCE FUNC U DIRECTOR,INSURANCE FUND UNDERWRITING This certificate can be validated on our web site at https://www.nysif.com/cert/certval.asp or by calling (888)875-5790 VALIDATION NUMBER:92971131 AC"RV CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) `� 1 03/31/2016 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 NA EACT Leslie Connolly Shore Line Insurance Agency Inc. PHONEFAX No (631)74433243 8 Broadway E-MAADDRESS INSURERS AFFORDING COVERAGE NAIC# Rocky Point NY 11778 INSURER A Utica First Insurance 15326 INSURED INSURERS Flanders Renovations Inc INSURER C 286 Flanders Blvd. INSURER D INSURER E. Flanders NY 11901 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 OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR rypE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MMI D MM/DD X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1000000 CLAIMS-MADE ❑X OCCUR DAMAGE TO 50000 PREMISESS(Ea occurrence $ MED EXP(Any one person) $ 5000 A N N ART136569407 11/17/2015 11/17/2016 PERSONAL&ADV INJURY $ 1000000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2000000 POLICY❑PROJECT E]LOC PRODUCTS-COMP/OP AGG $ 2000000 OTHER: $ AUTOMOBILE LIABILITY CEa acciOMBINdentED SINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accrdenl UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ r-TDED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVEE L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N N/A (Mandatory in NH) E L DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below I E L DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space Is required) Certificate holder is added as additional insured as required by written contract. CERTIFICATE HOLDER CANCELLATION Town of Southold SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 53095 Route 25 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS AUTHORIZED REPRESENTATIVE Southold NY ils7i a�;, ��• -s . ©1988-2014 ACORD CORPORATION. All rights reserved. FftACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD r6aJ ELECTRICAL LEGEND: „ INSPECTION REQUIRE® PLAN ELEVATION SECTION 51 -6 LED LIGHT `it-off 43'-6" 4'-0„ CIRCULATION RETURN , p� APPR�. VED AS NOTED PLAN SECTION 9" SQUARE OUTLET COVER DATE: _ 8.P. FEE:F_.E• BY: 0 N a i NOTIFY BUILDING DEPA M" AT TYPICAL AUTOFILL 7651so2 8 A To 4FPA FOR THE FOLLOWING INSPECTiOi�ls: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE -........_...---...-- -._...._.........._...._.._...._.__.._.................._.........._. ........_ .. _ ROUGH - RAi�9{NG & PLUi4fiBlNG Notes : _ _...._----.._............._.... 3 I.ISULATION — — — — — — 4. T N CONSTR Co 0 BE COMPLETE FORTC.O. ALL CONSTRUCTION aIALL MEET THE 5'-0" 10'-0" 5'-0" 5'-0" 10'-0" ' S'-0" i REQUIREMENTS OF THE CODES OF IdE4'V YORE{ STATE. NOT RESPONSIBLE FOR ' CL DESIGN OR CONSTRUCTION ERRORS. 12111/ 40'-0" I 30" i TYPICAL CIRCULATION i RETUTN DEEP END J (WATER DEPTH.7'-9") I COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED AND CONDITIONS OF AUTOMATIC I M of COVER ITOIAIAI Elf ARIUNO BOARD toff I .�i J Ct I 9„X9„ FR - SWIMMING POOL AME GRATE MAIN 0 o I: DRAIN T'D TOGETHER IN - z o N (800sgft) ACCORDANCE WITH VGB ACT o ' OCCUPANCY OR N O ' USE IS UNLAWFUL � I SHALLOW END -� M f (WATER DEPTH: 3'-3") '�*�� - I WITHOUT CERTIFICATE OF OCCUPANCY I RETAIN STORM WATER RUNOFF PURSUANT TO CHAPTER 236 OF THE TOWN CODE. l.I.rvE`DIA°�E1�.�'• ,y'1• 7'-0" IENCLOSEs OOL TO COdE Ilk 15'-0” 13'-0" UPOT4 COMPLETION BEFORE"WATER" 250W INCANDESCENT " 18 R SWIMOUT ('�1a °° POOL LIGHT 1 CD I TYPICAL SKIMMER TYPICAL SKIMMER - - 4'-0" 2" THK. STONE COPING 4'-0" 11'-9" 11'-9" ON MUD BASE 15'-9" %2" EXPANSION JOINT W/ 6"H FROST FREEr�alltt�ase 15 -9 BACKEROD AND SEALANT WATERLINE TILE ���� :�€ � ���d°� NE O ;�.rj...,, ; • STONE PATI WATERLINE �� '..`�,►�s��i,��;� CENTER OF TILE Vis. 9 �� 5, 00 s- <r4 IN POOL WALLS WITH WATER DEPTH OF 5'-0" OR LESS 4 MIN. SAND BASE, WHEN NECESSARY TO AID REBAR SHALL BE PLACED DRAINING IN SLOW DRAINING SOIL " " HORIZONTALLY AND VERTICALLY @12"O.C. 201-011 SWIMMING POOL WALLS, d BOND BEAMS, AND FLOORS— _---i� �.'..�-��; „�4 . .. 2" THK. POOL FINISH SHALL BE STEEL REINFORCED GUNITE. GUNITE SHALL -- - „ BE MINIMUM 4,000 P.S.I. @28 DAYS. STEEL RE BAR d 7 SWIMMING M M I NG POO L AND PATIO LAYOUT SHALL CONFSTANDARD , - 1 RIM TO AST, A615 GRADE 60 _.Y _............... rt_..... ®. 7" THK. GUNITE POOL -' ' SHELL ' REV: DESCRIPTION: BY: DATE: IN POOL WALLS WITH A WATER DEPTH GRATER THAN ' -- DESIGNER: 5'-0", ADDITIONAL VERTICAL BARS SHALL BE PLACED _y "— .,_ VERTICALLY FOR A SPACING OF 6" O.C. AND EXTEND pp pp FROM TOP OF WALL AND BENT INTO THE BOTTOM OF =.-'......... rr ,::lf-:# ° BA D E R FLOOR EXTENDING 24" HORIZONTALLY. • POOL ......,..... _...._. Phone: (646) 400-3850 VERTICAL BARS 12" O.C. SHALL BE BENT IN BOND _. * Website: www.Banderapool.com BEAM AS SHOWN. - FLOOR REINFORCING SHALL Email: Info@ Banderapool.com i CONSIST OF RE-BAR CAGE __..,...,..._...._.. PROJECT: SPACED @ 12" O.C. C/q,rj a p I A N C0 —.: RESIDENCE CRUSHED STONE, WHEN NECESSARY TO DRAINAGE IF - - '' ; ° ^ d a R ES I D E N C E GROUND WATER IS ENCOUNTERED IN SLOW DRAINING SOIL _ � � •�;+ti C.�'``�I�(" ���``�;V� `.�' �,,i,r---„,,,,�� EAST MARION N w TITLE: ir SWIMMING POOL LAYOUT 2 TYPICAL WALL, SECTION SCALE AT AO: DAME: DRAWN: CHECKED: SCALE: 3/4” = V-0" AS NOTED 4-04-16 VG VG IPROIECT NO: SHEET N0: 1600 P 2