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HomeMy WebLinkAbout41460-Z -� ��o��S�FFtIl�-cOG� Town of Southold 10/23/2021 P.O.Box 1179 C* _ 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 42466 Date: 10/23/2021 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 1835 Reeve Rd,Mattituck SCTM#: 473889 Sec/Block/Lot: 100.-3-10.4 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 3/17/2017 pursuant to which Building Permit No. 41460 dated 3/23/2017 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 Albanese,Craig&Laura S of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 41460 7/18/2017 PLUMBERS CERTIFICATION DATED tho iz S'gnature �o�Suc�co TOWN OF SOUTHOLD �y BUILDING DEPARTMENT TOWN CLERK'S OFFICE • SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 41460 Date: 3/23/2017 Permission is hereby granted to: Albanese, Craig & Laura S 1330 1st Avenue, Apt. 1219 New York, NY 10021 To: construct an in-ground swimming g pool as applied for. At premises located at: 1835 Reeve Rd, Mattituck SCTM #473889 Sec/Block/Lot# 100.-3-10.4 Pursuant to application dated 3/17/2017 and approved by the Building Inspector. To expire on 9/22/2018. Fees: IN-GROUND SWIMMING POOL $250.00 CO - SWIMMING POOL $50.00 Tota $300.00 Building 1 pector Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings,property lines,streets,and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1%lead. 5. Commercial building, industrial building,multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings(prior to April 9, 1957)non-conforming uses,or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines,streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied,the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy-New dwelling$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00, Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,Businesses$50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential $15.00, Commercial$15.00 Date. 3 -Z�_I 1 New Construction: Old or Pre-existing Building: (check one) Location of Property: ?-,Eev6s- 1?�,D lM►+4-fit-t-�. cV__ vt)( i 1q 5 2— House No. Street Hamlet Owner or Owners of Property: Nvl_ AL .5 A k)S-5 C-7 IA-3< Reeve` Suffolk County Tax Map No 1000, Section Block Lot Subdivision Filed Map. Lot: Permit No. y 4 0 Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: ✓ (check one) Fee Submitted:$ 50 V Applicant Signature OF SOUTH'®l � o Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 CA P.O.Box 1179 , ® �Q roger.richert(a-town.Southold.ny.us . Southold,NY 11971-0959 1,011 4 A-UNTY,�� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Albanese Address: 1835 Reeve Road city:Mattituck st: New York zip: 11952 Building Permit#: 41460 Section: 100 Block: 3 Lot: 10.4 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Luminaire Electric License No: 37665-ME SITE DETAILS Office Use Only Residential X Indoor Basement Service Only Commerical Outdoor X 1st Floor Pool New X Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt Ceiling Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps 2 Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks Disconnect Switches Twist Lock Exit Fixtures �] TVSS Other Equipment. Inground Pool to Include: Bonding, 100A Pool Panel, 2- GFCI Circuit Breakers, Gas Pool Heater, Salt Generator, 5- Pool Lights. Notes: Inspector Signature: Date: July 18, 2017 0-Cert Electrical Compliance Form.xls Of SOUTyo� 'coUNi'1,� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ELECTRICAL (FINAL) REMARKS: DATE INSPECTOR � o TOWN- OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLRG. [ ] FOUNDATION 2ND [ ] SULATI N [ ] FRAMING / STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION_ [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: Q rL e Yo b Qin c � ` �,/ �v►.�'h�(/ vim- DATE INSPECTOR 7 IO �Of SOpT�, o� o� � o TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [ YSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) 1 REMARKS: p.,�s �' lS tf9 om/�✓mkAlml 11Iw✓ t In ;7&/ 6V&4� 4-1)'tiyaFT �- y DATE t INSPECTOR SO(/lyo N o a old 0 My,N TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [ ] SULATI N FRAMING / STRAPPING Vf FINAL �oa� [ ] FIREPLACE & CHIMNEY- [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: UIS oh p%r - i w� ori- D -�(e ins �vbw,' W -fir reg DATE ! INSPECTOR • • -_ • • i ROUGH FRAMING : r � ENERGYPLUMBING INSULATION PER N.Y. STATE •D I` •DD • • • • 1 ! Ll 1 �11f , WWI Mo M' mf . ��rs � I . TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUHLDING 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 /(�6 Survey SoutholdTown.NorthFork.net PERMIT NO. I Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Exammed 20 Single&Separate 3 Storm-Water Assessment Form Contact: Approved 20 Mail to: Disapproved alt ' Expiration Phone: ,20 t Building Inspector \/ D APPLICATION FOR BUILDING PERMIT MAR 1 7 2017 Date 20 t� INSTRUCTIONS BUMJDn MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 ,r® f ° �n to scale.Fee according to schedule. VYI� o p a o mg location of lot and of buildings on premises,relationship to adjoining premises or public streets or areas,and waterways. c The work covered by this application may not be commenced before issuance of Building Permit. d.Upon approval of this application,the Building Inspector will issue a Building Permit to the applicant.Such a permit shall be kept on the premises available for inspection throughout the work. e.No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f.Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date.If no zoning amendments or other regulations affecting the property have been enacted in the interim,the Building Inspector may authorize,in writing,the extension of the permit for an addition six months.Thereafter,a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold,Suffolk County,New York,and other applicable Laws,Ordinances or Regulations,for the construction of buildings,additions,or alterations or for removal or demolition as herein described.The applicant agrees to comply with all applicable laws,ordinances,building code,housing code,and regulations,and to admit authorized inspectors on premises and in building for necessary inspections. � 5•�/,��. S'�ACvyy�,�-� �ct��s int, (Signature of applicant or name,if a corporation) 2.0-0 13L m7Er-iV.3U9.6)\-, Z SLAI C,%A Sita t, (Mailing address of applicant) State whether applicant is owner,lessee,agent,architect,engine=generalcontractor,electrician,plumber or builder I Name of owner of premises A IV'C=- sif (As on the tax roll or latest deed) If qpplicant is a corporplion,signature of duly authorized officer (Name and title of corpor to officer) uilders License No. 3O Q 33--1A Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: 16a5- ?e g-V;-- -i,->- M A-1-y-, V-5- House Number Street Hamlet County Tax Map No. 1000 Section 1 o d Block d Lot O le `�' Subdivision Filed Map No. Lot Y 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy S i H c3 t k vvi ( 3*:� ly eA�i ti b. Intended use and occupancy. i ��M �'( ��u<M 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition Other Work1 t-4 6%,-.0.,,A D Grp;-,_ t (Description) 4. Estimated Cost 00C®= 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 ox- 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 i S12 17 Rear 'i S-6 Depth 05 7 10.Date of Purchase Name of Former Owner A."rVAe jl, -,3V i c_ 11.Zone or use district in which premises are situated / 12.Does proposed construction violate any zoning law,ordinance or regulation?YES_NO r/ / 13.Will lot be re-graded?YES NO /Will excess fill be removed from premises?YES V--NO- -3 ' cc' 14.Names of Owner of premises///)) 6✓/5r✓1� Address t,Acv/ Phone No.57/.,- Name of Architect A(-64yi L`-5 6- Address/P,!S Renu•�Phone No6,?/-yy»/V sl- Name of Contractor 5 E iq t.iz- Aycj�. AddressZ-k;' SL 4 Neu. wce#one No. Ai-Z 3 _ 131 15 a.Is this property within 100 feet of a tidal wetland or a freshwater wetland?*YES NO s� *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 S aria s \ �rS J� .k j IF L i being duly swom,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the C(ContraqqAr,Agent,Corporate Officer,etc.) of said owner or owners,and is duly authorized to perforin 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 j f ] day ofd vL 20 1 , S- Notary Public Signature of Applicant ®ae®�Q�oyQ�p°6y64®61=ppppp pp®B®OBO®Iosos �STATE��'�� �e o OF NEW YORK. NOTAL PUBLIC i Qualified in S Camry; p m 01SA6312961 a v s, O % .• _G e sSeON�Eo°e°p6®0�®eoeo Scott A. Russell -� � STOIRMWAXIEIEZ SUPERVISOR IMI A NA G]EACEN T SOUTHOLD TOWN HALL-P_O.Box 1179 a i 53095 Main Road-SOUTH OLD,NEIN Town YORK 11971 '�O �- �( own of Southold CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET (TO BE COMPLETED BY THE APPLICANT) Yes No (CHECK ALL THAT APPLY El DA. CIearing, grubbing, grading or stripping of land which affects'more than 5,000 square feet of ground surface. El[3 I'. 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. t ❑[ E. Site preparation within the one-hundred-year floodplain as depicted on. FIRM Map of any watercourse. ®Dt. 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 Departmot_wiilLyour Building Permit Application. APPLICANT_ (Property Owner,Design Professional,Agen ontractor,O her) S.C.T Nl. OOO t Date ` District l j� L NAME: N XWt_(�S Q� • V c-&-L- 9 I v w�, )t Section Block Lot L Gs.. FOR B�IIMING DELPAt?T�°IENT USTL :SIN �- Contact Informatwrt &3 -20 Z 3a - Reviewed By: r%^' A — — — — — — — — — — — — — — — — — — Date: Property Address / Location of Construction Work: — — — — — — — — — — — — — — — — — © Approved for processing Building Permit. Stormwater Management Control Plan Not Required. r; Stormwater Managennerit Control Plan';_-,Required LJ (Forwardto Engineering Deparlmeni for Review) FORM ' SMCP - TOS MAY 2014 Tows Ball Annex Telephone(631)765-1802• 5405Box 117Main 5 G.� c roger.richertOR&W-SOW6.ny us Southold,NY 11971.0959 Vi�l,t BUILDING DEPARTMENT - TOWN OF SOUTHOLD APPLICATION- FOR ELECTRICAL INSPItCTION REEIlESTE13 SY:StiA wr /L,zv��t-72 Dafe: �7 * ® Company Dame: L C e 61,6ZA� IVarrre: .S4{AciJN 0C d�U�'b2 cense.No,.: Address: 11716 - Phone No,.: JOSSITE INFORMATION: ( Indicates required informatio ) �,'Idame: C I6 Le � 4 A/ba17ef *address: - - 1636 �2E&1/E Rb /�ATr17-VCA *Cross Street: QU7- 1246 *Phone No.: 63/- y-21- /,V r2- 8 u j 1 j m- Pearrit No.: _- -im 0 Tax Map Qistrict: 1000 Section: 10 o ' Stock: Lot: /O. *BRIEF DESCRIPTION OF WORK(Please Print Clearly) - .(€+lease circle Aft That Apply) *Is•job ready for Inspection: S Rough In Final. * -- Da you need a Temp Certificate. YDS/ Ump-Information (If needed} *Service Size: 1 Phase 3Phase 400 150-- - 200 300. 350 400 Other *New Service: Re-connect Underground Number of Meters Change of Service Overhead Additional Information: PAYMENT DILE WITH APPLICATION �`DfY d1V&V 000D `02®,�� R w pW. o axxjop ,) CA-�b—1 7 HM ENGINEERING P.C. 3 CHERRYWOOD DRIVE EAST NORTHPORT,NY 11731 TEL:516-476-5392 EMAIL:HMARNIKA@OPTONLINE.NET March 16, 2017 Town of Southold Building Department Town Hall Southold,NY 11971 Dear Sir/Madam: This is to certify that the drainage facilities to be used exclusively for the construction of a swimming pool on the premises of: Albanese 1835 Reeve Road Mattituck,N.Y. 11952 will not require draining because the pool is constructed with a vinyl liner. The pool water will be continuously recirculated through the filter and will be reused from year to year. The drainage from the filter backwash is nominal and will not interfere with the public water supply, the existing sanitary facilities or public highways. Sincerely, HMS Ogineering P.C. Hrvoje Marnika P.E. ' SSL�-. w.f�Z`xu-4Y?.•3 rei. ,••• �..f ,."'• ,.• - , ••. V • '%��`�T��l NL�'•���'� iib(.^)d,si ..l FS•��A'�d^'F.i�f ((ry/{�l) � ___ REEVEROAp U`'� m �yA �F�;�SaAF1�yr :aa'Qr "t'Y°"*•!' He °}. i. �`� ;•/�,' EY 10H S1 .4Z .Z •���,:��;,'.�yt:4p<;,we,'��;"," '1.1442 ' CL 110.03 CL 109.87 CL 109.52 1• ;} `k EP 110.39 110.03 108. EP 109.73 J EP 100.12 W.M. DJ.EL109.20 } -- -- ---— bi • ' '' ,ty . I pz� DRYWELL 1 j 5 T* t CONC. S.T. 0. " 49.7' ci 3t S� F&JrcfSLAB 18.3''cl10. G 2 STORY FRAME DWELLING i 1(i R F.F. EL 111.9 z, ? O.F. EL 110.2 Ld f d b s z',� R.. R(i�« s 1.4 COM R.O. gip b Te r'1 FpJ.JPOOt 641 E10 u } int z `CL F3, r + d �Q�]}�5 .y�{{{,,.,;• .s �L p,T f well � ,_ ° -2 T-S•- ?• LOT No. 4 40,092 nim LOT No, g. MM . GER C • R (DW-LL-) # ,Lro,,�. FNC. . ;�' +, -,N 15'23 30p W -156.00 .tAfD ' �tNY.• NOT a. . d d I�., .� Lor No. 5 � o r � t (DwaL) LUT N0. 7 F' ,a�,r (DV,ELL) 7'O 1x5 sURwr 4'A VMr�ff 5EC71M .720.4; "�'�^�y�t £IX1G/TDAPJ Nt .rrR'i i�SrA I f G�1PlES��CJFelr?�ifnS S�'��� �Fl/,ll'�IVOr:bYY•.`Z ,,✓�7ys �_f r b>;p • �W LAW , f�Y3CRif art IY of A 1'� llrVfi'.+.. � 4"`..+l Ate• ' �JO 5 `. �r• )n .�yt,A" ELEVA1 M SHOWN ARE Ci1ARArJT££SfiCsl7>:D i 'IF1+lLL'RUN 1N ASSUMED DATUM L7 PR 6 T1�E•A_-' V,dfL1 ,play.TNrr�SVXVEY Ali. SURfiWkOlkC PROPERTIES IMTHW 160' OF PROPOSED SAkiTARY (.QdIPAN GB TQC AMP aSYSTE)I ARE CiOW'IOCTED'TO PUBLIC WATER SUPPLY EXCEPT AS 5NOWW III F.LE7t M0 p i711>hICW�.GISit7�J,iEREG+� AND Nl'rDNd€T�SI_fS AND OFf5E15 SHOWN 71 IFfE�A, GR IXfGIJOdJG`WSIIe �y tip'pD`A '' i 7U7KHfF 6UAP4Fl�S'•ISREyNDr3 RABl� SURVEY OF:�s' ���V,1�;4,(,!.W��.`�c'��-4�g..,r�'C{s�i��;fi=�•ry�t`!'i~�i,� }w '..A ��•.:� v7� -4- { �f w- x'r t.INl, '1'q� T:ESTA,TES. ' �:: t' r�f SITUATED: `,� r� y ` Surveying and Land PlEi7�Il lN.� ¢fATT�jKENNETH H. BECKMAN, tICK" .'' 1 j :li(( �ry�( � ' /�=x .- A} :° 1..•? �� 1814 Middle Cuunk ad I V 07 1814 y' ,, i �•� K Suitt; °? (• .; '' �}� Ridge, N.Y. 11961 suFFouC.c:O� TY.w.NEW?YORK +;.,?c � , : � � `' t ` ,' ; ^3 �•; ' '; FAX (f131) 3 4 5-842 13 j DAZE: e�/nor � ,�c�sfuKo::��r2-:r441a -SCALE.;-�..�• DIST, SEcl �' "BLK., LOT t S.QT.M. NO. 1000 *N ' ,, 'r• SV FWAL ^V 1/16/1014 014-•19446 , tOA ` 0.3 010.4 FOUKDA11ON LOCATION 5/30/2013 810--15095 W. OWILJ a 12/17/2012 B12-14711 V GhQI2012 A fib' 1 r 'r:r'(','`:' ?e:: .�p':r%% � t,{'7/(Lrr'y�Y;a��Np•1 r"`I ,t. t ,a r r :.�.it„�ur+«t�1 lhyzr{r, x 4f� � :,� 'i� } tl •r,� "., �, .'s:,., ,� Lp 'r. SEACT-1 OP ID:VM CERTIFICATE OF LIABILITY INSURANCEDATE(MId1DDIYYYY)09/14/2016 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(les) 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 NAME CT Bagatta Associates, Inc. Bagatta Associates,Inc. P .631-864-1111 Afc No.631-864-8274 823 W Jericho Turnpike Ste 1A arc No E Smithtown, NY 11787 E-MAIL ADDRESS Bagatta Associates,Inc. INSURER(S)AFFORDING COVERAGE NAIC C INSURERA-Wesco Insurance Company- 25011 INSURED Sea Crystal Pools Inc INSURER B. James Vitelli INSURER C: 200 Blydenburgh Rd. Islandia,NY 11749 INSURERD. INSURER E. INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING�ANY REQUIREMENT,TERM OR CONDITION 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.LIMB'S SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS IAIJUL SUbil POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSDPOLICY NUMBER MMIDD MMlDDfYYYY LIMITS A X COMMERCIAL GENERAL•LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR PP119706302 09/10/2016 09!10/2017 DAMAGE PREMISES Ea occurrenceI $ 100,000 X Contractual Liab- MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER GE14ERALAGGREGATE $ 2,000,00 POLICY 0 PEST �LOC PRODUCTS•COMPIOP AGG $ 2,000,00 OTHER AUTOMOBILE LIABILITY . - Ealaccide $ accident) nt $ 1,000,000 AANY AUTO - r WPP119706302 - 09/10/2016 09/10/2017 BODILY INJURY(Per person) $ ALL OWNED - rr �:SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ X HIREDAUTOS AUTOS (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE 4 AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION 3' PER 0 H- AND EMPLOYERS'LIABILITY i , .x ' bl AI U I t tR ANY PROPRIETORIPARTNERIEXECUTIVE' YIN F—] N I A EL EACH ACCIDENT $ OFFICERIMEMBER EXCLUDEG?., (Mandatoryur NH) :, y,' - FI DISFASF-FA FMPI OYFF $ If yes,describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ A Property Section , ,; PP119706302 09/10/2016 09/10/2017 Bldg 41,82 DED:$1,0.00 Bus Inc 100,000 I DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Swimming Pool Installation Service&Repair CERTIFICATE HOLDER - CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. TOWN OF SOUTHOLD . 53095 MAIN ROAD SOUTHOLD,`NY 11971 AUTHORIZED REPRESENTATIVE 7 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD New;York State.Insurance Fund Workers',Compensa`tion&Disability Benefits Specialists Since 1914 CORPORATE CENTER DR,3RD FLR,MELVILLE,NEW YORK 11747-3129 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE (RENEWED) ^^^^^ 030486684 SEA CRYSTAL POOLS INC 200 BLYDENBURGH ROAD STE#4 ,r ISLANDIA,NY 11749 . Scan to Validate POLICYHOLDERsN�,; ` SCERTIFICATE HOLDER` SEA CRYSTAL`°`PQOL,S INC, ;;;h z, ;!'.�j>;-3=Y 1 TOWN OF SOUTHOLD 200 BLYDENBURGIi ROAD': STE#4`" 53095 MAIN ROAD ISLANDIA NY 11749-`4 }+ in a'ss - SOUTHOLD NY 11971 POLICY NUMBER',,' CERTIFICATE NUMBERPOLICY PERIOD DATE 11336,880;8 $ 754670 ,• ;', _+`- 10/19/2016 TO 10/19/2017 10/7/2016 THIS IS TO CERTI,Y'THAT THE POLICYHOLDER--N,AMED,"'ABOVE-IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER$ POLICY< NO�1336 8,80;8,U Q01/ R,ING THE+?,ENTIRE ,OBLIGATION OF THIS POLICYHOLDER FOR WORKERS COf�AP-EN�SAjIONx+U QER?•`fHE RNEW'.-,,YORK,' WORKERS' COMPENSATION LAW WITH RESPECT. TO ALL OPERATIONS,INs,THkfSTATE rO,F�NE)W ORK;,iEXCEPT;sAS:'INDICATED BELOW. IF YOU WISH TO RECEIY,E NOTIFICATIONS'REGARDING SAID POLICY,INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE�THIS CERTIFICATE;VISIT OUR.WEB' TE AT HTTPS:/NWM.NYSIF.COM/CERT/CERTVAL.ASP. , ; THIS CERTIFICATES S.:IS$UED,AS A,,MATTER OFF;INF,ORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE�,,UPQN `THE CERTIFICATE 'HOLDER.,' THIS i CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE',A q])ED, BY THE'POLICY�. !'kli"F C�:j 1*,.�`d+� ..,-.,,'w®,I'?" •:'-,�'s :?' ..'<=,�'r�5¢�+t-�'`y+"•,��� 'rFv'.Y��4"%+5 y.w i:,,;'�s;f.t;' '`x' ry t , , f ' t-'`" ? NEW YORK STATE INSURANCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER:'46069224 r voRwt' 'Workers' CERTIFICATE OF INSURANCE COVERAGE TATE Boardardo 'nSaLlbrL UNDER THE NYS DISABILITY BENEFITS LAW B PART I.To be completed by Disability Benefits Carrier or Licensed Insurance Agent of that Carrier 1a.Legal Name and Address of Insured(Use street address only) 1b.Business Telephone Number of Insured SEA CRYSTAL POOLS, INC. 631-234-7023 1c NYS Unemployment Insurance Employer Registration Number of Insured 200 BLYDENBURGH ROAD SUITE#4 653600 ISLANDIA, NY 11749 1d.Federal Employer Identification Number of Insured or Social Security Number 030486684 2.Name and Address of the Entity requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity being listed as the Certificate Holder) ShelterPoint Life Insurance Company 3b.Policy Number of Entity listed in box"1a": i DBL188483 3c.Policy effective period: I 10/17/2015 to 10/16/2017 4 Policy covers: a. ®f All of the employer's employees eligible under the New York Disability Benefits Law b. 0 Only the following class or classes of the employer's employees: Under penalty.of pedury,l certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has NYS•Disability Benefits insurance coverage as described above. Date Signed 1017/2016' By ! fl (Signature of insurance carrier's authorized representative or NYS Licensed Insurance Agent of that insurance carrier) I Telephone Number : 516-829-8100 Title Chief Executive Officer jIMPORTANT:If box"4a"�is checked,and this form is signed by the insurance carrier's authorized representative or NYS Licensed Insurance Agent -of thatcamer,this certificate is COMPLETE:Mail it directly to the certificate holder if boXF"4b"i is checked,this certificate is NOT COMPLETE for the purposes of Section 220,Subd.8 of the Disability Benefits Law ,It must be mailed for completion to,the Worker's Compensation Board,DB Plans Acceptance Unit,328 State Street,Schenectady,NY 12305. PART 2. To be'completed by NYS,Worker's'Compensation Board (Only if box "4b" of Part 1 has been checked) State of New York — Worker's Compensation Board According to information maintained by the NYS Worker's Compensation Board,the above-named employer has complied with the NYS Disability Benefits Law with respect to all of his/her employees. Date Signed By (Signature of NYS Worker's Compensation Board Employee) Telephone Number Title Please Note:Only insurance carriers licensed to write NYS Disability 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 (9-15) l:f ^'';ir �s,..,ti •F! _esti`S' .Y. ..iyY:, ,. r , : ,• :`:tri-`+,, .\t'}.�y :1 ' - .`.•.—_ SUFFOLK COUNTY DEPT OF LABOR, LICENSING&CONSUMER AFFAIRS }, HOMEIMPROVEMENT - —-------- - p ; CONTRACTOR LICENSE e ! I JAMES E VITELLI ; •' • BUSNESSNAME This certifies that the SEA CRYSTAL POOLS INC bearer Is duly licensed by the E36633-H County of Suffolk02/22/2005 '.DATE 02/01/2019 1 Commlaebnar ' .._- - aP�3,} '•�_7';- _ rn q: 'r;r,•, :';ir '� .,`'r,y• _.. C—.e.., ._..!...._ ._...� _ —_"" .�� - -- `• __ - ( , .�.' air ;'•y��• _' . .1 - L ��, � � ., .'l.;i+fie ` - , f , � ��•�� -+ ' p ,4^, rF qty°Ic ;r. _ r, . n ,.��'' •�'.l ie,i''�;.1"' , , t.,.'u(, ' .:="`„ .+, •ski:. _ _ _ � i:, -r;��v��;�:;��i7,�i"tk'+{q�_ ., ,f,.'a' ,�.+.r;;}�-��"'`''i,^`��if(�r.'.��i:r,�'•^.t��� -���a � � � � �•• - ��, .t` - 'r'< '�o11fd'I;`,{'�h','1 •t .�;2�rF(,i q4 r_A _S:S"z:$ la-<..p •�,r_' 't "r 's' •� S , • { �,r i X01 >,- r� +,�`r'`,1ry^..��t���,• ��h�7t�:dF-r..��`i �riz°tt t;i,'�d�,,'r�s^F';+ 7, � ,, � APPROVED AS NOTIED `-S DATOa—*2 3 a OF 's p --3p .'r. COD FE ,)EPAP �T 11 -14 �I MENT AT NOTI f BUILDING U I R 765-1802 SAM 10 4 PIA FOR THE FOLLOWING INSPECTIONS: I. FOUNDATION -- TWO REQUIRED Hill- FOR POURED CONCRETE HIS I'l, 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETEOR 0. ALL CONSTRUCTION SC HALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR pv im CY DESIGN OR CONSTRUCTION ERRORS j 0 ', UNLAWFUL 444 GERTIRCATE CUI 0 F 0 E QOOL to'CODE cUPAN ENCLOSE UPON COMPLETION BEFORE NOTES: 1. UNSUITABLE MATERIAL SHALL BE REMOVED UNDER LEACHING POOL UNTIL 6' MINIMUM PENETRATION INTO VIRGIN STRATA SAND AND GRAVEL AND BACKFILLED WITH SAND AND GRAVEL TO BOTTOM OF BASIN. CAST IRON FRAME & COVER IF UNDER PAVED AREA FINISHED GRADE 2. AS AN ALTERNATIVE TO THE DOME TOP, A FLAT SLAB CAN BE SUBSTITUTED WITH APPROVAL OF THE ENGINEER. 8' MIN. — 12' MAX. � ` 24' ';�`�ti BRICK LEVELING COURSE-----"L""�MIN�'''I 3. LOCATION OF DRAINAGE POOL TO BE DETERMINED BY OTHERS. CONCRETE COVER 4. ALL DRAINAGE PIPES MUST BE PROVIDED WITH A MINIMUM 2'-0" COVER. PRECAST CONC. COLLAR MAX AS REQUIRED 5. COLLAR IS NOT REQUIRED WHEN RATEABLE MATERIAL EXISTS FOR FULL DEPTH. PRECAST RE INF. CONC, 6. THE MATERIAL USED FOR COLLARING SHALL BE COMPRISED OF SAND AND DOME GRAVEL CONTAINING LESS THAN FIFTEEN (15) PERCENT FINE SAND, SILT AND CLAY. 4'0 PVC SILT AND CLAY FRACTIONS ARE NOT TO EXCEED (5) PERCENT. MIN. SLOPE ER FOOT ® ® ® ®0 INVER ® ® ®p NON-SHRINK � DRYWELL CALCULATION GROUT ®p REQUIRED: 3' MIN, SAND BACKWASH AT 70 GPM X 5 p AND GRAVEL MIN. = 350 GAL. a COLLAR (TYP) o a ALL AROUND cn as PROVIDED: DRYWELL CAPACITY W PRECAST REINF. m = 1,263 GAL. (169 CF) > CONC. LEACHING I-- RINGS oe «J+ � a `Vl W F. W 8' DIAMETER Mo M �> :)w v Za ui •,a;;;.o,..••F-Q a ••e.o•;:•:p ••'•: 'b:••':••O' illy .e'.e ;:Z3 ••:.o•• .••'•6°': ;:a°°• /'�/ z 6' MIN, PENETRATION Fu o INTO VIRGIN STRATA GROUND WATER cz OF SAND L GRAVEL DRAINAGE POOL DETAIL NOT TO SCALE PREPARED FOR: ALBANESE -- -1-835-REEVE ROAD MATTITUCK,'N.Y. 1 952 DATE: 03/16/2017 NOTE: HM ENGINEERINGP.C. SCALE: ASSHOWN , THESE PLANS ARE AN INSTRUMENT OF SERVICE AND ARE THE PROPERTY OF HM ENGINEERING P.C..UNAUTHORIZEDSHEET: 2 OF 2 ALTERATIONS OR ADDITIONS TO THESE DOCUMENTS ARE A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE 3 CHERRYWOOD DRIVE EAST NORTHPORT,NY 11731 EDUCATION LAW.INFRINGEMENTS WILL BE PROSECUTED. 31160111-7 Tel:(516)476-5392 Fax:(631)980-7671 www.hmarnika@optonline.net DRYWELL DETAIL POOL NOTES: 4'x8' 1.POOL AND PROPERTY,TO CONFORM TO 2015 IRC&NYS 2016 UNIFORM CODE SUPPLEMENT SECTION R326 STEPS AND CODE OF THE TOWN OF SOUTHOLD. 2. POOL SHALL CONFORM TO ANSI/NSPI STANDARDS R326.3.1. 3.SECTION R326.7 POOL ALARM REQUIRED. 4.POOL SHALL COMPLY WITH BARRIER REQUIREMENTS SECTION R326.5. 8' S.POOL SHALL COMPLY WITH INTERNATIONAL ENERGY CONSERVATION CODE SECTION R403.10: -- — — -- --__P_OOLS_AND PERMANENT SPA ENERGY CONSUMPTION(MANDATORY). SECTION 11403.10.1 HEATERS SECTION R403.10.2 TIME SWITCHES 40' SECTION R403.10.3 COVERS 6.REBAR SHALL BE 2" MIN.CLEAR TO EARTH. 7.CONSTRUCTION METHODS AND PRECAUTIONS ARE DICTATED BY GROUND AND SOIL CONDITIONS TO BE 20' DETERMINED BY CONTRACTOR. 8.LOCATION OF PROPOSED SWIMMING POOL AND POOL EQUIPMENT BY OTHERS AND SHALL COMPLY WITH ALL LOCALZONING REQUIREMENTS. — — — — — — — — — — — — — — — — — — — — — — — 9.ALL DRAIN COVERS TO MEET ALL REQUIREMENTS OF THE VIRGINIA GRAEME BAKER(VGB)POOL AND SPA — — — — — — — — — — — — — — — — — — — — — — — — — �/ SAFETYACT. r I 10.SLOPE PATIO SURFACE 1/4"PER FOOT AWAY FROM POOL. I SWIMMING POOL 11.BACKFILL MATERIAL TO BE FREE DRAINING GRANULAR MATERIAL(NO CLAY OR LARGE ROCKS). 6 1,080 S.F. I 12.SUCTION OUTLETS SHALL BE DESIGNED AND INSTALLED IN ACCORDANCE WITH ANSI/APSP-7. 13.NO SURCHARGE ALLOWED WITHIN 4'OF SHALLOW END AND 6'OF DEEP END. L_ — — - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - J 14.NO DIVING EQUIPMENT PERMITTED. 15.CONTRACTOR SHALL VERIFY SOIL BEARING LOADS PRIOR TO INSTALLATION OF POOL. 16. THIS PLAN IS FOR CONSTRUCTION ON PROPERTY AT 1835 REEVE ROAD MATTITUCK,N.Y.11952 ONLY. 17.REINFORCING STEEL SHALL BE INTERMEDIATE GRADE BILLET STEEL WITH A MINIMUM LAP OF 30 BAR 75' DIAMETERS. 18.HM ENGINEERING,P.C.SHALL NOT BE RESPONSIBLE FOR CONSTRUCTION MEANS,METHODS,TECHNIQUES POOL PLAN OR PROCEDURES UTILIZED BY THE CONTRACTOR,NOR FOR THE SAFETY OF THE PUBLIC OR CONTRACTOR'S NOT TO SCALE 3.5' EMPLOYEES,OR FOR THE FAILURE OF THE CONTRACTOR TO CARRY OUTTHE WORK IN ACCORDANCE WITH THIS PLAN. 2" X 6" CCA PRESSURE TREATED WOOD 4.5' flrt VINYL LINER 1091 (MIN.) FOAM PADDING d 3,500 PSI CONCRETE 3" COMPACTED SAND a UNDISTURBED EARTH POOL PROFILE 4 REBAR NOT TO SCALE t/2" TO WASTE TOP, MIDDLE A 42" FILTER HAIR & LINT STRAINER & BOT. PUMP PUMP (SEE NOTE #3) e e FILTER AUTO SKIMMER 2.� MID.) d DUAL MAIN DRAIN WITH 3.0' STRAINER (VGB POOL (MIN.) SAFETY ACT 'POOOL TO e APPROVED DRAINS) S) POOL OPTIONAL DUAL MAIN SCHEMATIC PIPING ARRANGEMENT DRAIN WITH HYDROSTATIC VALVE TYPICAL WALL DETAIL NOT TO SCALE AND COLLECTOR TUBE PREPARED FOR: IN GRAVEL BASE SCALE: 3/4" = 1'-0" FILTERED WATER ALBANESE NOTES: RETURN, NUMBER OF1.WALLS SHALL BEAR ON UNDISTURBED SOIL NOZZLES VARIES PER 1835 REEVE ROAD 2.ALL CONCRETE SHALL BE PLACED AS A MONOLITHIC POUR. POOL SIZE NOTE: M TTITUC K Y. 119P2 3.PROVIDE DOUBLE#4 REBAR FOR TOP AND MIDDLE ROW OF 75' DRAWING CONFORMS TO ANSI/APSP-7 SUCTION ' POOL WALL MAIN DRAIN PIPING SCHEMATIC ENTRAPMENT AVOIDANCE CODES. ., NOT TO SCALE DATE: 03/16/2017 NOTE: HM /� SCALE: AS SHOWN ■ THESE PLANS ARE AN INSTRUMENT OF SERVICE AND ARE THE PROPERTY OF HM ENGINEERING P.C..UNAUTHORIZED /�1J✓ / FTel: 1�1y� ENGINEERING, P.C. ALTERATIONS OR ADDITIONS TO THESE DOCUMENTS ARE A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE ?,. /1�j/!'73 CHERRYWOOD DRIVE EAST NORTHPORT,NY 11731 SHEET: 1 OF 2 EDUCATION LAW.INFRINGEMENTS WILL BE PROSECUTED. ` /// 516)476-5392 Fax:(631)980-7671 www.hmarnika@optonline.net RESIDENTIAL CONCRETE �, VINYL LINER POOL PLAN