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HomeMy WebLinkAbout47580-Z �o�'U'Rt,��oGy Town of Southold 7/8/2022 P.O.Box 1179 0 o _ 53095 Main Rd ''✓1 �p���r Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 43219 Date: 7/8/2022 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 11003 Route 25,East Marion SCTM#: 473889 Sec/Block/Lot: 31.4-27 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 6/10/2008 pursuant to which Building Permit No. 47580 dated 3/22/2022 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 around swimming pool with fence to code as applied for. The certificate is issued to Novick,Eric&Martinson,Elizabeth of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 47580 7/7/2022 PLUMBERS CERTIFICATION DATED torize gnature o�Su�Fo1p�o TOWN OF SOUTHOLD �s :may BUILDING DEPARTMENT y TOWN CLERK'S OFFICE oy • o� SOUTHOLD, NY ?sol 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#: 47580 Date: 3/22/2022 Permission is hereby granted to: Novick, Eric 11003 Route 25 PO BOX 243 East Marion, NY 11939 To: CONSTRUCTION OF AN IN-GROUND SWIMMING POOL FENCED TO CODE. REPLACING EXPIRED BP # 36065. At premises located at: 11003 Route 25, East Marion SCTM #473889 Sec/Block/Lot# 31.-4-27 Pursuant to application dated 3/22/2022 and approved by the Building Inspector. To expire on 9/21/2023. Fees: PERMIT RENEWAL $175.00 ELECTRIC $100.00 4 Total: $275.00 Building nspector FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL 'COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 36065 Z Date DECEMBER 3, 2010 Permission is hereby granted to: ERIC W NOVICK PO BOX 243 EAST MARION,NY 11939 for CONSTRUCTION OF AN IN-GROUND SWIMMING POOL FENCED TO CODE. REPLACING EXPIRED BP # 34005 at premises located at 11003 MAIN RD EAST MARION County Tax Map No. 473889 Section 031 Block 0004 Lot No. 027 pursuant to application dated DECEMBER 3, 2010 and approved by the Building Inspector to expire on JUNE 3, 2012 _ Fee $ 250 . 00 Authorized Signature ORIGINAL Rev. 5/8/02 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 34005 Z Date JUNE 24, 2008 Permission is hereby granted to: ERIC W NOVICK � 2G2 � I &aAiZA'16Pq PO BOX 243 EAST MARION,NY 11939 for CONSTRUCTION OF AN INGROUND SWIMMING POOL FENCED TO CODE at premises located at 11003 MAIN RD EAST MARION County Tax Map No. 473889 Section 031 Block 0004 Lot No. 027 pursuant to application dated JUNE 20, 2008 and approved by the Building Inspector to expire on DECEMBER 24, 2009 . Fee $ 250 . 00 Authorized Signature COPY Rev. 5/8/02 l pf SO!/��ol 0 Town Hall Annex Telephone(631)765-1802 54375 Main Road P.O.Box 1179 �Q sean.devlinCa)town.southold.ny.us Southold,NY 11971-0959 Q�y�OUNTY,�� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Eric Novick n Address: 11003 Route 25 city:East Marion st: NY zip: 11939 Building Permit* 47580 Section: 31 Block: 4 Lot: 27 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: AS BUILT License No: SITE DETAILS Office Use Only Residential X Indoor Basement Service Commerical Outdoor X 1st Floor Pool X New 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 1 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 2 4'LED Exit Fixtures Pump 1 Other Equipment: Pump 220GFI, 1 Light 120GFI, Bonding Is Good Notes: " AS BUILT NO VISUAL DEFECTS " POOL Inspector Signature: e Date: July 7, 2022 S.Devlin-Cert Electrical Compliance Form ho��OF SOblyo� SV O loo # # TOWN OF SOUTHOLD BUILDIN DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST ' [ ] ROUGH PLBG. [ ]-. FOUNDATION 2ND [ ] INSULATIOWCAULKING' [ ] FRAMING/STRAPPING [ ] FINAL [ ] FIREPLACE& CHIMNEY [ ].' FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION - [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) j ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: N, 9,4719 74>- G n-� .DATE 17� Z INSPECTOR SOUIhO� * # TOWN OF SOUTHOLD BUILDING DEPT. `ycourm,ti�' 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] SUL ION/CAULKING [ ] FRAMING /STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL ARKS: ut Gt) DATE INSPECTOR FIELD INS ECTION REPORT DATE COMMENTS .b -] t=i Un' FOUNDATION(1ST) coo i 0• ---------------=--------------------- `l FOUN7PATION (2ND) y O H i ROUGH FRAMING& PLUM iNc, i INSULATION PER N. Y. - -- y STATE ENERGY CODE _. r Ml tin Y✓ p � FINAL i ! I ADDITIONAL COMMENTS 3-a rc aS?. I l oo0 - 00 Iola LAP - ec 1o�a5 .� O Z o x i � d i y i I 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 3 sets of Building Plans TEL: 765-1802 Survey PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees Examined �— ,`20 Contact: Approved. ,20 Mail to: Disapproved a/c Phone: Building Inspector APPLICATION FOR BUILDING PERMIT Date c J t IVIP, , 20Qa__ INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 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 throughput the work. e.No building shall be occupied or used in whole or in part for any purpose what-so-ever until a Certificate of Occupancy is issued by the Building Inspector. 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. ALL CONSTRUCTION SHALL OCCUPANCY OR (Signatunr f applicant fname,if a corporation) MEET THE REQUIREMENTS OFT IWE IS=UNLAWFUL g2A Kf 274 Milk< AW 1AJ 11IV CODES OF NEW YORK STATE WITHOUT CERTIFICATE (Mailing address of applicant) State whether applicant is owndoFs °O PAStt Y, enginee general contracto electrician, plumber or builder -Eow-ft o v, .Name of owner of premises &C- C, C h(15-1n� Novi el)C* (as on the tax roll or latest deedw� A PPR -OVER AS NOTED .�� If applicant is a corporation, signature of duly aDuAlEgrizG eer P. (Name and title of corporate officer) FEE:— _— esY: , II 1 NOTIFY BUILDING r1L1 ;'.:;:�i �!T AT `�,•f'`� ��� Builders License No. 443- - 41765-1802 8 AM TO 4 TIM FOR THE FOLLOWING Plumbers License No. 1. FOUNDATION - TWO REQUIRED v, ONCRETE �oj� d ENC Electricians License No. o9l0- 1 ..ROUGH - FRAMING & PLUMBING CIO:rPs SOL-TO CoDV�UfONC- , .OMP.�ETiON .3. INS '' Other Trade's License No. 4. FINAL - COr!STPUCTION MUST EFOf�E.-WATER^ BE COMPLE E r v-O- .. F:^s.------ 1. -- :.., UCTION SHALL MEET THE UNDER. ` 1. Locati�}onzof land on which proposed work��1 V �: ;: ,gip p VaJ I\ L� REQUI{� N11i E :sr °ir�T1I11�O, r' V I IAL-01 V1 House Number Street YORK ' DESIGN OR CONSTRUCTION y-3A(3IA .A T38AORAW, County Tax Map No. 1000 Section 31 Block ,a� �1�o s$��1;'� cj)dLzerlall Subdivision RETAIN STORM-WAT t E•".=3t}iQ (Name) PURSUANT TO CHAPTER 36 ;li u OF THE TOWN CODE. �;,isr���Zigx3 noi2zirn�0:7�.re1 2. .State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy 2 b. Intended use and occupancy f: 56wQ11J1ytL1 6W- M" mli^jo )9W L 3. Nature of work(check which applicable): New Building . Addition Alteration. Repair Removal Demolition Other Work L► e�,yN p �wimmPOO c- (Description) 4. Estimated Cost 4H, 000 - Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units 1JjA 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. MIA 7. Dimensions of existing structures, if any: Front `72' Rear 72r' Depth 310' Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories p� 8. Dimensions of entire new construction: Front 2-01 Rear 40 ` Depth Height Number of Stories 9. Size of lot: Front a03' Ream �0�� 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: �l'1 13. Will lot be re-graded PM1, d k Will excess fill be removed from premises: NO ES 14. Names of Owner of premises ECAC d-6k1C►�?Je_ i r ddress l 10e 3 1 na ,' ec, Phone No. 4 77-5q 2q Name of Architect`-fl� 0 (le,kl P� Address 4 kezei Ln) 611'11170Phone No `7_q-7HS- Name of Contractor A-c-,*,%- r Na ros Ro,s- Address 92g 2•+ 2T,4 Phone No. _71N-1 lis • i1lnl,iec�(�ittee., ll7e'{ 6 u, :• 0 15. Is this property within 100 feet of a tidal wetland? *YES ` t " `NOi • IF YES, SOUTHOLD TOWN TRUSTEES .P.,ER1yI'I,TS,MA.'Y BE REQ.U.IRED 16. Provide survey, to scale, with accurate foundation plan�'a111nd distances •tolproperry lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF ) G7, )" �' O WAiOS being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) aboov.e,named, (S)He is the W � (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.fi the,mann6f'set,forth in the application filed therewith. Sworn to bef6re•!he t�lus )0 ._d ay of 20Q d otary Public Signatur f Applicant MARGARET A. KIDNEY Notary Public-State of New York No. 01K1602111�1rl1�,4Y?j 1,+.;r r� ,� -•-. Qualified in S , - "i +J;} Suffolk County� iii:a ;=;d•(`�,'�t i;) �.• My Commission Expires March 8,20 S —msf old �2)1Do �JUuthold, DEPARTMENT- Electrical Inspector i� TOWN OF SOUTHOLD H h �ih I�QEr�n Hex - 54375 Main Road - PO Box 1179 o _ app New York 11971-0959 souTt-ft phone (631) 765-1802 - FAX (631) 765-9502 1 " rogerr(a).southoldtownny.gov - seand(c-southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All information Required) Date: Hl;,- t)31 poaa, Company Name: � 4r✓+.cr' Electrician's Name: License No.: Elec. email: Elec. Phone No: ❑I request an email copy of Certificate of Compliance Elec. Address.: JOB SITE INFORMATION (All Information Required) Name: i�ntc. /tlovtck Address: 1 ( 003 r-k)'0- /f/. Cross Street: tX11e Grp. Phone No.: 9/ [-VI Bldg.Permit#: �j email: ,UpVlc/e&c- c Tax Map District: 1000 Section: 3 ( Block: Lot: -? 7 BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): 16- Square Footage: Circle All That Apply: Is job ready for inspection?: YES ❑ NO ❑Rough In ❑ Final Do you need a Temp Certificate?: ❑ YES ❑NO Issued On Temp Information: (All information required) Service Size 1.Ph' FI.. . 3 Ph -Size: :- A. # Meters Old Meter# 0 I.E]New Service❑FireReconnect❑Flood Recorinect❑Service Reconnect❑Underground❑Overhead # Underground Laterals 1 2 H Frame Pole Work done on Service? Y ON Additional Information: PAYMENT DUE WITH APPLICATION � O �V1 old o SUEFQ�,� i�. rte. +i- ' L� FG DEPARTMENT- Electrical Inspector� is . TOWN OF SOUTHOLD TgWn H r�nex - 54375 Main Road - PO Box 1179 o uthold, New York 11971-0959 �oU Pphone (631) 765-1802 - FAX (631) 765-9502 1 " rogerr(cDsoutholdtownny.aov — seand(cD_southoldtownny.gov APPLICATION FOR ELECTRICAL-1NSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: ptl?-- a ) , )o la, Company Name: -cam Electrician's Name: License No.: Elec. email: - Elec. Phone No: ❑I request an email copy of Certificate of Compliance Elec. Address.: JOB SITE INFORMATION (All Information Required) Name: J�ntc- /(/o yr ck Address: I ( O©3 r-k i%J E. /V Cross Street: cT'�,Cl zet. Phone No.: 'g-1 Bldg.Permit#: Cj email: A)pV1ckf&,4tG .f�ofl, co Tax Map District: 1000 Section: 3 ( Block: t-( Lot: 7 BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Square Footage: Circle All That Apply: Is job ready for inspection?: YES❑ NO ❑Rough In ❑ Final Do you need a Temp Certificate?: ❑ YES❑ NO Issued On Temp Information: (All information required) Service Size❑1 PhF]3 Ph Size: A # Meters Old Meter# ❑New Service❑Fire Reconnect[]Flood Reconnect❑Service Reconnect❑Underground❑Overhead # Underground Laterals n 1 FJ2 0 H Frame M Pole Work done on Service? Y nN Additional Information: PAYMENT DUE WITH APPLICATION C., Erosion, Sedimentation and Storm-water Run-off Control Plan ASSESSMENT FORM Yes. No. EXEMPTIONS:. — A. Does.this project meet the.minimum standards.for classification as.an Agricultural Project. Note: If you.answered.Yes.to any.of the.above,a.Storm-water,Grading,Drainage.&.Erosion Control Plan is not required. ------------------------------------------------------------------- ACTIONS.REQUIRING THE.SUBMISSION OF A STORM-WATER, GRADING,DRAINAGE &EROSION. CONTROL.PLAN,CERTIFIED.BY A DESIGN.PROFESSIONAL.IN.THE.STATE.OF NEW.YORK.. Item Number:. (A Check Mark (J)for each question is.required for complete.application). Yes.• No. 1. Will this.project retain all Storm-Water.Run-off generated on Site? (This:will include.all run-off created by site clearing and/or coristruction activities.as.well as.all Site.Improvements.and the permanent creation of impervious.surfaces.). ✓. 2.. Will this.project require any land filling, grading or excavation where.there.is.a change to the natural existing grade.involving more.than 200.cubic.yards.of material within any.parcel? K Will this application require land disturbing activities.encompassing an area of five.thousand(5,000)square feet of ground surface.or.more?. . 4. Is there.a Natural Water.course.running through the.site.or is.this.project within One hundred(100).feet'of wetlands or a beach? ❑ 5. Will there be site preparation on slopes which exceed fifteen(15).feet of vertical rise to One.hundred(100).feet of horizontal distance? 6.. Will driveways,parking areas or other impervious.surfaces direct Storm-Water Run-off into.and/or in the.direction of a Town Right-of-Way? 7. Will this application require the placement of material,removal of vegetation and/or the construction of any.item within the Town Right-of-Way.or road shoulder.area? (This.item.does.not include.the.installation.of driveway.aprons.). 8. Will there be.site.preparation within the one hundred(100).year.floodplain of any watercourse? y.. Note: If.any answer to.questions one.through.eight is.answered.with.a check mark in the.Box,a Storm-water,Grading, Drainage&.Erosion.Control Plan is required.and must be.submitted for review prior to.issuance.of any building.permit. ------------------------------------------------------------------- STATE OF NEW YORK, COOF............� C .................. ss That I. ............... .. .. ... :.. �1�1QS...........being duly sworn, deposes and says that he/she is the applicant for Permit, (Name of individual signing Document) Andthat He/She is the ......................................... .&.-.!t -............................................................................................. (Owner,Contractor,Agent,Corporate Officer,etc.) Owner and/or representative of the Owner or Owner's,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 belier;and that the work sill be performed in the manner set forth in the application filed herewith. Sworn to before me this; l � �Uu.w ....................!0...... ......day of..... .....................06. ..... Notary Public: ................... (/ �c:........... •• MARGARET A. KIDNEY 'Notary-Public—State of New York..•..•••.... . #ofpl�icant) No. 01 K16021 I I I igna .Qualified in Suffolk County My Commission Expires March 8,20j,L �o��®f SOUPyQI 0 Town Hall Annex J Telephone(631)765-1802 54375 Main Road cn -*AC Fax(631)765-9502 P.O.Box 1179 �Q Southold,NY 11971-0959 Q �yCOUNT`I,� BUILDING DEPARTMENT TOWN OF SOUTHOLD FIRST NOTICE October 19th, 2010 Eric Novich Elizabeth Martinsen P.O. Box 243 East Marion, N.Y. 11939 RE: 11003 Main Rd. (IN-GROUND SWIMMING POOL) SCTM: #1000-31.-4-27 To Whom It May Concern: Please be advised that your Building Permit # 34005 issued June 24th, 2007 has expired. According to the Code of the Town of Southold, a Certificate of Occupancy must be issued before use of the structure. To renew your Building Permit, please submit a fee of $250.00. At that time, we can schedule an inspection by one of our Building Inspectors. `LE EE - 01MIMII!N- P-WL 60p.E-- If you have any questions, please call us at 765-1802. Respectfully, SOUTHOLD TOWN BUILDING DEPT. Am rvE it `;n --% pi I lx"Ali.A A 0ld k M A-A I, fj 0 M., "M" 14 Suffolk Co-untyExecu.-Me's Office of Consumer ArTa-Irs0- rs VETERANS MEMORIAL HIGHWAY HAUPPAUGE, NEWYORK 11788 ............... DATE ISSUED: 5/1/80 No. 2740-ME ---------------- SUFFOLK COUNTY Master -L-tectric-ian License This is to certify that EDWARD S REIFF doing business as UNDERGROUND SPECIALTIES INC having given satisfactory evidence of competency, is hereby licensed as MASTER ELECTRICIAN in accordance with and subject to the provisions of applicable laws, rules and regulations of the County of Suffolk, State of New York. SUFFOLK COUNTY EXECUTIVE'S OFFICE OF CONSUMER AFFAIRS Additional Businesses MASTER ELECTRICIAN NMr IFF EDWARD S RE mmc This certifies that the UNDERGROUND SPECIAL-nES INC owygL OZ. bearer is duly licensed r by the County of Suffolk Lk—0-� 2740-ME 1980 1-Director 05/01/20.10 4- � � •O' 4 �' ''� `!''�'r ,' Zd`yhY.Iirr LH' if .+'IA}S}rr..�lN:rM,`�J iriyy r! \.. I l; '''''"� �� ..9r^ '+t�%�a I/O�` �� rf�' .;� \,,�.,' r r� ;�> �+ -!%�':�\�,,'s.:�� �;*�>P•: � r.-s 4 n?'� f,. 'Wawl r ti�' w } Pr�, �: tV•;4`P HW'S'.h. 4'�'rA` �: �' r i d e'xw� '�V?}Ni "`�t!}' •/t� '' �: t r r �t � ..f ,! a•. �'v rvvxz ,wrzS"�r'i a� '�•`�v vyVP`,.`��,}:j.: y� P <� ,+�N' �\ Yv v •4 IP �!�IP I! d r r,�.fr� ��`PY t�'P.t,r�itYIP'e� i•-' ��i`�ril+f'.•��,'�"' I �`�,i... /t t J \• 5<'��Y` •�1�\`♦ f 4:� 4'l l) 'V�.� �r .. t$S� �� ��r .� G •y > Y� JAN l°r,r A• ;�Qq�,W�,/Y'r'1 1� t�A�': r Ya,, v�{YIPi^%A ��y�r y fiyhr �'1+ 'y/� ,rtj 0 0 o t YN �? ,p� ���ir ' �tCa�T/. .�: � ,� .,�`il t� �f•, k •rr•/ .f ��f����ti`'rJ,`�./of`{/' o �Fi a�i� O�I.h�,.'.s P;C�,+ �• oil yl '•n''4.a'�'ryP• yi„t Pry + 'P� - r/�y. c- r,• 't ��- r/1R�9F`y`��i .• '7��,.a /�. h. ,� C�*"'9/�,(�. ti �l •'•'14c.✓/� '/'' .a,4�•� .!'.,y'•'' Y a�ti .may ,'F" /.\;.fr'v�wayRyd''ii?'4 ':r° > 'y�,,,�$ 9':......�. _ 4 t e Y y.., .� •n� '•h; r /�?17 d` /'i;7 ��\ �� is-�, :• �!.. //// '�Y.:9///ii -���!eiv� Y��^'��1,.f'� t�' S+f..2%?-a. > Suffolk Cou-nty ExecutlVe s Office of Consumer Affairs - - VETERANS MEMORIAL HIGHWAY HAUPPAUGE, NEW YORK 11788 DATE ISSUED: 7/1/78 No. 4436-H =� SUFFOLK COUNTY . �. mon-•e .T repro veill.ent' Contractor License This is to certify that ARTHUR J EDWARDS doing business as ARTHUR EDWARDS MASON CONTRACTING INC n 1z�ivit7 l u} Licht-_ <��'� reci—a ements set for u1 in accordance wAh and subject to the provisions of a licable laws, g _ j P PP S. > `` k, York is hereby licensed to conduct business as a =: Qom - 1 _sem fZiil Ltcl�s V: ��c. Co�>nt;V �Jf SLifiO� State of 1 � -: HOME RvOROVEMENT CONTRACTOR in the County of Suffolk. SUFFOLK ti r ' K COUNTY EXECUTIVE'S i i Businesses OFFICE OF CONSUMER AFFAIRS Additional HOME IMPROVEMENT r CONTRACTOR r LICENSE •h��+C�S-,• NAME ARTHUR J EDWARDS - h:-y This certifies that the "E�NAME ARTHUR EDWARDS MASON i �� •5.- bearer is duly licensed c - c� CONTRACTING INC . by the County of Suffolk ucroseNunez oeelssu.a ,� -------- ,�#��• .. 4436- 07/01/1978 Director , ot.a.r ExRwmoN ogre %y,.. 07/01/2008 .:rf n Fra. .• l',t5 �r.�'` �,.1 P \,i• f;, ��...�s �. .i /li�ti" r,� :iy, 6' � .4 �. �>: ��'. �-.r � 1;i s3• _ `:� ..o �t 1: 'h• -,I'' .� \.., \_'•� 1 ` '? /->. %•�'('`'=-. } -�,. ;s1 �1.�.: \ "'>,�,.: ;�\F T1•a•�`, e3�.s. ,`_sem-„•.,•. � 1 b... t:u�'!YaY!h. ��'F.lP �`. `'a .7•, 'l. � ��,.. o -0!d e„d\ ::�. :-; �..�2'`.'4�','.• �7..,\b ..1.,p .rc "rte' - nom.”' `�' i.`�I. �Y ..i..�C _ 'tit t, r rs �•4 I „ - '�`.. 1 A I L. A 4��7'r i .� . •r<:�Q�•` y.9 .a..F, ,,:� r� ,'.rr'6:�, - s d �'` t r`./ .:/i :,� k , r �.r .'� i3.r .'((�� ,h -.•�. ^9: '`•y /"Y 4 r�\•r�.r •��j,,,gq1'.•4T1`t'--:1 4... �i '/.,, ,A1W m' r4.r,C`. O.trr•JI'RH.le.M..J11��'I'I..i..TI P 'I.Y Y:', 1 1• I hr. ,�N .rl.P” �:3'i/'1`ii" J�.t� ��,*J:.•: �• ♦'l. .P r' �Y. MLS q'\�aY ��w �> 4. ".. r.� '{Y ¢ . •U�WYrW.:: P A14.j.,•-r'Urjy"}l''h..J, cB�!' �. y....•. , �.''/y oSi ah' vM1..L..`.,,,Ar. .tYt6... aNglll 4-r.1I;AAk.fwl,,h�. J�'tq'llfy ll;�,.,:A r.t�Yl;,;+1r'.%/a.i Cv.7 \..•..f1l`.:1•I�'',,.,•..II 4V►�"U'•.a,rJl.oA9l yll;.:l�Pc4i'4V.>t:l'i�'.. 64 r .:s . �'rr��. -Yr�O� yr .�U. ;�r oyL}•.�'wry x •"4�M1•rl�.v IJ�:��v..J .,'i,lY•pry 4.,<q.�C':YM iyir!V'.`s".oryl�•IkjJ�. :YrK411iro a'r...��f,�S4""/••�'1�".yv}�iPV'I.<[a'Vd�E.+i�Yt�J . ytle.>/:,,":.Ptr. o :<aNf YYh�tit.11�y�P�;q� .�.h s.,,' .�f.Ali7.•.� V.QD�,� ?f:. *1j �?NtiiS'.'r� `�\ 4i �ti\C;.. 'NX�YQ.^:7'S• `�`'�f{yHt.0<J5.wSy/`?dJ.'l4 •f;�,'rr;Mj,•1�}..�,+.dN, ,���.Y ...�3 moi.�:S o- V�¢'u 6�{�v..A rWi•l'y� .;h41�< 'la.;�to- ti:�•��. r uA% 3• fp��V ti.\ 1, i 4Avh���' r4;4VdfT ✓6"$�N'}+�ti.ilyr{.Y.Oti,2��' :r� ��Cs err,•Ivh��\ r�irM� ��A4 ke°vr�laliyirf yttf�@F j p.. .' s. `I t� / \ fv4,, f• .�\ ! ,+; y.r�.}Ir//,A.��' fl{Ayf'h�•'�i dy42S. r'�+y�}� 3fr�::i'�;V+��'r tf �'•f�rt�''•1r` l �64in�'`"" Y CY.`.� "�"Y�:E 1 f 4.'a •lt. t. .{�{� d��� A r 1 f..�f A.,•,� ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID VM7DATE(MMIDDNYYY) ARTHU-1 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Bagatta Associates, Inc. HOLDER.THIS'CERTIFICATE DOES NOT AMEND, EXTEND OR 823 W Jericho Turnpike Ste 1A ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Smithtown NY 11787 Phone: 631-864-1111 Fax:631-864=8274 INSURERS AFFORDING COVERAGE NAIC# INSURED Arthur J Edwards Mason INSURERA: Worcester Insurance Company 26182 Contracting Inc DBA: INSURER B: Arthur J. Edwards Pool & Spa Centre, 593 Center LLC INSURERC: 929 Route 25A INSURER D: Miller Place NY 11764-2700 INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INbK AYDEPDEYDLTRNSR TYPE OF INSURANCE POLICY NUMBER DTEMMID� ATMMIIDIY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $1r000 000 A X COMMERCIALGENERALLIABILITY MPABG0912 01/01/08 01/01/09 PREMISES(Eaoc'crance) $50,000 CLAIMS MADE Fx]OCCUR MED EXP(Any one person) $5,000 A X Contractual Liab PERSONAL&ADV INJURY $1,000,000 A X Blanket Addtl Ins GENERAL AGGREGATE s2,000,000 GEHL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $2,000,000 POLICY PROJECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS • BODILY INJURY $ SCHEDULEDAUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR LICLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WC STATu--T--TMFP WORKERS COMPENSATION AND TORY LIMITS ER EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER A Property MPA8G0912 01/01/08 01/01/09 Building 919,000 A Inland Marine MPABG0912 01/01/08 01/01/09 Ded 1,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION 0000000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 15 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Town of Southold IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Town Hall P.O. BOX 728 REPRESENTATIVES. Southold NY 19971 aN ACORD 25(2001/08) ©ACORD CORPORATION 1 This certificate is an original. State of New York Worker's Compensation Board CERTIFICATE OF PARTICIPATION IN WORKER'S COMPENSATION GROUP SELF INSURANCE Ia.Legal Name and Address of Business Participating In Group Id.Business Telephone Number of Business Referenced in"la". Self-Insurance(Use Street Address Only) (631)744-7185 Arthur J. Edwards Mason Contractor, Inc. DBA:Arthur Edwards Pool&Spa Centre 929 Route 25 A le.NYS Unemployment Insurance Employer Registration Number of Business Miller Place, NY 11764 Registered in Box"la". 1b.Effective Date of Membership in the Group 4/24/2002 24108715 Issue Date 6/10/2008 Expiration Date 6/9/2009 lf.Federal Employer Identification Number of Business Referenced in Box lc.The Proprietor,Partners,or Executive Officers are ® Included.(Only check if all partners/officers inluded. 111277925 All excluded or certain partners/officers excluded. 2.Name and Address of the Entity Requesting Proof of Coverage 3.Name and Address of Group Self Insurer. (Entity Being Listed as Certificate Holder). Town of Southold Special Trades, Contracting And Construction Trust Town Hall 6250 South Bay Road PO Box 728 Syracuse,NY 13039 Southold,New York 11971 Policy:W521504 This certifies that the business referenced above in box"1 a"is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law as a participating member of the Group Self-Insurer listed above in box"3" and Participation in such group self-insurance is still in force. The Group Self-Insurer's Administrator will send this Certificate of Participation to the entity listed above as the certificate holder in box"T'. The Group Self-insurer's Administrator will notify the above certificate holder within 10 days IF the membership of the Participant listed in box"la"is terminated. (These notices may be sent by regular mail.)Otherwise,this Certificate is valid for a maximum of one year from the date certified by the group self-insurer.'. If this certificate is no longer valid according to the above guidelines and the business referenced in box "I a"continues to be named on a permit, license or contract issued by the certificate holder, the business must provide the certificate holder either with a new certificate or other authorized proof the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury,I certify that I am an authorized representative of the Group Self-insurer referenced above and that the business referenced in box"la"has the coverage as depicted on this form. Certified By: David Francey (Print name of authorized representative of the Group Self-insurer) Certified By: a 6/10/2008 I Of (Signature) (Date) Title: Trust Admin/ rator Telephone Number: (315)699-8475 GSI-105.2 (2-02) Worker's Compensation Law SUR\/EY OF PROPERTY N SITUATE: EA5T MARION TOM: 5OUTHOLD °r F°r er,y �N y��y �Ow Atte SJFFOLK GOUT 1y v !Y I '' °O'\ 3. e\\;rea "eu r SURVEYED 10-03-00 AMENDED 03-2q-01 04-24-01, 05-25-01 FINAL SURVEY 03-31-2005295 A2 N �Q�`q� SUFFOLK COUNTY TAX # �� v q 1000-31-4-2-1 025'�� � �� 0����o @ 9,. o E�, /r/ p•��'' N yrl l ` 1 I de mood ck ' r`e�P�•i• ?tli Krl', so po[lo I 5CeP5 Steps. 1 o lY 2 Story Masonry .. IT, s1• i pol''' stone wall ! I � �A. So`v Q , . 0 Cil q' CJ q°\2�5�"� q` p Y s �. . 'q,\250 tnter\y N_ Of F°'°Gk OVA cxkp 2 e � 90 Ns ♦N .Q I oto N °� ♦, _=- , ,,3E F;-JEALITH SERVICES • S� �♦ ,:}:']r::.,ct,r�'�"yi' ��•:�.., r Ci.�.. .:....'i',`,i f'C:•:J 1"ti.sil I i tL Q�Y ♦N 1 �r. Y - .i.�r7!�.�,1 ,, r _. a�}'; -'.4,,.hili\ii ::i�F+,'', i:f.c i�I''+� h{:`r v i}l:l-:: N° ♦ lV,`.d�dfkaa%:sd7�5�s,�i•i4'I':DrZ: s:..:ii.��'''.�7e9�U�lifi Q \ CERTIFIED TO: ti f �,� �; ( ♦ ERIC NOVICK nI u u u- .I � .•:..:, ,,, CHR15TINE M. NOVICK CHICAGO TITLE INSURANCE GO. JUN 2 4 2008 i I 1 ,; ir f � v,wuwm:va puerotlon or odonan to o x+vcy • lc—a Ii eL Ila o — X-01. n°°pewlnuar�pl, -12ntl0,S p-IvpSlnn 2.11 Ila 7•Ln-C J---n I _ ♦ y r G-..':.,•(,,r' - ' nn.,rare state ea.Lpuon Lw: r±o OF SCL1TH0L�J �9 t y .�, -pi- -I.. pinemr.-,a..Ith rn prlgh,pl nr Ine lana,I,.veypr NOTES: ♦ .' l _ .: fJ. StRroca>eal hall to Lpnl aerea it,pe t— Th ♦ i�� s'eenlncatlwn.rakpteo lereon elg,lry enol IN.� i a q•atl br pLLP'aanLe nl'l tM e MONUMENT ♦ �. ;. ,.4 ,I y woe o r oLllLa rw«tl 5—, ptlopteG ♦ ,-6}t'.R ' L. W re nen fpr•51.1.A„ptint-or ProrpMlp,al 9 '�; x,3,v,w`. ,:.. Awa err-rpyors.Soya cenlr¢tlpon,,non rvr wy O - ,l. ,t'4 ., l,`,<- Ie M vena•rn nnrar,Iro orrwey w p•ovaretl.[ ^bvye�? na w.ln,uemlr:a u:e lrue coop nrn:�n•t PIPE �” r n � �� �.1 n^c ♦ ``�a '•;;,11I,.•�- - _ al age y lentlhy m,IINIlw1 h,°o brew,,ar,a STAKE FSS : D w o,s g ene ar!le la ong m,nwpon. eeruraa- 4r "u; ..a 3Outw1 :lwo we ml prm,rerwle anwuwrrn e,eut•l1G•„ 1 Y�� AREA = 4,,1,5 S.F. JOHN C. EHLERS LAND SURVEYOR GRAPHIG 5GALE 1"= 40' 6 EAST MAIN STREET N.Y.S.LIC.NO.50202 SRI•��' RIVERHEAD,N.Y. 11901 369-8288 Fax 369-8287 REFA\Hp server\e\2000 pros\20-257fd. ssnoos o.st•ssr.t .a...e.,e aoo o,ua-2sne A Skimmers Returns I L > B /Aluminum E F B To Filter From Fllte ' Filter do Pump To WRetums (Dry Well OpUnao Plan A Ra Wal Foa Piping Arrangement Wall Section Vl* Un /4 Rebor 42" Sond—/—/ Section B—B 2' 3500 Pal.Concrete H Section A—A Typical Wall Section SIZE A B C D E F G H AREA CAP. FEET FT. FT. FT. FT. FT. FT. FT. FT. SQ.FT. GAL. Purc*aw 16$32' 16' 32' 8' 14' 6' 4' 4' 8' 512 19,000 ift 16'$36' 16' 36' 12' 14' 6' 4' 4' 8' 576 21,600 - &SPA CENTRE "dam°°° PERMACRETE WALL SYSTEM 18'x36' 18' 36' 12' 14' 6' 4' 5' 8' 648 24,300 929 Route 25A Miller Place NY 11764 city tt stet. 20'x40' 20' 40' 16' 14' 6' 4' 6' 8' 800 30,000 (631) 744-7185 FAX (631) 744-0174 2444' 24' 44' 18' 14' 8' 4' 6' 10' 798 30,000 Suffolk License #4436-HI Phone ZIT) code 2448' 24' 48' 20' 16' 8' 4' 6'- 10' 900 30,000 Nassau. License #HI74450000