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HomeMy WebLinkAbout48687-Z .'afO(.-cam out Town of Southold job oGy� 4/13/2024 P.O.Box 1179 0 o _ 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 45119 Date: 4/13/2024 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 1100 Alvahs Ln. Cutchogue SCTM#: 473889 Sec/Block/Lot: 109:-2-18 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 11/9/2022 pursuant to which Building Permit No. 48687 dated 1/4/2023 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 Compagno,Alexander of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 48687 8/30/2023 PLUMBERS CERTIFICATION DATED r 0- - Autho z s tore �J �O�g�FFDl��o TOWN OF SOUTHOLD ay BUILDING DEPARTMENT H r 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#: 48687 Date: 1/4/2023 Permission is hereby granted to: Sawastynowicz Fam 2012 Irry 1100 Alvahs Ln Cutchogue, NY 11935 To: construct accessory in-ground swimming pool as applied for. At premises located at: 1100 Alvahs Ln. Cutchogue SCTM #473889 Sec/Block/Lot# 109.-2-18 Pursuant to application dated 11/9/2022 and approved by the Building Inspector. To expire on 7/512024. Fees: SWIMMING POOLS-IN-GROUND WITH-FENCE ENCLOSURE $250.00 CO-SWIMMING POOL $50.00 Total: $300.00 Buil ing Inspector o��OF SO!/r�,ol � o Town Hall Annex Telephone(631)765-1802 54375 Main Road P.O.Box 1179 Q sean.devlin(aD-town.southold.ny.us Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Alexander Compagno Address: 1100 Alvahs Ln city:Cutchogue st: NY zip: 11935 Building Permit#: 48687 Section: 109 Block: 2 Lot: 18 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: Electrician: Peconic Bay Electric Corp License No: 46360ME 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 Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt 1 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 Transfer Switch UC Lights Dryer Recpt Emergency Strobe Heat Detectors Disconnect Switches 1 4'LED Exit Fixtures Sump Pump Other Equipment: Pump 220GFI, Heater, Salt Generator, 1 light 120GFI, Time Clock Notes: Pool Inspector Signature: - Date: August 30, 2023 S. Devlin-Cert Electrical Compliance Form 0E S0Glyo� 4 aU Alv,4 4A # TOWN OF SOUTHOLD BUILDING DEPT. �yco 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION LECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) ] CODE VIOLATION [ ] PRE C/O [ ]' RENTAL REMARKS: ♦�� DATE INSPECTOR d ` drol 0FS0UlyO� J VV 1 # # TOWN OF SO HOLD BUILDING DEPT. cou 631-765-1802 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 [ ] PRE C/ [ ] RENTAL :REMARKS DATE INSPECTOR OF SOUTyO� Lt 6 C f'Co 7 /1 cc) 41v""X - * # TOWN OF SOUTHOLD BUILDING DEPT. co 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. j [ ] FOUNDATION 2ND [ ] INSULATION/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 REMARKS: �— g� n c, DATEZ'� INSPECTOR 25�� NOF SOUly�lo # * TOWN- OF SOUTHOLD BUILDING DEPT. couto, 631-765-1802 INSPECTION [ ]. FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ v 1FINAL 19,ro [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: 'passive, ri e ej s be la".ed- I- Lo6 lam. se&u 2, kea.,5 6+1` w►r- i4e,s k- R14 h9)44A_ g-0-41 40 5�wuze.. 06 "uss — DATE /l-a a3 INSPECTOR OF SOUTyO� # * TOWN OF SOUTHOLD BUILDING DEPT. cou 631-765-1802 gwr INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] SULAT N/CAULKING [ ] FRAMING /STRAPPING [vj FINAL P4 �� [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION ,{ [ ] PRE C/O [ ] RENT L REMARKS: Svr&� lkgAvv, tv li'/+, Wov (Aff wd qf ov -g DATE 3119 INSPECTO �7 Cj\l r �` � '. it t "+f^?—... � 9 r"` ���• - wer .. -vim, �^ ir" _,.... 7. �♦• w 7 =0 SCE 9 Ll L iyj _ c+:c, r a� r !sue, i�f+1�fL�• I� '•`f ri�w�y A f ... - < r � w r err f ., L• t� �;- ` � .cam Y. ,.....�! �" .. _ { • �_ r • � SAS':�"'���` � III FIELD INSPECTION REPORT DATE COMMENTS 6- FOUNDATION (1ST) y --------------------------------- .FOUNDATION (2ND) — z -- o ROUGH FRAMING& y 0 PLUMBING -� 1 o@ r INSULATION PER N.Y-. y STATE ENERGY CODE l�• •�3 s WpAkeies e - coL) . passive &; e- nea5 e 144dQA v Se-vie. A-Aea m IA)itzc FINAL 06 AccesS - -J-o t�6c.�vle- . 2 wc4c-' a.la, m oc . aS s tinW C�hcs1^ da+eJ q 2-1 ADDITIONAL COMMENTS 2 CAY- L Re clt 1059!944-Vol ' - L-5 -a3 r6p - G0 aa tp- - db-8ctaS 2 is ar ess ter H Z. C H TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone(631) 765-1802 Fax (631) 765-9502 hops://►1rz��x�_soi�tr'�aldtonn .�otiF Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only PERMIT NO. Building Inspector. � : . • � Applications and forms must be filled 0 9 20�2ed out in their entirety.Incomplete �P;,. , applications will not be accepted. Where the Applicant is not the owner,an Owner's Authorization form(Page 2)shall be completed. TO, Date: 1/ 7 ZZ OWNER(S)OF PROPERTY: Name: /e-y��� n SCTM#1000- /ZJ 9 Project Address: K � � zu�a Ny/fg3S Phone#: &V&- g-?Z-f 2 917 Email:c Texan e�rrr�aSnoc L,il�ol,ev� Mailing Address: :S, CONTACT PERSON: Name: e Mailing Address:r7,v M73S Phone#: 3/^�/br - � TErnall., o�C(n 4vlGa�cS���r�1 i vV- �+ DESIGN PROFESSIONAL INFORMATION: Name: Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: Name: - Mailing Address: 10,4 A)Y /193S Phone#: (g 31 -`f�5/-�/2:�.5 Email: !36i' 1 jV63c?+on 1, ,rye o rl e+ DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ❑Alteration ORepair ODemolition Estimated Cost of Project: JXOther Toe.)) $ �,SouO.06 Ej:llthe lot be re-graded? &Yes ❑No Will excess fill be removed from premises? OYes 21Vo 1 PROPERTY INFORMATION FExistingf property: / Fn ��!&:s Intended use�oyf property:!th I MM,rr Zoneor use district in which premises is situated: Are there any covenants and restrictions with respect to -Lo-fir a., this property? ❑YesMft IF YES,PROVIDE A COPY. , X&Me&BOX After I$P.BES$titg: The ownericontractorMesign professional is responsible for all drainage and stonn water issues as provided by {hapter236 of the Town Code.APPLICATION IS HEREBY MADE to the Building Department forthe issuance of a Building Pennitpursuant to the Building Zorn: Ordinance of the Town of Southold,Suffolk,County,New York and other applicable laws,Ordinances or Regulations,for the construction of buildings, additions,alterations or forremoval or demolition as herein described.The applicantagreesto complVwith all applicable laws,ordinances,building code, housing code and regulations and to admit authorized inspectors on premises and in buildings)for necessary inspections.False statements made herein are punishable as a Class A misdemeanor pursuantto Section 210.45 of the NewYorkState Penal Law. Application Submitted By(pri t name): 'vgerl- 1-1 Authorized Agent L=1 Ovuner Signature of Applicant: Date: STATE OF NEW YORK) SS: COUNTY OF ,'5Lj-4'O'k k )) �yCe n� 01n 1 =k being duly sworn,deposes and says that(s)M is the applicant (Name o individual signing contract)above named, (S)heisthe 0-4111ITrAl ty' (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/her knowledge and belief;and that the work will be performed in the manner set forth in the application file therewith. Sworn before me this 7'h dayof November- .201:;9a N ry ublic STM PARNM tel: 0#!NW VIk PROPERTY OWNER AUTHORIZATION QIJ, .d� B (Where the applicant is not the owner) C'IMatWW fwdy residing at 1 o V Gl.'ks CAcJA 04 ye. , do hereby authorizeilU l�lJ7 S �7 to apply on my behalf to the Town of Sou -)ding Department for approval as described herein. tt � 3 �tiZ Owner's i a ur Date -Al2%44AA Print Owner's Name 2 o _ BUILDING DEPARTMENT-Electrical Inspector Gy TOWN OF SOUTHOLD o Town Hall Annex- 54375 Main Road - PO Box 1179 o _ Southold, New York 11971-0959 4 - Telephone (631) 765-1802 - FAX (631) 765-9502 rogerr a-southoldtownny.aov— seandOb-southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: 2/27/23 Company Name: Peconic Bay Electric Corp Electrician's Name: Jose M. Umana License No.: ME-46360 Elec. email:pecbayelec@gmail.com Elec. Phone No: 631-987-4406 ElI request an email copy of Certificate of Compliance Elec. Address.: 218 Oak Ave, Flanders, NY 11901 JOB SITE INFORMATION (All Information Required) Name: Alexander Compagno Address: 1100 Alvahs Ln, Cutchogue, NY 11935 Cross Street: Rte 25 Phone No.: 646-872-0247 Bldg.Permit#: 48687 email:alex@alexandercompagnoarchitect.com Tax Map District: 1000 Section:102 Block: 4 Lot:6.1 BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Pool bonding and equipemnt wiring Square Footage: Circle All That Apply: Is job ready for inspection?: YES rV NO Rough In Final Do you need a Temp Certificate?: YES R NO Issued On Temp Information: (All information required) Service Size❑1 Ph❑3 Ph Size: A #Meters Old Meter# ❑New Service Fire ReconnectOFlood ReconnectOService ReconnectOUnderground DOverhead #Underground Laterals 01 02 0 H Frame 0 Pole Work done on Service? DY ON Additional Information: PAYMENT DUE WITH APPLICATION F Q BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD Town Hall Annex - 54375 Main Road - PO Box 1179 Southold, New York 1 1 971-0959 15�, ��`�' Telephone (631) 765-1802 - FAX (631) 765-9502 rogerrfisouthoidtownnygov - seandasoutholdtownny.gov APPLICATION FOR ELECTRICAL INSPECTION (ELECTRICIAN INFORMATION (All Information Required) Date: 2/27/23 Company Name: Peconic Bay Electric Corp Electrician's Name: Jose M. Umana License No.: ME-46360 Elec. email:pecbayelec@gmail.com Elec. Phone No: 631-987-4406 01 request an email copy of Certificate of Compliance Elec. Address.: 218 Oak Ave, Flanders, NY 11901 JOB SITE INFORMATION (All Information Required) Name: Alexander Compagno Address: 1100 Alvahs Ln, Cutchogue, NY 11935 Cross Street: Rte 25 Phone No.: 646-872-0247 Bldg.Permit#: 48687 email:alex@alexandercompagnoarchitect.com Tax Map District: 1000 Section:102 Block: 4 Lot:6.1 BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Pool bonding and equipemnt wiring Square Footage: Circle All That Apply: Is job ready for inspection?: ® YES 0 NO ®Rough In ® Final Do you need a Temp Certificate?: Cj YES n NO Issued On Temp Information: (All information required) Service Size❑1 Ph®3 Ph Size: A #Meters Old Meter# ❑New Service®Fire Reconnect[]Flood Reconnect❑Service Reconnect®Underground Overhead # Underground Laterals 1 2 H Frame M Pole Work done on Service? Y N Additional � 1 1.-5- L: Addi tonal nnur�rna ion: PAYMENT DUE WITH APPLICATION .33 4g � P �w ! �� � ��✓ �1 .,�� � iQ � � � � � I 5URVEY OF O RT1r SITUATE: CAJTGHOCAM N TOWN: SOUTNOLD SUFFOLK COUNTY, N SURVEYED 01-05-2022 W E TAX MAP REV. 08-I et-2022 SUFFOLK COUNTY TAX # 1000 - 1001 - 2 - 18 CERTIFIED TOL AN6I=LIGA GOMPAGNO AL..EXANDER COMPA6NO OLD REPUBLIC TITLE COMPANY BANK OF AMERIGA S � cooc�� I ' / � I / � 29' fe- kp 10 10 1 65 °�, tiny ® I � 1 i I I Si�tlary.oRsrnita�.r aAdtbn t.a army .i �vM�d..Nlon 7707, BANan],d tlr Il.w Yark'.lR.�Law! �Ot 1J c�p1�h'am HI.�gnGl of tln wwy mvtod w�h m sslgMl d 8r bd yk otorpoa...1 tlnll W cunl0.ro0 to ba wlM3ar NOTES: Y,a1RlaaVer.n61taNE/a'onv.mly Viet qn I-Uld =W-YpY xmn A..a,WM a Land B.vryws.saa cRtwtdW..reu r,.�..y 4 STAKE SET ,aid� '� I to m.nrg,.c.d Vo rnmy m�rt+ani raulr �y�� �y� (fir LAND for a. tr auNraq.to aIkCk.i►.MAk- Area = �40,(089 SO FT J®�11`�l C. JL;'IU o�0.7 �l'LLal1J SURVEYOR Area = OA5 ACRES 6 EAST MAIN STREET N.Y.S.LdC.NO.S�l02 6R/4PHIG SCALE ,N.Y. 11901 631 369.41M im 1 Q\g9aemVchd vn 1 ® DATE(MMMD/YYYY1 ACOR® CERTIFICATE OF LIABILITY INSURANCE `� 11/09/2022 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 have ADDITIONAL INSURED provisions or 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). CONTACT Lauren Murphy PRODUCER -NAME: Roy H Reeve Agency,Inc. a/cNr o Ext: (631)298 4700 al Nu: (631)298-3850 PO Box 54 E-MAILss: Imurphy@royreeve.com 13400 Main Road INSURER(S)AFFORDING COVERAGE NAIC# Mattituck NY 11952 INSURERA: Valley Forge Insurance Company 20508 INSURED INSURER B: Wesco Ins Co 25011. Chituk Pools Ltd. INSURER C: PO BOX 9 INSURER D: INSURER E Cutchogue NY 11935 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2232116484 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. ILTR TYPE OF INSURANCE INSD V rVD POLICY NUMBER PMMIDDY EFF MPIIWDD EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED I00,000 CLAIMS-MADE OCCUR PREMISES Ea occurrence $ X Contractual Liability MED EXP(Any one person) $ 15,000 A 6018146726 03/15/2022 03/15/2023 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2.000,000 POLICY ®PRO- POLICY LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident P $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ R,EXCESS LIAR HCLAIMS-MADE AGGREGATE $ D I I RETENTION$ $ rB WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE I I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEREXCLUDED? NIA VWUC3563869 01/01/2022 01/01/2023 (Mandatory in NH) i E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Alexander Compagno ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Alvahs Lane AUTHORIZED REPRESENTATIVE Cutchogue NY 11935 A ©1988-2015 ACORD CORPORATION. All rights;reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD 7 ® DATE(MMIDD/YYY`n A`�® CERTIFICATE OF LIABILITY INSURANCE 11/09/2022 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 poliey(ies)must have ADDITIONAL INSURED provisions or be endorse(i. 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). CONTACT Lauren Murphy PRODUCER NAME: HONN Ext: (631)298-4700 ac No: (631)298-3850 Roy H Reeve Agency,Inc, IPA PO Box 54 A DDDRIESS: Imurphy@royreeve.com 13400 Main Road INSURER(S)AFFORDING COVERAGE NAIC# Mattituck NY 11952 INSURER A: Valley Forge Insurance Company 20508 INSURED INSURER B: Chituk Pools Ltd. INSURER C: _ PO BOX 9 INSURER D: INSURER E: Cutchogue NY 11935 INSURER F: COVERAGES CERTIFICATE NUMBER: CL228417514 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. INSPOLICY EFF POLICY EXP TR TYPE OF INSURANCE INSD WVD POLICY NUMBER MWDD MMIDD LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 100,000 CLAIMS-MADE ®OCCUR PREMISES Ea occurrence $ Contractual Liability MED EXP(Any one person) $ 15,000 A 6018146726 03/15/2022 03/15/2023 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO LOC PRODUCTS-COMPIOPAGG $ 2,000,000 OTHER: CMBINED AUTOMOBILE LIABILITY JE,O .den SINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Alexander Compagno,1100 Alvahs lane,Cutchogue,NY 11935 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of Southold ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 1179 AUTHORIZED REPRESENTATIVE Southold NY 11971 @ 1988-2015 ACORD CORPORATION. Ali rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD NOTES: 1. DIVING BOARD TO CONFORM WITH ANSI/APSPRCC-5 SEC 6 = 2. NO SOIL DISCHARGE PERMITTED WITHIN 4 FEET OF EXCAVATION 3. POOL MUST BE SURROUNDED BY A CONTINUOUS BARRIER CONSTRUCTED IAW REQ.OF SEC 326.4.2.1-R326.4.2.6 OF THE NYS RESIDENTIAL CODE(2020)AND ALL SECTIONS OF THE SOUTHOLD CODE 4. WALLS MAY SERVE AS PART OF THE POOL BARRIER AS PER SEC 326.4.2.8 AND ALL WINDOWS HAVE A SELF LATCHING DEVICE 5. ACESS GATES SHALL COMPLY WITH SEC R326.5.2 OF THE NYS RESIDENTIAL CODE(2020)AND BE SELF CLOSING,SELF LATCHING AND BE SECURELY LOCKED WHEN POOL IS NOT IN USE OR SUPERVISED. ALLL GATES ARE APP OVED AS NOTED TO OPEN AWAY FROM THE POOL AREA. -3 .�6. DURING CONSTRUCTION THE CONTRACTOR SHALL ERECT A TEMPORARY BARRIER AROUND THE EXCAVATION IAW CODE OF THE TOWN OF SOUTHOLD. DATE: B.P.# 7. POOL MUST BE EQUIPED WITH AN APPROVED POOL ALARM CAPABLE OF DETECTING'ENTRY INTO THE WATER AND SOUNDING AN AUDIBLE ALARM WHEN DETECTED THAT IS AUDIBLE AT THE POOLSIDE AND INSIDE THE FEE: EY: DWELLING.THE ALARM MUST BE INSTALLED,MAINTAINED AND USED IN ACCORDANCE WITH TEH MAUFACTURERS INSTRUCTIONS.THE ALARM MUST MEET ASTM F2208"STANDARD SPECIFICATION FOR POOL ALARMS".THE NOTIFY BUILDING DEPARTMENT A DEVICE MUST OPERATE INDEPENDENT(NOT ATTACHED TO OR DEPENDENT ON)OF PERSONS. _ 765-1802 8 AM TO 4 PM FOR THE 8. POOL SUCTION FITTINGS(EXCEPT FOR SURFACE SKIIMERS)MUST BE PROVIDED WITH A COVER THAT CONFORMS TO ASME/ANSI Al12.19.8M OR A MINIMUM 18"X23"DRAIN GRATE OR A CHANNEL DRAIN SYSTEM.POOL FOLLOWING•INSPECTIONS: CIRCULATION SYSTEM MUST BE EQUIPTED WITH ATMOSPHERIC VACUUM RELEIF.SUCH VACUUM RELIEF SYSTEMS SHALL CONFORM WITH ASME A112.16.17 OR BE A GRAVITY SYSTEM APPROVED BY THE TOWN OF 1. FOUVDATION - TWO REQUIRED SOUTHOLD.POOL SALL BE PROVIDED WITH A MINIMUM OF 2 SUCTION FITTINGS OF THE ABOVE MENTIONED TYPE.THE SUCTION FITTINGS SHALL BE SEPARATED BY A MINIMUM OF 3'AND MUST BE PIPED SUCH THAT WATER FOR POURED CONCRETE IS DRAWN THROUGH THEM SIMULTANEOUSLY THROUGH A VACUUM RELIEF-PROTECTED LINE TO THE PUMP(OR PUMPS).VACUUM/PRESSURE CLEANING FITTINGS SHALL BE IN ACCESSIBLE POSITION,MINIMUM OF 6"AND 2. ROUGH - FRAMING & PLUMBING. NO GREATER THAN 12"BELOW THE MINIMUM OPERATIONAL WATER LEVEL OR BE AN ATTACHMENT TO THE SKIMMER/SKIMMERS. A REQUIRED POOL ATMOSPHERIC VACUUM RELEIF SYSTEM SHALL BE INSTALLED AS PER 3. INSULATION NYS RESIDENTIAL CODE R326.6.3(2020)AND IN ACCORDANCE TO TOW CODE 4. FINAL - CONSTRUCTION MUST 9. ALL ELECTRICAL WORK SHALL COMPLY WITH THE REQUIREMENTS OF NFPA 70(NEC),PRINCIPALLY ARTICLE 680 AND THE NYS RESIDENTIAL CODE SECTION 4102 THROUGH 4106.ALL ELECTRICAL DEVICES MUST BE BE COMPLETE 'FC�a :;•O, APPROVED BY UNDERWRITERS LABORATORIES AND BE PROTECTED BY A GOUND FAULT CURRENT INTERRUPER(GFCI).CURRENT CARRYING ELECTRICAL CONDUCTORS EXCEPT FOR THOSE PROVIDING POWER TO POOL ALL CONSTRUCTION SHALL MEET T LIGHTING AND POOL EQUIPMENT SHALL MEET THE SEPARATION REQUIREMENTS OF TABLE E4203.5. ALL METAL ENCLOSURES,FENCES OR RAILINGS NEAR OR ADJACENT TO THE SWIMMING POOL THAT MAY BECOME ELECTRICALLY CHARGED DUE TO CONTACT WITH AN ELECTRICAL CIRCUIT SHALL BE EFFECTIVELY GROUNDED. YORK STATE REQUIREMENTS NOT THE CODES OF NE . T RESPONSIBLggEQFC� 10. WATER SOURCE FILLING THE POOL SHALL BE EQUIPPPED WITH A BACKFLOW PROTECTION DEVICE IAW NYS PLUMBING CODE 608. f CDESIGN OR OMPLY WITH ALL CODEESRB 11. ALL PIPING IS DIAGRAMMATIC UNLESS OTHERWISE STATED. ELECTRQ(;AL. oa ¢ �� - ��� I������LY.��� NEW YORK STATE & TOWN COD S 12. WALKS,IF PROVIDED SHALL BE NONSLIP AND SLOPE AWAY FROM THE POOL EDGE. a _ ., . e6�9��ECTA®b� g��Q�JBO�� ENCLOSE POOL TO'.CQb:E;:= ;''UPON COMPLETION':., AS REQUIRED AND CONDITIONS F 13. A MEANS OF EGRESS FROM DEEP AND SHALLOW ENDS MUST BE PROVIDED IAW ANSI/NSPI-5 SECTION 6. {;, x. ._BEFORE. WAT.ER4,_ •.;:,;,; 14. CONTRACTOR TO PLACE THE POOL IAW TOWN OF SOUTHOLD CODE SETBACKS. j' �_ -T L 15. ALL DRAINAGE FROM THE POOL SHALL BE MAINTAINED ON THE SUBJECT PROPERTY. _. Ti J v ri NING B0 RD 16 THE DESIGN IS BASED ON A DRAINAGE SOIL WITH<10%SILT.GROUND WATER SHALL NOT EXIST WITHIN THE EXCAVATION. IF GROUND WATER EXISTS WITHIN 60"FROM GRADE,DEWATERING FACILITIES WILL BE 1, N TRUSTEES REQUIRED. 17 ALL GAS AND OIL WATER HEATERS(IF INSTALLED)FOR THE IN-GROUND SWIMMING POOL SHALL BE NATIONAL APPLIANCE ENERGY CONSERVATION ACT(NAECA)COMPLIANT.POOL HEATERS SHALL BE TESTED IAW ANSI N J GE�u Z21.56 AND SHALL BE INSTALLED IAW MANUFACTURERS SPECIFICATIONS.OIL FIRED POOL HEATERS SHALL BE TESTED IAW UL726.POOL HEATERS SHALL BE LOCATED OR GUARDED TO PROTECT AGAINST ACCIDENTAL CONTACT OF HOT SURFACES BY PERSONS.POOL HEATERS SHALL BE PROVIDED WITH TEMPERATURE AND PRESSURE-RELIEF VALVES.A BYPASS LINE SHALL BE INSTALLED FROM THE INLET TO OUTLET TO ADJUST WATER FLOW THROUGH THE HATER.POOL HEATERS SHALL BE PROVIDED WITH THE FOLLOWING ENERGY CONSERVATION MEASURES: ALL POOL HEATERS SHALL BE EQUIPPED NG AND 17.1 ALLOW RESTARTING WITHOUT RELIGHTING-THE PILOT LIGHT. AT LEAST ONE THTH AN ON-OFF SWITCH MOUNTED OER OSTAL MUST BE PROVIDED OR EACH HEATING R EASY ACCESS TO ALLOW SHUTTING OFF THE OPERATION SYSTEM.HEAEDESa SWIMMER ING POOLS SHALL THOUT I BE EQU PTED WITH NG THE AA POOL I COVER.(e0xempt `JCCU PANCY OR FROM THIS ARE OUTDOOR POOLD)DERIVING 20%OF THE ENERGY FOR HEATING THE POOL FROM RENEWABLE SOURCES OVER AN OPERATING SEASON. USE 1S`UNLAWFUL 17.2 TIME CLOCKS SHALL BE INSTALLED SO THE PUMP CAN BE SET TO RUN DURING OFF-PEAK ELECTRICAL DEMAND PERIODS,AND CAN BE SET TO RUN THE MINIMUM TIME NECESSARY TO MAINTAIN THE POOL WATER IN A WITHOUT CE 'IF1CA� . CLEAN AND SANITORY CONDITION IAW APPLCIABLE SANITORY CODE OF NEW YORK STATE. 18 BACKFILL WILL BE DONE WITH CLEAN EARTH FREE OF ROOTS AND DEBRIS. BACKFILL HEIGHT AND WATER LEVEL TO BE WITHIN 8"OF EACH OTHER. PLACE CONCRETE ON SANDY LOAM SOIL. CLAY TO BE REMOVED AND JF OCCU.PANCY REPLACED WITH SANDY LOAM. 19 THERE ARE MAIN DRAINS IN THIS POOL.THERE ARE TWO APPROVED SUCTION OUTLETS WITH A MINIMUM OF T OF SEPARATION. THE SUCTION OUTLETS ARE PIPED SO THAT WATER IS DRAWN THROUGH THEM SIMULTANEOUSLY THROUGH A VACUUM-RELEIF-PROTECTED LINE TO THE PUMP.COMP I WITH ENTRAPMENT PROTECTION AS PER CODE. 20 THE POOL WAS DESIGNED REFERENCES AS THE FOLLOWING: 20.1 THE RESIDENTIAL BUILDING CODE OF NEW YORK STATE(2020)SEC R326 OF p Ely '!�4 20.2 THE ENERGY CONSERVATION CONSTRUCTION CODE OF NEW YORK STATE(2020)SEC R403.10 �- 20.3 THE FUEL GAS CODE OF NEW YORK STATE(2020) *f 4 �r, ':. •'¢ 20.4 THE NEW YORK STATE SANITORY CODE. 20.6 ANSI/APSP/ICG5 STANDARD FOR RESIDENTIAL IN-GROUND SWIMMING POOLS. :. �v" F s Y= _� POOL NOTES SCALE: NTS 20.6 BOCA CODE SECTION 421. OpR �� - P�' JAMES DEERKOSKI, P.E. 20.7 CODE OF THE TOWN OF SOUTHOLD O SS, 260 DEER DRIVE DATE: 101212020 MATTITUK, NEW YORK 11952 DRAWING NUMBER Now 2 OF 2 Q€ '•wiUtsfep=' ;.'A: reB. ..$ :a :E. F, POOLS .G . H 'K '•L."., N.: Gal --- 6. '.4 4: 6•, :4:-0'' �fi :1s:: :.as:...a a•;6 6'. .s.. ;. :. . e� '.4•.::4 : .�.: '4'a T-a'9�00 • .•. - .fOQG'�: 16xZ{:-. :16::" :'i3"•{;; - _ 16.4 •.3j -2 ' �12' 26<- •S•a':,6§� .•6': :410,• :-6.- -:4:• �-�¢: :I•.'.,A:O'.' ':T :ra1�900 1G u:E� -.q. N W1l,L -shoo " :•x .: ;1<5D' R: :4'4>I'= i<'-0!' '.i� yl�" �6'.i7�:. :a q:"•. �6x98. aa: .;�a:.::F--a-: :_e: :1a._ ��s:::u ,a: .4_ _+2. '.o r. ' moo S� }p 4-0 T 21000 .� :; t1"6a :71 ` iR �' .R ' � •, _ :z46: :'�n-. �'. 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'- Comm _ 1 1 POOL SIECT1®N Complies With— 2020 Code Section 3032.1``=303.4 Swimming Pools,Spas and Hot Tubs RIFE&S1� P l Sdalon'11326 of the-Resideritial Code of New York ________--- :==j------------- Sectiori3109oftheBuilding.Codeo- New York Section N1103.12(R403.12)Residential Pools and Permanent Residential Spas POOL!YPE.RECTANGLE REV. SME: NTS7 , Section 31093.12-3109 A Pools and Spas Gates,Barriers jAi1�ES®EERK0SKf,P.E. Section G106 Entrapment Protection . " DATE: TYPICAL P • EL$TIFFNER 'Section G107 Alarms 200 DEER DRIVE Section 1=42b1—E4312 bdct& Connectiofis for Pools I�AT�I I,I.I�K; ®Ii;K�.1952 ORWING NUMBER - 1 ' OF 1