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HomeMy WebLinkAbout49640-Z O�Og�FFO1/(coG Town of Southold 8/8/2024 y� P.O.Box 1179 o _ 53095 Main Rd y, o�A Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 45273 Date: 6/10/2024 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 1565 Brigantine Dr, Southold SCTM#: 473889 Sec/Block/Lot: 79.-4-57 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 7/27/2023 pursuant to which Building Permit No. 49640 dated 9/5/2023 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 swimmming pool fenced to code as applied for. The certificate is issued to TSC Holdings LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 49640 6/10/2024 PLUMBERS CERTIFICATION DATED t oriz d ignature TOWN OF SOUTHOLD �SUFFDt� ' moo BUILDING DEPARTMENT y x 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#: 49640 Date: 9/5/2023 Permission is hereby granted to: Brennan, Victoria- c/o Sheila Brennan 90 Riviera Dr S Massapequa, NY 11758 To: Construct in round swimming g pool at existing single family dwelling as applied for. Must maintain minimum 10 foot setbacks to pool and equipment from property lines. At premises located at: 1565 Brigantine Dr, Southold SCTM #473889, Sec/Block/Lot# 79.4-57 Pursuant to application dated 7/27/2023 and.approved by the Building Inspector. To expire on 3/6/2025. Fees: SWIMMING POOLS-'IN-GROUND WITH FENCE ENCLOSURE $250.00 CO- SWIMMING POOL $50.00 Total: $300.00 Building Inspector *pF SOUj��l Town Hall Annex Telephone(631)765-1802 54375 Main Road P.O.Box 1179 G Q Southold,NY 11971-09.59 Jamesh .southoldtownny.gov BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: TSC Holdings LLC. Address: 1565 Brigantine Drive city:Southold st: New York zip: 11971 Building Permit#: qq b q D Section: 79 Block: 4 Lot: 57 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: K.V. Electric INC. Electrician: Kennith.Vaughn License No: ME-3389 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 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 2 4'LED Exit Fixtures Sump Pump Other Equipment: 1 240v pump, 1 salt gen, 1 auto pool cover, 1 heater gas, 3 Iv pool lights, 1 300watt tr 1 b pool panel Notes: POOL Inspector Signature: Date: June 10, 2024 1565 brigantine dr pool ho�A0ES0Ulyo� � Z IS SOS I�r�_ �: =ram e r�r # TOWN OF SOUTHOLD UILDING DEPT. .631-765-1802 INSPECTION [ ] FOUNDATION 1 ST/ REBAR . [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [. ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [. ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH).. [,SQ ELECTRICAL (FINAL) . [ ] CODE VIOLATION [ .] PRE C/O [ ] RENTAL REMARKS: v �- 000f0 ne jjecij ok,,e,�-e�o� a.+ 06�� f Iv *k . ip- Cootc ra,kk a.+ onjods t Jf side Df e-.of el- ne fo be bonjeA vi eed v ee u w 60wi WOW brOLkEA5 604 DATE INSPECTOR Y loaf so 6qo 5 8v,, - vt lvt( # # TOWN OF SOUTHOLDZIO LDING DEPT. 631-765-1802 INSPECTION [ ] FOUNDATION 1 ST/ REBAR [ ] 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/O [ ]. RENTAL REMARKS: &Q � - Hav wak Gou[� o&K vieAs lo be, 66vA,e-cL jMuA� 116 e, awi�e c,6i� —C A V14 a[up- C rTl- I'vi4t> Eo./- he Vl q �o o pin DATE INSPECTOR SOUIyO� ! 49 qU 1 b 042 dJ d`XILDING � IfTOWN:OF SOUTHOLD DEPT. W, 631-765-1802 INSPECTION [ ] FOUNDATION 1ST/ REBAR [ ] 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/O [ ] RENTAL REMARKS: ho[ 4M buW4 vied �Fl ® eG rovL eve need �� �/o r6� o bo �e rod 4 0V, � 80- 'bmA If lv� Aw cooiv-flhf bcl,V�Aboa' 00 ( �kKd oj�� DATE `l INSPECTOR pFSOGIyOIo 15�5 Bri � 4oAe_ * # TOWN OF SOUTHOLD. B ILDING DEPT. "cou 631-765-1802 INSPECT-ION [ ] FOUNDATION 1ST/ REBAR [ ] 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/O [ ] RENTAL REMARKS: Poo l cqn 1204 alae carf_l�x Boy - I flq k, ,5 4'&ed 720 �� s e a r,� 72 e a�c� DATE 3�� INSPECTOR " it.� . _ O au rl yS f z T, r � * • ifr4 ,y.�t �y •� ;i , :� ..; ��, •. y ` +'•• �� ; ��� �, 1 i �1 � � t- �. f ��� �`'. � � �` �-- 1 _ � ]R ; � .1 ' i r F � ` /� _ 1 ♦ .' � � t� r .; ..�-� S E� `:�F � + kt k' .{y, j s• r . { �� z '4 _. ,y: �. s { h� �, �� i l.. ..�_.. _. �J „yam r 'K��� .. ��. ,�,�,. �_ i• v. OFF MANUAL LEVER ON CAUTION - RISK OF ELECTRICAL SHOCK Turn power off at main panel before servicing this switch or the equipment it controls. Use copper conductors only. Reinstall this safety guard after wiring. CY -0000, f a r 4� � w ryE r%_ i i. 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'f �- .4 •c.. ma`s.. ?IELD INSPECTION REPORT DATE COMMENTS b FOUNDATION (IST) �H ------------------------------------- FOUNDATION (2ND) � z � o H ROUGH FRAMING& 1 PLUMBING � I � J r r� INSULATION PER N.Y. H STATE ENERGY CODE 0 FINAL ADDITIONAL COMMENTS 9 a 2,3 c" ck W-rco l i. it 1-9 (2`4 6I C G G C. VC-1O —to•�� Fi C� �� kP4 b N H � O z x Z� d b H `�p�0S11fF0(rCOpy 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 https://www.southoldtownny.goov, Date Received APPLICATION FOR BUILDING PERMIT �7 For Office Use Only h N114% I ' PERMIT No. Building Inspector: JUL 2 7 2023 Applications and forms must.be filled out in their entirety.Incomplete applications will not be accepted. Where the Applicant'is not the owner,an BUH,DTNG DE'PT. Owner's Authorization form(Page 2)shall be completed. �" ' COI ' :?'1 Date:7-25-2023 OWNER(S)OF PROPERTY: . Name:Victoria Brennan SCTM#1000-79_4_57 Project Address:1565 Brigantine Dr. Southold NY 11971 Phone#: Email: Mailing Address: CONTACT PERSON:' Name:McCarthy Management Mailing Address: _46.52.0_.CO.unt ._Road._4-8 _Southold ._NY 11-9-7_1 _- Phone#:631-7.65-581.5 __.._-_.____- _._._..______ Email:_tmccar_th. ...tmccarth- _ mail.com DESIGN PROFESSIONAL INFORMATION: Name:NA Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: Name: Chltuk.-P_ools-LTD. Mailing Address: Phone#:. .631 -4.84-4245.___--,._____-___. __.___-_.___ Email- chltuk o tonline.net______--._____ DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: DOther Inground swimming pool $ Will the lot be re-graded? ❑Yes R No Will excess fill be removed from premises? ❑Yes ®No 1 PROPERTY INFORMATION Existing use of property:Re$Identla�- ---- •- - ___ Intended use of property:peS)•lentlal--------_____�_ Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to R-40y this property? Dyes 50No IF YES, PROVIDE A COPY. 8 Check Box After Reading: The owner/contractor/design professional is Pesponsible for all drainage and storm water issues as provided by Chapter 236 of the Town Code. 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,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 piemises and in building(s)for necessary inspections.False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210AS of the New York State Penal Law. Application Submitted By(print nam )•Th mas J McCarthy BAuthorized Agent ❑Owner Signature of Applicant: Date: 7/25/2023 STATE OF NEW YORK) SS: COUNTY OF Suffolk ) Thomas J McCarthy being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the Agent, McCarthy Management (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 applicgilgr,,ge true to the best of his/her knowledge and belief;and that the work will be performed in the manner set ? hl&��g�'ISpjlcation file therewith. ``rP'. Sworn before me this N0.01B00007727';QUALIFIED IN ' FFOLK COUNTY ay of , OMM.EXP. 705-16-2027 s • Nota Public 111111 PROPERTY OWNER AUTHORIZATION (Where the applicant is not the owner) I, residing at do hereby authorize to apply on my behalf to the Town of Southold Building Department for approval as described herein. Owner's Signature Date Print Owner's Name 2 Thomas J. McCarthy Real Estate, Inc. www.thomasjmecarthy.com AUTHORIZATION LETTER I, Victoria Brennan (owner), and Alicia Brennan (owner) hereby authorize Thomas J McCarthy Real Estate, McCarthy Management and/or TSC Holdings to act on my behalf and handle all necessary work involved with.Local Townships, County and NY municipalities or any other entity for permits, expediting, development, or any other matter for the subject property located at: 1565 Brigantine Drive Southold, New York 11971 SCTM,: 1000-794-57 3 Property Owner Signature Date Property Owner Signature Date State of i )SS: County of ,rj,& ) On this,the z ! day of� ,2023, before me a notary public,the undersigned officer,personally appeared "� t & , known to me(or satisfactorily proven)to the person w ose name is subscribed to the within instrument,and acknowledged that he executed the same for the purposes therein contained. In witness hereof, I hereunto set my hand a fffiicial seal. Lr" JLL0 R.UTANNA r l.Aol, WBLJC,state o!New rm f Ah.Ifi27200 Notary Public 9�m Namu Cart rt■NWz wave 1 46520 Route 48 Tel. 631.765.5815 Southold, NY 11971 Fax.631.765.5816 affO('k, BUILDING DEPARTMENT- Electrical Inspector 6 COGy1 TOWN OF SOUTHOLD o Town Hall Annex- 54375 Main Road - PO Box 1179 o Southold, New York 11971-0959 Telephone (631).765-1802 - FAX (631) 765-9502 ' iamesh _southoldtownny.gov - sea ndCaD-southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: 1/18/24 Company Name: K.V. Electric Inc Electrician's Name: Kenneth Vaughn License No.: 3389 Elec. email: kvelectricinc@gmail.com Elec. Phone No: 631-724-4758 El request an email copy of Certificate of Compliance Elec. Address.: 405 Central Avenue, Bohemia NY 11716 JOB SITE INFORMATION (All Information Required) Name: TSC Holdings, LLC Address: 1565 Brigantine Drive Cross Street: Phone No.: 631-765-5815 Bldg.Permit#: 49640 email: lorraine.fredricks@thomasjmccarthy.com Tax Map District: 1000 Section: 79 Block: 4 Lot: 57 BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Swimming Pool 20x40 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❑3 Ph Size: A # Meters Old Meter# 0 New Service❑Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground❑Overhead # Underground Laterals 1 2 H Frame 0 Pole Work done on Service? 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LETTER OF TRANSMITTAL ,46520 COUNTY ROAD 48 SOUTHOLD, NY 11971VA) DATE J B NO (631) 765-5815 FAX (631) 765-5816 � ATTENTION i RE WE ARE SENDING YOU ❑ Attached ❑ Under separate cover via the following items: ❑ Shop-drawings ❑ Prints ❑ Plans ❑`Samples ❑ Specifications j ❑ Copy of,letter ❑ Change order, ❑ COPIES DATE NO. DESCRIPTION _ 1 � v v THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FORBIDS DUE ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS COPY TO SIGNED: if enclosures are not as noted,kindly notify us at once. MCCARTHY MANAGEMENT, INC. LETTER OF TRANSMITTAL ;.. 46520.000NTY ROAD 48 SOUTHOLD, NY' 11971 DAT7//&)/>t JOB NO. (63H 765=5815. FAX (631) 765-5816 I' � ATTENTION TO ' /c o- RE: pi Iland./n� j ` V I i • f I � f '.WE ARE SENDING YOU ❑ Attached ❑ Under separate cover via the following items: ❑ Shop drawings ❑ Prints �`` ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order° ❑ j COPIESDATE NO. DESCRIPTION vl dl arm a THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FORBIDS DUE ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS COPY TO SIGNED: If enclosures are not as noted,kindly notify us at once, Suffolk County Dept.of A` Labor;Licensing&Consumer Affairs HOME IMPROVEMENT LICENSE ¢. . Name ° THOMAS J MCCARTHY Business Name This certifies that the bearer is duly licensed MCCARTHY MANAGEMENT INC by the County of suffolk License Number:H-45254 Rosalie Drago Issued: 09/04/2008 Commissioner Expires: 9/1/2024 THE STATE INSURANCE FUND 8 Corporate Center Drive,3rd Floor,Melville,NY,11747-3166 (888)875-5790 Document Type: Group No: Period Covered: * R.B.File No: INFORMATION PAGE 090 03/19/2023 TO 03/19/2024 00008929411 INSURED: 11143 348-9 REPRESENTATIVE: 363077 Policy No: MCCARTHY MANAGEMENT INC ROY H REEVE AGENCY INC 46520 ROUTE 48 13400 MAIN RD 11143 348-9 p0 BOX 54 Date: SOUTHOLD NY 11971 MATTITUCK NY 11952 01/30/2023 Document Number: E10001732913 MP 1247 *PERIOD OF COVERAGE BEGINS AND ENDS AT TWELVE AND ONE MINUTE O'CLOCK A.M.EASTERN STANDARD TIME TYPE OF BUSINESS: CORPORATION (FOR PROFIT) INFORMATION PAGE RENEWAL POLICY THIS POLICY INCLUDES THESE ENDORSEMENTS AND/OR SCHEDULES: YOU MUST REPORT ANY CHANGE IN OWNERSHIP TO US IN WRITING WITHIN 90 DAYS OF THE DATE OF THE CHANGE. CHANGE IN OWNERSHIP INCLUDES SALES, PURCHASES, OTHER TRANSFERS, MERGERS, CONSOLIDATIONS, DISSOLUTIONS, FORMATIONS OF ' A NEW ENTITY, AND OTHER CHANGES PROVIDED FOR IN THE APPLICABLE EXPERIENCE RATING PLAN. EXPERIENCE RATING IS MANDATORY FOR ALL ELIGIBLE INSUREDS. THE EXPERIENCE RATING MODIFICATION FACTOR, IF ANY, APPLICABLE TO THIS POLICY, MAY CHANGE IF THERE IS A CHANGE IN YOUR OWNERSHIP OR IN THAT OF ONE OR MORE OF THE ENTITIES ELIGIBLE TO BE COMBINED WITH YOU FOR EXPERIENCE RATING PURPOSES. FAILURE TO REPORT ANY CHANGE. IN OWNERSHIP, REGARDLESS OF WHETHER THE CHANGE IS REPORTED WITHIN 90 DAYS OF SUCH CHANGE, MAY RESULT IN REVISION OF THE EXPERIENCE RATING MODIFICATION FACTOR USED TO DETERMINE YOUR PREMIUM. THIS REPORTING REQUIREMENT APPLIES REGARDLESS OF WHETHER AN EXPERIENCE RATING MODIFICATION IS CURRENTLY APPLICABLE TO THIS POLICY. THE EXPERIENCE RATING CHARGE SHOWN BELOW IS IN ACCORDANCE WITH YOUR PAST ACCIDENT EXPERIENCE UNDER THE EXPERIENCE RATING PLAN AS PROMULGATED BY THE APPROPRIATE RATING ORGANIZATION. # 89 03/30/1995 NEW YORK EXCLUSION OF EXECUTIVE OFFICERS) ENDORSEMENT THIS POLICY DOES NOT COVER FOR CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE SOLE EXECUTIVE OFFICER AND ONLY STOCKHOLDER OF THE INSURED CORPORATION, OR TWO EXECUTIVE OFFICERS WHO TOGETHER ARE THE ONLY OFFICERS AND STOCKHOLDERS OF THE INSURED CORPORATION, WHEN SUCH CORPORATION HAS OTHER EMPLOYEES WHO ARE REQUIRED TO BE COVERED BY THE LAW, AND THE CORPORATION HAS ELECTED TO EXCLUDE FROM COVERAGE THIS IS NOT A BILL. IMPORTANT PREMIUM CALCULATION,PLEASE RETAIN FOR YOUR RECORDS. FOR ATTACHMENT TO WORKERS'COMPENSATION-EMPLOYERS'LIABILITY POLICY (SEE REVERSE SIDE FOR CONDITIONS) PAGE 1 CONT. This policy includes,with their permission,some copyright materials of the National Council on Compensation Insurance and the New York Compensation Insurance Rating Board. NIF10S/NIF10SV2(10/2017) r CONDITIONS 1. THE POLICY ISSUED BY THE STATE INSURANCE FUND IS A CONTINUOUS ONE AND REMAINS IN EFFECT UNTIL CANCELLED. 2. THIS DOCUMENT NEITHER REINSTATES THE POLICY IF PREVIOUSLY CANCELLED NOR RESCINDS ANY OUTSTANDING CANCELLATION NOTICE. 3. FOR THE PURPOSE OF SERVING NOTICE, THIS ASSURED AGREES THAT THE ADDRESS SHOWN ON PAGE ONE OF THIS DOCUMENT IS BOTH BUSINESS AND RESIDENCE ADDRESS OF THIS ASSURED AND/OR ANY REPRESENTATIVE OF THIS ASSURED UPON WHOM NOTICE MAYBE SERVED. 4. PURSUANT TO CHAPTER 55 OF THE LAWS OF 1992, ALL CHECKS RETURNED UNPAID WILL BE SUBJECT TO A $20 ADMINISTRATIVE FEE. 4IF512/NIF512V2 (10/2017) �•� MCCAMAN-02 LMAIONE ACORO' CERTIFICATE OF LIABILITY INSURANCE DATE(M 7/26/202YYY) 2023 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). PRODUCER CONTA NAME:CT Will Sm0111rf0 DGA Insurance Services,LLC PHONE FAX 3333 New Hyde Park Road (A/C,No,EXt):(718)745-1500 (A/C,No): Suite 409 A DRESS:smoltino@narrowsins.com New Hyde Park,NY 11042 INSURERS AFFORDING COVERAGE NAIC# INSURER A:Southwest Marine&General Insurance Company 12294 INSURED INSURER B: McCarthy Management Inc. INSURER C: 46520 Route 48 INSURER D: Southold,NY 11971 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICDY EFF POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE 7 OCCUR GL2021 LHB00341 9/18/2022 9/18/2023 DAMAGE TO RENTED 100,000 PREMISES Ea occurrence $ MED EXP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY 3PCT LOC PRODUCTS-COMP/OP AGG $ 2,000,OUO OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY Per erson $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ AUTOS ONLY NON-ONED PROPERTY DAMAGE Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE I ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 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) CERTIFICATE HOLDER CANCELLATION . SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE EVIDENCE OF COVERAGE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD - a(�\f, Slandord N Y B.1 U.Fonn SUU? Barg;un wld Sale Dced xidi Covenant against Granmr�;�Z:e[.t'I-"nJividu�rporalion!$inglc Shceq CONSULT YOUR LAWYER BEFORE SIGNING Tills INSrRU.11ENT—THIS INS'I'RUNIENT SHOULD BE USED BY LAWYERS ON1.1' THIS INDENTURE,made the to day of August two thousand twenty three BETWEEN VICTORIA BRENNAN, residing at 206 Bayvievv Massapequa, NY 11758 a fifty ercent interest as tenant-in-common,and ALICIA BRENNAN, residing at 16 Greenland Court,Princeton,NJ 08540,a fifty percent interest as tenant-in-common party of the first part,and , TSC IIOLDINGS,LLC with offices at 46520 Rte 48 Southold,NY 11971 party of the second part, WITNESSETH, that the party of the first part, in consideration of ten dollars and other valuable consideration paid by the party of the second part, does hereby grant and release unto the party of the second part,the heirs or successors and assigns of the party of the second part forever; ALL that certain plot, piece or parcel of land, with the building and improvements thereon erected, situate,lying and being 3ECTION:79 «Schedule "A"Attached Hereto" PARTY OF FIRST PART PART being and intended to be the same premises conveyed to Victoria Brennan and Alicia Brennan by deed made by Sheila Brennan, as surviving tenant by the entirety of BLOCK:4 William T.Brennan,deceased and recorded in Liber 12723 cp 175. LOT:57 SAID PREMISES known as 1565 Brigantine Drive Southold,NY 11971 See Schedule"A" TOGETHER with all right,title and interest,if any,of the party of the first part in and to any streets and roads abutting the above described premises to the center lines thereof, TOGETHER with the appurtenances and all the estate and rights of the party of the first part in and to said premises:TO HAVE AND TO HOLD the premises herein granted unto the party of the second part, the heirs or successors and assigns of the party of the second part forever. AND the party of the first part covenants that the party of the first part has not done or suffered anything whereby the said premises have been encumbered in any way whatever,except as aforesaid. AND the party of the first part,in compliance with Section 13 of the Lien Law,covenants that the party of the first part will receive the consideration for this conveyance and will hold,the right to receive such consideration as a trust fund to be applied first for the purpose of paying the cost of the improvement and will apply the same first to the payment of the cost of the improvement before using any part of the total of the same for any other purpose. The word "party" shall be construed as if it read "parties" whenever the sense of this indenture so requires. IN WITNESS WHEREOF,the party of the first part has duly executed this deed the day and year first above written. IN PRESENCE OF: VICTORIA BRENNAN . h A IA BRENNAN • J USE ACKNOWLEDGMEiVI' FORA BELOW wri-HIN USE ACKNOWLEDGMENT FORM BELOW WITHIN NEW YORK STATE ONLY: NEW YORK STATE ONLY: State of New York,County of Nassau)ss.: State of New York,County of )ss.: On the 7 clay of August ,in the year 2023,before On the day of_ ,in the year 2023,before me, the undersigned, personally appeared Victoria me,the undersigned,personally appeared Brennan and Alicia Drennan,personally known to me or personally known to me or proved to me on the basis of proved to me on the basis of satisfactory evidence to be satisfactory evidence to be the individual(s) whose the individual(s)whose names(s)is(are)subscribed to the names(s)is(a:e)subscribed to the within instrument and within instrument and acknowledged to me that acknowledged to me that he/she/they executed the same he/she/they executed the same in his/her/their in his/her/their capacity(ies), and that by his/her/Ihcir capacity(ics),and that by his/her/their signature(s)on the signature(s) on die instrument, the individual(s), or the instrument,the individual(s),or the person upon behalf of person upon behalf of which the individual(s) acted, which the individual(s) acted, executed the instrumea executed the instrument. J�, Gl Notary Public Notary Publie CAMILLO R.GIANNATTASIO NOTARY PUBLIC,State of New York No. 0204627209 edinNassau ACKNOWLEDGMENT FORM FOR USE OUTSIDE NEW Qualified in Nassau County YORK STATE,ONLY: Commission Expires September 30,20- (Out of Stale or Foreign General Acknowledgment Certificate) ...............)ss: ACKNOWLEDGMENT FORM FOR USE WITHIN NEW (Complete Venue with State,Country,Province or YORK STATE ONLY: 41uncipality) (New York Subscribing Witness Acknowledgment Certificate) On the day of in the year 2023 before me,the undersigned,personally appeared State of New York,County of Nassau )ss: personally known to me or proved to me on the basis of satisfactory evidence to be the individuals)whose names)is (are)subscribed to the within instrument and acknowledged to On the day o f in the year 2023, me that he/she/they executed the same in his/hedtheir before me,the undersigned,personally appeared capacity(is),that by his/her/their signature(s)on the instrument, the individual(s),or the person upon behalf of which cite individual(s)acted,executed the instrument,and that such the subscribing witness to the foregoing instrument,with individual made such appearance before the undersigned in the whom 1 am personally acquanited,who,being by me duly swam, did depose and say that he/she/they reside(s) in (Insert the city or other political subdivision and the state or country or other place the acknowledgment was taken). (if tie place of residence is in a city,include the street and street number,if any,thereon;that he/shelthey know(s) Notary Public to be the individual described in and who executed the foregoing instrument;that said subscribing witness was present and saw said execute the same;and that said witness at the same time subscribed his/her/their name(s) as a witness thereto. Notary Public BARGAIN AIND SALE DEED SECTION: 79 WITH COVENANTAGAINST GRANTOR'S ACTS BLOCK: 4 Lol'(s): 57 COUNTY:SUFF'OLK TITLE NO. NY5904-01 BRENNAN STREETADDRE.SS: 1565 BRIGANVTIMi DRIVE TO Southold,NY 11971 TSC HOLDINGS RE'rURN BY MAILTO: PLACE FOR USE OF RECORI)ING OFFICE 1 Issuing Office File Number: NY5904-01 SCHEDULE A-1 AMENDED 8-9-2023 ALL that certain plot,piece or parcel of land,situate,lying and being in the Town of Southold, County of Suffolk and State of New York,known and designated as Lot 71 as shown on a certain map entitled, "Map of Harbor Lights Estates,Section 3", and filed in the Office of the Clerk of the County of Suffolk on August 7, 1968 as Map No. 5147, bounded and described as follows: BEGINNING at.a point on the easterly side of Brigantine Drive distant 1101.73 feet northerly as measured along the easterly side of Brigantine Drive from the corner formed by the intersection of the easterly side of Brigantine Drive and the northerly side of North Bayvlew Road; RUNNING THENCE North 19 degrees 13 minutes 20 seconds East,along the easterly side of Brigantine Drive, 100.00 feet; THENCE South 70 degrees 46 minutes 40 seconds East,204.96 feet to the westerly side of Paradise Shores Road; THENCE South 19 degrees 36 minutes 20 seconds West, along the westerly side of Paradise Shores Road,97.46 feet; THENCE North 71 degrees 29 minutes 50 seconds West,204.33 feet to the easterly side of Brigantine Drive,the point or place of BEGINNING. APPROVED AS NOTED OCCUPANCY ~ ' :r'S �`A1fEflytATELY - a DATE__a�.B.P.# ®R :ENGL7SF POOLC6MOLE TO CODE 3�• ,BY: USE IS UNLAWFUL = ��BEI°OR WA EIR'N`'`�� FE WITHOUT C NOTIFY BUILDING DEPARTMENT AT ` CERTIFICATE 631-765-1802 8AM TO 4PM FOR THE OF OCCUPANCY-- FOLLOWING INSPECTIONS: 1. FOUNDATION-TWO REQUIRED FOR POURED CONCRETE RETAIN STORM WATER RUNOFF 2. ROUGH-FRAMING&PLUMBING PURSUANT TO CHAPTER 236 3. INSULATION 4. FINAL-CONSTRUCTION MUST OF THE TOWN CODE. BE COMPLETE FOR C.O.CONSTRUCTION C®(i/(PL o..:Vlf(�H ALL CODES CONSTRUCTION SHALL MEET 'NEW YpR�S �TO1N(V-Cps REIIUIREMENTS OF THE CODES OF NEW YORK STATE NOT RESPONSIBLE FOR AS REQUIR ANQ4I ON JIn DESIGN*OR CONSTRUCTON ERRORSON$'QF} sn: S(?Uit�IQLD>TOYVNZ�p �,. b TOWN ,TAIISW . P00 512E D P00LSI2E MTM'� A B C 0 E F O N R L M F . 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I 6 POOL PLAN 1 TYPICAL WALL SECTION AT"A"FRAME rr H p P B CORNER CONNECTION N DETAIL 1 POOL SECTION Complies With: t°, 2016 NYS Uniform Code Supplement Sec R326 R3263.3 h Gtoend Fools Shag Be in Caafmm—aith ANSPNSPI-5 _. R326S BuHa lequi—tss Temp Fence smnthe tmtalkd rt time of Pool tamstmetlon,sad Fea went fm*g b the Enna-ere seapoml6Wry R326.6 Fahapmnt P=WCUan b"taUcd SCALE: NTS mm - - '- R326.7SwilagPaoIandSpeAi— ..tbel"staHed p00LTYPE:RECTANGLE REV. 2015 W= JAMES DEERKOSKI,P.E. DATE: See R403.10.2 Time switches oratba emtsal methads lhuem nm TYPICAL PANEL STIFFNER eetoeitinnyt=cir end enam=&g tee pesdsrbedaleabeRbe 260 DEER DRIVE metalled farbeata"and pump as o .Heaven and pomp mats"Wst DRAWING NUMBER baeeb.Htia BmeswStcha shall he io eomph'ance wit69eeR403.10.2 MA'TTITUK,NEW YORK 11952 ° 1 OF 1