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HomeMy WebLinkAbout49599-Z �O�Og�EFQL Town of Southold 7/21/2024 y P.O.Box 1179 0 o ` 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 45380 Date: 7/21/2024 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 165 Gin Ln Southold SCTM#: 473889 Sec/Block/Lot: 88.4-2 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 7/11/2023 pursuant to which Building Permit No. 49599 dated 8/18/2023 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: accesso , in ground swimming pool fenced to code as applied for. The certificate is issued to Buonocore,George&Rosa of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 49599 7/3/2024 PLUMBERS CERTIFICATION DATED 0 Autho z Si a e FF04 TOWN OF SOUTHOLD BUILDING DEPARTMENT y TOWN CLERK'S OFFICE SOUTHOLD, NY awn- 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#: 49699 Date: 8/18/2023 Permission is hereby granted to: Buonocore, George 18 Waterview Ave Massapequa, NY 11758 To: Construct an accessory inground swimming pool to an existing single family dwelling as applied for. Pool and pool equipment must maintain a minimum setback of 5'. At premises located at: 165 Gin Ln Southold SCTM #473889 Sec/Block/Lot# 88.4-2 Pursuant to application dated 7/11/2023 and approved by the Building Inspector. To expire on 2/1612025. 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 • iQ sean.devlinl'a-town.southold.ny.us Southold,NY 11971-0959 Q COMM BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: . George Buonocore Address: 165 Gin Ln city,Southold st: NY zip: 11971 Building Permit#: 49599 Section: $$ Block: 4 Lot: 2 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: Electrician: Black Tie Electric License No: 31154ME 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 2 Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO 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: Intermatic Pool Panel 4 Circuit/ 3 Used w/Timeclock, Pump 220GFI, Heater 220GFI. (2) Lights 120GFI, Water Feature 120GR, Bond Integrity Test Notes: " AS BUILT NO VISUAL DEFECTS " POOL Inspector Signature: Date: July 3, 2024 S.Devlin-Cert Electrical Compliance Form � �fUL�e BUILDING DEPARTMENT- Electrical Inspector ©��� TOWN OF SOUTHOLD C, Town Hall Annex - 54375 Main Road - PO Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 lameshg-southoldtownny.gov — seand(cr_southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: 6/20/2024 Company Name: Black Tie Electric II LLC Electrician's Name: Ignacio Vazquez License No.: 31154-ME Elec. email: Blacktieelectric@hotmail.com Elec. Phone No: 6319226181 01 request an email copy of Certificate of Compliance Elec. Address.: 42 Pennsylvania ave Medford N.Y. 11763 JOB SITE INFORMATION (All Information Required) Name: Bounocore Address: 165 Cain Ln Cross Street: Main Bayview Rd Phone No.: 6319226181 Bldg.Permit#: BP#49599 email: Blacktieelectric@hotmail.com Tax Map District: 1000 Section: Block: Lot: BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Square Footage: r Circle All That Apply: Is job ready for inspection?: YES ONO [:]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: 200 A # Meters 1 Old Meter# New Service0 Fire ReconnectOFlood Reconnect Oservice Reconnect❑Underground ✓QOverhead # Underground Laterals 1 F2 R H Frame Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION �� 2( Z� 7f P-o- g4s99 PERMIT# Address: Switches Outlets GFI's Surface Sconces H H's UC Lts Fridge HW POOL Av? o'er- Pane11��T��� Fans Mini Fr. W/D a G Pump Exhaust Oven Sump "-` Heater Trnsfmr �d Smokes DW Generator Salt Gen. Carbon Micro GrbDis Water Bond Lights Z ] Heat Pucks ERV HOT TUB/SPA Inst Hot DeHum Transfer Disc Combo Cooktop Minisplit Blower AC AH Hood Blower Service Amps Have Used Sub Amps Have Used Comments OF SOUTyO� - - - # T�*N 0 SOUTHOLD UILDING DEPT. ou 631-765-1802 1''NSPECTION [ ] 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: p ocf 7Z3/�V5;Z JI Eza WIL ArtnoWd_Wa�v 4��orz OcAiw- �v " oo C !F 28 a-o� &I r? 0 CA CA8 r J l r4coi r l+y �� DATE " INSPECTOR Q ` SOUIyO� # TOWN OF SOUTHOM BUILDING DEPT. cou 631-765-1802 INSPECTI-ON' [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND XFINAL SULATION/CAULKING FRAMING /STRAPPING [. ] FIREPLACE'.& CHIMNEY . [ ] FIRE.SAFETY-INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REM KS: Nrd led, .v C sh %.01 �G DATE INSPECTOR East End Inspection Agency, LLCy P.O. Box 35 East Quogue, New York, 11942 E E 1 (631) 594-2272 Fax(631) 594-2598 East End Inspection Agency office@eastendinspectionagency.com CERTIFICATE OF ELECTRICAL COMPLIANCE This Certificate of Compliance is limited to the inspection and,compliance of electrical equipment and/or work described below, installed by the applicant and not after the final inspection date listed. Owner: George Buonocore Date: July 3, 2024 Address: 18 Waterview Ave Certificate No: 24-657 Massapequa , NY 11758 Location of Property Inspected 165 Gin Lane Southold, New York STCM--Dist--—01-000 Section:_8.8-.._.____Block:_4_U____ Lot:-_2 _ , Permit Number [X] Electrical Survey [X] Residential [X] Swimming Pool [X] Swimming pool bonding GFCI Receptacles- 1 Pool Us-2 low voltage. Swimming Pool- 1-inground4-Corners Time d- Time Clock- 1-40 Amp Intermatic 07 Ohms of grounding resistance Switches-1 GFCI Breakers-2 Pool Pumps- 1 1 hp Pool Heater- 1-Gas .00 Volts/Current Special Rec. - 1-20Amp Date of Roughing Inspection: Date of Final Inspection: 7/1/2024 The electrical work and /or equipment described above were inspected and appear to be in compliance with local, state and national electrical code requirements at the time of inspection. Installer: Black Tie Electric II LLC License Number: ME31154 42 Pennsylvania Ave Medford, NY 117 Electrical Inspector: Edward Seltenreich I ♦ ��►. • r� � '� *ram r# i I i l I ti W� x4( -��� ��',�� ��t ,' ''A-�• .go- + a a FIELD INSPECTION REPORT DATE COMMENTS -4 FOUNDATION(IST) ------------------------------------ � c FOUNDATION (2ND) _ z l3? G� ROUGH FRAMING& PLUMBING aj 5 � r r� 'INSULATION PER N.Y. STATE ENERGY CODE y c,� N•• VPwlt FINAL GA le m ADDITIONAL COMMENTS recce D?7 (I C o -111LI24 bec%c Ced. -3 z -3 m X re y � O z x H x d r� b H =�O�SpfFO(,��oG TOWN OF SOUTHOLD—BUILDING DEPARTMENT y Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 hLtps://www.southoldtownny.gov Date Received - APPLICATION FOR BUILDING PERMIT For Office Use Only `�. D)) PERMIT NO. Building Inspector: JUL 1 1 2023 Applications and forms must be filled out in their entirety. Incomplete BtJ1I,DING DEPT. ,- applications will not be accepted. Where.the Applicant is not the owner,an '_TOVI*N `�,�"f� '�'R- �''' Owner's Authorization form(Page 2)shall be completed. Date: Z 6 Z 3 OWNER(S)OF PROPERTY: Name: �Cy SCTM#1000- ` Project Address: �" r Phone#: IL j� -12 - C 6 Email: `l L_C( Mailing Address: CONTACT PERSON: Name: Mailing Address: Phone#: Email: DESIGN PROFESSI INFORMATION: Name: Mailing Address: _3 Phone#: Email: L rcrn.�c►_� �a CONTRACTOR INFORMATION: Name: Mailing Address: Phone#: Email: DESCRIPTION OF PROPOSED CONSTRUCTION ew Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: ❑other Will the lot be re-graded? ❑Yes ®< Will excess fill be removed from premises? ❑Yes Cato PROPERTY INFORMATION Existing use of property: � - Intended use of property: Zone or use district in which premises is situated: Are there any covenants ad restrictions with respect to this property? ❑Yes Xci IF YES, PROVIDE A COPY. 'D Check Box After Reading: The owner/contractor/design professional is responsible 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 premises and in building(s)for necessary inspections.False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the New York State Penal Law. Application Submitted By(prin amo �� i�� oYYelrcl_ pCl. Authorized Agent ❑Owner Signature of Applicant: Date: 7 STATE OF NEW YORK) COUNTY OF <Sub ) L7 ! being duly sworn, deposes and says that(s)he is the applicant (Name dA individual signing contract)above named, (S)he is the fcAUCb- (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 day of U I� , 2023 Notary Public CHEYENNE A KEELAN Notary Public-State of New York NO.01KE6396745 Qualified in Suffolk County ROPERTY OWNER AUTHORIZATION My Commission Expires Aug 26, 2023 (Where the applicant is not the owner) I, r7ed CPtC Cl, residing at l C7—,,Itl S0�7T'1Gr quV J do hereby authorize G� c c apply n be al f t e ow of Southold Building Department for approval as desccribed erein. Z `la ZaZ� Owner's Signat Date Print Ow er's Name 2 BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD .' Town Hall Annex - 54375 Main Road - PO Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 iamesh -southoldtownny.gov - seand(cDsoutholdtownny_gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All information Required) Date: 6/20/2024 Company Name: Black Tie Electric II LLC Electrician's Name: Ignacio Vazquez License No.: 31154-ME Elec. email: Blacktieelectric@hotmail.com Elec. Phone No: 6319226181 211 request an email copy of Certificate of Compliance Elec. Address.: 42 Pennsylvania ave Medford N.Y. 11763 JOB SITE INFORMATION (All Information Required) Name: Bounocore Address: 165 Gin Ln Cross Street: Main Bayview Rd Phone No.: 6319226181 Bldg.Permit#: BP#49599 email: Blacktieelectric@hotmail.com Tax Map District: 1000 Section: Block: Lot: BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Square Footage: Circle Ali 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 SizeFV11 Ph❑3 Ph Size: 200 A # Meters 1 Old Meter# ❑New Service❑Fire Reconnect[]Flood Reconnect❑Service Reconnect❑Underground ✓❑Overhead # Underground Laterals 1 2 H Frame Pole Work done on Service? Y ON Additional Information: PAYMENT DUE WITH APPLICATIONto I v Z� dl 1 rt ot- 1 a77 L�O Y SYMBOL LEGEND El MONUMENT FND WIRE FENCE 0 I.P. /I.B. FND © GAS METER C� I.P. /I.B. SET ® WATER METER 00355 SPOT ELEVATIONS DN4 GAS VALVE CQ..3 UTILITY POLE pQ WATER VALVE >---- GUY WIRE 46 TEST HOLE ­==o UTILITY POLE W/LIGHT TREE A LIGHT POLE © SHRUB R0 SIGN • BOLLARD V r1(V(�1/// o� FIRE HYDRANT A WETLAND FLAG QO MANHOLE Y Jr•1J, �Y D.C. DEPRESSED CURB B • •�'� A -3ee "A"-INLET FE. FENCE A I M 1\I 1DFj) -INLET MAS. MASONRY (66 1 _ 0 YARD INLET PLAT. PLATFORM J ® YARD INLET W.W. WINDOW WELL Z A/C UNIT B/W BAY WINDOW ® ELECTRIC METER C/E CELLAR ENTRANCE — PVC FENCE (PVC) O/H OVERHANG — STOCKADE FENCE (STK) R/O ROOF OVER I —X— CHAIN LINK FENCE (CLF)CANT. CANTILEVER O O ew WRF FM LOT 24 —2.0' I LL FM LOT 25 TAX LOT f f ON o TAX LOT 26 PVC 0 I \�� FEN 1 STK - -� > MTL*Q3 —0 2' FEN 0.74 S52005 r50rr E a 0 2' 125.00,6' WIRE FEN.f0.1' 2.0. — FND — — -- _ PVC 4' PVC FEN. F �3 HD STK PIPEFEN�0.3' ry8.5' 0.54 O I io W O 0.1'� N i- � / Hs o L _ w 0 — - - - -� 24.2 2.7' ASPHALT Wlo DRIVEWAY .t < w a W �_ 12.0' 1 I 32.9' S �Q J w FI CT a ,mj CONC. z ¢� �- - — TA LOT 2Z3 FM LOT 26 TAX LAT PS -4- 1 STORY I FRAME a 4.1 RESIDENCE Y '0 eD #165 iV w m �� Dp N 00 zw w o l W 36.8' 36.0' Oo< Ago L) 1 0 a a ON chi � • N 0 A/C GENERATOR o 21If , �•� ' ON h l 0A _ o w N cv }Co ON FEN 3' STOCKADE 0 a f 0 / — . . 0.4' FEN. STf — — r rr w STK a FND N52 05 50 W STK 6' ST CKADE FEN. r o FEN PIPE f— o FENl 125.00 Y 0.7-4 LY.7 z 1.7'w✓L o w 0.5'-► m.r FM LOT 27 FM LOT 22 I TAX LOT 24 TAX LOT 3 LOT AREA 12,500.00 S.F. 0.29 AC. GRAPHIC SCALE 20 0 10 20 GUARANTEED TO: TITLE NO. WOLF-3305-S GEORGE BUONOCORE AND ROSA BUONOCORE ( IN FEET ) WGF NATIONAL TITLE INSURANCE COMPANY 1 inch = 20 ft. of N E!N y �- SURVEY OF PROPERTY �`P�PEL J. s ��p '� LOT 23� SCALICE MAP OF / land surveying BAY HAVEN FILE DATE: 01/22/1959 MAP N0. 2910 m s I andsurve . COn1 P: 631 -957-2400 SITUATE N •,vs 05OB6" a�� DR.:MC CREW.:AN SCALE: 1M = 201 SUFFOLK TAX MAP NO. SOUTHOLD FD LAN � 1000-08800-0400-002000 SUFFOLK COUNTY, NEW YORK DATE SURVEYED:10/13/2020 JOB No.S20-2093 (1)UNAUM QED ALTEWTION OR ADDITION TO THIS SURVEY MAP BEARING A LICENSED LAND SURVEYOR'S SEAL IS A NOTATION OF SECTION 7209.SUB-DM ON 2.OF NEW YORK STATE EDUCATION LAW.(2)ONLY BOUNDARY SURVEY MAPS WITH THE SURVEYOR'S EMBOSSED SEAL ARE GENUINE TRUE AND CORRECT COPIES OF THE SURVEYOR'S ORIGINAL WORK AND OPINION. (])CERTIFICATIONS ON THIS BOUNDARY SURVEY MAP SIGNIFY THAT THE MAP WAS PREPARED IN ACCORDANCE WITH THE CURRENT EXISTING CODE OF PRACTICE FOR LAND SURVEYS ADOPTED BY THE NEW YORK STATE ASSOCIATION OF PROFESSIONAL LAND SURVEYDRS,INC.THE CERRFIMION IS UNITED TO PERSONS FOR WHOM THE BOUNDARY SURVEY MM IS PREPARED,TO ME TITLE COMPANY,TO THE GOVERNMENTAL AGENCY.AND TO THE LENDING INSTITUTION LISTED ON THIS BOUNDARY SURVEY MAP.(4)THE CERTIFICATIONS HEREIN ARE NOT TRANSFERABLE(5)THE LOCATION OF UNDERGROUND IMPROVEMENTS OR ENCROACHMENTS ARE NOT ALWAYS KNOWN AND OFTEN MUST BE ESTIMATED.IF ANY UNDERGROUND IMPROVEMENTS OR ENCROACHMENTS EAST OR ARE SHOWN.THE IMPROVEMENTS OR ENCROACHMENTS ARE NOT COVERED BY THIS SURVEY.(6)THE OFFSET(OR DIMENSIONS)SHOWN HEREON FROM THE STRUCTURES TO THE PROPERTY LINES ARE FOR A SPECIFIC PURPOSE AND USE AND THEREFORE ARE NOT INTENDED TO GUIDE THE ERECTION OF FENCES,RETAINING WALLS,PODLS.PATIDS PLANTING AREAS,ADDITIONS TO BUILDINGS,,AND ANY OTHER TYPE OF CONSTRUCTION.(7)PROPERTY CORNER MONUMENTS WERE NOT SET AS PART OF THIS SURVEY.(B)THIS SURVEY WAS PERFORMED WITH A SPECTRA FOCUS DO ROBOTIC TOTAL STATION, (9)THE EXISTENCE OF RIGHTS OF WAY AND/OR EASEMENTS OF RECORD IF ANY,NOT SHOWN ARE NOT GUARANTEED. (10)SURVEY IS SUBJECT TO ANY STATE OF FACTS WINCH M UP-TO-DATE TIRE EXAMINATION MAY DISCLOSE. r�nr...�,>.-+•;._,-;x;1,.;..�,:.F - _.: .•Su,ffolk County Dept.of labor,Licensing$Consumer Affairs HOME IMPROVEMENT LICENSE a, Name REMIGIO BAR RERA Business Name s certifies that the ;uer is duly licensed BM CONSTRUCTION 't`.'�e_County of suffolk License Number:H-53123 gg� ( Rosalie Drago Issued: d3/2;7/2014 7 I� Cor7missioner f Expires: : 3/1(2024 , ry l This license is the property of Suffolk County Department of Labor,Licensing&Consumer Affairs. Possession of this license does not guarantee its validity. Additional Business Name a License Category H6-Masonry;H1-GC I • f � s I ACORU® DATE(MM/DDNYYY) CERTIFICATE OF LIABILITY INSURANCE 7/6/2023 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((es)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 CONTACT NAME: Borg Risk Management Services, Inc PHONE FAX 148 East Main Street c o •631-673-7600 A/c No:631-351-1700 Huntington NY 11743 _ ADDRESS: insurance@borgins.com INSURERS AFFORDING COVERAGE NAIC# License#:PC-1544422 INSURERA:Utica First Insurance Company 15326 INSURED BARRREM-01 INSURER B: Remigio Barrera Dba B M Construction 18 Syracuse Avenue INSURER C: Medford NY 11763 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1494602555 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 EFF POLICY EXP LIMITS LTR POLICYNUMBER MM/DD MM/DD A X COMMERCIAL GENERAL LIABILITY Y ART3000223170 4/26/2023 4/26/2024 EACH OCCURRENCE $500,000 DAMAGE To CLAIMS-MADE 7 OCCUR -PREMISES Ea occu RENTED Ace $50,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $500,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $1,000,000 POLICY❑ PRO- POLICY ❑ LOC PRODUCTS-COMP/OP AGG $1,000,000 X 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 $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE I I ER ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ NIA E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If es,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached If more space is required) Re:Client:George Buonocore 165 Gin Lane Southold NY 11971. Town of Southold is included as Additional Insured under General Liability,with respects to the operations of the named insured as required by written contract. Subject to policy terms,conditions and exclusions. 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 554375 Main Road AUTHORIZED REPRESENTATIVE Southold NY 11971 �a ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD o ad APPROVED AS NOTED DATE g-e8-23 B:P.# COMPLY WITH ALL CODES OF 00• NEW YORK STATE &TOWN CODES FEE: `� BY AS REQUIRED AND CONDITIONS OF NOTIFY BUILDING DEPARTMENT AT AM TO 4 PM FOR THE 5ltt a:>t'r,;5iiri°yc;g.'t ;fi'`:'•t'i• 765-1802 8 SOUTHOLD TOWN ZBA :r. ;F ` +,ia. . FOLLOWING INSPECTIONS: 1. FOUNDATION-TWO REQUIRED FOR POURED CONCRETE SOUTHOLD TOWN PUWNING BOARS .:'''. .:r:;, 2. ROUGH-FRAMING,PLUMBING, STRAPPING,ELECTRICAL&CAULKING SOUTHOLD TOWN TRUS M 3. INSULATION 4. FINAL-CONSTRUCTION&ELECTRICAL N.Y.S.DEC } MUST BE COMPLETE FOR C:O. � ALL CONSTRUCTION SHALL MEET THE ; REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. i "IMMEDIATELY" ENCLOSE-POOL.TO CODE UPON COMPLETION BEFORE"WATER" ELECTRICAL INSPECTION REQUIRED RETAIN STORK!WATER WJIWF PLIFISUANT TO CHAPTER 81 OF THE TOWN CODE. i 1 SKIMMER SWIMMING POOL BARRIER REQUIREMENTS o The barrier must completely surround the swimming pool and must obstruct access to the swimming pool. 0 The barrier must be at least 4 feet (48 inches) high. A building wall can form part of the required barrier. SKIMMER However, where a wall of a dwelling serves as part of the barrier, at least one of the following requirements must be satisfied: LADDER LED LIGHT the pool must be equipped with a powered safety cover LED LIGHT all doors with direct access to the pool through that wall must be equipped with an alarm or other means STEPS of protection, such as self—closing doors with self—latching devices, which are approved by the governing body 6'-0" DEEP In the case of an above—ground pool, the pool structure itself can serve as a part of the required Q 34'-0" C', 3'-6" DEEP barrier, provided that the pool structure is sufficiently bo rigid to obstruct access to the pool. However, where an above—ground pool structure is used as a barrier or where the barrier is mounted on top of the pool structure, and the means of access is a ladder or DUAL ANTIVORTEX steps, then: VGB COMPLIANT the ladder or steps shall be capable of being secured, MAIN DRAINS. locked or removed to prevent access, or the ladder or PLUMBING TIED i' steps shall be surrounded by a barrier when the ladder or steps are secured, locked or WITH "T" removed, any opening created shall not allow the passage of a 4—inch—diameter sphere. RETURN Barriers shall be located so as to prohibit permanent structures, equipment or similar objects from being RETURN used to climb the barriers. SWIMMING POOL ENTRAPMENT PROTECTION POOL SHALL BE BUILT TO 2020 Suction outlets must be designed to produce circulation RETURN RCNYS AND 2020 ECCC NYS throughout the pool or spa EQUIPMENT LIST. RETURN Single outlet systems, such as automatic vacuum cleaner ALL PIPING 2" SCHED 40 PVC p NOTES: POOL SHALL MEET ALL SWIMMING POOL systems, or other such multiple suction outlets whether PUMP: HAYWARD VS SUPER PUMP SP2603VSP RELATED CODES IN THE 2020 NYS UNIFORM CODE isolated by valves or otherwise must be protected against FILTER:HAYWARD CLEAN AND CLEAR CARTRIDGE FILTER SUPPLEMENT SECTION 326 user entrapment WALL RETURNS:4 MASONRY SHALL BE DESIGNED IN ACCORDANCE Suction Fittings: All pool and spa suction outlets (except SKIMMERS:2 %1TH PROVISIONS OF SECTION R606 OF 2018 IRC surface skimmers) must be provided with: 2 LED POOL LIGHTS POOL PLAN OR IN ACCORDANCE WITH PROVISIONS OF ACI a cover that conforms with reference standard 530/ASCE 5/TMS402 ANSI/ASME A112.19.8 Suction Fittings for Use in 8" Swimming Pools, Wading Pools, Spas, Hot Tubs, and 8" Whirlpool Bathtub Appliances, or 2" THICK STONE COPING "2+ a drain grate that is 18 inches x 23 inches or larger, or an approved channel drain system Atmospheric vacuum relief system required: All pool and «i CONCRETE WALL WITH VINYL LINER spa single— or multiple—outlet circulation systems must I '4 I be equipped with atmospheric vacuum relief should grate covers located in the pool become missing or broken The vacuum relief system needs to include at least one of the following two approved or engineered methods: Safety vacuum release system conforming to ASME 0 1 -0 A112.19.17; or COMPACTEE SAND An approved gravity drainage system BASE UNDER VINYL Dual drain separation: Single or multiple pump circulation P OOL C E C TI O N LINER systems must have: at least two of the approved type of suction outlets, and a minimum horizontal or vertical distance of 3 feet POURED CONCRETE WALLS WITH (4) #5 between the outlets, and BARS HORIZONTALLY AND CONTINUOUS the suction outlets piped so that water is drawn through DUAL ANTIVORTEX VGB SWIMMING POOL ALARM REQUIREMENTS them simultaneously through a vacuum—relief—protected COMPLIANT MAIN DRAINS. AROUND ALL FOUR WALLS @ 4000PSI AT s capable of detecting a person entering the water at any point on the surface of the pool and giving line to the pump or pumps PLUMBING TIED WITH T 28 DAYS an audible alarm Pool cleaner fittings: Where provided, vacuum or pressure cleaner fittings shall be located in accessible positions at to provide detection capability at every point on the surface of a swimming pool, it may be necessary 9 P WASTE TO DRYWELL I GALV to install more than one pool alarm least 6 inches and not more than 12 inches below the #" STEEL PIPE is audible poolside and at another location on the premises where the swimming pool is located minimum operational water level, or Doom is not an alarm device which is located on a person, or which is dependent on a device located on a as an attachment to the skimmers 2" STAB RISER 2" STAB RISE :HEATEBR p proper TU erson for its ro er operation SAND HEATER 2" P.E. PIPE meets ASTM F2208 FILTER LTER SEAL - '"t- h M1` .4 ARCHITECT PROJECT DRAWING TITLE SCALE DATE 3/gn=11-O° 7-10-2023 PUMP JEFFREY SANDS B U 0 N 0 C 0 R E CONCRETE WALL OR AYNNG NUMBER RETURN TO POOL A;`- `r_ ° ' t ,`1` PROPANE TANK GAS RISER SCHEMATIC _ =�`�'o ARCHITECT VINYL LINER 4 SWIMMING POOL FROM 9 �! �- 1 6 EVERGREEN LANE POOL �' s"/, i �i j EAST QuoGUE, NY 11942 16 5 GIN LANE EQUIPMENT SCHEMATIC DRYWELL ��}.� /�rr,f PHONE 631.375.5997 SWIMMING POOL �,` 0// FAX 631.576.8916 SOUTHOLD, NEW YORK DETAILS