HomeMy WebLinkAbout49874-Z �o��S11FF01 Town of Southold 10/9/2024
P.O.Box 1179
0
C.
_ M,.r� 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 45559 Date: 9/15/2024
THIS CERTIFIES that the building IN GROUND POOL
Location of Property: 10305 Route 25,East Marion
SCTM#: 473889 Sec/Block/Lot: 31.-4-12
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
4/20/2021 pursuant to which Building Permit No. 49874 dated 10/12/2023
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:
accessoKy in ground swimming pool fenced to code as applied for.
The certificate is issued to Gatland,jeffrey&Schnore,Zinta
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 46206 3/7/2022
PLUMBERS CERTIFICATION DATED
U- Au o ize S nature
�SUFFotK a TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y TOWN CLERK'S OFFICE
o • 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'#: 49874 Date: 10/12/2023
Permission is hereby granted to:
Gatland, Jeffrey J
355 E 86th St Apt 4A
New York, NY 10028
To: Construct in-ground vinyl swimming pool as applied for. Replaces BP#46206
At premises located at:
10305 Route 25, East Marion
SCTM #473889
Sec/Block/Lot# 31.4-12
Pursuant to application dated 4/20/2021 and approved by the Building Inspector.
To expire on 4/12/2026.
Fees:
PERMIT RENEWAL $200.00
Total: $200.00
Building Inspector
�o�SUfFaIK�o TOWN OF SOUTHOLD
ay 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#: 46206 Date: 5/10/2021
Permission is hereby granted to:
Gatland, Jeffrey
355 E 86th St Apt 4A
New York, NY 10028
To: Construct in-ground vinyl swimming pool as applied for.
At premises located at:
10305 Route 25, East Marion
SCTM #473889
Sec/Block/Lot# 31.4-12
Pursuant to application dated 4/20/2021 and approved by the Building Inspector.
To expire on 11/9/2022.
Fees:
CO- SWIMMING POOL $50.00
SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00
Total: $300.00
Building Inspector
OF SO�j�ol
� o
Town Hall Annex Telephone(631)765-1802
54375 Main Road
P.O.Box 1179 �Q sean.devlina-town.southold.ny.us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Jefferey Gatland
Address: 10305 Route 25 city:East Marion st: NY zip: 11939
Building Permit#: 46206 Section: 31 Block: 4 Lot: 12
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE .
Contractor: DBA: South Electric License No: 58024ME
SITE DETAILS
Office Use Only
Residential X Indoor X 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
Transformer UC Lights Dryer Recpt Emergency Fixture Time Clocks 2
Disconnect Switches 1 4'LED Exit Fixtures Pump 2
Other Equipment: Intermatic Pool panel 8 Circuit/6 used, Pump 220GFI, Cleaner Pump 220GFI,
Heater, Salt Generator, 2 Lights
Notes: Pool
Inspector Signature: Date: March 7, 2022
S.Devlin-Cert Electrical Compliance Form
pf SOpj�o6 �"� t47 2-0 6
# TOWN OF SOUTHOLD BUILDING OEPT.
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/O
REMARKS: 7-0�1-2- DQA�Alt�
DATE 1 2- INSPECTOR C
OFSOUIyOIo (o ! S65AA N "R
# # TOWN OF SOUTHOLD BUILDING DEPT.
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/O
REMARKS:
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DATE lLU 124 INSPECTOR
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# # TOWN-OF SOUTHOLD BUILDING DEPT.
765-1802
. . 1 NSPECTION
[ ] 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/O
REMARKS: 8da"
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DATE INSPECTOR
�o��pE SOUIyOlo
co 3 aS MAiAi Rp
# # TOWN OF"SOUTHOLDBUILDING DEPT.
765-1802
1,NSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[` ] 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
REMARKS: /NA-LcL
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DATE J V 02 INSPECTOR �-�
oF soolyo 4 b�
# # TOWN OF SOUTHOLD BUILDING DEPT.
�ycoom, - 765-1802
_ -INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2NDt [` ] 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
REMARKS:
GTG
DATE INSPECTOR
oF soolyolo 62a l �7 dS Moo n `,.
# TOWN-,OF;SOUTHOLD-BUILDING DEPT.
765-1802
: I NSP
ECTI-0N
[ ] FOUNDATION 1ST [ '-] ROUGH PLBG.`
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY- [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] -ELECTRICAL (ROUGH) [\A ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS: O�U'�
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DATE :INSPECTOR
4v �F SO(/Tyolo
f TOWN OF SOUTHOLD BUILDING DEPT.
Crown 631-765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] SULA ION/CAULKING
[ ] FRAMING /STRAPPING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATIO [ ] PRE C/O [ ] RENTAL
REMARKS: AfA
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DATE 1,0 (ol Y INSPECTOR
/ ho�aOF SOUTyOIo
* # TOWN OF SOUTHOLD BUILDING DEPT.
cou 631-765-1802
�%+q INSPECT-ION
[ ] FOUNDATION 1ST/REBAR [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] SULAQQTION/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:
DATE ot10 INSPECTOR
FIELD:INSPECTIO N REPORT 'DATE
COIVIIVIENTS
FOUNDATION(IST)
--------------------
------`. ----- :t'
FO JNDATION (2NA)
p
ROUGH FRAMING:&
PLUMBING: �.
INSULATION.PER N.Y. H
STATE ENERGY CODE
FINAL :
ADDITIONAL COMMENTS'
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o�S�FFOIK�o TOWN OF.SOUTHOLD=BUTLDTNG.DEPARTMENT: .. . . .. . .? Town Hall Annex 54375 Main Road P. O.:Box 117'9 Southold' NY 11971.-0959
Telephone(631)765-1:8Q2 Fax:(631) 765=9502 https:LLwww.aoutholdtownny.go . :.::
Date Received;
APPLICATION FOR-BUILDING PERMIT.:: : ; s . i.._:.:.
Fof Office Use Only
�. �:Ya
�a.0� , ; u.. . o zoz1:. .. .. .. .. .
PERMIT N0. Building Inspector:" APR
:. ..::
Applications_and forms must be filled;ou#:in their;entrety.Incomplete
applications will not be accepted. Where the Applicant is not the owner,a.n
Owner's.Authorization form(Page 2)shall be.completed. . : .. . . : .. J: .. . : .. .
Date: .. .... ?c� ZI .. .... .: ::. ... .... :...
OWNERS)OF PROPERTY: .
Name: na SCTM,#:1000- 4:
�1r Q :.
. .... ... ...: . .... . .
Physical Address:
Phone#: Email:
:.: (a (e:. 8 3.(=:18(3
Mailing Address:::. :.. :. ...: .. .... ::. ...: :.. ...:
CONTACT PERSON:
:. Name: ::
I-vim... : ::��.lCLIAn csz�:.1:
Mailing Address:.
Phone#: ::: Co Email: v0. Cam. c�
DESIGN PROFESSIONAL INFORMATION:
Name:
.. .... Mailing Address: . :.::
Phone#: TFM;711 : .. . . -
:.:CONTRACTOR INFORMATION:.:: -... :..
Name: � -Es 1 ci.r\
Mailing Address: ,SCE OC�0::1k00.\r �� c�jo c C� 1 :. L�—1
::. .... .
Ph
:. Email: -
DESCRIPTION,OF.PROPOSED:CONSTRUCT ION
❑New Structure:.❑Additicin ❑Alteration ❑Repair'❑Demolition : : Estimated Costof.Project:
VOther
Will the lot be:re-graded?: Yes:❑No Will:excess fill be removed from premises? ❑Yes:.Wo ::
1 : :
i !PROPERTYANF,,ORMATION: n
Existing use of property: -!,Z � � Intended use of property:cAD
Zone or use district in which premises is situated: Are there-any covenants and restrictions with-respect to
t PROVIDE A COPY..
his property?..❑YesSAio,,IF:YES,
heck Box After Reocift: The owner)contractor%deslgn'professional Is responsibla for,alfdrainage and sform.water;issues as provided;bV:';
chapter 236,of fhe Tawn Code.:APPIICATION IS'HEREBY.MADEto the Building Dgpartment'fordhe Issuance of a:Building Permit pursuant to the Building one
16rdinance af.theTown of5ouihold;'suffolk,.County,Newyork and otherapplicable'laws,Ordinances or Regulations;,for the'consiruction of:buildings,_'
additions,alterations mfor removal.or demolition as;hereln'described..The appiicant'a&ees to.'compiy!vMh all appllcablG laws,ordinances,building code,
i'housing code and regulations and to adinit authors:edlaipectors on prertilses:andlin buiiding(s),for necessary Inspections.False statements,made'herein are :! "
punisbabie as a Class A inisdemeanoi•puisubnt to"Sc6ti6n'210.05 ofthc;NewYork state:Penal:law:
Application 5ubmitted:By:(print name): � �- uthorized Agent ❑Owner
r -- --
Signature:of Applicant p�. I I o l"?�
II
Date:
..
STATE OF NEW YORK)
COUNTY OF 4roi l
�. being:duly.sworn,dep oses and says that(s)he:is the applicant'
(Name of individual sighing contract)above named-
(Name
the ... ...
(Contractor,Agent,: rporate Officer,etc.)
of said owner or owners,and:is duty authorized to peiform: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
IEdayof
v' . . 200
tary Public
TRACEY L. DWYF_R
PROPERTY OWNER AUTHORIZATION NOTARY PuLlc,STATE OF NEVPORK
.(Where ttie applicanS is not the owner) NO.01 DW6306900
QUALIFIGL IN SUFFOLK COUP ITY
COMMISSION EXPIRES JUNE 36 21Ap2
_hrao-CP_ . : . residing.at
do hereb apply on
= c cm Yauthorize
rriy b3, a q the Town of Southold Building Department for approval as;described herein..
'L
O g
wne s SI n ure
:Print Owners Name:: ..
: :.. '2: .
�o�QS�FfOl,fr�O BUILDING DEPARTMENT-Electrical Inspector
� Gym TOWN OF SOUTHOLD
H = Town Hall Annex-54375 Main Road- PO Box 1179
1) Southold, New York 11971-0959
411 �a0�' Telephone (631) 765-1802 - FAX (631)765-9502
rogerr(a)southoldtownnv.4ov--seandasoutholdtownny.aov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (Ali information Required) Date: 8/6/21
Company Name:South Electric Inc
Name:Zinta Schnore
License No.: 58024-ME email: li.poolcare@gmail.com
Phone No: 646-831-1813 ❑✓ I request an email copy of Certificate of Compliance
Address.. 1305 Main Road, East Marion , NY 11939
JOB SITE INFORMATION (All Information Required)
Name: Zinta Schnore
Address: 1305 Main Road, East Marion , NY 11939
Cross Street:
Phone No.:646-831-1813
Bldg.Permit#: 46206 email: li.poolcare@gmail.com
Tax Map District: 1000 Section:31 Block: 4 Lot: 12
BRIEF DESCRIPTION OF WORK(Please Print Clearly) Pool
pool
pool
Check All That Apply:
Is job ready for inspection?: DYES ONO ❑Rough In ❑Final
Do you need a Temp Certificate?: ❑✓ YES [—]NO Issued On 8/6/21
Temp Information: (All information required)
Service Size Q1 Ph ❑3 Ph Size: A #Meters Old Meter#
❑New Service ❑Service Reconnect ❑Underground ❑✓ Overhead
#Underground Laterals ❑l ❑2 ❑H Frame❑Pole Work done on Service? ❑Y ❑N
Additional Information:
PAYMENT DUE WITH APPLICATION
Electrical Inspection Form 2020.xlsx
o�S"aFFOL,Cco BUILDING DEPARTMENT-Electrical Inspector
TOWN OF SOUTHOLD
H = Town Hall Annex-54375 Main Road - PO Box 1179
Southold, New York 11971-0959
�'y,j �a0�� Telephone (631) 765-1802- FAX (631)765-9502
I 411 rogerr(aDsoutholdtownnv.00v--seandta'�southoldtownnv gov
I1
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (Ail information Required) Date: 8/6/21
Company Name:South Electric Inc (� o& &' re
Name:Zinta Schnore _ (� 0 j-709
License No.: 58024-ME email: li.poolcare@gmail.com
Phone No: 646-831-1813 ❑✓ I request an email copy of Certificate of Compliance
Address.: 1305 Main Road, East Marion , NY 11939
JOB SITE INFORMATION (All Information Required)
Name:Zinta Schnore JG -
Address: { 5.Main.Road, East.,Marion:, NY 11939
Cross Street: (VW6L :-
Phone No.:'646-831-1813
Bldg.Permit#: 46206 . email: li.poolcare@gmail.com
Tax Map District: 1000 Section:31 Block: 4 Lot: 12
BRIEF DESCRIPTION OF WORK(Please Print Clearly) pool
pool
pool
Check All That Apply:.
Is job ready for inspection?: [DYES ❑NO ❑Rough In ❑Final
Do you need a Temp Certificate?: [DYES ❑NO Issued On 8/6/21 ~ ,
Temp Information:, (All information required)
Service Size 01 Ph ❑3 Ph Size: A #Meters Old Meter#
❑New Service ❑Service Reconnect ❑Underground Overhead
#Underground Laterals ❑1 2 ❑H Frame❑Pole Work done on Service? ❑Y ❑N
Additional Information:
r
PAYMENT DUE WITH APPLICATION
Electrical Inspection Form 2020.xlsx
PERMIT# Address:
Switches
Outlets"'`
GFI's '
Surface
Sconces
,IdH's
z
UC Lts
Fans Fridge HW
C
Exhaust ` Oven Dryer
Smokes DW Service
carbon. Micro Generator
Combo Cooktop Transfer
AC AH Mini
J
Special: 1
Comments: 1 �� d (� V t�C� (��`�✓=
VD
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v \
DATE(MMIODIYYYY)
ACORO
�,..� CERTIFICATEDID LIABILITY INSURANCE
-1v1y2o2o
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 ft AUTHORIZED
REPRESENTATIVE OR PRODU.CER�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`fhe policy,;certain•policies.may require an endorsement. A statement on
thi's_cettificate:does:not;confer:rightstotalo:certffiaate•lioldeti�l`lieu.cfsuch`end'orsentent(s:: "
PRODUCER': 9 y ;:CONTACT:
Morstan'Geneta1:A`enc Aug. .
P-O:B.OX.90O5. PHONE.. ', : FAIT
Alc No. '.63,t`578-0890 Alc:Na: 631.582-1412
New:.Hyde;F�ark. NY 1104.E . AD"c'uRIESS:-
IN$IIRER S:AFFO.RDINt$COVERAOE NAICS'.
MM)ROA-W: .CBritu; -Sur/3t •Ct)m -an . -3695"1
_INSU.RED Long ISlandPOlil.`Care.COCpC :INSuRERB:
Pt)BSIX_-f 6.9'. INSURERCt
INSURER:D,:
'60uthold. NY 1:1971 .. INBURER.E
NSUR ItF:
COVERAdE$ CER'nFICAtE'NUMBER: REVISION NUMBER:
THIS:IS"TO CERTIFY THAT THE POLICIES..OF':INSURANCE.LISTED.BELOW HAVE.BEEN.dSSUED:-O THE INSURED NAMED:ABOVE FOR THE.P.OLICY.PERIOD
INDICATED, .NOTWITHS7ANUING ANY RECdEIIREMEN,T,TERM.OR.CONDITION OF ANY.CONTRACT QR OTHER DOCUMENT WITH RESPECT TO WHICH"THIS
CERTIFICATE MAY BE ISSUED OR;MAY-PERTAIN,.THE.INSURANCE.:AFFORDED:BY THE POLIC1ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
FSUPClS IMIHON.MYk A IMS,EXbLUSIONSPNO CONITIONSO . W DY C
jR A CSUBR 01pEF pM1DP�T'YPEOPINSURANCE D LIMIT$
lC: Cti1VAME(tCtAtdENERAt LIADII.ITY EACH'OCCURRE. E $ 1,000i000
CW + OCCU . EES_Ea. Nce 10 .A : RM S
0-CPS98t76 4Y30120, " 4(3012 MIi13,lacP(Aayoneper_5¢n) $ 5;000
PEI#sDNAL;sAbvIrUUF2Y $: 1;OOQ'066
GENL'AGGRlGA%UM1TAPPLIE$pe#; GENEf2AL'AGGREGATE $ Z;OCIO,OOO.
X POLICY" LO
PR04
G" PAf5Dl1G" GOW/OPACES $ tCI00;CI00
OTHER:
AU0OI000.pIILU►91Ln1f' CUMBINE SI GLE'LIMIT $
Ea;acclaa"1)_
gNYAUTO BdOILYINJURY'(Perwwop $
OYVNED. SCHEDULED 8db6INJURY(peraccident) $ .
A TOSONLY
H" ED NONxSWNET? PROPF-RTYDAMAGE" $
AlC#t)S:ONI V JiU1 p3 iJNE'Y Pal aoddeM
$
UNIBRELLAUAB Oi;GUR' FQCH"OCCUAK CE:
E>SC.ESSL'tAB; LpIMSMAdE - :AGGREGATE. $
DED' F2ETENTION
WQRKER CgMFENSATIPN, PER OTH-
AND`FNIPIOIftFtSi4W81CITY• YIN TO STA•lL1TE- E
ANIfP#20PRIEiORIPARlh1ER/FJ(ECUTIVE E.L,,FJICH'ACCIDENT $
OFFICER!{JIEMBERExCIUOwl. Ell
Q t 0. aryory in NMlE.L.DI$EAS,E-EA'EMPLOYEE $
if C tleadlba under.
E CRP N' F.P �E;Li DISEASE-POLICY LIMIT
"DESCRIPTION O.F.OPERATIONS I LOCATIONS L:V&M;:LES_IACt)RD,I01;Add.ional.Reinarks scliedula,may be ettaelied,lf mote,$pae®la-requlied).
SUBJECTTO:COMPANY TERMS-CONDITIONS`AND"EXCLISIONS
CERTIFICATE HOLDER 'CANCELLATION
Town of-Southold
Builiiih DS ..lament. SHOULDANYiOF'THE ABOVE'DESCRIBED.P.OLII;IESBE CANCELLED"BEFORE
"
9 THE, EXPIRATION DATIB "'THEREOF, NOTICE WILL BE "DELIVERED IN
Town-HaII:Mnex 'ACGORbMtE".WITH.Tme,P.,OLItY.PROVISIONS.
PO Box:'II79
Southold;NY'I1971 AUTHORIZED REPRESENTATIVE
0:1988401SAGORD CdR P Tl N. I "ghts erved.
ACORD:25(2016103) The,'ACORD name:and logo are registered marks:'of ACORD"
.. :.'. UNAUTHORIZED ALTERATION'0 ADDITION
... ..... (61':N11 'dIEQ;ED IIV: /20q '..(A 'I�&a NO.17- ':.".. .: .TO THIS SURVEY AS A VIOLATION:OF O ..
SECTION.7209 OF.THE NEW YORK STATE... ...
.. .. EDUCATION LAW. .. ..
mm.
-- a •- - COP) .OF THIS SURVEY:MAP NOT BEARING
-- '',' THE LAND SURVEYOR'S:INKED SEAL.OR
88,b� EMBOSSED SEAL SHALL NOT BE CONSIDERED -
, •" TO:BE A VAUD TRUE COPY.
..... .... .:':: .. ou E.- .. .. .. GUARANTEES INDICATED:HEREON SHAL1.'RUN.
.. ". .. ... .. .. ... .5�g'.A ... ...ONLY TO.THE PERSON FOR.WHOM.THE SURVEY ... ...
IS PREPARED,AND ON HIS:BEHALF.TO THE :-
C .: TITLE COMPANY,:GOVERNMENTAL'AGENCY AND
'.LENDING INSTITUTION LISTED HEREON.AND
'LA g TO THE ASSIGNEES OF THE-LENDING INSTI—
TUTION. GUARANTEES ARE NOT-TRANSFERABLE.,;
O
G
THE EXISTENCE OF RIGHTS OF WAY
4 AND/OR-EASEMENTS OF-RECORD F�•
.. .. .. :," a '� ANY. NOT SHOWN ARE NOT
... :. ... ... ... GUARANTEED.
...... '.: '�: '.. - -�
Premises known Gs
r, Moi •R ad, Southold
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,dXt9 Po1a etch• .. gxn� * * ,
Certified to: •.
� �cgTLairoo ZINTa s {�oRE Survey,of.Described:Property
EMINENT ABSTRAQT,AC. 01919;S)• " ."" situv#e in the :':: .
CQMMQNYIEALTH LAND.TITLE.INSUPANCE:COMPANY
cmawlc,:NA Village of East:Marion
Town of'Southold '
y ' .
Michi t'el r '. Min.t.o; Suffolk Coun N:ew.. 4 York rT
District LICENSED'EROFES$IDNAL'LAND SURVEYOR: 1:000 Section 31 'Block Lot '12
NEW YORK-STATE LICENSE.NUMBER 050871 .. .. .
Cent Tfbodvie-Tv Lane
11720:: , $CO P 2 le- 1"' 30'.' Surveyed :July 5, :2017
GRAPHIC SCALD
.. ...PHONE/FAX:'(631) 580=1202' ... .. .. ... ...30 .. .. -
CELLULAR:'(631) 766-:V14' o :fa .f 30 .eo .,Zo
EMAIL: m1kam1n101spc0gma11Xo'in IS .. '
:.. ( IN FEET)
- " ' '1 Inch ='30' It,
APPROVED AS NOTED
DATE: B.P.# 6a0 OCCUPANCY OR
FEE: & ?ov.crd BY: `40USE IS UNLAWFUL
NOTIFY
1802BUILDING
TOD4 PM TMENT OR THE WITHOUT CERTIFICATE
FOLLOWING INSPECTIONS: OF OCCUPANCY
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION- MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET THELY
REQUIREMENTS OF THE CODES OF NEW -
EN'CLOStP bk T ,E3O E
YORK STATE. NOT RESPONSIBLE FOR UPON COItiAlLE710N
DESIGN OR CONSTRUCTION ERRORS. BEFORE"WATER"
RETAIN STORM WATER RUNOFF
PURSUANT TO CHAPTER 236
COMPLY WITH ALL CODES OF OF THE TOWN CODE.
NEW YORK STATE & TOWN CODES
AS REQUIRED AND CONDITIONS OF
SOUTHOLD TOWN ZBA
SOUTHOLD TOWN PLANNING BOARS
SOUTHOLD TOWN TRUSTEES �
N.Y.S.DEC
NOTES
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1. NO SOIL SURCHARGE PEPVITTEPWITHIN4 FEET OF EXCAVATION AT THE SHALLOW END,OR 6 FEET OF EXCAVATION ATTHE PEEP ENP.
B
A 2. THIS POOL MEETS THE REQUIREMENTS OF AN5I/APSP/ICC-5'AMERICAN NATIONAL STANDARD FOR RESIDENTIAL INGROUNDSWIMMING
POOLS"AND 1996 BOCA CODE-SECTION 421.DIVING EQUIPMENT 15 NOTALLOWED.^ J
o O3. SWIMMING POOL SHALL BE COMPLETELY AND CONTINUOUSLY SURROUNDED WITH A BARRIERCONSTRVCTED IAW REQVIREMENT50F
SECTION R326.4.2.1 THROUGH R326.4.2.6 OF THE NEW YORK STATE RESIDENTIAL CODE(2020)AND IN CONFORMITY WITH ALL SECTIONS O
OF THE SOUTHOLD TOWN CODE,DWELLING WALL(S)MAY SERVE AS PART OF THE POOL BARRIER AS PER SECTION R326.4.2.8 AND
CONDITION(1)ARE MET.OPERABLE WINDOWS IN THE WALL(S)USED AS A BARRIER SHALL HAVE SELF LATCHING DEVICE.ACCE55 GATES
SHALL COMPLY WITH SECTION R326.5.2 OF THE NYS RESIDENTIAL CODE(2020)AND BE SELF CLOSING,SELF LATCHING AND BESECURELY
LOCKED WHEN POOL 15 NOT IN USE OR SUPERVISED.ALL GATES ARE TO OPEN AWAY FROM THE POOLAREA.
H2O ° H20 4. PUkING CONSTP UCTION THE CONTRACTOR SHALL EkECTA TEMPORARY BARR IEP AROUND THE EXCAVATION IAW THE CODE OF THE
TOWN OF SOUTHOLD.
rn
5. POOL MUST BE EQUIPPED WITH AN APPROVED POOL ALARM CAPABLE OF DETECTING ENTRY INTO THE WATER AND SOUNDING AN
AUDIBLE ALARM UPON DETECTION THAT 15 AUDIBLE AT POOLSIDE AND INSIDE THE DWELLING. THE ALARM MU5T BE INSTALLED, w Z a MAINTAINED AND USED IN ACCORDANCE WITH THE MANUFACTURERS INSTRUCTIONS. THE ALARM MUSTMEEFASTM F2208
R"STANDA )SPECIFICATIONFORPOOLALARMS. THE DEVICE MUST OPERATE IN DEPEN DENT(NOT ATTACH ED TO OR DEPENDENT ON)OF V
40' ° PERSONS. cv O
6. POOL SUCTION FITTINGS(EXCEPT FOR SURFACE SKIMMERS)MUST BE PROVIDED WITH A COVER THAT CONFORMS TO ASME/ANSI O O E-
10" 10" A112.19.8M OR A MINIMUM 18"x 23"DRAIN GRATE OR A CHANNEL DRAIN SYSTEM. POOL CIRCULATION SYSTEM MUST BE EQUIPPED WITH O S
ATMOSPHERIC VACUUM RELIEF IN THE EVENTTHE GRATE COVERS LOCATED WITHIN THE POOL BECOME MI551NG OR BROKEN.SUCH Ln O
PLAN VACUUM RELIEF SYSTEMS SHALL CONFORM WITH A5ME A112.19.17 OR BE A GRAVITY SYSTEM APPROVED BY THE TOWN OF 5OUTHOLD.
POOL SHALL BE PROVIDED WITH A MINIMUM OF 2 SUCTION FITTINGS OF THE ABOVE MENTIONED TYPE. THE SUCTION FITTINGS SHALL BE
N.T.S. SEPARATED BY MINIMUM OF3'AND MUST BE PIPED SUCH 7iAT WATER 15 DRAWN THROUGH THEM SIMULTANEOUSLY THROUGH A
VACUUM RELIEF-PROTECTED LINE TO THE PUMP(OR PUMPS) VACUUM/PRESSURE CLEANING FITTINGS SHALL BE IN AN ACCE551BLE
POSITION,MINIMUM OF6"AND NO GREATER THAN 12"BELOW THE MINIMUM OPERATIONAL WATER LEVEL OR BEAN ATTACHMENTTO
THE SKIMMER/SKIMMER5.A REQUIRED POOL ATMOSPHERIC VACUUM RELIEF SYSTEM SHALL BE INSTALLED AS PER NYS RESIDENTIAL CODE
VINYL COVERED R326.6.3(2020)AND IN ACCORDANCE WITH TOWN CODE.
CONCRETESTEPS
7. ALL ELECTRICAL WORK SHALL COMPLY WITH THE REQUIREMENTS OF NFPA 70(NEC)PRINCIPALLY ARTICLE 680 AND THE NYS
° RESIDENTIAL CODE SECTIONS 4201 THROUGH 4206.ALL ELECTRICAL DEVICES MUST BE APPROVED BY UNDERWRITERS LABORATORIES AND U
;a
t BE PROTECTED BYA GROUND FAULTCURRENT INTERRUPTER(GFCI)CURRENTCARRYING ELECTRICAL CONDUCTORS EXCEPT FOR THOSE
PROVIDING POWER TO POOL LIGHTING AND POOL EQUIPMENTSHALL MEETTHE SEPARATION REQUIREMENTS OF TABLE E4203.5.ALL
2"T04"5AND BOTTOM 'D METAL ENCLOSURES,FENCES OR RAILINGS NEAR OR AD)ACENTTO THE SWIMMING POOL THAT MAY BECOME ELECTRICALLY CHARGED s
DUE TO CONTACT WITH AN ELECTRICAL CIRCUIT5HALL BE EFFECTIVELY GROUNDED. L'
QJ
8. WATER SOURCE FILLING THE POOL SHALL BE EQUIPPED WITH A BACKFLOW PROTECTION DEVICE:IAW NY5 PLUMBING CODE 608.
SECTION A 9. ALL PIPING 15 DIAGRAMMATIC UNLESS OTHERWISE STATED. i }
o �z
N.T.S. 10, WALKS IF PROVIDED SHALL BE NONSLIP AND SLOPE AWAY FROM POOL EDGE. O c4
WATER LINE TOP OF WALL -�
t� 0
11. A MEANS OF EGRE55 FOR DEEP AND SHALLOW ENDS MUST BE PROVIDED IAW AN5I/AP5P/ICC-5 SECTION 6. v t
4' 12' 4' t N 12. CONTRACTOR TO PLACE THE POOL IAW TOWN OF SOUTHOLD CODE SETBACKS. O O l C O
Ln
d 11
0 0 13. ALL DRAINAGE FROM THE POOL SHALL BE MAINTAINED ON THE SUBJECT PROPERTY. f-- Lt�.!
15. THE DESIGN 15 BASED ON A DRAINAGESOIL WITH<10%SILT.GROUND WATER SHALL NOT EXIST WITHIN THE EXCAVATION. IFGROUND
WATER EXISTS WITHIN 6'-O"FROM GRADE,DEWATERING FACILITIES WILL BE REQUIRED.
N
16. ALL GASAND OIL HEATERS(IF INSTALLED)FOR THE INGROVND SWIMMING POOL SHALL BE NATIONAL APPLIANCE ENERGY tY
SECTION B CONSERVATION ACT(NAECA)COMPLIANT. POOL HEATERS SHALL BE TESTED IAW ANSI Z21.56 AND SHALL BE INSTALLED IAW
MANUFACTURERS SPECIFICATIONS. OIL FIRED POOL HEATERS SHALL BE TESTED IAW UL726. POOL HEATERS SHALL BE LOCATED OR
N.T.S. GUARDED TO PROTECT AGAINST ACCIDENTAL CONTACT OF HOT SURFACES BY PERSONS. POOL HEATERS SHALL BE PROVIDED WITH
TEMPERATURE AND PRE55URE-RELIEF VALVES. FOR HEATERS NOT PROVIDED WITH AN INTEGRAL BYPASS SYSTEM.A BYPA55 LINE SHALL BE
INSTALLED FROM INLET TO OUTLET TOAD)U5T WATER FLOW THROUGH THE HEATER, POOL HEATERS SHALL BE PROVIDED WITH THE u
2'-2"
FOLLOWING ENERGY CONSERVATION MEASURES: _. Lkn
`n �
CHECKt
COPING AND WALKWAY 16.1 AT LEAST ON E TH ERMOSTAT SHALL BE PROVI DEL)FOR EACH H EATI NG SYSTEM. • 0000
MOTHERS) - 10 16.2 ALL POOL HEATERS SHALL BE EQUIPPED WITH AN ON-OFF SWITCH MOUNTED FOR EASY ACCESS TO ALLOW SHUTTING OFF THE (�
FROM SKIMMER z
PUMP GRADE OPERATION OF THE HEATER WITHOVT"ADJVSTING THE THERMOSTATSETTINGAND TO ALLOW RESTARTING WITHOUT RELIGHTING THE y WATER LINE PILOT LIGHT.
a
TO DIS
III E::Ii
16.3 HEATED SWIMMING POOLS SHALL BE EQUIPPED WITH A POOL COVER(EXEMPTED FROM THIS REQUIREMENTARE OUTDOOR POOLS
DRYW VNDI5TURBED EART}I ° DERIVING 20%OF THE ENERGY FOR HEATING FROM RENEWABLE SOURCES AS COMPUTED OVER AN OPERATING SEASON) W wf�`t�GV m �j
16.4 TIME CLOCKS SHALL BE INSTALLED 50 THE PUMP CAN BE SETTO RUN DURING OFF-PEAK ELECTRICAL DEMAND PERIODS AND CAN BESET W
3500 PSI POURED CONC. �4 1 TO RUN THE MINIMUM TIME NECE55ARY TO MAINTAIN THE POOL WATER IN A CLEAN AND SANITARY CONDITION IAW APPLICABLE
DIVERT N SANITARY CODE OF NEW YORK STATE. y
I.q YZ fD ,D
VALVE 3/e"REBAR.2)TYP. . a y ra s a
VINYL LINER • 17. THIS DRAWING 15 FOR STRUCTURAL SHELL ONLY.ALL ACCESSORIES AND APPURTENANCES ARE DEFINED BYOTHERS. z
2"T04"SAND �j Y 0
FILTER \ 18, BACKFILL WITH CLEAN EARTH,FREE OF ROOTS AND DEBRIS. DO NOT ALLOW THE HEIGHT OF BACKFILL TO EXCEED THE HEIGHT OF THE Is C 10 0
WATER IN THE POOL BY MORE THAN 8", OR THE WATER TO EXCEED BACKFILL BY MORE THAN B" Y y 41,
~tea
\ 19. PLACE CONCRETE ON SANDY TO LOAM SOIL. REMOVE ANY CLAY DEPOSITAND REPLACE W/COMPACTED CLEAN BACKFILL.
R � Q.
ro ENRNs 20. THERE IS NO MAIN DRAIN IN THIS POOL.SUCTION FOR POOL WATER CIRCULATION 15 PROVIDED BY THE SKIMMERS ONLY.THIS MEETS U
CHECK VALVE VERTICALS/8"REBAR W O.c. REQUIREMENTS OF THE NYS RESIDENTIAL CODE-SECTION R326.5 FOR ENTRAPMENT(NOT SHOWN) PROTECTION. m
PLUMBING SCHEMATIC y NEW Y
21. THE POOL WAS DESIGNED IAW THE FOLLOWING:
N.T.S. WALL SECTION 21.1. THE NEW YORK STATE RESIDENTIAL CODE-SECTION R326(2020) H O/y�s
21.2. THE NEW YORK STATE ENERGY CONSERVATION CONSTRUCTION CODE-SECTION R403.10(2020) A U Q �.
N.T.5. 21.3. THE NEW YORK STATE FUEL GAS CODE(2020)
21.4. THE NEW YORK STATE SANITARY COPE. c" a,
21.5. ANSI/APSP/ICC-5 STANDARD FOR RESIDENTIAL IN-GROUND SWIMMING POOLS. . ' m w
21.6. BOCA CODE-SECTION 421. .�Y Z
21.7. CODE OF THE TOWN OF SOUTHOLD. -
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22, ALL BACKWASH TO BE SELF-CONTAINED ON-SITE.
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