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HomeMy WebLinkAbout49458-Z �O�s11FFOlkcoG Town of Southold 9/28/2024 P.O.Box 1179 o - :Z 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 45602 Date: 9/28/2024 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 3600 Wells Ave, Southold SCTM#: 473889 Sec/Block/Lot: 70.-3-22.7 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 6/2/2023 pursuant to which Building Permit No. 49458 dated 7/10/2023 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 Shauger,Kelly&Steven of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 49458 10/31/2023 PLUMBERS CERTIFICATION DATED Au or ed i nature o�Su FF o/( TOWN OF SOUTHOLD BUILDING DEPARTMENT y x TOWN CLERK'S OFFICE "oy . -V 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#: 49458 Date: 711012023 Permission is hereby granted to: OWB REO LLC 3637 Sentara Way Virginia Beach, VA 23452 To: Construct an in-ground swimming pool to an existing single family dwelling as applied for. Pool and pool equipment require a minimum setback of 15 feet. At premises located at: 3600 Wells Ave, Southold SCTM #473889 Sec/Block/Lot# 70.-3-22.7 Pursuant to application dated 6/2/2023 and approved by the Building Inspector. To expire on 1/8/2025. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO- SWIMMING POOL $50.00 Total: $300.00 JA Building Inspector OF SO(/r�ol � o Town Hall Annex Telephone(631)765-1802 54375 Main Road P.O.Box 1179 sean.devlina-town.southold.ny.us Southold,NY 11971-0959 COUff '�� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: OWB REO LLC Address: 3600 Wells Ave city:Southold st: NY zip: 11971 Building Permit* 49458 Section: 70 Block: 3 Lot: 22.7 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE' Contractor: Electrician: Darling Electric License No: 38041 ME 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 1 4'LED Exit Fixtures 11 Sump Pump Other Equipment: Sub Panel 12 Circuit/ 3 Used, 1 Light 120GFI, Pump 220 Gfl, Waterbond Notes: Pool Inspector Signature: r' Date: October 31, 2023 S.Devlin-Cert Electrical Compliance Form OE SOUT 1 64e)e) # # TOWN OF SOUTHOLD BUILDING DEPT. co 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) j ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: DATE 12 INSPECTOR aOf SOUTyolo # # TOWN OF SOUTHOLD BUILDING, DEPT.. , °y�oo►�,� 631-765-1802 s - INSPECTION [ ] FOUNDATION 1 ST/REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I ULATION/CAULKING [ ] FRAMING /STRAPPING [ FINAL,�ffu__� L ] FIREPLACE &CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION -j ] FIRE RESISTANT PENETRATION [ ]. ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: 104)etz Lt100". of DATE 7 3 — 'INSPECTOR . *®# TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 INSPECTION ( ] FOUNDATION 1 ST/REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING/STRAPPING [ j FINAL ot7 --- ( ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL(ROUGH) [ j ELECTRICAL(FINAL) [ ) CODE VIOLATION ww [ ] PRE C/O [ ] RENTAL REMARKS: {� S�v P IN PA/tM A.eq, i - DATE f INSPECTOR,, V r. ;u � y } ....�,+. •�. � .e �R`:,� �r�. y��w' � At. iA 1^:., // YJ' YYr C yY�j�'�J �y •, . �' •' `1�. � � �i�Y'1/� 1r� a 1! 11 Ww ., i j� 1 id vC+r t q> - r r r r _ r food inoli o4uin{slad ao uaipptja{i tounin spunog ti iVd '1d�Od GILL PAT Sounds alarm if children or pets fail into your pool 0 CT 3 1 2023 1 ,. � RAtARnaftKtRK 1NQCR,unbsroN OR ARc Hom�llrnaLofd Gnur/CmVo d.urgf Homfllna" /wN l.,.Pro*"A Ml.bf d.11-11 Y'..AI VPOWV\DN.aINP nwwr+nl11VVfl.rd Type 7R En.a Ic.bN wT1 N.rru 7R I/ :N.4.a.11olwN.fnitW.]..r—A7 q �A •T.».a,Wr+....r.,w a„ru.e ww N..v,a aVIW '""'""6 u��� M.Hlo+wtp.y.wlM.y •IMn+w.V.O.Wr'Yrow"Y r..^✓V d..bbovUrm Go.w.rAl Su w'.MNr a.nK.}.mrWlrv`G l.ruB.E •PW.0 M o.K...Oxon,eN oav,bbn.n4�m Www b M qJNrronl M.Id.N mE[afar 4v.,b.Mr.1WIfO. lNIN.b lebw W..IrWcll.b wal m.P In a.NA N.Nbv.NMrY }o r...t now ANb b Of1 pr.00A M b ON luear 1 PELIGROR.wror.MNouY wM1.rA.n ffrc W.n MUYW. .[UORO bf.KICUIOAlURRKI.GVIOfAN O bl1T[LL° Cb......w1 uaw erWw apa�q.wT a.r N....CM.w N bb..p RW AROUlO NOYfR .Ow.ru Oa.bwvl�b.Nr opwwp ' 'N.r..ar0o�t�A.ar pw.a'N I VP1.DIo}�..0 4Y W Nor.M OOYIIR -CJr.1.r�.Mn brr y�O ..Pfb.t 4bti..uN.aO..Oa u Cp'DN ImwN.1.rein.r.iTA iM.) __ w�py� ldNwM MwrW NNLIm.U.bWMO MCNf.ruw YDWW wMb iom�aWr NrYM.)nv.tl WIMSJ[RVKf pfCO/IN[CI.1f •f�P'..Nrvnb .e GN�.tbMW�xvn a�W'�n 4. rdN+4.O.ngtrl pen Y..b u.wON r l.O.mnvlr M.AON a 6�w A•f.r.•... `�w...aar v.o�a.W� ww.Y W aaw,w..a 1.o.lwo N�w.a0n.+.wrW Nb W.r r�.pYAMOO4.+Nnm "w+r MORv 4.a.pe (°IfJ M.N..mui Yn�N� ,)uoO+M AMIRfO W.�w. .y..M.N NW MWSNwf MMa uNrI.IwM. � � � C[11GOO IPv1 • RNh.W r..unlwr rwa.1.W Nr N nun Lr...l..e.w Nr.Nlo. 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Y NI per nl a.wvb raNYn mwvov .�coNelaR a Aco•lnw+oN w,u N+.a•r.wb 1 aN....V�r✓t wW� <tww 1wr.D.Mw.W�wu.a .n....a, �..�w..�ilunYs.O+..w r Satyr.b NwOr N.nn^.O..•A+ww ❑ by Sehne4d I E 1.car if u c.wnwya ynVsrRN.aoNp"Eu i aua.lr,on e..crmr cufRa.n RAr.wl fO?dL61Y 1O Pupt tv I� Misyl.Woo wmlf OU. ro..11l w 9— — — — -- — — — —10 11— — — — —_ _ _ _ _12 ® wOq �m + -—' +I 1 I FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION(1ST) O�y ------------------------------------ FOUNDATIOn'(2ND) �O I W o o y OUGH FRAMING& y PLUMBING U 1 � a INSULATION PER N.Y: y STATE ENERGY CODE `y FINAL ADDITIONAL COMMENTS o L( 6 '� 0 11611,3 c g � o qc. 02 • 2 �. c�n�i.n �/ ►r.¢ry e vJ � c No z H t7 t�J b H 6�$UfFozk�Q 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://www.soutlioldtowimyffov Date Received APPLICATION FOR BUILDING PERMIT _ For Office Use Only PERMIT NO. 1 5 8 Building Inspector: ''' JUN 2 2023 'Applicationsarid'forms musfbe filled out'in'fheir entir'ety.'lncomple't'e' 'applications,will`not be'accepted. lAlheire'the Applicant is.not tHe,owner an ,A.�;.; , .., .Owner's Authoriiation'form(Pagel)shall be completed. Date: ,OWNER(S)OF PROPERTY:; Name: �� S by ref2 $Ter j-qA' S SCTM#1000- 70 3 - 27-.1 Project Address: 3(oc® lJ a`S Vim.VC- $©U -EL.calr� Phone#: S1(Q_ Li�1 � 3 X-(9 Email: K _%\.( L ��J�QYJ C�-rlaor, Co-^ Mailing Address: 3 �C►� WaS AxALv'e t LI-( Name: Mailing Address: 3(00® �,9ealS A.le. Phone#: S(� -__� -� Email:to (� ec�vc �.d otl looc� CC�v. DESIGN PROFESSIONAL:INFORMATION:' Name: Mailing Address: Phone#: Email: CONTRACTOR-INF RMATIOit O 1 , Name: 1?i 4k:Vy 1�oC��S 1Gd Mailing Address: Phone#: (031 - F-16,.ocl Email: cl��;��pPOa�S�C®inn DESCRIPTION OF:P.ROPOSED.CONSTRUCTION El New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: [$(Other 1 L�`�'3Co° 1,�gsc��.cQ ��,n�..,n� (�001 $ 34�►.tip Will the lot be re-graded? ❑Yes XNo Will excess fill be removed from premises? XYes ❑No 1 PROPERTY J N FORMATION- Existing use of property: (may,d�C„�,c� Intended use of property: Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? Dyes 59No IF YES, PROVIDE A COPY. Check-Box After Reading .the owner/contractor/design.professional is responsible for all'draieagea'ni storm water issues asprovided 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;,Or'dinances orRegulations,for th`e construction of building's;' - additions,alterations or for removal or demolition as herein.desciibed:The.applicant agrees.to;comply with all applicable taws;"ordinances,'building code,-= housing'code and,reguhnions,and,to"admit authori ed inspectors on p emises and in,buildiing(s)for necessary inspections:False statements made hereiri"arei punishable"es a Class A misdemeanor pursuant to Section 210'45 of the NewYork Statw enal Law. Application Submitted By(got name): kw a'& Nuthorized Agent ❑Owner Signature of Applicant: � ?tto, Date: S" 3�?�3 STATE OF NEW YORK) SS: COUNTY OF ) being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the CO AAfck-aor (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 ` 315� day of , 20 013 Notary PIM SSE PINTO NOTARY PUBLIC-STATE OF NEW YORK No. 01 P16024144 PROPERTY OWNER AUTHORIZATION Qualified In Suffolk County (Where the applicant is not the owner) y Commission Expires May 03, 20 a I, residingat 3(eO6 l,ucgs ,QJe_ S t..dkJ�01 do hereby authorize 1:2�LwaVC1 ?"jo OX �; a oGx S to apply on my behalf to the Town of Southold Building Department for approval as described herein. JUG,Y-- ' S-AO/Z 3 Owner's Signature Date Steym 4 54a,i cr Print Owner's Name 2 BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD y. s Town Hall Annex - 54375 Main Road - PO Box 1179 _ Southold, New York 11971-0959 'jfj� a0� Telephone (631) 765-1802 - FAX (631) 765-9502 roaerr(Msoutholdtownnv.gov - seand0-southoldtownnv.aov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: Company Name: ��� •L Electrician's Name: tcld to License No.: Elec. email: 1 2�eC}r; k� o u,• , Elec. Phone No: 31-7 6- It 71 _ Of request an email-- py-of Certificate'of Compliance Elec. Address.: T7 o SZd.Fa o r JOB SITE INFORMATION (All Information Required) Name: -cl i Shay Address: o Cross Street: Qc U�qWh Phone No.: Bldg.Permit#: email: Tax Map District: 1000 Section: Block: Lot: BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): 11n�6��o1 Swttn.w.�w� �0�1 , wtijt% L=l�W, , Square Footage: Circle All That Apply: Is job ready for inspection?: EYES ❑NO ❑Rough In2--Final Do you need a Temp Certificate?: ❑ YES �O Issued On Temp Information: (All information required) Service Size Ph Size: A # Meters Old Meter# ❑New Service❑Fire Reconnect❑Flood Reconn Service Reconnect❑Underground❑Overhead # Underground Laterals 1 2 H Frame Pole ork done on Service? Y MN Additional Information: . ... AYMENT DUE WITH APPLICATION R 23 01,,`o( oar?- �e l osajo v®§u¢fQ(, cd BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD Town Hall Annex - 54375 Main Road - PO Box 1179 o ? Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 rogerras'outholdtownny.gov - seand@southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION '(All information Required) Date: Company Name: (� Electrician's Name: CIC( I,,, License No.: Elec. email: Ca VA Elec. Phone No: 31-? 6- 7 j Of request an email cbpy of Certificate of Compliance Elec. Address.: N7 c>ld JZJ. _�,v� J ,c1'So A1. . 1 JOB SITE INFORMATION (All Information Required) Name: Sk4u Address: Cross Street: oc, V\laf th Phone No.: Bldg.Permit#: email: Tax Map District: 1000 Section: Block: Lot: BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): 1��6�,,rd Sw►�n•w►cw� �oJ1 . wti� I���w�- Square Footage: Circle All That Apply: Is job ready for inspection?: ff"Y' ES ❑ NO Rough In P]-Onal Do you need a Temp Certificate?: F I YES Fq-110 Issued On Temp Information: (All information required) Service Size❑1 Ph Size: A # Meters Old Meter# ❑New Service[]Fire Reconnect[]Flood Reconn Service Reconnect QUnderground❑Overhead # Underground Laterals 1 n2 F1 H Frame Pole Work done on Service? Y DN Additional Information: PAYMENT DUE WITH APPLICATION R —7 1 VS LZo(_� (Oao�J �'e c-#, 10S"Voip 16 Pofr 149(4 S� � rr d✓-� Sc 0 Ao. Russell s S'7C'c0�ltb��1 WA\']C'IE]k � MA IAA\�G�IEI��t]EI�T SOUPMOM TOWN MALL-P.O.Box U79 M095MagnRoad-S0vrr€0LD,NWYORK U971 � ,Town of Southold :. ' I` CHATTER 236 a ST011 MWATER MANAGEMENT REFERRAL FORM l (APPLICANT INFORMATION TO BE COMPLETED BY THE APPLICANT ONLY FOR PROPERTIES ONE ACRE IN AREA OR LARGER.) APPLICANT: (Property Owner, Design Professional, Agent, Contractor, Other) t NAME: Ulu shftIL49.0rDate: !Pont) Z3 Ligna id Contact Information: [EnNbd&Telephone Number) Property Address / Location of Construction Site: 31a0 MIC HC AV nip 0 . S.C.T.M. #: 1000 District %iAn)d N/V 114,11 IF J on 22--1 Section Block Lot TO BE COMPLETED BY SOUTHOLD TOWN ENGINEERING DEPARTMENT XArea of Disturbance is less than I Acre. No S.P.D.E.S.Permit is Required! 0 - Project does Not Discharge to Waters of the State. No S.P.D.E.S.Permit is Required I d 0- Area of Disturbance is Greater than 1 Acre&Storm-water Runoff Discharges Directly to Waters of the State of New York. THE APPLICANT MUST OBTAIN a S.P.D.E.S.Permit DIRECTLY From N.Y.S. D.E.C.Prior to Issuance of a Building Permit. 0 - Area of Disturbance is Greater than I Acre&Storm-water Runoff Flows Through Southold Towns MS4 Systems to Waters of the State of New York. THE APPLICANT MUST OBTAIN a S.P.D.E.S.Permit through the Southold Town Engineering Department Prior to Issuance of a Building Permit. tjj Reviewed By: i�i w Date: FIRM A CMrP-T0q 0r-tnhr r 9n 19 e- cc v(! Suffolk County Dept.=of a Labor,Licensing&Consumer Affairs_. HOME IMPROVEMENT LICENSE ` Name EDWARD S.PINTO JR.• . Business Name i Tc•E r fiiscertifies that the 4?Parer-is duly licensed PINTO SWIMMING.POOL SERVICE INC' the County of suffolk License Number:H-21244 F Rosalie Drago Issued: 04/01/1992., Commissioner + Expires:. 04/01/2024, 4;:7 Client#:2373 PINTSWI1 ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 5/31/2023 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. —----....._......._----"-,----l'--i--.—.—._.._.__.—._._..._--.._....U,---._.....t"he p._. 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 any rights to the certificate holder in lieu of such endorsement(s). CON PRODUCER NAME: T Commercial Suppot Edgewood Partners Ins.Center PHONE 31 324-1440 .............. I(Asc............................._._._.................. __... 40 Marcus Drive E iiw� —1:s.--- _...__._...-__-_ aC,Ne__. _ ADDRESS: NEcertifcates@epicbrokers.com 3rd Floor -� � -- _---_ INSURER(S)AFFORDING COVERAGE NAIC# Melville,NY 11747 --- INSURER A:Hartford Fire Insurance Company 19682 INSURED INSURER B o Property&Casualty Ins Co of Hartford 34690 Pinto Swimming Pool Service Inc. — � Merchants Preferred Insurance Co. T ---- 12901 PO BOX 40 INSURER C - -- — ------ East Moriches,NY 11940 INSURERD: 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 CONTRACTOR 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 — ADD L SUB POLICY EFF POLICY EXP TYPE OF INSURANCE -..-.__--___INSR.W1/�........................_POLICY NUMBER.........._.---__..(MM/DD. Y) (MM/DD/YYY`() LIMITS LTR...._.........._..........................__..........---._...._........-------- ....._................................................................_._............_....--............._._...................._...................... A X COMMERCIAL GENERAL LIABILITY 12UUNOL7042 02/28/2023CO2/28/2024 EACH OCCURRENCE $1 OOOOOO CLAIMS-MADE X OCCUR PREMIS S(Ea RENTED $300 000 _ _ MED EXP(Anyone person).- $1 OzQOO— _ — PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER_X I GENERALAGGREGATE $2,000,000 P — --------------------- POLICY .........1 CT I I PRODUCTS-COMP/OP AGG $2,000,000 1 .......... LOC OTHER: _ _ - $ -------- C AUTOMOBILE LIABILITY CAP9268325 02/28/2023 02/28/202 1,000,000 COMBINED SINGLE LIMIT -..-.._ (Ea apcldentl_—_..... _$_.._.____.. X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED ! BODILY INJURY(Per acGdent) $ AUTOS ONLY AUTOS -Fi- bWMAdt -- - XHIRED NON-OWNED \ PROPERTY DAMAGE $ AUTOS ONLY X AUTOS ONLY ..LPer_accideml..................-................_................................................. UMBRELLA LIAB OCCUR EACH OCCURRENCE _$____ EXCESS LIAB CLAIMS-MADE AGGREGATE -- $ DED 1 I ON,$—.._..._..—. _..._.. ..-. -.-- _—_ _ ____ _ _ _ $ WORKERS COMPENSATION PEROTH- B 12WEQD9B84 02/28/20231 02128/2024 AND EMPLOYERS'LIABILITY Y/N X I M ANY PROPRIETORIPARTNER/EXECUTIVE -' I E.L.EACH ACCIDENT $500 000 OFFICERIMEMBER EXCLUDED? FRI N/A --------------••--------- -- --r (Mandatory In NH) - I E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under - ---- DESCRIPTION OF OPERATIONS below I --- _ I E.L..DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Evidence of Insurance. CERTIFICATE HOLDER CANCELLATION Town of Southold SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 54375 Main Rd. ACCORDANCE WITH THE POLICY PROVISIONS. Southold,NY 11971 AUTHORIZED REPRESENTATIVE - ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S5613224/M5243913 ECAST r � - LOT AREA 50,554 sq. fk ,1 �OgF�� 22-142 LO x� a s " ass a 70. �Y v r 8V 'ems. Am os'w LOT NUMBER 5 FC LOT NUMBER 10 1.2 S 0.7'E fil '2 Peas pRoP, w Sw rl O x 1 FC 0.3'W o 23- C � v m f0.6'E . 0.3v 37.7' �: 27. 2 SiY. Fit. .+ I 4.07E DWEIUNG Gw_ I 26.0' 1 w r 29 00 m° w w o IQ z I I m 344. 1 44.1 8' S 73' 0'00"w S $1. I I poo® I I 7W 00SOM OF NOW OF WAYS AND OR CiSFJMM OF RLY OND, OF ANY,NOT SFIOWN A4iE NOT OUMA►nFm 7-14-2022 UPDATED SURVEY IM OFPJEM(OR D OHS)SOWN H MM FROM TM SMtUCRJMPRMW 7O 7HE i M ES AMVW O"M OF RU�, �°T JOB No. 01-617 FILE No. PECONIC DEVEL. CORP. F1/WiRNi AREASy ADOff10N to BUILgN(iS OR ANY 07MOR Luc°°"' SURVEYED FOR KEL.I.Y TALMAGE SHAUGER a STEVEN R. SHAUGER MWWOMM ALWAI ON OR ADMM TO THIS SURVEY W A VIOIJ M OF SWUM LOT NUMBER 7 7=of 7W Mw IM SrA1>:M MMVm Lo' MAP OF PECONIC DEVELOPMENT CORP. AT SOUTHOLD GUAR NiM MiDtW 0 HMM%ML RIM ONLY 10 7HE PERSM FOR WWN 7HN StAIM 8 PREPAM.ANO ON tM GULF m 1HE MFE COMPAW.OWMWAM,. SITUATED AT SOUTHOLD AOENCr NO IEN M0 MSMMOMON US M HEREON,AND TO iME ASSMEM OF THE.' LEON o M AM W' "M TO � TOWN OF SOUTHOLD — SUFFOLK COUNTY N.Y. 00"OF"SUM MAP Nor WARM nE lMD'stfflvE,mM s 000m six OR SCALE 1" = 50' DATE 12-20-2001 EMM MO SM SHAM Nor FE CONSOMM TO BE A VALID TRUE Copt FILED MAP No. 10723 DATE 12-27-2001 CERTIFIED ONLY TO: TAX MAP No. 1000-70-3-22.7 -DISK 500 KELLY TALMAGE SHAUGER & STEVEN R. SHAUGER J.P. MORGAN CHASE BANK HAROLD F. TRANCHON JR. P.G. ADVANTAGE TITLE GROUP AGENCY LLC LAND SURVEYOR AMTRUST TITLE INSURANCE COMPANY 1866 WADING RIVER—MANOR RD. WADING RIVER, NEW YgRK, 11792 Y. LIC, No. 048992 631-929-4695 HAROLD F. TRANCHON JR. PENN. LIC. No. 2115—E 'Road APPROVED AS NOTED COMPLY WITH ALL CODES OF 4 DATE�` B.P.# �� �� NEW YORK STATE & TOWN CODES FEE 3CO.0O BY ��!� AS REQUIRED AND CONDITION$OF NOTIFY BUILDING DEPARTMENT AT 765-1802 8 AM TO 4 PM FOR THE SOUTHOLD TOWN ZBA FOLLOWING INSPECTIONS: x 1. FOUNDATION`=TWO REQUIRED . SOUTHOLD TOWN FOR POURED CONCRETE 2. ROUGH-FRAMING„PLUMBING, SOUTHOLD TOWN TRUSTEES STRAPPING, ELECTRICAL&CAULKING 3. INSULATION N,Y.$.DEC 4. FINAL-CONSTRUCTION&ELECTRICAL 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. ELECTRICAL INSPECTION'REQUIRED "IMMEDIATELY" ENCLOSE,POQL TO CODE UPON COMPLETION BEFORE"WATER" RETAIN STORM WATER RUNChgF PURSUANT TO CHAPTER 2X OF THE TOWN CODE. GENERAL NOTES: DURING CONSTRUCTION THE CONTRACTOR SHALL ERECT A TEMPORARY BARRIER AROUND 1. ALL WORK TO COMPLY WITH THE STATE BUILDING CODE AND LOCAL CODES AND THE EXCAVATION IAW THE CODE OF THE TOWN OF SOUTHOLD.POOL MUST BE EQUIPPED ORDINANCES HAVING JURISDICTION: WITH AN APPROVED POOL ALARM CAPABLE OF DETECTING ENTRY INTO THE WATER AND • 2020 THE NEW YORK STATE RESIDENTIAL CODE-SECTION R326 SOUNDING AN AUDIBLE ALARM UPON DETECTION THAT IS AUDIBLE AT POOLSIDE AND INSIDE • 2020 THE NEW YORK STATE ENERGY CONSERVATION CONSTRUCTION CODE-SECTION THE DWELLING.THE ALARM MUST BE INSTALLED,MAINTAINED AND USED IN ACCORDANCE R403.10 WITH THE MANUFACTURERS INSTRUCTIONS.THE ALARM MUST MEET ASTM F2208"STANDARD • 2020 THE NEW YORK STATE FUEL GAS CODE SPECIFICATION FOR POOL ALARMS.THE DEVICE MUST OPERATE INDEPENDENT(NOT • THE NEW YORK STATE SANITARY CODE. � - ATTACHED TO OR DEPENDENT ON)OF PERSONS. • ANSI/APSP/ICC-5 STANDARD FOR RESIDENTIAL IN-GROUND SWIMMING POOLS. POOL SUCTION FITTINGS(EXCEPT FOR SURFACE SKIMMERS)MUST BE PROVIDED WITH A • BOCA CODE-SECTION 421. COVER THAT CONFORMS TO ASME/ANSI Al 12.19.8M OR A MINIMUM 18"x 23"DRAIN GRATE • CODE OF THE TOWN OF SOUTHOLD. OR A CHANNEL DRAIN SYSTEM.POOL CIRCULATION SYSTEM MUST BE EQUIPPED WITH • THIS POOL MEETS THE REQUIREMENTS OF ANSI/APSP/ICC-5"AMERICAN NATIONAL ATMOSPHERIC VACUUM RELIEF IN THE EVENT THE GRATE COVERS LOCATED WITHIN THE STANDARD POOL BECOME MISSING OR BROKEN. SUCH VACUUM RELIEF SYSTEMS SHALL CONFORM WITH FOR RESIDENTIAL INGROUND SWIMMING POOLS"AND 1996 BOCA CODE-SECTION 421 ASME A112.19.17 OR BE A GRAVITY SYSTEM APPROVED BY THE TOWN OF SOUTHOLD.POOL 2. CONTRACTOR TO FIELD CHECK ALL EXISTING CONDITIONS AND CALL NY-811 FOR UTILITY SHALL BE PROVIDED WITH A MINIMUM OF 2 SUCTION FITTINGS OF THE ABOVE MENTIONED MARKOUT BEFORE COMMENCING WORK. TYPE.THE SUCTION FITTINGS SHALL BE SEPARATED BY A MINIMUM OF 3'AND MUST BE PIPED 3. ALL PIPING IS DIAGRAMMATIC UNLESS OTHERWISE STATED. SUCH T15AT WATER IS DRAWN THROUGH THEM SIMULTANEOUSLY THROUGH A VACUUM 4. WALKS IF PROVIDED SHALL BE NONSLIP AND SLOPE AWAY FROM POOL EDGE. I RELIEF-PROTECTED LINE TO THE PUMP(OR PUMPS)VACUUM/ PRESSURE CLEANING FITTINGS S. A MEANS OF EGRESS FOR DEEP AND SHALLOW ENDS MUST BE PROVIDED IAW SHALL BE IN AN ACCESSIBLE POSITION,MINIMUM OF 6"AND NO GREATER THAN 12"BELOW ANSI/APSP/ICC-5 SECTION 6. THE MINIMUM OPERATIONAL WATER LEVEL OR BE AN ATTACHMENT TO THE 6. ALL DRAINAGE FROM THE POOL SHALL BE MAINTAINED ON THE SUBJECT PROPERTY. SKIMMER/SKIMMERS.A REQUIRED POOL ATMOSPHERIC VACUUM RELIEF SYSTEM SHALL BE INSTALLED AS PER NYS RESIDENTIAL CODE R326.6.3(2020)AND IN ACCORDANCE WITH TOWN STRUCTURAL: CODE. • 42"POURED CONCRETE POOL WALL AS INDICATED IN DETAIL A OF POOL PLAN. • 8"TO 12"FLARED WALL-POURED CONCRETE(3000 PSI)CONTINOUS#4 REBAR TOP ELECTRICAL: AND BOTTOM(DETAIL A). ALL ELECTRICAL WORK SHALL COMPLY WITH THE REQUIREMENTS OF NFPA 70(NEC) • THE DESIGN IS BASED ON A DRAINAGE SOIL WITH< 10%SILT. GROUND WATER PRINCIPALLY ARTICLE 680 AND THE NYS RESIDENTIAL CODE SECTIONS 4201 THROUGH 4206. SHALL NOT EXIST WITHIN THE EXCAVATION.IF GROUND WATER EXISTS WITHIN 6-0" ALL ELECTRICAL DEVICES MUST BE APPROVED BY UNDERWRITERS LABORATORIES AND BE FROM GRADE,DEWATERING FACILITIES WILL BE REQUIRED. PROTECTED BY A GROUND FAULT CURRENT INTERRUPTER(GFCI) CURRENT CARRYING • BACKFILL WITH CLEAN EARTH,FREE OF ROOTS AND DEBRIS.DO NOT ALLOW THE ELECTRICAL CONDUCTORS EXCEPT FOR THOSE PROVIDING POWER TO POOL LIGHTING AND Seal/Signature HEIGHT OF BACKFILL TO EXCEED THE HEIGHT OF THE WATER IN THE POOL BY MORE POOL EQUIPMENT SHALL MEET THE SEPARATION REQUIREMENTS OF TABLE E4203.5.ALL THAN 8",OR THE WATER TO EXCEED BACKFILL BY MORE THAN 8"PLACE CONCRETE METAL ENCLOSURES,FENCES OR RAILINGS NEAR OR ADJACENT TO THE SWIMMING POOL ON SANDY TO LOAM SOIL.REMOVE ANY CLAY DEPOSIT AND REPLACE W/ THAT MAY BECOME ELECTRICALLY CHARGED DUE TO CONTACT WITH AN ELECTRICAL _ COMPACTED CLEAN BACKFILL. CIRCUIT SHALL BE EFFECTIVELY GROUNDED. 1. BONDING PER SECTION E4204 � SAFETY: 2. MINIMUM 8AWG BARE SOLID COPPER CONDUCTOR FOR EQUIPOTENTIAL BONDING 18 ` 1. THIS POOL MEETS THE REQUIREMENTS OF ANSI/APSP/ICC-5"AMERICAN NATIONAL TO 24 INCHES FROM THE INSIDE WALLS OF THE SWIMMING POOL FOLLOWING r, # CONTOUR AND BONDING AT FOUR POINTS. 3 STANDARD FOR RESIDENTIAL INGROUND SWIMMING POOLS"AND 1996 BOCA CODE- ���. �� °°�• �� SECTION 421. DIVING EQUIPMENT IS ALLOWED.DIVING BOARD AND INSTALLATION TO CONFORM WITH ANSI/APSP/ICC-5-03 STANDARDS FOR RESIDENTIAL INGROUND HEATERS/ENERGY EFFICIENCY: SWIMMING POOLS FOR A TYPE H POOL. ALL GAS AND OIL HEATERS(IF INSTALLED)FOR THE INGROUND SWIMMING POOL SHALL BE A)FRAMES ARE MADE OF 1.90"O.D.x.065 WALL.ALL BENDS ARE 6"RADIUS.FRAMES ARE NATIONAL APPLIANCE ENERGY CONSERVATION ACT(NAECA)COMPLIANT.POOL HEATERS DRILLED TO ACCOMMODATE"0 REINFORCED RODS.REAR STAND HAS(2)916"HOLES, SHALL BE TESTED IAW ANSI Z21.56 AND SHALL BE INSTALLED IAW MANUFACTURERS Fwject DRILLED ON 12"CENTERS FOR D.B.ANCHORING. SPECIFICATIONS. OIL FIRED POOL HEATERS SHALL BE TESTED IAW UL726.POOL HEATERS SHAUGER POOL B) COMPRESSIVE STRENGTH OF CONCRETE SLAB FOR DIVING BOARD TO BE 3500 PSI OR SHALL BE LOCATED OR GUARDED TO PROTECT AGAINST ACCIDENTAL CONTACT OF HOT GREATER. SURFACES BY PERSONS.POOL HEATERS SHALL BE PROVIDED WITH TEMPERATURE AND 3600 Wells Avenue 2. SAFETY COMPLIANT BARRIER PER SECTION R326.5 PRESSURE-RELIEF VALVES.FOR HEATERS NOT PROVIDED WITH AN INTEGRAL BYPASS Southold,NY 11971 3. ENTRAPMENT PROTECTION PER SECTION R326.6 SYSTEM.A BYPASS LINE SHALL BE INSTALLED FROM INLET TO OUTLET TO ADJUST WATER -VGB COMPLIANT:DUAL MAIN DRAIN SPACED MIN.3'-0"APART WITH COVERS FLOW THROUGH THE HEATER.POOL HEATERS SHALL BE PROVIDED WITH THE FOLLOWING Architect of Record CONFORMING TO ASME/ANSI Al12.19.18M ENERGY CONSERVATION MEASURES:AT LEAST ONE THERMOSTAT SHALL BE PROVIDED FOR Nicholas A. Vero, EACH HEATING SYSTEM.ALL POOL HEATERS SHALL BE EQUIPPED WITH AN ON-OFF SWITCH Architect, PC 4. POOL ALARM PER SECTION R326.7 MOUNTED FOR EASY ACCESS TO ALLOW SHUTTING OFF THE OPERATION OF THE HEATER 120 Mill Road WITHOUT ADJUSTING THE THERMOSTAT SETTING AND TO ALLOW RESTARTING WITHOUT Westhampton Beach,NY 11978 (MEETS ASTM F2208 T:631.288.1404 F:631.288.0549 SMARTPOOL-"POOL EYE"ALARM WITH REMOTE (M ) RELIGHTING THE PILOT LIGHT.HEATED SWIMMING POOLS SHALL BE EQUIPPED WITH A POOL E:nveroarch(@aol.com COVER(EXEMPTED FROM THIS REQUIREMENT ARE OUTDOOR POOLS DERIVING 20%OF THE SWIMMING POOL SHALL BE COMPLETELY AND CONTINUOUSLY SURROUNDED WITH A BARRIER ENERGY FOR HEATING FROM RENEWABLE SOURCES AS COMPUTED OVER AN OPERATING Date: Scale: CONSTRUCTED IAW REQUIREMENTS OF SECTION R326.4.2.1 THROUGH R326.4.2.6 OF THE SEASON)TIME CLOCKS SHALL BE INSTALLED SO THE PUMP CAN BE SET TO RUN DURING OFF- 05/31/23 1/8"=r-0" Drawing Title: NEW YORK STATE RESIDENTIAL CODE(2020)AND IN CONFORMITY WITH ALL SECTIONS OF PEAK ELECTRICAL DEMAND PERIODS AND CAN BE SET TO RUN THE MINIMUM TIME THE BROOKHAVEN TOWN CODE.DWELLING WALL(S)MAY SERVE AS PART OF THE POOL NECESSARY TO MAINTAIN THE POOL WATER IN A CLEAN AND SANITARY CONDITION IAW SWIMMING POOL PLAN BARRIER AS PER SECTION R326.4.2.8 AND CONDITION(1)ARE MET.OPERABLE WINDOWS IN APPLICABLE SANITARY CODE OF NEW YORK STATE. THE WALL(S)USED AS A BARRIER SHALL HAVE A SELF LATCHING DEVICE.ACCESS GATES SHALL COMPLY WITH SECTION 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.ALL GATES ARE TO OPEN AWAY FROM THE POOL AREA. • TY�A�- •n1A�-t-. �E'rA•��- �CALfC: y2►► _ ��o►' VrNy` l-1 IZ COtNC-C'ETt `�y► F oAM ?NtiDrwKT ' o a T�1;FaAiz,S o a'r o u ' . '• J, I Z L F ELT E R Seal/Signature 'WrA1L. A SrcIMNIE� - t—'V 1`1P Zn �— {`. � � , •r,r� '•ate Z" RETJZN To SHAUGER POOL 0 3600 Wells Avenue SCHEMATIC PIPING ARRANGEMENT (N T S) Southold, NY 11971 Architect of Record 18' X 36' SWIMMING POOL PUMP: HAYWARD MODEL SP2670OVSP Nicholas A. Vero, Architect, PC SCALE: 1/8"= V-0" - VARIABLE SPEED 120 Mill Road PROBRAMABLE TIMER Westhampton Beach,NY 11978 T:631.288.1404 F:631.288.0549 -CONFORMS WITH 2O20 IRC RESIDENTIAL CODE-CHAPTER 42 SHAUGER RESIDENCE - IECC R403.10.2 COMPLIANT E:nveroarchaa,aol.com Date: Scale: -SAFETY COMPLIANT BARRIER&POOL ALARM TO CODE 3600 WELLS AVENUE FILTER: HAYWARD MODEL DE4820 PROGRID 05/31/23 1/$^=1�-0^ Drawing Title: -ENTRAPMENT PROTECTION: DUAL MAIN DRAINS SOUTHOLD, NEW YORK 11971 - 2" MULTIPORT VALVE SWIMMING POOL PLAN - SPACED MINIMUM 3'-0"APART PINTO POOLS INC. - VGB COMPLIANT COVERS PER ASME/ANSI A112.19.8.M 66 MONTAUK HIGHWAY s EAST MORICHES, NY 11940