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HomeMy WebLinkAbout49879-Z of Solo/ Town of Southold * * P.O. Sox 1179 0 53095 Main Rd COUNMa�''y Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 45817 Date: 12/10/2024 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 610 Wildberry Ln Southold, NY 11971 Sec/Block/Lot: 51.-3-12.10 Conforms substantially to the Application for Building Permit heretofore, filed in this office dated: 09/27/2023 Pursuant to which Building Permit No. 49879 and dated: 10/28/2024 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: Twin Barns LLC Of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL: ELECTRICAL CERTIFICATE: 49879 9/23/2024 PLUMBERS CERTIFICATION: Au eSignature suFeot.r TOWN OF SOUTHOLD 1 BUILDING DEPARTMENT TOWN CLERK'S OFFICE o' • SOUTHOLD, NY o � 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#: 49879 Date: 10/12/2023 Permission is hereby granted to: Beta II LLC 230 E 85th St New York, NY 10028 To: construct accessory in-ground swimming pool as applied for. Swimming pool and pool equipment must be located at a minimum of 10' from rear yard lot line. At premises located at: 610 Wildberry Ln, Southold SCTM # 473889 Sec/Block/Lot# 51.-3-12.10 Pursuant to application dated 9/27/2023 and approved by the Building Inspector. To expire on 4/1212025. Fees: CO- SWIMMING POOL $50.00 SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $300.00 Total: $350.00 Building Inspector o�x0f SOUT�OI � o Town Hall Annex Telephone(631)765-1802 54375 Main Road P.O.Box 1179 �Q sean.devlin(a-town.southold.ny.us Southold,NY 11971-0959 COMM BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Beta 11 LLC Address: 610 Wildberry Ln city:Southold st: NY zip: 11971 Building Permit* 49879 Section: 3 Block: 12 Lot: 10 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: Electrician: Prime Electric License No: 52402ME 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 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 4'LED Exit Fixtures Sump Pump Other Equipment: Intermatic Pool Panel 8 Circuit/4 Used, Pump 220GF1, Heater, Hayward Salt gene, (1) Light 120GF1, Autocover 120GF1 w/ Keylocked Switch, Waterbond Ionizer Notes: Pool Inspector Signature.: Date: September 23, 2024 S.Devlin-Cert Electrical FormCopy OF SOUIyOIo Ll� V _7 I (J # * ' TOWN OF SOUTHOLD BUILDING DEPT. o � 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: DATE INSPECTOR OF 50(/1 �1 -7 ®JJ l r v6 TOWN.OF SOUTHOLD BUILDING DEPT. / Quo, 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: t DATE � INSPECTOR OF SOUTyOIo # * TOWN OF SOUTHOLD BUILDING DEPT. urm��'' 631-765-1802 INSPECTION - I FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ .] SUL IO 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:_l C � (^VC Qi-P� &eD 3U WOO-- IAS�6_ P 9 tnJaj y� SDWK. � DATE R )'ZJ INSPECTOR OE SOUTyOlo # * TOWWOF SOUTHOLD BUILDING. DEPT. �u �0 631-765-1802 .q INSPECTION - FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] ,,I16ULATIOWCALLLKING [ ] FRAMING /STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ . .]. FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION f -] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] -CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: DATE INSPECTO Jeffrey Sands Architect 11/19/2023 Property/swimming pool location: L°R Jessica Hersch & Hal Coopersmith 610 Wildberry Lane �ts�F �sr,ei Southold, NY '�� ` t RE: Swimming gool rebar and drywell inspection Attention Town of Southold Building Department: Upon inspection of swimming pool rebar and drywell at above mentioned property, I find all to have been installed to meet current building code requirements. Sincerely, rL F ',:- Jeffrey Sands Architect 6 Evergreen Lane, East Quogue, New York 11942 phone-631-375-5997, fax, 631-576-8916 email—Jeffrey sands(ftotmail.com Bunch, Connie From: Lanza, Heather Sent: Monday, December 23, 2024 3:36 PM To: Bunch, Connie Subject: RE: 610 Wildberry Lane - items to be corrected prior to c.o. Attachments: Wildberry Fields - M. Collins Support of issuance of CO.pdf Hi Connie, I don't know if you are still holding this c.o. because of this issue, but if so, here is the newest inspection showing they moved the berm and pipes and all is clear for their c.o. Regards, Heather -----Original Message----- From: Lanza, Heather Sent:Thursday, October 31, 2024 3:39 PM To: Bunch, Connie<Connie.Bunch@town.southold.ny.us> Subject: RE: 610 Wildberry Lane- items to be corrected prior to c.o. And the owner just called so I sent him a copy of it so he has it. -----Original Message----- From: Bunch, Connie<Connie.Bunch @town.southold.ny.us> Sent:Thursday, October 31, 2024 3:37 PM To: Lanza, Heather<heather.lanza@town.southold.ny.us> Subject: RE: 610 Wildberry Lane- items to be corrected prior to c.o. Ok,thank you. -----Original Message----- From: Lanza, Heather<heather.lanza@town.southold.ny.us> Sent: Thursday, October 31, 2024 3:35 PM To: Bunch, Connie<Connie.Bunch @town.southold.ny.us> Cc: Verity, Mike <Mike.Verity@town.southold.ny.us> Subject: 610 Wildberry Lane- items to be corrected prior to c.o. Hi Connie, See attached report from Michael Collins as to why this property should not yet be issued a c.o., and what needs to be rectified. Thanks. Heather 1 MELD INSPECTION REPORT DATE COMMENTS �o FOUNDATION (IST) a --------------------------------- cr --- t FOUNDATION (2ND) z 0 S• . O ROUQH FRAMING& PLUMBING Q, � W CO 1 o r r INSULATION PER N.Y. "3 STATE ENERGY CODE N FINAL Ovid rl P. L 6v G- ADDITIONAL COMMENTS C( 0 Z Q,-O TAW M, N � o z x d r� �o H M,`�guFFo�� � ;02 a 4�I TOWN OF SOUTHOLD—BUILDING DEPARTMENT a, Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 ems://www.southoldtoLAM.gov .y Date Received • r, APPLICATION FOR BUILDING PERMIT For Office Use Only '�� �/��Qn �7� ^• PERMIT N0. Building Inspector: i � I Applications andLfor ms must be filled out in their entirety"Incomplete - ` a'pplications,will not be accepted Where the Applicant is not,the owner,an Owner's Authoraat�on form(Page'2)shall be completed , rt DE ,. BUILDING Date: ®` - f010 "� ' - OWNER(S);OF PROPERTY ; x �y ,r rsv .i.:• Name: L L C SCTM# 1000-51 63 _ ) Project Address: 1® �9`^„Y O Phone#: Email: At Coy�eySV,, ' t Cc W o 10 I QA S Mailing Address: CONTACT PERSON t Name: I n CA I- W✓ ID Mailing Address: S I\q ', Phone#: Ol Email: ha thC_(a 6IS nv'Il• PROFESSIONAL INFORIIlIATION E.>.....•fi �► ;. Name: Mailing Address: Phone#: Email: ` 7 A 7 Yti'� s ! } 4 a � ,�a �. �.r -a L S .x1�' e � 7 Z > < #yY ,x � y✓' te•.r rx CONTRACTOR INFORMATION. rr �< �� u tir Name: v 15 -rhe. Mailing Address: ��� a� — Q00 - , jaya :. 30 Phone#: (020 1 9 03 l uIQ� Email. SOIL eS !r DESCRIPTION OF PROPOSED CONSTRU,CTIO�V A. ❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: Mother S (e- I by 4y QunIfe- Sw�rnrY,�v� $%SZ�G Will the lot be re-graded? *es ❑No Will excess fill be removed from premises? ❑Yes PINo 1 z ;PROPERTY INFORMATIONQ- Existing use of property: Intended use of property: Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to An this property? DYes T Qo IF YES, PROVIDE A COPY. Check B,ox ldr:aWdralqpg�;�!Jc After qtiajst�000h�WIL -P 'it pur�ui�i.16.&!, "':code.,,A?1 fo�tfii lssWnc6­4,a iiu646j 6MBuildingZone Ordinance of the Town:ofSouthold,Suffolk,County,•New York�and other applicable Laws;Or'dmences orRegulation;„tor the constriction of bui�tlings,�<� � additions,alterations or:for removal or demohtion as hereiridescribed_The a rlicant;a reel to coin I wit6;all a licable,laws;ordinances buildm code� `• housing code,and regulations and to admit authorized inspectors on premises�and in buildmg(s)foi necessa"ry inspections;False statements made herein arec t Application Submitted By(print name): I C) Outhorized Agent DOwner Signature of Applicant: Date: q la1 1,9-3 STATE OF NEW YORK) CONNIE D.BUNCH Notary Public,State of New York SS: No.01BU6185050 COUNTY OF Qualified in Suffolk County Commission ExplresApril 14,2-QDq being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the (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 F; &D-J�6ay of 20� Notary Public PROPERTY OWNER AUTHORIZATION (Where the applicant is not the owner) 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 t t BUI�D'IhG DEPARTMENT- Electrical Inspector F E B 2 1 2024 - TOWN OF SOUTHOLD Town Hall Annex- 54375 Main Road - PO Box 1179 _x J Southold, New York 11971-0959 7elep.hone (631) 765-1802 - FAX (631) 765-9502 IameshCab-southoldtownny.aov seandCc�southoldtownnLr aov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: 2/15/2024. Company Name: prime electric Electrician's Name: michael hunter License No.: me-52402 Elec. email:mike@primeli.biz Elec. Phone No: 6313875650 0 I request an email copy of Certificate of Compliance Elec. Address.: 1380 broadway ave holbrook ny 11741 JOB SITE INFORMATION (Ail Information Required) Name: twin barn lic hal &jessica coopersmith Address: 610 wildberry lane southold Cross Street: soundview ave Phone No.: 6133875650 Bldg.Permit#: 49879 email:mike@primeli.biz Tax Map District: 1000 Section: Block: Lot: BRIEF—DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please.Prin_early hee bonding insp tion my on-gunite,pag6hasauteo�er tra tcs�'"II be bonded ugon.compleafiion of+jo_ 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# ❑New Service❑Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underg round❑Overhead # Underground Laterals 1 2 H Frame Pole Work done on Service? Y DN Additional Information: PAYMENT DUE WITH APPLICATION lees / (oW 21�42--V Ji2 f- Buildint Department Application AUTHORIZATION (Where the Applicant is not the Owner) '1�on 4fd ta;sq' Q v _1mf) ecyrvc LL- res g-at (Print property owner's name) (Mailing Address) Nel year 1NY (Dv o\} do hereby authorize Qlrl.l a (Agent) C v(4,0 to apply on my behalf to the Southold Building Department. r (Owner's Signature) (Date) (Print Owner's Name) OPERATING AGREEMENT OF TWIN BARNES LLC This Operating Agreement is made effective by the undersigned as of the 18th day of November 2022. ARTICLE I FORMATION 1.1 The undersigned have formed a limited liability company under the laws of the State of New York by filing,on September 15,2022,Articles of Organization with the Secretary of State of New York. 1.2 The name of the company is TWIN BARNS LLC(the"Company'). 1.3 The purpose for which the Company is formed is to acquire,own,and manage real property and for all other lawful activity. 1.4 The term of the Company became effective on September 15, 2022, the date the Articles of Organization were filed with the New York Secretary of State and shall continue until the Company is dissolved pursuant to the provisions of this Agreement or as provided under the laws of the State of New York. 1.5 The location of the principal place of business of the Company shall be 610 Wildberry Lane,Southold,New York 11971. ARTICLE II DEFINITIONS 2.1 "Agreement" shall mean this Operating Agreement, as amended, modified, or supplemented from time to time. 2.2 "Capital Account"shall mean the Capital Account of each Member established on the books of the Company as maintained and adjusted pursuant to Article III. 2.3 "Manwd 2 Members"shall mean Hal Coopersmith and Jessica Coopersmith. 2.4 "Members" shall mean the individuals listed on Schedule"A" which is attached hereto and made a part hereof. 2.5 "Participatina Percentage"shall mean,as to each Member,the amount shown on Schedule"A"attached hereto,as such amounts may be modified from time to time in accordance with this Agreement. 2.6 "Profit"and"Loss"shall mean for any Company Fiscal Year,the net income and net loss of the Company for Federal income tax purposes as determined by the independent certified public accountant of the Company as shown on the Federal income tax return of the Company for such Fiscal Year, including any gain or loss recognized on the disposition of the assets of the Company, except that such Profit and Loss shall also take into account (i) all income of the Company exempt from Federal income taxation and(ii)all expenses which are non-capitalizable and non-deductible for Federal income tax purposes. ARTICLE III CONTRIBUTION OF CAPITAL 3.1 The names and participating percentages of each Member are set forth in Schedule "A"which is attached hereto and made a part hereof. 3.2 There shall be established on the books of the Company a capital account for each Member which shall initially be the amount of the initial capital contribution to the Company by such Member. The capital account shall be increased by (i) the amount of any additional cash contribution made by such Member to the Company and(ii)the amount of all profits allocated to such Member and shall be decreased by(x)the amount of any distributions made by the Company to such Member and(y)the amount of all losses allocated to such Member. ARTICLE IV MANAGEMENT 4.1 The Managing Members of the Company shall have the responsibility for managing its business affairs and shall distribute such responsibilities as the Managing Members deem appropriate. 4.2 The Managing Members shall devote their time and efforts to the business of the Company as they deem appropriate in their reasonable discretion. ARTICLE V TRANSFER OF MEMBERS'INTEREST 5.1 The Managing Member shall not cause the Company to issue a Membership Certificate without the consent of both Members. 5.2 No Member shall sell,assign,transfer,hypothecate,encumber or in any way dispose of any interest in the Company,nor shall any of the Certificates be transferable on the books of the Company or archives without the consent of both Members,which may be withheld for any or no reason at all. 5.3 In the event of the death of a Member the surviving Member shall become the sole owner of the Company without payment to the deceased member's estate. 2 ARTICLE VI ALLOCATION OF PROFITS AND LOSSES 6.1 Net Profits and Losses for each fiscal period shall be allocated among the Members in proportion to their participating percentage ARTICLE VII ACCOUNTING 7.1 The Managing Member shall cause to be kept,at all times during the continuance of the Company,complete and accurate books of account of all transactions,assets and liabilities of the Company. Such books shall be balanced and closed at the end of each Fiscal Year. 7.2 All matters of accounting for which there is no provision in this Agreement are to be governed by generally accepted accounting principles consistently applied. 7.3 The fiscal year of the Company shall be deemed to be the calendar year and the income and loss of the Company and its books of account shall be maintained on a calendar year basis. 7.4 The books of account shall be on a site designated by the Managing Member and are to be open for inspection by any Member at all reasonable times on reasonable notice. 7.5 The Managing Member shall make financial reports on an annual basis. ARTICLE VIII DISSOLUTION AND TERMINATION 8. Upon the occurrence of any of the foregoing events,the Company shall be dissolved: (a) The Company ceases its business operations. (b) The Members unanimously vote to terminate the Company. (c) Entry of judicial dissolution of the Company ARTICLE IX MISCELLANEOUS 9.1 The parties hereto covenant and agree that any controversy arising out of or relating to any of the terms of this Agreement shall be determined and settled by arbitration in the City of New York,through the auspices of,and in accordance with the rules of,the American Arbitration Association then obtaining,and judgment upon the award rendered by such arbitration tribunal may be entered in any court of competent jurisdiction including,without limitation,the Supreme Court, New York County and the United States District Court for the Southern District ofNew York,upon which Courts the parties expressly confer jurisdiction.In its award,the Arbitrator(s)may determine the manner in which and upon or among whom the costs and expenses of the arbitration proceeding shall be assessed or apportioned. 3 9.2 Any notice to be given hereunder,including any offers for the sale of Membership Interest and any acceptance thereof,shall be in writing and shall be deemed given when delivered personally or three (3) days after mailed, postage prepaid, by registered or certified mail, return receipt requested,to the Parties at the addresses set forth herein. 9.3 This Agreement may be,amended in any respect upon the unanimous vote of the Members,or,in lieu of a meeting,by written consent of the required percentage of Members. 9.4 If any provision of this Agreement shall be held to be invalid,such invalidity shall not invalidate the entire Agreement,but it shall be construed as if this Agreement did not contain the particular provision or provisions so held to be invalid. 9.5 The terms,covenants,conditions and provisions herein contained shall benefit and be binding upon the Members hereto and their respective successors,heirs,legal representatives and assigns. 9.6 This Agreement may not be modified, changed, altered, terminated or cancelled, except by an instrument in writing executed by all of the Members hereto. 9.7 This Agreement and the rights of the parties hereunder shall be governed and interpreted in accordance with the laws of the State of New York. 9.8 Wherever from the context it appears appropriate, each tern stated in either the singular or the plural,and pronouns stated in either the masculine,feminine or the neuter gender, shall include the masculine,feminine and neuter. 9.9 Captions contained in this Agreement are inserted only as a matter of convenience and no way define,limit or extend the scope or intent of this Agreement or any provision thereof. 9.10 This Agreement may be executed in several counterparts and by electronic signature, each of which shall be deemed an original, but all of which shall constitute one and the same instrument.In addition,this Agreement may contain more than one counterpart of the signature page and this Agreement may be executed by the affixing of the signatures of each of the Members to one of such counterpart signature pages;all of such counterpart signature pages shall be read as though one,and they shall have the same force and effect as though all of the signers had signed a single signature page. 4 IN WITNESS WHEREOF, the parties hereto have set their hands and seals as of the Effective Date. MANA ING MEMBER: MANAGING MEMBER: d HAL COOPERSMITH J SSI A COOPERSMITH 5 SCHEDULE A NAME AND ADDRESS PARTICIPATING OF MEMBER PERCENTAGE Hal Coopersmith 300 East 56 Street 50% New York,NY 10022 Jessica Coopersmith 300 East 56 Street 50% New York,NY 10022 6 400 O b'*rAW Av—,RNerhsOd,Hen York I19O1 V� Rao HEALTH DEPARTMENT USE Kfl.e5117-2305 m"6517To1A4 ��c N viti`� ,,, - - _- O```\D j SUfFOIA DEFAATMDIT OF HEALTH SERVICES � e� 5 ?UdCTM1tAPFAOVALOTC0WnUCIiO MRA H—d LK YOYng:m 5 r. ,- \\ MMLH FAMILY RRSIDENC6 ONLY 7na,ra_P pert,P o1e""bna E�9g _ / D"I-E.Ad—,F4otevbro'.Engi-- DATE 2 T.v?, ,TIO. u� va lel A.waver:md s,r�e9- , e9 W �$ AITROYED o$ I POOL OF�_ tlE3NKOrMNS SITE DATA N.' OQSRES T"M YBARS FFDk,OATS()F APFRAVAL AREA=37,841 SQ.FT. S DICAVAT'.OW INS3 EmON r.''t2Yyt*a* •SVBDIVISION-•WILDBERRY FIELDS'FILED IN THE OFFICE OF THE CLERK OF FOR'N:TAKY SYS". '1 SUFFOLK COUNTY ON JUKE 21,2001 AS FILE NO.M41 NOTES 'i�c BY H-ALTH o2P.A'f YP•:- .L,?j ---..__..�—.._ DEPTH TO GROUNDWATER =18 FT 1.THE OWTS SHALL BE MODEL CEN-T MANUFACTURED BY FUJICLEAN USA. �• NUMBER OF BEDROOMS(DESIGN EQUIVALENT) TEST HOLE =5 2.THE DESIGN ENGINEER.FUJICLEAN USA REPRESENTATIVE,AND SCDHS ENGINEER'S CERTFuTioN REQUIRED. REPRESENTATIVES SHALL OBSERVE THE INSTALLATION OF THE OWTS AND LEAC141m MINIMUM REQUIRED VA OWTS CAPACITY =5506AL P/tvR SYSTEM,APPROVAL FROM ALL THREE PRIOR TO BACKFILL SUBMIT P.E.OR R.A.CERTIFICATION PROVIDED LA OWTS CAPACITY :700 GAL o FQRINST TIaON T1CON5TRUCTI014 r LEACHING SYSTEM =400SFSWA io�r Ual 3.THE SYSTEM START IP WILL BE COMPLETED UNDER THE DIRECT SUPERVISION OF A OF REQUIRED FUJICLEAN USA REPRESENTATIVE. Vr C `y LEACHING GALLEYS PROVIDED =A2{SFSWA M 5ND l5l 4.ANEXECUTED OPERATION AND MAINTENANCE CONTRACT BETWEEN THE `\ FOR FINALAPPR N..USEFOKAMM-073.1 +o MAINTENANCE PROVIDER AND PROPERTY OWNER MUST BE SUBMITTED TO THE `1c SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES(SCDHS)PRIOR TO APPROVAL OF FnE THE IIA OWTS REGISTRATION BY TIE 5CbK5IN ACCORDANCE WITH ARTICLE 19 OF t T, y, w THE SUFFOLK COUNTY SANITARY CODE. \� AT[At�{T1""'• •��c ENGINEER'S CERTIFICATION c"tt.uf , 5.FINISHED FLOOR ELEVATIONS)TO BE VERIFIED BY ARCHITECT .Is -. MAT91NrAtE Pne • I HEREBY CERTIFY THAT THE WATER 51PR.Y(S)AND/OR SEWAGE DISPOSAL seo lsry `'* SVSTEM(S)FOR THIS PROJECT WERE DESIGNED BY ME OR UNDER MY 150 DIRECTION.BASED UPON A CAREFUL AND THOROUGH STUDY OF 4E..S,pIL, WA NN U po SITE AND GROUNDWATER CONDITIONS.ALL FACLLITI ""\ IONFORM 10 THE SUFFOLK COUNTY 'vo T IN CONSTRUCTION STANDARDS EFFECT ARTMENT OF PS C.L^✓p`pp\• 10 w�+o1� � I 1 �jjzt>7yls�.G�ogvwK� I Lot 3 t10 '1 SlbdiYision-'Wildbelry Field{ 1 I �OPVARD w.YCrP+6,NY.S.Ls.NO.455dl!5n -HOMAS1 ; DOUSLA C..ADAMT,KY.S.P.E.NO.06q-T 6'' (Vaee,t) � � - OdJ5LA5 E.ADAMS,NY9.►L NO.DOD9'1 1 e I s.e 586°55'29"E SURVEYOR'S CERTIFICATION 2W.04' S ,fl:" nUaS®FIHa ANK,N.Aj THEIR TO TWLN BARNS LLC.C BANK,N.A.THEIR BI LICCEBBO RB - R GNS €� DRAINAGE CALCULATIONS ><�I AS THEIR INTEREST MAY APPEA PIIp1,p5ED 25TORY-- 9aFas AGENCY LLC THATTHISSIAWEYWAS RDB Y FRAME HOUSE.AFARAGE "e+ WITH THE CODE OF PRACTICE FOR LAND SUIVEY troy THE R y0.lM1E REQVIPED(ROOF AREA 1) .%-Is BEDROOM) WOODS 1 _ r STATE ASSOCIATION OF PROFESSIONAL LAND oR� R 730 5F.2/12.LO =122 OF g x'U--` FFE 250 se no dgy rA U 2 t ( e GT VOLUME PROVIDED - w Lot4 GFEL-23S orv�s KAsmrM / Ir. USE NEW OWMl: s Subdivi5ion- AMRF k 6'DIAx3'DEB bWAVETL =1Z7 W �, 'Zdberry Fields'g�Ps Jes, _ to' NYC f .�� �•~�, my ''+" J/V y� VOLUME REQl1DEo,GOOF AREA 2) £ �9u rugs® .R pP/' �' IK)WARD W.YOUNG,N.Y. NO. 3 SFD •S$9,SJ� E FAO SF:UIIALO =1236� TPA+'$ �Ur - M /1( LAND Y VENT .+uR DANIEL A WEAVER,LAYS.LS.NO.50M V0.11ME PROVIDED � USE NEW DWMz g a, --- i k« tie, 6'DIAx3'DEB ORYWELL 127 CFCF1 g �j,� S MA•»,+a' F#1H35- v a vauME REQUIRED(ROOF AREA 3) $ 3so OD / SURVEY FOR 1135 SF a 2/12:LO =169 CF > DB y -nc % VOLUME PROVIDED - / A TWIN BARNS LLC USE NEW DWM3 n `� 6 olAxs oEBORYWEL — LOT 4"WILDBERRY FIELDS" € y ME REQV7AED(DRIVEWAY) TH �� V at Southold,Town of Southold fl 3.elosF.znz.lo =602CF ✓� Q' Suffolk County,New York VOLUME PROVIDED PROPOSED USE NEW LEA[1@1G FIELD'A* SANITARY N ' i�R PROPOSED „2j` 9�0�/ ' (3)6'DLA,G'DEEP DRYWEILS 760 OF SYS EM BUILDING PERMIT SMVEY Z( = SERVICE R # S PROPOSED �° C—ty Tw Map 1000 51 eon. 03 12.10 V - GAS SERVILE i A FIELD SURVEY COMPLETED JAN.25,2022 d MAP PREPARED SEPT.13,2022 jROpsm Record of Revisions --_ ,�•1�Wry / B�C7R7t REVISION DATE 46,561 /. SERNICf +�\ SLDHIS NOIAMI NOV 29 2022 LEGEND -- B - \ CC =CONCRETE CLY9 ---- £ CMF =CONCRETE MONUMENT FOUND $ U S ��,YA CM5 :CONCIXTE MONUMENT SET\•^"") WSF =WOOD STAKE FOUND aD 0 20 AO 60 120 W55 =WOOD STAKE SET - =END OF DIRECTION/DISTANCE Scale:1"= 40' UI :GB NO.2022-0020 1 DW6 2022_0020_bP 1 OE 2 SAIVl I AKY MtASVKCMCIV I i BROADBAND BOX I A 1 B WIF CIC TRANSFORMER 0.3N 588055r29"E wIF 268.04 ELECTRIC METER W N OWTS 37.5' 19.5' WOODPANELCd 1)8 46' 31.5' 41 ELECTRIC BOX 37.5' Lot 4 CZ.j E-, L61 55.5' � r..-----�_—...._.--._. in 40.2' ) POOL r LP2 65' 45' Subdivision- I i j POOL EQUIPMENT y+ a y LP3 52' ! 31.5' N "Wildberry Fields" L GENERATOR Oo 3 � MASONRY I a� LP4 61.5 39.5' PATIO ROOF OVER i WATER 5CREENROOM -1 WOOD DECK WINDOW WELL - SERVICE i 24.4' 14.8' 14.4' I AC UNITS ON PLASTIC A w WOOD 7 24.3' w CONCRETE / DOW WELL_. DECK 41.3' iy WOOD � CONTROL VENT v + r4 12.7' to f WALLS O �/ PANE v 2 STORY FRAME O WDF B ru NOVSE&GARAGE Qn a� WDF SLOWER 8 9.0'in 12.7' G --- ci N O �g 1_-_= ' = COd- .5' and 23 rD _ a DB V - o OWTS g 24.3' _ < � ROOF OVER_j�. \. LANDING t ++ WOOD PORC'rl _....................'! STONE DRIVEWAY r SANITARY SYSTEM r OO 9 / j r 41 AA r 1 i / \ 579.?515 / cc CE w N 46.56CH A -n _>-- r CIC CMF =CONC CMS =CC bi WIF ` WDF WSF W SS • =ENDC �, VC A CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDmmr) `-� 05/24/2023 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 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 Nicholas Zulkofske NA E Brookhave P"oNE n Agency,Inc. 631 941-4113 FAx 631 941-4406 IN Oakland Ave,Ste 1 E-MAIL certificates brookhavena enc .com Port Jefferson,NY 11777 INSURERS AFFORDING COVERAGE NAIC# INSURERA: Philadelphia Indemnity Insurance Company INSURED INSURERB: Merchants Mutual Insurance Company Patrick's Pools,Inc. INSURERC:Wesco Insurance Company PO Box 3024 INSURER D, East Quogue NY 11942 INSURERE: 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. IN R TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP POLICY NUMBER / LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000 000 A CLAIMSWADE X�OCCUR rren DAMAGE TO RENTED $1 OO 000 X Contractual Liability PHPK2517025 02/28/2023 02/28/2024 MED EXP(Any oneperson) $5,000 PERSONAL&ADV INJURY $1 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2 000 000 POLICY X jE O LOC PRODUCTS-COMP/OP AGG $2 000 O00 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT(Fa acdclant) $5OO OOO B X ANY AUTO BODILY INJURY(Per person) $ r ALL OWNED SCHEDULED X X CAP9267113 07/12/2022 07/12/2023 BODILY INJURY(Per accident $ •.��, AUTOS AUTOS ) $j NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ WORKERS COMPENSATION X I PER tJTF OTH- AND EMPLOYERS'LIABILITY Y/N ANY C OFFICER/MEM ER EXCLUDED?ECUTIVE� N/A E.L.EACH ACCIDENT $1 OO OOO WWC3647363 05/13I2023 05/13/2024 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEEI$100,000 If yes,describe under DESCRIPTION OF OPERATIONS below 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) Town of Southold is included as additional insured per written contract. r! CERTIFICATE HOLDER CANCELLATION Town of Southold,Town Hall Annex SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE n THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 64375 Main Rd. ACCORDANCE WITH THE POLICY PROVISIONS. Southold,NY 11971 AUTHORIZED REPRESENTATIVE <BS> r ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD fJ tt ............ . .... . .. P OVED As OTED 97 0. ? . ....... p .......... .......... NOTIFY gUILDINP DEPAR ENT AT FOR THE .---FoLLbwh 11ON IN E FOUNDATION 0 F EMARED _.,I_...... R URED CO Clriffi ...... 1.4 QU H-FR IN3 u-lol ihsuLATt3N -4- ........... ............- 01-:bONSTRU-CONSTRUCTION 4. 11 C N MUST 3 . 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