HomeMy WebLinkAbout36578-ZTown of Southold Annex
54375 Main Road
Southold, New York 11971
10/27/2011
CERTIFICATE OF OCCUPANCY
No: 35259
Date:
10/27/2011
THIS CERTIFIES that the building
Location of Property:
SCTM #: 473889
Subdivision:
IN GROUND POOL
750 Shipyard Ln, East Marion,
Sec/Block/Lot: 38.-7-10.7
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
7/22/2011 pursuant to which Building Permit No. 36578 dated 7/25/2011
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:
in ground swimming pool fenced to code as applied for.
The certificate is issued to
Llukaci, Albert & Joti, Leokratia
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
36578 10/21/11
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
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 #: 36578
Date: 7/25/2011
Permission is hereby granted to:
Llukaci, Albert & Joti, Leokratia
24 Maple Ln
East Marion, NY 11939
To:
construct an inground swimming pool, fenced to code as applied for
At premises located at:
750 Shipyard Ln
SCTM # 473889
Sec/Block/Lot # 38.-7-10.7
Pursuant to application dated
To expire on 1/23/2013.
Fees:
7/22/2011
and approved by the Building Inspector.
SWIMMiNG POOLS - iN-GROUND WITH FENCE ENCLOSURE
CO - SWIMMiNG POOL
Total:
$250.00
$50.00
$300.00
Building Inspector
~orm No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCy
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. For new building or new use:
1. Final survey 0f propeay with accurate location of all buildings~ property lines, streets,.imd unusual nsterat or
topographic features. '
2.Final Approval from Health Dept. of water supply and sewerage-disposal (8_9 form).
3.Approval of electrical installation from Board 0f Fire Underwriters.
4.Sworn statement from plumber certifying that the soldor used in system contains less than 2/10 of 1% lead..
5. Commercial building, industrial building, multiple residenoes and similar buildings and installations, a ceCdfieate
of Code Compliance from architect or engineer responsible for the building.
6,Submit Planning Boast Approval of completed site plan requirements.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses:
1. Aceurate survey of property showing all property lines,'streets, building and:unnsufil natumi or topographic
features. '
2. A properly completed appiication and consent to inspect signed by the applicant. If a Certificate of Occupancy is
denied, the Building Inspector shall state the reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy - New dwelling $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00,
. Swimming po01 $50.00, Accessory building $50.00, Additions to accessory building $50.00, Businesses $50.00:
2. Ceytifieate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $ 25
4. Updated Certificat~ of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
ate> 0'-It
New Construction:
Old or Pre-existing Building:
House No. ' Street ?
Suffolk County Tax Map No 1000, Section
Subdivision
Health Dept. Approval:
Planning Board Approval:
.Date of Permit.
(check one)
]Lot
Block .'-~
Filed Map..
Applicant:
Underwriters Approval:
Request for: Temporary Certificate
Foe Submitied: $ ~ · '
Final Certificate:
(check one)
/ ' Applican! Signa'h~- ·
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, NY 11971-0959
Telephone (631 ) 765- 1802
Fax (63 I) 765-9502
ro.qer, richort~town.southolct, ny. us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Albert Llukaci
Address: 750 Shipyard Ln City: East Marion St: NY Zip: 11939
Building Permit #: 36578 Section: Block: Lot:
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: as built DBA: License No:
SITE DETAILS
Office Use Only
Residential ~ Indoor [~ Basement ~ Service Only ~
Commerical Outdoor 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 3 ph Hot Water GFCI Recpt
Main Panel NC Condenser Single Recpt
Sub Panel NC Blower Range Recpt
Transformer Appliances Dryer Recpt
Disconnect Switches Twist Lock
Other Equipment:
Ceiling Fixtures ~ HID Fixtures
Wall Fixtures [~ Smoke Detectors
Recessed Fixtures ~ CO Detectors
Fluorescent Fixture ~.~ Pumps
Emergency Fixtures[~ Time Clocks
Exit Fixtures ~ TVSS
in 9round swimming pool, to include, bonding, 1 pool light, 1 GFCI circuit breaker,
1 pool pump
Notes:
Inspector Signature:
Date: Oct 21 2011
81-Cert Electrical Compliance Form
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ]FOUNDATION 1ST [ ] ROU~ PLBG.
[ ]FOUNDATION 2ND [ ] 1~iSULATION
[ ]FRAMING / STRAPPING [~/]/FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ]ELECTRICAL(FINAL)
[ ] ELECTRICAL (ROU~GH)~
REMARKS:~_
DATE
INSPECTOR
N OF SOUTHOLD BUILDING DEPT. 765-1802
INSPECTION
[ ]FOUNDATION 1ST
[ ]FOUNDATION 2ND
[ ]FRAMING / STRAPPING
[ ]FIREPLACE & CHIMNEY
[ ] ROUGH PLBG.
[ ] INSULATION
[ ] FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ~ELECTRICAL
(FINAL)
REMARKS:
DATE
iNSPECTOR~~~-~-~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HA~L
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (651) 765-9502
SoutholdTown. NorthFork.net
PERMIT NO.
^pproved
Disapproved
APPLICAT )N ]FOR. BUILDING PER.MIT
Date
INSTRUCTIONS
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applyin§?
Board of Health
4 sets of Building Plans
Planning Board approval
Survey
Check
Septic Form
Flood Permit
Sterm-Water Assessment Form
Contact:
Mail to:
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
sets ofplaus, accurate plot plan to scale. Fee according to schedule.
b. Pict plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or
areas, and waterways.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in par~ for any purpose what so ever until the Building Inspector
issues a Certificate of Occupancy.
£ Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not been completed within 18 months fi.om such date. lfno zoning amendments or other regulations affecting the
property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an
addition six months. Thereafter, a new permit shall be required.
APPLICATION IS HEREBY MADE to the Building Department for the issuance cfa Building Permit pursuant to the
Building Zone Ordinance oftbe Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, '~ .., alterations or for removal or demolition as herein dascdbed. Thc
applicant al; ;~_t, r~ ~cas, building code, housing code, and regulatious, and to admit
authorized ~ ~ ~ sary inspections, t / I /
ENCLOSE POOL,TOCOD I/ [ ~l"X['~l i;' ,, ..7;\//~%1'~, " I/(Signatereof~pgl~l~l~~r~
- , ' 2_5..0
,/
State whed ~~00~J~er, general contr~i:~~aYrmbu'~/,-4' '
, OUILUINU DEPARTMENT AT
(pLO UPANCY . _785-1802 8 AM TO4 pl~l FOR THE
PULLOWING INSPECTIONS:
Nameofownerofpremisus/4li .rt- LILI C'.l 1. eOUnDarlON.Twn OU, . n
(As'on tl~elta~ roll or latest deco, OR POURED coN~R~-]2E
If applicant is a corporation, signature of duly authorized officer 2. ROUGH'FRAMING. PLUMBING
(Name and title or co ll ,t&llCAL
Ucense NSPECTIOhl g F. OUIRED
STRAPPING. ELECTRICAL & CAULKING
3. INSULATION
4, FINAL- CONSTRUCTION & ELECTRICAL
MUST BE COMPLETE FOR C 0
Plumbers Ltc nse NO ...... -~. ..... , '~ ,,. ALL CONSTRUCTION SHALL MFET THE
Electncmns L]c~nse~o. · , ::v, ~,e:~ . ~QUIREMENTS
Other Trade's L~.~O~ ~['~ YORK STATE NOT RESPONSIBLE FoROF THE COD~S OF
NEW
1. Locatirm&l~d on which ~ ~r~lJ be done: . ~ ~SIGN OR CON~TR~TIO~
House Numger/ ~ Street Hamlet
CountyT~MapNo. 1000 Section D~ Block D7 Lot
Subdivision Fil~ Map No. Lot
2. State existing use and oceupancy of premises and intended use and oceupancy of proposed coastruction:
a. Existing use and occupancy ]{e~i l~t~,F~ .
,J
,d
3. Nature of work (check which applicable): New Building Addition A~ter~t~n_~
Repair Removal Demolition Other Work ~~
~ - ~D~sc{ipti~n) '
4. Estimated Cost ~ i ~, 0 ~) O ' Fee
5. If dwelling, number o f dwelling units_
If garage, number of cars
6. If business, commercial or mixed occupancy, specify nature and extent of each type o f use.
(To be paid on filing this application)
Number of dwelling units on each floor
Depth
7. Dimensions of existing stroctures, if any: Front
Height Number of Stories
Rear
Dimensions of same structure with alterations or addj~tions: Front
Depth Height_ Number of Stories
Rear
8. Dimansions of entire new construction: Front Rear
Height Number of Stodes
9. Size oflot: Front ~ ~D Rear I ,~)O'~ Depth
.Depth
10. Date of Purchase ~C)o z~ Name of Former Owner tJ/) ~/~t~1-42/~ ·
I I. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO ~'(
13. Will lot be re-graded? YES __ NO Will excess fill be removed from premises? YES __ NO
14. NamesofOwnerofpremisesLL/~C~l' Address ' 'mapE PhoneNo. ~77~'~p~/---~
Name of Architect '--~ Address Phone No
NameofContractor C,t-Pr~ol +~L4IO Address~l~ne/~lp. (::~- ~//~,
15 a. Is this property within t 00 feet of a tidal wetland or a freshwater wetland? *YES __NO
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMtTS MAY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES NO ~
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
18. Are there any covenants and restrictions with respect to this property? * YES NO X~
· IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF )
~J~/l~ i ~ ,t~ ~ 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 tbi~)13~l~C~.O~RA DY
that all statements contained in this application are tree to the best of his knowledge and belief; and that the work ~ill~i ~'i~7~24
performed in the manner set forth in the application filed therewith. NOTARY PUBLIC. STATE OF NEW YORK
Sworn to before me thi~
~('~ day of ,. )
· - Notary P~bli~
QUALIFIED t! SUFFOLK COUN.~I~
MY COMMISSION EXPIRES 11/24/~-~)J ~
Signature of Appl~a~ ~
Town Hall Annex
54375 Main Road
P.O. Box 1179
Sou~hold, NY 11971-0959
Telephone (63l) 765-1802
· (631) 76& 50
ro.qer, r,chertt~.~wn.sou{~o~d.ny.us
BUILDING DEPARTMENT
TOWN OF SOUTHOI,D
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY:
Company Name:
Date:
Name:
License No.:
Address:
Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
*Address:
*Cross Street:
*Phone No.:
Permit No.:
Tax Map District: 1000 Section:
*BRIEF DESCRIPTION ~)~WORK (Please Print Cleady)
Block: ~ Lot:
(Please Circle All That Apply)
*Is job ready for inspection:
*Do you need a Temp Certificate:
Temp Information (If needed)
*Service Size: 1 Phase
*New Service: Re-connect
Additional Information:
YES/NO Rough In
YES / NO
3Phase 100 150 200 300 350 400
Underground Number of Meters Change of Service
PAYMENT DUE WITH APPLICATION
82-Request for Inspection Form
Other
Overhead
Town Hall Annex
54375 Main Road
P.O. Box 1179
Soulhold, NY 11971-0959
Telephone(631)765-1802
Fax(631)765-9502
October 17, 2011
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Albert Llukaci
24 Maple Lane
East Marion, NY 11939
TO WHOM IT MAY CONCERN:
The Following Item(s) Are Needed To Complete Your Certificate of Occupancy:
__ Application for Certificate of Occupancy. (Enclosed)
~. Electrical Underwriters Certificate.
A fee of $50.00.
Final Health Department Approval.
Plumbers Solder Certificate. (All permits involving plumbing after 4/1/84)
__ Trustees Certificate of Compliance. (Town Trustees #765-1892)
__ Final Planning Board Approval.
__ Final Fire Inspection from Fire Marshall. - Bob Fisher
__ Final Landmark Preservation approval.
BUILDING PERMIT: 36578- In-Ground Swimming Pool
STATE OF NEW YORK
WORKERS' COMPENSATION BOARD
CERTIFICATE OF INSURANCE COVERAGE UNDER THE NYS D!SABILI ,Ty BENEFITS LAW
I PART 1. TO be completed by Disability Benefits Carder or Licensed Insurance Agen o hat Carrier
la, Legal Name and Address of Insured (Use street address only)
[LONG ISLAND POOL &
PAT O NC
543 MIDDLE COUNTRY ROAD
CORAM, NY 11727
2. Name and Address of the Entity Requesbng Proof of Coverage (Enfi
Being Lisfed as the Certificate Holder)
TOWN OF $OUTHOLD
53095 ROUTE 25
SOUTHOLD, NY 11971
1 b. Business Telephone Number of Insured
(631) 689 - 4100
lc. NYS Unemployment Insurance Employer Registration Number of
insured
Numberld Federa~ Employer Identificafion Number of insured or Social Security
112590890
NIATIONAL BENEFIT LIFE INSURANCE COMPANY
3b. Policy Number of entity listed in box
8-910-0~385
3c. Policy effective pedod:
02/26/2009 to 02/16/2013
4 Policy covers:
a. ¢' All of the employer's employees eligible under the New York Disability Benefits Law.
b. Only the following class or classes of the employer's employees:
Under penalty of perjury. I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the
named insured has NYS Disability Benefits insurance coverage as descdbod above.
Date Signed: 02/16/2011
Telephone Number: 800-535-2711
By ,
Titile: Mica President
IMPORTANT:
if box "4a" is checked, and this form is signed by the insurance corner's authorized representative or NYS Licensed insurance
Agent of that carrier. ~his certificate is COMPLETE. Mail it directly to the certificate holder.
If box "4b" is checked, this certificate is NOT COMPLETE for purposes of Section 220. Subd. 8 of the Disabifity Benefits Law. It
must be mailed for completion to the Workers' Compensation Board, DB Plans Acceptance Unit. 20 Park Street, Albany. New
York 12207.
PART 2. To be completed by NYS Workem' Compensation Board (Only if box "4b" of Par~ 1 has been checked)
State Of New York
Work:ers Compensa on Board
According to information maintained by the NYS Workers' Compensation Board the above-named employer has complied with the NYS Disab Ii y
Benefits Law with respect to all of his/her employees. [
Date Signed: By
(Signature of NYS Workers' Compensation Board Employee)
Felephone Number: Tifile:
Please Note: 0nly insurance corners licensed to wdte NYS disab y benefits insurance policies and NYS licer~sed insurance agents of those
~nsurance comers are authorized to issue Form DB-120.1. Insurance brokers are NOT authorized to issue this t'orm.
D8-120.1 (5-06)
INew ork State Insurance Fund
I Workers- Compe.satlo. & Disabilio' BeneJ~' Specialists Sbtce 1914
8 CORPORATE CENTER DR, 3RD FLR, MELVILLE, NEW YORK 11747-3129
Phone: (631) 756-4300
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
112590890
LONG ISLAND POOL & PATIO INC
543 MIDDLE COUNTRY ROAD
CORAM NY 11727
POLICYHOLDER
LONG ISLAND POOL & PATIO INC
543 MIDDLE COUNTRY ROAD
CORAM NY 11727
CERTIFICATE HOLDER
TOWN OF SOUTHOLD
53095 ROUTE25
SOUTHOLD NY 11971
POLICY NUMBER
I 2067 755-5
CERTIFICATE NUMBER
425638
PERIOD COVERED BY THIS CERTIFICATE DATE
02/26/2010 TO 02/26/2012 2/16/2011
THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ASOVE IS INSURED WITH THE NEW YORK STATE INSURANCE
FUND UNDER POLICY NO. 2067 755-5 UNTIL 02/26/2012, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER
FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL
OPERATIONS iN THE STATE OF NEW YORK. EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS
OUTSIDE OF NEW YORK. TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY
IF SAID POLICY IS CANCELLED, OR CHANGED PRIOR TO 02/26/2012 IN SUCH MANNER AS TO AFFECT THIS CERTIFICATE.
10 DAYS WRITTEN NOTICE OF SUCH CANCELLATION WILL BE GIVEN TO THE CERTIFICATE HOLDER A6OVE.
NOTICE BY REGULAR MAIL SO ADDRESSED SHALL BE SUFFICIENT COMPLIANCE WITH THIS PROVISION. THE NEW
YORK STATE INSURANCE FUND DOES NOT ASSUME ANY LIABILITY IN THE EVENT OF FAILURE TO GIVE SUCH NOTICE
THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE
iNSURED CORPORATION.
MICHAEL DOMINICI(PRES)
OF A ONE PERSON CORP
LONG ISLAND POOL & PATIO iNC
THIS CERTIFICATE JS ISSUED AS A MA~-~-ER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE
COVERAGE UPON THE CERTIFICATE HOLDER THIS CERTtFICATE DOES NOT AMEND, EXTEND OR ALTER
THE COVERAGE AFFORDED BY THE POLICY
U-263
NEW YORK STATE INSURANCE FUND
.¥
DIRECTOR,iNSURANCE FUND UNDERWRITING
This certificate can be validated on our web site at https:/Iwww.nysif.com/cert/cer[val.asp or by calling (888) 875-5790
VALIDATION NUMBER: 612284378
PRODUCER
BINDSEIL ASSOCIATES INC
631-732-4100
950 MIDDLE CNTRY RD
SELDEN NY 11784
LONG ISLAND POOL & PATIO INC
543 MIDDLE COUNTRY RD
CORAM NY 11727
12/16/11
THIS CI=HilEiCATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIRCATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED SY '/'HE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
COMPANY
A
HARTFORD CASUALTY INS CO
COMPANY
S
COMPANY
C
COMPANY
D
THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY SE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POMCIES DESCRIBED HERE~N IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. UMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS.
co i ~'TWE IPOUCY EXPIP, ATIONI
LTR I TYPE OF INSURANCE POUCY NUMBER DATE (MM,~D/YY) [ DATE (MM,~DJY~I~ UMFrS
GENERAL UAEILF~ [ 12UENQY2538
2/27/10:
2/27/12 [ GE~EP-~. ^GG,EG^TE 152, 000, 000
PRODUCTS- COME,DP AGGI S2 , 000, 000
.ERSO.~ ~ ^OV .JURY I sl, 000, 000
~CH OCCURREDCE i $1,000,000
I FIRE DANIAGE (Any one frre) IS 000
300,
jMEDEXP(Anyonei~-son) !$ 10, 000
~J- OWNED AUTO~
SCHEDULED AUTOS
ANY AUTO
j UM~B RELLA FORM
BODILY INJURY
(Per person) i $
BODILY INJURY
(Per accident)
PROPERTY DAMAGE r s
AUTO ONLY * EA ACCIDENT
AGGREGATE I $
[ Q-ACH OCCURRENCE ; $
PERMIT
Lot 21
",,.- '(~)o~
J SUBDIVISION
THE OF[ICE O[ THE CLERK OF SUFFOLK COUN1Y Oh, M/,Y 21.
2002 AS FILE NO.
631- 727-2303
SURVEYOR'S CERTIFICATION
· Wi_ HEREBY CERTIFY TO ALBERT LLUKADI,
ANTIGE]NI LLUKAE:I, LEDKRATIA JDTI~ KDSTA
G. JDTI, LDNB BEACH MDRTGAGE & BTEWAI~9'
TITLE A[-~ENBY THAT 1HIS SURVEy WAS
ACCORDANCE WF[H THE CODE OF PRACTICE FOR LA'VD
ADOPTED BY THE NEW YORK STATE ASSOCiATiON Oc
PROFESSIONAL LAND SURVEYORS.
/
HOWARD W. YOUNG, N.Y.S.L.S NO. 45~95"
SURVEY FOR
ALBERT LLUKACl, ANTIlSONI LLUKACI,
LEOKRATIA dOTI & KOSTA G. dOTI
LOT 21 "SUMMIT ESTATES, SECTION 2"
At: East Morion, Town of Southold
Suffolk County, New York
County }ox Mop r)~,~,,~ 1000 s~t~o~ 38 B~o~ 07 ~o~ 10.7
I I i [ I-- gU R VI:-- Y ~
MAP PREPARED DEC 0 2004
SCALE 1" = 50' ...... ~- ~
JOB NO 2004 0754
DWO 2004_07~4_tiU(!_surye¥
ENGINEER'S SEAL
ALL MANUFACTURED ITEMS AND CONSTRUCTION SHALL COMPLY WITH THE RESIDENTIAL BUILDING CODE OF NEWYORK STATE 2010, INCLUDING THE SPECIFICATIONS IN APPENDIX G:
SECTIONG103 -SWlMMINGPOOLS; SECTIONG105 - BARRIER REQUIREMENTS; SECTIONG106 - ENTRAPMENT PROTECTION FOR SWIMMING POOL & SPA SUCTION OUTLETS; SECTIONG107 -SWIMMINGPOOL&SPAALARMS
Z
iOF1