Loading...
HomeMy WebLinkAbout38488-Z I N$1.- FEtil,t4 Town of Southold 9/11/2015 too Ia P.O.Box 1179 cf,* 53095 Main Rd ,k` Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 37773 Date: 9/11/2015 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 2300 Paradise Shore Road, Southold SCTM#: 473889 SecBlock/Lot: 80.-1-11 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 4/18/2011 pursuant to which Building Permit No. 38488 dated 11/8/2013 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 with fence to code as applied for. The certificate is issued to Carla-Ann Dilberti of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 38488 7/22/2011 PLUMBERS CERTIFICATION DATED 7 ,4 A y e Signature r TOWN OF SOUTHOLD ,r'`gUfFDI,�e��, BUILDING DEPARTMENT 4`A x•{, TOWN CLERK'S OFFICE it:'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#: 38488 Date: 11/8/2013 Permission is hereby granted to: CARLA-ANN DILBERTI P.O. BOX 873 SOUTHOLD, NY 11971-0873 To: CONSTRUCT INGROUND SWIMMING POOL,FENCED TO CODE AS APPLIED FOR.REPLACES EXPIRED B.P. # 36349 At premises located at: 2300 PARADISE SHORE RD. SOUTHOLD SCTM # 473889 Sec/Block/Lot# 80.-1-11 Pursuant to application dated 4/18/2011 and approved by the Building Inspector. To expire on 5/8/2015. Fees: PERMIT RENEWAL $125.00 Total: $125.00 4 W . Ai. ,1 Building Inspector fSo oTN� TOWN OF SOUTHOLD hoo BUILDING DEPARTMENT CA TOWN CLERK'S OFFICE �•o,_ SOUTHOLD', NY sol * ,�a4 _.,. 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#: 36349 Date: 4/26/2011 Permission is hereby granted to: CARLA-ANN DILBERTI P.O. BOX 873 SOUTHOLD, NY 11971-0873 To: EXPIRED SEE B.P. # 38488 construct inground swimming pool, fenced to code as applied for At premises located at: 2300 PARADISE SHORE RD. SOUTHOLD SCTM # 473889 Sec/Block/Lot# 80.-1-11 Pursuant to application dated 4/18/2011 and approved by the Building Inspector. To expire on 10/25/2012. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO - SWIMMING POOL $50.00 Total: $300.00 Building Inspector Form 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 of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building,multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board 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. Accurate survey of property showing all property lines, streets,building and unusual natural or topographic features. 2. A properly completed application 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 pool $50.00,Accessory building$50.00,Additions to accessory building$50.00,Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy- $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy-Residential $15.00, Commercial $15.00 DOL Date. New Construction: ?2� Old or Pre-e ing Building: (check one) • Location of Property'- c)C , rod/,5e ��de j� �� l�T 16 House No. S reet Hamlet Owner or Owners of Property— cI//Q AAL.. /tZeri Suffolk County Tax Map No 1000, Section Block Lot Subdivision �[ Filed Map. Lot: Permit No. g g Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (che one) Fee Submitted: $ #000,.iefeW4 . Applicant . , natur/ I,,,, 000^,,„,..... Si Town Hall Annex i'41 lis t Telephone(631)765-1802 54375 Main Road % N Fax(631)765-9502 %P.O.Box 1179 % G Q �� Southold,New York 11971 0959 �, �® ®111 roger.richert(a�town.southold.ny.us 11 "93. ,4,-- i*a ----•-... o'S BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Carla Diliberti Address: 2300 Paradise Shore Rd City: Southold St: NY Zip: 11971 Building Permit#: 36349 Section: 80 Block. 1 Lot. 11 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: USI Electric License No: 2740-me SITE DETAILS Office Use Only Residential X Indoor Basement Service Only Commerical Outdoor X 1st Floor Pool X New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph Heat 1 Duplec Recpt Ceiling Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures Smoke Detectors Main Panel NC Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel NC Blower Range Recpt Fluorescent Fixture Pumps 2 Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks Disconnect Switches Twist Lock Exit Fixtures TVSS Other Equipment in ground swimming pool to include, bonding, 1 pool light, control panel, 1 GFCI circuit breaker Notes: Inspector Signature: ;, r Date: July 22 2011 81-Cert Electrical Compliance Form 3 (3 ' � ,,,,,,,,,,,,,, a���,,SO(/P,,o%i '� *3 so€ o"� 4-cou„,,,ir..... TOWN OF SOUTHOLD BUILDING DEPT. ZI1NSP 765-1802 - TION [ FOUNDATION 1 .= W f' ] ROUGH PLBG. [ ] FOUNDATION :SND [ ] INSULATION [ ] FRAMING I STRAPPIN [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: A C37 c-c-)4//r - 63/7 - i t 4 DATE -6- )3/ INSPECTOR ii 1 3 4w . 4) uryt #'; TOWN OF SOUTHOLD BUILDING-DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] "SULATION [ ] FRAMING/STRAPPING [ FINAL 2� [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: 4K 6/1"r (" 1 7 v- 7z) /:cf /7 ci /14 DATE 3 , / INSPECTOR • 385 . ,,,,,,,,,,,,,___ ,,,wvsou41„,„ Ig t t TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST . [ ] ROUGH PLUMBING [ ] FOUNDATION 2ND [ ] INS ATION [ ] FRAMING /STRAPPING [ INALPdv- _ [. ] FIREPLACE& CHIMNEY. [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: O7 i C2 / , i Cii-- 474zDATE INSPECTOR '` • FIELD INSPECTION REPORT D TE COMMENTS CO •• 14- J ,/ _,c cs. 0 ,, 'OUN),ATION(1ST) ® ,�' '� .. 1,...,,,ne • A ma 0 • FOUNDATION(2ND) t4 9C • • d H • ROUGH FRAMNg& PLUMBING • km- • INSULATION PER N.Y. - y STATE ENERGY CODE /P 9 / 7-(11 g 1 , i7,‘„ / aero = . ( /, TO GO: ' fii t. 4 pb . . ( /Lo-a64--- fock__.- ))"...,4 4..; FINAL 9,1'- ' . _ • . • • . V ., , ,, • ADDITAL COMMENTS e'(-' -i- it-24.0,-(A 1.-e e ) -- ' I • % r I 6Yr_- 6,-69L°„' (4-- 7 Z l/ ‘• I m 73 TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPART NX Do you have or need the following,before applying? � � oa � ;-_ TOWN HALL Board of Health SOUTHOLD, NY 119 3 sets of Building Plans TEL: 765-1802APR 11 RR �n111 Survey PEIT N 3/7 Check Septic Form BLDG DEPT. N.Y.S.D.E.C. TOWN OF SOUTHOLD Trustees Examined `. ,20 I Contact: Approved ,L' ,20 I/ Mail to: Disapproved a/c • t-yy • (0A-1/ 7 )-- Phone: 4. Building Inspector . APPLICATION FOR BUILDING PERMIT Date 4/is! 1'>' .. 26 INSTRUCTIONS a.This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 sets of plans, accurate plot plan to scale.Fee according to schedule. b. Plot plan showing location of lot and of buildings on pi emises, 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 part for any purpose what-so-ever until a Certificate of Occupancy is issued by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuancef of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County,New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions, or alterations or for removal or den.olition as herein described. The applicant agrees to comply with all applicable laws, ordinances,building code,housing code d regulations, and to admit authorized inspectors on premises and in building for necessary inspections. OCC's./FANCY OR / • "IMMEDIATELY" ��Qa y r'�si t E L •(Signature of •applicant o� a ame,if a corporation) ENCLOSE POOLTO CODE V UPON COMPLETION WITHOUT CEICATE2s* M I R4-ee 1170V BEFORE "WATER" OF OCCUPANCY (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder LttX TD .Name of owner of premises0A-KLA-Uhh Q 11 been P.O. &DX' R7 3 ED A, a14D (as on the tax roll or latest deed) DATE . (/ B.P.# 345$ • If applicant is a corporation, signature of duly authorized officer FEE: '-- BY r —% (Name and title of corporate officer) NOTIFY BUILDING DEPARTMENTPM \T 76 -18O2 8 AM TO 4 FOR Th FOLLOWING INSPECTIONS. Builders License No. )431,1- FrT1. FOUNDATION-TWO REQUIRED FOR POURED CONCRETE Plumbers License No. 2, ROUGH-FRAMING,PLUMBING, STRAPPING,ELECTRICAL&CAULKING Electricians License No. 0.740- i 1 ' 3 INSULATION �. �� r��� • 4 FINAL-CONSTRUCTION&ELECTRIC, _ EMUST BE COMPLETE FOR C.O. . Other Trade's License No. [INPETl,e, FIEGUIRED ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW 1. Location of land on which proposed worklwill be done: YORK STATE. NOT RESPONSIBLE FOR 02300 PAM14e,. shote go ,,,DESIGD� ARI r -M WA I N I-1 f. N O, t House Number Street AloY�. Tetr ttra. -PU •SU'ANP4-0 CHAPTER 236 VIN County Tax Map)No. 1000 Section YO Block lnuo0 lottuu OF` i CODE. � 1 at� . Subdivision KelOO 61'10g/5 Filed Map Naos Oltm"''4" ' Lot - (Name) 2. State existing use and occupancy of premi es and intended use and occupancy of proposed construction: • a. Existing use and occupancy t `' b. Intended use and occupancy keslC xti1. '),,11mrv►/RI El7L 3. Nature of work (check which applicable): New Building ' Addition , Alteration_ Repair Removal Demolition Other WorkT ez.,hvy, Si-Atm-NA/1 Pao. (Description) 4. Estimated Cost 1i(363_ Fee . (to be paid on filing this application) 5. If dwelling, number of dwelling units _ Number of dwelling units on each floor _ If garage, number of cars 6. If business, commercial or mixed occupancy, speci jrr nature and extent of each type of use. _ • t 7. Dimensions of existing structures, if any: Front ' 5.3' Rear 53' Depth 2i 1 Height Number of Storrs Dimensions of same structure with alteratic;,is or additions: Front Rear Depth Height , Number of Stories 8. Dimensions of entire new construction: Frp-}ii, 20' Rear A' Depth -,)� z- 8' i Height Numberc,of Stories 9. Size of lot: Front q0R ear /o ' Depth 1 o ' 10. Date of Purchase 0 - Name of Former Owner 11. Zone or use district in which premises are situated . 12. Does proposed construction viol te; any zoning law, ordinance or regulation: No 13. Will lot be re-graded 6L OL'. Will excess fill be removed from premises: NO I&Ito-ann 14. Names of Owner of premises iLit ie-i Addressh. Bay ?73 oNitoto Phone No. -3Y5- 33/ Name of Architect _ ke,I ly PC Address 4 � &ISrimt v&Phone No 7Z6---1// -S- Name z t-71/ Name of Contractor ` Cowi„os Pas Address eJ29 et-2_6•A- Phone No. 7,4---7/(1-1— PI tl lec Pota --7I fPItlIec0,t Imy 15. Is this property within 190 feet of a tidal wetland? *YES NOI • IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE. ,,Q•mRED, �.,s:,,c',1.:.,,l- 16. Provide survey, to scale:. with accurate foundation plan and distances to property lines: - 17. If elevation at any poirr, on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF - A J -C bS being duly sworn, deposes and says that(s)he is the applicant "(Name-ofii dividiial stgning-contract) above named, (S)He is the ,,,rcaclatFlry >°tl•airt rfr 1p +t-.r-rr ; epd146"704- - "‘d",r? ix OT MA :3 (Contractor, Agent, Corporate Officer, etc.) ?,vl T3r39,?L<;i ;.a[•Irtf'al.1`j1 of said owner or'SOwnirrs;aridis-dul'y'aiithorized to perform or have performed the said work and to make and file this application; that all statenientl coritairied'in0liis'application are true to the best of his knowledge and belief; and that the work will be lllFt:‘,1!?(Li ;Y,•q,r, tr17 f-f jt )l performed in;the mannera set fp t ,m,the application filed therewith. k,O11,,;RAI ; Sworn to before;rne)thi 15.;1 t: - , I, I S Cday;of' U') 'r.7 '.21 Ii., 20)I ,lawkair r 9 J'iM J 1Arl';v i..tit's' '!O.) ii'', /- I aid iji vI -1�)Ti, j; rotary Publrc ' Signature • Applicant - ..,y••;,� ,fl lap+"l<,;T •t41', l ;;-: - :MARGARET A.' KIDNEY ,: ;�1Votary.Public-State of New York -`,.-i L' �'',+',�, No.011(1602'1111 • Qualified'in Suffolk County • My Commission Expires March 8,20[ / • ., �°S" � - , Town of Southold . - : 8 1 ' 0 -n1/2 Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM - PROPERTY LOCATION: S.C.T.M.#: _ �-- THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A ', 04*)W. 0. I j,4 ir0 Sii0 i 0 STORM-WATER,GRADING,DRAINAGE AND EROSION CONTROL PLAN 0 strict Section —WEE— Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM# / WORK ASSESSMENT , YesNo a. What is the Total Area of the Project Parcels? I Will this Project Retain All Storm-Water Run-Off (Include Total Area of all Parcels located within 131 2.7O Generated by a Two(2')Inch Rainfall on Site? the Scope of Work for Proposed Construction) 1111 �Acres ) (This item will include all run-off created by site b. What is the Total Area of Land Clearing . clearing and/or construction activities as well as all and/or Ground Disturbance for the proposed 900 Site Improvements and the permanent creation of - construction activity? ) impervious'surfaces.) GO,Acres PROVIDE BRIEF PROJECT DESCRIPTION (ProvidaAda tions!Pages as Neeaed) 2 Does the Site Plan,and/or Survey Show All Proposed Drainage Structures Indicating Size&Location?This L —�� Item shall include all Proposed Grade Changes and fl R1jQa,?,-0 v,MI 40 ` L 0ivimmhl, Slopes Controlling Surface Water Flow. • 3 Does the Site Plan and/or Survey describe the erosion -Ni in )L ' and sediment control practices that will be used to control site erosion and storm water discharges. This — item must be maintained throughout the Entire Construction Period. 4 Will this Project Require any Land Filling,Grading or • Excavation where there is a change to the Natural Existing Grade Involving more than 200 Cubic Yards I of Material within any Parcel? • 5 Will this Application Require Land Disturbing Activities e Encompassing an Area in Excess of Five Thousand (5,000 S.F.)Square Feet of Ground Surface? 6 Is there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction General DEC SWPPP Requirements: or within One Hundred(100')feet of a Wetland or Submission of a SWPPP is required for all Construction activities involving soil Beach? disturbances of one(1)or more acres; including disturbances of less than one acre that 7 Will there be Site preparation on Existing Grade Slopes are part of a larger common plan that will ultimately disturb one or more acres of land; which Exceed Fifteen(15)feet of Vertical Rise to including Construction activities involving soil disturbances of less than one(1)acre whereIII ii the DEC has determined that a SPDES permit is required for storm water discharges. One Hundred(100')of Horizontal Distance? (SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit 8 Will Driveways,Parking Areas or other Impervious for Storm Water Discharges from Construction activity-Permit No.GP-0-10-001.) Surfaces be Sloped to Direct Storm-Water Run-Off MI / 1.The SWPPP shall be prepared prior to the submittal of the NOI.The NOI shall be into and/or in the direction of a Town right-of-way? submitted to the Department prior to the commencement of construction activity. 2.The SWPPP shall describe the erosion and sediment control practices and where 9 Will this Project Require the Placement of Material, required,post-construction storm water management practices that will be used and/or Removal of Vegetation and/or the Construction of any e constructed to reduce the pollutants in storm water discharges and to assure Item Within the Town Right-of-Way or Road Shoulder compliance with the terms and conditions of this permit.In addition,the SWPPP shall Area? identify potential sources of pollution which may reasonably be expected to affect the (This item will NOT include the Instillation of Driveway Aprons.) quality of storm Water discharges. NOTE: If Any Answer to Questions One through Nine Is Answered with a Check Mark 3.All SWPPPs that require the post-construction storm water management practice in a Box and the construction site disturbance is between 5,000 S.F.&1 Acre in area, component shall be prepared by a qualified Design Professional Licensed in New York a Storm-Water,Grading,Drainage&Erosion Control Plan is Required by the Town of that is knowledgeable in the principles and practices of Storm Water Management. Southold and Must be Submitted for Review Prior to Issuance of Any Building Permit -(NOTE: A Check Mark(4)and/or Answer for each Question is Required for a Complete Application) STATE OF NEW YORK, �� ut COUNTY OF SS That I, J i being duly sworn,deposes and says that he/she is the applicant for Perna 44„,,,,„: mof ndividual signing Document) //l PP t, And that he/she is the l;OillN6/61 , (Owner,Contractor,Agent,Corporate Officer,etc.) • Owner and/or representative of the 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 knowledge and belief;and that the work will be performed in the manner set forth in the application filed herewith., Sworn to before me •s; • d day of APCLC I //'- Nota � � KIDNEYry Public: ` :.{(/!4!-�,0...k : 10�(;PubliC—,State of ,YRrk " fi • No.01 K16021 I 1 S natur-'Applicant) I ( FORM - 06/10O fid In Suffolk County • , *Chi EiOrea MMarch 8,20 i *of 8004; Town Hall Annex * 4 ; Telephone(631)765-1802 54375 Main Road eno ,ax(631)76 -g5p P.O.Box 1176 • ��' roger.rlChertLOWn.SOuIl0l�.ny.uS - Southold,NY 11971-0959 =�l�C 0� '11 UNi`l, , BUILDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION • REQUESTED BY: Date: 4)15111 Company Name: U,5 ,T. Elkc - Ic Name: ED h&F License No.: • 2r140 Address: )25 PULASti t(O .1111§3 Pix. • Phone No.: (031- 5)4 -Ot/Ov JOBSITE INFORMATION: (*Indicates required information) *Name: t-/k Diu�ikn *Address: 2300 PAIge 6hoe 6amtelf3 *Cross Street: 8kki view Po *Phone No.: te3 I- 33- 0�1 0 Permit No.: 3(,b c' Tax Map District: 1000 Section: . s{j Block: 01 Lot: 11 *BRIEF DESCRIPTION OF WORK (Please Print Clearly) 'NgitoJ No Vim' 6,-dienmr,J 9 �� . • (Please Circle All That Apply) *Is.job.ready for inspection: YES / NO Rough In Final *Do you need a Temp Certificate: YES / NO Temp Information (If needed) • • S *Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other *New Service: Re-connect Underground Number of Meters Change of Service Overhead Additional Information: PAYMENT DUE WITH APPLICATION 110 82-Request for Inspection Form l7 Southold Town Building Department '+Q�r�V- 'eaG-„ P.O.Box 1179 Permit#: 36349 I•ff t d 54375 Main Road ` . Southold,New York 11971 Permit Date: 4/26/2011 ��j®1 �o� (631) 765-1802 Expiration Date: 10/25/2012 Parcel ID: 80.-1-11 Dated: 10/31/2013 Applicant: CARLA-ANN DILBERTI Location: 2300 PARADISE SHORE RD. SOUTHOLD Work Description: IN GROUND POOL construct inground swimming pool, fenced to code as applied for Owner: CARLA-ANN DILBERTI Address: P.O. BOX 873 SOUTHOLD, NY 11971-0873 Your BUILDING PERMIT #36349 has been referred to me because you have not responded to requests to obtain your Certificate of Occupancy as required by Southold Town code. Pursuant to 144-15A, of the Southold Town Code, "No building hereafter erected shall be used or occupied in whole or in part until a certificate of occupancy shall have been issued by the Building Inspector." Therefore, you have ten days from the receipt of this letter to submit a check made out to the Town of Southold in the amount of$250.00 to renew the building permit, or legal action will be taken against you. Should you have any questions, call the building department between the hours of 8:00 a.m. and 4:00 p.m. Respectfully Yours, 4:..„,„,,,;44/ Michael Verity: Chief Building Inspector _ Southold Building Department • \ Town Hall Annex ~ ® : Telephone(631)765-1802 54375 Main Road ilig Fax(631)765-9502 P.O.Box1179 %, coo • ��,'��� Southold,NY 11971-0959 • BUILDING DEPARTMENT TOWN OF SOUTHOLD April 17, 2014 Carla-Ann Dilberti PO Box 873 Southold, NY 11971 Re: 2300 Paradise Shore Rd, TO WHOM IT MAY CONCERN: The Following Items(if Checked)Are Needed To Complete Your Certificate of Occupancy: Application for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. w- A fee of$50.00. Final Health Department Approval. Plumbers Solder Certificate. (All permits involving plumbing after 411184) Trustees Certificate of Compliance. (Town Trustees#765-1892) Final Planning Board Approval. (Planning#765-1938) Final Fire Inspection from Fire Marshall. Final Landmark Preservation approval. Final inspection by Building Dept. Final Storm Water Runoff Approval from Town Engineer BUILDING PERMIT — 38488 — Swimming Pool pf Town Hall Annex t Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 0 47c, Southold,NY 11971-0959 February 24, 2015 lyC®UNT`O° • �*-0°• BUILDING DEPARTMENT TOWN OF SOUTHOLD Carla-Ann Dilberti PO Box 873 \ Southold NY 11971 C� � (—c\��c� Jlo0 / Re: 2300 Paradise Shore Rd, TO WHOM IT MAY CONCERN: The Fs •wing Items(if Checked)Are Needed To Complete Your Certificate of Occupancy: /i 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. (Planning#765-1938) Final Fire Inspection from Fire Marshall. Final Landmark Preservation approval. Final inspection by Building Dept. Final Storm Water Runoff Approval from Town Engineer BUILDING PERMIT — 38488 — Swimming Pool It& Postal ServiceTM +"" � • ru CERTIFIED-''°,AILTM RfiECEIPT � .D (Domestic Mail Only;No Insurance Coverage,Prowded) f� Fordelivery information visit our website at www.usps.corn® = Postage $ N �� S 1 r1 Certified Fee qm. rr f .0 O g® O Return Receipt Feeostlf,�<�c /I� (Endorsement Required) r 71)" -Si"a: Her '2/ j 'iii(),-4 3 a•?L f O Restricted Delivery Fee (Endorsement Required) ®) c0 — �® C1 Total Postage&Fees $ -1' I/I C -- f oSenr Q C1J , J r_ Street, pA t l[o.; or PO Box No. p.71 seO e27O City, •te,ZIP+4 V _,,,0 , l of l I — 0 73 PS Form 3800,June 2002 See Reverse for Instructions'' 1 Y SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY . • Complete items 1,2,and 3.Also complete A. Sign. - item 4 if Restricted Delivery Is desired. /�– —r–_p . - t • Print your name-and address on the reverse X i/� r. Addressee so that we can return the card to you. R ved-b (• ted N- - - ate of Delivery • Attach this card to the back of the mailpiece, 4� or on the front if space permits. r V.J 1 Il r , - D. Is delivery address different from item 1? 0 Yes 1. Article Addressed to: 35 vs 2- �t If YES,enter delivery address below: 0 No C - p N to `L-s-Deft. i .,:,„„,_„0.04 1 ,, Ni. I ,0,11_ d ISI3 3, Service Type 0 Certified Mail 0 Express Mail ❑Registered 0 Return Receipt for Merchandise ❑ Insured Mall 0 C.O.D. 4. Restricted Delivery?(Extra Fee) 0 Yes 2. Article Number (Transfer from service label) 766lo 0$ O . ow I N t q z /-C if I PS Form 3811,{February 2004 'I ' -Domestic Return Receipt _ V U 102595-02-M-1540 • ..40.,,-,•„:,•,.4., ,440,,,,,,, 0.1;::,,,n.,... ,6,4,,,,;:,...4,0,:,, 4,,,,,,,,,,:;p4,,,,..,. ,,,,„,1,.,,,,,14,04,44:,,it„fr,,,,..t., :Aft:,LAW 4t;\/<-;—‘-`0-1!:',',,,,1„.7„N'`,,,AF'7,1?):',,,, ill.,'A,„,,,,,,,, -0,,pf.,A ',47,'.pro.A.00 ,..' 51',''1-4 447.40,,, ..'17::,.,:e Alzfr `\,/h° :,"..1,i,...„,,,, -4,., , , ,','''-;-- --'v,,,,,,:t py.'\ ,,, -,,,4.„-''''',.42,. .,«470,. ,'. \77-.-- ,..1‘...,,,I,..;,;.;„,,,,,,, ..4.-..tg.,,,,,,,,,,,k,,,,,4;;I:.,1,.0„,s3,..v,,,A, ,,,/§vi....1.•:,.0,...6wip,;,*.A....lci.m..101; ,,,,,,,,14.,p- 44.04,4-1..,4,4,44.41;.1..10,r`er04,4'.01,40,tio '-`44,.V•40.1.;;WotgiV;s'"1,e4 gri.401k Allite:'4.12r".`, 4,-\ c!'!..41;.;,P:tgisttk$5!"41:1:Vf.t.60"V.:://lie;f;t:31P"11(14.0:0:44:C401111 ,:!1"440$10,Z4441-,"Att:WoOilltqat.e;c4glitlAC/..0411,4,2,01:,,14SeAlp.:0004,NiAte,WN'944UttlIglitSAVP'ilifeffAnt, AP'', 44244.141V ,A,A/ rk,?4,, ,,4.,,,,,, , ,/opft.it,,,,..,„',we .,,$;:f.4.,`',N14/41'ejs.:y,pil•:::.;-4".kp peA:,0#:,,,,114114.g7ir:,4:iok:,,v;,..,,y,s., 4,04:40A,FAvr.,-,14,"0.17V•le,k, wylie,,'AV'w,'10\in.*''IT4'''''',:t4:44'4,1•10-1::iierei Afir',.- --te,' -%-_,:.::::,,;.-y,-.:AT4,6,bw.,,,,,,,m,0,,,,,..,5:15s,4,1,,::, ,,,0,11,1.*. 4,..?,,,-4-t,..y,,,,0,44...,p4, 40. ,,,e4,-Vsis0,\`".4 40,,,Y,!'N.:\s"-.47,00'-:,"4-1,4,,;(110---,,•:,,'".;,#,F0-1:4-%ego,/iv,,_,...,,,_/).41r,A, ee-,„,>•44 .14p', 7 ,,it ti,!::,,,/,,..,e.k', ,i.:, ,,,...26,1,4;•;,p.,,,,,,,„,.;, .:.:4.4.,,e,.;,_tz A 4....t,414,,, I.:4k,_A•,,a1.•,/,czt Ato,iFia, ^A*,At,.AL.112 ---14Atlaky 7,r• 412 1"AI.4'*?.-4..'I% 'Z'''''',,41.,P! 'Va4 V..'?`'',iW4i 4.:.,'•14.1 ''''„?tt:' ','''::--4V?:.'2-',;". ..,„ ,tigt.:ZW:-v il,",i,'14ScrW --__......„. •. ,,,,, Eii.E.:•:••,...:r.,,'1 Suffolk County Exectitiv- is Office of Consumer Affairs -e•2: :":;:,•'" VETERANS MEMORIAL HIGHWAY * HAUPPAUGE, NEW YORK 11788 ci,......:,.........,,, , „,,_-„4, ki-5:f4-4X"1,'r DATE ISSUED: 5/1/80 No. 2740-ME .----".---*--S1 SUFFOLK COUNTY r....2,.•.4:AS.* al..0,Nitt.,-fiCS Master Electrician License ,,,,,•,,....,,,',.. 2,- •••,--- - This is to certify that EDWARD S REIFF 4.---,.......v..-,-,-.. ---_-- --------- doing business as _ UNDERGROUND SPECIALTIES INC _ _ _ having given satisfactory evidence of competency, is hereby licensed as MASTER ELECTRICIAN in accordance with and subject to the provisions of applicable laws, rules and regulations of ---,-..,.4z.-•,-,-, -1- — the County of Suffolk, State of New York...-,-,_.,_—_,_,..,• — •:-...,...-,....., ,...,-.3,...,,,,,,,2-4._ • - . SUFFOLK COLINY IDEPARTMEITI'T , 1 Additional Businesses OF CONSUMER AFFAIRS ' :ESiE1,:47.'"'4- ' "4,$e.,'.:;:-.-7- •• MASTER ,__,...,t,,,7,t_0,.... ,_-• „, r4, ',•10 ;7`.::'t,,,,',:'40.:,:ii4 LEC TR I CIA N i ''- ''f::::',..:".f---;--,-;'• ,.-i;:-1- ----v,c,,,-.:,-;-:-- , . I t 4 -41,44,;,?.V:.: we EDWARD S REIFF ,,. , Al, , 44, .... ---ae.--z-4....:,;-; A 11ti., 4 eddg, buswemvAms UNDERGROUND apecife L-11 Es WC 1 .2.1. This certifies that the 1 C-724.112e4 6?-.Z4-0/(-;-:1-'1A-RA—.. ..,..,1/4-`••,-,-,,,,,, ,.,.....,--:-i.-,,` , 1I i bearer is duly licensed I -------- -I 01,,,•,:- •, LIMI..A anbe.l. Date fasuk `s::::..,-:::‘,"•2y; by the County of Suffolk _----,—,-- 2740-ME 05/01/1980 . Director , glow:64.4 qauGun 8:12•11WrilDNI2AIE -. ... ,......:1r,". * 05/01/2012 , DIract?r ,... . - I .---- _ —---......-...... s,,,X,Ap.,,r,--*,qr.,t-5-•, '4' :,_".14,w,,,_ , ,,•„,, ,,_„,,,, 4,•",, „ , , ..,,.., 14,,,_ ,.... ,,,,i ,„..v• ,•,,_ • ,,46,,,,,„ _ -, •47.,,,,,r,„.„...„ „..,-...tfx..,„:7*,,,,A,t,w,,,-....„14,,,„4., ,s.riv.„.,4r*:-.,..47,,,,,,,,.,;-,,-,-,0,-_,434_,_;:i,,, ,,,.il,,,„,„;._,,•,„„,.:tv,.:.:v.-,-.-.e.,,,,,I,•,.•-,,r-- ,,,„..,;_..;,!,,,„, 4•---,---i•,v.1..',,..,44,-w ;, „,4x .4`-'Ar''‘A.V:rl'''"r.''`I''''' --;-•.. ,tkesorwip,,,,:ofto.L.6..04.(447,,t ..,!,,,gr',,,,,.„,.air,,,!..:,,3,-,3,;,,,,,,-,,,,N.A. 1,A.,,'_,,,k4,,,,,, ,4. -44..*;:%.,,,'44?).4l.mtv. ,A'A,,,,,..;.p,44.4, Iti.0,-. -e..-',A.i.f N.-,Ate,;.4:,..ot.,,,,6,,if.4.4**47,:-.:ir- g ,,,,..,,,„,,A.,...,,..„...,,,„„,,„,,...,„.....,,„,„.„,,,.,,,A„,,,,,,,, „.,..,,,,,,,,,,„,...,,....„.,,,,,i,„,0„,.. ",,,,,, .•,, ,...,,, ,.,,...„ ,,,,,,,,, .•,,,,,,,-44,....:,,,N.,„,,,,....,. ,.,./.. ,,,,,;..„.., ,,,,....,..„:, pro ',,9x,o,.. ,":0,,,Tat.6-,. This certificate is an original. State of New York Worker's Compensation Board CERTIFICATE OF PARTICIPATION IN WORKER'S COMPENSATION GROUP SELF INSURANCE la.Legal Name and Address of Business Participating In Group ld.Business Telephone Number of Business Referenced in"la". Self-Insurance(Use Street Address Only) Arthur J.Edwards Mason Contractor, Inc. (631)744-7185 DBA:Arthur Edwards Pool&Spa Centre 929 Route 25 A le.NYS Unemployment Insurance Employer Registration Number of Business Miller Place,NY 11764 Registered in Box"la". lb.Effective Date of Membership in the Group 4/24/2002 24108715 Issue Date 7/27/2010 Expiration Date 7/26/2011 lf.Federal Employer Identification Number of Business Referenced in Box lc.The Proprietor,Partners,or Executive Officers are "la". ® Inclded.(Only check if all partners/officers inluded. 111277925 All excluded or certain partners/officers excluded. 2.Name and Address of the Entity Requesting Proof of Coverage 3.Name and Address of Group Self Insurer. (Entity Being Listed as Certificate Holder). Town of Southold Special Trades, Contracting And Construction Trust Town Hall 1 6250 South Bay Road PO Box 728 Syracuse, NY 13039 Southold,New York 11971 Policy;W521504 This certifies that the business referenced above in box"1a"is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law as a participating member of the Group Self-Insurer listed above in box"3" and Participation in such group self-insurance is still in force.The Group Self-Insurer's Administrator will send this Certificate of Participation to the entity listed above as the certificate holder in box"2". The Group Self-insurer's Administrator will notify the above certificate holder within 10 days IF the membership of the Participant listed in box"la"is terminated. (These notices may be sent by regular mail.)Otherwise,this Certificate is valid for a maximum of one year from the date certified by the group self-insurer.'. If this certificate is no longer valid according to the above guidelines and the business referenced in box "la"continues to be named on a permit, license or contract issued by the certificate holder, the business must provide the certificate holder either with ci new certificate or other authorized proof the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury,I certify that I am an authorized representative of the Group Self-insurer referenced above and that the business referenced in box"la"has the coverage as depicted on this form. Certified By: David Francey rint name of authorized representative of the Group Self insurer) Certified By: 7/27/2010 (Signature) (Date) - 31 Title: Trust Admi rator Telephone Number: (315)699-8475 GSI-105.2 (2-02) Worker's Compensation Law Worker's Compensation Law Section 57 Restriction on issue of permits and the entering into contracts unless compensation is secured. • 1. The head of a state or municipal department,board, commission or office authorized or required by law to issue any permit for or in connection with'any work involving the employment of employees in a hazardous employment defined by this chapter, and notwithstanding any general or special statute requiring or authorizing the issue of such permits, shall not issue such permit unless proof duly subscribed by an insurance carrier is produced in aform satisfactory to the chair,that compensation for all employees has been secured as provided by this chapter.Nothing herein,however, shall be construed as.creating any liability on the part of such state or municipal;department,board, commission or office to pay any compensation to any such employee if so employed. 2. The head of a state or municipal department,board, commission or office authorized or required by law to enter into any contract for or in connection with any work involving the employment of employees in a hazardous employment defined by this chapter,notwithstanding any'general or special statute requiring or authorizing any such contract, shall not enter into any such contract unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair,that compensation for all employees has been ' secured as provided by,this chapter. • • • please Note:This Certificate is valid only through the policy dates indicated above,OR a maximum of one year after this form is approved by the authorized representatives of the Group Self-insurer. At the • expiration of those dates,if the business continues to be named on a permit or;eopntract issued by the above government entity,the business must provide that government entity with a new Certificate.The business must also provide a'new Certificate upon notice of cancellation or change in status of the policy. GSI-105.2 (2-02)Reverse OP ID:VM .44:70:2)1WCERTIFICATE OF LIABILITY INSURANCE DAT01/11DYYYY, 01!11!11 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 CER11FICATE 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 631-864-1111 CONTACT Bagatta Associates,Inc. 631-864-8274 PHONE FAX 823 W Jericho Tumoike Ste 1A (A/C,No,Ext) (A/C,No). Smithtown, NY 11787 • EMAIL ADDRESS ' Bagatta Associates,Inc. PRODUCER ARTHU-1 CUSTOMER ID INSURER(S)AFFORDING COVERAGE NAIC# INSURED ArthurJ Edwards Mason INSURER A.Worcester Insurance Company 26182 Contracting Co Inc DBA Arthur INSURER B• Edwards Pool&Spa Center INSURER C 929 Route 25A Miller Place,NY 11764 INSURER 0 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LTRINSR WVD POLICY NUMBER (MMIDD/WYY) (MMIDDIWYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY MPA00000038801 H 01/01/11 01/01/12 DAMAGES(RENTED PREMISES(Ea occurrence) $ 100,000 CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 X BLANKET ADDITIONA GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGC $ 2,000,000 —1 POLICY n PRO- JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ • SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (Per accident) NON-OWNED AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- r AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E L DISEASE-EA EMPLOYEE $ If yes,descnbe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER CANCELLATION 0000000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Southold ACCORDANCE WITH THE POLICY PROVISIONS Town Hall P.O. Box 728 AUTHORIZED REPRESENTATIVE Southold, NY 19971 CGe ©1988-2009 ACORD CORPORATION. All rights reserved ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD % r�� SYS iY7F Yt, r mtq i vn� -'0",;t.). {K•>� 5 rApp. �roi rr fiF �74F,F -i 4- ' i ,�' r 1 trf ,t•!s 4if e„,?,,,,„ S tj"rr41;v,;,,,,,,,. '..r. 1h ! ti'' , .r. �( ;5 ,, ..`4 ' 4 4 .� •s ,a 'n *„W'Y' " 'r ay"q}y, ., :•yetyyr i 'l' r j ,t/ .,,,-,,,-..1,1, �4, nr"'��9..AI', {ti°3 r,t/•$ �,�. �$p''1�<+��lf'u,�+t7Pp�,¢�y�3� � .µ3.�••Po,',lK,:� !8 7� _�•$�+4 wI SP"'',fin' �v;$i•'Ir l�. '. �J-4°-,`\�� "kFr '1:.4�R�`�'�C>ay Q"''•',. r ,�'y7.}'f,..{�'a.1'''.40$.43, ''•I�Nf � .j' P - V, t W1+ § g/03..ip j•W't+J'. ,V. t it.,, 14%�.r9- .'' ! •t✓ ptioi ...!,,. ::‘‘J,1,40,1, i �.`•, ,1 vo•e .P� 9�. • t 1._. h: ./..'",,,,,,.„,,,-,' rna� ,• 1 94/. ...4.' f r 1, r`,A,4/`• Y r c i ,r 4•Jv�, e♦/ ,(� JM� 5M f� � �+ T s�C•'�s�}\ijr 'Sr • - !,, ti 1 I,. :0 diq 4y1'f�tf ,4/. . 'I,'2' i 1p j1 .1` !!I-�11,'"i . e''1 ' eg 2.:11794.,''..5,— .�4 JN Ru 'r,'rr. \: 6 eir f p 9 r•�4, P;ryn 4 'rdil�'..r4„'' .N' Ail,M4 I� `t. ~b�,°o /: :�.(�,,�4��`�'�' ';!�'�J��3�tr `^,"J, d .�, � �P .l�i � �Y• d ti`„ �� •moo fG- S�'t'��� �n4s' r1.4 U'e'�'ti ,,,;: °� up f ae.a r� ' �3Y i ��/` i�'\\On,•8 hlt�xN \\mN/ 'Lt :y @M' �. �� � � 'C � � r�i �Jr p 't J• tij,�y.J�o�ty "�b ���.'s,'��5 .,,,4 . . ....�iy,i '!g_ �tl, 1\#, /, • ile,"r.,, 'i^�\ . 4.L;f Lvr/�i ,':z' \✓, :w\° ,'..\1,414 ? • -t..94 "j�✓%�.i':, i f ; ,., 1 1• .'4,--7-42,-,f"r :f ef•'/``56 S>> c d r=. ,2 alt!t 'h�_ �.'� .a `t,,,t r.. 'l;�tT ;• @' .} :i-2-z- -j ,,,/.. \�,,H l a d/ 1•1-'' ' I✓G c. \\`✓�//�-t' - ,tt\'41,,,,,,„':-.,,.."..tyl� { .•- i�,.�':-M �,�5.,: .-w e"". ' mn �t eva./x )� .x t � r .,,yam.: � �c� l _ ., ...�/ ,.. ��_s? �` :_r�.Y: - {� a„�., � . f •t..� �' .e.+: s i aa.r ,hr ,. , - 4 y �r,.l s�.A��•.,. ��' . .. a,.t €: oue _ • . .f!-•uo+ '3� +ai•'' P.-6...,.1s�31 �.'�'�� .\. "<i._ -mee 1U �r : ` Y n Y .c : Suffolk County Executive's Office-of Coils mer Affairs y ~ ;•••.-_,-....,.., VETERANS MEMORIAL HIGHWAY * HAUPPAUGE, NEW YORK 11788 w � . ,T'{- . }' ' DATE ISSUED: 7/1/78 No. 4436-H ` � '' ' 1 _-- ' SUFFOLK COUNTY - t:> ' • g z- 'mss-` . Monne improvement contractor* License : - . s 7 _-1-:.w..,.F This is to certify that - A• RTHUR J EDWARDS • d5 0y doing business as _ _ARTHUR EDWARDS MASON CONTRACTING INC _ _ _ _ : � ` 4k•-•:'.,; Laving fti1_,dsl�ecl the 1,I.�i�•rcments set forth ire accordance with and subject to the provisions of applicable laws, ,� �, rules and i.g rations of the Coun of Suffolk, State-of New York is hereby licensed to conduct business as a J -HOME IMPROVEMENT CONTRACTOR, in the County of Suffolk. - - �' ti = — --- — - -- ='; - r�;: x _ i SUFFOLK COUNTY DEPARTMENT • ' - -y' - .4dditional Businesses " t OF CONSUMERAFFAIRS _ = +-/ HOME IMPROVEMENT - - - :,F:' s �,� ``k . 4': j 1 CONTRACTOR . . , LICENSE- ' r� 1 ddl.,u,' NAME - H 9, 4 i r. .4--; ;e- ARTHUR J EDWARDS7,4..,,4•43,,p. �cc.c k' ..4--,.. - This,certifies that the BUSINESS NAME - ��:«.-; ARTHUR'EDWARDSN IASON • - -;v.--J.. h: bearer is duly .4.` CONTRACTING9NCDBA ,� f .> ,' licensed:by the CDur}ty-Of Suffolk License Number bate Issued --_-- -- — t e ; t'�¢ , 07/01/7978 AR + r1 443'6-kl ^ Director i Denis McElligott ` ;t.--_ COMMISSIONER EZPIRAnoN DATE 07/01/201.2 - - ` -'' - , •� ..spit... g, - ' . ` .. - . - , . - � � • - - - • � ', IYp >y: QeV !TA. >rVI? 31'./d>TC • -G,O !'”, ;9ti' .y,¢ ;Cfi _''' -`tYV ,7, �Ci' q!- ,- ti s ,,kk r i . ,::"1-. ;_ �. :rA,y.. a:. i ,T , ,) ,,, i'' µX I+v f ,, 't,r -- , ';r 1, w . x, h - r'0" -' : y• t:rf�,\a. H y .<< .• �ti ei . J� 1i ;fp ;j;1'y \.Y. \, .I.��`° X11.✓ "a�„ r; °\�` F .�: �pi �S \ r ,tea.. G--t S. n, t ,/r y• p: „,�;-,T^, /'\`�.y \ f/ A bl ,� , +i”, , o / \ r Yg:\ ;•; q> \a n Z r r � �,, ,,4 -. ... •• , o v ,r'v.0 ,,'' . ....v-,J„nJ, 'f s I f.' ri F'0%,,,,41 ',11(1,4 9 !'tti ';,9' at`.1 I�' r Q,V. :,-k,; :„,,, 401,t1, .:„p,,Wpn"J r' , 11,/, r5 d , l \ rl'4•?�\\,1{ .Mote \ y J'B• On: __, @r '�b•� I N64 r' o6'e'drpi r 11�,tl�gAgl�a,°,•11eu'�� I��•\ilb�Y.i�I'b�.f, 4 x141', �°t+ o '41$n b�:Ce bra'. Sry��n ;•,'r ri4d 17,,�,..r :/i ;ill•�y5d>nrt,yl?'v+fh.?:ryP'N"`vl�� al'��.:,e<S'P c,�{llf '��,,{„ntiIr'�° :'rl''rPceidllf �a. 1^'.�i+yb 7�', e iq:N'r�� ' 4x` �M;"'yJliVi} ,utt�41.4,,, II ..4"�••�.k. 4,, q , �� �i•o-.. ', t 4.144- r.{!. n F e .!",I '... a ll , •?JJC nJlj,',,' Way olttj'J It., •l1JC'•Stu1J,°• Ie`r ,,'•'.'\ y'A' a n;., ^•.'T1 (1:144 •*-4C,' M:^Y4"'.�•• o • •T4 ✓'h4r�� aa���� � +t � <,n��cc��115"4 �Mld+i r ","� t h rl ♦ 4, �'�i�ygy-Y •V+ Y'!�� r c,''',,,'.'6....0."� ,�iL` t t<f�., A Yw• ., .. r,ti `'<k.'4r••.A. '.lia.l. ' •A, ;�vY SL t ',W .TQ.b •.r, •e ✓rf1 - 'N' f e .ire f1 be' 4'2 neo 'i 4.3s , : •:o,°to "4 i•• l+, ,44p,',;,,„,,,:',3„.., .67' T", -' Aifi, ,- r l .v..4-"',:l �`--'144/A04. A 4 1 rh`F''' '�'• t O •0**., r .'';' shy i'•,� d +,� 4.7057"" .,..,,{{�� - .•,,'[ . t. r r . t r .t� ., '�d7, fl �'� �;�, ', ti •y •zr,� rp, -r \ r.I({ s ;�-Mak ,"9 r, 4"'//'�YnrV! e - J r{ ,{ FF�^^}"' r% A a, t' -1,,e. {' •••:.0 d.%04Y;e a lt> •1' 4..t`c ;- , +£5'l+ '4,.t s., rrf`.[yR,.i ter'.+ _ /, .4} { k:A�` f, t tt s. r fffi yy� s�s- STATE OF NEW YORK WORKER'S COMPENSATION BOARD CERTIFICATE OF INSURANCE COVERAGE UNDER THE NYS DISABILITY BENEFITS LAW PART 1. To be completed by Disability Benefits Carrier or Licensed insurance Agent of that Carrier 1 a. Legal Name and Address of Insured(Use street address only) lb. Business Telephone Number of Insured 631-744-4455 Arthur J Edwards Mason Contracting Company Inc. lc.NYS Unemployment Insurance Employer Registration 929 Route 25A Number of Insured Miller Place, NY 11764 24-10871 1d. Federal Employer Identification Number of Insured or Social Security Number • 11-2377925 2.Name and Address of the Entity Requesting Proof of 3a. Name of Insurance Carrier Coverage(Entity Berg Listed as the Certificate Holder) Guardian Life Insurance Company of America Town of Southold 3b. Policy Number of entity listed in box"la": 53095 Main Road 984424-0000 PO Box 1179 3c. Policy effective period: Southold, NY 11971 07/01/1986 to 06/30/2011 4. Policy Covers: a.® All of the employer's employees eligible under the New York Disability Benefits Law b.0 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 Disabi01Z-;* j U . e coverage as described above. Date Signed: September 29,2010 By I �� r Telephone Number: (212)964-2150 Title: President IMPORTANT: B box"4a"la checked,and this form is signed by the Insurance carders authorized representative or NYS Licensed insurance Agent of that carrier,this certificate Is COMPLETE.Mall 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 Disability 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 Workers'Compensation Board(Only if box"4b"of Part 1 has been checked) • State Of New York Workers' Compensation Board According to information maintained by the NYS Workers'Compensation Board,the above-named employer has complied with the NYS Disability Benefits Law with respect to all of his/her employees. Date Signed: By: Telephone Number: Title: Please Note:Only insurance carriers licensed to write NYS disability benefits insurance policies and NYS licensed insurance agents of those insurance carriers are authorized to issue Form DB-120.1.Insurance brokers are NOT authorized to issue this form. DB-120.1 (7/09) Additional Instructions for Form DB-120.i By signing this form, the insurance carrier identified in box "3"on this form is certifying that it is insuring the business referenced in box"la"for disability benefits under the New York State Disability Benefits Law.The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed as the certificate holder in box "2". This Certificate is valid for the earlier of one year after this form is approved by the insurance carrier or its licensed agent, or the policy expiration date listed in box 3c'. Please Note: Upon the cancellation of the disability benefits policy indicated on this form, if the business continues to be named on a permit, license or contract issued by a certificate holder, the business must provide that certificate holder with a new Certificate of NYS Disability Benefits Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Disability Benefits Law. DISABILITY BENEFITS LAW . §220.Subd.8 (a) The head of a state or municipal department, board, commission or office authorized or required by law to issue any permit for or in connection with any work involving the employment of employees in employment as defined in this article, and not withstanding any general or special statute requiring or authorizing the issue of such permits, shall not issue such permit unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair, that the payment of disability benefits for all employees has been secured as provided by this article. Nothing herein, however, shall be construed as creating any liability on the part of such state or municipal department, board,,commission or office to pay any disability benefits to any such employee if so employed. (b) The head of a state or municipal department, board, commission or office authorized or required by law to enter into any contract for or in connection with any work involving the employment of employees in employment as defined in this article, and notwithstanding any general or special statute requiring or authorizing any such contract, shall not enter into any such contract unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair, that the payment of disability benefits for all employees has been secured as provided by this article. • DB-120.1 (7/09) Reverse , 'SURVEYED FOR: MARC OILORENZO .P PROPERTY LOCATED AT BAYVIEW 4,i7. .\ P-,st, ifr- c, --- TOWN OF SOUTHOLD I . -) 3. S.Z .-SUFFOLK COUNTY. NEW YORK <0 v 4)0 ,....T.M. # 105'0 -08 0-01-11 • = AREA = 1.3.270 SF. = 0,3048 ACRES 7 SCALE: 1'=30 f.....4 NOTE THE EXISTENCE OF RIGHT OF WAYS • 0 4. WFTLANDS AND/OR EASEMENTS OF RECORD fr IF ANY. NOT SHOWN ARE NOT GUARANTEED 46 . 4,0 F.E. M A FLOOD ZONE X' • 4k7 oRIVE LAND N/F DRIVE 18/S R M SCISCENTE 3 S . 69 / 0 'r. t '--- 40' , . AY 0 Q V- • •-, iSp • • • ,-- / IVA,.7 . FRAME co GARAGE - t-v \ L 0 T 4 0) ' OHO UTIL _ -•,. Oka 034,o FeAtt 20, -r A'c --- POLE 1, 1,5' a c\i ,, S TOOP hi Atf , ivi:::;n:-Z--, ,.:T C 1 56 8, '., CERTIFIED TO. ,...,---. ••••,—(- —.— ---- ?....N!- - ,.--, . , 14 pkoe, 0, LOT 5 , tgrA RC DILORE , t.c.,/,..„,,---.. ,--41,=.:. ,..!.,, . ,i4, i STORY / / . . BA( i FR RES /I a FISBC BANK "14 CT ' '&,--.7-'/..., ',.'")\ '-' • / roo L. o 4, If FIRST A m E R re i .,n 'pi Ttm,,ii-pys et-,)::-.:OF N Y ( , ,.. — ASPHALT DRIVEWAY @ r --,_•--- ISP 15489S) 1 --A ti.,..!: ::,,-- :I: 1 , . 20_ f -..- , MON 4r1r,.. k Cal- l% ii ','/")% 0 - ,,.'“,:•'• /-- /;.: 4 ‘"' -,,,* ":::'j 1Cli..t i -,',4 =:,.• 4 ,s, 4,!---• . T ..._ 37' —GAZEBO LOT 6 'C.' .... . 0 1 g ^ k' e., C:3 MAP OF RE Y DON SHORES FILE No 631.....• At ,t,k p.ID ibAy,.:_e#• _s'''''",•-•-----_,::--- - oi — ,.. ,,? ,--.. ----, I' ....-- -, --/ CO N -S-• _ `- ,,,, N 7 ,_ UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION a co OF SECTION 7289 OF THE NEW YORK STATE EDUCATION LAW •Z' 18 /.. LOT 7 SURVEYED BY: ,C8PIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYORS INKED Q-- •OR _EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID;TRUE COPY 0 LAND N/F BARYLSKI LAND SURVEYING . - R 8 G GEIB CONC TurrAERRAS74 EFISDRORWHOCEMR ITIZATIQSURZ re.IeRCAETREADR I-ZED REON ONSHAHILLs RBUIENHALONIF._YTOTO MON. ---...„ 2320 MAIN ST. P.O. BOX 122 -_____ THE TITLE COMPANY.GOVERNMENTAL AGENCY AND LENDING INSTITUTION NEIANAN FT CONDO. 0. i, LISTED HEREON.AND TO THE ASSIGNEES OF THE LENDING INSTITUTION GUARANTEES DR CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL i• -.. BRMGEHAMPTON. NEW YORK INSTITUTIONS DR SUBSEQUENT OWNERS ../ LOT 6 •DECEMBER 9, 2200 - 18E77 , ....... (.0-"b L(61 A B rr ________________________________ p,-"-- 11.1 , i,, Skimmers Return,, . ., iii 110.1111 /Aluminum B C D -E F— B To Fitter From Fine l \ Filter& Pump \ -- / '\. ., DTo r W Well O To Returns (Dry OptinaQ Plan A Rolled Wall Foa \ Piping Ar°r°angemeiit Wall Section Vinyl Un- 0 , #4 Rebar I 42" ] - � �a Section B B / 3500 P.S.I. Concrete :Li R y^QY,I 2'San. .;'a L 11 ,G.I 4 0433 ; Typical Wall Section koF Section. A—Ai Ess�o�`% SIZE A B C D E F G H AREA CAP. '' -17-114. 1--r.'"*h . FEET FT. FT. FT. FT. FT. FT. FT. FT. SQ.FT. GAL. AI �aeibvLiLI�jelz C1 16x34' 16' 34' 10' 14' 6' 4' 4' 8' 512 19,000 att & i r�3U® PA BX, $hoke_ go r 16'x36' 16' 36' 12' 14' 6' 4' 4' 8' 576 21,600 POOL&SPA CENTRE Address 16'x36' 18' 36' 12' 14' 6' 4' 5' 8' 64e 24,300 PERMACRETE WALL SYSTEM City3Oum k 3w Qt1J 929 Route 25A Miller Place NY 11764 State 20'x40' 20' 40' 16' 14' 6' 4' 6' 8' 800 30,000 (631) 744-7185 FAX (631) 744-0174 (ae2I ICIril 24'x44' 24' 44' 18' 14' 8' 4' 6' 10' 798 30,000 Suffolk License #4436–HI VD case 24'x48' 24' 48' 20' 16' 8' 4' 6' 10' 900 30,000 Nassau License #HI74450000