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' uFFOt,q��0= Town of Southold 4/28/2016 P.O.Box 1179 53095 Main Rd Southold,New York 11971 !.. * CERTIFICATE OF OCCUPANCY No: 38274 Date: 4/28/2016 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 150 Shore Ln, Peconic SCTM#: 473889 Sec/Block/Lot: 86.-1-4.15 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/18/2012 pursuant to which Building Permit No. 37607 dated 11/2/2012 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 PER NYS PETITION#2014-0040, DATED 03/27/2014, AS APPLIED FOR The certificate is issued to Tanzi,Vito&Tanzi, Lena Trieu of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 37607 07-18-2013 PLUMBERS CERTIFICATION DATED / Au ' edF S gnatu e rte" TOWN OF SOUTHOLD SUFFac,,/it #kABUILDING DEPARTMENT T TOWN CLERK'S OFFICE oy ,a„,` SOUTHOLD, NY �®1 * $pal 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#: 37607 Date: 11/2/2012 Permission is hereby granted to: Tanzi, Vito & Tanzi, Lena Trieu 70 Washington St Brooklyn, NY 11201 To: construct an In-Ground Swimming Pool, fenced to code At premises located at: 150 Shore Ln, Peconic SCTM # 473889 Sec/Block/Lot# 86.-1-4.15 Pursuant to application dated 10/18/2012 and approved by the Building Inspector. To expire on 5/4/2014. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO - SWIMMING POOL $50.00 Total: $300.00 a:t.,..„--k_-- - C-1--e(--: 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 Date. 4/ o / 16 New Construction: Old or Pre-existing Building: (check one) Location of Property: /50 5) 2by P ec al i G House No. ' Street Hamlet / Owner or Owners of Property: V t�V �A 1J 2- 1 Suffolk County Tax Map No 1000, Section Block I Lot 2//5 Subdivision 2 Filed Map. Lot: Permit No. 3/(o") Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: V(check Request for: Temporary Certificate Final Certificate: one) Fee Submitted: $ ------ ------ - -- -- - - - - ------ -- --- ----------------- - - - ---- - --- --- ---- ---- --- -------- - - - ------ -- ----- --- ApplicantSignature t 1 CONSENT TO INSPECTION an-2) , the undersigned, do(es)hereby state: Owner(s)Name(s) That the undersi (is) ( mep),,the owner( •i the p mises�in the Town of Southold,located at '/) -5 which is s i and designat don the S olk County Tax Map as District 1000, Section (, , Block 0) , Lot That the undersigned (has) (have) filed, or cause to be filed, an application in the Southold Town Building Inspector's Office for the following: That the undersigned do(es)hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, including any and all buildings located thereon,to conduct such inspections as they may deem necessary with respect to the aforesaid application,including inspections to determine that said premises comply with all of the laws, ordinances,rules and regulations of the Town of Southold. The undersigned, in consenting to such inspections, do(es)so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used in subsequent prosecutions for violations of the laws, ordinances, rules or regulations of the Town of Southold. Dated: o S CZ—. Raie (Print Name) (Signature) (Print Name) Kiri ,,, iii offatir Town Hall Annex �,O�p�® ®Gi Telephone(631) 765-1802 54375 Main Road ® - t Fax (631) 765-9502 P.O. Box 1179 kN ° Southold, NY 11971-0959 *4, ti,� x,0$7 I' roger.richert@town.southold.ny.us BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To. Vito Tanzi Address: 150 Shore Lane City: Peconic St: NY Zip• 11958 Building Permit#: 37607 Section 86 Block: 1 Lot 4 15 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 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 Duplec Recpt Ceiling Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors Main Panel NC Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel NC Blower Range Recpt Fluorescent Fixture Pumps 1 Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks 1 Disconnect Switches 2 Twist Lock Exit Fixtures TVSS Other Equipment: in ground swimming pool to include, bonding, 2-pool lights, 1-GFCI circuit breaker 1-salt generator,1-heat pump Notes. ir Inspector Signature: , :,ed - Date: July 18 2013 Electrical_Certificate.xls 1��O��OE SOUryo4 \ 41 \ ' \ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) REMARKS: DATE *2 Iz7 INSPECTO 3 o 7 � 0 �. a ,O / _ si,./ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH P G. [ ] FOUNDATION 2ND [ ] INS ATION [ ] FRAMING /STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: 4/t/ (df-z-irf---tf c::: &fri-7j7-(1 7i.) rg-K--- Cit .fir Ea/ il-AJ _i_o_ _L DATE '7r 8'1 1 INSPECTOR 47. _ 4TH FIELD INSPEON REPORT DATE COMMENTS • ' J '6 FOUNDATION(1ST) -- --.------- ----- • • FOUNDATION(2ND) .� t4 • • • ROUGH FRAMING& a y PLUMBING G, nt Cq • INSULATION PER N.Y. 4STATE ENERGY CODE 4 . •( . FINAL y l/ (o .,., . .A.„....__,„( F_e J.... CL.,f- (2 ?"." fit - ritiqs-- 4-FL 09,-/vc-c- (112- 1 f . 7 it -ox- la ADDITIONAL COMMENTS 10 c germ' - 7 ,/60 C � ./too lees-8"36-el • • N a E(toc, G°e✓•k-- i r . z m ..x.,,,,mr- ,, , j ..2, ,,,+ //Aii jr • .).. , : tx.,.4a - r ,.'I ' # ./ ki y< 1( ' ' P / . . g Z g •C tzl HI 1-,. , • i TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST 2 viitiING DEPARTMENT Do you have or need the followin61 before applym�? TOWN HALL Board of Health I SOUTHOLD,NY 11971 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey SoutholdTown.NorthFork.net PERMIT NO. 51(O7 Check Septic Form ' N.Y.S.D.E.C. Trustees i Examined Nov ,20 Storm-Water Assessment Form Contact: Approved I ( ,1,---,20 1 )-- Mail to: Disapproved a/c Swim King Pools 471 Route 25A 81cy Point, NY 11778 Expiration 61 if ,20 L L/ 631-744$3100 6....-et-,-' i �-7 C U Q V E wilding Inspector \ ! ) OCT 18 2012 APPLICATION FOR BUILDING PERMIT i 1'6- Date ic/i 5 , -,4_ BLDG DEPT INSTRUCTIONS TOWN OF SOUTHOLD . _-us application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans,accurate plot plan to scale.Fee according to schedule. b. Plot 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. - 11 d.Upon approval of this application,the Building Inspector will issue a Building Permit to the applicant. Such a pennit 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 the Building Inspector issues a Certificate of Occupancy. f. 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 from such date. If no 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. j APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold,Suffolk County,New Yo k, and other applicable Laws, Ordinances or Regulations,for the construction of buildings,additions,or alterations or for -moval or demolition as herein described. The applicant agrees to comply with all applicable laws,ordinances,buildu.,_ cod=, ousing :•-, :f c..ulations,and to admit authorized inspectors on premises and in building for necessary inspecti ins. f �aI I A TELV" OCCUPANCY OR ENCLOSE POOL TO CODE C pp g ' (S ature of app cant or name,if a corporation) UPON COMPLETION ,4 1a L. 10 �� U BEFOREVATER" l .siP` � �' '© -- kcYE �� /i 1,1 AP I a a -,U CEE TIFLIC a , i ant) OF OCCUPANCY' State whether applicant is owner, lessee, agent, architect, engineer, generdUa drakgrect AU.,AfIg or builder 6 FEE. 10' BY / f.A—__`. To..112-4 _ NOTIFY BUILDING D r'RTMbN I A I 1 Name of owner of premises V 1�� FOi L765-1OWING INSPECTIONS:2 8 AM TO 4 PM FOR THE (As on the tax roll oriatepl)iON-TWO REQUIRED If applicant is a corporation, signature of duly authorized officer FOR POURED CONCRETE 2 ROUGH-FRAMING,PLUMBING, (Name and title of corporate officer) STRAPPING, ELECTRICAL&CAULKING 3 INSULATION 4 FINAL-CONSTRUCTION &ELECTRICAL Builders License No 1I' 1 I MUST BE COMPLETE FOR C 0. Plumbers License No. e---' - alt CONSTRUCTION SHALL MEET THE Lti L.'_QU1REMENTS OF THE CODES OF NEW Electricians License No. c N' ' K STATE. NOT RESPONSIBLE FOR Other Trade's License No. G_. . I N OR CONSTRUCTION ERRORS. 1. Location of land o which.propo d work T'11 be e: i s,o��,rbr� of • t. l I ' House Number Street �J et County Tax Map No. 1000 Section g(2 Block 0 I L6t `1'r l S Subdivision Filed Map No. RFTAl11FVTORM WATER RUNOFF ll1MI PURSUANT TO CHAPTER 236 INSPEQVCIN Fig;;}1..VED OF THE TOWN CODE. 4 L { 2. State existing use and occupancy of premises and intended use and occupancy fpr oon,..fot,4,., a. Existing use and occupancy b. Intended use and occupancy r�lr,6 10 01- 1 1(e -1/) C 04sL___ 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost \ LI 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, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front_ Rear Depth Height Number of Stories 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner - 11. 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 ill excess fill be removed from premises?YESNO 15D `Q(10 :P o 1� --7 S-7 /-�14.Names of Owner o premise. J 0n Address one No. Name of Architect J , - V1 '•m A Address Phone NO 31-2.4 n1–;-52(Li Name of Contractor 11. NFAI • i ddress Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NOY . * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE QUIRED. 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 t.61 *IF YES,PROVIDE A COPY. STATE F NEW YORK) , S..lik �` \� CO T OF - ��l-Wig duly sworn,deposes and says that(s)he is the applicant (Name of indiv': nal signing co A act)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 knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. 01.1 r . Sworii rbefore meta)/ ' '.LIVE . Y, -.: ' J CC �A day of -•� t._ .:LC STA1EpF NEW 1 , �q� .SUFFOLK COUNTY ��L� EIC-'#O M,:Ya4 165 ` .„Aii, Not., Public COMM.EXP _ /_.zAN Signa • •pplicant J` ' 41 1EDE - WE APR 2 2014 STATE OF NEW YORK DEPARTMENT OF STATE BLDG DEPT ONE COMMERCE PLAZA TOWN OF SOUTHOLD ANDREW M. CUOMO 99 WASHINGTON AVENUE CESAR A. PERALES GOVERNOR ALBANY, NY 12231-0001 SECRETARY OF STATE In the Matter of the Petition of: DECISION PETE PONTERIO For a Variance to the New York State PETITION NO. 2014-0040 Uniform Fire Prevention & Building Code Upon the application of Pete Ponterio, filed pursuant to 19 NYCRR 1205 on January 27, 2013 and upon all other papers in this matter, the Department makes the following determination: • NATURE OF GRIEVANCE AND RELIEF SOUGHT The petition pertains to the installation of an in-ground swimming pool for a one-family dwelling, located at 150 Shore Lane, Peconic, Town of Southold, County of Suffolk, State of New York. Relief is requested from: 19 NYCRR Part 1220, Residential Code of New York State, (2010)Section AG105.3 section 8.2, which,requires;,in.part, that all gates_shall be self latching,with the,latch,handle located within the pool enclosure(Le., on,the pool side of,the enclosure)and at least 40 inches above grade. In addition if the latch handle is located less than 54 inches from the bottom of the gate, the latch handle shall be located at least 3 inches below the top of the gate. [The Petitioner request permission to permit latch handles for two pedestrian access gates as a part of a pool enclosure, located 54 inches above the bottom of the gate, to be located on the outside of the pool enclosure.] FINDINGS OF FACT 1. An in-ground swimming pool was installed at the subject premises. In doing so an enclosure was provided around the pool with two pedestrian access gates. 2. The two pedestrian access gates swing outward from the pool and have latch handles that are • located at least 54 inches above the bottom of the gate. However the latch handles have been located,on the outside of the gate. -- - 3. The previous,-2003 and 2007, Residential Codes,of,Newyork State allowed the latch handle to be placed on the outside of the pool enclosure as long as the handle was located a minimum of 54 • WWW.DOS.NY.GOV • E-MAIL:INFO@DOS.NY.GOV Petition No. 2014-0040 Page 2 ' inches above the bottom of the gate. The current 2010 Residential Code of New York State requires that even if the latch handle is 54 inches above the bottom of the gate that it must be located on the pool side of the enclosure. 4. The provisions for barriers around swimming pools are to protect young children, less than 5 years of age, according to the International Residential Code Commentary. 5. The 2006 International Residential Code, on which the 2010 New York State Residential Code is based, allows a latch that is 54 inches above the bottom of the gate to be located on the outside of the enclosure. 6. The commentary for the International Codes states that the"54 inch latch height requirement limits the potential for small children to reach and activate the latch." if the latch is located lower than 54 inches then the Code requires that the latch be located 3 inches below the gate on the inside of the enclosure. 7. Section 303.2, Part 8 ,of the current, 2010, Property Maintenance Code of New York State has retained the language about pool latches that was in the previous Residential Codes of New York State and still allows a latch that is located 54 inches above the gate to be located on the outside of the enclosure. 8. Based on the above findings, it is the assumption that the 54 inch height of the latch above the bottom of the gate is adequate to protect the children that the Code has identified from reaching the latch and gaining entrance to the swimming pool regardless on which side of the enclosure the latch is located. 9. On some gate configurations it may be,possible to reverse the latch to be'in compliance with the current Code requirements. However in this instance the enclosure and the gates would have to be completely reconfigured or replaced to reverse the latch.The Petitioner has stated that this would both physically and financially impractical. 10. The Petitioner has proposed that the pool enclosure and pedestrian gates will be in compliance with all other applicable provisions of Appendix G of the Residential Code of New York State. 11. The local code enforcement official has been consulted in this matter and does not object to the granting of a routine variance under the provisions of 19 NYCRR 1205. Petition No. 2014-0040 Page 3 CONCLUSIONS OF LAW Strict compliance with the provisions of the Uniform Fire Prevention and Building Code would be unnecessary in light of the fact that the latches as configured will be a minimum of 54 inches above the bottom of the gate and should be out of reach of the children that the Code provisions are.trying to protect and would ensure theachievement of the Code's intended objectives more efficiently,'effectively or economically such that granting a variance would not substantially adversely affect the Uniform Code's provision for health, safety and security. DETERMINATION WHEREFORE IT IS DETERMINED that the application for a variance from 19 NYCRR Part 1220, Section AG105.3 section 8.2, to permit latch handles fortwo pedestrian access gates as a part of a pool enclosure, located 54 inches above the bottom of the gates, to be located on the outside of the pool enclosure; hereby'PROPOSED TO BE GRANTED with the following conditions: 1. That the latch handles be located a minimum of 54 inches above the bottom of the pedestrian gates. 2. That the pool enclosure and pedestrian gates will be in compliance with all other applicable provisions of Appendix G of the Residential Code of New York State. This DECISION is issued under 19 NYCRR 1205.6. Unless objected to by the petitioner in writing received by the Department, the decision shall become FINAL after fifteen days of receipt of the decision by the'parties. This decision is limited to the specific building and application before it, as contained within the petition, and should not be interpreted to give implied approval of any general plans or specifications presented in support of this application. Ronald E. Piester A.I.A., Direc r Division of Building Standards nd Codes DATE:3/ 7/ y RAS: nc NYS DEPARTMENT OF STATE DIVISION OF CODE ENFORCEMENT AND ADMINISTRATION Variance Attest List Petition No: 2014-0040 The persons below are advised to TAKE NOTICE of the attached document. The attached document pertains to a petition for relief related to code requirements.' If there are any questions,call(518)474-4073 and ask for the Variance Unit. Please refer to the petition number in all related conversations or correspondence with us., _ / APR 2 2014 MICHAEL VERITY/ TOWN OF SOUTHOLD BLDG DEPT BLDG DEPT 54375 MAIN ROAD TOWN OF SOUTHOLD SOUTHOLD, NY 11971 VITO TANSI 150 SHORE LANE PECONIC, NY 11958 PETE,PONTERIO,PRES NORTH FORK FENCE P.O.BOX 1525 MATTITUCK, NY 11952 02/11/2014 Page 1 of 1 361 Z ; f � /�,,%�0�Sa�TyD Town Hall Annex Telephone(631)765-1802 54375 Main Road ` (631)76 - 5Q2 P.O.Box 1179 ; G Q �� roger.richertown.SOU5t�Oftl.ny.US Southold,NY 11971-0959 ='{� ••%( 0��► CQy acts BUILDING DEPARTMENT TOWN OF SOUTLIOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Date: Company Name: Name: License No.: Address: Phone No.: JOBSITE INFORMATION: (*Indicates required information) *Name: \k- 1 (/t Zt *Address: 5a S *Cross Street: `Phone No.: p # l��" ^ S� S g(0cJ Permit No.: Tax Map District: 1000 Section: Block: Lot: *BRIEF DESCRIPTION OF WORK(Pie a Print Clean ) 11 rif)l2— u` °71 c2L1 ± Q (Please Circle All That Apply) *Is job ready for inspection: YES/ NO Rough In Final *Do-you need a Temp Certificate: YES/ NO - I Temp information (If needed) *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 82-Request for Inspection Form PV) / TOWN OF SOUTHOLD PROPERTY RECORD CARD iia OWNER STREET �,� VILLAGE DIST. SUB. LOT 5 , � � o till) f /e/Q '(ieU a 7/1 d'lp`6'e. Loll le, eco ).-1 16. �✓' Rt-C_1.-tJ-1-; _)F(,'4 S 1'fQY`'s r'.t`1 1:3,..»..0 'FORMEF OWNER - N _ !/P!/, /�Gf Y e v iv ryiez- E O Ge9 hem; W - TYPE OF BUILDING R 0 , �NYI%�'1�'�t5ovi /41. 4.4 s Inc. , 201J-3 RES. 12,A0 SEAS. VL. / FARM COMM. CB. _ MICS. Mkt. Value , LAND IMP. TOTAL - DATE REMARKS 5-60 . d MEM 11 i0 9 — L 11 .1. 1 i.5ED - >2, e. e- > 14 Cu ' 1944-c s - • Uri ,,(-,r) MEM 0 :. C5CD, 5 0 IiV > a ,_ 41.. - Z. -_/. _' �F l ) 0g 0 . eoc � Jl5 113 I Q., .ce D . ) !., : , ga . l ... . /, fit. . I1 W / _ e6, [ - -.,• : Jo IMIME Tillable FRONTAGE ON WATER Woodland. . FRONTAGE ON ROAD Meadowland DEPTH House Plot BULKHEAD Total . 3 i r `' z tV rG w.sa r , ���{k, si TRIM 4 :, sr .t a c_ai 13,., j_. Itil'IS.� 4 K t 4' j t r 4 r t Fv.•-t-,,sa.1,-^.,.''',:`,,x.b'41 • NC-r :i..1�r 2t 1• ,r ` f I 3 i y ',:5,1,44,41,1,G Icffx� cr44 k xt J * r-,r`w ��5 a i �/ Sry Y s4C-',,t-r..i ,, ..a tt,y`i 4 {Z j,V •;7 J,t, 'f ..4.9 (14 y � Ffirr r i ;: e r? �FYe, •"nP v� -� ti,t r Siyyi 1.4 6 s^ t..�"�k.yl.i,,i�� a ri.-"d`r" •::.i.,',L',:f ' C N.*.''' .,4,:';'.Y-3-4. x t; f :Li '�r . 3-`ft % 5^"" iy i'.4',...., ! if i, I ..,,,4,.....:i < w4 ,' f t r �-- r oS ,r,,,,-, t.t .. ^1+d a + tz 9Y ' .... 't . s.,•____,...------ s;s.�V -iL,. r-_.-...•— „�. .-Y`".. t f ,er mom, u..? 1,., 4 ra n �. - 86-1-4.15 01/03 :o -� - �- f arm 1 • 2--1 X "7- 1 =:-41.41 S 1&11 2 ..1-9_ A(p7 44 Extension /I/ X /6 = Z.7-1/ Z.7-1/ ua /17 2'3 Ex`fensidn 59Y 12 =- l-f-&& " i'.T 51512 Extension 7 X /� 1 9 5 5.3 (46 PEK Ns) Foundation ['lL.. Bath 2I/.,, Dinette Porch Basement . Floors // K. Porch Ext. Walls 7,664(.Ff( Interior Finish LR. Breezeway Fire Place y ES Heat DR. 1 Garage Q.5 X .-4 g> /_,_l{i i' i J s Type Roof Rooms 1st Floor BR. Patio (G'_J b Recreation Room Rooms 2nd Floor FIN. B Dormer Driveway Total ( ,�`" ._ ♦ - D eo %OF SOj,j. Town Hall Annex �I ~® ®l® : Telephone(631)765-1802 54375 Main Road * Fax(631)765-9502 P.O.Box 1179 : G Q ,i Southold,NY 11971-0959 .* �® �� May5, 2015 ``®lyC®UNT'�,��'��', BUILDING DEPARTMENT TOWN OF SOUTHOLD Vito Tanzi 70 Washington St Apt 60 Brooklyn NY 11201 RE: 150 Shore Lane, Peconic TO WHOM IT MAY CONCERN: The Folio ng Items(if Checked)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. (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 — 37607 — Swimming Pool STATE OF NEW YORK WORKERS' COMPENSATION BOARD CERTIFICATE OF NYS WORKERS' COMPENSATION INSURANCE COVERAGE la. Legal Name and address of Insured(Use street address only) lb. Business Telephone Number of Insured Randy T Rodecker, Inc. 631-744-8100 Dba: Swim King Pools lc. NYS Unemployment Insurance Employer 471 Route 25A Registration Number of Insured Rocky Point NY 11778 Id. Federal Employer Identification Number of Insured Additional Named Insureds: or Social Security Number Fence King of Rocky Point,Inc. 113092960 Work Location of Insured (Only required if coverage is specifically limited to certain locations in New York State, i.e.a Wrap-Up Policy) 2. Name and Address of the Entity Requesting Proof of Coverage 3a. Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Wesco Insurance Company Town of Southold 3b. Policy Number of entity listed in box"la": 50395 Route 25 WWC3044104 PO Box 1179 Southold NY 11971 3c. Policy effective period: 9/1/2012 to 9/1/2013 3d. The Proprietor,Partners or Executive Officers are: X included. (Only check box if all partners/officers included) all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box"3"insures the business referenced above in box"la"for workers'compensation under the New York State Workers'Compensation Law.(To use this form,New York(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2". The Insurance Carrier will also note the above certificate holder within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail.) Otherwise, this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent, or until the policy expiration date listed in box "3c",whichever is earlier. Please Note:Upon the cancellation of the workers'compensation 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 Workers' Compensation Coverage or other authorized proof that 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 or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Henry C. Sibley (Print name of authorized representative or licensed agent of insurance carrier) Approved by: e`er G A 9/7/2012 (Signature) (Date) Title: Underwriting Manager Telephone Number of authorized representative or licensed agent of insurance carrier: 800-438-0160 Please Note:Only insurance carriers and their licensed agents are authorized to issue the C-105.2 form. Insurance brokers are NOT authorized to issue it. C-105.2(9-07) 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 la.Legal Name and Address of Insured(Use street address only) lb.Business Telephone Number of Insured RANDY T. RODECKER, INC. DBA SWIM KING POOLS 1c.NYS Unemployment Insurance Employer Registration 471 ROUTE 25A Number of Insured ROCKY POINT, NY 11778 8561753 1d.Federal Employer Identification Number of Insured or Social Security Number 113092960 2.Name and Address of the Entity requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity being listed as the Certificate Holder) The First Rehabilitation Life Insurance Town of Southold Company of America 3b.Policy Number of Entity listed in box"1a": 53095 Route 25 DBL37154 PO Box 1179 3c.Policy effective period: Southold NY 11971 02/01/2011 to 01/31/2012 4.Policy covers: a. ri 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 described above. 2/7/2011 ' Date Signed By ��� I/ �r (Signature of insurance carrier's authorized representative or NYS Licensed Insurance Agent of that insurance carrier) Telephone Number 516-829-8100 Title Chief Executive Officer IMPORTANT:If box"4a"is checked,and this form is signed by the insurance carrier's authorized representative or NYS Licensed Insurance Agent of that carrier,this certificate is COMPLETE Mail it directly to the certificate holder. If box"4b"is checked,this certificate is NOT COMPLETE for the purposes of Section 220,Subd.8 of the Disability Benefits Law. It must be mailed for completion to the Worker's Compensation Board,DB Plans Acceptance Unit,20 Park Street,Albany,NY 12207. PART 2. To be completed by NYS Worker's Compensation Board (Only if box "4b" of Part 1 has been checked) State of New York Worker's Compensation Board According to Information maintained by the NYS Worker's 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 (Signature of NYS Worker's Compensation Board Employee) 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 (5.06) C, - PLOT PLAN LOT 15 -- ------- - ----- - ------- MAP Of - - RICHDWOND-SHORES-AT - € Etie s 22. 174 f SITUATED AT - - - PECONIC TOWN- OF SOUTHOLD .' SUFFOLK COUNTY, NEW YORK ''k ' 4' SUFFOLK TAX No. ,000-B6-O1-4.1 S Ci " yam '• SCALE 1.= . �"6'..,.. 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O O TOP OF WALL \ `'r CLEAN BACKFILL O 0 0 U WATER LINE \ \ //j/ ti.a > Ln d \\\ 5 WALKS TO BE SMOOTH,NON SKID TYPE,SLOPED AWAY FROM POOL �•VARIES 4' - 'O ROLLED FOAM BETWEEN�.ti >. 6 WATER DISPOSAL SHALL BE LIMITED TO OWNERS PROPERTY IN ACCORDANCE WITH LOCAL R4 ljr r'" '" LINERANDCONCREIE '// REGULATIONS W ): o ,o \ FORM TIES d \\/ 7 PROPERTY OWNER 15 RESPONSIBLE TO INSTALL PERMANENT FENCE AROUND POOL IN Z v'1 Z Z \� I ACCORDANCE WITH THE NYS BUILDING CODE,APPENDIX G,SECTION AG105 PERMANENT 0 o v LU Z 3500 PSI POURED CONC. ��,� \\, ,) ENCLOSURE MUST BE COMPLETED WITHIN NINETY DAYS AFTER THE DATE OF COMMENCEMENT OF t/'1 W Q 0 N _ , AN CONSTRUCTION Z - L.-. VINYL LINER ', \ __ tWi to o �/ i 8 THERE IS NO MAIN DRAIN IN THIS POOL SUCTION FOR POOL WATER CIRCULATION IS uj LL M SECTION B a O v L�] w e-- �� PROVIDED BY THE SKIMMERS ONLY THIS MEETS REQUIREMENTS OF RC-SECTION AG106 FOR m L/m -�rn Scaso le: 1/8"=1'-0" 2"TO 4"SAND i< �� ENTRAPMENT PROTECTION. Q rsi >\/�\ 9 THIS POOL SHALL BE EQUIPPED WITH AN APPROVED POOL ALARM WHICH IS CLASSIFIED BY `-- a. 2 >%�%\%/\%`%. /z\%'\Y/\72\''Y\ \ \ UNDERWITERS LABORATORY,INC TO REFERENCE STANDARD ASTM 2208 ENTITLED j/��j��///\\/�j� �j/-\\/,‘,/�jj��j/ "STANDARD SPECIFICATION FOR POOL ALARMS,"AS ADOPTEDIN 2008 10. A TEMPORARY ENCLOSURE,OR 4 FT FENCE SHALL BE INSTALLED AND REMAIN IN PLACE 10-15-2012 WALL SECTION COMPLETHONOFAPERMANENTECONSTRUCT NC OSUREIONOFTHE SWIMMING POOL, OR UNTIL THE N al ITY N