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��o�g�FFO(,�coG Town of Southold 5/16/2018 y� P.O.Box 1179 0 d' T 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39646 Date: 5/16/2018 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 215 Marina Ln, East Marion SCTM#: 473889 Sec/Block/Lot: 35.-8-5.9 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 12/2/2016 pursuant to which Building Permit No. 41215 dated 12/9/2016 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: ACCESSORY IN-GROUND SWIMMING POOL,FENCED TO CODE,AS APPLIED FOR The certificate is issued to Foy,Edward&Veronica of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 41215 05-11-2017 PLUMBERS CERTIFICATION DATED A razed Signature SvfFolX� TOWN OF SOUTHOLD BUILDING DEPARTMENT Q TOWN CLERK'S OFFICE AM 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#: 41215 Date: 12/9/2016 Permission is hereby granted to: Foy, Edward 48 Heights Rd Fort Salonga, NY 11768 To: install an in-ground swimming pool as applied for. At premises located at: 215 Marina Ln, East Marion SCTM # 473889 Sec/Block/Lot# 35.-8-5.9 Pursuant to application dated 12/2/2016 and approved by the Building Inspector. To expire on 6/10/2018. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO - SWIMMING POOL $50.00 CT C $100.00 otal: $400.00 uildi g Inspector r Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be fled 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 I%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$510.00,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 ii Date. I a / J New Construction: Old or Pre-existing Building: (check one) Location of Property: ? i 5 Morino We, (MUM `/' �UM House No. Street Hamlet Owner or Owners of Property:- _1� �a rd ��' Suffolk County Tax Map Ido 1000, Section 0;5, ou Block 0 Lot 005- Subdivision Filed Map. Lot: rr I Permit No. `�1 i a ( 5 Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ Q A i igna e pF SOU��� Town Hall Annex MIL Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 �� roger.richertCaD-town.southoId.ny.us Southold,NY 11971-0959 C®UNV BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Edward Foy Address: 215 Marina Lane City: East Marion St: New York Zip: 11939 Building Permit#• 41215 Section- 35 Block- 8 Lot- 5.9 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: TRC Electric License No: 46689-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 Duplec Recpt Ceiling Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps 2 Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks Disconnect FA Switches Twist Lock Exit Fixtures TVSS Other Equipment: Inground Swimming Pool to Include: Bonding, Control Panel, Gas Pool Heater, 2- GFCI Circuit Breakers. Notes: Inspector Signature: Date: May 11, 2017 0-Cert Electrical Compliance Form.xls SOUjyolo `ycourm,��' TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) REMARKS: 0 DATEV11112 INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ JNSULA ON [ ] FRAMING / STRAPPING [ FINAL G� [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: i V 6!S:, S Vwf k C DATEINSPECTOR f f ' -Joe OFSOUT # TOWN OF SOUTHOLD BUILDING DEPT. coorm, 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] SULATI [ ] FRAMING /STRAPPING [ FINAL a Z [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: In (o DATE INSPECTOR FIELD INSPECTION REPORT I DATE COMMENTS FOUNDATION(1ST) ------------------------------------ FOUNDATION(2ND) tsi � O ROUGH FRAMING& y � PLUMBING ` r INSULATION PER N.Y: ' STATE ENERGY CODE e — A4,,, l FINAL ADDITIONAL COMMENTS e c D d All-c` 0 z m O e b y TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying �'TOWN HALL Board of Health SOUTHOLD,NY 11971 4 sets of Building Plans TEL:(631)765-1802 Planning Board approval FAX:(631)765-9502 or, Survey SoutholdTown.NorthFork.net PERMIT NO. Check Septic Form N.Y"S D E C Trustees C.O.Application Flood Permit Examined 20 Single&Separate Sto ater Assessment For Contact: A Approved 20 Mail to. lslah d- /� 4-1 o ^( - Disapproved a/c F Com m1113-1 Phone- LAR-q 106 Expiration 20 1 f) 1 (C 1 '(D,61—312-3gq L n5 e Bui gInspecto DAPPLICATION FOR BUILDING PERMIT DEC 2016 Date ,20 INSTRUCTIONS a' ST be completely filled in by typewriter or.in ink and submitted to the Building Inspector with 4 � t o scale.Fee,`according to schedule. iW 4e tion of rot 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 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.Thefeafter,a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold,Suffolk County,New York,and other applicable Laws,Ordinances or Regulations,for the construction of buildings,additions,or alterations or for removal or demolition as he in described.The + applicant agrees to comply with all applicable laws,ordinances,building code,housing code,and regal to admit authorized inspectors on premises and in building for necessary inspections. (SIg&kWe-of applicant or name,Jfa cc poration) 41 ei o N L1-16Z (Mailing address of applicant) State whether applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder C)W ry Qi(- Name of owner of premises Edward R®A (As oA the tax roll or latest deed) If applicant is a corporation,signature of duly authorized officer (Name and title of corporate officer) Builders License No. L45-710 —1 Plumbers License No. Electricians License No. t}(n(p&q— M E Other Trade's License No. 1. Location of land on which proposed work will be done: 21 5 AMI-i dict L4n.e Mart 60 House Number Street Hamlet County Tax Map No. 1000 Section �� '60 Block &00 Lot i Subdivision Filed Map No. Lot 3 2. State existing use and occupancy of premises and intended use anoccupancy of proposed construction: a. Existing use and occupancy { � b. Intended use and occupancy 3. Nature of work(check which applicable):New Building Addition ter on Repair Removal Demolition Other Work l P1 r0IJ 14/7 5VQ (Description) 4. Estimated Cost 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 j X10, 7 , Rear t 3 iR' Z"•1��++ Depth : 5' 10.Date of Purchase ���I 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 ,,jWill excess fill be removed``--from premisy ? tSNO 14.Names of Owner of re 'ses U f Addres G/I Phone No. (%�J 90 0 "/ Name of Architect Vi Woo Address'010 f0 a Of 1e No - 27 Name of Contractor ' � 00 -_} ! Address 5 VneNo. -YYDD 15 a.Is this property within 100 feet of a tidal wetland or a freshwater wetland?*YES y NO *IF YES,SOUTHOLD TOWN TRUSTEES&D.E.C.PERMITS 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 ✓ *IF YES,PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF Edward 604 A� P l 4riAe g' my sworn,deposes and says that(s)he is the applicant 06j~pal s /�fg�contract)above,�naamed,(�vl'fff'A�U r (S)He is the ` V`1 Iya l.{ar (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 Rd file this application, that all statements contained in this application are true to the best of bis knowledge and belief;and that work will be performed in the manner set forth in the application filed therewith. Sworn to before me this day of er20d—to Akhvll- IM ip Y01* Notary Public in�u�dk county f Applicant COrifYt'it(f 0 r No.OILA61249M Commission Expires April 4,LO V FFQ Scott A. Russell ,� ®SU ��� STO�][�.��1[WA�C'lE][� SUPkRVISOR MANAGEMENT SOUTHOLD TOWN HALL-P.O.Box 1179 53095 Main Road-SOUTHOLD,NEW YORK 11971 Town own Of Southold CHAPTER 236 - STORMWATER MANAGEMENT WORD SHEET - ATO BE COMPLETED BY THEAPPLICANT ) y DOES THIS PROJECT INVOLVE Alm OF THE IiOLLOWUNC: Yes No (CHECK ALL THAT APPLY) ❑❑x A. Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. ❑® B. Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. ❑Q C. Site preparation on slopes which exceed 10 feet vertical rise to 100-feet of horizontal distance. ❑® D. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. ❑[7] E. Site preparation within the one-hundred-year f loodplain as depicted on FIRM Map of any watercourse. [:][A F. Installation of new or resurfaced impervious surfaces of 1,000 square feet or more, unless prior approval of a Stormwater Management Control Plan was received by the Town and the proposal includes -in-kind replacement of impervious surfaces., If you answered NO to all of the questions above, STOP! Complete the Applicant section below with your Name, Signature, Contact Information, Date & County Tax Map Number! Chapter 236 does not apply to your project. If you answered YES to one or more of the above, please submit Two copies of a Stormwater Management Control Plan and a completed Check List Form to the Building Department with your Building Permit Application. APPLICANT: (Property Owner,Design Professt nal A "t'Contractor,Other( S.C.T.M. `: 1000 Date. District NAME Q35 0 SLID N5. 001 11 '114' O' i' c mei Section Block Lot t5 FOR BUILDING DEPARTMENT USE ONLY**** Contact Information 1TdephoM Yumhen Reviewed By: Date: Property Address/Location of Construction Work: — — — — — Q�S Approved for processing Building Permit. n ' ormwater Management Control Plan Not Required. Stormwater Management Control Plan is Required. (Forward to Engineering Department for Review.) FORM # SMCP-TOS MAY 2014 F s�tiryo� Town Hall Annex Telephone(631)765-1842 54375 Main Road ,ax P.O.Box 1179 G roger.riCherttOW11 SO D nV uS Southold,NY 11971-4959 BURDING DEPARTMENT TOWN OF SOUTHOLD = - APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Date: �-- Company Name: fiR PC.fYi CO r Name: License No.: 4A- ME Address: aV Q/1 Q n C LTq , Phone No.: . _ JOBSITE INFORMATION: (*Indicates required information) *Name: edlA/ rd fDl 'Address: ) 5' Ma r i L - '-Cross Street: h1° f 'Phone No.: —3 — 'ermit No.: (j rax-map District: 1000 Section:_ Block: Lot: 5 `BRIEF DESCRIPTION OF WORK(Please Print Clearly) Please Circle Ail That Apply) Is job ready for inspection: YES/ NO Rough In Final Do-you need a Temp Certificate: YES/ NO ernp Information(If needed)' Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other New Service: Reconnect Underground Number of Meters Change of Service Overhead ►dditional Information: PAYMENT DUE WITH APPLICATION ---------- 82;-Request for Inspection Formi .�` 1 f0 "'ryiR��y14Ll�rOP 14 ca�RACnOR IYBJ "CHAELi DOAMC, o Cbl Y TM` ,ai `a�ras�a 8 Jnr STATE OF NEW YORK WORKERS'COMPENSATION BOARD CERTIFICATE OF NYS WORKERS' COMPENSATION INSURANCE COVERAGE Is.Legal Name&Address of Insured(Use street address only) Ib.Business Telephone Number of Insured 631-698-4100 Long Island Pool&Patio Inc lc.NYS Unemployment Insurance Employer 543 Middle Country Rd. Registration Number of Insured Coram NY 11727 Work Location of Insured(Only if coverage is specifically limited Id.Federal Employer Identification Number of Insured to certain location in New York State,i.e.a Wrap-Up Policy) or Social Security Number 11-2590890 2.Name and Address of the Entity Requesting Proof of 3a. Name of Insurance Carrier Coverage(Entity Being Listed as the Certificate Holder) Hartford Fire Ins Co 3b.Policy Number of entity listed in box"la" 12 WEC ZI4101 Town of Southold 53095 Route 25 3c. Policy effective period 04/10/16—04/10/17 Southold, NY 11971 3d. The Proprietor,Partners or Executive Officers are ❑ included. (Only check box if all partnerstoliicers 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 entitylisted above as the certificate holder in box"2". The Insurance Carrier will also notes the above certificate holder within 10 days IF a policy is canceled due to nonpayment ofpremiums 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 maybe sent by regular mail.) Otherwise,this Certd,fYcate is valid jot one year after this form is approved by the insurance carrier or in 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 bolder,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: Brenn Regan t name of authorized representative or licensed agent of insurance carrier) Approved by: 04/06/2016 afore) (Date) Title: Partner Telephone Number of authorized representative or licensed agent of insurance carrier:_631-669-3434 Please Note. Only insurance carriers and their licensed agents are authorized to issue Form C-105.2. Insurance brokers are NOT authorized to issue it. C-105.2(9-07) www.wcb.state.ny.us Workers' Compensation Law ~~ STATE OF NEW YORK WORKERS'COMPENSATION BOARD CERTIFICATE OF INSURANCE COVERAGE UNDER THE NYS DISABILITY BENEFITS LAW ART 1.To be completed by Disab Benefits Carrier or Licensed Insurance Agent of that Carrier Ia.Legal Name and Address of Insured(Use street address only) lb.Business Telephone Number of Insured LONG ISLAND POOL&PATIO INC lc.NYS Unemployment Insurance Employer Registration 543 MIDDLE COUNTRY ROAD Number of Insured CORAM,NY 11727 ld.Federal Employer Identification Number of Insured or Social Security Number 11-2590890 2.Name and Address of the Entity Requesting Proof 3a.Name of Insurance Carrier of Coverage(Entity Being Listed as the Certificate Halder) WESCO INSURANCE COMPANY TOWN OF OUTHOLD 53095 ROUTE 25 c3' entity 3b.Poli Number of enti listed in box"la.": SOUTHOLD,NY 11971 0222285 3c.Policy effective period: 2/11/2016 to 12/31/2017 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 described above. `f f_- Date Signed 7/11/2016 By •. (Signature of insurance carrier's authorized representative or NYS Incensed Insurance Agent of that insurance carrier) Telephone Number 800-535-2711 Title Vice President 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 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,328 State Street,Schenectady, NY 12305. PART 2.To be completed by NYS Workers'Compensation Board(Only if box'1011 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 - , (Signature of NYS workers'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(12-13) LONGI-7 OP ID: DO DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 03/30/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT AX PRODUCER NAME; Brennan P.Regan Regan Agency,Inc. PHONE 631-669-3434 No)..631-669-3035 463 Deer Park Ave Arc No Ext Babylon,NY 11702 A00RESS: Brennan P.Regan INSURERS AFFORDING COVERAGE NAIL# INSURER A:American Casualty Company 015 INSURED Long Island Pool&Patio,Inc INSURER B:Hartford(Fire Insurance Co. 162 543 Middle Country Rd. INSURER C Coram,NY 11727 INSURERD: INSURER E* ---:::A 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_ LTR ADD SUB POLICY EFF POLICY EXP LIMITS I TYPE OF INSURANCE N D D POLICY NUMBER MM/DD MMMD EACH OCCURRENCE $ 1,000+000 A X COMMERCIAL GENERAL LIABILITY 12120/2015 12/20/2016 DAMAGE o TED 100,000 CLAIMS-MADE ®OCCUR X 5099218546 PREMISES a occurrence $ 5,000 MED EXP(Any one person) $ PERSONAL&ADV INJURY $ 1,000,000 GEML AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 PRO- PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY❑JECT F1 LOC $ OTHER COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident $ BODILY INJURY(Per person) $ ANY AUTO ALLOWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS NAUTOS ON-OWNED DAMAGE $ Per accident HIRED AUTOS AUTOS $ UMBRELLA LU►B OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ IPER m WORKERS COMPENSATION X I STATUTE ER AND EMPLOYERS'LIABILITYY12 WEC Z14101 04/10/2016 04/10/2017 El EACH ACCIDENT $ 100,00 B ANY PROPRIETORIPARTNERIEXECUTIVE ❑ NIA OFFICERIMEMBERIXCLUDEDT EL DISEASE-EA EMPLOYEE $ 100,000 (Mandatory in NH) If yes,describe under E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more spare Is required) Certificate Holder is additional insured. CERTIFICATE HOLDER CANCELLATION SOUTHOL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of Southold 53095 Route 25 AUTHORIZED REPRESENTATIVE Southold,NY 11971 �w ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD s SUFFOLK COUW?Y CEpT OF LAOM LICENSIft S CONSUMN AFFARS WASTERa ELECTRICIAN ROY D CHALMERS Tf�s tfia!`the . bearer Is duty t R c ELEcrnic COWP f rased by the County of Suffolk sr'a ff 46689-Mi e .rte a�uar�aoyye 01W1/2017 z New York State Insurance Fund 1Yvrkers'Compellsalion&Disability Benefits Specialists Since 1914 8 CORPORATE CENTER DR,3RD FLR,MELVILLE,NEW YORK 11747.3129 Phone:(631)756.4300 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE AIA A A A A 270916601 ` TRC ELECTRIC CORP 16 VIVIAN LANE LAKE GROVE NY 11755 Scan to Validate POLICYHOLDER CERTIFICATE HOLDER TRC ELECTRIC CORP TOWN OF SOUTHOLD 16 VIVIAN LANE 53095 ROUTE 25 LAKE GROVE NY 11755 PO BOX 1179 SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER PERIOD COVERED BY THIS CERTIFICATE DATE 12219 263 7 563832 07/09/2016 TO 07/09/2017 7/27/2018 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO.2219 263-7 UNTIL 0710912017, 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 07/09/2017 IN SUCH MANNER AS TO AFFECT THIS CERTIFICATE, 10 DAYS WRITTEN NOTICE OF SUCH CANCELLATION WILL BE GIVEN TO THE CERTIFICATE HOLDER ABOVE. NOTICE BY REGULAR MAIL SO ADDRESSED SHALL BE SUFFICIENT COMPLIANCE W1TH THIS PROVISION. THE NEW YORK STATE INSURANCE FUND DOES NOT ASSUME ANY LIABILITY IN THE EVENT OF FAILURE: TO GIVE SUCH NOTICE. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE INSURANCE FUND �U IRECTOR,IURANCE FUND This certificate can be validated on our web site at https://www.nysif coM/Cert/certval.asp or by calkg(888)875-5790 UNDERWRITING VALIDATION NUMBER:772676025 U-26.3 YOK WorkerV CERTIFICATE OF INSURANCE COVERAGE ATE Com IDensa it31!'l. Board UDDER THE NYS DISABILITY BENEFITS LAW PART 1,To be completed by Disability Benefits Carrier or licensed Insurance Agent of that Carrier 1a.Legal Name and Address of Insured(Use street address only) 1b.Business Telephone Number of Insured T.R.C. ELECTRIC CORP 631-648-7958 1c.NYS Unemployment Insurance Employer Registration Number of Insured 16 VIVIAN LANE LAKE GROVE, NY 11755 1d.Federal Employer Identification Number of insured or Social Security Number 270918601 2,Name and Address of the Entity requesting Proof of Coverage 3a.Name of Insurance carrier (Entity being listed as the Certificate Holder) ShelterPoint Life insurance Company TOWN OF SOUTHOLD 3b.Policy Number of Entity listed in box"Wa 53095 ROUTE 25 DBL342305 PO BOX 1179 3m Policy effective period: SOUTHOLD, NY 11971 07/09/2016 to 07/08/2017 4.Policy cavem a. ® All of the employer's employees eligible under the New York Disability Benefits Law b.E] Only the following class or classes of the employer's employees: Under penalty of pe duty,l certify that 1 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. Date Signed 7/28/2015 By (Signature of Insurance carrier's authorized representative or NYS Licensed insurance Agent of that insurance carrier) Telephone Number 516-829-8'100 Title Chief Executive Officer IMPORTANT:if box'4e is checked,and this form!s 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.Sof the Disability Benefits Law. It must be mailed for completion to the Worker's Compensation Board DS Plans Acceptance Unit,328 State Street,Schenectady,NY 12305. 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 compiled with the NyS Disability Benefits Law with respect to all of hislher 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. D13-120.1(915) AR� V® CERTIFICATE OF LIABILITY INSURANCE DATE(MM(DDIYYY) 8/18/2016 THIS CERTIFICATE ISISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)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). PRODUCERcox? C Tina Shanahan E: The Schaefer Agency, Inc. PHONExrx) (631)979-7474 FAX ,(631)979-7465 201 H. Main Street E-MAIL P.O. Box 688 ADDRESS: INSURER(S)AFFORDING COVERAGE MAIC Q Smithtown NX ]1787 INSURED IHSURERA:Merchants Mutual Insurance Co. INSURERB:The State insurance Fund 16 ViviaannLane T.R.C. eCarp INSURERC:Shelter Point Life Insurance ane INSURERD; INSURER E Lake Grove NY 11755 INSURER F COVERAGES CERTIFICATE NUMBERCL1681802258 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. IAIR I L RR TYPE OF INSURANCE ma-mm ODLsm POLICY EFF NEIPOALI o EXP LIMITS 8 COMMERCIALGERALLWBILITY POLICYNUMBER MIDDhffm EACH OCCURRENCE $ 11000,000 A CLAIMS-MADE X OCCUR LIAMAPRFJAi z TO R T $ 50D,000 80P1059298 9/16/2016 9/16/2017 MEDEXP(An onsperson) S 15,000 PERSONAL&ADVINJURY $ 1,000,000 GENLAGGREGATEUF.IITAPPLIESPER GENERALAGGREGATE S 2,000,000 R POLICY 0 J5ECT ❑LOC PRODUCTS-COMPJOPAGG $ $,000,000 OTHER " AUTOMOBILE LIABILITY S COM&BINdEO SINGLE LIMIT $ ANY AUTO AEOBODILY INJURY(Per person) $ Zkoos"ED SCHEDULED NON-OWNED BODILY INJURY $ HIRED AUTOS AUTOS PPReOPERTYDAMAGE $ UMBRELLA LIAR OCCUR $ CLAIAiS-MADE EXCESS LIAB EACH OCCURRENCE $ AGGREGATE $ DED RETENTION$ WORKERS COMPENSATION S AND EMPLOYERVUAB1Lny Y/N A 7E ER ANY PROPRIETOM M'INERIEXECUrNE OFFICERR,SEMBEREXCLUDED9 N)A E.L.EACH MCIDENr $ 100 000 8 (Mand alory1nNH)und 22192637 7/9/2016 7J9/20i7 E,LDISEASE•EAEMPLOYE S 100 000 �noN of oPERAnoNs neavr - E.LDISEASE-POLICYUMIT $ 500,000 C Disability D342305 7/9/2010 Until Cane DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(ACORD 101,AddiBonal Remarks Schedule,may be attached N more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Southold THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 53095 Route 25 ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 1179 Southold, NY 11971 AU7HORi2ED REPRESENTATIVE C Schaefer/DEMICO ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014!01) The ACORD name and logo are registered marks of ACORD' d,( 4410 as treapRder � )u�gr�fe e 1dEGrssrfif-*11 r ;VC.'u, Y's><•rk f t oal E#ct"��a si'. �'�a:rJ�t. �°.�:a � a•�I f.�aps�i �:r!aef► °��� 18f88f`t8Y<� ° V'vt'm rzl�, r tiv-d X4'6)4�jfJ R ',�'�II%Ftif'Pohi i"r t���#;t,l�r?. �'/{lff:�:?JLh9'JtYf �><„}8P'tt0•a, ``xa 110 t 1 ' 3 Iw � r t e 8� y f >si �.�s f f yd { 'jD` � �"1 a3 :ti y�r 'it 8„ rvl t rStf� � tJ�la < A 10 <Y d� '`d”! <r a✓rr t t>y "1Yyp 8 JP vi ,e' .P• ,. ff fY B s r r � e t P•s a� op '• .. ivs'•f° >.,,E`= JY r<•>'� t;.R"4,'1 91�;s� > �e y�.v .8 �'S .�. ,� ♦�tf'rpq�e - .f v Sa' <� /N '+y f' �tsA,�>sJ �, ar'F '..•'' F,' .a�f '� (70 i 1� .>' y.'•P> f`�J SJ f '�[ .r rpY 'C49. ,�P Sr�„,�r' '•[ A ', �1�<,•�yj A bi , ,M. r $'k . .� .3 /� 'Sy ,`."+t 'rq r ve' '�•i�" °':f �t > e+V'y P`. wli,l e2 i.tfK+� P R *> t1 ! 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K<:�.ewu;:'o,.:<•..,w.Y,M..),,:.<..•'wu.»wwml$.eneo�.v wgr.w .Y �.rry,a.eee• a.•<a. ..v.Vii, �J rl 1¢ �,s� �'ilfi`t�,4afj W. °`aG�4LiP h..�,�8. �,., �� ' $:sdStA'e t ' •Iry s 44, tR�� eek ,r°�REpg 1 ✓�� � �h�J HH 1� ��� . Er AFeetv3i ,MIw FOR I K�wj i YNt d M'N ( ��°'aa gyp' t y� f '�g �v°�• } ��,” �`i° "� pip A O i , `S td Q 01 1 E w f+P'R�we�f Yr E r s'�o/[Y 1 PP r R f e"* r °i f y16p 4Y N• '"� f., 'I' •�,10�01i:'Z :'.: ::::�Le'`'i' {^{ tk � j 'SJ 5A�1"{x y I%a:8: �fiarda� oi'SISY�I f 4��1i'�e::SB;':':rJtq;..�n).....�•�'4'f' 'r.) ,e. eaY•nw,w,aceo.•o.•.a.:.::...a>,�w.r..••>n':.).,a..u:r«a>ees,w.wYa.:ino-x:M.•..• ..a..., „w,�,roex•nnr<,•• 'JY.Y..wn,.w.�N,^ryny„tOP1l00bf%sre•M r/rw .t..rla...>.•.,<n+M.wieoa• > a hOOVOV%W 1'i ..• , : Y E r 4�4 r i Ne{�1 r NLS TQ�`�1 S �9{..V/t •e>f. N.AyYqJ1 E At tarM, Marian. Town of L> Y�.�K>,.�. a,�,�v•,,,r��c,:�:'1 1.,. ;. VAY la, 41141 ps���,y • r� �a>(�pp�� � f�yt!•.' ird tw i"�+^k i'..' !iobi. ad'/•+ 3`�"3 tea{ 'A s t# r•hM,Y...y.a.Iv>r4�yr:.,:. ' .f. r, , M,pApn,Y>'o.� .O •roc.w+ydt• .v...,.. A 1 .c.:..wrar„v >.w«,aiww;d...^Y!7!�'°'"re`"° ...v•,...aY�.gniit�vws;-ero R 1 qs r.;)I .:' , •s'x'f,[�6, fa,tr y'� '.f rt• JL r '{Ie> e,F.s,i $��� OAs�: r'sbi,,. 1i`,'� w wl+rN.aoK :YA... .., ,.e..K•.w•r)vrv<[a yJ ...: • ♦vw•'Y/ 'V./aYiNwvyrwM.+Y.a v <I .. YA`•K.nfgbW/R „+ .,yppw:i)raypy,p > . w.5 ...�y ........,\[M.,•M'•Na.[. :r.)a;:. : : r.. ,M'. .. .. ... .r. �.aw.: w ... ... . a. ( .ww. .r.• a[I rr4ar,v. ,^I♦•.) ,r' ,..vY+4 VMv.. 1 " �...•v ..r,.wa}vMM,w.,r)v, d. .. .r. � ny'Vra0.0 1 vv.w .. v�wr.wwrrr... , v , w v • . , . r M . •1•r ♦ r [[ a4 •M APPROVED AS NOTED L DATE: B.P.# ✓?:; FEE. !S / BY: D_ 1L- NOTI BUILDING DEPARTMENT AT 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION.MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. NE-W YO. K ,S iE: - &x I-OWiq CODES A.,S REQUIRED "'r ," �P11Tln ,Q nC7 1Uv' SUSTEES OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY .c•r.>is 'clk A � m ILTERED WATER RETURN NUMBER Itt FI R OF NOZZLES VARIES PER POOL SIZE FQ O - mlyPosl'r�w�u pool sYsr�M ► 1 ! ! 1 p�/� DEG m 20' X 40' RECTANGLE - 90 DEG , 6"R KIMMER DWIG#:CM-1.004 DATE: 10/Z2/2009 REV:A PAGr 2 ori 40'0" ► �rPOOL—�� LMAIN FLIZION BRACE UAINW y r 8'-0" CU-9004CR(4 PLC) 3'-0P C STRAIN/ O SPACI G STRAINE oma C 770 C 720 C-720 C-72U C-7Z0 C-720 C 4St1 w aECE s"vaar 3'-4" C-120 z'o(TyP) z z 'enux UGWErn rq SYSTEM 1LOC41.01 C3 d' 4'-0" w D ower wEo4 C 720 U BRACE sniEM GO- 00 c,Z �rE tNk s4E 'VIRGINIA GRAEME BAKER SA ACTAPPROVED DRAINS NOTE f DRAWING CONFORMS TO ANSI/APSP-7 SUCTION ENTRAPMENT q. 5rAKCS 12'0" 20'-0" G-720L 44'-8 5/8" FS-9504SBW r AVOIDANCE CODES COMPLETE BRACE MAIN DRAIN PIPING SCHEMATICI ) m < m N Z (NOT TO SCALE) oEcc PA" CODE COMPLIANCE NOTES: � s IN ADDITION TO THE 2016 UNIFORM BUILDING CODE .rr C-770 �j ERICr moi, SUPPLEMENT,SECTION R326 REFERENCED AT THE z M a� E"Gt SrsTr" C-720 BOTTOM OF THIS DRAWING,ALSO REFER TO c �c 4'-0" 2015 INTERNATIONAL RESIDENTIAL CODE m 5 .41i SECTION N1103 10(R403 10)-POOLS AND in �� o PERMANENT SPA ENERGY CONSUMPTION o o- C-120 SECTION N1103.10 1 -HEATERS B111M a C3 of . 90° CORNER DETAIL C-720 C 720 G 720 SECTION N1103.10 2-TIME SWITCHES a a OPTIONAL IL C 720 C 7Z0 C 720 C 48U SECTION N1103 10 3-COVERS ❑o o M DoE a BRACES&DECK SUPPORTS C CO _; 5 AT PANEL JOINTS AS SHOWN o x GENERAL NOTES: U A-FRAME BRACE I ALL WATER EITHER OVERFLOWING OR EMPTYING r FROM THE POOL SHALL BE DISPOSED OF ON THE in C) fig° ;9Y zC 8 HP OWNERS LAND,AND PLANS SUBMITTED SHALL N O €no n FOAM TRIANGLE SHOW PROVISIONS MADE FOR SUCH WATER FROM g `t-° FOR 6"RADIUSFLOWING ON THE LAND OF ANY ADJOINING " ` E (OPTIONAL) 3'-4' V-4" PROPERTY OWNER OR INTO ANY ABUTTING C D I psi aQ STREET. 7^�C �� 1 \< T-O" u F S1, SUCTION OUTLETS SHALL BE DESIGNED AND Hq �orrr { INSTALLED IN ACCORDANCE WITH ANSI/APSP-7. m —AT TO PANEIrS W/3/8"-16 SI AN RD BOLTS it ro mI 7 sa ( I tu PROTECTIVE BARRIER NOTE: a a5 — 4'0"- i=-6'0"--+I' 14'-0" 16'-0" y io `4 BRACE ATTACHMENT N.S.P.I. TYPE 2 DURING CONSTRUCTION OF THE POOL,A � j � TEMPORARY BARRIER SHALL BE INSTALLED WITH RAkrrr;ptulHG MAY xoxessEanC?, _ M ;k ,-, A MINIMUM HEIGHT OF 4'-0". UPON COMPLETION � Tnvator Mfg Inc.makes only those'rBp esentaWris wtuch are stated In Its wnMen warranty.Any older representations,statements,or contracts made by the dealer/contractor to the customer regaramg any components produced by Tnw-ctor Mfg. Svc m � `�- ?,F:`', ' OF POOL INSTALLATION,OWNER SHALL INSTALL A NO RESULT IN SERIOUS ?r-are atmWtable to the(eater/cwWacW only.The dealer or conha=who sells or Installs your pad is an independant contractcr and Is not an agent or employee of Tnvector Mfg.Inc.The consN,cum methods illustrated here are suggestions •y _y,eygt,, 1bfJlfRY OR DEATH. �. IP 40 and apply only to normal ground condro°ns.Them maybe adc9donal p e aubons and/or metJwds orconstmctlon The respen9tskty is the mntractors.-A Safety line,YAM buoys,Is to be Permanently attached t•-o•to ttte dimow side or the pont W' au ". PERMANENT BARRIER,MINIMUM HEIGHT OF 4'-0", Signage must be permanently attached around the 1 st��altla fw ISI( dancie a a ctcd �methods�u, fed a�t�sttea�rtd i ewrgcoaeby varrous srsIaand daws:/nss>�i s�dg sinnd�ar and Iii BOhe TTOMty Lf who olr EXCEot an ED RECOMMEND/APSP.urer°RGCOf the component nE o o sir NA o�Rt>s `s WITHIN 90 DAYS M O_ perimeter of the pool- 'No Ulylfxi'signage must Oe permanently attadted to the endre perimeter of the pad see Instructions wltlT signage-rr IS NOT RECOMM ENDED To USE DIVING AND/OR SLIDING EQUIPMENT ON RESMERTIAL POOLS. W �� r a Z 00 Q Z�r` Q}N Q z Q Z � LL0 OZ ENGINEER'S ''-- 0 EE _ 'A, EtA G. y �' to U)2" Q�Q N ~ C0(n Z LO CO co �� t W rt-1 Jh w 1' ,oB SFO 0605L0.1 ��� "RAw"BY NIA P`• CTC OFESStO� EcBB. SGH .. , NOVEMBER 22,2016 AS NOTED ALL MANUFACTURED ITEMS AND CONSTRUCTION SHALL COMPLY WITH THE 2016 UNIFORM BUILDING CODE SUPPLEMENT,INCLUDING THE SPECIFICATIONS IN SECTION R326 1 OF 3 SECTION R326.3-SWIMMING POOLS, SECTION R326 4-SPA&HOT TUBS, SECTION R326.5 -BARRIER REQUIREMENTS; SECTION R326.6 -ENTRAPMENT PROTECTION FOR SWIMMING POOL&SPA SUCTION OUTLETS; SECTION R326.7 -SWIMMING POOL&SPA ALARMS SECTION 326 SWIMMING POOLS,SPAS,AND HOT TUBS o R326.1 GENERAL 2 Openings in the barrier shall not allow passage of a 4-inch-diameter 10.1.The ladder or steps shall be capable of being secured,locked or R326.8 STANDARDS R326.1 The provisions of this section shall control the design and (102 mm)sphere. removed to prevent access;or A326.8.1 General m construction of swimming pools,spas and hot tubs installed in or on the lot of a one-or two-family dwelling. 3 Solid barriers which do not have openings,such as a masonry or 10.2.The ladder or steps shall be surrounded by a barrier which meets the ANSI-American National Standards Institute stone wall,shall not contain indentations or protrusions except for requirements of R326.5 2,Items 1 through 9.When the ladder or steps are R326.3 SWIMMING POOLS normal construction tolerances and tooled masonry joints. secured,locked or removed,any opening created shall not allow the ANSI/APSP 7-13-Standard for Suction Entrapment Avoidance in R326.3.1 In-ground pools. In-ground pools shall be designed and passage of a 4-inch-diameter(102 mm)sphere. Swimming Pools,Wading Pools,Spas,Hot Tubs,and Catch Basins constructed in conformance with ANSI/NSPI-5. 4.Where the barrier is composed of horizontal and vertical members (R326 6.1) and the distance between the tops of the horizontal members is less R326.5.4 Indoor Swimming Pool. Walls surrounding an indoor swimming z R326.3.2 Above-ground and on-ground pools. Above-ground and than 45 inches(1143 mm),the horizontal members shall be located on pool shall comply with Section R326 5.2,Item 9 ANSI/NSPI-3-99-Standard for Permanently Installed Residential Spas o w on-ground pools shall be designed and constructed in conformance the swimming pool side of the fence.Spacing between vertical (R326 4.1) E 0 with ANSI/NSPI-4. members shall not exceed 1-3/4 inches(44 mm)in width Where there R326.5.5 Prohibited locations. Barriers shall be located to prohibit R are decorative cutouts within vertical members,spacing vothin the permanent structures,equipment or similar objects from being used to ANSI/NSPI-4-99-Standard for Above-ground/On-ground Residential o R326.4 SPAS AND HOT TUBS cutouts shall not exceed 1-3/4 inches(44 mm)in width. climb them. Swimming Pools (R326.3.2) R326.4.1 Permanently installed spas and hot tubs. Permanently installed spas and hot tubs shall be designed and constructed in 5.Where the barrier is composed of horizontal and vertical members R326.5.6 Barrier Exceptions. Spas or hot tubs with a safety cover which ANSI/NSPI-5-03-Standard for Residential In-ground Swimming Pools conformance with ANSI/NSPI-3 as listed in Section 326 8 and the distance between the tops of the horizontal members is 45 complies with ASTM F 1346 shall be exempt from the provisions of this (R326 3.1) inches(1143 mm)or more,spacing between vertical members shall not appendix. R326.4.2 Portable spas and hot tubs.Portable spas and hot tubs exceed 4 inches(102 mm) Where there are decorative cutouts within ANSI/NSPI-6-99-Standard for Residential Portable Spas shall be designed and constructed in conformance with ANSI/NSPI-6. vertical members,spacing vnthm the cutouts shall not exceed 1-3/4 R326.6 ENTRAPMENT PROTECTION FOR SWIMMING POOL (R326.4 2) inches(44 mm)in width. AND SPA SUCTION OUTLETS z' R326.5 BARRIER REQUIREMENTS 8326.6.1 General.Suction outlets shall be designed to produce circulation ANSI/ASME Al 12 19 8M -(1987,R-1996)Suction Fittings for Use in R326.5.1 Application. The provisions of this section shall control the 6 Maximum mesh size for chain link fences shall be a 2-1/4-inch(57 throughout the pool or spa Single-outlet systems,such as automatic Swimming Pools,Wading Pools,Spas,Hot Tubs and Whirlpool Bathing design of barriers for residential swimming pools,spas and hot tubs mm)square unless the fence has slats fastened at the top or the vacuum cleaner systems,or multiple suction outlets,whether isolated by Appliances (R326 6 2) 0 ata t These design controls are intended to provide protection against bottom which reduce the openings to not more than 1-3/4 inches(44 valves or otherwise,shall be protected against user entrapment heti potential drownings and near-drownings by restricting access to mm). APSP-Association of Pool and Spa Professionals z jig a swimming pools,spas and hot tubs. R326.6.1.1 Compliance alternative. Suction outlets may be designed and 6 7.Where the barrier is composed of diagonal members,such as a installed in accordance with ANSI/APSP-7. ANSI/APSP-7-13 Standard for Suction Entrapment Avoidance in Swimmingo 5A o R326.5.2 Temporary barriers. An outdoor swimming pool,including an lattice fence,the maximum opening formed by the diagonal members Pools,Wading Pools,Spas,Hot Tubs,&Catch Basins 9 Cn $ in-ground,above-ground or on-ground pool,hot tub or spa shall be shall not be more than 1-3/4 inches(44 mm). R326.6.2 Suction fittings. Pool and spa suction outlets shall have a cover (R326 6 1) ri c to 's surrounded by a temporary bamer during installation or construction that conforms to ANSI/ASME Al 12 19.8M,or an 18 inch'23 inch(457 mm ° f2 co and shall remain in place until a permanent bamer in compliance with 8 Gates shall comply with the requirements of Section R326 5 2,Items by 584 mm)drain grate or larger,or an approved channel drain system. ASME-American Society of Mechanical Engineers a CDD Y i Section R326 5 3 is provided. 1 through 7,and with the following requirements R326.6.3 Atmospheric vacuum relief system required. Pool and spa ANSI/ASME Al 12.19.8 2007-Suction Fittings for Use in Swimming Pools, Do n°. Exceptions: 8 1.All gates shall be self-closing.In addition,if the gate is a pedestrian single-or multiple-outlet circulation systems shall be equipped with Wading Pools,Spas,Hot Tubs,and Whirlpool Bathing Appliances D o(x3 1.Above-ground or on-ground pools where the pool structure is the access gate,the gate shall open outward,away from the pool atmospheric vacuum relief should gra covers located therein become (8326 6.2) LL ,gra barrier in compliance with 8326 5.3. missingor broken.This cauum reliefs stem shall include at least one ' 1 f 2.Spas or hot tubs with a safety cover which complies with ASTM F 8 2 All gates shall be self-latching,with the latch handle located within approved or engineered method of the type specified herein,as follows: ASTM-ASTM Internationalm 1346 provided that such safety cover is in place during the period of the enclosure(i.e,on the pool side of the enclosure)and at least 40 1.Stafety vacuum release system conforming to ASME Al 12.19.17;or cy o �hx �c installation or construction of such hot tub or spa The temporary inches(1016 mm)above grade.In addition,if the latch handle is 2 An approved gravity drainage system ASTM F 1346-91 (1996)Performance Specification for Safety Covers and $� removal of a safety cover as required to facilitate the installation or located less than 54 inches(1372 mm)from the bottom of the gate,the Labeling Requirements for All Covers for Swimming Pools,Spas and Hot 2 ;- construction of a hot tub or spa during periods when at least one person latch handle shall be located at least 3 inches(76 mm)below the top of Exception:Surface skimmers Tubs 6� -fig I5 engaged in the installation or construction is present is permitted the gate,and neither the gate nor the barrier shall have any opening (R326.5 2;R326.5.3,R326.5.6;R326 7.1) ° o" JE64 a£ greater than 0.5 inch 12 7 mm within 18 inches 457 mm of the latch R326.6.4 Dual drain separation. Single or multiple circulations stems 9 ( ) ( ) P 9 P Y � �F �g�= R326.5.2.1 Height.The top of the temporary barrier shall be at least 48 handle have a minimum of two suction outlets of the approved type A minimum ASTM F2208-2008 -Standard Specification for Pool Alarms §§nf a inches(1219 mm)above grade measured on the side of the barrier horizontal or vertical distance of 3 feet(914 mm) shall separate the outlets. (R326 7 1) m E n which faces away from the svnmming pool. 8.3.All gates shall be securely locked vnth a key,combination or other These suction outlets shall be piped so the water is drawn through them child proof lock sufficient to prevent access to the swimming pool simultaneously though a vacuum-relief-protected line to the pump or NSPI-National Spa and Pool Institute a �4 R326.5.2.2 Replacement by a permanent barrier. A temporary barrier through such gate when the swimming pool is not in use or supervised pumps5 ANSI/NSPI-3-99-Standard for Permanent) Installed Residential Spas a° € shall be replaced by a complying permanent barrier within either of the Y P $ 1�� following periods: 9 Where a wall of a dwelling serves as part of the barrier,one of the R326.6.5 Pool cleaner fittings. Where provided,vacuum or pressure (R326.4 1) 1 90 days of the date of issuance of the budding permit for the following conditions shall be met: cleaner fitting(s)shall be located in an accessible position(s)at least 6 installation or construction of the swimming pool;or inches(152 mm)and not more than 12 inches(305 mm)below the ANSI/NSPI-4-99-Standard for Above-ground/On-ground Residential 2.90 days of the date of commencement of the installation or 9 1.The pool shall be equipped with a powered safety cover in minimum operational water level or as an attachment to the skimmer(s) Swimming Pools construction of the swimming pool compliance with ASTM F 1346,or (R326 3 2) M O R326.7 SWIMMING POOL AND SPA ALARMS R326.5.2.2.1 Replacement extension. Subject to the approval of the 9.2.Doors with direct access to the pool through that wall shall be R326.7.1 Applicability.A swimming pool or spa installed,constructed or ANSI/NSPI-5-03-Standard for Residential In-ground Swimming Pools W � a o code enforcement official,the time period for completion of the equipped with an alarm which produces an audible warning when the substantially modified after December 14,2006,shall be equipped with an (R326.3.1) Z 00 permanent barrier may be extended for good cause,including,but not door and/or its screen,if present,are opened.The alarm shall be listed approved pool alarm Q z Q�N limited to,adverse weather conditions delaying construction. in accordance with UL 2017 The audible alarm shall activate within 7 Exceptions: ANSI/NSPI-6-99-Standard for Residential Portable Spas seconds and sound continuously for a minimum of 30 seconds after the 1.A hot tub or spa equipped with a safety cover which complies with ASTM (R326.4.2) } Z Z O 5 oz R326.5.3 Permanent Barriers. An outdoor swimming pool,including door and/or its screen,if present,are opened and be capable of being F1346 ENGINEER'S SEAL O � LL(L v g an in-ground,above-ground or on-ground pool,hot tub or spa shall be heard throughout the house during normal household activities.The 2 A swimming pool(other than a hot tub or spa)equipped with an UL-Underwriters Laboratories,Inc. LLQ Q w surrounded by a barrier which shall comply with the following alarm shall automatically reset under all conditions.The alarm system automatic power safety cover which complies with ASTM F1346. Zo D: - shall be equipped with a manual means,such as touch pad or switch, UL2017-2000-Standard for General-purpose a: )� -2 0 1 The top of the barrier shall beat least 48 inches(1219 mm)above to temporarily deactivate the alarm for a single opening.Deactivation Pool alarms shall comply vnth ASTM F2208,and shall be installed,used, Signaling Devices and Systems with Revisions ` ® r'!/ Lo_ grade measured on the side of the barrier which faces away from the shall last for not more than 15 seconds The deactivation switch(es) and maintained in accordance with the manufacturer's instructions and this through June 2004 �`V �N G. /yq N Z swimming pool.The maximum vertical clearance between grade and shall be located at least 54 inches(1372 mm)above the threshold of section (R326 5 3) Q� Q O the bottom of the barrier shall be 2 inches(51 mm)measured on the the door,or �� W J side of the barrier which faces away from the swimming pool Where R326.7.2 Multiple Alarms. A pool alarm must be capable of detecting `The NSPI documents are available 00 cq the top of the pool structure is above grade,such as an above-ground 9.3 Other means of protection,such as self-closing doors with entry into the water at any point on the surface of the swimming pool.If through APSP jj pool,the barrier may be at ground level,such as the pool structure,or self-latching devices,shall be acceptable so long as the degree of necessary to provide detection capability at every point on the surface of S1 `l W mounted on top of the pool structure.Where the bamer is mounted on protection afforded is not less than the protection afforded by Item 9.1 the swimming pool,more that one pool alarm shall be provided. NIA top of the pool structure,the maximum vertical clearance between the or 9.2 described above tis C?� -BV 8326.7.3 Alarm Activation. Pool alarms shall activate upon detecting 6052 crc top of the pool structure and the bottom of the barrier shall be 4 inches P 9 SOA �� \, `"B`�B. scH (102 mm). 10 Where an above-ground pool structure is used as a barrier or where entry into the water and shall sound poolside and inside dweilling. A FESS\SNP the barrier is mounted on top of the pool structure,and the means of NOVEMBER 22,2016 access is a ladder or steps* R326.7.4 Prohibited Alarms. The use of personal immersion alarms shall AS NOTED not be construed as compliance with this section. 2OF3 0 MANUFACTURER: ISIACO Industries Inc. Z o SPILL-OVER SPA PLUMBING SCHEMATIC 460 Finley AvenueA'ax, ONTARIO, CANADA LIS 2E3 a PSS-1 &SOS-1 Y , 1 fax:(905)683-0708 tel:(905)428-6990 email:custsery@triac.com SINGLE PUMP SYSTEM WITH 3-WAY VALVES 78 r PART NUMBERS DESCRIPTION Z PS&OrASSt PASB$SPAPLUMBIMIRIM z g Z Q 0 PSSCFGPSSI•U POOLMESPAWFW WIM o F O m m a a Z U U j N PUMP z8 r:� PSSCF<rP581$G POOl5l0ESPAFLO96WBlUEOFANfE Z n, fir;>r U OfO ;:r,''S,r, v PS&a:G t 8G PUSIESPAWfILIMBIMM41IE b � ,�• ,he.•,:'i;>;>� � PSSCFCrPSSi$G POOLSIDESPAPLI.MWf#OG14WIE 3-WAY FILTER ,;,_,5,; ;,3 ,, •? 78 Mar-MWW POOLSIDESPAWFLUYBW( YGPNiIE VALVE c�7 I_I (n jag gO D o m lea HEATER a 0)co 31 o o gig¢ 3-WAY M m83 VALVEI�IR — °?u :°6 4 CD o gra' H 152 C4 co Hai C) O cov a-ye 8 o � 6� 0 4-SuctionFrtings :,;., s2 POOL POOL 1•Recialaion Filing �90 g SUCTION RETURN ° 6- Jets �a �£ I-AirCmtrd �~ ��H o °o g 0 4# F2iei 31 1/2' a m 34 / ESI: ag Volume-approx.225 gal gill M q 4 S 0CY) 0 W IL� Q Z 00 Q } Z}N J Z Q�ti Q —1~ 0 sOOz ENGINEER'S SEAL 0 LL 2 _ : Q Ow Q goo ® NES Z,ENG' y N � z w ioe ra, N/A S �\ -BY XCTC �O 50520'1 °e. A �� SGH OF�tS SIO NOVEMBER M.2016 AS NOTED 3OF3