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Home My WebLink About46175-Z of Sou T Town of Southold * * P.O. Box 1179 �g 53095 Main Rd Southold, New York 11971 CERTIFICATE OF OCCUPANCY, No: 46575 Date: 10/11/2025 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 122 Hickory Ave Southold, NY 11971 Sec/Block/Lot: 78.-7-51 f Conforms substantially to the Application for Building Permit heretofore, filed in this office dated: 04/13/2021 Pursuant to which Building Permit No. 46175 and dated: 04/30/2021 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: William Ayers , Jeanette Ayres Of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL: ELECTRICAL CERTIFICATE: 46175 08/01/2022 PLUMBERS CERTIFICATION: A hori ed ign ture SUFFnc� TOWN OF SOUTHOLD �o BUILDING DEPARTMENT y z ' TOWN CLERK'S OFFICE 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#: 46175 Date: 4/30/2021 Permission is hereby granted to: Ayers, William 147 Park Blvd Malverne, NY 11565 To: construct accessory in-ground swimming pool as applied for per Trustees & DEC approvals. At premises located at: 122 Hickory Ave., Southold SCTM #473889 Sec/Block/Lot# 78.-7-51 Pursuant to application dated 4/13/2021 and approved by the Building Inspector. To expire on 10130/2022. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO- SWIMMING POOL $50.00 Total: $300.00 Building Inspector OF SO�ryol h O Town Hall Annex Telephone(631)765-1802 54375 Main Road P.O.Box 1179 sean.devlin(a-town.southold.ny.us Southold,NY 11971-0959 �yMUNT`l,�� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: William Ayers Address: 122 Hickory Ave City,Southold st: NY zip: 11971 Building Permit#: 46175 Section: 78 Block: 7 Lot: 51 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Linear Electrical License No: 34402ME SITE DETAILS Office Use Only Residential X Indoor X Basement Service Commerical Outdoor X 1st Floor Pool X New Renovation 2nd Floor Hot Tub Addition Survey X Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors Sub Panel 30A A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO Transformer UC Lights Dryer Recpt Emergency Fixture Time Clocks Disconnect Switches 2 4'LED Exit Fixtures Pump Other Equipment: 30A Sub Panel 6 Circuit/ 5 Used, 1 Light 120GFI, Pump 220GFI, Auto Cover 120GFI w/ Key Locked Switch, Heater, Intellichlor Salt Generator Notes: " AS BUILT NO VISUAL DEFECTS " Pool Inspector Signature: Date: August 1, 2022 S.Devlin-Cent Electrical Compliance Form - SOUTyO� f TOWN OF SOUTHOLD BUILDING DEPT. co 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] I ULATION/CAULKING - [ ] FRAMING /STRAPPING [ FINAL D� T [ ] FIREPLACE & CHIMNEY [ ]- FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE-RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE /O REMARKS: ok f S.i At •P/✓ -b �nV �� • Svc F g � 1 r DATE I°I INSPECTOR pF SOUTH°lo q �17� �G�7 # # TOWN OF SOUTHOLD BUILDING EPT. Own 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING/STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIO ATI N [ ] P E C/O REMARKS: U 1a0 � I l nd -000�ra- f Mej s 1A /JA 01 A rl- ,or rails J,2re AQ . lAl 4)(z dec p- box 1 � Ate eAl.10 1 DATE 6A INSPECTOR i} - In SOUTy�Io H Yi �� 2., # # TOWN OF SOUTHOLD BUILDING DOT. Comm, 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION FIRE RESISTANT CONSTRUCTION FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL V REMARKS: AS !9 Ill1,T !90rn� d o t tae i,�- LoAap to v I,v r I . - I, it Yo U ioa A CO& 1 4 JAA �s LIA c(RLO-Alo PA Ot ' IA-1464, 6, PJA lk/1% Ad (JbEfldf. o-r -�" A I?ZL M Ilakek,4 . do � d Iry e l j Qn 0� 2 4- �- L) eaU .0r Gtrdn�' DATE (01�b�Z Z INSPECTOR 1�.!( OF SOOT # # TOWN OF SOUTHOLD BUILDING DEPT. u 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] SULATION/CAULKING [ ] FRAMING/STRAPPING [ FINAL Pawl,,, , �A� [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ '] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: LA C% - � c rc� DATE 1r 'LoLv INSPECTOR rr \ &UF SO(/Tyo� y ( - rz 2 # TOWN OF SOUTHOLD BUILDING DEP . courm, 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING/STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) [ ] CODE VIOLATION ] PRE C/O [ ] RENTAL REMARKS: A I L I- ol-el DATE INSPECTOR SOUIyo - # # TOWN OF SOUTHOLD'BUILDING DEPT. `ycourm��' 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [eSLATION/C U UL ING FRAMING /STRAPPING [ AL ?k [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: .04 DATE ?7(XVI-0000' INSPECTOR a AF f20 20 20; 20 20 1� INTERRUPRNG ` U10 kA D -P�o((11HORHOM' rm�a�v- 1 �°� 10 kA r RATING ,� _p '� 10 000 A ®Ib,E11 l AICy c„ te. me 1�srs wcarrre c.3 fi/40 I , n.m. v_ DP-4075 _m � i s �A�om.1/AIR � U�iJ ;,_ Sp 6 4075 mo E AP '' �• 14 i 1 t• - r r. l+r y t MOO- }i CENTRO de CARGA ,Omeline� ❑ HOME 12L100 se0,60H � ®LOAD CENTER � No.de Catalogo Ma. 1 t,jSe,50/bo Hz Homeline Serves 0p1 Gabmele Tipo 1 121/240 0- No. F1OM6-12UEnClo_0� �mea Pnnctpal de t00 A Como maxtmo. t _ o a xamst�. Galalo9 rA Ty a 11D A Yu � yP p�Msu�+��'•wte N de4+r"'es arrd�a V+��aolena rawre, / .,..sEm rr S,rree Decwr'°.a+5 rt rutairea nunw+Ns a.u.marrs a rneren. i. 1 ••,wr'a>sra,r,a✓.�asde"m9' . �,��nEN BREAKER] W�,raC/SE•000IEHDA R>t#NECHA EN INTENPUVfONES EN TANDEM. Wv6 b0er CNrre earpacasrb relIe^HOMFVNuras s,nusardel intermptOf aulomahc0. yyop rp 110Mfv $olp,, el no.GecalaMogo Ml palanc,en povnort nlaomt'7ia and ca Rue s.,E DISPARAgalaa cnlPcar enu , yp+sbaJ rr a TRIPPED.Tu reset cam.I-pelaram+Po11,Pe ARIERTO:laiego. pyn d1. Poacron de CEIIPADO. rrr0,to pEE o,— . b b�acorrwcr aY Iw6 GMUctors Ndn tiv:vrp.ty VICE Para 6esearctlar IoaoS bf con0uctae nm.]I[o5 marcaAoS"descPnetl Pn�p enld[ronP. _ MMN or SERVICE cdaaw iM 1>a�k� rMe acs °Rinr o1Or'°r h-dwv � <aescan,no de acometrda P.SiC�On Oe ab-lo(O(. DISCONNECT P.oim ^ 20— 20 �O .wl llou � w.uwurt,c DiYwV. IF=��IU.,gG1 �'p Ir^M 1�I ';I' •re OPaws „ A DANGER _ / PElIGRO ,I• ti At e _ ._ i� ' . Ai � t i k #Ap .fi y 'j7 . �� '-� � ' `• �` �.. A } _ + ^. 1, - • _ - ts r IA • ° a�tr50_ t1 I!! 1 , to-• C�1', 1 i k rlq t _ i lid Iy�lm�l i ry' kill �' 'i 'b � �' i�I�IiI• R I�' __`_ � x s 1 � I 1 I k -. . .�\ - - - \a k (° - e�#� % � k_ 2 /) z o . ƒs / j! FDA ' ` ` � 7= ~ � q ■ � ^ ' ` ! � � \< ,■�� . - � �� \ \ �l ?4 . ■ :� _ A= �� , I ` • . % s � � FOUNDATION(I$T) ZiDAT ON ROUGHYRAMINPA INSULATION. STATE-ENERGY CODE 13 FRO r r. • � s • e `►, �Iwl� 1 TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 hqps://www.southoldtownny.gov Date Received 7 APPLICATION FOR BUILDING PERMIT J For Office Use Only PERMIT NO. Building Inspector: Q f Ak,.. Applications and forms must be filled out in their entirety. lncomplete 3 applications will not be accepted. Where the Applicant is not the owner,an APR 3 2021 Owner's Authorization form(Page 2)shall be completed.' Date: OWNER(S) OF PROPERTY: Name: OJJ�4-4--%. �/—1e /9-Ve/15; SCTM#1000-7 Project Address: 2,2- /tc 7-110 L Phone#: 5�6 --3)6 Email: Mailing Address: IV? f,,/Z 0 RL )1,f/V Oy L CONTACT PERSON: Name: Mailing Address: Phone 9: PZ6 3�6 1716 , Email: DESIGN PROFESSIONAL.INFORMATION: Name: Mailing Address: Phone#: Email:7 CONTRACTOR INFORMATION: 4 Name: C S /k 61K T,J (,J Mailing Address: ' 7V /-D*-d 11)b 7 711A 147 '106- Phone#: 30Z- Email: A-71-,.,Oup� 6(5,m DESCRIPTION OF PROPOSED CONSTRUCTION El Kw Structure E]AdditiOR Estimated Costof6roject: Alteration EIRepair ElDemolition. FOther 3 .2— Will the lot be re-graded? E]Yes No Will excess fill be removed from premises? E]Yes No. PROPERTY INFORMATION Existing use of property: Intended use of property: Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? ❑Yes No IF YES, PROVIDE A COPY. ❑ Check Box After Reading:' The owner/contractor/design professional is responsible for all drainage and storm water issues as provided by Chapter 236 of the Town Code. 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,alterations or for.removal or demolition as herein described.The applicant agrees to comply with all applicable laws,ordinances,building code, housing code and regulations and to admit authorized inspectors on premises and in building(s)for necessary inspections.False statements made herein are punishable as a Class A misdemeanor,pursuant to Section 210AS of the Newyork State Penal.Law. Application Submitted By(print name): ❑Authorized Agent ❑Owner Signature of Applicant: Date: STATE OF NEW YORK) SS: COUNTY OF tLAAWO I K ) W( \l CLM �V�� being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing CAtract)above named, (S)he is the Owm r (Contractor,Agent,Corporate Officer, etc.) of said owner or owners,and is duly authorized to perform or have performed the said work and to make and file this application;that all statements contained in this application are true to the best of his/her knowledge and belief; and that the work will be performed in the manner set forth in the application file therewith. Sworn before me this } ]� day of 209,1 4j atg !L/ H— Notary Public TRACEY L.DWYER NOTARY PUBLIC,STATE OF NEW YORK PROPERTY OWNER AUTHORIZATION NO.01 DW6306900 (Where the applicant is not the owner) QUALIFIED IN SUFFOLKCOUNI COMMISSION EXPIRES JUNE 30,2_ I, residing at do hereby authorize to apply on my behalf to the Town of Southold Building Department for approval as described herein. Owner's Signature Date Print Owner's Name 2 - r \ / ., \\II°/ //1/// V�i`\NI/ IIIA%/r� ..: .. � III°I'1�°Ir/%%%/r .. reel\°1,°♦l0•`rll��/ \\I°IO/t,/./r/%// \`�1°Its,'o�l�%r/ d`� '- � _� � Ir 1.• z" J.��,l c �� i.% , ,�-� G a \fie '�.,-. a:,�,..s.. �'e...>sa'�aa�a.°:.s4T' a1k..�m;....�,G><,. "sG!v5aL".; 1''PT14'=S°°'+4* v.:f�'G.��,:'>�sae,�v�f..�.,.�,^'>d •'!,ea.,,.,..,extvn�Y.,.LL,,,. � E :.;All ' 1\ BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD,NEW YORK k 1\ PERMIT NO. 9821 DATE: FEBRUARY 17,2021 ``'o°+► I ISSUED TO:, WILLIAM&JEANNETTE AYERS PROPERTY ADDRESS: 122 HICKORY AVENUE,SOUTHOLD �� z ,:, r is .� � • �7,A1 SCTM# 1000-78-7-51 11s" AUTHORIZATION Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in .\1111 accordance with the Resolution of the Board of Trustees adopted at the meeting held on February 17,2021, and J in consideration of application fee in the sum of$250.00 paid by William&Jeannette Ayers and subject to the @ Terms and Conditions as stated in the Resolution,the Southold Town Board of Trustees authorizes and permits �� r the following: € Wetland Permit to install a 16'x32' in-ground swimming pool made of steel and poured "° concrete with edge stonework trim approximately 18 24 around the pool; excavated soil to F; remain on the property; install a 9'x12' shed; install stonework from the existing walkway to the shed; and install pool enclosure fencing; with the condition that the pool backwash be connected to an existing drywell; and as depicted on the survey prepared by Young& Young, :•l:,,1,1 N< Licensed Land Surveyor, received on February 9,2021and stamped approved on February 17, 2021. r ' IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these 1 presents to be subscribed by a majority of the said Board as of the 17th day of February,2021. x; O � h r,�Ail 4,� I,N° •.��Illf � � llll% 91 J. e: r!iA,ll c� � 1°I°1sa 4 i .v Z J ?' r7"v"rS�uTr r Ya;r r rrr'�7t5ta r is�'si ti"Pt tYi ,rr � �' !.ur Aa"rJw'°'7v'�°�G"'�aF°3"'"rfi°°°:; •Y "'�'°St,, rr �%c , .�,5'�r�S`�"'ii=`R.:;CF�""""�t--r. i 'e�'i5,� nr Syr'�"r°.z�d = r i��A/ /1,1Ni�� 4eQ11/ 1111i� ,,:• x ;,,. :iQlo/l IIN�•• -.. • .ilAl 1\\ -. ,:i//e ei!� t i^ie ,t�l` •'��esid /11 a\ ..,,. ...90♦o. ..z. s e se°. :,::. ..:�. e,.oN.. :...• t .rA:�::y° ._: :::,_- 4°:::... TERMS AND CONDITIONS The Permittee William&Jeanette Avers, residing at 122 Hickory Avenue, Southold,New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto,to the complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for a period of 24 months,which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved,to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation,of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation,the said Permittee will be required, upon due notice,to remove or alter this work project herein stated without expenses to the Town of Southold. 8. That the said Board will be notified by the Permittee of the completion of the work authorized. 9. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit,which may be subject to revoke upon failure to obtain same. 10. No right to trespass or interfere with riparian rights. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. Glenn Goldsmith,President ® of SOUj�®� Town Hall Annex A.Nicholas Krupski,Vice President 54375 Route 25 P.O. Box 1179 Eric Sepenoski Southold, New York 11971 Liz Gillooly t9a G � Telephone(631) 765-1892 Elizabeth Peeples ® �a0 Fax(631) 765-6641 Cou1�11 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1978C Date: November 14,2022 THIS CERTIFIES that the installation of a 16'x32' in-around swimming pool made of steel and poured concrete with edge stonework trim approximately 18"-24" around the pool, excavated soil to remain on the property; and install pool enclosure fencing; with the condition that the pool backwash be connected to an existing drywell; At 122 Hickory Avenue, Southold Suffolk County Tax Map#1000-78-7-51 Conforms to the application for a Trustees Permit heretofore filed in this office Dated November 18,2020 pursuant to which Trustees Wetland Permit#9821 Dated February 17,2021,was issued and conforms to all the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the installation of a 16'x32' in-ground swimming pool made of steel and poured concrete with edge stonework trim approximately 18"-24"around the pool; excavated soil to remain on the property; and install pool enclosure fencing;with the condition that the pool backwash be connected to an existing_drywell. The certificate is issued to William &Jeannette Ayers owner of the aforesaid property. Authorize ignature E � W EP 0 CT 1 0 2025 S:j! Obi NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-04477 PERMIT Under the Environmental Conservation Law ECL, Permittee and Facility Information Permit Issued To: Facility: WILLIAM AYERS AYERS PROPERTY 147 PARK BLVD 122 HICKORY AVEISCTM 1000-78-7-51 MALVERNE,NY 11565 SOUTHOLD,NY 11971 (516) 376-1910 Facility Location: in SOUTHOLD in SUFFOLK COUNTY Facility Principal Reference Point: NYTM-E: 716.686 NYTM N: 4547.015 Latitude: 41°02'44.0" Longitude: 72°25'18.7" Authorized Activity: Construct pool, shed and fence. All authorized activities shall be done in strict conformance with the attached plans prepared by Young and Young, last revised on 4/2/2021, and stamped NYSDEC Approved on 4/21/2021. Permit Authorizations Tidal Wetlands -Under Article 25 Permit ID 1-4738-04477/00002 New Permit Effective Date: 4/21/2021 Expiration Date: 4/20/2026 NYSDEC Approval By acceptance of this permit,the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, and all conditions included as part of this permit. Permit Administrator:SHERRI L AICHER, Deputy Permit Administrator Address: NYSDEC Region 1 Headquarters SUNY @ Stony BrookJ50 Circle Rd Stony 1001c,NY 11790 -3409 ` Date Authorized Signature: Page 1. of 6 i NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-04477 Permit Components NATURAL RESOURCE PERMIT CONDITIONS GENERAL CONDITIONS,APPLY TO ALL AUTHORIZED PERMITS NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS NATURAL RESOURCE PERMIT CONDITIONS - Apply to the Following Permits: TIDAL WETLANDS 1. Conformance With Plans All activities authorized by this permit must be in strict conformance with the approved plans submitted by the applicant or applicant's agent as part of the permit application. Such approved plans were prepared by Young and Young,last revised on 4/2/2021, and stamped NYSDEC Approved on 4/21/2021. 2. Post Permit Sign The permit sign enclosed with this permit shall be posted in a conspicuous location on the worksite and adequately protected from the weather. 3. Notice of Commencement At least 48 hours prior to commencement of the project,the permittee and contractor shall sign and return the top portion of the enclosed notification form certifying that they are fully aware of and understand all terms and conditions of this permit. Within 30 days of completion of project,the bottom portion of the form must also be signed and returned, along with photographs of the completed work. 4. Concrete Leachate During construction,no wet or fresh concrete or leachate shall be allowed to escape into any wetlands or waters of New York State,nor shall washings from ready-mixed concrete trucks,mixers,or other devices be allowed to enter any wetland or waters. Only watertight or waterproof forms shall be used. Wet concrete shall not be poured to displace water within the forms. 5. No Construction Debris in Wetland or Adjacent Area Any debris or excess material from construction of this project shall be completely removed from the adjacent area(upland)and removed to an approved upland area for disposal. No debris is permitted in wetlands and/or protected buffer areas. 6. Materials Disposed at Upland Site Any demolition debris, excess construction materials,and/or excess excavated materials shall be immediately and completely disposed of in an authorized solid waste management facility. These materials shall be suitably stabilized as not to re-enter any water body, wetland or wetland adjacent area. 7. No Disturbance to Vegetated Tidal Wetlands There shall be no disturbance to vegetated tidal wetlands or protected buffer areas as a result of the permitted activities. 8. Storage of Equipment,Materials The storage of construction equipment and materials shall be confined within the project work area and/or upland areas greater than 75 linear feet from the tidal wetland boundary. Page 2 of 6 rr NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-04477 9. Seeding Disturbed Areas All areas of soil disturbance resulting from the approved project shall be stabilized with appropriate vegetation(grasses, etc.) immediately following project completion or prior to permit expiration,whichever comes first. If the project site remains inactive for more than 48 hours or planting is impractical due to the season,then the area shall be stabilized with straw or hay mulch or jute matting until weather conditions favor germination. 10. Straw Bales or Other at Tidal Wetland A row of staked straw bales or approvable erosion control devices shall be placed at the landward edge of the buffer area or 75 linear feet from the tidal wetland boundary,or as per the NYSDEC-approved plan,prior to commencement of any regulated activities and remain in place and in good, functional condition until the project is completed and all disturbed areas are stabilized with vegetation. 11. No Drywells in or near Wetland Dry wells for pool filter backwash shall be located a minimum of 75 linear feet landward of the tidal wetland boundary. 12. No Pool Discharges to Wetland There shall be no draining of swimming pool water directly or indirectly into wetlands or protected buffer areas. 13. Contain Exposed, Stockpiled Soils All disturbed areas where soil will be temporarily exposed or stockpiled for longer than 48 hours shall be contained by a continuous line of staked haybales/silt curtains (or other NYSDEC approved devices)placed on the seaward side between the fill and the wetland or protected buffer area. Tarps are authorized to supplement these approved methods. 14. Maintain Erosion Controls All erosion control devices shall be maintained in good and functional condition until the project has been completed and the area has been stabilized. 15. State Not Liable for Damage The State of New York shall in no case be liable for any damage or injury to the structure or work herein authorized which may be caused by or result from future operations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue from any such damage. 16. State May Order Removal or Alteration of Work If future operations by the State of New York require an alteration in the position of the structure or work herein authorized, or if,in the opinion of the Department of Environmental Conservation it shall cause unreasonable obstruction to the free navigation of said waters or flood flows or endanger the health, safety or welfare of the people of the State, or cause loss or destruction of the natural resources of the State,the owner may be ordered by the Department to remove or alter the structural work, obstructions, or hazards caused thereby without expense to the State, and if,upon the expiration or revocation of this permit,the structure, fill, excavation, or other modification of the watercourse hereby authorized shall not be completed,the owners, shall,without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require,remove all or any portion of the uncompleted structure or fill and restore to its former condition the navigable and flood capacity of the watercourse. No claim shall be made against the State of New York on account of any such removal or alteration. Page 3 of 6 v NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-04477 17. State May Require Site Restoration If upon the expiration or revocation of this permit,the project hereby authorized has not been completed,the applicant shall,without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may lawfully require,remove all or any portion of the uncompleted structure or fill and restore the.site to its former condition. No claim shall be made against the State of New York on account of any such removal or alteration. 18. Precautions Against Contamination of Waters All necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended solids, sediments, fuels, solvents, lubricants, epoxy coatings,paints, concrete, leachate or any other environmentally deleterious materials associated with the project. GENERAL CONDITIONS - Apply to ALL Authorized Permits: 1. Facility Inspection by The Department The permitted site or facility, including relevant records, is subject to inspection at reasonable hours and intervals by an authorized representative of the Department of Environmental Conservation(the Department)to determine whether the permittee is complying with this permit and the ECL. Such representative may order the work suspended pursuant to ECL 71- 0301 and SAPA 401(3). The permittee shall provide a person to accompany the Department's representative during an inspection to the permit area when requested by the Department. A copy of this permit, including all referenced maps, drawings and special conditions,must be available for inspection by the Department at all times at the project site or facility. Failure to produce a copy of the permit upon request by a Department representative is a violation of this permit. 2. Relationship of this Permit to Other Department Orders and Determinations Unless expressly provided for by the Department,issuance of this permit does not modify, supersede or rescind any order or determination previously issued by the Department or any of the terms,conditions or requirements contained in such order or determination. 3. Applications For Permit Renewals,Modifications or Transfers The permittee must submit a separate written application to the Department for permit renewal,modification or transfer of this permit. Such application must include any forms or supplemental information the Department requires. Any renewal,modification or transfer granted by the Department must be in writing. Submission of applications for permit renewal,modification or transfer are to be submitted to: Regional Permit Administrator NYSDEC Region 1 Headquarters SUNY @ Stony BrookJ50 Circle Rd Stony Brook,NY11790 -3409 4. Submission of Renewal Application The permittee must submit a renewal application at least 30 days before permit expiration for the following permit authorizations: Tidal Wetlands. Page 4 of 6 Am w NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-04477 5. Permit Modifications, Suspensions and Revocations by the Department The Department reserves the right to exercise all available authority to modify, suspend or revoke this permit. The grounds for modification, suspension or revocation include: a. materially false or inaccurate statements in the permit application or supporting papers; b. failure by the permittee to comply with any terms or conditions of the permit; c. exceeding the scope of the project as described in the permit application; d. newly discovered material information or a material change in environmental conditions,relevant technology or applicable law or regulations since the issuance of the existing permit; e. noncompliance with previously issued permit conditions, orders of the commissioner,any provisions of the Environmental Conservation Law or regulations of the Department related to the permitted activity. 6. Permit Transfer Permits are transferrable unless specifically prohibited by statute,regulation or another permit condition. Applications for permit transfer should be submitted prior to actual transfer of ownership. NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS Item A: Permittee Accepts Legal Responsibility and Agrees to Indemnification The permittee,excepting state or federal agencies, expressly agrees to indemnify and hold harmless the Department of Environmental Conservation of the State of New York, its representatives, employees, and agents ("DEC")for all claims, suits, actions,and damages,to the extent attributable to the permittee's acts or omissions in connection with the permittee's undertaking of activities in connection with,or operation and maintenance of,the facility or facilities authorized by the permit whether in compliance or not in compliance with the terms and conditions of the permit. This indemnification does not extend to any claims, suits, actions, or damages to the extent attributable to DEC's own negligent or intentional acts or omissions, or to any claims, suits, or actions naming the DEC and arising under Article 78 of the New York Civil Practice Laws and Rules or any citizen suit or civil rights provision under federal or state laws. Item B: Permittee's Contractors to Comply with Permit The permittee is responsible for informing its independent contractors, employees, agents and assigns of their responsibility to comply with this permit, including all special conditions while acting as the permittee's agent with respect to the permitted activities, and such persons shall be subject to the same sanctions for violations of the Environmental. Conservation Law as those prescribed for the permittee. Item C: Permittee Responsible for Obtaining Other Required Permits The permittee is responsible for obtaining any other permits, approvals, lands, easements and rights-of- way that may be required to carry out the activities that are authorized by this permit. Page 5 of 6 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION 'Now' Facility DEC ID 1-4738-04477 Item D: No Right to Trespass or Interfere with Riparian Rights This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title,or interest in real or personal property held or vested in a person not a party to the permit. Page 6 of 6 Og�FFO4 oG BUILDING DEPARTMENT-Electrical Inspector may. y� TOWN OF SOUTHOLD H = Town Hall Annex- 54375 Main Road - PO Box 1179 o Southold, New York 11971-0959 - 'j.1j0 Telephone (631) 765-1802 - FAX (631) 765-9502 roQerre-southoldtownnv.gov-- seande-southoldtownny.Qov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: Company Name: LIM&W -' c vl' Name: License No.:�3qt_}p ;email: hi r G Phone No:-8 ^g a-3WS- Q(request an email copy of Cm Ificate of CoMpliance IAddress.: of kocu S,, -k&m e- k1 i'ller , /au., A& /l 74,� JOB SITE INFORMATION (All Information Required) Name: bil f-rs Address: jai. Cross Street: SaJA D Phone No.: 51 U - i q 10 Bldg.Permit#: // 1-7 email: 'F' j v).e-A �(Tol.can Tax Map District: 1000 Section: Block: 07 Lot: BRIEF DESCRIPTION OF WORK (Please Print Clearly) Check All That Apply: F Is job ready.for inspection?: YES ❑NO ❑Rough In 'K;TFinal Do you need a Temp Certificate?: DYES jjjrNO Issued On Temp Information: (All information required) Service Size ❑1 Ph ❑3 Ph Size: A #Meters Old Meter# ❑New Service ❑ Service Reconnect ❑ Underground ❑Overhead #Underground Laterals ❑1 02 ❑H Frame❑Pole Work done on Service? ❑Y ❑N Additional Information: PAYMENT DUE WITH APPLICATION r - Electrical Inspection Form 2020.xlsx J U L 2 2021 BiT7sDTIC DEPT. gtifFOL,��o BUILDING DEPARTMENT- Electrical Inspector ��O Gym► TOWN OF SOUTHOLD o Town Hall Annex - 54375 Main Road - PO Box 1179 c '� Southold, New York 11971-0959 yfj- �aO�� Telephone (631) 765-1802 - FAX (631) 765-9502 "X" rogerr(a southoldtownny.gov - seand(a)southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (Ali Inform ion Req�d) Date: Company Name: L/ � ,r' q-C-I ('/C Electrician's Name: License No.: Elec. email: Elec. Phone No: / �s�J� , I request an email copy of Certificate of Compliance Ca ill'' Elec. Address.: 6QU5 �- Z2L JOB SITE INFORMATION (All Information Requiredl Name: ( //�' A-�, _ Address: Z 2 G /1 Q Cross Street:. V� Phone No.: j Bldg.Permit#: q6 Z , email: Tax Map District: 1000 Section: ,, Block: Lot: J BRIEF DESCRIPTION F WORK, I C DE SQUARE.WOTAGE (Please Print Clearly); /"X 3 Square Footage: Circle All That Apply: Is job ready for inspection?: YES ❑ N ❑Rough In ❑ Final Do you need a Temp Certificate?: ❑ YES �NO Issued On Temp Information: (All information required) Service Size❑1 Ph❑3 Ph Size: A # Meters Old Meter# ❑New Service❑Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground❑Overhead # Underground Laterals D 1 FJ2 H Frame Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION �S BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD Town Hall Annex- 54375 Main Road - PO Box 1179 oy Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 rogerr(a7southoldtownny.gov - seand(&.southoldtownnv.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: Company Name: \J1i&UV , Name: o u , ), License No.:;3gL/p -M-F- email: 41h nth S L � CG Phone No: -9&2-3WS 121 request an email copy of CerYificate of Compliance Address.: % kocaS-�-kztk e ,1.idler A)>1 � 74 JOB SITE INFORMATION (All Information Required) Name: Address: , , kcr Cross Street: SaAh olcl Phone No.: 5 W 3`)b -- i '10 Bldg.Permit#: / j ry email: `R o'eAl � Qd .Ct; n Tax Map District: 1000 Section: Block: 07 Lot: BRIEF DESCRIPTION OF WORK (Please Print Clearly) 1)e)d Check All'That Apply: Is job ready-for inspection?: '; YES ONO ❑Rough In r\ 'inal Do " you need a Temp Certificate?: DYES NO Issued On Temp Information: (All information required) Service Size ❑1 Ph ❑3 Ph Size: A # Meters . Old Meter# ❑New Service ❑ Service Reconnect ❑ Underground ❑Overhead # Underground Laterals 01 ❑2 ❑H.Frame❑Pole Work done on Service? ❑Y ❑N Additional Information: PAYMENT DUE WITH APPLICATION i�_ i c-`�j/'�' ir J U L - 2 2021 Electrical Inspection Form 2020.xlsx PERMIT# Address: Switches Outlets G F I's Surface Sconces H H's UC Lts Fans Fridge HW Exhaust Oven W/D Smokes DW Mini Carbon Micro Generator. Combo Cooktop Transfer AC AH Hood Service Amps Have Used Special: Comments: VC, s� tAl s vJ -t 22� (1)UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW.(2)DISTANCES SHOWN HEREON FROM PROPERTY ONES TO EXISTING STRUCTURES ARE FOR A SPECIRC PURPOSE AND ARE'NDT TO BE USED TO ESTABLISH PROPERTY LINES OR FOR ERECTIDN OF FENCES(3)COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY.(4)CERTIFICATION INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TINE COMPANY.GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON,AND TO THE ASSIGNEES OF THE LENDING INSTITUTION.CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS (S)THE LOCATION OF WELLS(W).SEPTIC TANKS(S7)R CESSPOOLS(CP)SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND OR DATA OBTAINED FROM OTHERS. SITE DATA 400 Ostrander Avenue,Riverhead,New York 114101 tel.651.121.2505 fax.651.T2"1.0144 AREA = 33, T adminagoungenginear(ng.com �SEE FLOOD INSURANCE RATE MAPP PANEL NO.O. 1V 36103G0166 H LAST DATED SEPT.25,2004. 4 o � / Howard K Young,Land Surveyor s Thomas G.Wolpert,Professional Engineer Mo�/!j�ry , . ®�®O Douglas E.Adams,Professional Engineer 1/ .�� A!/j^ � C �. 'o w E Robert G.Tast,Architect 10 ry OG) -'`Y'�4e`( HEALTH DEPARTMENT USE Moil O `, 3e �^�` 0 OIS� \tea%/ '� \ ,�"�/• . 0 01 �01 r \ , � � At •o moo K� ,c� �s \ a• \ \ ry* o e4 �o , P 3Es / ° SURVEYOR'S CERTIFICATION --�. \ / T (� vI \ ^20) i' ti -�^C� *M HEREBY CERTIFY TO W 1 L L I A M AY (� a �g 7.04 n� " \ a�4� &° i "h ^/ / AYERS THAT THIS SURVEY WAS PREP I ANG,pE < '� (A `� .t \ ' \ / S ��i� / YORK STATE ASSOCIATION OTHE COVE Or-FR.ACTICE FORP�D I 5 \ </4 0, 676� Lis'yi� as t� ,� Q' / he/ 0 ONPS�l'A Cs � 1 > Ap 17.18 9' c O'6• i ry /� 7 �S?�% E q @ O� SIC' ' ' / / �1L�^ / 6 / �� - f \ ` 0/^4p �y',� h 7/0 DA / / HOWARD W.YOUNG,N.Y.5.L.5.NO.45898 o�^D�i a�^ SURVEY FOR ; WILLIAM AYERS 4 \ ; Nkz33�6 rw% .,� ��, / / JEANNETTE AYERS of Southold, Town of 5outhold 0 'w" Suffolk County, New York BUILDING PERMIT SURVEY County Tax Map olstFlOt 1000 seotlDR 78 BIQCk O'7 Lot 51 MAP PREPARED DUNE I5,2016 \ k / t� Record of Revisions° ,' �\tip REVISIONS DATE GENERAL AMENDMENTS SEPT.O'f.2016 ADDRESSED SGDHS NOICA OCT. 12.2016 ADDRESSED SCVID S NOIGA DEC-0'1.2016 AMENDED BUILDING PERMIT DATA FEB_ 4,201 i ADDED SWING DATA MAR. Ib.201'1 "o \ AMENDED DRAINAGE MAY 04.201-1 <, 5AN I TARY MEA5UREMENT5 FOUNDATION LOCATION AUG.25.201"1 FINAL SURVEY Al16.0'7.201b \� B AMENDED WATER SERVICE JAN.OR.2014 o ADDED BUILDING PERMIT DATA JAN.05.2021 y ADDED BUILDING PERMIT DATA JAN,26.2021 m ST 35, 25, ADDED BUILDING PERMIT DATA FEB.04.2021 e 50 0 25 5o 100 o LPI 62' S'1' J D. LP2 (01' 51' Scale: 1" = 50' -0085 E) MONUMENT SET MONUMENT= ■= FOUND. Q STAKE SET STAKE FOUND= = PIPE SET JOB NO.201 5,R-2 = Q= REBAR d GAP FOUND NUMBERED FLAG DWG.2015_0159.�016_0085_bpr3 I OF I (T)UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW.(2)DISTANCES SHOWN HEREON FROM PROPERTY LINES TO EXISTING STRUCTURES ARE FOR A SPECIFIC PURPOSE AND ARE NOT TO BE USED TO ESTABLISH PROPERTY LINES OR FOR ERECTION OF FENCES(3)COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY.(4)CERTIFICATION INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY,GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON.AND TO THE ASSIGNEES OF THE LENDING INSTITUTION.CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS (5)THE LOCATION OF WELLS(W).SEPTIC TANKS(ST).CESSPOOLS(CP)SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND OR DATA OBTAINED FROM OTHERS. SITE DATA 400 Ostrander Avenue,Riverhead,New York II6101 P-64Pw tel.651.121.2505 fax.651.'121.0144 AREA = 55,5?8 50. FT. admfnoyoungenglneering com SEE FLOOD INSURANCE RATE MAP PANEL NO.561oac0166 H l�l � LAST DATED SEPT.25,2009. 7 Howard K Young,Land Survagor Thomas G.Wolpert,Professional Engineer "i u0� ,�. o Douglas E.Adams,Professional Engineer Robert G.Tast,Architect O y ,�� s ^� ��o ,� J S HEALTH DEPARTMENT USE 00 le 0 R o y� FRF 2 p� .\ "Al l5 0 V N1 �Dp` �, e o ' �.•�..�•' g�� 9� q� ,, �0 \ \ \ ��C - 9 2021 01 Southold Town \ Board of Trustees s �\ �'0° c SURVEYOR'S GERTIFIGA O 1 1 DI \ ^E70�' %' U� /—r q�� / s WE HEREBY CERTIFY TO WILLIAM A �{`E�+BVE p 'S 9 7.94Rt \ �// AYERS THAT THIS SURVEY WAS PREP 'IN'ARDA \` S 'o� e ti ` \ `�' r� / h ^ THE CODE OF WORK STATE PRACTICE F OF I ^ -'ay ORsz' A �q o�s 6�D� 4s�gsjc� B � "'t Q� \ 'qqS o��^ 4<0��o� �6 Q Q,°"� -� 9 ® 3`�� `�?' ,�o ,/n' �/ 12b / _ I` _ I; , rf I i _ `�t 66, 7S, y/o/ \ p�0'y � � '`� ��,. P BFL ryo �C e'�17.18 iq�e ati ,3F .SIG 468�4 No C. rye,, g y� :' { HOWARD W.YOUNG,N.Y.S.16 ly L .No.45895 L,q D N / �:ki �►� o SURVEY FOR '"Y WILLIAM AYER5 4 ® BY JEANNETTE AYERS B 0FARUSTEES at Southold, Town of Southold TOWN O SOUTHOL® Suffolk County, New York o , al�tt`®� BUILDING PERMIT SURVEY ®A�_E e� 17 2021� ��rTF'� .. � County Tax Map District IOOO Section 18 19100K 0'1 Lot 51 MAP PREPARED JUNE 15,2016 1 � � k c Record of Revisions \ w 0 ,, kV REVISIONS DATE `(` \ # T' GENERAL AMENDMENTS SEPT.O7,2016 ' ADDRESSED 51_'DH5 NOIGA orT- 12.2016 ADDRESSED 5GDH5 NOIGA DEC-01,2016 i AMENDED BUILDING PERMIT DATA FEB. 14,2011 o \ f / ADDED SWING DATA MAR. I6.2011 / AMENDED DRAINAGE MAY OQ.2011 s <, 5AN I TARY MEA5UREMENT5 FOUNDATION LOCATION AUG.25.2011 c FINAL SURVEY AUG.01.2015 \� A B AMENDED WATER SERVICE JAN.01,201 c ADDED BUILDING PERMIT DATA JAN.05,2021 y ADDED BUILDING PERMIT DATA JAN.26,2021 DO ST 55, 25, ADDED BUILDING PERMIT DATA FEB.09.2021 50 O 25 50 100 c LPI 62' S?' a LP2 61, 51, Scale: P = So' JOB NO.2016-0085 l] = MONUMENT SET ■= MONUMENT FOUND 0= STAKE SET ♦= STAKE FOUND ®= PIPE SET Q= RE5AR It GAP FOUND = NUMBERED FLAG DWG.2015_O159__2016_0085_i;pr5 I OF I � AR—C {*s e3'�T°"e_iTnr t0W V . , _ I oo I 4, 3 is dC. .r 4 \ ^J 1 00 Ix -LAlDNrn Cr'JGViTYJLD + r3 2• \ e. 10 06 la `; � ��' r0 QS.'brb .�i: � 9 � •\, 3�,��FO`'�tl Q �T� Try i � ``•�„ryxsr -^��*^, 'it` Ja. 'ta-', r ��n(�,r' �� . {ri AGj �. I�M4r Ye'�'A �• �K .,t may,�d4R .\. �y / � �� Off( / (\� \ # 1 its / 3 s APR "6 AS NOTED DATE: 3 B.P.# OCCUPANCY OR NOTIFY BUI D NG DEPARTMENT AT . USE IS UNLAWFU L 765-1802 .8 AM TO 4 PM FOR THE -�- ELECTRICAL FOLLOWING INSPECTIONS: WITHOUT CERTIFICA ' INSPECTION REQUIRED 1. FOUNDATION - TWO REQUIRED OF OCCUPANCY 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. COMPLY WITH ALL CODES OF RETAIN STORM WATER RUNOFF -NEW YORK STATE-&TOWN CODE; - PURSUANT-TO CHAPTER 236 AS REQUIRED AND CONDITIONS O OF THE TOWN CODE. ENCLOSE POOLTO cPo : ``ttPON,COMPLETION PORE�W R - SO ^' TOWNILRANNING BOAR: OUTHOLD TOWN TRUSTEES _v._ N.Y.S.DEC L Z� 3 NOTES nFIUL 1. NO SOIL SVPCHARGE PERMITTED WITH IN 4 FEETOF EXCAVATION AT THE SHALLOW END,0"FEET OF EXCAVATION AT THE DEEP END. 2. THIS POOL MEETS THE REQUIREMENTS OF AN51/NSPI-5'AMERICANNATIONALSTANDARDFORRESIDENTIALINGROVNDSWIMMING POOLS'AND 1996 BOCA CODE-SECTION 421,DIVING EQUIPMENT 15 NOTALLOWED. CorvCRETE I1v.-D 3. SWIMMI NC POOL SHALL BE COMPLETELY AND CONTINUOVSLY SURROVNDED WITH A BARRI ER CONSTRUCTED IAW REQUIREMENTS OF ALVM.COPINGCAP -115 OTHEU)VP COPING SECTION R326.5.3 OF THE INTERNATIONAL RESIDENTIAL CODE(2016)AND INCONFORMITY WITH ALL SECTIONS OFTHE BROOKHAVEN TOWN CODE ACCESS GATES SHALL COMPLY WITH SECTION U26.5.2 OF THE IRC AND BE SELFCLOSING.SELF LATCHINGAND BE SECURELY I-TO-- LOCKED WHEN POOL IS NOT IN USE OR SUPERVISED.ALLGATES ARE TO OPEN AWAY FROM THE POOLAREA. a•-a• A w E 4. DURING OF BROOKHAVEN. ERECTATEMPORARY BARRIERAROUND THE EXCAVATION IAW THE CODE OF THE TOWN OF BROOKHAVEN. 5. POOL MUST BE EQUIPPED WITH AN APPROVED POOLALARM CAPABLE OF DETECTING A CHILD ENTERING THE WATER AND SOUNDING - ALTERNATIVERIMLOCKCOPING ANAVD ISLE ALARM WHEN DETECTED THAT 15 AVOIBLE AT POOL5IDEANDATANOTHER LOCATION ON THE PREMISES WHERE THE POOL ISLOCATED.THE ALARM MUST BE INSTALLED,MAINTAINED AND USED IN ACCORDANCE WITH THE MANUFACTURERS INSTRUCTIONS. N.TS. THE ALARM MUSTMEETA5TM F22M•STANDARD SPECIFICATION FOR POOL ALARMS.THE DEVICE MVSTOPERATE INDEPENDENT(NOT n NOTEDE-ERRWNTOeEPITCHEDAWAVFCOMPOOL ATTACHEDTOORDEPENDENTON)OFPERSONS. GS PT FOR SURFACE )MUST BE PROVIDED PLAN 6 A�198M OKA MINL UCnON SIMUM 18Ex 23-DRAIN GRATEIORACSHANNEL DRAIN SYSTEM FOOLTH A LCCIIRCVIATION SYSTEM MUST BE EQVIPER THATCONFORM5 TO SPEDWITH NTs. ATMOSPHERIC VACUUM RELIEF IN THE EVENTTHE GRATE COVERS LOCATED WITHIN THE POOL BECOME M1551NG OR BROKEN.SUCH VACUUM RELIEF SYSTEMS SHALL CONFORM WITH ASME A112.19.17 OR BE A GRAVITY SYSTEM APPROVED BY THE TOWN OF BROOKHAVEN. POOLSHALL BE PROVIDED WITH A MINIMUM OF2 SUCTION FIMNG50F THEABOVE MENTIONEDTVPE.THE SUCTION FITTINGS SHALL BE .a NeEscwsOFO SEPARATED BYA MINIMUM OF3'AND MUST BE PIPED SUCH THAT WATE0.15 DRAWN THROUGH THEM SIMVLTANEVUSLY THROUGH A VACUUM RELIEF-PROTECTED NNE TO THE PUMP(OR PUMPS)VACUUM/PRESSURE CLEANING FITTINGS SHALL BE IN AN ACCESSIBLE POSITION,MINIMUM OF 6'AND NO GREATERTHAN 12'BELOW THE MINIMUM OPERATIONAL WATER LEVEL OR BEAN ATTACHMENTTO 'T •Da TH ESKIMMER5KIMMERS. 7. ALL ELECTRICAL WORK SHALL PLY WITH TH E REQUI REMENTS OF NFPA 70(NEC)PMNCIPALLYARTICLE 690 AND TH E 10.0 SECTIONS 4 M THROUGH 4206.ALL ELECTRICAL DEVICES MU5TBE APPROVED BY UNDERWRITERS LABORATORIES AND BE PROTECTED BYA x ma Sa.DeorTonl GKOVND FAVLTCVRRENTINTEDAVPTER(GFCD CVRRENTCARRYINGELECrRICALCONDUCTOMEXCEPTFORTHOSEPROVIDINGPOWER TO POOL LIGHTING AND POOL EQUIPMENTSHALL MEETTHE SEPARATION REQUIREMENTS OF TABLE E4205.5.ALL METAL ENCL05VRE5, v SECTION A FENCES OR RAILINGS NEARORADIACENTTO THE SWIMMING POOLTHATMAY BECOME ELECTRICALLYCHARGED DUE TO CONTACT U N.TS. WITH AN ELECTRI04LCIP.CUITSHALL SE EFFECTIVELY GROUNDED. CMFfetygLyEq SM-WILFADEDROPSOTHENDS 8, WATER SOURCE FILLING THE POOL SHALL BE EQUIPPED WITH A BACKFIOW PROTECTION DEVICE IAW NYS PLUMBING CODE 609. FROM scLMMER _y n PVMF ETEELPANEL ;/a•ST.-111 9. ALI PIPING IS DIAGRAMMATIC UNLESS OTHERWISE STATED. L' 000LLL 10.WALKS If PROVIDED SHALL BE NONSLIP AND SLOPE AWAY FROM POOL EDGE. IR } �- f- CONCRETE- 8 C V Z 6 11, AMEANSOF EGKE55FORDEEPAND5HALLOW ENDSMVSTBE PROVIDED IAWANWNSPI-SSECTION6. 'SC ED DISNSAV 12. CONTRACTOKTO PLACE THE POOL IAW TOWN OF BROOKHAVEN CODE SETBACKS. �' d -R. =_ 13. ALL DRAINAGE FROM THE POOL SHALL BE MAINTAINED ON THE SVBIECTPROPERTY, d tT VALVE O HS.IZO jALTRgc[ 15, THE DESIGN IS BASED ON A DRAINAGE SOIL WITH,lOr SILT.GROUND WATEK5HALL NOT M5TWTHIN THE EXCAVATION,IFGROVND W. WATER EXISTS WITHIN b'-D•FROM GRADE,DEWATERING FACILITIES WILL BE REQUIRED. 1.s is•.as•-1aW. 16. ALLGAS AND OIL HEATERS(IF INSTALLED)FOR THE I NGROVND SWIMMING POOL SHALL BE NATIONAL APPLIANCE ENERGY FT FILTER CONSERVATION ACT(NAECAICOMPLIANT.POOL HEATERS SHALL BE TESTED IAW ANSI Z21.56 AND SHALL BE INSTALLED IAW .gyp ALTERNATEA-FRAMEDEfAIL MANUFACTURERSSPECIFICATIONS.OIL FIRED POOL HEATERS SHALL BETESTED IAW VL726.POOL HEATERS SHALL BE LOCATED OR GVARDEDTOP0.0TECTAGAINSTACCIDENTALCONTACTOFHOTSU0.FACE5BYPERSON5.POOL HEATERS SHALL BE PROVIDED WITH y N.TS. TEMPERATURE AND PRESSURE-RELIEF VALVES.FOR HEATERS NOT PROVIDED WITH AN INTEGRAL BYPA55 SYSTEM.A BYPASS LINE SHALL ' SEIN5TALLEDFROMINLETT000TLETTOAD)USTWATER FLOW THROUGH THE HEATER.POOL HEATERS SHALL BE PROVIDED WITH THE RG FOLLOWING ENEYCONSERVATION MEASURES: V n ww m CHECK VALVE 16,1 ALLEAST HE TERS SHALL LL EQUIPPED WITH FOR EACH HEATING Fy 162 ALL POOL HEATERS SHALL R EQUIPPED W ITH AN ON-OFF SWITCH MOUNTED AN EASYACCESS TO ALLOW SHUTTING OFF R.EU HE OPERATION OF THE HEATER WITHOVTAD/USTING THE THERMOSTATSETTINGAND TO ALLOW RESTARTING WITHOVTRELIGHTING THE (� TO RETURNS PILOTLIGHT. z t63 HEATED SWIMMING POOLS 514ALL BE EQUIPPED WITH A POOLCOVER(EXEMPTED FROM THIS 0.EQVIREMENTARE OUTDOOR POOL$ DERIVING 20SOF THE ENERGY FOR HEATING FROM RENEWABLE$0URCESAS COMPUTED OVERAN OPERATING SEASON) ALLM.CpPlrvcu 3re'-te.3/a•tc.HEx HD. 16.4 TIME CLOCKS SHALL BE INSTALLED 50 THE PUMP CAN CESETTO RUN DURING OFF-PEAK ELECTRICAL DEMAND PERIODS AND CAN BESET Z Y B01-FLAT-SECT TOR THE MINIMUM TIME NECESSARY TO MAINTAIN THE POOLWATER INA CLEAN AND SANITARYCONDITION IAW APPUCABLE Z i9! •A'FMMF eASESTEFI G obi LD-+• G4ALVMINIZEp SANITARY CODE OF NEW VORKSTATE OVER INEIDS STEELANLLF DRNFSTAKE WELDS ON SIDE OF PANEL i'-1-1h• WAnR v cOgwMlrvuMCOPINc LONG._LPEDTOv480T10MA3 17, THIS DRAWING 15 FORSTRVCWRALSHELLONLY.ALLACCESSORIES AND APPURTENANCES ARE DEFINED BYOTHERS. 3 daD eDp SHOwN,4ALVMINIZEDCOATNG e/R'-16.T.HEX i �Ir E o� I R-, SSS 6 STEELFANLL HD:eoITHFXNtrt 18. BACKFILL WITH CLEAN EARTH,FREE OF ROOTS AND DEBRIS.DO NOTALLOW THE HEILHTOF CACKFILL TO EXCEED THE HEIGHTOF THE I. WATER IN THE POOL BYMORETHAN 8.OKTHEWATEKTOEXCEED SACKFILL BY MORE THAN B' SOv p HEKS(n) 20MIMILMIN. I W WNGSTEEL 19, PLACE CONCRETE ON SANDYTO LOAM 501L REMOVE ANYCLAY DU05MAND REPLACEW/COMPACTED CLEAN SACKFILL 20 MILMIN. 'ILSAA TFFENER AAANE _ 20.THEREISNOMAINDRAININTHISPOOL SUCTION FOR POOL WATER CIRCULATION 15 PROVIDED BY THE SKIMMERS ONLY.THISMEETS U $ Z'TOISAND I REQUIREMENTSOFTHE IRC-SECTION 9326.6 FOR ENTRAPMENTPROTECTION. m .0 21. THE POOL WAS DESIGNED IAW THE FOLLOWING: U 21.1, THEINTERNATIONALRZIDENTIALCODE(IRC)-CHAMEK4 C20I6) 211.THE I NTERNATIONALENEWYCONSENVATIONCONSTRVCTIONCODE-SECTIONR103.10(2MS) ID'VJHC RE-uRDaIVEIIrvaa-�� 21.3. THE INTERNATIONAL FUELGA5 CODE(2015) INTOUNDISTURBEO UnTi.\ ORTm. aa•.e•coNcaETECouga 21.4.THE NEW YORK STATE CODESVPPLEMENT-SECTION Ri26 Q01]) IrsE HOLES IN PANEL6ASE. \ ANCLE 21.5. THE NEW YORK STATE SANITARY CODE. Ai PODLPENMETER 21.6. AN51/NSPI-55TANDARD FOR KESIDENTIALIN-GROVND5WIMMINGPOOL5, VNRl-.ED EARTH A FRAM, 21.7. COCA OF DE-SECTIONTHE TOWN FB 1. 21.8.CODE OF THE TOWN OF BROOKHAVEN. A-FRAME WALL SECTION TYPICAL PANEL5TIFFENER 22. ALL BACKWASH TO BE5ELF-CONTAINEDON-SITE. N.rs. N.is.