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Home My WebLink About43561-Z suFfot �t O 1pG Town of Southold 7/26/2021 a y� P.O.Box 1179 o • �1 53095 Main Rd ; Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 42187 Date: 7/26/2021 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 9575 Nassau Point Rd., Cutchogue SCTM#: 473889 Sec/Block/Lot: 119.4-3 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 3/7/2019 pursuant to which Building Permit No. 43561 dated 3/15/2019 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 per ZBA#7476, dated 4/15/2021. The certificate is issued to Miller,Emily of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 43561 6/13/2019 PLUMBERS CERTIFICATION DATED U ut ori d ignature o�gUfFOdIcPGy TOWN OF SOUTHOLD �o BUILDING DEPARTMENT co c TOWN CLERK'S OFFICE oy • 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#: 43561 Date: 3/15/2019 Permission is hereby granted to: Miller, Emily 143 Reade St 6A New York, NY 10013 To: construct accessory in-ground swimming pool as applied for. At premises located at: 9575 Nassau Point Rd., Cutchogue SCTM # 473889 Sec/Block/Lot# 119.-1-3 Pursuant to application dated 3/7/2019 and approved by the Building Inspector. To expire on 9/13/2020. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO - SWIMMING POOL $50.00 Total: $300.00 Building nspector Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings,property lines,streets,and unusual natural or topographic features. 2. Final Approval from Health Dept.of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1%lead. 5. Commercial building,industrial building,multiple residences and similar buildings and installations,a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings(prior to April 9,1957)non-conforming uses,or buildings and"pre-existing"land uses: 1. Accurate survey of property showing all property lines,streets,building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant.If a Certificate of Occupancy is denied,the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy-New dwelling$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00, Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,Businesses$50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15.00,Commercial$15.00 Date. New Construction: Old or Pre-existing Building: i (check one) Location of Property: I C;�`�� b 1 2�S S ou House No. Stree� Hamlet Owner or Owners of Property: Suffolk County Tax Map No 1000,Section Block ®, Lot Subdivision Filed Map. Lot: Permit No.� Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ 5b X1, Applicant Si atur SO(/l�®l Town Hall Annex Telephone(631)765-1802 54375 Main Road c� Fax(631)765-9502 P.O.Box 1179 G Q Southold,NY 11971-0959 ® • �® roper.riche rt(Q-town.south old.ny.us c®UNT°19� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To. Emily Miller Address: 9575 Nassau Point Rd City: Cutchogue St: New York Zip: 11935 Budding Permit#: 43561 Section: 119 Block: 1 Lot 3 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: LC Electric License No: 38043-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 1 Ceiling Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt 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 1 Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks 1 Disconnect Switches 1 Twist Lock Exit Fixtures 11 TVSS Other Equipment. In ground swimming pool to include, bonding, control panel, time clock, 1-switch, 2-GFCI circuit breakers,pool pump,heat pump,salt generator,cover motor,pool lights. Notes: Inspector Signature: Date: June 13 2019 81-Cert Electrical Compliance Form.xls ` BOE SOGTy # °# TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INS - : P-ECTION - [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ rSULATIOWCAULKING FRAMING/STRAPPING [ NAL4l ___ '] ' FIREPLACE & CHIMNEY [ ] FIRE SAFETY'INSPECTION ` [ ] FIRE RESISTANT CONSTRUCTION [ ]' FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH)- [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: . VPcti/ N1_ ROaAV)--- ::J�ol 0 KAIL Q10 CA r ,tom co ��✓ k4 _ - DATE INSPECTOR, �o��,oF soulyolo # TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 _ANSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ VNSULATION/CAULKING [ ] FRAMING/STRAPPING [ ] FINAL P0� [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ]" ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: I r i �r com-* -� DATE A INSPECTOR ��OE OUT,yo h� `o TOWN OF SOUTHOLD BUILDING DEPT. co 765-1802 INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ rSULATIOWCAFRAMING /STRAPPING [ FINAL Pm4- (��; [ ] FIREPLACE-&-CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: T;ry DATE Ly 'Lf) INSPECTOR FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION (1ST) ------------------------------------ 'FOUNDATION (2ND) ROUGH FRAMING& , PLUMBINGlei H 1 INSULATION PER N.Y: y STATE ENERGY CODE o� Q K FINAL C ADDITIONAL COMMENTS V I afA 5 i)EZ 1�;zv �Al U ---LV C.P ren, � - ' • z d • b H - 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 Survey Southoldtownny.gov PERMIT NO., 1 Check Septic Form N.Y.S.D.E.C. Trustees g C.O.Application Flood Permit Examined v ✓ ,20 Single&Separate l 20�g Truss Identification Form �AR Storm-Water Assessment Form G-+ za- _ Contact: p� 9�/ 1Gen Il Approved 20ws®-VS® Mail to: Disapproved a/c �� Phone: ��` 5 r►q -65oZq Expiration ,20 1 Bui g nspe or APPLICATION FOR BUILDING PERMIT Date , 20 1 INSTRUCTIONS a.This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans,accurate plot plan to scale.Fee according to schedule. b.Plot plan showing location of lot and of buildings on premises,relationship to adjoining premises or public streets or areas, and waterways. c.The work covered by this application may not be commenced before issuance of Building Permit. 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.Thereafter,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 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 for necessary inspections. ``//II f �/ Pi Cis P00 lS (Signature of applicant or name,if a corpo atron) Q-e�s i2t41Aa,,,eoik kJ` (Mailing address of applicant) State wte�ther app 1* ant is owner lessee, agent, architect, engineer, general contractor, electrician,plumber or builder Name of owner of premises'`u("7 (As on the tax roll or latest deed) If applicant i a co oration, signature of duly authorized officer Vu (Name(And title of corporate officer) Builders License No. ( CV9— Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will bed done- S6 qL.) pin-�— (Z �G�o V . House Number Streetft-A.41 et , County Tax Map No. 1000 Section 4\ Block t_ ``,f'v`, ; ;?,�.6: Lot 3 • � S.d ,i., ii 1f�+,t4 f _ r7+"::-i'i l 1._.:`It Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended q§e and occupancy of proposed construction: a. Existing use and occupancy f ,w� b. Intended use and occupancy 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition z ,, Other Work p0 d4" '¢ "J` it:' i .1 ' ;'`' '� (Description) 4. Estimated Cost !9 ec;-I D az Fee j' (To b'b,paid on filing this application) If dwelling, number of dwelling units Number of dwelling units'ori each floor If garage, number of cars If business, commercial or mixed occupancy, specify nature_,and extent of each type of use. Y Y'h• '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 Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 4LI 1) 12. Does proposed construction violate any zoning law, ordinance or regulation?YES NO 13. Will lot be re-graded?YES NO Wi ll excess fill be removed from premises?YES NO 14.Names of Owner of premises Address I P A40.16�J'Phone No. Name of Architect _ F 50A--, Address 7- -c! � ( hone No Q 1-`0-5-- S7-il,7- Name of Contractor 016 Address le4 fe4L, Phone No. C 3 I Q-) �Cf�- 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES 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 SRk Q,Vl/l & T,-' being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract) 'above _named, � (S)He is the d� 1 ��► `@��W (Contractor,Agent,Corporate Officer,etc.) of said owner or owners,and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief;and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this T& day of I ACLYCh 20j�_ Alaw qp Notary Publi TRACEY L. DWYER Sigt re of A licant NOTARY PUBLIC,STATE OF NEW YORK NO.01 DW6306900 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,2 Oot� 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 3 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631)765-9502 Survey www. northfork.net/Southold/ PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees Examined ,20 Contact: Approved 120 Mail to: Lark & Folts, Esqs. 1,� P.O. Box 973 Cutchogue, Disapproved a/c �.k��--� �' 1935 Vm1WMWkW Y Phone: (631) 734-6807 u Expiration ,20 � E Q:V]tor } D Es - D APPLICATION FOR BUILDING PERMIT SEP 1 5 2020 Date September 8 � 2020 BUM, DFNG,DEIN. INSTRUCTIONS ' OW.T'tfiis ap�iliJMAST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 sets of plans,accurate plot plan to scale.Fee according to schedule. b.Plot plan showing location of lot and of buildings on 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.Thereafter,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 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 for necessary inspections. (Signature of a licant or name,if a corporation) Richard F. Lark, Attorney for Emily Miller P.O. Box 973, Cutchogue, NY 11935 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder attorney for Emily Miller Name of owner of premises Emily Miller (As on 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. Q Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: 9575 Nassau Point Road Cutchogue House Number Street Hamlet County Tax Map No. 1000 Section 119 Block 1 -Lot F 3' Subdivision Amended Map A of Nassau Point Filed Map No. 156 Lot `75 (Name) owned by Nassau Point Club Properties Inc. �� 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy pool fence b. Intended use and occupancy pool fence 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work"as built" pool fence (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 Rear Depth 10. Date of Purchase June 5, 2017 Name of Former Owner Peter Doran and Janet Doran, Trustees of the Janet Doran Living Trust 11. ,Zone or use district in which premises are situated R-40 12.Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded?YES NO X Will excess fill be removed from premises?YES NO X 143 Reade Street 6A 14. Names of Owner of premises Emily Miller Address New York, NY Phone No.(917) 270-7509 Name of Architect Address 10013 Phone No Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO X * 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. STATE OF NEW YORK) SS: COUNTY OF SUFFOLK ) RICHARD F. LARK being duly sworn,deposes and says-that(s)he-is-tlie-appliealtt (Name of individual signing contract) above named, (3)Heisthe attorney for the applicant, Emily Miller (Contractor,Agent,Corporate Officer,etc.) ofsaici-erwmr-or-ownem,and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the-best of his knowledge and belief;and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this 8th day of September 20 20 Notary Public Signature of Applicant Richard F. Lark, attorney for applicant, BARBARA DIACHUN Emily Miller Notary Public, State of New York No 01 D14635190-Suffolk County Commission Explros Oct,31,2022- Scott A. Mussell 0s0FFQk� STOWWWA\T]EIk SUPERVISOR MIA NA,Gr]EM IENT SOUTHOLD TOWN HALL-P.O.Box 1179 53095 Main Road-SOUTHOLD,NEWYORK 11971 Town of Southold CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) DOES "<'I-l1IS PROJECT 1INVOLVE ANY OF THE I;OI,I,OW][NG: (CHECK ALL "rHAT APPLY) Yes No ❑ 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. ❑ C. Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. •ry.r ❑ D. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. ❑ E. Site preparation within the one-hundred-year floodplain as depicted on FIRM Map of any watercourse. ❑ 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 (Piopetty Owner.Design Pr essiona, gent,Connacto Other) S.C.T.M. �: 1000 Date D,etnct I 0q NAME ectton Bloc Lot FOR BUILDING D L11MENTUSE ONLY Contact Information 6:5 Rcviewcd By: — — — — — — — — — — — — — — — — - - - - _ _ - -Dale_ —� ' Property Address/Location of Constrt ctlon Work. �5 Appio\ed for processing Building Permit. Stormwatei Management Control Plan Not Required S .� c�, a5� e !J`.t' 3�' - - - - - - - - - - - - - - - - - �l°iStoim\�atei Management Control Plan is Required. L (Forward to Engineering Department for Review.) FORM 41 SMCP,-'FOS MAY 2014 c Ctf- •?1 ING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD ,A� MAY 2 9 20Tbwn all Annex - 54375 Main Road - PO Box 1179 Southold, New York 11971-0959 02 i�„'_�,:gTelephone (631) 765-1802 - FAX (631) 765-9502 TOWN OF SOUP; �&i�-Droger-:richert a(&,town.southold.ny:us APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: �� i ✓� craf_.-C°. cTc,v� Date: Company Name: A-C__ gleam - Name: License No.: 3golf 3 .M-- - email: Ls�a�t C i-� Address: as u/n°m 4N VY 111110 Phone No.: JOB SITE INFORMATION: (All Information Required) Name: _ _ - Address: -- Cross Street: Phone No.: Bldg.Permit#: , email: Tax Map District: 1000 Section: Block: Lot, BRIEF DESCRIPTION OF WORK(Please Print Clearly) P061 Circle All That Apply: Is job ready for inspection?: YES / NO Rough In Final Do you need a Temp Certificate?: YES / NO Issued On Temp Information: (Ail information required) Service'Size 1 Ph 3 Ph Size: - - A #Meters._ Old Meter# New Service - Fire Reconnect- Flood Reconnect-Service Reconnected - Underground -Overhead #-Underground Laterals 1 2 H Frame Pole Work.done on Service? Y N_ Additional Information: - PAYMENT_.DUE WITH APPLIC-AVON - - 'I y05s 82-Request for Inspecdon FormAs FORM NO. 3 NOTICE OF DISAPPROVAL DATE: September 23, 2020 TO: Lark&Folts, Esqs. (Miller) PO Box 973 Cutchogue,NY 11935 Please take notice that your application For permit to legalize an"as built" 4.5' pool fence in the front yard at Location of property: 9575 Nassau Point Road, Cutcho ug e,NY County Tax Map No. 1000 - Section 119 Block 1 Lot 3 Is returned herewith and disapproved on the following grounds: The proposed construction is not permitted pursuant to Article XXII Section 280-105, which states, "Fences, walls or berms may be erected and maintained, subject to the following height limitations: A. "When located in the front yard of residential zones, the same shall not exceed four feet in height" The proposed fence is 4.5 feet in height. ;rize ZSign Note to Applicant: Any change or deviation to the above referenced application, may require further review by the Southold Town Building Department. CC: file, Z.B.A. FORM NO. 3 NOTICE OF DISAPPROVAL DATE: September 23, 2020 RENEWED: November 30, 2020 TO: Lark&Folts, Esqs. (Miller) AM 2 fi d, o, 3 i PO Box 973 1 Cutchogue,NY 11935 Please take notice that your application For permit to legalize an"as built"4.5' pool fence in the front.ward at Location of property: 9575 Nassau Point Road, Cutchog_ue,NY County Tax Map No. 1000 - Section 119 Block 1 Lot 3 Is returned herewith and disapproved on the following grounds: The construction is not permitted pursuant to Article XXII Section 280-105, which states "Fences, walls or berms may be erected and maintained, subject to the following height limitations: A. "When located in the front yard of residential zones,the same shall not exceed four feet in height" The "as built" fence is Vfeet in height.f '% O/L- Authorized Signature Note to Applicant: Any change or deviation to the above referenced application, may require further review by the Southold Town Building Department. CC: file, Z.B.A. .t. 311_� BOARD MEMBERS OF $AUT Southold Town Hall Leslie Kanes Weisman,Chairperson �& y� 53095 Main Road•P.O.Box 1179 Southold,NY 11971-0959 Patricia Acamporac Office Location: Eric Dantes Town Aimex/First Floor, Robert Lehnert,Jr. 54375 Main Road(at Youngs Avenue) Nicholas Planamento Iycou Southold,NY 11971 http://s outholdtownny.gov ZONING BOARD OF APPEALS RECEIVE" APR 2 6 2021TOWN OF SOUTHOLD �- S 2N Tel.(631)765-1809 •Fax(631)765-9064 APR 2 6 20 1 7 ice--,.,,;8_r`iT=,rS't-'�. ��cc� • S®@,.lhold Town Clerk FINDINGS,DELIBERATIONS AND DETERMINATION MEETING OF APRIL 15,2021 ZBA FILE: #7476 'NAME OF APPLICANT: Emily Miller PROPERTY LOCATION: 9575 Nassau Point Road,Cutchogue,NY SCTM# 1000-119-1-3 SEM DETERMINATION: The Zoning Board of Appeals has visited the property under consideration in,this application and determines that this-review falls-under the Type II category of the State's List of Actions, without further steps under SEQRA. SUFFOLK COUNTY ADMINISTRATIVE CODE: This application was not required to be referred to the Suffolk County Department of Planning under the Suffolk County Administrative Code Sections A 14-14 to 23. LWRP DETERMINATION: The relief, permit, or interpretation requested in this application is listed under the Minor Actions exempt list and is not subject to review under Chapter 268. PROPERTY FACTS/DESCRIPTION: The subject property is a conforming 51,495 square foot water front parcel located in an R-40 Zoning District. The parcel runs 100.27 feet of bulkhead frontage along Little Peconic Bay,runs 106.14 feet along Nassau Point Road,501.11 feet on the North side,and 529.05 feet along the South side. The parcel is improved with a two story framed house with roof over attached wood decks, a frame garage, an in-ground swimming pool surrounded by an as-built vinyl fence measuring 5.2 feet in height and a slate patio. All is shown on a survey prepared by Nathan Taft Corwin,III,LLS dated November 2,2020. BASIS OF APPLICATION: Request for a Variance from Article XXII, Section 280-105 and the Building Inspector's November 30, 2020 Notice of Disapproval based on an application for a permit to legalize an"as built" 5.2 feet pool fence in the front yard; at 1) fence more than the code permitted maximum four(4) feet when located in the front yard; located at: 9575 Nassau Point Road,Cutchogue,NY, SCTM No. 1000-119-1-3. RELIEF REQUESTED: The applicant requests a variance to legalize an as built 5.2 feet in height vinyl fence built on top of a stone wall of various heights where the code permits a maximum of four (4)feet in height fence in the front yard. ADDITIONAL INFORMATION: The survey's elevation data, the site inspection, testimony, and letter from Patrick's pools show that the pool and property are on a sloped elevation. The Pool is partially raised to compensate ,y J' Page 2,April 15,2021 #7476,Miller SCTM No. 1000-119-1-3 for the elevational difference and the non-conforming fence height is caused by the sloping elevation in relation to the raised section of the pool. FINDINGS OF FACT/REASONS FOR BOARD ACTION: The Zoning Board of Appeals held a public hearing on this application on April 1,2021 at which time written and oral evidence were presented. Based upon all testimony,documentation`,personal inspection of the property and surrounding neighborhood,and other evidence,the Zoning Board finds the following facts to be true and relevant and makes the following findings: 1. Town Law 4267-b(3)(b)(1). Grant of the variance will not produce an undesirable,change in the character of the neighborhood or a detriment to nearby properties. Nassau Point is a residential community consisting of water front homes. A pool is a permitted accessory structure in the front yards of waterfront properties. The non-conforming as built fence is located 142 feet from the street and screened by vegetation. The fence is not visible from the street. 2. Town Law 4267-b(3)(b)(2). The benefit sought by the applicant can be achieved by some method, feasible for the applicant to pursue, other than an area variance. However, the property has a sloping elevation making a code conforming fence awkward. In order to be code compliant,the pool fence must be a minimum of 4 feet in height surrounding the pool,and a maximum of 4 feet in height in the front yard. The contractor would have to perfectly match the contour of the ground in order for the pool fence to be code compliant. 3, Town Law 4267-b(3)(b)(3). The variance granted herein is mathematically substantial,representing 100%relief from the code, Howeverthe as built fence'only runs across a small'section of the front yard in'order to safely enclose the pool area as required by building code. 4. Town Law §267-b(3)(b)(4). No evidence has been submitted to suggest that a variance in this residential community will have an adverse impact on the physical or environmental conditions in the neighborhood. The applicant must comply with Chapter 236 of the Town's Storm Water Management Code. 5. Town Law§267-b(3)(b)(5). The difficulty has been self-created., The applicant purchased the parcel after the Zoning Code was in effect and it is presumed that the applicant 'had actual or constructive knowledge of the limitations on the use of the parcel under the Zoning Code in effect prior to or at the time of purchase. 6. Town Law 4267-b. Grant of is the minimum action necessary and adequate to enable the applicant to enjoy the benefit ofa pool fence while preserving and protecting the character of the neighborhood and the health, safety and welfare of the community. RESOLUTION OF THE BOARD: In considering all of the above factors and applying the balancing test under New York Town Law 267-13,motion was offered by Member Dantes,seconded by Member Planamento,and duly carried, to GRANT the variance as applied for, and shown on survey prepared by Nathan Taft Corwin, III, L.L.S. dated November 2, 2020. The Board reserves the right to substitute a similar design that is de mihimis in nature for an alteration that does not increase the degree of nonconformity. r Page 3,April 15,2021 #7476,Miller SCTM No. 1000-119-1-3 Any deviation from the survey, site plan and/or architectural drawings cited in this decision will result in delays and/or a possible denial by the Building Department of a building permit, and may require a new application and public hearing before the Zoning Board of Appeals. Any-deviation from the variances)granted-herein as shown on the architectural drawings; site plan-and/or survey cited above, such as alterations, extensions, or,demolitions, are not authorized under this application when involving nonconformities under the zoning code. This action does not authorize or condone any current or future use,setback or other feature of the subject property that may violate the Zoning Code, other than such uses, setbacks and other features as are expressly addressed in this action. Pursuant to Chapter 280-146(B) of the Code of the Town of Southold any variance granted by the Board of Appeals shall become null and void where a Certificate of Occupancy has not been procured, and/or a subdivision map has not been filed with the Suffolk County Clerk,within three (3)years from the date such variance was granted. The Board of Appeals may, upon written request prior to the date of expiration, grant an extension not to exceed three (3) consecutive one (1)year terms. Vote of the Board: Ayes:Members Weisman(Chairperson),Acampora,Dantes,Lehnert,and Planamento(5-0). Leslie Kanes Weisman;Chairperson. Approved for filing 141,,b' '/2021 LARK& FOLTS Attorneys at Law 28785 MAIN ROAD PO BOX 973 CUTCHOGUE,NEW YORK 11935 Tele.No.(631)734-6807 RICHARD F.LARK Fax No. (631)734-5651 MARY LOU FOLTS E-mail: Attys@larkandfolts.com September 9, 2020 Mr. Michael J. Verity Southold Town Building Department- SEP 1 5 2020 54375 Main Road - P.O. Box 1179 Southold, NY 11971 IE,T�J d DER"T. RE: Emily Miller 9575 Nassau Point Road, Cutchogue, New York (SCTM #1000-119-1-3) Dear Mr. Verity: In connection -with the above-captioned premises, I, am enclosing the following: 1 . Application for Building Permit (pool fence) 2 . Copies of Building Permit #43561 dated 3/15/2019 to construct accessory in-ground swimming pool as applied for; Certificate of Electrical Compliance dated June 13, 2019; Inspection Report dated 12/5/2019; Survey by Stanley J. Isaksen, Jr. dated May 4, 1998; and Plans of Proposed Pool for Emily Miller 3. My Check No. 3036 payable to the Town of Southold in the amount of $50 . 00 Very truly yours, Richard F. Lark RFL/bd Enclosures LARK&FOLTS Attorneys at Law 28785 MAIN ROAD PO BOX 973 CUTCHOGUE,NEW YORK 11935 Tele.No.(631)734-6807 RICHARD F.LARK Fax No. (631),734-5651 MARY LOU FOLTS E-mail: Attys@larkandfolts.com May 3, 2021--, r Mr. Michael J. Verity MAY 6 2021 Southold Town 'Building Department 54375 Main Road - P-0. Box 1179 Southold, NY 11971y'4,`- ,RE: Emily Miller 957x' Nassau Point Road, Cutchogue, New York (SCTM #1000-119-1-3) .Dear ,Mr. Verity: I received approval from the Zoning .Board, of Appeals granting the variance request on 4/20/2021 for the "as built" pool fence, a copy of which, is enclosed., In regard to Building Permit #4-3561 dated 3/15/2019 which expired on 9/.13/2020, I' am requesting an extension to obtain the Certificate of "Occupancy for the in-ground swimming pool. Thank you f'or your consideration in this matter. Very truly yours, Richard F. Lark RFL/bd 'Enclosures s ---- - - Muer_ wArV spv LOT 74 - — RESIDENCE 'Emp-IT ' 0Va?-4,6 5 1.11' m INSTA, D &' R_3 fi• __- ,�,A42' 10--E - _ . . �� EARTN . . 16aD ew ORI AY lz .0 REIOC -- J FAR eg �J� n 7741S AP.EA�---' 30 \ 1�� 0 1 51, Y � �a ,Jr � v � 3 �L7 2 _:7xa Sy } W � se II� �,,� h 1 �^ 4 mJ1 T r }� G \ 4oa 2 4D' Q yt\� zt 4 529.05 a1 S 78' 42' 10 WLOT 76 O PRGo MUNI. WATER SERV RESIDENCE 7EST HOLE By 16ORNIA412 (kSCIbNCE F7ER P:- by�� g�Illl► Ez. 35 EX15'r. INSTALLED t6be DARK BROWN SANDY LOAM, FRAW IPL OVER aSWOVER IS- SUNRISE ROAD (25) Ll SAND SLI 1Sa0'i7 w SAND Slti a _ _ P _OSEfJ WATER S-aVTt€-- ----- „ ` 6WRANTE7S WrA70 MW Gv 91AM MW SUFFOLK C08Y'i t fi_rr Y.:,:.�-�..'`�...._ "iE.:Vlt� R DECKS PALE BROWN a4r TG w 7omw FGR 7R w Aw.gyp wr I a s3.sMED/UN SAND m FN.0A lav teS e8Ta7F m r PERMIT FbR APPROVAL Or CONST?UC;ION FAIR i PRflP05FD ��m SP GTLE a waffl Cpt•T3UCi1L7 m mmW 9•ti____ u117A9T6"+a=011�F �> ANO SINGLE FAMILY RESIDENCE ONLY CESSPOOL , C '--' iq 77VI AS9GNfES 77 tE7flA7tlG tlRS71TU774L a� RDPOSED ADUTO� 7RAfTSFtSMI 7D Cr� SFP?1C TANK- ADG177GRfAL YtSR7U1KW5[iP s78'+�GU£M7' DATE 7• t?1H.5CR , eq•� r'� 3D8' 58t SECM 720 OF APPROVE:' -- �5,�. ® GARA°Pc°.ESFD 1R ' FOR MAmmu• _ _BEDROOMS w'!+ IbA- 0 f a►` I C&40 OF 00 AMfY MAP NOr WA47Aes TW 7.y�V1O seAc snit EXPIRES THREL•'u.KE -: : �'•'�P APRRD ! � M M y • NOT 8f 717 8f A Y.WO 77!11£ •••- .-••• �• S ye• A� SURVEY t OF u I w !u� �fit• S"J v�t 1.�� i St, ��ii 1 LO 75 St - , rK N"6,PT �AAJIC 7w r 119-o1-D3 J /N I y q FYI 156A, F11ED AUG 16, 7922 �fl AMENDED MAP A' OF NASSAU POINT H SURVEYED 70 JULY, 2000 p G`1 C w4A-! SITUATE I= ( CUTCHOGUE, TOWN OF SOUTHOLD SURVEYED BY AREA =51,494.64 SF'\\ SUFFOLK COUNTY, N. Y *7J NBOJ. AKGSE R. 1,182R ACRS 5N 56 SURVEYED FOR JANET L DORAN FLOOD ZONE DATA FROMFIRM MAP 3610JC0506G GUARANTEED Ta _ DATED MAY 4, 1998 JANET 1. DORAN NOTE• 1. 30 MARCH, 2001 ADD CONTOURS, FLOOD ZONE_ DATA, elew7lons ore m 7929 nota 17!JW R ADELITYNA770NAL 7771EINS. c0 CESSPOOL LOCA77ONS & WATER SERVS . 273 2 18 JUNE, 2001 ADD PROPOSED DRIVEWAY, RELOCATE PROPOSED SANITARY & WATER SERV OOR921 7 to nnvn+ nnn mcr, A ry nFnwuFn -n CIV+YN h^rT �' .--_----- MUNI_ WATER SERV. LOT 74 RESIDENCE Q ETEF PIT ------ 1 cz INSTAL- D •1 ' " OVER 5."5 OVER 3.6' 1 1 _ R 7�A.,,42 10 E FRAME 165.0' 14 �c,All - R SER v EARTH FD DRI A Y FD SHED ow Q A GARAGE \\ C \ 12 W a J� IN O.W. CRAa<EL ` V. , BRIO(� CEL 2M 27'— O J� MUNI WA 7_R ER -----------------_ „_SSPOOLS ENT (I T O BE RELOCA(ED EARTH = N Q Q � THIS AREA 1 �� ¢ ( �`S v 10 i o 0 1 STORY 4 �(�( 4 / 3 W Q �0Q 3 N WOOD FRAME / ? RES. `\? J 25 "'310' J6.0 2f�42 16.0' 4 , sB3 � �\ } W k Q LuQ Z 2 4D (� ' Q y. 4 FDPo 529.05' ►� N Q S 78. 42' 10/ W O F• POLE J LOT 76 1 TEST HOLE BY McDONALD GEOSCIENCE O PROP MUNI. WATER SERV RESIDENCE 16 APRIL, 2001 O •------------- r` METER P:- ---'---- 'aTfitOt't TtT11ent. INSTALL=.� ,, �0��g by Health Dep3 EL. 35 EXIST. DARK BROWN SANDY LOAM , P: FRAME FRAME L _ -• 1 OVER 5.6 $COVER 3.6' SUNRISE ROAD (25) ' ADBROWN b 165.0 Zo FD SAND Sb, --.,��_.-._.._.. .._.. . ._ .....-. .._ ...�_. ...�. -----f?,kOPOSED_W.aTER SERVICE_ -____-- 3' SUFFOLK COJV i"> c;_r.� :.:..:;::' �...... iL.;YtCCS- ---- - -- - - - PROPOSED PROPOSED o GUARANTEES INDICATED HERE ON SHALL RUN CESSPOOLS DECKS ac PALE BROWN ONLY TO THE PERSON FOR WHOM 774E'SURVEY ,),' TO E ABANDONED m MEDIUM SAND IS PREPARED, AND ON HIS BEHALF TO INE PERMIT FOR APPROVAL Or::ONSTi?UCI ION FOR C 4 8EDR0 PROPOSED., SP LEND COMPANY, GOVERNMENTAL AGENCY, LENDING lNS77TU1TCN, IF LISTED H£REON,'AND - -" - - -- - -- - ---- -- ; -- CESSPOOL �•�-----C ---- — -- SINGLE FAMILY RESfDEVCF ONLY - - -TO 7HE ASSIGNEES OF THE LENDING WSnTUnON. d��OPOSED - CUARAN7EES ARE NOT TRANSFERABLE rO �o RES/DENC SEPTIC TANK ADDInONAL 1NS777U77ONS OR SUBSEQUENT ONNER --- --- - DATET r) o w.S. F. �(�'4 l i 3 cc% w JOB' ST +aI R 1 5 t LAVAUTHDR12F11 AL1ERAncw ORADDIiIaN ro THIS OPOSED ARAGE _ SURVEY IS A k1OLA770M OF SECnON 7209 OF APPROVE,"S ®Q`®q. O EE- E THE NEW YORK STA 7E EDUCA77CN LAW. at FOR i1AAXf141U-' `'" _L !BEDROOMS �`� j7, •17. - CORWE LAND SURVEr1ORs EWBOSSNEDDTS 4L SHALL EXPIRES THREE• ' ViLARE - =C. :1=��OF APPRO L :� m "� CM � P OLE NOT'8E CONSIOERED 717 BE A VALID TRUE �-- __ • '�"—" �' yyj S 0.6• coPY.�JVJn 1a �e�' �C`Z V L t h� 1 SURVEY OF ` R ZA U0 �v r C.� In A,c-j L O T 75 1 iia r- SJ '�►� N� �� S /N , o a o, TM 1000-119-Of-03 , FM,4 156A, FILED AUG. 16, 1922 AMENDED MAP A OF NASSAU POINT 3' SI TUA TE SURVEYED 10 JULY, 2000 SCALE 1"=50' ff CCS TCHOGUE, TOWN OF SOU THOLD SURVEYED BY AREA = 51,494.64 SF SUFFOLK COUNTY, N. Y. ;; STANLEY J. ISAOR KSEN R. P.O. BOX 294 1.182 ACRES NEW j6UFFOLK N 56 SURVEYED FOR JANET I. DORAN FLOOD ZONE DATA FROM 631 734— 5 • FIRM MAP J510JC0506G GUARANTEED TO- DATED MAY 4, 1998 JANET 1. DORAN NOTE: 1. 30 MARCH 2001 ADD CONTOURS, FLOOD ZONE DATA, elevations are in 1929 Laud, NYS L NOLAND URVEYOR NYS . 273 FIDELITY NATIONAL 77TLE INS. CO. CESSPOOL LOCATIONS & WATER SERVS. 2. 18 JUNE, 2001 ADD PROPOSED DRIVEWAY, RELOCATE PROPOSED SANITARY & WATER SERV. DOR921 3 18 Jui YOI ADD WFI 1 A CF.S51'n0I / Or Of 1)W,yEP Tn Cn11TH h(7TA4' - f SURVEY OF LOT 75 AMENDED MAP A OF NASSAU POINT FILE No. 158 FILED AUGUST 16, 1922 SITUATE NASSAU POINT TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000- 119-01 -03 SCALE 1 "=30' NOVEMBER 2, 2020 AREA = 51 ,495 sq. ft. 1 .182 ac. NOTES. 1. TOPOGRAPHY TAKEN FROM SURVEY BY STANLEY J. ISAKSON, Jr. LAST DATED OCTOBER 23, 2001 ELEVATIONS ARE REFERENCED TO N.G.V.D. 1929 DATUM EXISTING ELEVATIONS ARE SHOWN THUS:KKK EXISTING CONTOUR LINES ARE SHOWN THUS: — F.FL. - FIRST FLOOR G.FL. - GARAGE FLOOR T.B. - TOP OF BULKHEAD B.B. - BOTTOM OF BULKHEAD T.W. - TOP OF WALL B.W. - BOTTOM OF WALL LOT 74 y N O \ , p FOUND MDN. 501 .1 1 g N 78'42'110" E I FOUND M FOUND O / — _ ca� CONC. MON. I CONC. MON. / Q — 1, / 165.0' ,a 150' O \ ^ .° .. ° tic n 48.7' C ci 7 I \\ BLO k ` •I.w ;. ELGIAN BLOCK CURB �'`• ? W 1.0 \ 4 C CL e > 9'^ 12.3' w 1 1 \\ .GRAVEL DRIVEWAYr;ri� ♦` w." / \ \ OOL t U .. •• , .. >- > N ao o/ o o I / / N SPEP ///�� U \ I �^' N ww.,. • b .SEPTIC TANK a o� u r ai x3 / COVER .i •a ' .. ° o o ° O S o y J J$ : a •9:;. ROOF OVER 20.7 �W ( 5.2'IHIGH VINYL FENCE ON SLATE WALL CESSPOOL ` �3 ~ 3 II I ISI / o CONC. APRON•i' Vl l,p I I i / ' N r T.W. 3.6' � T.W. 2.6 a 4.3' v �o V I LOT 75 T.F. 8.8' I GRASS AREA m T.F. 7.9' : COVER • a �• 111 NMN ry n1/� 'N ,-• V Z ',a...: - w) 28.3' n O M M\ 1 l I �d 02 1 55' _ 16 WALL & FENCE HEIGHT LEGEND 1.0' INGROUND POOL o •�_e. o FRAME 4i I HEIGHT OF WALL ABOVE GRADE:T.W. X.X' " °'. / a• m 40.4' N \ j , M !� w� I HEIGHT OF FENCE ABOVE GRADE:T.F. X.X' VINYL ;.,•, : : l.o' GARAGE / �\ \\\\\ \\\ 1 I I mI oi / W I ARBOR ', :. in \ % I I SLATE ATIO TEPS 0/SLATE •;e a.. ! rn 28.3' I 1 \4 1 11 \\\\\\\\ \ \ ` 1 1OI m ti W e r \ T.W. 2.8' _ of W / BELGIAN BLOCK CURB 701 0 \ \ \ 1 1 I3I a CO T.F. 6.0' POOL WALL IS 81.0'/ J �� LAMP I o n / \\� / 1.D' WIDE + i + Tf POST UNDERGROUND �, i� ' / \ \ \ \1\1 1 I 1 I < O 0 I ml POOL EOUIPM/NT �� I of .,_ LP TANK CAPS wl II \1 1 11`1 1 1 111 1 1 2 VINYL FINCE VN o o' I ON GRAVEL �� o Io v:w ° 167.8' I 297.4' ON SLATF�WALL iN r FOUND I coQ4 V 1 FOUND / I FOUND CONS. / CONC. MON. 12 9.O co CONC. MON. /� M MON. 0.6'S. POLE S 78-42'10" W M N LOT 76 Bldg Dept copy from ZB -H Final reviewed d Date: � C ZBA File./ -7V1 w0 t` II F-• PREPARED IN ACCORDANCE WITH THE MINIMUM STANDARDS FOR TITLE SURVEYS AS ESTABLISHED BY THE L.I.A.L.S. AND APPROVED AND ADOPTED FOR SUCH USE BY THE NEW YORK STATE LAND �p TITLE ASSOCIATION. SUNRISE LOAD ( 25 -4- or r�9 d N.Y.S. Lic. No. 50467 �. . UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 LAW.OF THE NEW YORK STATE EDUCATION LANathan Taft Corwin COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR Land Surveyor EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. CERTIFICATIONS 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 Stanley Successor To: Sle J. Isaksen, Jr. L.S. h LENDING INSTITUTION LISTED HEREON, AND P A. In e 9 9nn L.S. TO THE ASSIGNEES OF THE LENDING INSTI— TUTION. Title Surveys y CERTIFICATIONS ARE NOT TRANSFERABLE. ys — Subdivisions — Site Plans — Construction Layout PHONE (631)727-2090 Fax (631)727-1727 THE EXISTENCE OF RIGHTS OF WAY OFFICES LOCATED AT MAILING ADDRESS AND/OR EASEMENTS OF RECORD, IF 1586 Main Road P.O. Box 16 ANY, NOT SHOWN ARE NOT GUARANTEED. Jamesport, New York 11947 Jamesport, New York 11947 4-262 NEWK Y 0 Wiprkers' ORCERTIFICATE OF SST TATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board Ia.Legal Name,&Addriss of lnsufifluie street address only) ib.Business Telephone Number of Insured Patricks Pools Inc 631-996-4687 PO"Box 3024, East buogiie NY 11942' I c.NYS Unemployment insurance Employer Registration Number of Insured Work Location of Insured(OnIktequired if coverage is specifically limited to ld.,Federal Employer Identification'Number of Insured or Social Security certain locations in New York State,1,0.,a Wrap-_Ub Pallcy) Number 262929943 2.Name,and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carder (Entity Being Listed as the Certificate Holder) wes6o Insurance Co Towh of SiiUtfiold� 54375'Main Rod 3b,Policy Number of Entity Listed in Box"13" Southold NY 11971 VVWC3349994 3c.Policy effective period 0511 3/2 01 8 to 05/13/2019 3d.The Proprietor,Partners or Executive Officers are included,(Only check box if all partnerstofficers included) all excluded or certain partners/officers excluded. This,certifies that the insurance carrier indicated cated above in box"T'insures the business referenced above in box"1 a"for workers' compensation I under the New State Workers'Compensation Law.(To use this form,New York,(NY)must be listed under ftem-3A on the,INFORMATION PAGE of the workers'compensation insurance pol I ley). The Insurance Cairier or its licensed agent will send this Certificate of Insurance,to the`entity listed above as the cerfiricafe,holder in box"2". ill'the carrier', otify-the ceitificatii holder within 10 days of a policy being cancelled for non-payment of_premium or within 30'dalys if -cancelled for any other reason orifthe insured,is,otherwise eliminated from the coverage indicated on this certificate prior to the end of the policy effective P'qrlod! EYES ENO _' This certificate is-issued as.s matterrights of'Wormation only and confers no upon the certificate holder.This certificate does not amend, extend or after the coverage affordedby,th6 policy listed,nor does it confer any rights or responsibilities beyond those•contained,, in the referenced policy. This certificate may be used as evidence of 6 Workers'Compensation,contract of insurance onlywhile the underlying policy isin effect. Please Note:Upon cancellation c4 the workers'compensation policy indicated on this form,it the business continues t6,be named on ip�ehnkt,licenie or contract issued by a certificate'holder,the business must provide that certificate bold i er with a Certificate of Workers'compensation Coverage or other authorized proof that the business is complying with the mandatory andaitory 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'thatthe-named insured has the coverage as depicted on this form. Approved by: �Nich6l6s,Zulkoftke (Print name o a horized representative or licensed agent of insurance carrier) Approved b 7—d (Date) Title;Authorized Agent T06phone Number of authorized representative or licensed agent of insurance carrier. 62'-941-4113 Please Note:'Only insurance carriers and their licensed agents are authorized to issue Form C-105.2.Insurance brokers ate,,Wr authorized t6'issue it C-106.2(9-16' wvrw.vii6l:i.ny.gov APPROVED AS NOTED DATE: 3 By.g J46 t -• FEE:+, ,_ BY: RETAIN STORM WATER RUNOFF NOTIFY BUILDING DEPARTM TAT r 765-1802 8 AM TO 4 PM FOR THE r PURSUANT TO CHAPTER 236 FOLLOWING INSPECTIONS: OF THE TOWN CODE. 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. v "B r IATELY" .ENCLOSE POOL TO CODE b,,fdN,COMPLETi6N, B�P�RI�';�IATER' COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED AND CONDITIONS OF -�8�#9EB-�F9VdN�9�r ARD �@tlfil#8t6 t6tltfl�T�tfS�EES ELECTRICAL INSPECTION REQUIRED OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF-OCCUPANCY i. 0 Y 77755 ;.-S;Su35;. , "".%;,,._...._--^;\_`__—r;,.vv�`.issr>,`3`,k�"f�i..-y �a`.'�,v.:+;`i& •.Ysrs' "�iYi +• ;a" i'` f';-1 SO 41 1 «r JOY a �� C0ton Ftchn�, kp,;,--a�C�P mc,:r� rAcm;tom, r w rp< t i; _ s,.`X3^' �^a':r_f—_�.W.w�yrrR:�l+�,�E,• ;sw+'f;.?_' ..r..c. r:,;t��t;,'x5< t as' •s »iw: �..j.,, at�.L's.�:.�.-.�....�':..,'^e*+`4`�''ki1,e`Xv�-:`:";='•�i �.:L^.-, >d.�� ...... .:�£;.czy_"',,r=� �i R 7*171 7_71717 7?14 1 0 w"le 6 vimkon� is MOAT A �o�of nnorcoc. co fn 3� far {;ove_C �'• -�` I (`fJ� [o)fS &Com" ai ct1�c ��QateU\ t�� Y �11(7u (0 Gvr<t dei �- 6ea'r`� 6" OC, vQ.IeS��Eu,h ov�� 5' �� ioaCS Wa4\,e. A —(Jos G0tcn • �„�� 3��;�tS wct2��> � #tt �� - {� coyet cDc�-.5 goal ovalvw- Come QC D�M\ t1 Nems tntat kn Scc*�T � ,k�0r` suf , b�{M,�1 .� pfnqn �Mokoc�. oC", _ Ao 'MCb�cG c�Yf� 8 S►l �n Q _ r r\. � B� {� ,.�cfitkRenatY+CBP p ate 5P X500 Off` �Q e �1 Q4f14fi5I019 \t� f 1,J�,l 57' .7 "i, if 14 vc tv If AU. 1"'NO "A7 ryt vV -jk ,a" AAnizY- �kvll ----- ..... 3 F Kit 't lo MA 06 0 _T. 1011, 00\1 &J,a "n 61 IREDiy a I I I Jill// guildin qirop5e_� Nak �p RAW o v 7Z CL TA ZV rho ASSOOMOOn Of s,. 89 Patrick Kenney,CBP CERTIFIED SINCE 2013 EXPIRES2010 t• Y _1C Poll