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HomeMy WebLinkAbout48747-Z .w TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE 0' 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#: 48747 Date: 1/18/2023 Permission is hereby granted to,- Chilton, o:Chilton, Alexander 86 Belden Ave Dobbs Ferrv. NY 10522 To: Construct gunite swimming pool addition to existing elevated deck as applied for, with flood permit, Trustees #10238 and DEC approvals. *,,Nome- existing spa on deck must be legalized. At premises located at: 105 Waterview Dr Southold SCTM #473889 Sec/Block/Lot# 78.-7-9 Pursuant to application dated 12/6/2022 and approved by the Building Inspector. To expire on 7/19/2024. Fees: SWIMMING POOLS -ABOVE-GROUND WITH REQUIRED FENCING $250.00 CO- SWIMMING POOL $50.00 Flood Permit $100.00 Total: $400.00 Building Inspector � TOWN ON SOUTHOLD— BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold, NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 httL)s://NvNvw.soLitholdto\vnnv.gov a Date Received APPLICATION FOR BUILDING PERMIT T, . I For Office Use Only �V, l`r, V � l� � �� fig R. PERMIT N0, Building Inspector; fl)[V P, Applications and forms must be filled out in their entirety. Incomplete N1 pP Y10 1 :D applications will not be accepted. Where the Applicant is not the owner,an � (Page 2)shall be completed. Owner's Authorization form-Pag LD Date:5-26-2022 OWNER(S)OF PROPERTY: TOWN OO Name: Laura Chilton SCTM # 1000-78-7-g Project Address: 105 Waterview Dr Phone#:646-334-5620 Email:laurahirsch@gmail.com Mailing Address: 105 Waterview Dr, Southold CONTACT PERSON: Name:Tortorella Swimming Pools LLC Mailing Address: 1764 County Rd 39, Southampton, NY 11968 Phone# 7373Email: mabdo@tortorella.com ......631 -283 DESIGN PROFESSIONAL INFORMATION: Name: Nigel Robert Williamson Mailing Address: P.O. Box 1758, Southold, N.Y. 11971 Phone#:631-834-9740 Email: _- nl elarchitect@hotmal g Isom CONTRACTOR INFORMATION: Narne.Tortorella Swimming Pools LLC g 17x74 Count Rd 39 Southampton,Mailing Address: Y NY 11968 .. . �_ 631 2$ _� ,__..�. .._ tEmail: Phone #: 3-7373 Mabd@tortorella.com DESCRIPTION OF PROPOSED CONSTRUCTION AgNew Structur.. LAddition t.]Afteration F]Repamir 1- ` Q L]Demoiition Estimated Cost of Project;: [I Other prop ed 1Wx32 yunile pool on exislinq pies s �`274,282,00 i_. Will the lot be re-graded? [ ]Yes (_7No - Will excess fill be removed from premises? ❑Yes El No 1 PROPERTY INFORMATION Existing use of property: Residential Intended use of property: Residential Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to R-40 this property? ElYesigNo 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 210.45 of the New York State Penal Law. Application Submitted By(print name):Jackie kopcho RAuthorized Agent ❑Owner Signature of Applicant: Date: 5-26-2022 STATE OF NEW YORK) SS: COUNTY OF -e- Laura e-Laufa Chilton being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)he is the Jackie kopcho - Tortorella Swimming Pools LLC _..._.....,�._....,m_m....._�__.�.. �..�__.�.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/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 LIM KIN A. ��`�� 20 1- Notary Public,State of Now York a day of. ._ ...__a.. ..a._ _ ,.-_..w. �..�< _ ._ No. OIL16144154 Qualified In Westchester countyotary Public Commission Expires Apr. 24, 204 PROPERTY OWNER AUTHORIZATION W«ere the applicant is not the owner) Laura Chilton residing at 105 Waterview Dr, Southold Jackie kopcho - Tortorella Swimming Pools LLC do hereby authorize „ to apply on my behalf to the T +;wn of Southold Building Department for approval as described herein,. 5-26-2022 Owner's Signature Date . .-A pea ?.. Print Owner's Name 2 Building Department Application AUTHORIZATION (Where the Applicant is not the Owner) 1. residing at vJ 04RV-0.0-Wv a)t,-e_ :::> ­­_­­ ...................... ownoi`s name I',, t- ,Print propert,, (Malling AGUreSS) ry do hereby authorize -Jackie kopcho (Agent) I ortorella Svvirnming, PoOls LLC to apply on my behalf to the Southold Building Department. 2- (Owner's Signature) (Date) aiwa &k)' ) . ...... -------­­­ -------- (Print Owner's Name) LIM KIM X NOWY Public,State of Now York No. 0IL16144154 Oualiffed in Weewhostsf County 1 Commlsolon Exp1res Apr, 24, 20 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Division of Environmental Permits,Region 1 SUNY,-&Stony Brook.50 Circle Road,Stony Brook,NY 11790 P:(631)44403651 F:(631)444-0360 www.dec.ny.gov April 14, 2022 Laura Chilton 86 Belden Ave. Dobbs Ferry, N.Y. 10522 Re: Permit No. 1-4738-02838100005 Facility: 105 Waterview Dr., Southold, N.Y. SCTM# 1000-78-7-9 Dear Permittee: In conformance with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing regulations (6NYCRR, Part 621) we are enclosing your permit for the referenced activity. Please carefully read all permit conditions and special permit conditions contained in the permit to ensure compliance during the term of the permit. If you are unable to comply with any conditions, please contact us at the above address. Also enclosed is a permit sign which is to be conspicuously posted at the project site and protected from the weather and a Notice of CommencementlCompletion of Construction. Sincerely, ns� Mary acKinnon Environmental Analyst 2 cc: John Tortorella, Bureau of Marine Habitat, File � 1 1GRX wwwxu wrw Oepert rwent cti `"" Fnvironunerta'i za onsery tion b M NEW YORK STATE DE1 O!rMENT OF ENVIRONMENTAL CONSERVATION Fiellity DEGID 1-4738-12839 PERMIT Under-the Enw ronM ntal C6nsoe r tiota Law (ECL) Permittee,and Facility'Information Petmit)issued To Facility: LAURA:CHILTON C.HI ..TON PROPERTY 86 BELDEN AVE 105 WATERVIEW DRISCTM# 1.000-78-7- 9 DO.BBS FERRY;.NY-10522 SOUTHOLD, NY 11971. (645) 334-5.620 Facility Application Contact: -i TORTORELLA CUSTOM GUNITE POOLS 1764 CO RD 39 SOUTHAMPTON;NY .11968 (631)2834373 Facility Location: iii.SOUTIj,OLD in SUFFOLK COUNTY Facility Principal keference.PoInt. NYTM-B.,. 716.439 NYT 9-N: 454:6.609 Latiitude. 41102131,0°' Longitude: '72125'29.$"' Proj ct U6cation: 105 WATER IEW DR., SOUTHOLD SCTM410.00,-78 7-9 GOOSE CREEK .Authorit ed ActMty:. Install A 1.602" poel witldn existing:patio, .Add a dry 11 f r poral waste,water.. E0ablisIv41.0'wide non-disturb s butler with native silt tolerant plahb',ngs located north of the.hor se. and driveway south of the tidal wetland..boundary. All wore,must be done in accordanee�v ith tht plan prepared by Kenneth M. Woychuk LS last:revise 3!412022 and statped NYSDEC approved 411.412022. Permit Authorizations Tidal Wetlands -Under Aitilc 25. 'ennit lD 1-4738-0 38/0.O0 New Permit Effective Date; 4/14/2022 Expiration Date: 4/1112027. NYS]DEC Approval By acceptance of this permit,theperini tee agrees that the permit is contingent upon,strict compliance with the ECL,,.all Applicable regulations,And all co..nditions included as part of this. permit. Permit Administrator: SHERRI L AICHER,Deputy P+ertnit Administrator Address: NY DECA-cgion 1 Headquarters SUNY @ Storry Brnokj5Q Circle Rd Stbily aBtnok,NY'.1.1790 -3400 Authorized $giiaturc: Date Page 1 'of 6 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION -Facility DEC ID 1473842838 Distribution List J-TORTORELLA CUSTOM. GUNITE POOLS Bureau of Marine Habitat Protection File Mary MacKinnon, innon, PermiI-Compo,enO NATORAL RESOURCE PFRMJT CONDITIONS GENERAL CONDITIONS,.APPLY TO ALL AUTHORIZED PE TS NOTIFICATION OF OTHER PER TirrEE OBLIGATION'S, ..... _._. NATURAL RESOURCE PERMIT CONDITIONS - Appiy to. tie k'oilo�ving Permits: TIDAL WETLAN S t, Past I'er mit Sign The etmit sigrt enclosed with this permit shall be posted in a conspicuous location ion the worksite and ade rta eiy protected ft-'Om' the wwaeather. 2. Notice of Conor rencewent At least 4&hours prior to-connmencement.of the project, the permittee and.oontractor:shall;sign and re' the op por�tipn of the enclosed irotificatiortfoirm cettifyirig,that they are fully aware'of and understand all'terms and conditions of this perrrtitM, 'Wittlin0,days of completion. ofprojeot,the bottom portion of the-form must-also be sign(,-4 and rettimed,along withphotooap'ts o the completed work. A. Confdrmahce With Plans .All acti ities.authonb,ed bythis' ermit.rnust be in strict conformance. with the approved plans su tn�it ed by the applicant,or°applicant's ageDt,as psrt of'the permit..apltlic�tlon. Such approved alatrs were pre a cd b T enneth l"�w'l Woychuk,LS last tt ised 111"� std sped. NYSDEC approved 4/1412022. 4. Concrete Leachate During construction, ,o wet of fresh 0norete or leachate shall be allowed d to escape into arty Wetlands or Waters of New York State nor sball washings from, ready n-i ed concrete trucks,mixers, or other devices be allowed,to enter any wetiand or waters. 'Only watertight ox waterproof forms shall.be used: Viet concrete.shall not be poured to displace.water Within the forms. 5. No Coirstr action D16bris ba Wetland or Adjacent Area Any debris or excess,material from, ecansiTuctio, Q,f'lltis projeot,slrall, e eornplet ly rcmoved froa, tho adjacent,ar'eaa(upland)and removed to ah approved upland area for disposal. No debris is permitted in wetlands and/or protected buffer areas. Page 2- of d NEW YORK STATE DEPARTMENT OF.ENVIRONMENTAL CONSERVATION SO F-acility DEC ID 14738-02838 6.,MAteriAl;sDisposed,at Upland Site Argy demolition,debris, canes ',colistrllc,tio�n,mater i6is,A,nd/or excess excavated nia,torials shall be immediately and completely disposed ofin an authorized solid.waste management facility. These materialse7"s ,shall buitably-stabilized as not to re-enter any Watoi bo,d' Wetland':or wetland-adj aeont'area, 7:.No Disturbance to Vegetated Tidal Wetlands There,shall be no disturbance to vegetated tidal a wed-ands'or protected.buffer areas asa kes li.of the perri'tted activities. 8. Storage of Equipment,Materials: The storage-of-construction-equipwent and materials shall be L c0fifined within the project`work area aridlar upland areas greater than 75 linear"feet from th6 tidal wetland boundary. 9. Seeding Disturbed Areas Allareasofsoil dis.turbance.,iesiliting.frgpi the* approvedpr1biect,shall be stabilized with apptopriate Nieg.etatioft-(grasses-, etc.) immediately following project completion or prior to permit it expirat.ion,:whichever comes-first., IT the.project site.xemaiils-jaactive for pare-than 48 hours orantmgis ii-Apractical due:tor the,seagon,theft the,area shO be stabilized with straw.of hdymulch or pi ," . Jute matting•until weather conditions favor gPiTnination. m. No Unauthorized Fill' No fill or backfill is authorized by this permit out further4ritten perm with approval from the depaitmetit(permit,.modi-fication, amendment), 11, Long-term"Piant,Survival The area 10'.1andwv.d of the tidal wetland boundary shall be planted' with native. sl4llttol,era4tvdKemiethMW y ychuk,LS las geta�io�asi�erplaiisb O -r v* ed 3/4/2022 and -... t eis stamped NYSDEC approved,4/14/2022 and the'pehnittee-shall ensure a mi.mmum.of.85% survival of plantings by thp,epd offivd growing seasons. Jf this goal is-n6t met,the oamit holder-shall re-evaluate the restoration,project,in order to deterinine how,to,meet-the mitigation:goal and submit plans.to,be approved by the.office of Marine:Habitat Protection NYSDEC Regio ji I Headqu lart ei7s SUN .Stony,13rookJ50 Circle,R d Stony Brook,NYJ 1790,-340,9 12. Install, Maintain Erosion Controls Necessary erosion co' nW,mbasures,i.e.,steaw bales,silt fencing, etc., are to be placed o the downslope edge of anydistuibed'area. Thig.sediment barrier is to be put in place before any disturbance of the gToundoccurs and is-to'bemAinig-ned in good and functional-condition until thidk vegetative cover is established. 13. No Dryw. 6118 in or near Wetland Dry wells for pool filter ba6kwash:shall be located.a minimum. of 75 linear feet.landward of the tidal.wetland bouhdary. 14. No Pool DistliArge's,to'Wttland- There-shall .be no draining of swimming.pool water directly or indirectly into wetlands or protected buffer areas. ts, Contain Exposed,Stockpiled Soils All disturbed areas where soil will be temporarily exposed by stockpiled for longer than 48,hotirs.shall be contained by a continuous line of staked hayboJeS silt curtains,(or other NYSDEQ approved devit6s)pj�c6d,on the seaward side b otween the till and the wetland or protected buffer,area. Tarps are authorized to supplement these approved methods. Page 3 of 6 NEW YORK STATE DEPARTME'NYOF F.NV.IRONMEENTAL CONSERVATION ON 461 Facility DEC ID 14738-02838 16. Maintain Erosion Controls All,ero§ion:Control deviQps.shall be-maintained in.good-and functional condition.until the.pi oj oct has been completed and the area has been.stabilized. 17. State Not Liable for Damage The State of New York shall.'In-no-oase.be liable for any damage or injury to the structure or work herein authorized.whichmay be daused by or result Born future operatioits-- -f r for other purposes, and no undertaken by the.State ot the conservation improvement of navigation,o claim or rightto compensation.shall-accrue fi-o rn any such.damaLre. 18. State May Order Removal or Alteration of Woek If future ope"tations by..the State of New York require an alteraiion.'In the-posit-ion.of the structure or work herein authorized,,or if,in the opinion of the Department of Environmental Conservation" ,it sha"ll 6du§&uiuzagon I" bbstrtictionto the free navigatione of said waters-or flood- ows,orendanger the saf6ty or welfare f the people of the State, . cause lossor destrUCtibn of the natural resources of the-S.tate,tyreownerbe ordetedby'the Depart'rhentio ' I remove or aftei the structut at work-',ob.4tractioris,-or hazakL 9 caused thereby,witboutexpense to,the"State, and if, upon the expiration or revocation of this permit, the structure. -fill,excavation, or qffier modification of the'w4t0dowser here byzuthoriz;pd'shall hot beconipjeted, the owners, shall,without expense to the State,sold to such extent and in such time and marincr as the Department of En' vironmentalQ,orservation may require, rexnove'all or airy Portion,of tyre;upcqmpleted structure or fill dfid restore.to'its fornler condition the na-vigable.and flood capacity of the watercourse. No claim shall be made.against theState-of New York on account of.any such removal or alteration. i.q. State M',ay Require Site Restoration, Tupon the,eXpiration orie-Vocation,of this permit"III& Project hereby authorl2cd has not been completed,the applicant,shall, withoutexpenseto the Stato, and to such extent and in such time,and,manner as the'Department of'.8nyi�onmental Conservation,may lawfuily-touire,'remoVe I alfor'ahy portion' of ihc uncompleted-structure or fill and restore the site to.,its 'former condition. No claim,shall be made against to State of New York ori,account.of any such removal or alteration. .20. Precautions,Against Contaiffination'of Waters All-necessary precautions shall b-etaken to preclude contamination of auywptland or waieylwayby. suspended solids, se-dii-ndn%, (gels, solvents, tub iticahts,cpdxy dbatin'gs,paints,concrete, leachate or any other environmentally deleterious materials as soe i ated with the p;r0J eci. Yage 4 of 6 roNEW YokkSTATE"DEPARTMENT OF`ENVIRONMENTALCONSERVi#�ION Facility DEC ID 1-47.38-02838 GENERAL CONDITIONS - Apply to ALL Autheriked Permits: t. Facility Inspection by The.Dsepa tment The permitted site or.facility, including relevaaat:recoi* i :- subject to inspection at reasonable flours and intervals by an authorized rgyesent66,e of the Department of Environmmntal CohservMian.(the Department) to'determine whether the permittee is`comolying:with this permit and'the:ECL. Such representative may.order-the work:suspended pursuant-to ACL 71-.0301 aiad.SAP&-441_(3);; The perrpittee shall.piovide a person to accompany the Department's rcpreseritative.during an irisp.ection to the permit area-When requested by the Department. A copy of dais-permit,.iiialudiug.'all referenced maps..dra wing$ and special conditions,must be available- for inspection by the.Department at all iirnes at the project site-or-facility. Failure to.produce a copy of the permit upon requesi by a Department.representative'is a violation of this:pe it. 2. Relationship o€this.Peri nit,to Other Department Orders acid,Determinations Unless expressly provided for by the,Depar:tment,issuance of this permit does not modify,supersede or rescind-any order or determination.previously issued 6y,tlie Dep ent-or any of the terms,:Condit bris or requirements contained in such order or detefinination. I-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'th s permit. each application must iaOude any fortes orsupplem. eiital infbn ation.the Department requires. Any renewal,modification or transfer granted.by the Department:must be in writing.. Submission of applications fot permit renewal, modification or..transfer are_to be-submitted.to: Regional Flernik Administrator NYSDEC Region.l Headquarters SVS' @,Stony Brook) 0 Circle Rd Stony EroAk NY'11106 -3409 4. Submission of Renewal Application The permittee must.submit.a:renewal application at least 30 days.before permit expiration for the following pennit authorizatioiis:.Tidal'Wetlands. 5. Permit-Mo.difieations, Suspensions and.Revocations.by the.Department The Deparirnent.. reserves the rigtat to exercise alt-available autlro ty ,tomodify, suspeiidor revoke this permit. The grounds-for.. modification,:suspension or-revflcation include: a: inatetiaily false or,inaecarrate statements in the permit application or supporting papers;. .b, failure by the-permittee to comply with any terms_orconditioris of the.permit; G. exceeding the scope of the project as described in.the.permit,application; d-. newly discoveredmaterial information.or a.material change in environmental conditions,-relevant technology or applicable law or regulations.since the issuance of the existingpern. dlt-., Page 5 of-6: NEW YORK-9TATE'DEPARTMt,,MT'0F ENVIRONMENTAL CONSERVATION Fa.qity.DEC JU 1-4738.0OM8 e.. noncompliance with-previotisly issued permit conditions,orders of.the commigsioner, any provisions ofthe Enviropmqptal Conservation Law or regulations of the Depotment-.rel.aied,to. the permitted detivity. 6.'P:"Permit.Tran 1e. Per.mitsarqrjxansf.errable pWess specificallye6fiWly prohibited lay statute,Kegplatlop or another pbrrritcbndi1ionApplicalibns fox permit transfer should be submitted pti*0r' to Actual transfer Of ownership. ............. NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS Item.A:,Permittee-Accepts-Legal Responsibility and.Agrees to Indemnification The permittee;ex'c'Opting-'sitate ot--fedetal agencies-, expressly agrees to indemnify andhold.harn)Jd§s the Department of Environmental Conservation of the State.*Of New York, its representatives, (miployees, 6' ' &,s,.to the,extent attributable to the and agents("DEC".)fqk all,clairn�s-, suits,.actions; and dam4 permitteds gets:or 6n' u­ssiO:n8 in'conftection with the peffnittee's,undertaking of activities in connection with, or operation and maintenance of,the,fiacility or,facilifies-aud,iorized by the permit whether in. compliance or not in com�olkatiee with the terms 6W.condition§of the permit. This indemAif101tioti 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, ims. suits, or-actions'nami.ng the DEC and arising under Article 78 of the Now York Civil Practice Laws and k-dies or Any citizen suitor civil rights.pidvision- under,federal'or-state laws. Item.W Permitteef s:Contractorg to Comply with Permit The-permittee is responsible f6r informip its indepeft&nt contractors, employees,agents d assigns of . ,g, . . gentan . . . . ss their responsibility to comply with-thig permit, including all special conditions while acting-.as the permitt.ee's agent with.respect.to,the permitted activities, and such persons shall be subject to the same safictio'ns for-violations-.of the EnVirohmental Cbnsei Vation LAW As those:preskribbd for the permittee. Item C., Permittee RespopsiMe for ObtainingOtherRequire.d Permits 'The permittee is re,st)onsible for obtaining any other permits, approvals, lands', easements andrig' htgror- way tbAt may be.reql4ired to carryout the aefivitiesthat are authorized by this pprinit. Item P: No Right to Trespass dr-hiterfere,with Riparian Rights This permit does not convey to the permittee any right to'I"respass upon the.lands 0'r-Aiiterfere,with the riparian rights of others in order to perforin the-permitted-:work ji&does it authorize the impairment.of :any rights,title, or interest in-real or.personal property held or vested in a person nota party to the permit.-. Page 6 of 6: -0 a) U o 0 _C C cu E N .� c 0 .� 4-1 c CC .0. U .� 0 G 0Q 4- , C� + . 0 f -v J a., Y YYY� .E LIU D. 0 o� C M cc 0 � �. — - v , �, Y� � a Q3 E 0 . 0 0. 0 ,Et. `0d a LU E- .._, �. a. Q Q o. cu C C Q) •N z t: C: o •o ,r p > . N' U ,> o v �. Q) "0 U C'7 N z U LL -0 0' 00 W +� > < p 4-... 0 0 N N O N. CL L-. 3:- M 0 D (6 0 C .E w .+- 0 m 0 0 C, -C o m Q. .-� Q3 4-.. •0 (D 0- 0 E K0 L C} (U '�w. C a W �, . ,,,, 1... SY!A `rL'kd"Yy sD Xl ''w""12%19''"�f1171 Wur^mf%G'reN"YY�"YYm�n`✓rvinrd'Y'p^v � y I ". BOARD OF SOUTHOLD TOWN TRUSTEES ' SOUTHOLD,NEW YORK PERMIT NO. 10238 ! Mr. DATE: OCTOBER 19 2022 r" ti ISSUED TO: t� LAURA CHILTON w r PROPERTY ADDRESS: 1.05 W TER"G"IEW r%Dn7E SOUTHOLD r SCTM# 0-00-78-7-9 µC AUTHORIZATION pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in yof accordance with the Resolution the Board Of Trustees adopted at the meeting held on October 1� . �� �?, acrd � I,r in consider°atron of application fee in the surn of�0 Q paid by I-aura. Chilton and subject to the Terms and ! ��,,,� � � Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the � following: � i "wetland Permit to install a 16'x32' swimming Pool with 12"coping on existing seaward side deck and pile, existing 52'8"x40'0"deck situated 12' above grade to remain and a "a high handrail in all deck parameters to remain; for the existing1,39 " existing 3 tg � sq,ft.of to ground; and existing 7'x7' spa to remain; establish and perpetually maintain a 10' wide non-turf buffer with the area,seaward of said buffer established and perpetually maintained as a non- disturbance area; and as depicted on the revised survey' �" prepared by Kenneth M. Woycltuk � �i' Land Surveying, PLLC,last dated November 4,2022, and stamped approved on November 17, 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 day and year first above written. ' 1 ! r 1 y law I " 8 m) L F Y ,/ , ���il�Yuµ�lU x✓,�4'�' xxG Sk#rLfAM�I�AAt"Nd 4AIfkQll� 18t�Yi ..— � '."aayMMa�J 'WU d'GW'aa,yy�agar ' '� ,r G»VWFpi�Gi'w�qffiGf�aPb;',.INwhll90�NCdoYd.Vb.�' x rtaaam f� ViOX' i1uvu �i V, a/ n M A Glenn Goldsmith, President µ Town Hall Annex A. Nicholas Krupski,Vice President t 54375 Route 25 Eric Sepenoski P.O. Box 1179 Liz Gillooly Southold, New York 11971 Elizabeth Peeples Telephone(631) 765-1892 Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD November 17, 2022 Jackie Kopcho Tdrtorella Swimming Pools LLC 1764 C.R. 39 Southampton, NY 11968 RE: LAURA CHILTON 105 WATERVIEW DRIVE, SOUTHOLD SCTM# 1000-78-7-9 Dear Ms. Kopcho: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, October 19, 2022 regarding the above matter: WHEREAS„ Tortorella Swimming Pools LLC on behalf of LAURA CHILTON applied to the Southold Towne Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated August 16, 2022, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinator issued a recommendation Consistent with the Local Waterfront Revitalization ProgrPolicy standards,amnd be found WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on October 19, 2022, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, ' 2 WHEREAS, the Boardhas determined that the project as proposed will not affect the health safety and general welfare of the people of the town, NOW THEREFORE BE IT„ RESOLVED, that the Board of Trustees have found the application to be Consisten Local Waterfront Revitalization Program, and, t with the RESOLVED, that the Board of Trustees approve the application of LAURA CHILT N to inst a 15'x32' swimming pool with 12" coping on existing seaward side deck and pile; existingall 5 "5"x40"0" deck situated 1 ' above grade to remain, and existing 3" high handrail in all deck Parameters to remain; for the existing 130s .ft. of stairs to ground„ and existing 7°x7" spa to remain; establish and perpetually maintain a 10''wide non-turf buffer with the area seaward of said b buffer s burse y d as a y pre tired b Menne p y Kenneth non-disturbance area and as depicted u er established and perpetually maintained November 4, 2022, and stamped approved on November 17„ 0, eying„ PI�LC lash daon ted Permit to construct and complete project will expire two years from the date the permit is si ned Fees must be paid, if applicable, and permit issued within six months of the date of this 9 notification. Inspections are required at a fee of$50.00 per inspection. (See attached schedule.) Fees. $50.00 Very truly yours, GleXGolds�ith4&�--i'4_X' President, Board of Trustees GG/dd 't �r II��III/I�M�IIINI�NM' ! , i Ap s 7 A i NEW YORx TTEI Board Compensation CERTIFICATE OF 1a.Legal Na NYS WORKERS' COMPENSATION INSURANCE COVERAGE e9 me&Address of Insured use street address only) 1b.Business Telephone Number of Insured Tortorella Swimming Pools LLC 631-728-8000 1764 County Road 39 Southampton,NY 11968 1c..NYS Unemployment Insurance Employer Registration Number of Insured Work Location of Insured(onty qui;red if cowerag�e is specifically limited to a cetfatrr local/Drys r New yk State,ie" a Wrap-Up polfcy) 1d,Federal Employer Identification Number of Insured or Social Security Number 87-3748207 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) The Town of Southold Berkshire Hathaway Homestate "town Hall Annex Building 54375 Route 25 3b.Policy Number of Entity Listed in Box"1a" Pn Box 1179 JTWC220096 3c.Policy effective period 12P, 2a r' t0 3d_The Proprietor,Partners or Executive Officers are included.(Only check box if all partners/officers included) all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box" "insures the business referenced above in box"Ia"for workers" compensation under the I�ew"y'ork State Workers"Compensation Law.(To use this forret,New N( York must be listed under Itearrt ) on the INFCDl2IN/IATION pAC of the worker"compensation insurance policy. The Insurance k(Carrier or is licensed agent will send this Certificate of Insurance to the entity listed above as the certiFrcate holder in y)."2"'7 The insurance carrier must notify the above certificate holder and the Workers"Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate te is valid for one he insured from the coverage indicated on this CertI ircate.(These notices may be sent by regular mail.)Otherwise,this piratiCertificatn date listed In box"31c"after whiche this rr Is earn er�avecl by the insurance carrier or its licensed agent,or until tate policy This certificate is issued as a matter of information only and confers no rights u pon the certificate holder.This certificate does extend or alter the coverage afforded by the policy listed,nor does it confer,,any rights o responsibilities ties beyond those cont'a nedtin the amend, referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note:Upon cancellation of the workers'compensation policy indicated on this form,if the business,continues to be named on a permit,license or contract Issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Workers"Compensation Coverage or other authorized proof that the business Is complying with the mandatory coverage requirements of the New York State Workers"Compensation Law. Herder penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insuredhas the coverage as depicted on this form. Approved by: August Felker (Print name of aulhorid reprarserstatiwe or licenser agent of insurance rrrice,,r) Approved by: 1/27/21 (Signature) (Date) Title: CEO Telephone Number of authorized representative or licensed agent of insurance carrier Please Note:Only insurance carriers and their licensed agents are authorized to i authorized to issue it. ssue Form C-105.2.Insurance brokers are NOT C-105.2 (9-17) www.wcb.ny.gov Workers` Compensation Law Section 57, Restriction on issue of permits and the entering into contracts unless compensation is secured. 1. The head of a state or municipal department, board, commission or office authorized or required by law to issue any permit for or in connection with any work involving the employment of employees in a hazardous employment defined by this chapter, and notwithstanding any general or special statute requiring or authorizing the issue of such permits, shall not issue such permit unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair, that compensation for all employees has been secured as provided by this chapter. Nothing herein, however, shall be construed as creating any liability on the part of such state or municipal department, board, commission or office to pay any compensation to any such employee if so employed. 2. The head of a state or municipal department, board, commission or office authorized or required by law to enter into any contract for or in connection with any work involving the employment of employees in a hazardous employment defined by this chapter, notwithstanding any general or special statute requiring or authorizing any such contract, shall not enter into any such contract unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair,that compensation for'all employees has been secured as provided by this chapter. C-105.2 (9-17) REVERSE BIGBRAN-02 , '1f' CERTIFICATE OF LIABILITY INSURANCE UATE(M 12022 YYY) __. ....... 5/25/202 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s)w _..........w PRODUCER CONTACT Olterle Risk Strateies,LLC PHONE "'" FAX 8820 Ladue Rd,Su to#3021 ) -.--......___ IAlcwNo�(636)391-0715 Saint Louis,MO 63124 uestions oberie-tisk.com Al No,Ext) 391 0700 INSURERS AFFORDING COVERAGE NAIC# ..... INSURER A:Hartford Fire Ins Co 19682 INSURED INSURER B:Berkshire Hathaway Homestate Insurance Company 20p" Tortorella Swimming Pools LLC _IN§y"R c 1764 County Road 39 INSURERD: Southampton,NY 11968 _ m_............ . INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: _ � REVISION NIUIM/IBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ............�............._ ...... _.._.... � _. .. ....._, INSR ADDI,SUER' POLICY EFF POLICY EXP T TYPE OF INSURANCE POLICY NUMBER / LIMITS A X CO MMERCWLGENERALLIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCURD+AMAGETO RENTED 300 000 84UUNOZ9994 12/30/2021 12/30/2022 .I?itiy.Fu113 �F2sattl :i� $ , MED EXP Any one person $ 5,000 .,,_,.,,,-.-............... ............ w.. .. ... ........._.. ( )m,....,...-,..__._.._..........,............-.... _._ _. PERSONAL a ADV INJURY $ 1,000,000 _._.�_. - _.._ _ .__ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2 000,000 POLICY Fx_1 sT 1-1 LOC PRODUCTS-COMP/OPAGG $ 2,000,000' OTHER. ..... ......... ......... ........ $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO BODILY INJURY Perperson $ OWNED ._..-.. SCHEDULED ..----..I. !JUR .�..... .._-__.......-..__.,. AUTOS ONLY AUTOS BODILYINJU Y,(Peracoldent $ HIRED NON-OWNED (14fI P7PEF2'1'''DAMAGE. AUTOS ONLY _-.AUTOS ONLY accldlant) $ UMBRELLA LIAB '.. I OCCUR EACH,OCCURRENCEww,,,,,, _ $ EXCESS LIAB CLAIMS-MADE m - ... .... AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY YIN " ANY PROPRIETOR/PARTNER/EXECUTIVE .ITWC22OO96 12/30/2021 12/3012022ITm7,000,000. OFFf 't MF'MBER EXCLUDED? N/A E.L.EACH ACCIDENT $ _ (Mandatoryln NH) E.L DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe underE L DISEASE POLICY t.MI 1,000,000 DESCRIPTION OF OPERATIONS below LIMIT $ .......... .,.-_.. ........... DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) � . ........ ..... ............ CERTIFICATE HOLDER CANCELLATION. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE of Southold THE EXPIRATIO Town h N DATE THEREOF, NOTICE WILL BE DELIVERED IN Town Route h I ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 1179 -• �._. _. ..._. Southold,NY 11971 AUTHORIZED REPRESENTATIVE . ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ri sST K workers' CERTIFICATE OF INSURANCE COVERAGE STATE Compensation Board DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW PART 1.To be completed by Disability and Paid Family Leave Benefits Carrier or Licensed Insurance Agent of that Carrier 1 a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured TORTORELLA SWIMMING POOLS LLC 1764 COUNTRY ROAD 39 6312837373 SOUTHHAMPTON, NY 11968 Work Location of Insured(Only required if coverage is specifically limited to 1c.Federal Employer Identification Number of Insured certain locations in New York State,i.e.,Wrap-Up Policy) or Social Security Number 87-3748207 '2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Standard Security Life Insurance Company of New York Town of Southold tY P Y 53095 Route 25 3b.Policy Number of Entity Listed in Box"l a" PO Box 1179 R93027-001 Southold, NY 11971 3c.Policy effective period 12/30/2021 to 5/23/2023 4. Policy provides the following benefits: ❑)C A.Both disability and paid family leave benefits. ❑ B.Disability benefits only. ❑ C. Paid family leave benefits only. 5. Policy covers: ❑X A.All of the employer's employees eligible under the NYS Disability and Paid Family Leave Benefits Law. B,Only the following class or classes of employer's employees: Under penalty of perjury, I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has NYS Disability and/or Paid Family Leave Benefits insurance coverage as desc d'.above. " Date Signed 5/24/2022 By (Signature of insurance carrier's authors d representAve or NYS Licensed Insurance Agent of that insurance carrier) Telephone Number (212) 355-4141 Name and Title SUPERVISOR-DBL/POLICY SERVICES IMPORTANT: If Boxes 4A and 5A are checked,and this form is signed by the insurance carrier's authorized representative or NYS Licensed Insurance Agent of that carrier,this certificate is COMPLETE. Mail it directly to the certificate holder. If Box 4B,4C or 5B is checked,this certificate is NOT COMPLETE for purposes of Section 220, Subd. 8 of the NYS Disability and Paid Family Leave Benefits Law. It must be mailed for completion to the Workers'Compensation Board, Plans Acceptance Unit, PO Box 5200, Binghamton, NY 13902-5200. PART 2.To be completed by the NYS Workers'Compensation Board(Only if Box 4C or SB of Part 1 has been checked) State of New York Workers' Compensation Board According to information maintained by the NYS Workers'Compensation Board,the above-named employer has complied with the NYS Disability and Paid Family Leave Benefits Law with respect to all of his/her employees. Date Signed By (Signature of Authorized NYS Workers'Compensation Board Employee) Telephone Number Name and Title Please Note: Only insurance carriers licensed to write NYS disability and paid family leave benefits insurance policies and NYS licensed insurance agents of those insurance carriers are authorized to issue Form DB-120.1. Insurance brokers are NOT authorized to issue this form. 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