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HomeMy WebLinkAbout48818-Z TOWN OF SOUTHOLD BUILDING DEPARTMENT t TOWN CLERK'S OFFICE SOUTHOLD, NY x( i 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 #: 48818 Date: 1/31/2023 Permission is hereby granted to: North Fork One LLC c/o Geoffrey Prisco 256 Union St Brooklyn, NY 11231 To: Construct in ground swimming pool at existing single family dwelling as applied for. *Pool equipment must be located in the rear yard and maintain a minimum 15 foot setback from property line. At premises located at: 290 Windward Rd, Orient SCTM # 473889 Sec/Block/Lot# 19.-1-12.3 Pursuant to application dated 1/3/2023 and approved by the Building Inspector. To expire on 8/1/2024. Fees: SWIMMING POOLS -lN-GROUND WITH FENCE ENCLOSURE $250.00 CO- SWIMMING POOL $50.00 Total: $300.00 Building Inspector n TOWN OF SOUTHOLD—BUILDING DEPARTMENT a Town Hall Annex 54375 Main Road P. O. Box 1179 Southold, NY 11971-0959 sy� Iy Telephone (631)765-1802' Fax(631) 765-9502 hLt :�I�vrYvw.sooi ll<,�1�11c 11, l;(ly Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only �. PERMIT NO. Building Inspector: JAN 0 3 2923 Applications and forms must be filled out in their entirety.Incomplete Irll I applications will not be accepted. Where the Applicant is not the owner,an ItI' rig O Owner's Authorization form(Page 2)shall be completed. Date:December 16, 2022 OWNER(S)OF PROPERTY: Name:Geoffrey Prisco scrM#soo0-19-01-12.3 Project Address:290 Windward Drive, Orient, NY Phone#:718-809-9152 Email:gprisco@brutuspark.com Mailing Address: CONTACT PERSON: Name: Jennifer Del Vaglio Mailing Address:P.O.Box 369 PecorliC, NY 11958 Phone#: 631-734-7600 Email:Cj@eastendpoolking.com DESIGN PROFESSIONAL INFORMATION: Name: Mailing Address: Phone#: Email: I CONTRACTOR INFORMATION: Name:East End Pool King Mailing Address:P.O.Box 369 Pecon c, NY 11958 Phone#: 631-734-7600 Eman:CJ@eastendpoolking.com DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ❑Alteration C7Repair ❑Demolition Estimated Cost of Project: ROther 16x38 gunite pool $ 126,000 Will the lot be re-graded? *Yes El No Will excess fill be removed from premises? ❑Yes ig No PROPERTY INFORMATION Existing use of property: single family dwelling Intended use of property: single family dwelling Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to R-80 this property? ❑Yes ❑No IF YES, PROVIDE A COPY. 91 Check Rola After Reading: The own r/ ntrattor/design professional is responsible for all drainage and storm water Issues as provided I Chapter 236 of the Town Code,APPLICATION 1S,HEREBY MADE to Ow duI'Iding Department for the Issuance of a Building Permit pursuant to the Building Zone ordinante of the Town of Southold,Suffolk,County,Now 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 appitcable laws,ordinances,building code, housing code and regulations and to admit authorized'Inspectors on premises and to building(s)for necessary Inspections.false staternerrts made herein are punishable as a Gass A misdemeanor pursuant to Section 210AS of the New York State penal'Law. Application Submitted By(print name):Jennifer Del Vag lIo &Authorized Agent ❑Owner Signature of Applic Date: 12/19/22 CONNIE D.BUNCH Notary Public,State of New York STATE OF NEW YORK) No.01BU6185050 Qualified in Suffolk County COUNTY OF SS: Commission Expires April 14, 2NA ) Jennifer Del Vaglio being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named,. (S)he is the Agent/ Contractor (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 I" ( 4 day ofd C ? ° Notary Public PROPERTY OPERTY "I EIR,AUTHORIZATION Where the applicant is not the owner Geoffrey Prisco residing at Jennifer Del Vagl(o and/or East End Pool King _e do hereby authorize to apply on may o e Tow of So thoa-aijilding Department for approval as described herein. Owner's Signature Date Print Owner's Name 2 E A+ DATE(MMMDMM) CERTIFICATE 1 11/16/2021 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 holdjer is an ADDITIONAL N NSURED,the poll y(les)must have ADDITIONAL INSURED provislons or he 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 certifieate holder In lieu of such andorsement e). PRODUCER NBarbara Dammers fAle`. Roy H Reeve Agency,Inc. oNE i)'298-4700 PO Box 54 EMAIL A%,Nll� (631285-3850 ,3400 Main Road AISS• amens@royreeve.com MattltUCk INSURERM)AFFORDING COVERAGE N'AIC Id NY 11952 INSURER A c 'CNA insurance Companies INSURED INSURER 0: Continental insurance Co. 38289 Eastern End Pools LLC,DBA:East End Pool King INSURER C: Transportation Insurance Co 20494 P O Box 369 INSURER 0 INSURER E; Peconic NY 11958 INSURER F COVERAGES, CERTIFICATE.NUMBER: CL21111815751 REVISION NUMBED: 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE im POLICY NUMBER ':MOLI MCYNIFF oL LIMITS COMMERCIAL GENERAL LIABILITY EAt MW OCCURRENCE $ 1,0001000 CLAIMS-MADE ®OCCUR P MITO urD S 100,000 Contractual Liability 15,000 A Y Y 6080837145 11/15/2021 11/15/2022 MED EXP(!MAs parson S PERSONAL&ADV WJURY 5; 1^000,000 GENi'LAGGREGATE LIMITAPPLIES PER GENERALAGGREGATE S 2,000,()00 POLICY �`'—�PRO- L_J JECT LOC 2,000,()00 PRODUCTS-COMP/OPAGG OTHER 5 AUTOMOBILE s 1,000^(9130 a MI ANYAUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED 6080837159 11/15/2021 11/15/2022 BODILYINJURY(Par accident) S AUTOS ONLY AUTOS HIRED NON-OWNED OPE AUTOS ONLY AUTOS ONLY S P r nr S UMBRELLA ILIA OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE S' DED RETENTION°a 5 WORKERS COMPENSATION OTH AND EMPLOYERS'LIABILITY YIN STAT T R C ANY PROPRIETOR/PARTNERIEXECUTIVE 1 000 000 OFOCEMMEMSEREXCLUDED? ' NIA 6080837162 11/15/2021 11/1512022 E.L.EACH ACCIDENT S (Mandatory If yes,describe under In E.L.DIS ASE 1,000 SE-EA EMPLOYEE S 1,00D,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMB S 1^000+000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101.Ad dWonlal Remarks Schedule,may be attached N more space Is ro qutreds Certificate hotder is included as additional insured under General LiablNity as per the terms and conditions of form#CNA75079XX-Blanket Additional insured with Products-Completed Operations Coverage Endorsement, Form CNA74705NY-Contractors GL Extension Endorsement,NY includes waiver of subrogation 6 primary all non-conidbutory coverages as required by written contract or agreement. Additional insured under the business auto is Included under Form#CNA63359XX-Auto Contractors Extended Coverage Endorsement-Business Auto Plus. CERTIFICATE HOLDER' CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of Southold ACCORDANCE WITH THE POLICY PROVISIONS. PO Bax 1179 AUTHORIZED REPRESENTATIVE Southold NY 11971 ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD p� 80°02'40"E 30.20' PIPE Aa ED WELL Sh110 HEAD VM' ,F O O M h PIPE b� EO 3 W V N D N O OIi N DM 7SD a ',,,� FD o fi n"9 sg ta. CP w o ssep Jl F O 0 J 4 00 0 �O 21.7T J Y Ors i �Q .. 0.3`W w PIP �... ED co Dl VE& DESCRIBED PROPERTY ? 1�F/EF �$ SITUATE;ORIENT 040 TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK CERTIFIED TO' GEOFF PRISCO CCOPYgIGHT 202E WAgD EROOIIS.ALL RIGHTS RESERVED.DUPLICATION OFTHIS OOCUMEM IS A VIOLATION OF FEOEMI LAW. THISSURVEYHASB PRFPARFDINACCOROANCEV2PHTHECODEOFPMCT¢EADOPIEOSYTHENPNYORKSTATEASSOCWIONOFPROFf95KWALLWDSUWUORS. SCALE 1" 40' CERTIFIG—N SRA RUN ONLY TO THE PERSON,THEIRINTERFST ANMR ASSIGNS CERDF—N ARE NDTTAANSFERAEIE SCfM:1000-19-01-12.3 THE E%LSTENCE OF RIGHT OF WAY,ANO/OR FASEMENTOF RECORD.IF ANY NOT SHOWN ARE NOTGUARANTEED. SURVEYED:02/18/2022 ANYALTERATONORADODIONTOTHISSURVEYISAVIOLATION OF5E ONn09-2OFTNENEWYORKSTALE WUCATION LAW. d DO NOTSCALE FENCES,OFF—SUPERCEDE ND DORMERS,NO SOLAR 2R POOL LAYOUT:07/06/2022 LAND SURVEY LONG ISLAND.COM WARD BROOKS LAND SURVEYOR 11 OCEAN AVENUE - w BLUE POINT, NY. 11715 "' (631) 576-7794 (631) 363-3179 0731 ` WARDBROOKSO@GMAIL.COM FILE 111176 I