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HomeMy WebLinkAbout49118-Z TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE 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 #: 49118 Date: 4/13/2023 mmmm _ Permission is hereby granted to IDK Mansion LLC .104 Little Wood,. -.... .............................m.�. -.�...._.�.............................. _-................................................�_____........... _�..............._�................ ...............�..�_ Ln Beach, FL 33444- .._Y �. .. ... __...... ... .. To: Construct an in-ground swimming pool as an addition to an existing single family dwelling as applied for. Must maintain secondary side yard setback of 35 feet and rear yard setback of 50 feet. At premises located at: 105 Mill Rd, Mattituck SCTM # 473889 Sec/Block/Lot# 113.-3-7.2 Pursuant to application dated 11/21/2022 and approved by the Building Inspector. _ To expire on 10/12/2024............, Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $857.60 CO- RESIDENTIAL $50.00 Total: � $1,157.60 157.60 Building Inspector TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold, NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only PERMIT NO. 99 / 15 Building In pectonNOV 2 1 2022 Applications and forms must be filled out in their entirety. Incomplete Suomwa DE71E applications will not be accepted. Where the Applicant is not the owner,an Owner's Authorization form(Page 2)shall be completed. Date: ® ( Z� OWNER(S)OF PROPERTY: Name: K1 L til I SCTM # 1000-// Q 3 Project Address: 670 e r A L,vafc - Phone#: Email: KA Z�i(`i C © OL" .CG►M Mailing Address: k)" L- �' u \Noo d Ln , OtA rad r ea-&h i-33L4Li'l CONTACT PERSON: Name: &W,�-XV v S / oSdy-\ IS Poo Mailing Address: P6 (�6�1- "(AVr&t0V1 ga' J NI-4 tlj"u Phone#: JEmail: CJ Fl « CO 0"J 100C/1S .r!C+Vl DESIGN PROFESSIONAL INFORMATION: Name: Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: .......... _._.. Name: A- JI o Q04 S Mailing Address: V6 �-Y�i A 1 '� �,1 a Q�(1 Phone#: '3Ii -)NIS Email DESCRIPTION OF PROPOSED CONSTRUCTION R�ewStructure ❑Addition ❑Alteration ❑Repair Demolition Estimated Cost of Project: []Other :)rll vW xjdd $ U0 1 0.00 Will the lot be re-graded? ❑Yes o Will excess fill be removed from premises? ❑Yes levo 1 PROPERTY INFORMATION Existing use of property: v(t�,di nb llk Intended use of property: ILS dj Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? ❑Yes ❑No IF YES, PROVIDE A COPY. Check Box After Reading: The owner/contractor/design professional is responsible for all drainage and storm water issues as provided by Chapter 236 of the Town Code. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold,Suffolk,County,New York and other applicable Laws,Ordinances or Regulations,for the construction of buildings, additions,alterations or for removal or demolition as herein described.The applicant agrees to comply with all applicable laws,ordinances,building code, housing code and regulations and to admit authorized inspectors on premises and in building(s)for necessary inspections.False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the New York State Penal Law. Application Submitted By(print name): p- PUG 19Authorized Agent ❑Owner 9 Signature of Applicant: , Date: 2- STATE STATE OF NEW YORK) SS: COUNTY OF O15 G yt Vv\,IM_®V`-J being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)he is the (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 da y of 2 Notary Public�j ww � PROPERTY OWNER AUTHORIZATION (Where the applicant is not the owner) 1 �L/. ( l� residing at V �VVQ 1 � IpAg MAM do hereby authorize � � � V"V.M, CJM _ IJ- o apply on my behalf to the Town of Southold Building Department for approval as described herein. O gnature Date G Print Owner's Name 2 i` M (o)I TV[WAVCIEI . Scott A. Russell err SUPERVISOR -tti da v MANAGEMENT 5tJU1-H(DL1D TOIbN HALL-1'.0.Rn� 11. 9 " " ����a17 (�� ���t���� 53095 Maintiaad-SOUTHOLID,NEVY YORK 11971 �0, � � r�w,° CHAPTER 236 5._TOMWA'TER NIANAGEMENT REFERRAL FORM �.._..R _ .�..�. .._�......�.�..�..�- _ I j-'0R�iA T If!N 'f'0 BI t(;MI'LE-TE D R) •1'HF; AF'f'Llt ;�i� I ONLY FOIA HiOPERTIES ONF ACIZE IN ARI.._',,\ ��k LAKGf:Fi ) APPLICANT: ' perty Owner, Des .� _ �pro � Design Professional, Agent, Contractor, C)tl�er) mansio►I ta..e NAME. � � �.a_CDate. 3 1� Contact Info-1 natroh q N �r• ' ' I I Pt'tet � I n of Constri i ton Site: ert+� Adclt'es / L�catio. � .r° - d S.C.T.NI. r: 1000 a _ � 1 L�f..1: ,-t .._ � Lot TO BE COMPLETED BY SOUTHOLD TOWN ENGINEERING DEPARI-NIENT 3Area of Disturbance is less than I Acre. No S.t'.D.E.S, Perrltit rs Re uir ed! µ Prctect r>• does Not Discharge to Waters of the State. d ' E] - Area of Disturbance is Greater than I Acre ti to wztc3 of INC State o New TH'E APPLICANT :.,MST OB i.�11`« a S I .D.I.S Per[nii r DIRT: 'T�L_Y F�t Ir�� N.Y S E�.E d':. Pt°1(it t,ro 0!sstld3ri�a°(�I.a Iiwllltr� h"er'rr�it.. P, r� I ltzlt +l:t�b] hal"eG (%f DISiillDcl liC til".:SICj t!1811 t .`�CtU ti .Jlvlfl: 7i('i F�1111!it, FI+�'+Y� �� I'o�+iis MSS S�rte: c ti•4a:c rs of tl,c.Stat(,()f Nox ftk THE APf'I_I�A�1T �lL�i OI3`I' �I a S.p,D,k:.S.Permit throij h the Satit1 old Town En fflc tf°tLDe °rtment Pt°1 t' tri VSs41ance of a Buildon flet°init_ Z 3 WO �Z ni cc W VOE"EC�CS' CERTIFICATE OF , � NYS WORKERS'COMPENSATION INSURANCE COVERAGE r Compensation Board _ Insured Detail 1 a.Legal Nanne and address of insured(Use street address only) I b.Business Telephone Number of insured - MaryMcg,Inc. 631-324-7844 P.O.Box 1331 Hamplon Bays,NY 11946 1 c.NYS Unemployment insurance Employer DBA:Bills Pools,Bills Pools Service,Jasons Pools,Jason and Bills Pool Registration Number or insured Service ld.Federal Employer Identification Number of Insured or Social Security Number 113168202 ftrk Loomion of Insured(Daly required ifcoverggr is.spYrccifically limned to Certain location in New York State,i.e.a(tarp-Up Profl4,v) 2.Namc and Address of'thc Entity Requesting Proof of Coverage 3a.Nannc of insurance Carrier (Entity Being Listed as the Certificate Holder) Technology insurance Company,Inc. TOWN OF SOUTHOLD BUILDING DEPARTMENT 54375 RT 25 3b.Policy Number of entity listed in box"I a PO BOX 1 179 SOUTHOLD,NY 11971 TWC4089971 3c.Policy effective period: 3/23/2022 to 3/23/2023 3d.The Proprietor,Partners ar Executive Officers are: included(Only check box if all partners/ol7icers included) all excluded or certain partners/officers excluded This certifies that the insurance carrier indicated above in box"3"insures the business referenced above in box"la" for workers'compensation under the New York State Workers'Compensation Law.(To use this form,New York(NY)must be listed under Item 3A at tilt INFORMATION PACE of the workers'compensation insurance policy).The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2". The insurance carrier must notify the above certificate holder and the Workers'Caupensation Board within 10(lays IF a policy is canceled dae to hhathpayment ofprewiahns or within 30(lays IF there are reasons otter than nonpayment of premiums that cancel tie policy or eliplinate the insured f-om the coverage indicated on this Certificate. These notices may be sent by regular mail. Otherwise,this Certificate is valid for one year after this forst is approved by the insurance carrier ar its licensed agent,a•until the policy expiration date listed in box"3c", whichever is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend,extend or alter the coverage afforded by the 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 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 forst,if(lie 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. Under penally of perjury,I certify that i am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved By: Matt Zender (Print name of authorized representative or licensed agent of insumnce carrier) . i Approved By: 3/15/2022 (Signature) (Date) Title: SVP,\Vorkers Comp Produclia:Management _ SSc S A POOL FENCE HOUSE " o. COVERED w E P TI DECK �� W w z Z <Z 'o w¢ zz a� rn m jw - J N _ W Q z N z 5a D PROPOSED'-20'X 45'POOL W a w - - a W LIM POO �r�/' W N N RAISED PATIO 12"ABOVE GRADE .� IS IN P Z RAISED PATIO Q J D H A w0Lo U) (Y � 0 POOL EQUIPMENT WZ O Y U d UQt d Ll1 J f- 0 Lu E- ` IC I+ ilr � U Z b I_� U c W MAR 2 9 2023 r ° j 73,1U,jw1y��Iat;?'4; ;�.� DESIGNER:DS - - � VV 'I.DI-��a DRAWN BY:DS DATE:3/27!2023 SCALE:AS NOTED C., SHEET PROPOSED PO N 1 OF 2 SCALE:1"=10'0" STEPS EXISTING GRADE LINE RAISED PATIO o ► EXISTING GRADE LINE bD t POOLFENCE s }: oD ELEVATION A W SCALE:'"= 1'0" W POOLFENCE Z O az POOLFENCE RAISED PATIO a� <m EXISTING GRADE LINE - - - - - - - - - zW W< aw ' _ w - N N O N ELEVATION B SCALE:B"=1'0" 1"STONE 1z'MORTAR BED 4"CONCRETE PAD 3"WALL CAP Q I- ' INTERLOCKING BLOCK WALL U QC rn o6 3 00 FINISH GRADE w W r O F- Z Q I .. , W Y W 12"RCA BASE COMPACTEDU Q w i (� AND INSTALLED IN 6" LIFTS J H w W fes/ j I— �— COMPACTED SUBSOIL N CO INSTALLED IN 6"LIFTS Z W O a o DESIGNERDS1 WALL DETAIL DATE 2023 2 SCALE: 1/2" = 11-011 SCALE:AS NOT SCALE:AS NOTED j SHEET 2OF2 CERTIFIED TO. IDK MANSION,LLC. BOSTON NATIONAL TITLE AGENCY.LLC FIDELITY PIATIONAL PILE :e ice;'.°�,., LAND NOW OR FORMfP.LY OF JOAN B.CARNEY E JOB NO:2071.184 MIL TON CARNE LAND NOW OR FORMERLY OF LORI L.BRIGGMANN 8 MAP N0.' AP RICHARD T.BRIGGhtAM1'F' + '$86'•19'20:E ........ ........... .....�-_....__:e .. REVISIONS: _ _ l -..-_. ..............19500:-.. . _ 25 ACCESS EASEMEPIT "�i- 4-'. ,_,.mac•-u :u:s:i •rcm` DIENSE NO:C-50383 375- Q NA N RVEYING ,34.3' : �• -�* i ... g NDS SU 0 26 SILVER BROOK DRIVE O LLu I FLANDERS,NEW YORK V^) �. TEL:(631,069-a312 o•0FAX,I6 31 360-83 t 3 MARTIN D.iIANC'�S yn D s S 12,903 SQ.FT.=1.674 ACRES y d— L 1LRI:'44:90`.tN. 261_20' urr�!%!!G4$T!lGL:'!.✓',:�� �!!r nr y'-`- .,.r _- _.- ;moi-7.:�'''�'L'`"'LV MILL ROAD 297.00' N87°a4op W zs.oc'� .7 2 O i S 69'01'40'W � ,(1 z �10 Q u z 3.00C' v o " �=1� S B8'0220'W p 0 �o g �~f 0 41.20' ✓C��p�V Sp j�YEI OF DESCRIBED PROPERTY zrn m�'� m pal �� u�r fa M urn /� 4, SITUAlTF AT x 1 11 111'J `�F ��j TOWN OF SOUTHOLD 1 c } 0 3 5'� /1 I I( �0�� �rn j_ InQn -f SUFFOLK COUNTY NEW YORK 25'„i a r 6111 Wnt� S.C.TR4.DIST.1000SEC 113SLK-03LOT 7.2 MATTITUCK(,REEK i Y n S ��.(© / 25 13 0 25 50 75 100 125 150 175 200 225 9 1 v4. I f r rear . �(O �r- `nc - SCALE-t'=50' DATE.OCTOBER 20,201 t