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HomeMy WebLinkAbout49209-Z ydat r TOWN OF SOUTHOLD BUILDING DEPARTMENT q TOWN CLERK'S OFFICE r 4 SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS ANIS SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 49209 Date: 5/4/2023 Permission is hereby granted to: Giblin, Frances 70 Washington St Apt#9E Brooklyn, NY 11201 To: construct accessory in-ground swimming pool as applied for. At premises located at: 2575 Skunk Ln, Cutcho ue SCTM # 473889 Sec/Block/Lot# 97.4-13 Pursuant to application dated 4/6/2023 and approved by the Building Inspector. To expire on 11/2/2024 Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO- SWIMMING POOL $50.00 Total: $300.00 Buil' %ng Inspector TOWN OF SOUTHOLD-BUILDING DEPARTMENT :A Town Hall Annex 54375 Main Road P. O. Box 1179 Southold, NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 htt ://www. oulholdtownn . ov Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only PERMIT N0. Building Inspector: I � �.�° APR 0 Applications and forms must be filled out in th"eirentirety.Incomplete '' applications will not be accepted. Where the ApPlicant isnot the owner,an Owner's Authorization form(Page 2)shall be completed. Date: 31..,22 OWNER(S)OF PROPERTY: Name: SCTM# 1000- 97- 61 Project Address: �y //9 Phone#: p 1/ Email: wry Mailing Address: 5�75� jl;un�/ / �c1 �,vs�o aJ� //g 3,5- CONTACT 5CONTACT PERSON: Name: ZjZ-;'LJZ--5- Mailing Address: :; J .may Phone#: Email: Cn3 ��y�-yZ ys DESIGN PROFESSIONALINFORMATION: Name: Mailing Address: Phone#: Email: CONTRACTOR INFORMATION:' 1 Name: Ch, �-Ulf 17WS LVA, Mailing Address:-7 o..-j?,,,x 9 i c y AV 1)9-?j5 Phone#: 3� ' 73y-,;76 LAS- Email: Com. c—k,4-vl� DESCRIPTION OF PROPOSED CONSTRUCTION El New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: Other ` r $ G' 1 Will the lot be re-graded? NYes ❑No Will excess fill be removed from premises? Mes F-1 No 1 01 c,�A ,1 . PROPERTY INFORMATION P Pe e 57' �. Intended use ofPperty: . EExistingpro Zone or use district in which premises is situated: �Are t ereanycove covenants restrictions with respect to property? IF YES,PROVIDE A COPY, a ,AftLT in The owner/contractor/design professional is responsible for all drainage and storms Water issues as provided by P Chapter 236 of the Town Code.APPUCA'nON 1S HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the SuAdft y Zone thin of the T of !sold,Suffolk,county,New York and odier applicable Laws,Ordinanow or Regulations,for the construction of butldrLgsl addltlons,alterations or for removal or demolition as herein described.The appli nta r to comply with all applimble Jaws,ordirrances,building des housing code and regulations and to admix authorized inspedors on premises and in ding(s)for necersarV inspections.False nts made herein are punish-able as a class A misdemeanor pursuant to Sermon 22CL45 ofthe New York State Penal Law. I I w Application Su l e By(Print name): L�vr7 ' GJ/�CAuthorized Agent ElOwner Signature of Applicant./ mate: STATE OF NEW YORK) r ( COUNTY OF v� • ) is a"i�e z,,ppkaw :�eing di led`sworn, d pa0Fc_,s ar.9 �y �§a e c 'Nairne of indivliduai signing contract!above I arae , (S)he is the ._. ._._. .�.�_.. �. _m..__. (awon:trart-ora /agent,Corporate uM&fTicer, etc. o gsaiid ownei..or owners and is lal,a y authorized to}�e orrn r:;r have pe nrm o the said wo!k and t.�:v ake ran13 ffie t au^, d�d�r»0�lBq� �� a$'tion are trll.te io'the best Nib l6 her�;rNE;iPAl4BNedg e and 1,).elit'.f 'i�l��d application that a H statements con a&id a'p(11 11 n 2 a�),Ci "l,j ie l egd Sworn before me this .'9 7 dav of C ria lWllblic� PROPEDITY OWNER W(Where the applicant is not the owner) _m r ))W11I, S G e residing at .� NNY do hereby authorize �►� �.... �to appGy ori 0t, ti krll �i �4 kR.jthoV_ l'!�'rt ffdnJa 6-paYtb8 ent fr:n app?RBvae re1n. R 3/.?�- %A.,ner's Signatufe Date z Print Owner's Name I b 2 i` AC 6 CERTIFICATE OF LIABILITY INSURANCE DATE(M `n 04/044/202/202YY3 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). CONTACT Lauren Murphy PRODUCER NAME:' Roy H ReeveAgency,Inc. PHONE (631)298-4700 arc No� (631)298-3850 PO Box 54 ADDRESSr Imurphy@royreeve.com 13400 Main Road INSURERS)AFFORDING COVERAGE NAICA Mattituck NY 11952 MSURERA: Valley Forge Insurance Company 20508 INSURED INSURER S; Chituk Pools Ltd. INSURER C: PO BOX 9 INSURER D! ?INSURER E Cutchogue NY 11935 INSURERF: COVERAGES CERTIFICATE NUMBER: CL2321518551 REVISION NUMBER: 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. SUSKI `�9 POLICY EFF POLICY EXP ?LTR TYPE OF INSURANCE INS POLICY NUMBER.. MMdOOPYYrY MSI DD YYYY LIMITS AMA'. E s 1,000,000 X COMMERCUIL GENERAL LIABILITY EACH OCCURRENCE _.. h rD 100,000 CLAIMS-MADE ©OCCUR P'EWSES La.1lrxurrence X Contractual Liability Y MED EXP(Any vie s emn) S 15,000 A P6018146726 03/15/2023 03/15/2024 PERSONAL&ADV INJURY S 1,000,000 CsEI^t"'L..AGGREGATE LIIMtITAPPLUES PER'' jjq GFNERAL,AGGRrGATE S 2,000,000 PROS # ; .PRw:DLGOTS-coMP/oPAGG ; 2,000,000 .. POLICY JECT ��LOC f 'OTHER: COMBINED SINGLE LINIff $ AUTOMOBILE LIABILITY ca,accddanI ANY AUTO 1 V BODILY INJURY(Per person) I S H AUTOS ONLY � AUTOS OWNED SCHEDULED BODILY INJURY(Per accident) S{HIRED ^ NON-OWNED y �� PROPERTY DAMAGE S AUTOS ONLY AUTOS ONLY @4P Pgde g UMBRELLA LIAR OCCUR l C i.EACH OCDURRENC '. _._ 15 EXCESS LIAB CLAIMS-MADE P t AGGREGATE 'S DED RETENTION S S WORKERS compex$ATION CI PE'R rJTH• 9 AND EMPLOYERS'LIABIUTY �- Sr,ATI,N E. ER Y/N e I ANY PROPRIETOR/PARTNER/EXECUTIVE r-7; E L EACH AC'CMENT S NIA, A, OFFICER/MEMBER EXCLUDED? P i I (Mandatory In NH) E I_,DISEASE EAE�MPLOYEE IS If yes,describe under DES%CRIP'NO'N OF OPCRATIGNS below E L DISEASE POLICY LIMIT S' 6 DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101,Addhlonal Remarks Schedule,maybe attached if more space Is required) 1,. Francis Giblin and Lori Levinson,2575 Skunk Lane,Cutchogue,NY 11935 4 � C 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 Box 1179 6 AUTHORIZED REPRESENTATIVE Southold NY 11971 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 'C � ) y .� � £ ` L zPA , x 4z a -4,7 voll s Fk Vr MAP or LOW W..AAV MIN"VANK sovirr DESCRIBED PROPERTY SITUATCD A7' 3 SARWA A.,0WKZl AECONIC -5 e a WIV 0, SQU7HOLD and UFa N.. • �� �111,vellll 10 West main street riverheo , nein yOrk 11901 4_ 434Y LARMA:l9,.ST0 3O. 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Y :7.y`' e:V.Y'YlY-:'. •�.f/VM[': �' - C S� - .���gpp H�o �s gyps O .r� �\ - it a O od Y O �.!_• ',�-:.-- � .. d141?I•di6a4+L,6 - Odd \�m_ l /. 'o \� DMNG BOARD K e M ..■� �� moo,.,■ - � o To Loma `0➢Pd B WALL.:,�. . N-AT IPA!8 FRAME CO g - CORNER ®�������1 �9� ==laws a :7 r 9 POOL SECTION CID �`' •". �-�`• � , - lli i - Co lies with:� � • - . . oFQ `�_ ~G� �+�%Slcr 2020 Code Section 3032.1'=303A Swimming Pools,Spas and Hot Tubs � i Section R326 of the Residential Code of New York e . =-----------=a'i— ------ Section 31U9 of the Building Code 'f Newyork Section N1103-12(R403.12)Residential Pools and Permanent Residential Spas ®®�,' ��; ������ REV. ��dEa :�� Section 3109,3.12-3.109 7.4.Pools and Spas Gates,Barriers JAMES®EERKOSK`,P.E. Section G106 Entrapment Profection . DATE: . TYPICAL PMK STIFFNER Section G107 Alannis .: 2E0 DEER DRIVE Section l 42b1—E43T2 Electiical Connections for Pools MAT'ITUK,NEW YORK 11952 DRAIWING NUMBER - 1 OF. 1 NOTES: 1. DIVING BOARD TO CONFORM WITH ANSI/APSP/ICC-5 SEC 6 2. NO SOIL DISCHARGE PERMITTED WITHIN 4 FEET OF EXCAVATION 3. POOL MUST BE SURROUNDED BY A CONTINUOUS BARRIER CONSTRUCTED IAW REQ.OF SEC 326.4.2.1-R326.4.2.6 OF THE NYS RESIDENTIAL CODE(2020)AND ALL SECTIONS OF THE SOUTHOLD CODE 4. WALLS MAY SERVE AS PART OF THE POOL BARRIER AS PER SEC 326.4.2.8 AND ALL WINDOWS HAVE A SELF LATCHING DEVICE 5. ACESS GATES SHALL COMPLY WITH SEC R326.5.2 OF THE NYS RESIDENTIAL CODE(2020)AND BE SELF CLOSING,SELF LATCHING AND BE SECURELY LOCKED WHEN POOL IS NOT IN USE OR SUPERVISED. ALLL GATES ARE TO OPEN AWAY FROM THE POOL AREA. 6. DURING CONSTRUCTION THE CONTRACTOR SHALL ERECT A TEMPORARY BARRIER AROUND THE EXCAVATION IAW CODE OF THE TOWN OF SOUTHOLD. 7. POOL MUST BE EQUIPED WITH AN APPROVED POOL ALARM CAPABLE OF DETECTING ENTRY INTO THE WATER AND SOUNDING AN AUDIBLE ALARM WHEN DETECTED THAT IS AUDIBLE AT THE POOLSIDE AND INSIDE THE DWELLING.THE ALARM MUST BE INSTALLED,MAINTAINED AND USED IN ACCORDANCE WITH TEH MAUFACTURERS INSTRUCTIONS.THE ALARM MUST MEET ASTM F2208"STANDARD SPECIFICATION FOR POOL ALARMS".THE DEVICE MUST OPERATE INDEPENDENT(NOT ATTACHED TO OR DEPENDENT ON)OF PERSONS. 8. POOL SUCTION FITTINGS(EXCEPT FOR SURFACE SKIIMERS)MUST BE PROVIDED WITH A COVER THAT CONFORMS TO ASME/ANSI Al12.19.8M OR A MINIMUM 18'X23"DRAIN GRATE OR A CHANNEL DRAIN SYSTEM.POOL CIRCULATION SYSTEM MUST BE EQUIPTED WITH ATMOSPHERIC VACUUM RELEIF.SUCH VACUUM RELIEF SYSTEMS SHALL CONFORM WITH ASME Al12.19.17 OR BE A GRAVITY SYSTEM APPROVED BY THE TOWN OF SOUTHOLD.POOL SALL BE PROVIDED WITH A MINIMUM OF 2 SUCTION FITTINGS OF THE ABOVE MENTIONED TYPE.THE SUCTION FITTINGS SHALL BE SEPARATED BY A MINIMUM OF 3'AND MUST BE PIPED SUCH THAT WATER IS DRAWN THROUGH THEM SIMULTANEOUSLY THROUGH A VACUUM RELIEF-PROTECTED LINE TO THE PUMP(OR PUMPS).VACUUM/PRESSURE CLEANING FITTINGS SHALL BE IN ACCESSIBLE POSITION,MINIMUM OF 6"AND NO GREATER THAN 12"BELOW THE MINIMUM OPERATIONAL WATER LEVEL OR BE AN ATTACHMENT TO THE SKIMMER/SKIMMERS. A REQUIRED POOL ATMOSPHERIC VACUUM RELEIF SYSTEM SHALL BE INSTALLED AS PER NYS RESIDENTIAL CODE R326.6.3(2020)AND IN ACCORDANCE TO TOW CODE 9. ALL ELECTRICAL WORK SHALL COMPLY WITH THE REQUIREMENTS OF NFPA 70(NEC),PRINCIPALLY ARTICLE 680 AND THE NYS RESIDENTIAL CODE SECTION 4102 THROUGH 4106.ALL ELECTRICAL DEVICES MUST BE APPROVED BY UNDERWRITERS LABORATORIES AND BE PROTECTED BY A GOUND FAULT CURRENT INTERRUPER(GFCI).CURRENT CARRYING ELECTRICAL CONDUCTORS EXCEPT FOR THOSE PROVIDING POWER TO POOL LIGHTING AND POOL EQUIPMENT SHALL MEET THE SEPARATION REQUIREMENTS OF TABLE E4203.5. ALL METAL ENCLOSURES,FENCES OR RAILINGS NEAR OR ADJACENT TO THE SWIMMING POOL THAT MAY BECOME ELECTRICALLY CHARGED DUE TO CONTACT WITH AN ELECTRICAL CIRCUIT SHALL BE EFFECTIVELY GROUNDED. 10. WATER SOURCE FILLING THE POOL SHALL BE EQUIPPPED WITH A BACKFLOW PROTECTION DEVICE IAW NYS PLUMBING CODE 608. 11. ALL PIPING IS DIAGRAMMATIC UNLESS OTHERWISE STATED. 12. WALKS,IF PROVIDED SHALL BE NONSLIP AND SLOPE AWAY FROM THE POOL EDGE. 13. A MEANS OF EGRESS FROM DEEP AND SHALLOW ENDS MUST BE PROVIDED IAW ANSI/NSPI-5 SECTION 6. 14. CONTRACTOR TO PLACE THE POOL IAW TOWN OF SOUTHOLD CODE SETBACKS. 15. ALL DRAINAGE FROM THE POOL SHALL BE MAINTAINED ON THE SUBJECT PROPERTY. 16 THE DESIGN IS BASED ON A DRAINAGE SOIL WITH<10%SILT.GROUND WATER SHALL NOT EXIST WITHIN THE EXCAVATION.IF GROUND WATER EXISTS WITHIN 60"FROM GRADE,DEWATERING FACILITIES WILL BE REQUIRED. 17 ALL GAS AND OIL WATER HEATERS(IF INSTALLED)FOR THE IN-GROUND SWIMMING POOL SHALL BE NATIONAL APPLIANCE ENERGY CONSERVATION ACT(NAECA)COMPLIANT.POOL HEATERS SHALL BE TESTED IAW ANSI Z21.56 AND SHALL BE INSTALLED IAW MANUFACTURERS SPECIFICATIONS.OIL FIRED POOL HEATERS SHALL BE TESTED IAW UL726.POOL HEATERS SHALL BE LOCATED OR GUARDED TO PROTECT AGAINST ACCIDENTAL CONTACT OF HOT SURFACES BY PERSONS.POOL HEATERS SHALL BE PROVIDED WITH TEMPERATURE AND PRESSURE-RELIEF VALVES.A BYPASS LINE SHALL BE INSTALLED FROM THE INLET TO OUTLET TO ADJUST WATER FLOW THROUGH THE HATER.POOL HEATERS SHALL BE PROVIDED WITH THE FOLLOWING ENERGY CONSERVATION MEASURES: 17.1 ALL POOL HEATERS SHALL BE EQUIPPED WITH AN ON-OFF SWITCH MOUNTED FOR EASY ACCESS TO ALLOW SHUTTING OFF THE OPERATION OF THE HEATER WITHOUT ADJUSTING THE THERMOSTAT SETTING AND TO ALLOW RESTARTING WITHOUT RELIGHTING THE PILOT LIGHT. AT LEAST ONE THERMOSTAL MUST BE PROVIDED FOR EACH HEATING SYSTEM.HEATED SWIMMING POOLS SHALL BE EQUIPTED WITH A POOL COVER.(exempt FROM THIS ARE OUTDOOR POOLD)DERIVING 20%OF THE ENERGY FOR HEATING THE POOL FROM RENEWABLE SOURCES OVER AN OPERATING SEASON. 17.2 TIME CLOCKS SHALL BE INSTALLED SO THE PUMP CAN BE SET TO RUN DURING OFF-PEAK ELECTRICAL DEMAND PERIODS,AND CAN BE SET TO RUN THE MINIMUM TIME NECESSARY TO MAINTAIN THE POOL WATER IN A CLEAN AND SANITORY CONDITION IAW APPLCIABLE SANITORY CODE OF NEW YORK STATE. 18 BACKFILL WILL BE DONE WITH CLEAN EARTH FREE OF ROOTS AND DEBRIS. BACKFILL HEIGHT AND WATER LEVEL TO BE WITHIN 8"OF EACH OTHER. PLACE CONCRETE ON SANDY LOAM SOIL. CLAY TO BE REMOVED AND REPLACED WITH SANDY LOAM. 19 THERE ARE MAIN DRAINS IN THIS POOL.THERE ARE TWO APPROVED SUCTION OUTLETS WITH A MINIMUM OF T OF SEPARATION. THE SUCTION OUTLETS ARE PIPED SO THAT WATER IS DRAWN THROUGH THEM SIMULTANEOUSLY THROUGH A VACUUM-RELEIF-PROTECTED LINE TO THE PUMP.COMPLIES WITH ENTRAPMENT PROTECTION AS PER CODE. 20 THE POOL WAS DESIGNED REFERENCES AS THE FOLLOWING: 20.1 THE RESIDENTIAL BUILDING CODE OF NEW YORK STATE(2020)SEC R326 20.2 THE ENERGY CONSERVATION CONSTRUCTION CODE OF NEW YORK STATE(2020)SEC R403.10 .�� F DE 1`OQ 20.3 THE FUEL GAS CODE OF NEW YORK STATE(2020) co Sr �0 20.4 THE NEW YORK STATE SANITORY CODE. 20.5 ANSI/APSP/ICC-5 STANDARD FOR RESIDENTIAL IN-GROUND SWIMMING POOLS. C� �I s � = ? POOL NOTES SCALE: NTS 20.6 BOCA CODE SECTION 421. JAMES DEERKOSKI, P.E. DATE: 101212020 20.7 CODE OF THE TOWN OF SOUTHOLD y ? 260 DEER DRIVE MATTITUK, NEW YORK 11952 DRAWING NUMBER 2 OF 2