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HomeMy WebLinkAbout47021-Z S�FFDix�, Town of Southold 3/26/2024 a P.O.Box 1179 0 o _ 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 45077 Date: 3/26/2024 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 1852 N Bayview Rd., Southold SCTM#: 473889 Sec/Block/Lot: 70.-12-39.4 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 9/7/2021 pursuant to which Building Permit No. 47021 dated 10/22/2021 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#7499 dated 6/17/2021 The certificate is issued to Tsekouras,Petros&Penny of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 47021 5/17/2022 PLUMBERS CERTIFICATION DATED th riz ignature o�SUFFet,r� TOWN OF SOUTHOLD BUILDING DEPARTMENT x TOWN CLERK'S OFFICE "oy • o� SOUTHOLD, NY 4jp1 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#: 47021 Date: 10/22/2021 Permission is hereby granted to: Tsekouras, Petros 76 Shore Rd Manhasset, NY 11030 To: construct accessory in-ground swimming pool as applied for per DEC No Permit Necessary letter, Trustees Non-Jurisdiction letter and ZBA approval. At premises located at: 1852 N Bayview Rd., Southold SCTM #473889 Sec/Block/Lot# 70.-12-39.4 Pursuant to application dated 9/7/2021 and approved by the Building Inspector. To expire on 4/23/2023. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO- SWIMMING POOL $50.00 Total: $300.00 Building Inspector °f SO�ryo� h O Town Hall Annex Telephone(631)765-1802 54375 Main Road P.O.Box 1179 Q sean.devlints'D_town.southold.ny.us Southold,NY 11971-0959 Q �yOUNTI,��' BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Petros Tsekouras Address: 1852 N Bayview Rd city:Southold st: NY zip: 11971 Building Permit* 47021 Section: 70 Block: 12 Lot: 39.4 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: LC Electric License No: 38043ME SITE DETAILS Office Use Only Residential X Indoor X Basement Service Commerical Outdoor X 1st Floor Pool X New X Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph X Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors Sub Panel A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO Transformer UC Lights Dryer Recpt Emergency Fixture Time Clocks 1 Disconnect Switches 4'LED Exit Fixtures Pump 1 Other Equipment: Intermatic Pool Panel 8 Circuit/ 7 Used, Pump 220GFI, Heater 250, Auto Cover 120GF1 w/ Keypad, Pool Pilot Salt Generator, 3 Lights 30OW Tranny 120GFI Notes: Pool Inspector Signature: Date: May 17, 2022 S.Devlin-Cert Electrical Compliance Form OE SOUly�6 ��o 24 1 e> # # TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] .FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND . [ ] INSULATION/CAULKING [ ] FRAMING[STRAPPING [ ] FINAL [ ] - FIREPLACE & CHIMNEY- ` [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ]<PRE C/O REMARKS:. DATE /6 °'- INSPECTOR _ J OF S0Uly0� 7 # # TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION y [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING/STRAPPING [ ] FINAL FIREPLACE-& CHIMNEY [ ]' FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: Or, 'F bliri (AA Q V j� Y 001' " 'h DATE - INSPECTOR OP SOUIyo -- � �o 7 0?� # TOWN OF SOUTHOLD BUILDING DEPT. courme 765-1802 �-INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [>Q ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: �v ✓I G P ��e sa %ZA d acg .� !s pi�op�, „�--� AL?-, ST2 DATE S ?/. - INSPECTOR �-oyl ho��OF SOUTyolo # TOWN OF SOUTHOLD BUILDING DEPT. courm,��' 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I SULATION/CAULKING [ ] FRAMING/STRAPPING [ FINALT� [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION 11 [ ] PRE C/O [ ] RENTAL REMARKS: 0 ✓� f) W r L 810 a 1-�� l DATE INSPECTOR OF SOUIho� # TOWN OF SOUTHOLD BUILDING-DEPT. `y�nuNn '' 765-1802 2 INSPECTION FOUNDATION 1 STfCjcjt.,WA,WtV-�[ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING/STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] `FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: - VA DATE � 024V-i INSPECTOR 1852 North Bayview Ave Southold — Pool alarms and window stops f, o r :r ��� f_ Kitchen window Laundry room door and window 1852 North Bayview Ave Southold — Pool alarms and window stops _ s Bedroom window left Bedroom window right FIELD.INSPECTION'REPORT. DATF, COMMENTS • '%- Q FOUNDATION(IST) .i 6 y 7 ------------------------------- FOUNDATION(2ND) ROUGH FRAMING:& H PLUMBING: INSULATION PER.N.Y. �. STATE ENERGY CODE L � ' • ,. es wZ-1& FINAL 10 ADDITIONAL C MMENTSrq U d . 0 2� bt` o atl IQI ir_oC 6f- 1�4 z • y • b i✓Nfl:2t^:r•t `kh6ydv3N �x:C 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 https://ww,,v.southol.dtownny.gov For Office Use only Date Received 16 ? LPL PERMIT NO. Building Inspector: D ; Applications and forms must be filled out in their entirety. Incomplete applications SEP - 7 2021 will not be accepted. Where the Applicant is not the owner,an Owner's Authorization form(Page 2)shall be completed. PiIY1JDIlNG DEFT. -..::, :.s�P•. TOWN OF SOUTH®ILD /APPLICATION FOR=BUI.,IDING.PE Date:Date: � �l Z� OWNER(Sj OF PROPERTYc„a . Name: Tax Map#:SCTM #1000- -7 ra.r_,.. .r", . _i . M k u . . ......... _ Physical Address: s, /Vpr �� . Phone#: 1 ,7 7Z J Email: r Mailing Address: /V o 0 Q S ,-:CONTACT PERSON. :w - Name: Mailing Address: Phone#: 6 5..�.._`...../ ._.._.. 6 61...... Email: D DESIGN PROFESSIONAHNFORMATION: Name: Mailing Address: Phone#: Email: ;CONTRACTOR INFORMATION: F Name: ,p Mailing Address: 'o /3 A Phone#: Email: >DESCRIPTIOUOF"PRQPOSEb CONSTRUCTION , �Other ew Structure ❑Addition ❑lAlter tion ❑Repair ❑Demolition Estimated Cost of Project: $ Will the lot be re-graded. Yes Cho Will excess fill be removed from premises? GXes ONO PROPERTY INFORMATION. Existing use of property: Intended use of property: Date of Purchase: Name of Former Owner: 1 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): f7 IeAuthorized Agent ❑Owner Signature of Applicant: Date: STATE OF NEW YORK) SS: COUNTY OF W f Q1 L ) Dar? M C - L"-,;"r W' being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)he is the QqLfq.+- (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 day of of , 20 C")L eye'%, otary Public ��t,: N0.01 F16413850'•y QUALIFIED IN SUFFOLK COUNTY : COMM.EXP. PROPERTY OWNER AUTHORIZATION J, , 02-01-2025 (Where the applicant is not the owner) NE���Q�\\ I, y AA) residing at d �/ do hereby authorize �� Po�. f „-, .,� s to apply on my behalf to the f Southold Building Department for approval as described herein. � 7 2l ner's Signature Date 79-;r-CA9 -5 9 Print Owner's Name o`9s°fFor�coG . TOWN OF SOUTHOLD-BUILDING DEPARTMENT s Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 gt Telephone(631) 765-1802 Fax(631) 765-9502 htti3s://www.southoldto PR6VAt Date Received APPLICATION FOR BUILDING PE IT For Office Use Only 1•. I i PERMIT NO. Building Inspector. '4 F E B 2 6 2021 Applications and forms must be filled out in their entirety. Incomplete '"<. applications will not be accepted. Where the Applicant is-not the owner,ani`-^f.,T Owner's Authorization form(Page 2)shall be completed. .3 Date: OWNER(S)OF PROPERTY: r ' Name: P eace fi Po-n - 1 SCTM#1000- Project Address: `(.(q,5 Z N : y,-mow �a� �-6-VQ 6 Phone#: q( 7-- 7`f7 - 01 � Email: -J-5e-K.0V VrCAs a ® Co yy) Mailing Address: 56X-w-c CONTACT PERSON: Name: �G�s�'Y coo. CD 0 re- Mailing Address: ( p"ZO G c� ROad �-�-�a l� ►� { ( Cf. '7 r Phone#: 6�j ( ' (pJ' �?j� Email: (2., o0y'r' DESIGN PROFESSIONAL INFORMATION: Name: Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: Name: Mailing Address: Phone#: Email: DESCRIPTION OF PROPOSED CONSTRUCTION New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: [--]other Rocs "- . $ Will the lot be re-graded? ❑Yes Biqo Will excess fill be removed from premises? `❑Yes E]No 1 PROPERTY INFORMATION Existing use of property: Hpy>'�-- Intended use of property: �po Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? ❑Yes G o 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. APPLICATIONJS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building2one 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 na -tY Ut.QL C. aAuthorized Agent ❑Owner Signature of Applicant: ` Date: -v7�^ 2—/ STATE OF NEW YORK) : COUNTY OFLaAl ) being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the (tbritractor,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 s ,' day of ,20�Q( N ublic BETSYA.PERKINS Notary Public,State of New YorlIPROPERTY OWNER AUTHORIZATION No.01PE:6130636 Qualified in Suffolk Coun (Where the applicant is not the owner.) Iwommission Expires duly 11 I, �TR f� residing at $M VI CU do hereby authorize ��� i(i Li C3�- �DDU YQ to apply on my behalf tot ' own,of Southold Building Department for approval as described herein. Owner's Signature. ate �ET2 oa • �S�l�� Print Owner's Name 2 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD,N.Y. NOTICE OF DISAPPROVAL DATE: March 15, 2021 TO: Patricia Moore (Tsekouras) 51020 Main Road Southold,NY 11971 Please take notice that your application dated February 26, 2021: For permit: to construct accessory in-ground swimming pool at: Location of property: 1852 North Bayview Road, Southold,NY County Tax Map No. 1000—Section 70 Block 12 Lot 39.4 Is returned herewith and disapproved on the following grounds: The proposed accessory in-ground swimming pool, on this conforming 75,292.59 sq. ft. lot in the R-40 District, is not permitted pursuant to Article III, Section 280-15, which states accessory buildings and structures shall be located in the required rear yard. The accessory is located in the side yard. 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. BOARD MEMBERS Southold Town Hall Leslie Kanes Weisman,Chairperson ®�*®T ® 53095 Main Road•P.O.Box 1179 Southold,NY 11971-0959 Patricia Acam Office Location: CA Eric Dantes Town Annex/First Floor, Robert Lehnert,Jr. G.'c ap 54375 Main Road(at Youngs Avenue) Nicholas Planamento 2ep,- Southold. ' RECEIVED http://southoldtownny.gov n 3"cJ V ZONING BOARD OF APPEALS O TOWN OF SOUTHOLD J U N 1 8�S ILA Tel.(631)765-1809•Fax(631)765-9064 Southold Town. CIer FINDINGS,DELIBERATIONS AND-DETERMINATION MEETING.OY JUNE 17,2021 ZBA FILE:#7499 NAME OF APPLICANT: Petros &Penny Tsekouras PROPERTY LOCATION: 1852 North Bayview Road, Southold SCTM No. 1000-70-12-39.4 SEORA 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 referred as required under the Suffolk County Administrative Code Sections A 14-14 to 23,and the Suffolk County Department of Planning issued its reply dated April 12,2021 stating that this application is considered am- after-for local determination as there appears to be no significant county-wide or inter-community impact. '' LWRP DETERMINATION: This application was referred for review under Chapter 268, Waterfront Consistency review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. The LWRP Coordinator issued a recommendation dated April 27, 2021. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department,as well as the records available, it is recommended that the proposed action is CONSISTENT with LWRP policy standards. PROPERTY FACTS/DESCRIPTION: The subject property is an 69,066 sq. ft.parcel located in an R-40 Zoning District. The property is an L-shaped lot with 100 feet of frontage on a private right of way,before it turns east for 325 feet towards Goose Creek. There is an approximately 361 feet frontage along Goose Creek before the property turns for approximately 146 feet west along Goose Creek,then turns upland for 174 feet before returning 300 feet back to the private right-of-way. The parcel is improved with a two-story frame dwellin&with a second-floor wood deck,as shown on survey, depicting the proposed swimming pool, prepared by Kenneth M. Woychuk, L.S., last revised January 20,2021. BASIS OF APPLICATION: Request for a Variance from Article III, Section 280-15;and the Building Inspector's March 15, 2021. Notice of Disapproval based on an application for a permit to construct an accessory in-ground swimming pool;at.1)located in other than the code-permitted rear yard;located at: 1852 North Bayview Road,(Adj. to Goose Creek)Southold,NY. SCTM No. 1000-70-12-39.4, RELIEF REQUESTED: The applicant requests a variance to install a swimming pool in the side yard where the code requires that all accessory structures be located in the rear yard: 1 E Page 2,June 17,2021 #7499,Tsekouras SCTM No. 1000-70-12-39.4 ADDITIONAL INFORMATION: The applicant's agent presented testimony to explain how the odd shape of the property necessitates the location of the proposed pool,as well as placement of the existing sanitary system. FINDINGS OF FACT/REASONS FOR BOARD ACTION: The Zoning Board of Appeals held a public hearing on this application on June 3,2021 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. The proposed pool will be at grade towards the rear of the house and will be screened from view by mature landscaping. Due to the odd shaped lots in this neighborhood,the large setback from North Bayview,and the waterfront nature of the parcel it will not produce an undesirable change in the neighborhood. 2. Town Law 4267-b(3)(b)(2). The benefit sought by the applicant or cannot be achieved by some method,feasible for the applicant to pursue,other than an area variance. The irregular shape of the property,the location of the tidal wetland boundary at the rear of the property, and the location of the existing sanitary system in an alternative conforming front yard on this waterfront parcel restricts the applicant from placing a pool in a conforming location. 3. Town Law M7-b(3)(b)(3). The variance granted herein is mathematically substantial,representing 100%relief from the code. However,due to the odd shape of the property,the proposed placement of the pool is most practical and reasonable with regards to setbacks from tidal wetlands and privacy from neighbors; Additionally,the setback of the proposed pool from North Bayview is approximately 150 feet and is located in the applicant's architectural rear yard.Locating the pool closer to the Tidal Wetland boundary,in the rear yard and adjacent to Goose Creek,may create adverse impacts. 4. Town Law 4267-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 and conditions set by this board. 5. Town Law 4267-b(Mb)(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 5267-b. Grant of the requested relief is the minimum action necessary and adequate to enable the applicant to enjoy the benefit of an accessory in-ground swimming pool 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-B,motion was offered by Member Weisman(Chairperson),seconded by Member Acampora, and duly carried,to GRANT the variance as applied for,and shown on the survey prepared by Kenneth M. Woychuk,Land Surveyor, last revised January 20,2021. c Page 3,June 17,2021 #7499,Tsekouras SCTM No. 1000-70-12-39.4 SUBJECT TO THE FOLLOWING CONDITIONS: 1. Pool mechanicals shall be placed in a sound deadening enclosure. 2. Drywell for pool de-watering shall be installed. That the above conditions be written into the Building Inspector's Certificate.of Occupancy, when issued. 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. In the event that this is an approval subject to conditions, the approval shall not be deemed effective until such time that the foregoing conditions are met;and failure to comply therewith will render this approval null and void. The Board reserves the right to substitute a similar design that is de minimis in nature for an alteration that does not increase the degree of nonconformity. 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 h /f f /2021 so Glenn Goldsmith,President _ Town Hall Annex 54375 Route 25 A Nicholas Krupski,Vice President ' P.O.Box 1179 John M.Bredemeyer III Southold,New York 11971 Michael J.Domino Telephone(631) 765-1892 Gre Williams ` ' g _ :.;��'�.,_4 • Fax(631) 765-6641 d!9519 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD October 15, 2021 Patricia C. Moore, Esq. 51020 Main Road Southold, NY 11971 RE: PETROS TSEKOURAS 1852 N. BAYVIEW ROAD, SOUTHOLD SCTM#: 1000-70-12-39.4 Dear Ms. Moore: The Southold Town Board of Trustees reviewed the survey prepared by Kenneth M. Woychuk Land Surveying, PLLC, last dated October 6, 2021 and determined that the proposed pool and patio are out of the Wetland jurisdiction under Chapter 275 of the Town Wetland Code and Chapter 111 of the Town Code. Therefore, in accordance with the current Wetlands Code (Chapter 27-5) and the Coastal Erosion Hazard Area (Chapter 111) no permit is required. Please be advised, however, that no clearing, no removal of vegetation, no cut or fill of land or removal of sod, no construction, sedimentation, or disturbance of any kind may take place within 100' landward from the top of the bluff, or seaward of the tidal and/or freshwater wetlands jurisdictional boundary or seaward of the coastal erosion hazard area as indicated above, without further application to, and written authorization from, the Southold Town Board of Trustees pursuant to Chapter 275 and/or Chapter 111 of the Town Code. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction and Coastal Erosion Hazard Area, which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and the coastal erosion hazard area and your project or erecting a temporary fence, barrier, or hay bale berm. 2 This determination is not a determination from any other agency. If you have any further questions, please do not hesitate to call. Sincerely, Glenn Goldsmith, President Board of Trustees GG:dd NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Division-of Environmental Permits,Region 1 SUNY:a;Stony Brock.50 Q cle Road.Stony Brook.NY 117k P:(631)444403651-F:(631)444-0360 wwo.dec nygov NO PERMIT NECESSARY Petros Tsekouras May 30, 2021. 1852.North Bayview Avenue Southold, NY"11971 . Re: Application# 1-4738-0315:1/00004 Tsekouras.Property..- 1852:North B:ayview Avenue STM#_10_60-70=12=3,9.4 Dear Applicant: The Department of Environmental Conservation (DEC) has completed a review of your proposal to construct a new pool with surrounding fence and patio located greater than. 75 feet from the Tidal Wetlands"Boundary as per the plans prepared by Kenneth M. Woychuk Land Surveying, last revised 05/1.9/2Q21. Based on the information you.. submitted, DEC has deterrrii_ned that.this type-of work is listed in the Tidal Wetlands Land Use Regulations (6NYCRR:Part.661,5) as an activity that.is not regulated. Therefore, no permit.is required under the .Tidal Wetlands Act (Article 25)of the. Environmental,Conservation Law. Be advised, any additional work or modification to the project as described, may require DEC authorization: Please contact this office if such activities are contemplated. Please note that this letter does not relieve you of the'responsiblity of obtaining any necessary permits or approvals from other agencies or local municipalities.. Sincerely, Laura F. Star Permit Administrator cc. Patricia C. Moore BMHP File srzvrrx Oapartmentof Erne onmeniai GdRReftui!:! cmme room n --" 202JUIL N DEPARTMENT- Electrical Inspector JAN. ;. TOWN OF SOUTHOLD rcv s BUILD iI�TC 'tFll Annex - 54375 Main Road - PO Box 1179 TOWN OF SOU Southold, New York 11971-0959 F. ii: cy°N ; Telephone (631) 765-1802 - FAX (631) 765-9502 rogerr(c_southoldtownny.gov - sea ndCa7southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ' ELECTRICIAN INFORMATION (All Information Required) Date: Company Name: LC Electrical Contracting Inc Electrician's Name: Lennie Cancellire License No.: ME-38043 Elec. email:office@LCElecetrical.co'ntracting.com Elec. Phone No: 631-814-0485 01 request an email copy of Certificate of Compliance Elec. Address.: 22 Woodbine Lane East Moriches NY 11940 JOB SITE INFORMATION (All.Information Required) Name: Peter Tsekouras Address: '1852 North Bayview Rd, Southold NY Cross Street: Phone No.: Bldg.Permit#: 47021 email: Tax'Map District: 1000 Section: Block: a Lot: . BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Pool with Autocover Square,Footage: 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: (All information required) Service Size❑1 Ph❑3 Ph Size: A # Meters Old Meter# ❑New Service❑Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground❑Overhead # Underground Laterals 1 FJ2 H Frame Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION ���� ,OD _ 6 UIL N DEPARTMENT la 0� la JAN 202� TOWN OF SOUTHOLD BUiro1rT:o�t 1HLDaII Annex - 54375 Main Road - PO Box 1179 rri TOWN OF SOU °L Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 rogerr(cDsoutholdtownny.gov — seandCa).southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: c�-a— Company Name: LC Electrical Contracting Inc Electrician's Name: Lennie Cancellire License No.: ME-38043 Elec. email:office@LCElecetricalcontracting.com Elec. Phone No: 631-874-0485 0 I request an email copy of Certificate of Compliance Elec. Address.: 22 Woodbine Lane East Moriches NY 11940 JOB SITE INFORMATION (All Information Required) Name: Peter Tsekouras Address: 1852 North Bayview Rd, Southold NY Cross Street: Phone No.: Bldg.Permit#:47021 email: Tax Map District: 1000 Section: Block: oZ Lot: BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Pool with Autocover Square Footage: .Circle All That Apply: Is job ready for inspection?: YES ❑ NO. ✓0 Rough In ❑ Final Do you need a Temp Certificate?: ❑ YES NO Issued On Temp Information: (All information required) Service Size❑1 Ph❑3 Ph Size: A # Meters Old Meter# ❑New Service❑Fire Reconnect❑Flood Reconnect❑Service Reconnect[—]Underground❑Overhead ' # Underground Laterals 1 2 H Frame Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION I Uv ��c�` OD s- PERMIT# Address: Switches Outlets GFI's . I Surface Sconces H H's UC Lts Fans Fridge HW Exhaust Oven Dryer Smokes DW Service Carbon . Micro. Generator: / - Combo: Cookt-0kt._............... op - _. ... Transfer AC � AH Mini Special: Comments: ` 4 - � r . A S 2 Er Q D _ 6 UIL N DEPARTMENT- Electrical Inspector JAN 202 TOWN OF SOUTHOLD Bu«o1fr MII Annex - 54375 Main Road - PO Box 1179 .. TOWN OF SOU 1„ Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 rogerr southoldtownny.gov — sea ndCab.south oldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: / 3 a O-A-2— Company Name: LC Electrical Contracting Inc Electrician's Name: Lennie Cancellire License No.: ,ME-38043 Elec. email:office@LCElecetricalcontracting.com Elec. Phone No: 631-874-0485 D I request an email copy of Certificate of Compliance Elec. Address.: 22 Woodbine Lane East Moriches NY 11940 JOB SITE INFORMATION (All Information Required) Name: Peter Tsekouras Address: 1852 North Bayview Rd, Southold NY Cross Street: Phone No.: Bldg.Permit#:47021 email: Tax Map District: 1000 Section: Block: Lot: ` BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Pool with Autocover Square-Footage:- - IT Circle All That Apply: Is job ready for inspection?: R1 YES ❑ NO �Rough In ❑ Final Do you need a Temp Certificate?: ❑ YES ❑� NO Issued On Temp Information: (All information required) Service Size❑1 Ph❑3 Ph Size: A # Meters Old Meter# ❑New Service❑Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground[]Overhead # Underground Laterals 1 M2 H Frame Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION CERTIFICATE OF pAK ®I'�CeI S NYS WORKERS'COMPENSATION INSURANCE COVERAGE TI>: C tt��eir sot tion Insure_ d Detail Is.Legal Name and address of lnstired(Use street,address only) lb.Business Icicpbonc Number of Insured Marykcg,.Inc, 631-324-7844 P.O.Box: Hampton Bays,NY'1.1916` lc.NYS Unemoloyment Insurance Employer DBA:Bills Pools,Dills pools Service;JAs6p$'Pools,Jason:and:Bilii"'Paol Registration Number of Insured Service Id.Federal Employer Identification Number of insured or SAcial;SecurJty Number. 113168202 Work-Location 6hnsitrcd-(Only.'.kegtii!yet!`lCcovdraga:rs.'speeiJacalfy.11miled4o; certain%calJan in.New:S'nrkSta1P,f e. {,.K'caji:UF'PQlley) 2:Name'and:Address of:�he,Entlty Acquesiing-Proof of:Cov+rage. 3a Name,oflnsurance;Carricr. (Entity'BeingListedastli�e.CeYtil7cafeslloldti' Telinology liisurance`Cotnpany,Inc: TOWN-AF SOUTfIH60 HU11 D1NG:UEPAItTMENT $b,Pollcy..Numbir of entity listed.in box ti",: TOWN HALL SOUTH.O'ED;•NY 119.1 - TWC3965837 3e..Poticy'eii'ective,period 372372021.(0'3L23%2022 3d,In Ii.roprietor,Partners:or Executive Officers^are: i'Included(Only eheckbbk ifall partders/dfficeis included) 4'l,41.1 excluded;orcertaiq partners/officers excluded This certifies'that.the in§urance.carrier indica"ted'akiove"itlaibx_1131"insures the.butiness referenced above in box"la"for workers!coml iensation under the.New York State:Workers'Contpensation.h aw:,(Tause Phis tiWiu;Ner1"York:(N.Y)=must be listed under Item 3A on the INFORMATION PACE of the workers";compensation.`insuraqmpol[ey).;The Insurance CarrIer:or its licensed agent will send tbis.Cert ficate,of Insurance'td the entity ltsfe'd:cilipvc s,tt e;cert>r3cate hplilier The insurance carrier must t otify iGe_above;:ceri icare hnlder.'arida%te.iYnrkers'Cori+pensatinn Board within IO.days.IF a policy.rs canceled zee to noitpayinet+t of premiutirs.or rviihin 30,days.IF there are reasons other than nonpayment ofyremiums.that cancel the.policy or eliminate the insured from the coverage indicated on this Ceitif+eate-(Thi ae.ni Mt #,*i y,.be sent by regti/ar.mail.)Otherwise;this Cerdf+cate is valid for one year 4 ter this form is approved bjr,the insurance carrier or its licensed.agent;or andl the policy expiration date listed in box u3c';.wtiichever.is earlier. This certificate U issued as a matter of information only-and confers no rights upon the certificate holder.This certificate does not amen d,extend or alter the cbverage•afforded by the policy.listed;no does itconfer any rights or responsibilities beyond those.contained in-the;referen ed 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 per m. 1t, license or contract issued by a cerrtifieate holder,the,business must provide.that.certif+cate holder with a new Certificate of Workers' Compensation Coverage or other,authorized proof that the buslneskis complying with the mandatory.coverage requirements of the Nov,York State Workers'Compensation Law. Under penalty of perjury,']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 dcpicfcd on this:form. Approved By: Henry C.Sibley (Print name df authorized representative of licensed ajik:of insuranoc carrier) An Approved By: 4/9/2021 (Signature) (Date) Title: Underwriting Manager, Telephone Nutober of authorized representative 0liceostd:agett of insurance cardin.CarrierP.hone Please Now Only insurance carriers and their licertsed agents are andoorized to issue the C-05.2 form.Insurance brokers are NOT authorized to lvsue it. S.C.T.M.# DISTRICT: 1000 SECTION:70 BLOCK:12 LOT:39.4 N.AAYVMW AOAD o Set."'.5 arAr I1°mr fora. 6 r,� 1 Jr{se, FIRM ZONE X ( FIRM ZONE AE EL 6 l as U avn 1' 1 . m 1 Ra. SOX .r \ '. ;. 'FIRM ZONE X*\\ Flst�ZONE EL 6 th . .,♦y' PPaECf IlO1W0'Ai IQICE .\ ft1 - ARFA 6F 05TLP fA:21600 SF.t 7C \ TYPICAL SIT SCREEN SECTION .. ", �• ._ ., _ \\�p�\ \CEOTE%TIIE F INAL MAP A9flIC '� SUPPORT OR N LOT COVERAGE REVIEWED BYZBA Posts SEE DECISION#,�q wooD ETAL � `1 FLOW DIRECTION UPLAND LOT AREA•69066 Sq.'Feet or 1.59 ACRES 'A \\ DATED IJ2_/.QDa HOUSE W/OECK:2296 S.F. 1 E% AND \ fiACKFlLLED Lf:D T TRRENCH PROPOSED SWIMMING POOL-BFO S.F. TOTAL•2936 S.F.or 4.25% £ \ EXISTING GROUND AA¢ Me 1 i rTi i r i- i - I RE(pjyEp \\r1 A Zoning Board OTA 1�, '" PDeals 1 1 � 11 1 1 1 FIRM MAP IS VWTC0166H WWrEp yµ1W fFR gFM0=W CTl= ' 1 PROPERTY IS WITHIN COASTAL BARRIER REASDURSES SYSTEM NOV.16,1990 lOGRDVS SrM%N ARF FROV FK1D 095FRIURGVS AND OR D47A O9rAWLD FRO/OnM FlRM ZONE I X AREA:75,292.59 SOFT. or 1.73 ACRES Ll[YAnpY0AlplC GNAOi—=ALl6 VW W A 1701 rD n05 S WY IS A WWAROV OF SEC"M?t OF WF ATW 1ORK SrAR rOVCA Rp/Uw. C�°8S�MIS SLRli/' �•� ' u.w Nor BEAI%NC n2lARo svRWMT 6MSOSSFD srAe S=Nor W CDYADEWD ro sF A VAw TRce ter. 6vARAxrus arm NlAEDV SNAf1.A!W FIRM ZONE AE EL 6 i a r m rHF PrRSYW Frx xHav rHE swlEr is FW6PARlD Arm(N Ns 9Ouer m INC nnr CWAAM;WtEANYlNFAt A09MY AND Lamm aesmm�om MTW HERM!Alm TO WE ASSO!!rS Or PC tEA'PRO MnWRQN GUARAHRE'ARE HOr 1RANSIMMUL \ ` IM eFES[IS OP IXAEN00K IDA)AN MnPEW AACA/RIC PRCiERIY lAR"t0 R2 SMVCRMES ARE!UR A�FODC PrA]POSE AN0 115C RlOO:iptF nIFY AR[ \ /. No wrnmin To uOvrArrxr n¢Fima.rr UHES OR To error Mr 6FYCOm W IT.=ApOnORA!saTrcruRcs oR AM onAR el»xoWvars FA,RNpIrS �� AHDAIT't SLYAAmFACr SalIC1WE5 RSL'0971D M(NRCLgPOED ARf NDr WARANTLFD(RREST PN/DGllY MDEM Or FW FPWZS Ar nee A WSW WY wav6r v:DESCRIBED PROPERTY CERTIFIED TO:PETROS TSEKOURAS; oAF nc PENNY TSEKOURAS; '1•,�, `� �' RItD: FlDEIRY NATIONAL TITLE INSURANCE SERVICES,LLC 41• \,jb M 97VAIW AT:SOUTHOLD S Ib,D5 t.S e5'1951 W roMrl a:SOUTHOLD 7.oz�ySTp ]CENNETH M NOYCHUK L1ND SURVEYING,P REVISED DT-20-21 CREEK SUFFOLK COUNTY,NEW YORK Profeeelon.l lend 6unes7ur and Deelt;u S W15.07'W , P.D.Be.150 ANoaboeOe,Ne.York 11961 REVISED 12-09-20 s` GOOSE RLE 0 220-70 SCALE:1"-30' OAa:JUNE 15.2020 N.Y.S USL"ND.osm2 P906(0e1)r 1500 ra(Wl)M-1009 S.C.T.M.# DISTRICT: 1000 SECTION: 70 BLOCK: 1'2-_ LOT: 39.4 N.BAYVIEW ROAD MON.El (NWN RW TO SAYVIEFO Vf R 0 T 1 2 2021 U. U. 0 MON. LAND N/F OF H DANIELLE MAVER OGOVC ILDING DEPT. x B TO ANTON BOGOWC N OF SOUTHOLD U.P 8 JOSIP 8000WC o s S 82°00'00" SANJA FLORIOC BOGOVr. ^' S�K40E _ 32S.58' FIRM ZONE X ` FIRM ZONE AE EL 6 GRAVEL DRIVEWAY m po O 4\ 33S / ARMOUR O !� .► E / \ � ASPHALT DRIVEWAY z � o � �y.o' o a• . ..... 2 \ ..::.:::::•::•. 27 150.6'— ::. ..........:.:.: pw�►�2.............;;::::::::. tic' \ \ N.....................: ... ': :;: :.:... a '00' \� • IRON PIN :::::o ::::... �O DRAIN `"' wruc sa•o' �0 FIRM ZONE yF\ FIRA� ZONE E EL 6 PROPOSED =� pp E X \ DRY WELL FOR POOL EQP. STEPS POOL WASTE WATER STEP ED- q —2. =PR�g,x44'=p001- _- --- c 13. '�ONC 0 am fence fro \ 1 0 b 7< -_-- - 100'min m 0 , ->r VA'F a G X wetland boundaryPROPOSED LAND N/F OF IPA E0 PAVER PATIO \\ t m SET IN GRASS SFIEBEEST SOUTHOLD LLC N690 6 SPACING \\ �n n 87.0 N PROJECT LIMITING SILT FENCE \ y AREA OF DISTURBANCE 3600 S.F.f \\ \ \ 3 \ � 00 00. \ TYPICAL SILT RACK \ \ SCREEN SECTION NYSDEC LOT COVERAGE \ GEOTEXTILE FABRIC (ALL IMPERVIOUS SURFACES) \ \ SUPPORT POSTS UPLAND LOT AREA: 69066 Sq. Feet or 1.59 ACRES \\ WOOD OR METAL � \ \ HOUSE W DECK 2296 S.F. o \ FLOW DIRECTION ASPHALT DRIVEWAY. 1821 S.F. " \ EXCAVATED AND CONC. WALKS/WOOD STOOP: 450 S.F. \ BACKFILLED TRENCH PROPOSED SWIMMING POOL: 640 S.F. TIDAL WETLAND BOUNDARY \ PROPOSED POOL PATIO: 870 S.F. AS DELINEATED BY \ EXISTING GROUND cOLE ENVIRONMENTAL SERWCII� — — PORTION OF WOOD CATWALK: 14 S.F. JUNE Z 2020 1 —1� TOTAL: 6091 S.F. or 8.81% \ �� 11-1( -1 11� ICI I I-11 I�.��I I ICI I I-1 f I I�I t -1 I�III-1�III-1 I I- �►1�IIiII I llilhTl�hII I l i�I llil: _=1 I ITi�I l i I I i�I IITI�ITi�ITI I lI�l l- \ ` v� --{ ,. Y MINIMUM \\ i `p m 1 � 1 � 1 � 1 FIRM MAP#36103C0166H THE WATER SUPPLY, WELLS, DRYWELLS AND CESSPOOL 1 PROPERTY IS WITHIN COASTAL BARRIER REASOURSES SYSTEM NOV.16,1990 LOCA77ONS SHOWN ARE FROM FIELD OBSERVA7701VS r AND OR DATA OBTAINED FROM OTHERS. FIRM ZONE X ! AREA: 75,292.59 SQ.FT. or 1.73 ACRES ELEVATFON DA7UM: / UNAUTHORIZED ALTERA7701V OR ADD177ON TO THIS SURVEY IS A WOLA1701V OF SEC77ON 7209 OF THE NEW YORK STATE EDUCA77ON LAW. COPIES OF THIS SURVEY \ MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VAUD 7RUE COPY. GUARANTEES INDICATED HEREON SHALL RUN FIRM ZONE AE EL 6 ONLY IO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF 70 THE 777LE COMPANY, GOVERNMENTAL AGENCY AND LENDING INS77TV710N LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INS71TU770N, GUARANTEES ARE NOT TRANSFERABLE. \ \ THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE i NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THERECIION OF FENCES, ADDITIONAL STRUCTURES OR AND 01HER IMPROVEMENTS. EASEMENTS AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE 77ME OF SURVEY SURVEY OF. DESCRIBED PROPERTY CERTIFIED TO: PETROS TSEKOURAS; ' MAP OF: PENNY TSEKOURAS; FILED: FIDELITY NATIONAL TITLE INSURANCE SERVICES, LLC; REVISED 10-06-21 0�'�y SITUATED AT: SOUTHOLD REVISED 09-21-21 S 4696 TOWN OF: SOUTHOLD ¢6?2• +y\ S 85'19 32 W REVISED 05-19-21 9.02, e�6,00 �a M MARK SUFFOLK COUNTY, NEW YORK KE�TH M WOYCHUK LAND SURVEYING, PLL REVISED 01-20-21 S 88.45'07 W gyTIE Professional Land Surveying and Design 5�y GOOSE IvREEK P.O. Box 153 Aquebogue, New York 11931 FILE # 220-70 SCALE: 1"--30' DATE: JUNE 15, 2020 N.Y.S. USC. NO. 050882 PHONE (631)298-1588 FAX (631) 298-1588 51020 MAIN ROAD SOUTHOLD NY 11971 FEB 2 6 2021 631.765.4330 u i 1 d,i n Q 0.r-t-m Q-c\t PATRICIA C. MOORE(BYROM _) �52 f�1 • 3 v i�,J �\• Spha\ �f SQ.1L �� z 1-D Z COMMENT: �+n u 0 C Nb 1)i v f�l S Q Q n i l3L t . a}m �ri-t §1 lso . 00 . ulia ©r�(�I Sr CERTIFICATE OF p NYS WORKERS'COMPENSATION INSURANCE COVERAGE STaTI= Compensation Board Insured Detail In.Legal Name and address of insured(Use street address only) Ib.Business Telephone Number of Insured MaryMeg,Inc. 631-324-7844 P.O.Box 1331 Hampton Bays,NY 11946 le.NYS Unemployment Insurance Employer DBA:Bills Pools,Bills Pools Service,Jasons Pools,Jason and Bills Pool Registration Number of Insured Service Id.Federal Employer-Identification Number of Insured or Social Security Number 113168202 Work Location of insured(Only required if coverage is specifically llntited to certain location in New Ynrk State,i.e.a litrap-Up Policy) 2.Name and Address of the Entity Requesting Proof of Coverage 3a.Namc of Insurance Carrier (Entity Being Listed as the Certificate Holder) Teefinology Insurance Company,Inc. TOWN OF SOUTh HOLD BUILDING DEPARTMENT 3b.Policy Number of entity listed in box"In": TOWN HALL SOUTHOLD,NY 11971 TWC3905837 3c.Policy effective period: 3/232021 to 323/2022 34.The Proprietor,Partners or Executive Officers are: "r 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"3"insures the business referenced above in box"ta"for-workers'compensation under the New York State Workers'Compensation Law.(To use this form,New York(NY)must be listed tiitderItem 3A on the INFORMATION PAGE of the workers'compensation insurance policy).The Insurance Carrier or its licensed agent will send this Cert ticate of Insurance to the entity listed above as the certificate holder in box 112". Tire insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy is.canceledfile to nonpayment of premirntts or within 30 days IF there are reasons other than nonpayment ofpremiums.that can the policy or eliminate the insured from tire coverage indicated on this Certificate.(These ngtices may be sent by regular mail.)Otherwise;this-Certificate-is valid for one year ter tins form is approved by the insurance carrier or its licensed agent,or 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 amen 1,extend or alter the coverage afforded by the policy listed,nor does it confer any rights or responsibilities beyond those contained in the.referen ed policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying poltey 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 lusiness is complying with the mandatory 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 that the named insured has the-coverage as depicted on this form. Approved By: Henry C.Sibley (Print name of outhorized representative or licensed agent of imuranec carrier) Approved By: 4/9/2021 (Signature) (Date) Title: Underwriting Manager Telephone Number of authorized representatide or licensed agent of insurance carrier:CarricrPhone Please Note:Only Insurance carriers and their licensed agents are authorized to hutre'the C-105.2 farm.Insurance brokers are NOT mriharized to issue it. 1 : Da APPRO ED AS NOTED DATE: B.P:# FEE- BY: NOTIFY:BUILDING DEPARTMENT AT . 76571802.',':&AM TO 4 PM FOR THE 1$ i! FOLLOWING.INSPECTIONS: ��� { �X. I. FOUNOATION TWO REQUIRED E:NG�dSE POOL-T(ll'G!(�"Q'_ compLET�( iV 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. (ELECTRICAL COMPLY WITH ALL CODES OF INSPECTION RE4UIREC NEW YORK STATE & TOWN CODES AS REQUIR AND CONDITIONS OF SOUTHOLD TOWN ZBA SO G BOARD SOUTHOLD TOWN TRUSTEES N.Y.S.DEC OCCUPANCY OR USE IS; UNLAWFUL WITHOUT CERTIFICA OF OCCUPANCY RETAIN STORM WATER RUNOFF PURSUANT TO CHAPTER 236 OF THE TOWN CODE. 'j e Jason's Pools Estimate PO Box 1331 Hampton Bays, NY 11946 Date Estimate No. 631-324-7844 Fax 631-329-5127 8/3/2021 4100 9u-P,1�--e� Peter Tsekouras Peter Tsekouras 1852 North Bayview Rd. 1852 North Bayview Rd. Southold NY 11971 Southold,NY 11971 Date Description Qty Rate Total Installation of a 16 x 40 Gunite Swimming pool. Pool permit included 1 56,700.00 56,700.00 Pool Includes: Marble Dust-Color of choice 12" Beam w/8" thick walls&8"floor 42"shallow end with an 6'deep end (test hole to determine depth before starting) Autofill connected to existing water supply Dual Main Drain 3 Skimmers&4 Returns 4 Pentair Intellibrite LED color globrite light 1 Pentair Variable Speed pump , 400 Sq. Ft.Sta-Rite Cartridge Filter Loop-Loc Green Mesh Winter Safety Cover and Installation 1 2,250.00 2,250.00 6"x12"Slate Tile($8 allowance) Rough Grade of Excavated Area Pool includes all plumbing 2"poly underground and 2"rigid above ground. Precast drywell as required by town code 3 water deliveries included same day as pool finish is done Removal of fill from site. Roughly 140 yards 140 24.00 3,360.00 Installation of 16'full length stadium steps with 4 14"treads 1 5,500.00 5,500.00 Installation of 2"x 14"natural stone coping 120 26.00 3,120.00 Estimated cost of 2"x 14"Blue Ice coping 120 18.00 2,160.00 -Additional coping options available Aqua-Cal Heatwave SQ145 SuperQuiet electric heat pump 1 5,700.00 5,700.00 Pentair IC20 salt system with power supply Including salt start up 1 2,800.00 2,800.00 Subtotal before tax 81,590.00 Dewatering-TBD-Each well point is$1,500.Average amount needed is 0.00 0.00 4$(6,000) Haybails/Silt fence as required by town 1 4,000.00 4,000.00 10%to apply for permit(s), 40%to start, 25%To Be Determined&25%after completion. Subtotal Tax(0.0%) Date: Signature: age I Total Jason's Pools Estimate PO Box 1331 Hampton Bays, NY 11946 Date Estimate No. 631-324-7844 Fax 631-329-5127 8/3/2021 4100 Peter Tsekouras Peter Tsekouras 1852 North Bayview Rd. 1852 North Bayview Rd. Southold NY 11971 Southold,NY 11971 Date Description Qty Rate Total ***Due to the large machinery used during this process access to pool area is needed.We do not re-install fences, gates etc..Due to the large machinery used during this process your landscape,grass and irrigation will get damaged.We will do our best to limit the damage caused but repair work(to be done by others)will be required after we are done. A landscaper will need to do final grade,we only do a rough grade around pool area only.*** Electric not included. Additional plaster finishes available. 10%to apply for permit(s),40%to start,25%To Be Determined&25%after completion. Subtotal $85,590.00 Tax(0.0%) $0.00 Date: Signature: age Total $85,590.00 40' RETURN ! Bonding Wire connected to all hardware WASTE FILTER HAIR 11 LINT CATCHER PUMP SKIMMER • f MAIN DRAIN WATER LINE MIN 3AP .—, 2"RETURN TO INLET DD PU i MAIN 9 DRAIN S E P — 7 2021 i PIPING SCHEMATIC 2"PIPE BLJ DING DE T01VN Off'SOiT H D SUO ON SUC ON OF NEW r DEf�jjO'P,� Z MAIN =C7 27 coaiNc DRAIN ' C\j 0 . i9 ROfiESSI NP " n ' :'a u ' 2•-1'.' TO Complies Wistfi: +e=10 30- :. 5•-0„ i 0.c.-trip) RADIUS Section%R326 of the 2020 Re�.,idential <. 4 12' 16' 12' Code'of New York Section N1103.12 W03.12)Residential ; uriopivca r TO DECK Pools and Permandnt Residential Spas ' P i �UGHT NICHE' ." ..1:.� '•.' - �.e4X Section R3264 Barriers :e. Section R3265—R326.6.5 Entrapment coPuvG= PAVEa > Avoidance LIGHT PIT DETAILS Section R326.7 Swimming Pool and - nanriroc � �- - . : -PERIMEIE4�ROND Spa Alarms LIGHT NICHE DETAILS (NTS) �- 3-hWC AMRBIE DU Jasons Pools f9MT WPEBAR —.iTll' . "iHORMWAU sill= . TO24RAD.U5-Si1A 01 Emo: �,W 11 i,N— #3.STEEL REINFORCED p �S•RADRK,-DEEPEND�.• c 10_ 52 N.Bayview Ave. COHCRESE ,, DEPTH <5'-0" >5'-0" Southold, NY b wuw A C'• " c' i! , l�lill II111! HORIZONTAL 10"O.C. 10""O.C. a> � " �I I-- I, l.i Ill— 11!IIii —Gillll hllu!-�lllil!i—,tl►hli. ill11 . VERTICAL _ " " . 10" O.C. 5"O.C. POOL TYPE- 16 x 40 Gunite SCALE: MIS FLOOR 12"O.C.em.OR . 12"O.C.em.OR JAMES DEERKOSKI, P.E. DATE: 8/30/2022 Prf POOL WALL SECTION(NTS) MESH EQUIVALENT MESH EQUIVALENT 260 DEER DRIVE MATTITUK,.NEW YORK 11952 DRAWING NUMBER 1 OF . 2