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HomeMy WebLinkAbout51396-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#: 51396 Date: 11/20/2024 Permission is hereby granted to: Michael Koke 200 Deer Run Southold, NY 11971 To: Construct an inground swimming pool accessory to an existing single-family dwelling as applied for. Pool and pool equipment must maintain a minimum rear and side yard setback of 10feet. Premises Located at: 755 Brigantine Dr, Southold, NY 11971 SCTM#79.4-49 Pursuant to application dated 09/25/2024 and approved by the Building Inspector. To expire on 11/20/2026. Contractors: Required Inspections: Fees: SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $300.00 CO Swimming Pool $100.00 Total $400.00 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 htt s://www.southoldtowtinv.gov' Date Received rV APPLICATION FOR BUILDING PERMIT For Office Use Only ) ;. I ,91 PERMIT NO. I Building Inspector: _jxw_ u�, y m .E. Applications and forms must be filled out in their entirety. Incomplete applications will not be accepted.,Where the Applicant is not the owner,an Owner's Authorization form(Page 2)shall be completed. Date: OWNER(S)OF PROPERTY: Name: ET: # 1000-y 7 Project Address: '7 - 1 a I 9`l Phone#: �l Q1 �� Email:�� r Mailing —2,557-Bo N cy r-° d ' \q- CONTACT PERSON: Name: Mailing Address.�Ipc* �C So 14—M�V 1 k01 Phone#: `7_S�CJb Email: DESIGN PROFESSIONAL INFORMATION: Nahne. Mailing Address: 1V` —�o Phone#: CO3 1—hSr .3`� Email:Q C CONTRACTOR INFORMATION: Name. —,�W Mailing Address: tC,- (o Phone M Email: S w DESCRIPTION OF PROPOSED CONSTRUCTION RZ,New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: ❑Other Sao ( $ `2Sf0 Q() Will the lot be re-graded? ❑Yes B�No Will excess fill be removed from premises? ❑Yes [�No 1 PROPERTY INFORMATION Existing use of property: ` Intended use of property: Zone or use district in which praTTiises is situated: Are there any covenants and restrictions with respect to this property? ❑Yes Q1Vo IF YES, PROVIDE A COPY. Check Box After Reading: The owner/contractur/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 pass A misdemeanor pursuant to Section 210AS of the New York State Penal law. Application Submitted By( rin name): M,C�j AAuthorized Agent ❑Owner Signature of Applicant: .. Date: "I J,3(4 L-4-i STATE OF NEW YORK) SS: COUNTY 0F5U r,:i7-bk V— being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the weuk s 4 (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 C day of y 20ai— L�lw Notary Public JENNIFER EATON QZATION NOTARY PUBLIC-STATE OF NEW YORK No. 01-EA6057243 (Where the applicant is not the owner) Qualified in Suffolk COun!y My Commission Expires April i o. 20 o ( .4( e § u I �Z residing at , , L fq,7 do hereby authorize !I✓' F�3 S ®ot7fs to apply on my behalf to the Town of Southold Building Department for approval as described herein. Ow er"s Sign" re Date R G h F-o 2-- Print Owner's Name 2 DATE(MMIDDNYYY) CERTIFICATE OF LIABILITY INSURANCE 9/24/2024/2024 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(es)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 erldorsernent(s). PRODUCER No OT Elk a L nch Borg&Borg Inc. PHONE 631-673.7600 ;631 351-1700 148 East Main Street EWMAIL Huntington NY 11743 - certificates bo org.corn INSURER 3 AFFORDING COVERAGE NAIC# INSURER A:Admiral Insurance Corn an 24856 INSURED �. IINSUR;ER B Twin Forks Pools&Spas, Inc. PO Box 1308 tNsuReRc, 1375 North Sea Rd INSURERD k Southampton NY 11969 INSUREREt INSURER F COVERAGES CERTIFICATE NUMBER:161430449 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. ADOL U POLICY ELF POLICY EXP 1 R TYPE OF INSURANCE POLICYNUM89R MMIDD1YYYY' MM1DOlYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y CA000052544-01 4/4/2024 4/4/2025 EACH OCCURRENCE $1,000,00o CLAIMS-MADE OCCUR PM15ES Eau�oourran $14I0,000 MED EX?(Any one pmot $5,000 PERSONAL&ADV INJURY 1$1,000„000 GEN`L AGGREGATE LIMIT APPLIESPER: GENERALAGGREGATE $2,000,000 POLICY PRO- LOC PROOUC'TS-COMP/OP AGG $2.,000,000 JECT OTHER, AUTOMOBILE LIABILITY 0 aO4$INGLELIMW'7 $ ANY AUTO BODILY INJURY(Per person) $ ••••••••- OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS •� HIRED NON-OWNED PROPERTYOAMAGE $ AUTOS ONLY AUTOS ONLY .Par accident UMBRELLA LIAB OCCUR EACHOCCURRENCE $ '.....EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEtA... RETENTION$, _ $ WORKERS COMPENSATION S U1!EER H AND EMPLOYERS'LIABILITY Y I N ANYPROPRIETOWPAR.TNEMEXECUTIVE. ❑ N/A E.L.EACH ACCIDENT $ OFFICERIMEMBB R EXCLUDED'! (Mandatory In.NH) E.L.DISEASE-EA EMPLOYEE $ If as,describe under D SS�CR)PTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Certificate holder is an additional insured to the fullest extent permitted by law when required by a written executed contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of Southold Building Department PO BOX 1179 AUTHORIZED REPRESENTATIVE Southold NY 11971 h ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD NEW I Workers' CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1 a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured (631)537-5700 1c.NYS Unemployment Insurance Employer Registration Number of Twin Forks Pools&Spas, Inc. Insured PO Box 1308 1375 North Sea Rd Southampton NY 11969 1d.Federal Employer Identification Number of Insured or Social Security Number Work Location of Insured(Only required if coverage is specifically limited to 844898628 certain locations in New York State,i.e.,a Wrap-Up Policy) 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Amtrust Insurance Company Town of Southold Building Department 3b.Policy Number of Entity Listed in Box 1a" PO Box 1179 KWC1349407 Southold NY 11971 3c.Policy effective period 3/12/2024to 3/12/2025 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"T'insures the business referenced above in box"1 a"for workers'compensation under the New York State Workers'Compensation Law.(To use this form,New York(NY)must be listed under Item 3A on the INFORMATION PAGE 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'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 the insured from the coverage indicated on this Certificate.(These notices may be sent by regular mail.)Otherwise,this Certificate is valid for one year after this 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 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 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. 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: Borg & Borg Inc., David M Borg President (Print name of authorized representative or licensed agent of insurance carrier) /y 9/24/2024 Approved by: (Signature) (Date) Title;—Authorized Representative Telephone Number of authorized representative or licensed agent of insurance carrier: 631-673-7600 Please Note: Only insurance carriers and their licensed agents are authorized to issue Form C-105.2.Insurance brokers are NOT authorized to issue it. C-105.2(9-17) www.wcb.ny.gov ZONING DATA ...........................T 000-0-7cf.00-04.00-04cf.000 U15TRIGT: R-40 (RE51DENGE) ITEM REQUIRED PROVIDED /P 71�—LOT7 AREA 40,000 5F 21f92b5 SF'(0.4qa Ar,) WIDTH MIN LOT ........ 150 FT -1.7�72 20%OF 21,6-121 5F (5 50% 5F DRAFT SNAP OR 4555 5 5F MAX,LOT COVERAGE A CHMM-L SERVICES 215 ROANOKE AVENUE MAXE31JILIPINO AT 35 FT 17 FT, MIN FRONT YARD ........... RIVERHEAD,NY 11901 .......... "A (631)115-3903 (BRIGANTINE DRIVE) 50 FT, 64,5 FT I'E?'E YARD 15 FT, 11.1 FT- SEAL: TOTALSUBJECT 51DE YAR05 35 FT, 3&4 FT AD-.Y 50 FT, 55,61525 FT, .......... .............'NOTE:EXISTING DWELLING 15 A PRE EXISTING,NON-GONFORMINO U51E. sl PROJECT INFORMATION 9NNER: IRAP LH FOLZ LYNDA FOLZ KEY MAP ADDRESS:' SC�I-E. � POOL LOCATION DIAGRAM :75 --Dkl&-ANTINE DR DATE: SOUTHOLD,NY 11971 215 ROANOKE AVENUE RIVERHEAD,NY 11901 SCALENTS j NQUqES:�20NT`Ar (631)655-3903 � I. DIMENSIONS ON THIS DIAGRAM ARE APPROXIMATE. (516)911-3q31 INDEX OF DRAWINGS FINAL LOCATION �5 TO BE VIF BY POOL CONTRACTOR PRIOR TO CONSTRUCTION. SP-1 51TE PLAN 4 COVER PAVE EXISTING BUILDING,FLOOR AREA: 1,757 SF PROPOSED BUILDING ADDITION: 594 SF A-r, TOTAL PROPOSED BUILDING AREA: Iqlb 5F BUILDING GON5TRUGTION TYPE: V A-0 DEMO PLANS &NOTE5 BUILDING Or-CUPANCY: R-111 A-1,1 PROPOSED FLOOR PLANS A-1.2 PPOP05ED GEILINO 6 POWER PLANS HIND DE510N FAGTOP: 130 MPH GROUND SNOWLOAD: 50 P5F A-2 PROPOSED DECK PLAN SEISMIC DESIGN FACTOR: 13 A-5.1 PROPOSED ELEVATIONS A-3.2 WINDOW DETAILS WEATHERING: SEVERE TERMITE DAMAGE: MODERATE To HEAVY A-4 SECTION it FOUNDATION DETAILS FP05T LINE DEPTH: 36"BELOW GRADE GENERAL NOTES 4 ;k, PE5[DENrE I. ALL GONTRAGTOR/TRADES AND THEIR SUB CONTRACTORS SHALL BE REQUIRED TO COORDINATE AND SCHEDULE THEIR WORK AS REQUIRED TO FACILITATE SEGUENGINO, COORDINATION, ETC. IT SHALL BE THE RESPONSIBILITY OF EACH CONTRACTOR TO NOTIFY xw� OTHER CONTRACTORS OF CONDITIONS THAT WILL AFFECT THEIR WORK THAT WILL REQUIRE COORDINATION AND/OR VERIFICATION. NO GHAN6E ORDERS WILL BE CONSIDERED FOR 1 EX15TINO � COSTS INCURRED DUE TO LAGr- OF PROPER COORDINATION. 2-r-AR I= C2 GARAGE Z THE CONTRACTOR SHALL REVIEW THE ENTIRE SET OF DRAWINGS TO COORDINATE THE ... cla WORK OF ALL TRADES AND TO VERIFY INFORMATION THAT WILL AFFECT THEIR WORK. IN a ca C" /V61. c Lu — m cr SUN ROOM NEN 306 5F ca = — �REENEP GENERAL, LOCATIONS INDICATED ON SITE PLANS TAKES PRECEDENCE OVER OTHER :N- 0 DOCUMENTS ARCHITECT SHALL PROVIDE INTERPRETATION OF LOCATIONS, ETC. WHEN P: W6 AV m 2� REGUESTEU.' -4 5. ALL ITEMS SPECIFIED INDICATE THE MINIMUM STANDARD FOR COMPONENTS TO BE ca INCORPORATED INTO THE PROJECT, ANY "OR EQUAL" MUST BE APPROVED BY THE C=� 0 [;Y: C2 cm I- ARCHITECT AND OWNER. ALL ITEMS CALLED FOR OR SPECIFIED SHALL BE INSTALLED IN In sr:PEA pa I (5'r SEPERATE PER�HT) In C2 - Y' COMPLIANCE WITH THE MANUFACTURERS WRITTEN SPECIFICATIONS AND INSTALLATION C2 r— COD Lu INSTRUCTIONS WHICH ARE INCORPORATED INTO THESE DRAWINGS IN THEIR ENTIRETY BY c#lj ad THIS REFERENCE. INSTALLATIONS SHALL INCLUDE ANY AND ALL HARDWARE, SUPPORTS, ICE A FITTINGS, COMPONENTS,CLEARANCES, ETC. HHIGH ARE REQUIRED FOR A COMPLETE AND PROPER INSTALLATION AND MAINTENANCE WITHOUT EXCEPTION. lcor 4. CONTRACTORS SHALL MAINTAIN ONE SET OF MARKED UP OP-AV41NOS TO INDICATE ANY AND Lu • ALL DEVIATIONS FOR AS BUILT CONDITIONS AND SHALL TURN OVER SAME TO THE co N41 ARCHITECT UPON COMPLETION OF THE PROJECT. X THEIR WORK AS REQUIRED FOR THE ISSUANCE OF THE CERTIFICATE OF OCCUPANCY UPON 5. CONTRACTORS SHALL COORDINATE ANY AND ALL INSPECTIONS DURING GOIN15TRUCITION FOR COMPLETION OF WORK. 6. GONTRAGTORS SHALL PROVIDE ALL REQUIRED INSURANCES AND WORKER COMPENSATION -f. ALL NEW CONSTRUCTION SHALL COMPLY WITH THE 2020 NYS BUILDING CODE, THE 2020 LPROJEcw: 2024-13 NYS MECHANICAL CODE AND THE 2020 NYS FIRE CODE AS WELL AS ALL TOWN PROPOSED SITE PLAN U) REOULATION5 AND LAH5. DRAWN BY: TNR SCALE:1"=10' DRAWING#: I. THIS SITE PLAN HAS PREPARED USING AS A BASE THE SURVEY DATED 07-26-2024 BY MICHAEL K. HIG<S L.S. 2. THERE ARE NO PRIVATE HELLS WITHIN 150 FT, OF THE SUBJECT PARCEL, s p .................... SHEET 1 OF 7 DIMENSIONS ARE TO GUNITE IEF — INSIDE EDGE OF FORMS IEG — INSIDE EDGE OF GUNITE / V9, 43'-9" IEF 40'-1" IEG 11'-10" 20'-1" r, 1, / f l / "r J i 5 POOL PLAN SCALE: 1/4 = 1 —0 % f ui LJ COPING OVERHANGS GUNITE 2" � I -to 2x24" COPING N N 6" CERAMIC TILE " MORTAR 49 04 / #4 BARS CONTINUOUS #4 BARS 12" O.C. E.W. WITH #4 VERTICAL ALTERNATES 6" 3.0 AT oe® oao ®oo /r %,: DEPTHS OVER FIVE FT f r d f; r / J 1 f f / / f, l /,r ,� 8'-6y2" 13'-4" 13'-4" 8'-6y2" —� INFERIOR 10 WALL FINISH ' 40'-1" 13'-4" 13'-5" 13'-4" =N 6" GUNITE FLOOR#3 BARS 12" O.C. E.W. rn WALL SECTION �"CALE: 1" = 1'-0" I CD 6" GUNITE FLOOR #4 BARS 12" O.C. E.W. POOL PROFILE SCALE: 1/4 = 1 —0 ARc 7;�, 0 4& OF NEB �r'i SYMBOL KEY SKIMMER — 2" PORT (2) DIRECTIONAL RETURN (3) ® VGB COMPLIANT DRAIN (2) d- LED NICHELESS LIGHT (3) N GUNITE ELEVATIONS Q TOP STEP (24" RADIUS) 74" BELOW BEAM POOL DATA 0 5 10 15 20 SECOND STEP (12" WIDE) 17" BELOW BEAM DIMENSIONS: 40'-0" X 20'-0" 6,1„I I I I I I I I I I I I I I I I I I I ( THIRD STEP (12" WIDE) 264" BELOW BEAM WATER DEPTHS: 3'-6" TO 8'-0" SCALE: 1/4" = 1'-0" FOURTH STEP (12" WIDE) 36" BELOW BEAM SURFACE AREA: 800 SQUARE FEET PERIMETER: 120'-0" LINEAR FEET z FLOOR AT STEPS 45 " BELOW BEAM TANK VOLUME: 33,500 GALLONS 0 0 o NO. REVISION DATE 616 cn ?SIN F � POOL LAYOUT FOLZID\1:7�SIDENCE t � a K P L PA SERVICE z . � T�UIl�T FOR S 00 & S NCR . � . P.O. BOX 1308 J �> :h & s . 755 BRIGANTINE DRIVE SOUTHAMPTONNY SECTIONSSOUTHOLD14—Au —24 NY g 631 -537-5732