HomeMy WebLinkAbout51577-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#: 51577 Date: 01/21/2025
Permission is hereby granted to:
Philip J Sicuro
490 Victoria Dr
Southold, NY 11971
To:
install hot tub as applied for.
Premises Located at:
490 Victoria Dr, Southold, NY 11971
SCTM#78.-9-71.3
Pursuant to application dated 11/20/2024 and approved by the Building Inspector,
To expire on 01/21/2027.
Contractors:
Required Inspections:
FOOTING/REBAR, ELECTRICAL- ROUGH, ELECTRICAL- FINAL, DRAINAGE, FINAL,
Fees:
SWIMMING POOLS-ABOVE-GROUND WITH REQUIRED FENCING $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 littps://www.soLitholdt�ownEyaov
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only 17 L
f Building
PERMIT N0. g Inspector:
Applications and forms must be filled out in their entirety.Incomplete ,
applications"will not be"accepted. Where the Applicant is not the owner,an,
nt
Owners Authorization form(Page 2)shall be completed.
Date:11/18/2024
OWNER(S)OF PROPERTY:
Name:Phil Sicuro SCTM#i000-78.-9-71 .3
Project Address=490 Victoria Drive Southold NY 11971
Phone#:631-734-7600 Email;
Mailing Address: S;C-Qco—%-�N'V@ 1C`o�c�
CONTACT PERSON:
Name:Jennifer Delvaglio/East End Pool King
MailingAddress:PO Box 369 Peconic NY 11958
Phone#:631-734-7600 Email:cj@eastendpoolking.com
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name:Jennifer DelVaglio/East End Pool King
Mailing Address:PO Box 369 Peconic NY 11958
Phone#:631-734-7600 Email:cj@eastendpoolking.com
DESCRIPTION OF PROPOSED'CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
❑Other 8x8 Hot rub $7,000
Will the lot be re-graded? ❑Yes ®No Will excess fill be removed from premises? ❑Yes @No
1
PROPERTY INFORMATION
Existing use of property:R_40 Intended use of property:Residential
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
R-40 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( +,tftar .Sharon McHugh Ag
g Auth rued ent ❑Owner
Signature of Applicant: Date:
STATE OF NEW YORK)
COUNTY OF Sly )
� + being duly sworn, deposes and says that(s)he is the applicant
(Name of individual sign n contract)above named,
(S)he is the
(Contract r,Agent, orporate Officer,etc.)
of said owner or owners, and is duly authori; to 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
n/
o�oday of 1 `�dV Q Y` _ 20 R 4 �.
ota�ry Public
TR,ACEY L.DWYefq
NOTA,IRy IPU&UCP STATE OF NEW YOB
PROPERTY OWNER AUTHORIZATION NO,OIDKS3 CI
7',WJ IFE IN FF 'Otp'�ITY
(Where the applicant is not the owner)
OOIirfiI�W,.;�;fhl RF. F#RM.J1fN
I, Phil Slcuro residing at
do hereby authorize to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
J"e
Ovoer's Signature Date
Print Owner's Name
2
CERTIFICATE OF LIABILITY INSURANCE DATE( YYYY)
11/15/2015/2024
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(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).
111 PRODUCER CONTACT Barbara Dammers
NAMES
Roy H Reeve Agency,Inc. PHONE t: (631)2984700 FNe (631)298-3850
PO Box 54 E-MAIL bdammers@royreeve.com
ADDRESS:
13400 Main Road INSURER(S)AFFORDING COVERAGE NAIC At
Mattituck NY 11952 INSURERA, Hartford Fire Ins Cc 19682
INSURED INSURER B: Trumbull Ins Cc 27120
Eastern End Pools LLC,DBA:East End Pool King INSURER C: Twin City Fire Ins Cc Cc 29459
PO BOX 369 INSURER D:
INSURER E 6
PBConic NY 11958 INSURER F
COVERAGES CERTIFICATE NUMBER: CL24111522084 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.
LTR TYPE OF INSURANCE INSO WVO POLICY NUMBER liO. o MOnDIY Yy MAtmoffY'MY LIMITS
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
CLAIMS-MADE �OCCUR PREMISES Es occurrence $ 100,000
X Contractual Liability MED EXP(Any one person) $ 15,000
A Y Y 12UUNQD9CVO 11/15/2024 11/15/2025 PERSONAL&ADV INJURY $ 1,000,000
M'OTHER!
LAGGREGI T'E LIMIT APPLIES PER: GENERAL.AGGREGATE $ 2,000,000
POLICY ❑PERCT F
OLOG PRODUCTS-COMPIOPAGG $ 2,000,000
. $
AUTOMOBILE LIABILITY COMBI ED-SINGLE.LIMIT $ 1,000,000
Ea ari:FdeGk�_
ANY AUTO BODILY INJURY(Per person) $
B Y Y 12UENQD9CV2 11/15/2024 11/15/2025 BODILY INJURY(Per accident)OWNED i SCHEDULED
AUTOS ONLY AUTOS
HIRED NON-OWNED P'ROPERTYDAh1A $
AUTOS ONLY AUTOS ONLY ReP auc,dartt
IX LJ $
UMBRELLA LIAO OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE AGGREGATE $
— 1 H
QED RETENTION$ PER
WORKERS COMPENSATION X STATUTE ER
AND
ANY OFFICEOPRIETEREXCLUDEE ECUTIVE ILITY YIN E.L.EACH ACCIDENT $ 1,000,000
C NIA Y 12WEQD9CUV 11/15/2024 11/15/2025 1,000,000
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $
'.If yes,dasolba under 1,000,000
DESCRIPTION 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 included as additional insured under General Liability as per the terms and conditions of form#HS3407(01/98)-Broadened Coverage for
Swimming Pools including a waiver of subrogation and primary&non-contributory coverages as required by written contract or agreement. Additional
insured,Primary&Non-Contributory and a Waiver of Subrogation are included for Auto coverage Under Form#HA9917(0W14)-Commercial Auto Broad
Form Endorsement. Workers Compensation contains a Blanket Waiver of Subrogation.
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
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
LEGEND
6 ----WATER METER TOPOGRAPHIC SURVEY -
® - `• -SANITARY MANHOLE �p OF
N/F -- DRAINAGE MANHOLE DESCRIBED PROPERTY -
JEANMARIE MCGUIRE SCANAPICO En -- ,CURB INLET -
- AND 4 _ ,,UTILITY POLE SITUATE AT
I. RAYMRND SCANAPICO F— --cur wtR£
SOUTHOLD
® - --ELECTRIC METER TOWN OF SOUTHOLD
S 77.5548' E 8�8l 'WI WY4 �'EQUIPMENT SIGN SUFFOLK COUNTY,NEW YORK
4 PAD 4Q - --SANITARY CLEANOUT j
FLAGPOLE AREA OF PARCEL = 35,275t SO.FT. OR 0.810t ACRE
i�- CONIFEROUS TREE
kTFs - DECTLUOUS TREE
R/Q 'ROOF OVERHANG
W >< n
C/E -•CELLAR ENTRANCE
A F / / / / •gym j V]_ a.FF -� �-FIRST FLOOR ELEVATION
i I� ,� Ri / x � (s� 4 � - I � x2693=--• -SPOT ELEVATION
EP' - EDGE OF PAVEMENT
WW WINDOW WELL
is "
/ 9
� P.ve �`�# _ A/C .-... ,AIR CONDITIONER
f k
,I/ P6' NOTES
Cie / 1. MEASUREMENTS ARE IN ACCORDANCE WITH U S STANDARDS.
W / r v 1 n -
As!- t '� LOT COVERAGE, :2. BEARINGS SHOWN ARE IN NEW YORK STATE PLANE COORDINATE SYSTEM NAD83,
3 rw EXIST,r4 �� 'Y 3HOUSE, 2,469 SOFT. I LONG ISLAND ZONE.
O / SHED, 55 SO.FT.
�Qy, �i / - I L� 3, ELEVATIONS REFERENCE NAVD 198E(GEOID1BA 1
Cie / ¢ �A / P '^� WORD STOOP(P. 13 SOFT
�C ilk pECK "; I Q wOOD STOOP(2)+ tD SOFT. q, UNAUTHORIZED ALTERATION OR AD0I770N TDASURVEY MAP BEARINGALICENSED
pq-g
STEPS+ 38 SOFT. LAND SURVEYORS SEAL ISA VIOLATION OF SECTION 7209.SUBDIVISION OF THE
WOOD DECK, 629 SOFT. NEW YORK STATE EDUCATION LAW.
' CONC.STOOP 32 SO.FT.
-_. _ 3 CIE, 27 SOFT. 5. ONLY COPIES FROM THE ORIGINAL OF THIS SURVEY MARKED WITHAN ORIGINAL OF
.zz
I " ; x l _ s STONE FIREPLACE+ 26 SO.FT. THE LAND SURVEYOR'S"EMBOSSED OR"INKED"SEAL SHALL BE CONSIDERED TO BE
ti f '1 k 1
� 1Es, EXIST. TOTAL LOT COVERAGE, 3,299 SO.FT/9.4% VALID TRUE COPIES
#f 5 $ 4 S a n '"'S Y3YTTT uSSURs`CYikASrAf'laISOM
P, LL7F L'IIg:' 'D -_ .S4w YtTrt T+E s'�ri 13 P Y� 401_0
2,469 SO.FT. ADOPTED BY THE NEWYORK STATE ASSVC PON OF AMrE&SOMLAND
S9/,;,[: 55 SOFT SURVEYORS.SAID CERTIFICATIONS SHALL RUN i&#IY tC fE ,4PERSO saQ WHOM
wL`P➢STOOP(Ih 13 Gfr`
SOFT THE S YIS PREPARED AND ON HIS TO THE DILL COYFAN'Y
LAiMNCvAw aEP GBEHALF
H c Rt €$TrdTY,€ `�'PTO THE
- IV=STOOP(2)- 10 SO.FT 'S.
SO.FT ASSIGNEES l;1R 6EeS T.aVa1iTU3'KOS` 74r 'T aSA ' T"7"
\ D DECK, 629 SOFT. TO ADDITIONAL INSTITUTIONS Cf€SG'3S�' 7�Ytt§ R3
IW
S' W`UK cA \ CONC. STOOP, 32 SOFT - Z RIGHTS.OF-WAYNOTSHOWNARENOTCERTIFIEO.
27 SOFT.
STONE FIREPLACE, 26 So..FT. 8. THE SURVEY CLOSES MATHEMATICALLY.
PROP.SWIMMING POOL, 512 SO.FT.
' r
{gr7 e' i PROP PATIO 688 SOFT 9, UNDERGROUND UTILITIES IF SHOWN ON THIS SURVEY ARE FROM UnUTY MARKOUr
EXIST. TOTAL LOT COVERAGE, 4,499 SOFT/12BZ LOCATED ON THE GROUND AND/OR RECORD PLANS.BEFORE ANY EKCAVA T70N IS TO
BEGIN.ALL UNDERGROUND UTILITIES SHOULD BE VERIFIED AS TO THEIR LOCATION ,
O, 'J \ MAX ALLOWABLE LOT COVERAGE,7,055 SOFT/20Z SIZE AND TYPE BY THE RESPECTIVE UTILITY COMPANIES.
?Byp L� 10. THIS SURVEY WAS MADE WITHOUT THE BENEFIT OF A 77TLE REPORT.SUBJECT TO
O�� 4 Of
N AN EASEMENTS.CONDITIONS OR ENCUMBRANCES AN UPDATED TITLE SEARCH MAY {
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as DRC .'€` ( � 380 Nletoris Orbs
cr nz.. - _ suufhrtid:.. New Y r
N 73-181 " I hereby certify that this map Was made from an actual survey Proposed Improvements
SUFFOLK COUNTY REAL PROPERTY TAX MAP w 10025, wmpleted by me on 1212012024. I.K. MtLEAN ASSOCIATES
DISTRICT 1000 £D/S'
SECTION 078.00 D �i1 ^GJ`' .t°.LOUNT�i+rN(;x 9URYEYA OPdY—�W
BLOCK 09.00 C50' _lr�t+4o'1k �� T 90.COUNTRY R6Aif:HROa9IiAVBN,NEWTAMARA L STILLMAN,P.L.S - �-we er aL isc ,,. €^ sDLOT 071A03 iF Da. ;.mn: WIR312ae4NYSPLS No.50528 r4 rt