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Home My WebLink About51676-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#: 51676 Date: 02/24/2025 Permission is hereby granted to: Patrick Marchand PO BOX 55 Southold, NY 11971 To: construct accessory in-ground swimming pool as applied for. The swimming pool must be located a minimum of 25'from the side yard lot line and be located behind the deck addition of the dwelling. Premises Located at: 344 Terry Ct, Southold, NY 11971 SCTM#69.-3-6.4 Pursuant to application dated 01/10/2025 and approved by the Building Inspector. To expire on 02/24/2027. Contractors: Required Inspections: Fees: SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $300.00 CO Swimming Pool $100.00 Tota I $400.00 Building Inspector 4' TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 5'� Telephone (631) 765-1802 Fax(631) 765-9502 fittt)s://www utlioldtow nii .go� Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only PERMIT NO. Building Inspector: 2025 i Applications and forms must be filled out in their entirety.Incomplete applications will not be accepted. Where the Applicant is not the owner,an Owners Authorization form(Page 2)shall be completed. Date:Jan 2, 2025 OWNER(S)OF PROPERTY: Name:Patrick and Tamara Marchand SCTM#1000-69.-3-6.4 Project Address:344 Terry Court, Southold, NY Phone#:917-414-1529 I Email:pm68305@g mail.corn Mailing Address:P.O. Box 55 Southold, NY 11971 CONTACT PERSON: Name: Jennifer Del Vaglio and/or East End Pool King Mailing Address:P.O. Box 369 Peconic, NY 11958 Phone#:631-734-7600 Email:jennifer@eastendpoolking.com DESIGN PROFESSIONAL INFORMATION: Name: N/A Mailing Address: Phone#: Email. CONTRACTOR INFORMATION: Name: Eastern End Pools DBA East End Pool King, LLC Mailing Address:P.O. Box 369 Peconic, NY 11958 Phone#:631-734-7600 Email:Jennifer@eastendpoolking.com DESCRIPTION OF PROPOSED CONSTRUCTION New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: 1 31 000 unite oo113x37 . ❑Other 9 P $ Will the lot be re-graded? *Yes ❑No Will excess fill be removed from premises? WYes ONO 1 PROPERTY INFORMATION Existing use of property: Single Family Intended use of property: Single Family Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to AC this properly? ❑Yes ❑No IF YES, PROVIDE A COPY. W Check,Box After r Reading: The owner/contractor/design professional is responsible for all drainage and stony 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 210AS of the New York State Penal taw. Application Submitted By(print name): Jennifer Del Vaglio BAuthorizedAgent El Owner Signature of Applicant: Date: STATE OF NEW YORK) SS: COUNTY OF Jennifer Del Vaglio being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the Agent/Contractor (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 nnm—a- 20�� --�- city Public VICTORIA GFlA,RGZ r^ Notary Public,State of New York N0.4650488 Otueti�ir.r�t In Suffolk Counfv comptalSeiCart Fxirires January 20,,,o_ kRCII) I[ IC Y OWNER AU°"'I' HDIUZATIQN where the applicant is not the owner) Tamara and Patrick Marchand 344 Terry Court, Southold, NY I, residing at East End Pool King and/or Jennifer Del Vaglio do hereby authorize to apply on my behalf to the Town of Southold in epa !m nt for proval as described herein. �VL� � Po Owner's Signature Date Print Owner's Name 2 DATE(MM/DDIYYYY) Ac " CERTIFICATE OF LIABILITY INSURANCE 11/15/2024 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. IMPORTANM 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,), PRODUCER NAME`.' Barbara Dammers Roy H Reeve Agency,Inc. PHONN (631)298-4700 AIc No. (631)298-3850 IAIC.PO Box 54 II s A*MA . bdammers@royreeve.com 13400 Main Road INSURERS AFFORDING COVERAGE NAIC# Mattituck NY 11952 INSURER A: Hartford Fire Ins Co 19682 INSURED INSURERB: Trumbull ins Co 27120 Eastern End Pools LLC,DBA:East End Pool King INSURER C: TVA n City Fire Ins Cc Co 29459 PO BOX 369 INSURER D: INSURER E: Peconic 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 CONTRACTOR 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. LXR TYPE OF INSURANCE N, YJUD POLICY NUMBER MMIDR LIMITS w COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE �OCCUR PREMISES.Eacccu nce $ 100 000 Contractual Liability MED EXP(An one arson) $ 15,000 A Y Y 12UUNQD9CV0 11/15/2024 11/15/2025 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 POLICY JET LOC PRODUCT$-COMP/OPAGG $ 2,000,000 OTHER AUTOMOBILE LIABILITYadtSIN NMIT $ 1,000,000 '..ANYAUTO I BODILY INJURY(Per person) s B OWNED SCHEDULED Y Y 12UENQD9CV2 11/15/2024 11/15/2025 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS - HIRED NON-OWNED P' ,.RTY OAMAGE $ AUTOS ONLY AUTOS ONLY Per TRIT nq UMBRELLA LIAB H OCCUR EACH OCCURRENCE s EXCESS LAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X STATUTE.. ER AND EMPLOYERS'LABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE � EL,EACH $ 1,000,000 C OFFICERIMEMBEREXCLUDED7 L__..__I NIA Y 12WEQD9CUV 11/15/2024 11/15/2025 (Mandatory In NH) E.L..DISEASE-EAEMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be 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-cortWbutory 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(06/14)-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(2016103) The ACORD name and logo are registered marks of ACORD 6 ZO, 00 ROBI TC AV yo a r rot `CrICA4.0 TITLE .NSURAACE CC �/ p SLeSLWACE SVWASr C sf fay T ca s of p*ols �f : f; set tv and an ��a rt harem � /r �� tf� t to tv P 4(� �P;J or from ! d tram afters. 's APPROVAL OF i. , r � ` fi r` iEA' r ' ` �. -� � v fL