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HomeMy WebLinkAbout51968-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#: 51968 Date: 06/02/2025 Permission is hereby granted to: BGV-Holdings LLC 168 Bergan St Brooklyn, NY 11217 To: Construct an accessory inground swimming pool to an existing single-family dwelling as applied for per Trustees and DEC approval. Pool and pool equipment must maintain setbacks of 15 feet. Premises Located at: 250 Midway Rd, Southold, NY 11971 SCTM#90.-1-9 Pursuant to application dated 04/28/2025 and approved by the Building Inspector. To expire on 06/02/2027. Contractors: Required Inspections: Fees: SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $300.00 CO Swimming Pool $100.00 Total $400.00 Building Inspector b TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 �µ Telephone(631) 765-1802 Fax (631) 765-9502 haps-//www south oldtownnySov pp Date Received APPLICATION FOR BUILDING II ` , E C E I ►E For Office Use Only PERMIT NO. v Building Inspector. APR 2 8 2025 Applications and forms must be filled out in their entirety. Incomplete BuildIng e-Part en applications will not be accepted. Where the Applicant is not the owner,an Town of Southold Owner's Authorization form(Page 2)shall be completed. Date: 4/15/25 OWNER(S)OF PROPERTY: Name: BGV-Holdings LLC/ David Godbout Sum# 1000-90-01-09 Project Address: 250 Midway Road Phone#: 917 363 2525 Email: dpg@ceresrealtycapital.com Mailing Address: CONTACT PERSON: Name: Carlos Perez Mailing Address: PO Box 2410, East Hampton NY 11937 Phone#: 516 885 0400 Email:jccontractingeh@gmail.com DESIGN PROFESSIONAL INFORMATION: Name: Charles M Thomas Mailing Address: PO Box 877, Jamesport NY 11947 Phone#: 631 727 7993 Email: CONTRACTOR INFORMATION: Name: Mailing Address: Phone#: Email: DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: ❑Other swimming pool $ $107,700 Will the lot be re-graded? ❑Yes ❑No Will excess fill be removed from premises? ❑Yes ❑No 1 I PROPERTY INFORMATION Existing use of property: Residential Intended use of property: Residential 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. 8 Check Box After Rfmdit1g: 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 na e):Carl Perez ®Authorized Agent ❑Owner Signature of Applicant: Date: STATE OF NEW YORK) SS: COUNTY OF being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)he is the CC TT C 10,f - (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 I 200!� Notary Public OLGA LUCIA CARDONA Oue"PR CAu6T�Zi4�ublic,SOW Of NOW fr1k PI) applicant 'i N (Where the pp ant is not the owner) co, NasionExplres MayZa.2id David Godbout residing at 168 Bergen Street Brooklyn NY 11217 I, do hereby authorize Carlos Perez to apply on my behalf t the + f Southold Building Department for approval as described herein. 4 4/22/2025 wner's Signature Date David Godbout Print Owner's Name 2 Town Hall Annex Glenn Goldsmith,President 54375 Route 25 A. Nicholas Krupski,Vice President P.O.Box 1179 Eric Sepenoski Southold,New York 11971 Liz Gillooly i CA Telephone(631) 765-1892 Elizabeth Peeples Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD December 23, 2024 Robert Herrmann En-Consultants 1319 North Sea Road Southampton, NY 11968 RE BGV HOLDINGS LLC 250 MIDWAY ROAD, SOUTHOLD SCTM# 1000-90-1-9 Dear Mr. Herrmann: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, December 18, 2024: RESOLVED, that the Southold Town Board of Trustees APPROVE the request for a Transfer of Wetland Permit#10282, as issued December 14, 2022, from Joseph & Kristina Ottomanelli to BGV Holdings LLC. RESOLVED that the Southold Town Board of Trustees grants a One (1) Year Extension to Wetland Permit#10282, as issued December 14, 2022. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, Gle old'srn#, Presideunyt Board of Trustees Glenn Goldsmith,President Town Hall Annex A.Nicholas Krupski,Vice President 54375 Route 25 P.O. Box 1179 Eric Sepenoski Southold,New York 11971 Liz Gillooly Elizabeth Peeples Telephone(631) 765-1892 P Fax(631) 765-6641 j BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD y March 20, 2025 Robert Herrmann En-Consultants 1319 North Sea Road Southampton, NY 11968 RE: BGV HOLDINGS LLC 250 MIDWAY ROAD, SOUTHOLD SCTM#: 1000-90-1-9 Dear Mr. Herrmann: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, March 19, 2025: RESOLVED, that the Southold Town Board of Trustees APPROVE the Administrative Amendment to Wetland Permit#10282, as issued September 14, 2022, to eliminate the proposed demolition of the existing dwelling and construction of a new two-story dwelling with a 3,130 sq.ft. footprint, 18' x 38' swimming pool, 8' x 8' spa, 425 sq.ft. cabana with outdoor shower, 2,360 sq.ft. raised paving stone pool deck with firepit, and 2' high berm; and to authorize renovation of the existing 2,481 sq.ft. footprint one-story dwelling to remain (including new replacement windows with partial re-framing of one waterside wall) and a proposed 615 sq.ft. one-story addition to landward side of house (more than 100 feet from wetlands); maintenance of existing 307 sq.ft. stone patio and removal of existing 221 sq.ft. grade level patio; construction of 18' x 44' in-ground swimming pool and 318 sq.ft. grade-level pool patio/coping accessed from existing stone steps to remain; installation of an 8'x4' pool drywell; modified locations/layouts for the previously proposed I/A OWTS sanitary system on the landward side of the dwelling, pool equipment, and a 4' high pool enclosure fencing with gates; and establish and perpetually maintain a 10' wide vegetated non-turf buffer landward of updated wetlands boundary; with the condition that the four(4) Eastern Red Cedars are to remain per original permit; and as depicted on the site plan prepared by CMT Architect received on February 19, 2025, and stamped approved on March 19, 2025. Any other activity within 100' of the wetland boundary requires a permit from this office. This is not a determination from any other agency. Sinceirel ,. Glenn Goldsmith, President Board of Trustees artn'1ent of KATHY HOCHUL K Governor sTATE Environmental Conservation SEAN MAHAR Interim Commissioner BGV Holdings LLC April 4, 2025 C/O David Godbout 168 Bergen St Brooklyn NY 11217 Re: Application #1-4738-04383100004 BGV Holdings LLC Property—250 Midway Road Southold NY 11971 SCTM# 1000-90-1-9 Permit Modification #2 Dear Permittee: In conformance with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing regulations (6NYCRR, Part 621) we are enclosing your modified permit for the referenced activity. Please carefully read all permit conditions and special permit conditions contained in the permit to ensure compliance during the term of the permit. If you are unable to comply with any conditions please contact us at the above address. This modified permit supersedes the original permit issued on 4/26/2023. Sincerely, /tephanie Sforza Environmental Analyst Cc: BMHP EN-Consultants File Division of Environmental Permits, Region 1 50 Circle Road, Stony Brook NY 11790 1 www.dec.ny.gov I P: (631)444-03651 F: (631)444-0360 AIM NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-04383 PERMIT Under the Environmental Conservation Law ECL Permittee and Facility Information Permit Issued To: Facility: BGV HOLDINGS LLC BGV HOLDINGS LLC C/O DAVID GODBOUT 250 MIDWAY RD1Sctm#1000-090-01-09 168 BERGEN ST Southold,NY 11971 BROOKLYN,NY 11217 (917)881-0675 Facility Application Contact: EN-CONSULTANTS 1319 N SEA RD SOUTHAMPTON,NY 11968 (631) 283-6360 Facility Location: in SOUTHOLD in SUFFOLK COUNTY Facility Principal Reference Point: NYTM-E: 718.504 NYTM N: 4545.444 Latitude: 41°01'51.3" Longitude: 72°24'02.9" Authorized Activity: Construct an addition to the existing single-family dwelling and an 18'x44' pool with associated patio and fence. Remove existing patio. Replace existing septic system with I/A OWTS sanitary system and create 10' vegetated non-turf buffer. All work must be done in strict conformance with the attached site plans prepared by Charles M. Thomas,pages 1-2 dated 1/29/2025 and stamped "NYSDEC Approved"on 4/4/2025. This modified permit supersedes the original permit issued on 4/26/2023. SAS Permit Authorizations Tidal Wetlands -Under Article 25 Permit ID 1-473 8-043 83/00004 New Permit Effective Date: 4/26/2023 Expiration Date: 4/25/2028 Modification# 1 Effective Date: 2/16/2024 Expiration Date: 4/25/202 Modification#2 Effective Date: 4/4/2025 Expiration Date: 4/258202 Page 1 of 7 Am NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-04383 NYSDEC Approval By acceptance of this permit,the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations,and all conditions included as part of this permit. Permit Administrator:KEVIN A KISPERT,Deputy Regional Permit Administrator Address: NYSDEC Region 1 Headquarters SUNY @ Stony BrookJ50 Circle Rd Stony Brook,NY 11790 - 09 Authorized Signature: Date Distribution List EN-CONSULTANTS Bureau of Marine Habitat Protection File Stephanie Sforza Permit Components NATURAL RESOURCE PERMIT CONDITIONS GENERAL CONDITIONS,APPLY TO ALL AUTHORIZED PERMITS NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS NATURAL RESOURCE PERMIT CONDITIONS -Apply to the Following Permits: TIDAL WETLANDS 1. Conformance With Plans All activities authorized by this permit must be in strict conformance with the approved plans submitted by the applicant or applicant's agent as part of the permit application. Such approved plans were prepared by Charles M. Thomas,pages 1-2 dated 1/29/2025 and stamped "NYSDEC Approved"on 4/4/2025. 2. Post Permit Sign The permit sign enclosed with this permit shall be posted in a conspicuous location on the worksite and adequately protected from the weather. Page 2 of 7 Am ra NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION `w Facility DEC ID 1-4738-04383 3. Notice of Commencement At least 48 hours prior to commencement of the project,the permittee and contractor shall sign and return the top portion of the enclosed notification form certifying that they are fully aware of and understand all terms and conditions of this permit. Within 30 days of completion of project,the bottom portion of the form must also be signed and returned, along with photographs.of the completed work. 4. No Construction Debris in Wetland or Adjacent Area Any debris or excess material from construction of this project shall be completely removed from the adjacent area(upland)and removed to an approved upland area for disposal. No debris is permitted in wetlands and/or protected buffer areas. 5. Materials Disposed at Upland Site Any demolition debris, excess construction materials, and/or excess excavated materials shall be immediately and completely disposed of in an authorized solid waste management facility. These .materials shall be suitably stabilized as not to re-enter any water body, wetland or wetland adjacent area. 6. No Disturbance to Vegetated Tidal Wetlands There shall be no disturbance to vegetated tidal wetlands or protected buffer areas as a result of the permitted activities. 7. Storage of Equipment,Materials The storage of construction equipment and materials shall be confined within the project work area and/or upland areas greater than 100 linear feet from the tidal wetland boundary. s. Seeding Disturbed Areas All areas of soil disturbance resulting from the approved project shall be stabilized with appropriate vegetation(grasses,etc.) immediately following project completion or prior to permit expiration, whichever comes first. If the project site remains inactive for more than 48 hours or planting is impractical due to the season,then the area shall be stabilized with straw or hay mulch or jute matting until weather conditions favor germination. 9. Clean Fill Only All fill shall consist of clean sand, gravel, or soil(not asphalt, slag, flyash,broken concrete or demolition debris). 10. Establish Vegetated Buffer To protect the values of the tidal wetlands, a permanent vegetated buffer zone shall be established. There shall be no disturbance to the natural vegetation or topography within an area extending 10 linear feet landward of the tidal wetland boundary. 11. Area of Disturbance for Structures Disturbance to the natural vegetation or topography greater than 25 feet seaward of the approved structure is prohibited. 12. Install, Maintain Erosion Controls Necessary erosion control measures,i.e., straw bales, silt fencing, etc., are to be placed on the downslope edge of any disturbed area. This sediment barrier is to be put in place before any disturbance of the ground occurs and is to be maintained in good and functional condition until thick vegetative cover is established. 13. Runoff Directed to Upland Drywells Roof runoff shall be directed to drywells a minimum of 50 linear feet landward of the tidal wetland boundary for immediate on-site recharge. 14. No Drywells in or near Wetland Dry wells for pool filter backwash shall be located a minimum of 75 linear feet landward of the tidal wetland boundary. Page 3 of 7 A& INNEW NEW'YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION 'MW Facility DEC ID 1-4738-04383 15. No Pool Discharges to Wetland There shall be no draining of swimming pool water directly or indirectly into wetlands or protected buffer areas. 16. Driveway/Parking Area of Pervious Material Driveway and parking areas shall be constructed of NYSDEC-approved pervious materials. 17. Direct Runoff Away from Tidal Wetland and Buffer Roads, driveways, and parking areas shall be graded to direct runoff away from tidal wetlands and protected buffer areas. 1& Authorized Innovative/Alternative Onsite Wastewater Treatment Systems (I/A OWTS) Septic Systems This permit authorizes the installation of any models of I/A OWTS septic system which have received the approval of the Suffolk County Department of Health Services(SCDHS). If SCDHS rescinds its approval of one or more of these models during the term of this permit, DEC will no longer approve new installations of that model. The list of I/A OWTS systems which have received approval by SCDHS are found on website -https://reclaimotu-water.info/ 19. Maintenance of Installed Innovative/Alternative Onsite Wastewater Treatment Systems (I/A OWTS) The permittee must maintain, service and repair the installed I/A OWTS in accordance with the maintenance schedule set forth in the Suffolk County Department of Health Services (SCDHS) permit issued for the system. 20. Long Term Plant Survival The permittee shall ensure a minimum of 85% survival of plantings by the end of 5 growing seasons. If this goal is not met,the permit holder shall re-evaluate the restoration project to determine how to meet the mitigation goal. The permittee must submit these re-evaluation plans to the department for review along with the annual report for that respective calendar year. The report must be submitted by January 15th of each calendar year and sent to: NYS DEC -Region 1 Bureau of Marine Habitat Protection, Attention Compliance 50 Circle Road Stony Brook,NY 11790 21. Incidental Disturbance to Vegetation It is the responsibility of the applicant to remedy any incidental disturbances resulting in damage or removal of wetland vegetation. Upon completion of construction activities, any disturbed areas shall be planted with the appropriate marsh vegetation. Please contact the Bureau of Marine Habitat at(631)444-0295 for more information. 22. Contain Exposed, Stockpiled Soils All disturbed areas where soil will be temporarily exposed or stockpiled for longer than 48 hours shall be contained by a continuous line of staked haybales/ silt curtains (or other NYSDEC approved devices)placed on the seaward side between the fill and the wetland or protected buffer area. Tarps are authorized to supplement these approved methods. 23. Temporary Mulch,Final Seeding If seeding is impracticable due to the time of year, a temporary mulch shall be applied and final seeding shall be performed at the earliest opportunity when weather conditions favor germination and growth but not more than six months after project completion. 24. Maintain Erosion Controls All erosion control devices shall be maintained in good and functional condition until the project has been completed and the area has been stabilized. Page 4 of 7 Am do./ NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION lqw Facility DEC ID 1-4738-04383 25. State Not Liable for Damage The State of New York shall in no case be liable for any damage or injury to the structure or work herein authorized which may be caused by or result from future operations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue from any such damage. 26. State May Order Removal or Alteration of Work If future operations by the State of New York require an alteration in the position of the structure or work herein authorized, or if, in the opinion of the Department of Environmental Conservation it shall cause unreasonable obstruction to the free navigation of said waters or flood flows or endanger the health, safety or welfare of the people of the State, or cause loss or destruction of the natural resources of the State,the owner may be ordered by the Department to remove or alter the structural work,obstructions, or hazards caused thereby without expense to the State, and if,upon the expiration or revocation of this permit,the structure, fill, excavation, or other modification of the watercourse hereby authorized shall not be completed,the owners, shall,without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require,remove all or any portion of the uncompleted structure or fill and restore to its former condition the navigable and flood capacity of the watercourse. No claim shall be made against the State of New York on account of any such removal or alteration. 27. State May Require Site Restoration If upon the expiration or revocation of this permit,the project hereby authorized has not been completed,the applicant shall,without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may lawfully require, remove all or any portion of the uncompleted structure or fill and restore the site to its former condition. No claim shall be made against the State of New York on account of any such removal or alteration. 28. Precautions Against Contamination of Waters All necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended solids, sediments, fuels, solvents, lubricants, epoxy coatings,paints,concrete,leachate or any other environmentally deleterious materials associated with the project. GENERAL CONDITIONS - Apply to ALL Authorized Permits: 1. Facility Inspection by The Department The permitted site or facility,including relevant records, is subject to inspection at reasonable hours and intervals by an authorized representative of the Department of Environmental Conservation(the Department)to determine whether the permittee is complying with this permit and the ECL. Such representative may order the work suspended pursuant to ECL 71- 0301 and SAPA 401(3). The permittee shall provide a person to accompany the Department`s representative during an inspection to the permit area when requested by the Department. A copy of this permit, including all referenced maps, drawings and special conditions,must be available for inspection by the Department at all times at the project site or facility. Failure to produce a copy of the permit upon request by a Department representative is a violation of this permit. Page 5 of 7 AM 40100 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION lqw Facility DEC ID 14738-04383 z. ReIationship of this Permit to Other Department Orders and Determinations Unless expressly provided for by the Department, issuance of this permit does not modify, supersede or rescind any order or determination previously issued by the Department or any of the terms, conditions or requirements contained in such order or determination. 3. Applications For Permit Renewals,Modifications or Transfers The permittee must submit a separate written application to the Department for permit renewal,modification or transfer of this permit. Such application must include any forms or supplemental information the Department requires. Any renewal, modification or transfer granted by the Department must be in writing. Submission of applications for permit renewal,modification or transfer are to be submitted to: Regional Permit Administrator NYSDEC Region 1 Headquarters SUNY @ Stony BrookJ50 Circle Rd Stony Brook,NY11790-3409 4. Submission of Renewal Application The permittee must submit a renewal application at least 30 days before permit expiration for the following permit authorizations: Tidal Wetlands. 5. Permit Modifications, Suspensions and Revocations by the Department The Department reserves the right to exercise all available authority to modify, suspend or revoke this permit. The grounds for modification, suspension or revocation include: a. materially false or inaccurate statements in the permit application or supporting papers; b. failure by the permittee to comply with any terms or conditions of the permit; c. exceeding the scope of the project as described in the permit application; d. newly discovered material information or a material change in environmental conditions, relevant technology or applicable law or regulations since the issuance of the existing permit; e. noncompliance with previously issued permit conditions, orders of the commissioner, any provisions of the Environmental Conservation Law or regulations of the Department related to the permitted activity. 6. Permit Transfer Permits are transferrable unless specifically prohibited by statute, regulation or another permit condition. Applications for permit transfer should be submitted prior to actual transfer of ownership. Page 6 of 7 r v NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION � Facility DEC ID 1-4738-04383 NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS Item .: Permittee Accepts Legal Responsibility and Agrees to Indemnification The permittee, excepting state or federal agencies, expressly agrees to indenxnify and hold harmless the Department of Environmental Conservation of the State of New York, its representatives, employees, and agents ("DEC") for all claims, suits, actions, and damages,to the extent attributable to the permittee's acts or omissions in connection with the permittee's undertaking of activities in connection with, or operation and maintenance of,the facility or facilities authorized by the permit whether in compliance or not in compliance with the terms and conditions of the permit. This indemnification does not extend to any claims, suits, actions, or damages to the extent attributable to DEC's own negligent or intentional acts or omissions, or to any claims, suits, or actions naming the DEC and arising under Article 78 of the New York Civil Practice Laws and Rules or any citizen suit or civil rights provision under federal or state laws. Item B: Permittee's Contractors to Comply with Permit The permittee is responsible for informing its independent contractors, employees, agents and assigns of their responsibility to comply with this permit, including all special conditions while acting as the permittee's agent with respect to the permitted activities, and such persons shall be subject to the same sanctions for violations of the Environmental Conservation Law as those prescribed for the permittee. Item C: Permittee Responsible for Obtaining Other Required Permits The permittee is responsible for obtaining any other permits,approvals, lands,easements and rights-of- way that may be required to carry out the activities that are authorized by this permit. Item D: No Right to Trespass or Interfere with Riparian Rights This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights,title, or interest in real or personal property held or vested in a person not a party to the permit. Page 7 of 7 NEW Department of YORK 'SAT Environmental Conservation NOTICE The Department of Environmental Conservation (DEC) has issued permit(s) pursuant to the Environmental Conservation Law for work being conducted at this site. For further information regarding the nature and extent of work approved and any Departmental conditions on it, contact, the Regional Permit Administrator listed below. Please refer to the permit number shown when contacting the DEC. Regional Permit Administrator SHERRI AICHER Permit Number: 1-4738-04383/00004 NYSDEC Region 1 Environmental Permits 50 Circle Road Stony Brook, NY 11790-3409 Expiration Date: 04/25/2028 Email: dep.rl@dec.ny.gov Note: This notice is NOT a permit aunUm%.uunLy UWPL.vi Labor,Licensing&Consumer Affairs HOME IMPROVEMENT LICENSE Name CARLOS PEREZ Business Name J&C Contracting of East Hampton Inc This certifies that the - bearer is duly licensed License Number HI-60520 by the County of suffolk Issued: 5/10/2018 Waywe,T. Rogers Expires: 05/01/2026 Commissioner Suffolk County Dept.of Labor,Licensing&Consumer Affairs F LIQUID WASTE LICENSE Name CARLOS E PEREZ l� r Business Name �- J&C CONTRACTING OF EAST This certifies that the HAMPTON INC bearer is duly licensed by the County of suffolk License Number L1N-47252 Way►+a.T Rogers Issued: 03/31/2010 Commissioner Expires: 03/01/2026 * ,� This license Is the property of Suffolk County r Department of Labor,Licensing&Consumer Affairs. Possession of tws license doe not guarantee its validity, Additional Business Name License Category LW9-Conventional Se0c System inslallatlon;LW10- innovallvewternative Treat Sys install r W Y Departmentlice of Labor,Licensing T property of Suffolk County ing&Consumer Affairs. t "+ Possession of this license dales not guarantee its validity. Additional Business Name License Category H26-Pools and Spas/Certified ► � Albert J. Kru p ski, Jr. W PTO R I��1MA' IER SUPERVISOR )�V�[A��A��G�]EI� 1ENT SOUTHOLD TOWN HALL-P.O.Box 1179 53095 Main Road-SOUTHOLD,NEW YORK 11971 Town of So u th o l d CHAPTER 236 - STORMWATER MANAGEMENT REFERRAL FORM ( APPLICANT INFORMATION TO BE COMPLETED BY THE APPLICANT ONLY FOR PROPERTIES ONE ACRE IN AREA OR LARGER. ) - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - APPLICANT: (Property Owner, Design Professional, Agent, Contractor, Other) NAME: a 2��C` Date: (Print) r� © 2 j- &'ti�gndtlu��a.! J Contact Information: 4rzA . m C (E-Mad&Telephone Numbed) IV '� Property Address / Location of Construction Site: 25-D 0a S.C.T.M. #: 1000 District Section Block Lot TO BE COMPLETED BY SOUTHOLD TOWN ENGINEERING DEPARTMENT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - -- - Area of Disturbance is less than 1 Acre, No S.P.D.E.S. Permit is Re uired ! ❑ - Project does Not Discharge to Waters of the State. No S.P.D.E.S. Permit is Re uired! ❑ - Area of Disturbance is Greater than 1 Acre & Storm-water Runoff Discharges Directly to Waters of the State of New York. THE APPLICANT MUST OBTAIN a S.P.D.E.S. Permit DIRECTLY From N.Y.S. D.E.C. Prior to Issuance of a Building Permit. ❑ - Area of Disturbance is Greater than 1 Acre& Storm-water Runoff Flows Through Southold Town's NIS4 Systems to Waters of the State of New York. THE APPLICANT MUST OBTAIN a S.P.D.E.S. Permit through the Southold Town Engineering" De artment Prior to Issuance of a Building Permit._ Cc '5 A Reviewed By: Date:/YX FORM # SMCP-TOS December 2024 PROJECT: APPROVED AS NOTED DAVID GODBOUT DATE: B.P# RESIDENCE FEE BY: NOTIFY BUILDING DEPARTMENT AT 631-765-1802 FOLLOWING 8AM T 4PM FOR THE 250 MIDWAY ROAD FOUNDATION-TVVO REQUIRED SOUTHOLD, NY FOR POURED CONCRETE 10"T-2" 8" ROUGH-FRAMING&PLUMBING INSULATION -- i FINAL COMPLETE FOR C.O.MUST COMPLY WITH ALL CODES OF ' I — NEW YORK STATE&TOWN CODES AS REQUIRED AND CONDITIONS OF ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW t �t 7p� 3------------------------------------------------------ I I I � SOUTHOLDTOY".IY LDf1 I I YORK STATE. NOT RESPONSIBLE FOR Q V N FUt�hT jG DESIGN OR CONSTRUCTION ERRORS SOUTHOLDTO" �'�' BOARD I I I SOUTHOLD TOV','N TRUSTEES i II I I SOUTHOLD HRC SCHD I II I I I II I I I 3 I I POOL 3'-6" 792 SQFT ' ' S.0 .TAX # 1000-90-01-09 DEEP 23,760 GALLONS DEEPDD LOT 141, 142, P/0 143 I II I I I II I I I II I I II I I i II I I I II I I I II I I II 1 I I II I I r II I I I II I I I II I I I I I I ---- c ----------------------------c= I I I ( I �o I I I CV L--J 0F NP i' POOL PLAN 1 SCALE: 114=1'-0" Fps 60214 ��V\ ��FfSSIONP�' AUTO COVER DAM 0 AUTO COVER VAULT 12"BLUE STONE COPING ® MARBLE DUST FINISH PHASE: POOL LIGHT ❑ SCHEMATIC DESIGN © POOL SKIMMER ❑ DESIGN DEVELOPMENT O POOL RETURN ® PERMIT DOCUMENT ❑ BID DOCUMENT ❑ CONSTRUCTION DOCUMENT ❑ PROGRESS/REVIEW DOCUMENT T-0"1'-2" 8" ❑ PRESENTATION C= C= C= C= C= C7 O it O O O O O Ol' r I, O SLOP: EARRI 5J.I;r,I• AYL 114■ FER ^ TABLE NON I r �9,, �y �ryt r '�0 .TEE���+ -.."I2 "ft'77k�p.�+ BARE., VAY' IFE ® Ln f`6e r C SLOP EL L!:.`d.r•.�! •r ,G OV: 1 L.,'Y"Y""1�'•I'� IvIke.I1i.^,A# 8r'.p I75✓'e L .k`f+:S'!.t� ''� L+'•..�'f'�!7.t� ��'sr 'hs+', 4P L!+!'r [:-,",4J V �'. r.crE:, i�r � F~� tL� T ,�����. f 4:ER4� '0 .. 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P1fY.911EO, OM ROT APPILY TO 1, FJ &00 IDET1 ) SHEET NO: DATE: 05- 04-2025 DRAWN BY: JS