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HomeMy WebLinkAbout40709-Z TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENTDo you have or need the following,before applying? ,w TOWN HALL Board of Health SOUTLD,NY 11971 4 sets of Building Plans_.__............ _. TEL: (631)765-1802 Planning Bcat'b n.ctarcval, FAX: (631)765-9502j Survey www.northfork.net/Southold/ PERMIT NO. /- Check Septic Form_._.__......_ N.Y.S.D.E.C. Trustees Examined 20 _ Contactr Approved, ....... � _,20 P�" Mail to: Disapproved a/c .... ....,....._—. Phone12 7 : . to �......�t - Building Inspector MAY - 9 2016 APPLICATION FOR BUILDING PERMIT Date ,20 t TOWN OF S OLD INSTRUCTIONS &.This application MUST be completely filled in by typewriter or in irrk and submitted to the,Building hispeclor with 3 sets of plans„accurate plot plana to scale.Fee according"to schedule. b.Plot plan shoving location of lot and of buildings on premises,relationship to,adjoining prenbises or public;streets or areas,and waterways. c.The work covered by this application may not be commenced before issuance of Building Permit. d.Upon approval of this application,the Building Inspector will issue a Building Permit to the applicant.Such a permit shall be kept on the premises available for inspection throughout the work. c.No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f.Every bulidin permit shall expire if the work authorized has not craarunenced within 12 months alter the date of issuance or has not been completed within 18 months£roma such date.If no zoning amendments or other regulations affecting the property have been enacted in the interim,the Building Inspector may authorize,in writirr,g„the extension of the permit for arr addition six months.Thereafter,a ne%v perniit shall be,required. APPLICATION IS THEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the BuiIdina Zone Ordinance,of tire,Town of Southold,Suffolk County,New York.,and other applicable Laws,Ordira�tnces or l;egulaticros,for the construction of buildings,additions,or 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 for necessary inspections. (Signature of applicant or name,if a corporation) P.a . 3 (Mailing� address of applicant) State whether applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder Name of owner of premises — (As on the-troll or latest deed) rpo gzttatte ok cltily authorized officer If a iican tqs and title t cos , (N rporate officer) Builders License No. ..2, -1. - Plumbers License No._ Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section Block_ Lot Subdivision Filed Map No. Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy IL--A ?_1ESLb1bjCE b. Intended use and occupancy 22SkZ*AjTML_ 3. Nature of work(check which applicable):New Building —Alteration Repair Removal Demolition Other Work...I,.L16- AL_ (Description) 4. Estimated Cast -.46,LLIb Fee (To be paid on filing this application) 5. If dwelling,number of dwelling units Number of dwelling units on each floor If garage, number of cars 6. If business,commercial or mixed occupancy,specify nature and extent of each type of use. www T Dimensions of existing structures,if any:Front —Rear— D'ePAII, Height Number of Stories V L Dimensions of same structure with alterations or additions: Front ReOr"' Depth Height Number of Stories 8. Dimensions of entire new construction:Front Rear epth Height Number of Stories 9. Size of lot:Front Rear Depth 10.Date of Purchase Name of Fortner Owner 11.Zone or use district in which premises are sitd44- 12.Does proposed construction violate any zoning law,ordinance or regulation?YES NO 13.Will lot be re-graded?YES-NOWillexcess fill be removed from premises?YES—NO 14.Names of Owner of premises Address -.Phone No. Name of Architect Address -Phone No Name of Contractor Address Phone No. 15 a.Is this property within 100 feet of a tidal wetland or a freshwater wetland?*YES NO •IF YES,SOUTHOLD TOWN TRUSTEES&D.E.C.PERMITS MAY BE REQUIRED. b.Is this property within 300 feet of tidal wetland? *YES-NO •IF YES-;D.E.C.PERMITS MAY RE'REQUIRED. 16.Provide survey,to scale;with accurate'foundation plan and distances to property lines. 17.If elevation at any point on property is at 10 feet or below,must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF + tieingduly swam,deposes and says that(s)he is the applicant ............. L (Name of individi4il signing contract)above named, (S)He is the ("'I -- (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 knowledge and belief,and that the work will be performed in the manner set forth in the application filed therewith. Swop i to before me this day of 20)L(I T , Notary Pulilic/ Signature of Applicant LAURIE KALHORN ' NOTARY PUBLIC,STATE OF NEM YORK IL Registration No.OIKA6205483 Qualified in SUFFOLK COUNTY MAY Commission EXPIrss MA"11,2017 BOARD MEMBERS Southold Town Hall Leslie Kanes Weisman,Chairperson 1 � 53095 Main Road•P.O.Box 1179 Southold,NY 11971-0959 Eric Dantes Office Location: Gerard P.Goehringer ,,, Town Annex/First Floor,Capital One Bank George Homing 54375 Main Road(at Youngs Avenue) Kenneth Schneider ` o Southold,NY 11971 http://southoldtown.northfork-net ZONING BOARD F APPEALS TOWN F SOUTHOLD Tel.(631)765-1809•Fax(631)765-9064 April 27,2016 Timothy P.Coffey 44900 Route 25 Southold,NY 11971 ZBA#6127-Fogarty Dear Mr.Coffey: I have reviewed your-letter dated April 20,2016 requesting a de minimus determination in the above referenced ZBA decision.Your proposal to demolish the existing in-ground swimming pool d replace it with a new in-ground swimming in the same location with total square footage of the poo1 to be 375 s .ft.is shown on the following documents which you submitted with your request: two parcel site plan sheets date stamped received y the ZBA office on Apl22,2016. Based upon the information provided above,I have determined that your requested modification is de minimus in nature because no additional nonconformity will be created,and the intent of the original ZBA decision will not be altered.However,the proposed wood fencing around the pool is not enough to mitigate the sound from the pool equipment and a separate sound proof enclosure is required as noted in the conditions as condition number(6)six.Please also note that the applicant must comply with Chapter 236 of the Town's drainage code. I will instruct the office to send a copy of this letter and your request to the Building Department so that you can apply for a building permit.If you have any questions,please call the office. S° care y, Leslie Kanes Weisman Chairperson/Dept.Head CC: Michael Verity,Chief Building Inspector __ .. w_ 'y ,s r r. (j `� F r�r� �a � 7�o _Lj f _ CS f1f1 g � Ax {Mq E' 61 o I ( ca Im p h CS�® 7w 0-4 OR Du n i � 77fdd01rtl�xM�,"7 , y �._•_ r rP wr M.r °..... .7�'.S g w CJ ar m � c JJJ �•, 5 ta.., '� P �" a�2 `�k nwr C.7 �. ,..� c� � �' �� � �"�•� DaX4 1 i .rye Id"�I t VI y x- v'1 krD J r ., r` =TimothyCoffey Timothy Coffey Nursery/Landscape, Inc. juligul aI ( 44900 Route 25, Southold NY 11971-4659 631-765-2554 ° Fax 631-765-2507 Nursery ,' RECEIVED * , "�.�rthe earth sine 1965 APR ZONING BOARD OF APPEALS April 20, 2016 TO: Southold Zoning Board of Appeals SUBJECT: Alteration to Permitted Pool Location RE: ZBA #6127 Thomas Fogarty 735 Jackson Street New Suffolk, NY On May 22, 2008, the Zoning Board approved the location of a pool with a pool size not to exceed 15 ft. x 25 ft. (375 square feat) . On behalf of the owner, I respectfully request a diminimus letter approving a modification as follows: That the existing pool will be removed and a new inground pool be situated as shown on the attached plan. The new proposed inground pool will not exceed the maximum allow- able square footage (375 sq.ft. ) which was previously approved so as not to exceed the maximum allowable lot coverage of 22.10. All other conditions listed in the permit will be adhered to and not altered. In effect, my request is to simply submit a modified site plan for a new pool to replace the previously approved site plan. En- closed find a copy of ZBA Permit #6127, the previously approved inground pool location and size and a proposed modified pool location in a different configuration, but not exceeding the maximum approved size (375 sq.ft. ) . Also enclosed is authorization from the owner to represent him in this matter. Thank you for your consideration in this matter. Sincer Enols. Timothy P. -Cof fey APPEALS BOARD MEMBERS � ' �, ailine Address: Gerard P.Goehrin-er,Chairman $`', y� Southold Town Hall 53095 Main Road-P.O. Box 1 179 Ruth D.Oliva Southold,NY 11971-0959 James Dinizio,Jr. " ' Office Location: Michael A. Simon +"1 Town Annex/First Floor,North Fork Bank Leslie Kanes Weisman Con lulb 54375 Main Road(at Youngs Avenue) Southold,NY 11971 http://southoldtown.northfork.net VX ZONING BOARD OF A a - OTOWN OF LD L� RECEIVED ' -- `6 Tel.(631)765-1 -Fax(631) 765-9016,4fAY 2 2 2008 DELIBERATIONS AND DETERMINATIO MEETING OF May 8, 2,008 SoutholdprbrwZn ZBA# 6127 —PAUL and MAUREEN CACIOPPO Property Location: 735 Jackson Street, New Suffolk CTM 117-9-6 SF RA DETERMINATION: The Zoning Boardof Appeals has visited the property under consideration in this application and determines that this review s under the Type Il category of theState's List of Actions, without further review under PROPERTY FACTS/'DFSCIIIPTION: The applicants' 134,055 square foot nonconforming pacel is locate a - Low-Density esi ei one District with 100 feet along Jackson Street. The property is improved with a single-family dwelling and accessory cottage building. IASIS"( F APPLICATION: Requested e variances based on the Building Inspector's Section 280-124, based on the Building Inspector's December 27, 2007 Notice of Disapprovalconcerning the location of an accessory in-ground swimming pool, which will exceed the code limitation of 0% lot coverage. ADDITIONAL INFORMATION: The property is improved with a house and accessory cottage building, which were the subject of variance under# 6020 dated 5- 30-2007. FINDINGS OF FACT The Zoning Board of Appeals held a public hearing on this application on February 2 , 2008 and April 2 , 2008, at which time written and oral evidence were presented. Based upon all testimony, documentation, personal inspection of the property, and other evidence, the Zoning Board finds the following facts to be true and relevant: AREA VARIANCE.... RELIEF-RE_QIJ SJ E : The Applicant's original application proposed an accessory 18' x 30' in-ground swimming pool, which was denied for the Page'2—May 8,2448 A#6127—P.and M.Cacioppo CTM 117-9-6 reason the lot coverage would be 23.4% instead of the 20% code limitation under Section 280-124. AMENDED VARIANCE RELIEF 1I ST D: On March 19, 2008, the applicant y their agent submitted amended plan dated March 12, 2008 as an alternative, showing a reduction in the size of the swimming pool from 18' x 0' to 15' x 25', and reducing the lot coverage percentage for more conformity with the code requirements. REASONS FOR BOARD ACTION: On the basis of testimony presented, materials submitted and personal inspections, the Board makes the following s: 1. 'Town Law., 207- 3 3 1 . Grant of the alternative relief, as amended by applicant, will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. In discussions with the applicant over the excess lot coverage and neighboring concerns, the applicant made the following amendments to their proposal: Evergreen scrubs will e planted maintained along the rear fence and at least 15 feet along the wood fence, along the east wall of the pool. The pool heater and pump equipment will be placed at the east side of the pool and wille soundproofed. The water to fill the pool will be brought from an outside contractor. There will be an overflow well for drainage oft e pool water. The pool size will be reduced o 1 ' o 15' x 25'. The lot coverage s amended will result in a maximum of 22.1%. This alternative reduces the variance relief and screening ° provide visual buffers so that it is not easily visible from adjacent properties. The 22.1% lot coverage is the maximum the Board will approve. 2. Town Law 287- r b °2' . The benefit sought by the applicant cannot be achieved by some method, feasible for the applicant to pursue, other than as area variance. 3. Town Law §207-b(3Vb)(3). The relief that was requested for 23.4% lot coverage is substantial. The amended requested for 22.1% lot coverage is less and will provide greater conformity to the code requirement, and will result in a smaller pool of 375 square feet, of which 274 square feet is over the code limitation of 20% by 2.1%. . To ii l.,aw ` 267-b(3)(W(5), The difficulty has been self created insofar as the applicant desires to build an accessory swimming pool. 5. Town Law 207 b( � . o evidence has been submitted to suggest that the relief as granted for alternative relief will have an adverse impact on the physical or environmental conditions in the neighborhood. Page'3—May 8,2008 A#6127—P.and M. Cacioppo CTM 117-9-6 6. Grant of the alternative relief, as amended, is the minimum action necessary and adequate to enable the applicant to enjoy the benefit of a swimming pool, while preserving the character of the neighborhood and the health, safety and welfare of the community. RESOLUTION OF THE BOA-RD: In considering all of the above factors and applying the balancing test under New York Town Law 267-B, motionwas offered y Member Oliva, seconded by Member Weisman, and duly carried, to Grant the variance as amended, ass own o -1 (Project No. 0643) last- ated Ma-rch 12, 2008, prepared by Peconic Permit Expediting, subject to the following Conditions: 1_ The existing stockade fencing shall be maintained at a height as exists of 6 feet tall, and evergreen scrubs shall be planted at 4 ft. separated tervals, 6' to ' tall, continuously maintained alongthe west and northborders. he pool shall be open tot e sky (not roofed over or enclosed). . Te pool shall be fenced in, as per Codes. . N outdoor lighting of the pool for nighttime use. 5. e landowner shall plant evergreen scrubs along the northern border and at least 5 feet along the eastern fence wood fence near the east wall of the pool. 6. T e pool equipment eater/ ter) shall be placed at the east side of the pool nd shall be soundproofed, 7. T ie water for the pool will be brought from another location by truck or other cont acti rig service, and shall not be from the owner's premises or a well. 8. here shall be a drywell for overflow of pool water and proper drainage- 9. _ 9. The pool size shall be reduced fr(. in 8'x30' to 15'x25'. 0) The lot coverage is limited to a Ca ian o 2-2.1%. ` That the above ZBA conditions shall be written into the Building Inspector's Certificate of°Occupancy, when issued. Any deviation from the variance given such as extensions, or demolitions which are not shown on the applicant's diagrams or survey site maps, are not authorized under this application when involving noncofor ities under the zoning code. This Pageh—May 8,2008 ZBA#6127—P.and M.Cacioppo CPM 117-9-6 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. The Board reserves the right to substitute a similar esi that is de minimis i nature for an alterationthat does not increase the degree of nonconformity. Vote of the Board: Ayes: Meni eiri.n Clairinan), Oliva, Dinizio, Simon, and Weisman. This Resol , ion w my opted GERARD P. GOEHRING , CHAI 5/20/2008 t Approved for Filing Scott sll STORMNWATEK IMIANAGIEMIENT SOUTHOLD TOWN HALL-F.0.Box 1179 79 53095 Main Road-SOUTHOLD,NEWYORK 119n Town of Southold CHAPTER 236 - STORMWATER MANAGEMENT ( TO BE COMPLETED Y THE APPLICANT ) DOES I (CHECK ALL MAJ APPLyiJ yes iota li A. Clearing, grubbing, grading or stripping of land which affects more 1 � than 5,000 square feet of ground surface. I 13, Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. , ite preparation within 100 feet of wetlands, beach, bluff or coastal i' erosion hazard area. E. -preparation within the one-hundred-year floodplain as depicted on FIRM Mapof any watercourse. 1 . Insta F. llation of new or resurfaced impervious surfaces of 1,000 square feet or more, unless prior approval of a Storrnwater Management Control Plan was received by the Town and the proposal includes in-kind replacement of impervious surfaces. �... answered �O to all of � � ns above, STOP! Complete�A Applicant section below Signature, If® atinIate & C��tp Tax l� Number! 236 does not apply to your project. . If you answered YES to one or more of the above, please submit Two copies of a Storrawater Management Control Plan and a completed Check List Form to the Building ep en wit��your Building PermitApplication. h h fl� �e QII u rartVy'�Yxi Kane a m.. _ S.0°T._ $' 1000 Dale, � .. .�..' `".. Section Block Lot BUILDING DEP Fel .. _ FOR (raMy[av4 Nti'uflrttuuat'uq[r: i i evie%vcTJ By: Date Prci erl�,' Addres,5 / L(ucatio n of i.tas°t"st nsct.o n wo-k.: � u rtt ttyc rp tor tat cx e,strtg Il�trtic�utig Pe-Ina,ha. lari Not Required, t7t�t��n tt a Maiaaaetnent 4"orilroll Plait Required, (Forward to Eiit.meei ung Departttuem'foo Review) .... _ 6 ORM 1, SY°✓6t Gz....'TOS NIMAY 2014 i l New York State Insurance Fund 199 CHURCH STREET,NEW YORK,N.Y. 10007-1100 (888)997-3863 CERTIFICATEINSURANCE AAAAAA 112399668 MATRIX DEVELOPMENT CORP 11 WOODED LANE P O BOX 1033 HAMPTON BAYS NY 11946 POLICYHOLDER CERTIFICATE HOLDER MATRIX DEVELOPMENT CORP TOWN OF SOUTHOLD 11 WOODED LANE BUILDING DEPARTMENT P O BOX 1033 TOWN HALL HAMPTON BAYS NY 11946 SOUTHOLD NY 11971 �IT—mIFICATE DATEWWW [!�Z CY NUMBER CERTIFICATE NUMBER PERIOD COVERED ETO THIS 8/201 639161-9 751589 7 01/20/2016 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER.. POLICY NO. 639 161-9 UNTIL 02/2812017, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERA11ONS IN THE 'S'TAT'E OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW'YORK„TO THE POLICYHiOLD R'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF SAID POLICY IS CANCELLED, OR CHANGED PRIOR TO 02/2882017 IN SUCH MANNER AS TO AFFEc,r THIS CERTIFICATE, 10 DAYS WRITTEN NOTICE OF SUCH CANCELLATION WILL BE GIVEN TO,THE CERTIFICATE HOLDER ABOVE. NOTICE BY REGULAR MAIL SO ADDRESSED SHALL BE SUFFICIENT COMPLIANCE WITH THIS PROVISION. THE NEW YORK STATE INSURANCE FUND DOES NOT ASSUME ANY LIABILITY IN THE EVENT OF FAILURE TO GIVE SUCH NOTICE. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY"THE POLICY. NEW YORK STATE INSURANCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING This certificate can be validated on our web site at hftps.-/Iwww-nysif-con-i/cer-Ucertval.asp or by calling (888)875-5790 VALIDATION NUMBER: 1002734706 ' � @ l�i llilIIVI<,ll l' )OOU 71080 0 0 0 02'7v IM 5o�ulii�2 1� l l arm WC 4,71=iWlr...:NOPPki"N'T'V"��o�r�rr Y(rJjl',P�VfX�rbV�,7��"�a":Y�°nYntiy-dr3eAW9� � 12 U-26.3 IOLIiC'PC![ICk�XC'1tMQ�1Q�:7.5¢aa,=t�!C1li:fdrllat-a�Cu€utuar"a<br law rr✓pNlimrlf v^v�¢akta7pc;.r or ed r.[,F;.R+xR..rPCrv-Crae�;,p�p MATRIA OP ID:VM A '4 CERTIFICATE F LIABILITY INSURANCE DATE(MMIDDKYYY) 02/1212016 THIS CERTIFICATE IS ISSUED ASA 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(les)must 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). CONTA BaoaCt�a Associates Inc. T _ Inc. r Ba 1- 64 1111 _ . AX Associates, In 82W Jericho Turnpike Ste 1A Carc No E - iIT 63164-8274 631 A1�I`i_. �i AIL. _ .. Smithtown,NY 11787 Iia atta Associates Inc. RESS: INSURERS)AFFORDING COVERAGE PWorcester _ m...._ ICw _t INSURER A.Worc Insurance 26182 Mxvpm _.. INsuRERB:WescoInsuran�Company25011INSIRE® entCorp DBA Matrix Gunite Pools INSURER C: Karl J Bonawandt P.O.Box 1033 suRER D Hampton Bays, NY 11946 INSURER E ''...INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFYTHAT 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, I EXCLUSIONS FONDINCEOF SUCH POLICIES..,LIMfS SHOWN YHAVE BEEN REDUCED BY PAID CLAIMS. S fW�? POLICY NUMBER R M9® mmm AMX!iLIMnS� TYPE � INS �0 A e COMMERCIAL GENERAL LIABILITY EACH Io CE_._.-.......... 1,000,000 'FA rTCFF=1 CLAIMS-MADE �X occuR MPA00000065795H 02/01/2016 0210112017 1DDDDMI�EI $ M (Anyoneperson) $ 5a00 PERSONAL&ADV INJURY $ VO-60-1 GEN'L AGGREGATE LIMIT APPLIES P : GEN.E....R_A�L.AGGREGATE ..$. ..._._ 2®00 DD0 POLICY PES LOC PRODUCTS COMPIOP AGG 2 OOO,OO ETHER AUTOMOBILE LIABWTYS f�BPc��D G'I U of I $ 1,000,00 B ANY AUTO WPP121600900 02!011201 B 0210112017 BODILY INJURY(Per person.) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS W.---•••••••mm NON-OWNED sIImL ERT`a'DAMAGE X $ HIR ED AUTOS AUTOS Pr ercrdect�_,,, $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGRFGACE $ DED RETE-NTION$ $ _W PER WORKERS COMPENSATION STATUTE ER EMPLOYERS'LIABILITY Y I N I P ....ANY PROPRIETORIPARTNER CUTIVE ❑ N 7 A EAC,II ACCIDEN 1 $..., ........ OFFICERPM BER EXCLUDED? (Mandatory In NH) DI,,d-AC'E...I A 6-MPY OYf=E $ It yes,describe under . I.,F.;t,_RIPTION OF OPERATIONS belowL-.L..UISI A`E-F'CJLIC'Y P_IMI C $ .. _......... ........ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION; SOUTHOL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. The Town of Southold Building Department AUTHORIZED PEPRESENTATIVE Town Hall Southold,NY 11971 I ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD gr tai f I g c a 5; v , v� i �o O N/off QA YTCW � � OX�P�l l sJA Allss E c 4 s car rPma �eraaa 129.90- CO 30° N r 1 7 GRnvq v�tynr �r b LANG '2 b G Y OF rw -- 11/0/1-ERsN �THfut HOUSTON - rIA W4RL4,V � FIFTHS7'REET 4 t4 t4 e c w .. I ;`u All QKD uk zu iv r I GENERAL NOTES: 1) The design Is based on a drainage soil with <10%silt. Ground 6.0 ClrAA tUM9'-Ac AA - /r LGA[.. water shall not exist within the limits of excavation, 4groundwater < ,, : ►. exists within 6'-G" below grade, special dewatering facilities will be {:. •.. ...: , -z �.toa <rA)'0 c�.�l�G►T`'/ > required. +: 2) No surcharge allowed within 4'-0"of shallow end and 6'-0'of deep a is 1 , 41. on •� 1 Ca t O� i�i 0io �C AJx end. e� STEEL RE-BAR SC►'Ervu sp.ey` �r h'•t.•" t�°- �' t?�� G,{,j�_ 3) The pneumatically applied concrete (gunite) shaiT be a 1.4 mix with t •:,.'':.. is DEPTH: < S'-0' > S'.p t �, Ip; O" pf �b;L''T�. �. 17�JG Gl.G• 8- /2g s e per sacicofconcreta. a max of 1 gallons of water 11ti'WAS 4) Reinforcing steel shall be Intermediate grade cold bMet steel with a �� _ TfA t'_�' Lf N�RrZ• T2' O.C. 1?' OC SIA •UNT K•. ' ; �aR. �.t.�G�L a A1C 95Y)1 C'Y'j�J'� ,� 4u)1�.�1�0 Pau minimum la of 30 bar diameters, _ ' p / T�u� vERTICAI T2 O.C. 6' O�C c•Ari.G I TY or— �tYIl�1 t,/i��1 G ��� Y'� �� OA41AI�.D i i �/ - 5) Pool water level ma ntained by fill spout, Poo to be kept full.during y„ 1: p �/� f Al A. Y r1NS� f�UP Q `'a �'t' ROttOM EACH WAY EACH 0 C ? �:;•; w WYE ¢ 1 � �,.�� freezing weather. Pump capacity to be sufficient to empty pool In 24 . '... d, ,�,, iii � O/11�1✓ 1/1`�T,l .. , B 1 WA � . .�;: 'i. �� Gf•ti C tJtrhT� It•J � �. i T'Y �� w�t t�uMt • t•.€;' I'lOUfS r;x'R�vKN yu�utfJl � . , To trills i f 6) nil spout to be 3/4' gooseneck with a 12" gap between spout and pool water line. MAIN DRAM• - I; ._... 12 R MARPI rnUST 4"C0NC.COVER 11tis is to ce�t1i,fy that the cunrrtnlrtian off Kwimming Ixmil on the subject PTIviiiiKes will ' soLio PnECAST (�) /� RE-BARS. DOME not rrquire any special drainage Iheiliticm, CONTINUOUS BOND 1� BEAM All AQOUNp OfP14 VAR!I4 ! The pool will he 1111ed by a direct,'/." rill spout pirrd Pram they himKe •�Ith control by n ` ecc rt a►o j.. 1Y SOA SS INLET grata valve at the house, Thcre IN a stainlem mte-el gooNeneek 0xwe 11te erring with o 12" t air gar between the till wr►rut and poral. PRECAST CONC.LIFECHINO 1. 1'Ito;+(KII will be conwtnlcted or irticumiticolly'APPII CI Ktccl rcinrnrCc�l conrtt'le Ait(t t�Tt! COLE RADIUS . : 1�04t. w j+cn�l water Ir+ des�IKncef to !� cvntinut,wily tvOrculated through the tilts r and revilmd rrorn VARIES i:.,J• .: . l t ► R vs SArvo ` y.car .to vear. The draingge I•mm div Inter w;ll nc,i interrere wiI the pubile +voter vurr,y', " 6- MIN' I o o w cite ex stl til B*aniln ierililtc.. neighboring Prop t► r 9 W Ya• ?•- MAY I• a• ;F„ AND GRAVEL w r) r TK crtlre r ulillc hi-li a SEE SCHEDULE -- - sEE 45cHfoult DRYWEL. 3 �� GROUND WATER , _ - — - - -- - - WAJwll�o P910o,4 ✓ .. T' .,,eon,._--�-r.I•/ _V./�...-w..- -1.----�•.. ------ :rt • "��y� •scute )" s� d Q Pt?OL AY,l�R.Nf ' CACH REgtDEPJTiIAL SWIMMING POOL,INSTALL. D.CONSTAVCT EO OR I O t. SUBSTANTIALLY'MOOIFIED AFTER DECEMBER JA, 3t�06)AND EACH ^i COMMERCIAL SWIMMING POOL`INSTALLED, CONSTAUG"f E D OR SUFiSTANTIALLY'MODIEIEDAFTER DECEMBER 5�1, 2006► SHALL BE 2-��ai►.1 , eaUIPPlO WITH AN APPROV40 POCK,ALARM WMICH1! A. 1S CA1PA®tE OF DETECTING A CHILD ENI CRING `141 WATER ANO GIVING ANO AUDIaLI ALARM WHEN IT DETECTS � CHILD OC ENTERING THE WATER 8. Ig AU01rt 1 P00LSI01 ANO AT ANOTHER WCA1 ION AT THE c PREMISES WhERE THE SWiMMiNG POOL IS LMTED I _ 15 INST•ALLEO,USQO AND MAINTAINED IN ACC RDANCE WITH � �. t rte,►� tv�la� �-.n �,�, ^,�A71�! THE MANUFACTURES INSTRVCTIONS — 9 A 1 _ 0, 1$CtJlSS11FIED BY VNOERWRITErtS LABORATORT S, INC. (OR AfI��T' VC iJ C'bM1�Li�W fir' . :. . •; ::',:' •.!+• ;, .' OTHER � . . . .... . . . APPROVEO INQEPENOENT TESTING WOMTORIES)TO REFERENCE STANDARD ASTM P;208,ENTITLED STANDARD SPECQICATION FOR pQQL ALARMS.AS ADOPTED iN 2002 AND EQITORiALLY , IN PUBLISHED AY ASTM INTERNATIONAL EO 1UN 204 COAREt:'1 E S. I :�,-.. �Q �-� 200 BARR NAReOR DRIVE,WEST CONSM0N0CKEy,F 19418;AND IS NOT AN ALARM DEVISE LOCATED ON 9ERSO (S) OR WHiCN IS OEPlrNDENT(?N OEViCE(S)LOCATED ON PERSON(S FOR iT5 , PROPER OPERATION ' ALARMS.A POOL ALARM iNSTALLEO — -- - - ,.s, ;� ,,:,•.: P. MUlY1PLIr POOL AU► S PURSUANT TO COOS MUST 8E CAPABLE QF DETECTINCI ENTRY INTO -- _ - -- _ — i P OL IP NECESSARY TO PROVIDE DETECIION CAPAOIJILITYAT EVERY�N T►it: 0 i POiNT ON THE SURFACE OF ME SWIMMING POOL, MORE THAN ONE _._ ;�01 _--- --_ I�'OOL pWM SHALL 8E INSTALLED i t ENTRAPMENT PROTECTION FOR SWIMMING POOL AND SPA SUCTION OUTLETS ; i, ti. AG106.1 GENERAL.,Suction outlets shall be designed to produce circulation throughout the pool or spa. Single outlet systems such as automatic vacuum cleaner systems or other such multiple suction outlets whether isolated by valves or otherwise shall be protected against user entrapment. ��� ! AG Al SUCTION FITTINGS. All pool and spa suction outlets shall be provide�f with a cover that conforms with ANSVASME - Al 12.19.6M OR A 12"X 12" drain grate or larger,or an approved channel drat system, � ! — — EXCEPTiON! surface skimmers - )# AG106.3 Atmospheric vacuum relief system required. All pool and spa single or multiple outlet circulation systems shall be equipped with etmosphertc vacuum re1lef shoVld grate covers located thereon become missing or broken.Such vacuum rectal I, I at loss one approved or on Ineored method of thv type s ecmed herein as follows,. systems shall include t . pp 0 !S . 1, Safety vacuum release system conforming to ASME A112,19.1y r I 2. An approved gravity drainage Mlerri i AG106.4 DUAL DRAIN SEPARATION. Single or multiple pump circulation syste s shah be provided with a minimum of two (2) 1i suction outlets of the approved type. A minimum horizontal or vertical distance of three (3) feet shall separate such outlets.These e ► -2. AMA>C ; BUCclon outlets shall be piped so that water Is.drawn through them simunoneously through a vacuum relief protected line to the t -- — — pump or pumps, G ��?,0 ARC c /Y 114, FqONAE..O C. HANNA i W4. use. � 781 COATES AVE, SVITE 18 HOI.®AOOK, N, Y. 11741 831 265 - 7870 9�' $'�