HomeMy WebLinkAbout43712-Z �UFFO[R
COG�.c Town of Southold 10/11/2019
a -
P.O.Box 1179
d' n 53095 Main Rd
Southold,New York 11971
CERTIFICATE ,OF OCCUPANCY
No: 40766 Date: 10/11/2019
THIS CERTIFIES that the building WINDOWS
Location of Property: 1945 Village Ln, Orient
SCTM#: 473889 Sec/Block/Lot: 25.-3-11
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
f
4/30/2019 pursuant to which Building Permit No. 43712 dated 5/7/2019
was issued, and conforms to allj of the requirements of the applicable provisions of the law. The occupancy for
which this certificate is issued is:
WINDOW REPLACEMENTS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to Woodard,Judith&Burks,Myrna
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
4
u ho ' Signature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y 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#: 43712 Date: 5/7/2019
Permission is hereby granted to:
Woodard, Judith
2005 Village Ln
PO BOX 402
Orient, NY 11957
To: install window replacements to existing single-family dwelling as applied for per
Landmarks approval with flood permit.
At premises located at:
1945 Village Ln
SCTM # 473889
Sec/Block/Lot#25.-3-11
Pursuant to application dated 4/30/2019 and approved by the Building Inspector.
To expire on 11/5/2020.
Fees:
SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $200.00
Flood Permit $100.00
CO -ALTERATION TO DWELLING $50.00
Total: $350.00
B u i I d i nsp166-tor
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. For new building or new use:
1. Final survey of property with accurate location of all buildings,property lines, streets, and unusual natural or
topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1%lead.
5. Commercial building,industrial building,multiple residences and similar buildings and installations, a certificate
of Code Compliance from architect or engineer responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings(prior to April 9, 1957) non-conforming uses,or buildings and "pre-existing"land uses:
1. Accurate survey of property showing all property lines, streets,building and unusual natural or topographic
features.
2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is
denied,the Building Inspector shall state the reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy-New dwelling$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00,
Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,Businesses$50.00.
2. Certificate of Occupancy on Pre-existing Building- $100.00
3. Copy of Certificate of Occupancy-$.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy-Residential$15.00, Commercial$15.00
Date.
New Construction: Old or Pre-existing Building: (check one)
Location of Property: q�'� 1 4 5e Lv, Ord 2n f
House No. Q Str
eet Hamlet
Owner or Owners of Property: CAI rAC,
Suffolk County Tax Map No 1000, Section Block Lot
Subdivision Filed Map. Lot:
Permit No. r t Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ 5Q
Applicant Signature
ESO
hO�aO UTyOlo
# # TOWN OF SOUTHOLD BUILDING DEPT.
courm, 765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] SULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] FINAL()/nd#WS
[ ]' FIREPLACE &CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION =[ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
RERKS:
7 AlAoft
D_
DATE _ INSPECTORkdm4qwz
o�*pG SOl ,
Telephone (631)765-1802 h O Town Hall,53095 Route 25
Fax (631)765-9502 Ji J P.O.Box 1179
Southold,New York 11971-0959
G,rc0 • �Q
COU
SOUTHOLD TOWN
LANDMARK PRESERVATION COMMISSION
CERTIFICATE OF COMPLETION
October 09, 2019
Judith Woodard and Myrna Banks
1945 Village Lane
Orient,NY 11957
This letter is to certify that you have completed your project to the satisfaction of the
Southold Town Historic Preservation Commission in accordance with your Certificate of
Appropriateness, issued on April 16, 2019.
Should you have any questions, feel free to contact me at the number above.
Sincerely,
j4at�Tracey L. Dwyer ,
Administrative Assistant
Southold Town Historic Preservation Commission
CC: file, applicant
i
\ ,,IELD INSPECTION REPORT DATE COMMENTS
FOUNDATION (1ST)
......................................
'FOUNDATION (2ND) �
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CA N
ROUGH FRAMING&
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PLUMBING I
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INSULATION PER N.Y. y
STATE ENERGY CODE
A AID
ax NJ
FINAL
ADDITIONAL COMMENTS
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL Board of Health
SOUTHOLD,NY 11971 4 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 Survey
Southoldtownny.gov PERMIT NO. Check
Septic Form
N.Y S.D.E.C.
D
Trustees
V \.�, D C.O.Application
Flood Permit
Examined 511 20_[q Single&Separate
M Ay 2 2019
Truss Identification Form
Storm-Water Assessment Form
Contact:
1 TOWN OF�®����
Approved 11 ,20 Mail to:
Disapproved a/c �C_ +
Phone: 5 � __ r L
Expiration 20 q17 99;�, 0110 11G
D
13N14igInspector
DD
PPLICATIONVOR BUILDING PERMIT
Date , 20
INSTRUCTIONS
Vis p i
T+ pli"4
a. ca i n e completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
sets of plans, accurate plot plan to scale.Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises,relationship to adjoining premises 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.
e.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 building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the
property have been enacted in the interim,the Building Inspector may authorize,in writing,the extension of the permit for an
addition six months. Thereafter,a new permit shall be required.
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, 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)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Ru-, a. e&
Name of owner of premises M,fi p iv, LdoaLr
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of co orate officer)
Builders License No. 3"
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land onwhich proposed work will be done:
ei4qr ,t� �
House Number 8treet Hamlet
County Tax Map No. 1000 Section Block Lot
Subdivision Filed Map No. Lot
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy
b. Intended use and occupancy
3. Nature of work(check which applicable,:New Building Addition Alteration
a . .�Ja9 E.
Repair Removal Diernoliion� ';'" ;? x Othar Work
$ •,r (Description)
4. \Dimension
ost `" Fee x
u� - L", P(To be paid on filing this application)
5. number of dwelling units Number of dwelling units on each floor
umber of cars
.n ?..l �1./; r ,'f y�it...,. ��
6. ommercial or mixed occupancy, specify nature and'extent of each type of use.
7. of existing structures, if any: Front Rear Depth
Number of Stories
Dimensions o ame structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire ew construction: Front Rear Depth
Height Number of Stories
9. Size of lot: Front Rear Depth
10. Date of Purchase Name of Former Owner
11. Zone or use district in which pre ises are situated
12. Does proposed construction violate y zoning law, ordinance or regulation?YES NO
13. Will lot be re-graded? YES NO Will excess fill be removed from premises?YES NO
14. Naives 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 wetla d or;freshwater wetland? *YES NO
* IF YES, SOUTHOLD TOWN TRUSTEES &D. C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetlan * YES NO
* IF YES, D.E.C. PERMITS MAY BE 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.
18. Are there any covenants and restrictions with respect to this property? * YES NO
* IF YES, PROVIDE A COPY.
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, CONNIE D. BUNCH
Notary Public,Siete of Now York
(S)He is the No.01 BU6165050Oua }
(Contractor,Agent, Corporate Officer, etc) Cor�Commissionssiaasin Expires Apra! 14,2 C
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.
Sworn to before me this _
QV-W\ of LAA�q 20
Notary Public Signature of Applicant
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
DATE:February 26, 2019
TO: Mike Prindle(Woodard)
PO Box 402
Orient,NY 11957
Please take notice that your application dated February 20, 2019:
For permit to install new windows at:
Location of property: 1945 Village Lane, Orient,NY
County Tax Map No. 1000—Section 25 Block 3 Lot 11
Is returned herewith and disapproved on the following grounds:
The proposed construction, on this non-conforming 13,503.6 square foot lot in the Residential R-
40 District, is not permitted without review and approval by the Southold Town Landmarks
Preservation Commission, because the property is listed on either the Southold Town,New York
State and/or the National Registers of Historic places and requires review by the Southold Town
Landmarks Preservation Commission.
If the requirements of the town code, pertaining to Landmarks (Local Law No.22)are met, a
Certificate of Appropriateness (C of A)will be issued. The C of A is required before a Building
Permit will be approved. Information about the requirements for applying for a C of A is
available at the information counter in the Building Department.
Auth ature
Note to Applicant: Any change or deviation to the above referenced application may
require further review by the Southold Town Building Department.
CC: file,Landmark
o40 FR
W
Edward Webb, Chairperson � Town Hall Annex
Anne Surchin,Vice Chair �J�1 ��qT 54375 Route 25
Donald Feiler PO Box 1179
James Grathwohl Southold,NY 11971
Robert Harper Fax(631)765-9502
James Garretson Telephone: (631)765-1802
Joseph McCarthy www.southoldtownny.gov
Tracey Dwyer,Administrative Assistant
Town of Southold Historic Preservation Commission
Tuesday,April 16,2019
RESOLUTION #4.16.19.2
Certificate of At propriateness
RE: 1945 Village Lane,Orient,SCTM#1000-25.-3-11
Owner: Judith Woodard and Myrna Banks
RESOLUTION:
WHEREAS, 1945 Village Lane, Orient,NY is on the Town of Southold Registry of Historic
Landmarks, and
WHEREAS, as set forth in Section 56-7 (b) of the Town Law(Landmarks Preservation Code)
of the Town of Southold, all proposals for material change/alteration must be
reviewed and granted a Certificate of Appropriateness by the Southold Town
Historic Preservation Commission, and,
WHEREAS, the applicant is requesting permission to install new windows, and,
WHEREAS, a pre-submission conference was held regarding the matter on March 19, 2019,
and a public hearing was held on April 16, 2019.
NOW THEREFORE BE IT RESOLVED,that the Southold Town Historic Preservation
Commission determines that the proposed work detailed in the above referenced application
meets the criteria for approval under Section 170-8 (A) of the Southold Town Code and,
BE IT FURTHER RESOLVED,that the Commission approves the request for a Certificate of
Appropriateness.
MOVER: Commissioner Harper
SECONDER: Vice Chair Surchin
AYES: Chairperson Edward Webb,Vice Chair Surchin, Commissioner Harper, Commissioner
Garretson and Commissioner Joseph McCarthy.
RESULT: Passed Unanimously
Please note that any deviation from the approved plans referenced above may requirefurther
review front the commission.
Signed• 4dacj4 d- &w
Tracey L Dwyer,Application Coordinator for the Historic Preservation Commission
Date: April XX,2019
ADMINISTRATIVE PERMIT
Applicant: Judith Woodard and Myrna Burks
Date of Receipt of Application: May 1, 2019
SCTM#: 1000-25.-3-11
Project Location: 1945 Village Lane, Orient
Date of Resolution/Issuance: May 21, 2019
Reviewed by: Commissioners
Project Description: Replace an additional 13 windows as per application and in
accordance to the Certification for Appropriateness issued April 16, 2019.
Findings: The project meets all the requirements for issuance of an Administrative
Permit set forth in Chapter 170 of the Southold Town Code. The issuance of an
Administrative Permit allows for the operations as described in the application received
on May 1, 2019.
- - - Special Conditions: No additional work permitted beyond the scope of that outlined in
the above referenced application.
If the proposed activities do not meet the requirements for issuance of an Administrative
Permit set forth in the Southold Town Code, a Certificate of Appropriateness will be
required.
This is not a determination from any other agency.
JA ld. Ci)-,
Tracey Dwyer
Administrative Assistant
Historic Preservation Commission
vy_ IG-2_01`l
Andersen Andersen Windows - Abbreviated Quote Report Andersen
Project Name: Copy Of JUDITH WOODARD
Quote#: 185156 Print Date: 04/15/2019 Quote Date: 04/15/2019 iQ Version: 19,0
Dealer: RIVERHEAD BUILDING SUPPLY Customer: 1 - ANDERSEN TRADE ID FOR RIVERHEAD BUILDING
BUILD SMARTER.BUILD BETTER. Billing
1-800-378-3650 Address:
WWW.RBSCORP.COM Phone: Fax:
Sales Rep: GREG VIANI Contact:
Created By: Kevin Britt Trade ID: 060055 Promotion Code:
Item oty Item Size(Operation) Location
�� 0001 2 ADH2848(AA) 1ST FLOOR
I
�EJ ROSize-2'8"Wx4'8"H Unit Size=2'71/4"Wx4'71/4"H
A Series
Unit,4 9/16"Frame Depth,White/Pine,White-Factory Painted,High Performance Low-E4(Each Sash),Divided Light without Spacer,Specified Equal
Lite,2w1 h,7/8", Ext Grille-White,Int Species-Pine, Int Grille Color-White-Factory Painted(Each Sash),Traditional,White, 1 Sash Locks,w/Standard
-- Flange
Equal Sash,Insect Screen,White
Viewed from Exterior
Zone:North-Central
U-Factor:0.29, SHGC:0.27, ENERGY STARS Certified:Yes
0002 3 ADH2858(AA) 1ST FLOOR
ROSize=2'8"Wx5'8"H Unit Size=2'71/4"Wx5'71/4"H
A Series
Unit,4 9/16"Frame Depth,White/Pine,White-Factory Painted,High Performance Low-E4(Each Sash),Divided Light without Spacer,Specified Equal
Lite,2w1 h,7/8", Ext Grille-White, Int Species-Pine,Int Grille Color-White-Factory Painted(Each Sash),Traditional,White, 1 Sash Locks,w/Standard
Flange
Equal Sash,Insect Screen,White
Viewed from Exterior
Zone:North-Central
U-Factor:0.29, SHGC:0.27, ENERGY STAR®Certified:Yes
Quote M 185156 Print Date: 04/15/2019 Page 10f 3 iQ Version: 19.0
i
Andersen Andersen Windows -Abbreviated Quote Report Andersen
.i
Project Name: Copy Of JUDITH WOODARD
............. i Quote M 185156 Print Date: 04/15/2019 Quote Date: 04/15/2019 iQ Version: 19,0
Dealer: RIVERHEAD BUILDING SUPPLY Customer: 1 - ANDERSEN TRADE ID FOR RIVERHEAD BUILDING
BUILD SMARTER.BUILD BETTER. Billing
11800-378-3650 Address:
WWW.RBSCORP.COM Phone: Fax:
Sales Rep: GREG VIANI Contact:
Created By: Kevin Britt Trade ID: 060055 Promotion Code:
j Item City Item Size(Operation) Location
0001 2 ADH2848(AA) 1 ST FLOOR
ROSize=2'8"Wx4'8"H Unit Size=2'71/4"W x4'71/4"H
A Series
�) Unit,4 9/16"Frame Depth,White/Pine,White-Factory Painted,High Performance Low-E4(Each Sash), Divided Light without Spacer,Specified Equal
Lite,2w1 h,7/8", Ext Grille-White, Int Species-Pine, Int Grille Color-White-Factory Painted(Each Sash),Traditional,White, 1 Sash Locks,w/Standard
Flange
Equal Sash,Insect Screen,White
Viewed from Exterior
I
Zone:North-Central
U-Factor:0.29, "SHGC:0.27, ENERGY STAR®Certified:Yes
i; `' 0002 3 ADH2858(AA) 1 ST FLOOR
j " " "
RO Size=2 8 W x 5 8 H Unit Size-=2'7114"W x 5'71/4"H
A Series
!' Unit,4 9/16"Frame Depth,White/Pine,White-Factory Painted,High Performance Low-E4(Each Sash),Divided Light without Spacer,Specified Equal
Lite,2w1 h,7/8", Ext Grille-White Int Species.--Pine Int Grille Color-White-Facto Painted Each Sash Traditional White 1 Sash Locks,w/Standard
Flange p Factory ( )� ,
Equal Sash,Insect Screen,White
Viewed froT Exterior
_ Zone:North-Central
U-Factor:029, SHGC:0.27, ENERGY STAR®Certified:Yes "
Quote#: 1185156 Print Date: 04/15/2019 Page 10f 3 iQ Version: 19.0
1
i
Andersen j Andersen Windows - Abbreviated Quote Report Andersen
Project Name:'Copy Of JUDITH WOODARD
.o... Quote#: 185156 Print Date: 04/15/2019 Quote Date: 04/15/2019 iQ Version: - 19.0 D ~
Dealer: RIVERHEAD BUILDING SUPPLY Customer: 1 - ANDERSEN TRADE ID FOR RIVERHEAD BUILDING
BUILD SMARTER.BUILD BETTER. Billing
l-800-378-3650 Address:
11(IWW.RBSCORP.COM Phone: Fax:
Sales Rep: GREG VIANI Contact:
Created By: Kevin Britt Trade ID: 060055 Promotion Code:
Item Qty Item Size(Operation) Location
0001 2 ADH2848(AA) 1ST FLOOR
is " " „
ROSize-2'8 Wx4 8 H Unit Size=2 71/4 Wx4 71/4"H
A Series
Unit,4 9/16"Frame Depth,White/Pine,White-Factory Painted,High Performance Low-E4(Each Sash),Divided Light without Spacer,Specified Equal
Lite,2wl h,7/8", Ext Grille-White, Int_Species-Pine, Int Grille Color-White-Factory Painted(Each Sash),Traditional,White, 1 Sash Locks,w/Standard
�. Flange
Equal Sash,Insect Screen,White
Viewed from Exterior
Zone:North-Central
U-Factor:0.29, SHGC:0.27, ENERGY STAR®Certified:Yes
I
I "
I -
i
0002 3 ADH2858(AA) 1 ST FLOOR
ROSize=2'8"Wx5'8"H Unit Size=2'71/4"Wx5'71/4"H
A Series '
Unit,4 9/16"Frame Depth,White/Pine,White-Factory Painted,High Performance Low-E4(Each Sash), Divided Light without Spacer,Specified Equal
Lite,2w1 h,7/8", Ext Grille-White, Int Species-Pine, Int Grille Color-White-Factory Painted(Each Sash),Traditional,White, 1 Sash Locks,w/Standard
Flange
Equal Sash, Insect Screen,White
Viewed from Exterior
Zone:North-Central
U-Factor:0.29, SHGC:0.27, ENERGY STAR®Certified:Yes
Quote#: 11185156 Print Date: 04/15/2019 Page 1 Of 3 iQ Version: 19.0
I
i
r
Andersen Andersen Windows - Abbreviated Quote Report Andersen
Project Name: Copy Of JUDITH WOODARD
i Quote#: 185156 Print Date: 04/15/2019 Quote Date: 04/15/2019 iQ Version: 19,0 ~ ...
Dealer: RIVERHEAD BUILDING SUPPLY Customer: 1 - ANDERSEN TRADE ID FOR RIVERHEAD BUILDING
BUILD SMARTER.BUILD BETTER. Billing
1'-800-378-3650 Address:
WWW.RBSCORP.COM Phone: Fax:
Sales Rep: GREG VIANI Contact:
Created By: Kevin Britt Trade ID: 060055 Promotion Code:
j Item C" Item Size(Operation) Location
_ I _
0001 2 ADH2848(AA) 1ST FLOOR
RO Size=2'8"Wx 4'&H Unit Size=2'71/4"Wx4'71/4"H
A Series
Unit,4 9/16"Frame Depth,White/Pine,White-Factory Painted,High Performance Low-E4(Each Sash),Divided Light without Spacer,Specified Equal
Lite,2w1h,7/8",Ext Grille-White, Int Species-Pine, Int Grille Color--White-Factory Painted(Each Sash),Traditional,White, 1 Sash Locks,w/Standard
Flange
Equal Sash,Insect Screen,White
Viewed from Exterior
Zone:North-Central
j U-Factor:0.29, SHGC:0.27, ENERGY STAR®Certified:Yes
I _
i 0002 3 ADH2858(AA) 1ST FLOOR
'
RO Size=2'8"Wx5'8"H Unit Size=2'71/4"W x5'7 1/4"H
A Series
Unit,4 9/16"Frame Depth,White/Pine,White-Factory Painted,High Performance Low-E4(Each Sash),Divided Light without Spacer,Specified Equal
Lite,2w1 h,7/8", Ext Grille-White, Int Species-Pine, Int Grille Color-White-Factory Painted(Each Sash),Traditional,White, 1 Sash Locks,w/Standard
Flange
Equal Sash,Insect Screen,White
Viewed from Exterior
Zone:North-Central
U-Factor:0.29, SHGC:0.27, ENERGY STAR®Certified:Yes
Quote#: 185156 Print Date: 04/15/2019 Page 1 Of 3 iQ Version- 19,0
I
stfM j"H T. TERRY
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'TOWN CLERK �. f O- nt,x 117h
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ftEGISfRAR OITA.STATIS11CS
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OF V
MARRIAOF OrrICI:R TcIc�,lr<rnc (.Sl(,)
RECO 1103 MANr10EMENT01TICE:I1
f REEDO M OF INrORMA"nON OFFICER /
OFFICE OF TETE TOWN CLERK
TOWN OF SOUTHOLD
THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION WAS ADOPTED BY THE
SOUTHOLD TOWN BOARD AT A REGULAR MEETING HELD ON AUGUST 24, 1993 :
RESOLVED that the Town Board of the Town of Southold hereby adopts
two (2) new forms to be used under the Flood Damage Prevent regulations
of, the Code of the Town of Southold: "Floodplain Development Permit
lCpplication" (FDP(93) ) , and ;'Certificate of Compliance fr5r Develo-pment in
Special Flood Hazard Area (CIC(93) )
.l t
0 DAFT
TOK4 OF SOUTHOLD
Ah T. Terr
Y
Southold Town Clerk
August 25 , 1993
APPLICATION
PAGE I of 4
TOWN OF, SOUTHOLD
FLOODPLAIN DEVELOPMENT PERMIT A-PPLICATION
This form is to be filled out in duplicate.
SECTION I• GENERAL PROVISIONS (APPLICANT to read and si6)-
1. No work may start until a permit is issued.
2 The permit may be revoked if any false statements are made herein.
3. If revoked, all work must cease until permit is re=issued.
4. Development shall not be used or occupied until a Certificate of Compliance is issued.
S. The permit will expire if no work is commenced within six months of issuance.
6. Applicant is hereby informed that other permits may be required to fulfill local,state and federal regulatory
requirements.
7. Applicant hereby gives consent to the Local Administrator or his/her representative to make reasonable
inspections required to verify compliance.
8. I,THE APPLICANT,CERTIFY THAT ALL STATEMENTS HEREIN AND IN ATTACHMENTS TO
_ THIS APPLICATION ARE,TO THE B T F MY KN DGE,TRUE AND ACCU
RATE.
(APPLICANTS SIGNATURE) DATE
/SECTION 2: PROPOSED DEVELOPIr'IENT (T�be completed by APPLICAB'D
_ NAME AD D R ESS TELEPHONE
APPLICANT �s 1�
T � W er o c)A t�
BUILDFR (fit` N y q13-021-0170
ENGINEER
PROJECT LOCATION:
• To avoid delay in processing the application, please provide caou¢h information to easily ideatify the project
location_ Provide the street address, lot number or Iegal description (attach) and, outside urban areas, the
distance to the nearest intersecting road or well-known landmark A sketch attacbed to this application showing
the project location would be helpful-
FDP(93)
APPLICATION
PAGE 2OF4
DESCRIPTION OF WORK (Check all applicable boxes)
A STRUCTURAL DEVELOPMENT '
ACTIVITY STRUCTURE TYPE
❑ New Structure sidctidal (1-4 Family)
❑ Addition ❑ Residential (More than 4 Family)
❑ Alteration ❑ Non-residential (Floodproofmg? ❑ Yes)
❑ Relocation ❑ Combined Use (Residential & Commercial)
❑ Demdlitioa P ❑ Manufactured (Mobile) Home (In Manu-
e tacement factured Home Park? ❑ Ycs)
ESTIMATED COST OF PROJECT S
B. OTHER DEVELOPMENT ACTIVITIES:
D Fill ❑ Mining ❑ Drilling O Grading
❑ Excavation (Except for Structural Development Checked Above)
❑ Watercourse Alteration (Including Dredging and Channel Modifications) ,
❑ Drainage Improvements (Including Culvert Work)
❑ Roafh, Street or Bridge Coastruction
/ ❑ Suf •vision (New or Expansion) /
i ❑ Idual Water or Sewer System
❑ Other (Please Specify)
r
Aftcr completing SECTION 2, APPLICANT should submit form to Local Administrator for revieai_
,SECTION 3• FLOODPLAW DETERMINATION (To be cornplctcd by LOCAL ADMIMSTRATOR)
The proposcd development is locatcd,oa FIRM Pancl No. . Dated
The-Proposed Development:
❑ Is NOT located in a Special Flood Hazard Area, (Notify the applicant that the application
review is complete and NO FLOODPLALN DEVELOPMENT PERMIT IS REQUIRED).
❑ Ls located in a Special Flood Hazard Arca.
FIRM zone designation is
100-Year flood elevation at the site is: Ft. NGVD (MSL)
❑ Uaavailablc
❑ The proposed development Is located In a floodway
FBFM Paocl No Datcd
❑ Scc Section 4 ,for additional iostrucnons-
SIGNED DATE
: APPLICATION #
PAGE 7 OF 4
SECTION 4 ADDITIONAL, INFORMATION REQUIRED (To be completed by LOCALADMINIS-FRATORI
The applicant must submit the documents checked below before the appficadon can be processed:
❑ A site plan showing the location of all exiting structures, water bodies, adjacent roads, lot
dimensions and proposed development.
❑ Devclopmcnl plans,drawn to scale, and specifications,including where applicable: details for
anchoring structures, proposed elevation of lowest floor(including basement), types of water
resistant materials used below the first floor, details of floodproofwg of utilities located below
Lbe first floor and details of enclosures below the first floor.
Also
❑Subdivision or other development plans (If the subdivision or other development exceeds 50
lots or 5 acres,whichever is the lesser, the applicant must provide 100-year flood elevations
if they are. not otherwise available).
O Plans showing the extent of watercourse relocation and/or landform alterations_
❑ Top of new fill elevation Ft. NGVD (MSL)-
0 Floodproof-ng protection level (non-residential only) Ft:NGVD (MSL). For ,
floodproofed structures, %applicant must attach certification from registered engineer or
_ architect.
❑ Certification from a•regxstercd engineer that the proposed acti,6t�in a regulatory floodway
will not result in any increase in the height of the 100-year flood. A copy of all data and
calculations supporting this finding must also be submitted.
❑ Other.
SECTIONS PERMIT DETERMINATION (To be compictcd by LOLAL ADMINISTRATOR
I hive determined that the proposed activity. A_ ❑ Is
B. ❑ Is not
in conformance with provisions of Local Law i 19_. The permit Ls issued subject to the condilloru
attached to and made part of this permit.
SIGNED DATE
If BOX A i5 chcckcd, the Local Administrator may issue a Development Permit upon payment of designated
fcc
If BOX B 15 checked, the Local Admuustrator will provide a written summary of deficiencies. Applicant may
revise and resubmit an appbcalion to the Local Administrator or may request a bearing from the Board of
Appeals
APPLICATION W
PAGE 4 OF 4
APPE_LL,S Appcalcd to Board of Appcalsl ❑ Ycs O No
Hearwg date:
p pc a --- Appoy,0 F3 Yes 9 Ne
Coadidoas
SECTION 6: AS-BUILT ELEVATIONS (To be submitted by APPLICANT before Certificate of Comolianee
is issued
The following information must be provided for project structures. This section must be completed by a
registered professional engineer or a Uccused land surveyor (or attach a certification to this application).
Complete 1 or 2 below.
1. Actual (As-Built) Elevation of the lop of the lowest floor, including basement rn Coastal High Hazard
Areas bottom of lowest structural member of the lowest floor, excluding piling and columns) is:
FT. NGVD (MSL).
L Actual (As-Built) Elevation of floodproofing protection is FT. NGVD (MSL)-
•j
NOT' Any work performed prior to submittaliof the above information is at the risk i[ the Applicant•
7 f ,I/
SECTION 7• COMPLIANCE ACTION (To be completed by LOCAL ADMINISTRATOR)
The LOCAL ADMINISTRATOR wtH complete this section as applicable based oo iaspcctioo of the project to
ensure comphancc with the community s local law for flood damage prevention.
INSPECTIONS: DATE BY DEFICIENCIES? O YES ❑ NO
DATE BY DEFICIENCIES? ❑ YES ❑ NO
DATE BY DEFICIENCIES? ❑ YFS O NO
SECTION 8: CERTIFICATE OF CLOMPLIANCE(To be completed by LOCAL ADMINISTRATOR)
Cerdficatc of Compliance issued: DATE: BY:
Attachment B
BAMPii B
CERTIFICATE PF COMPLIANCE
'
l Flood Hazard Area for Development in a Specia
,r
•IF w
TOWN OF SOUTHOLD
CERTIFICATE OF COMPLIANCE
FOR DEVELOPMENT IN A SPECIAL FLOOD HAJARD AREA
(O"WEE MUST RETAIN THIS CERTIFICATE)
PREMISES LOCATED AT: PERMIT NO. '
PERMIT DATE ,
OWNERS NAME AND ADDRESS: CHECK TONE:
0 NEW BUILDING
0 EXISTING BUILDING
O VACANT LAND • '� .
THE LOCAL ADMINISTRATOR IS TO COMPLETE A. OR B. BELOW:
A. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF
LOCAL LAW # , 19_
SIGNED: DATED:
B. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF
LOCAL LAW # , 19_, AS MODIFIED BY VARIANCE # ,
DATED
SIGNED: DATED:-
CIC ( 93)
APPROVED AS NOTED
DATE:
FEE: _ BY:
NOTIFY BUILDING DEPARTMENT AT OCCUPANCY OR
*-1802 �8 AM TO 4 PM FOR THE p
FOLLOWING INSPECTIONS: USE IS UNLAWFUL
!.-FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE WITHOUT CERTIFICATE
2. ROUGH FRAMIW- & PLUMBING
3. INSULATION OF OCCUPANCY
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS.
r RETAIN STORM WATER RUNOFF
PURSUANT TO CHAPTER 236
COMPLY WITH ALL CODES OF OF THE TOWN CODE.
NEW YORK STATE &TOWN CODES x
AS REQUIRED AND CONDITIONS-OF
SOUTHOLD TOWN ZBA
SOUTHOLD TOWN PLANNING BOARD
SOUTHOLD TOWN TRUSTEES
0
N.Y.S.DEC
r�
Andersen Andersen Windows -Abbreviated Quote Report Andersen
Project Name:judy woodard phase 1
Quote#: 181129 Print Date: 01/31/2019 Quote Date: 01/31/2019 - iQ Version: 18,2
Dealer: RIVERHEAD BUILDING SUPPLY Customer: 1 - ANDERSEN TRADE ID FOR RIVERHEAD BUILDING
BUILD SMARTER.BUILD BETTER. Billing
1-800-378-3650 Address:
WWW.RBSCORP.COM Phone: Fax:
Sales Rep: GREG VIANI Contact:
Created By. Trade ID: 060055 Promotion Code:
Item Qty Item Size(Operation) Location Unit Price Ext.Price
0001 2 ADH2848(AA) 1ST FLOOR $ 614.86 $ 1229.72
ROSize=2'8"Wx4'8"H Unit Size=2'71/4"Wx4'71/4"H
- -= A Series
i; Unit,4 9/16"Frame Depth,White/Pine,White-Factory Painted,High Performance Low-E4(Each Sash),Traditional,White, 1 Sash Locks,w/Standard
-
-J Flange
Equal Sash,Insect Screen,White
Viewed from Exterior Zone:North-Central
U-Factor:0.29, SHGC:0.30, ENERGY STAR®Certified:Yes
0002 3 ADH2858(AA) 1ST FLOOR $ 689.34 $ 2068.02
i; ROSize=2'8"Wx5'8"H Unit Size=2'71/4"Wx5'71/4"H
-__I,
A Series
I; Unit,4 9/16"Frame Depth,White/Pine,White-Factory Painted,High Performance Low-E4(Each Sash),Traditional,White, 1 Sash Locks,w/Standard
Flange
Equal Sash,Insect Screen,White
Viewed from Exterior Zone:North-Central
U-Factor:0.29, SHGC:0.30, ENERGY STAR®Certified:Yes
Quote M 181129 Print Date: 01/31/2019 Page 10f 3 iQ Version: 18.2
Item) Qty Item Size(Operation) Location Unit Price Ext.Price
0003 1 ADH2648(AA) STAIR $ 650.86 $ 650.86
!! _a ROSize=2'6"Wx4'8"H Unit Size=2'5 1/4"Wx4'7 1/4"H
ij A Series
Unit,4 9/16"Frame Depth,White/Pine,White-Factory Painted,High Performance Low-E4(Top Sash),High Performance Low-E4 Tempered(Bottom
Sash),Traditional,White, 1 Sash Locks,w/Standard Flange
Equal Sash, Insect Screen,White
Viewed from Exterior Zone:North-Central
U-Factor:0.29, SHGC:0.30, ENERGY STAR®Certified:Yes
0004 7 . ADH3040(AA) 2ND FLOOR $ 637.15 $ 4460.05
ROSize o3'0"Wx4'0"H Unit Size=2'111/4"Wx3'111/4"H
Ci 1i. A Series
Unit,4 9/16"Frame Depth,White/Pine,White-Factory Painted,High Performance Low-E4(Top Sash),High Performance Low-E4 Tempered(Bottom
Sash),Traditional,White, 1 Sash Locks,w/Standard Flange
Equal Sash, Insect Screen,White
Viewed from Exterior Zone:North-Central
U-Factor:0.29, SHGC:0.30, ENERGY STAR®Certified:Yes
Subtotal $ 8 408.65
Total Load Factor Tax(8.6259/6) $
Customer Signature ,<< 4 2.69.9 725'2
Grand Total $
9,133.90
Dealer Signature ; i�, t;,,
Quote#: 181129 Print Date: 01/31/2019 Page ZOf 3 iQ Version: 18.2
JIII I it' jig'—
Andersen -- r Andersen Windows-Abbreviated Quote Report Andersen
Project Name:judy Woodard phase 1
Quote M 181129 Print Date: 01/31/2019 Quote Date: 01/31/2019 iQ Version: 18,2
Dealer: RIVERHEAD BUILDING SUPPLY Customer: 1 - ANDERSEN TRADE ID FOR RIVERHEAD BUILDING
BUILD SMARTER.BUILD BETTER. Billing
1-800-378-3650 Address:
WWW.RBSCORP.COM Phone: Fax:
Sales Rep: GREG VIANI Contact:
Created By: Trade ID: 060055 Promotion Code:
Item (qty Item Size(Operation) Location Unit Price Ext.Price
0001 2 ADH2848(AA) 1 ST FLOOR $ 614.86 $ 1229.72
RO Size=2'8"W x4'8"H Unit Size=2'71/4"W x 4'7 1/4"H
A Series
Unit,4 9/16"Frame Depth,White/Pine,White-Factory Painted,High Performance Low-E4(Each Sash),Traditional,White, 1 Sash Locks,w/Standard
Flange
Equal Sash,Insect Screen,White
Viewed from Exterior Zone:North-Central
U-Factor:0.29, SHGC:0.30, ENERGY STAR®Certified:Yes —
I� 0002 3 ADH2858(AA) 1ST FLOOR $ 689.34 $ 2068.02
. " " "
� I RO Size=2 8 W x 5 8 H Unit Size=2 71/4 W x 5 71/4"H
A Series
li�I Unit,4 9/16"Frame Depth,White/Pine,White-Factory Painted,High Performance Low-E4(Each Sash),Traditional,White, 1 Sash Locks,w/Standard
0 Flange
Equal Sash,Insect Screen,White
Viewed from Exterior Zone:North-Central
U-Factor:0.29, SHGC:0.30, ENERGY STAR®Certified:Yes
Quote M 181129 Print Date: 01/31/2019 Page 1 Of 3 IQ Version: 18,2
• Item Oty Item Size(Operation) Location Unit Price Ext.Price
0003 1 ADH2648(AA) STAIR $ 650.86 $ 650.86
IL ROSize=2'6"Wx4'8"H Unit Size=2'51/4"W x4'71/4"H
t --
i
A Series
Unit,4 9/16"Frame Depth,White/Pine,White-Factory Painted, High Performance Low-E4(Top Sash),High Performance Low-E4 Tempered(Bottom
Sash),Traditional,White,1 Sash Locks,w/Standard Flange
Equal Sash, Insect Screen,White
Viewed from Exterior Zone:North-Central
U-Factor:0.29, SHGC:0.30, ENERGY STAR®Certified:Yes
0004 7 ADH3040(AA) 2ND FLOOR $ 637.15 $ 4460.05
RO Size=3'0"Wx4'0"H Unit Size=2'11 1/4"Wx3'11 1/4"H
i A Series
Unit,4 9/16"Frame Depth,White/Pine,White-Factory Painted, High Performance Low-E4(Top Sash),High Performance Low-E4 Tempered(Bottom
�= Sash),Traditional,White,1 Sash Locks,w/Standard Flange
Equal Sash,Insect Screen,White
Viewed from Exterior Zone:North-Central
U-Factor:0.29, SHGC:0.30, ENERGY STAR®Certified:Yes
Subtotal $ 8,408.65
Customer Signature
Total Load Factor Tax(8.625%) $ 725.25
., _
Grand Total Is 9,133.90
Dealer Signature
,
Quote#:-. 181129 Print Date: 01/31/2019 Page 2Of 3 iQ Version: 18.2
Item Qty Item Size(Operation) Location Unit Price Ext.Price
**All graphics viewed from the exterior
**Rough opening dimensions are minimums and may need to be increased to allow for use of building wraps or flashings or sill panning or brackets or fasteners or
other items.
Ask to see if all of the products you purchase can be upgraded to be ENERGY STAR®certif led.
® This image Indicates that the product selected Is certified in the US ENERGY STAR®climate zone that you have-selected.
Data is current as of August 2018 This data may change over time due to ongoing product changes or updated test results or requirements Ratings for all sizes are specified by NFRC for testing and certification.Ratings
may vary depending on the use of tempered glass or different grille options or glass for high altitudes etc.
Nexia is a registered trademark of Ingersoll Rand Inc.
Project Comments:
Riverhead Building Supply offers a two year parts and labor warranty on any Andersen Window or Patio Door products ordered through any of our locations.
See your Riverhead sales associate for more details.
Quote#: 181129 Print Date: 01/31/2019 Page 301' 3 iQ Version: 18.2