HomeMy WebLinkAbout10961-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office Of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No...Z.l.qs. 7.2 ......... Date ......... .F.e.b.v.u..a.v.y..5. ........... ,19.8.2.
THIS CERTIFIES that the building ................................................
Location of Property 3.65 ................ Ba~;i. sl .~Ot~.c[ .............. 5.o. tlt;ho~..d .......
House No. Street Ham/et
County Tax Map No. 1000 Section . .0.61 ....... Block . . .q 1. .......... Lot . .0.1.3, ............
Subdivision. I~v.~dl,*.e. PozLnt ............. Filed Map No, 3.7.61...Lot No.. 5 ...........
conforms substantially to the Application for Building Permit heretofore fried in this office dated
.~o.¥ .e!n.b.o..v..1.0. ....... , 19 .B.0. pursuant to which Building Permit No. 10961 Z
dated ..... D.o.~ emb.e,.r..t ........... 19 ~80., was issued, and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is .........
p. riYat fa nily d.w..e.l.l.i.n.g
The certificate is issued to ...... .B:a?.n. ~ y..V.: . .~..lq. t..c ~.e.~. ~ .n.a..~ .o .n.~.5..q o..1.i.q ..............
[owner,:~.~e~ooRt~t~l~g~
of the aforesaid building.
...-....-~.9. ~. 99.t., . ¢.0.,. ! ~.8.1. ~..R.o.b.o..r.t..A.~. Villa,
Suffolk County Department of Health Approval 10 BO .
P.E.*
UNDERWRITERS CERTIFICATE NO .... .N.5.3. ~ 9.7.3. .....................................
*Well water may contain amounts of Sodium tl~at should be of
concern to persons on a do~ium restr~d diet,
Building Ins!Sector
Rev. 1/81
,
TOWN .oF
BUILDING
Town 'HALL
$OUTHOLD,
BUILDING PE~IT
!' ~' Bu dng[lnspectdr
Building Inspector.
(THIS PERMIT MUST BE KEPT ON THE PRE/~IS~S UNTIL CULL
ED)
COMPLETION OF THE WORK AUTHORI~ '
Permission is hereby granted to: ,
at premise~s located at ......................................................... ~.... ........
Cou,~ Tdx Mop No. 1000 Section ~? / Block ~....~.'~/ ............. ;Lot No.s~ ...................
~)~/': ¢/L~ approved by the
pursuant to application dated .................................. ~ .......... ,...~ .......
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec-
tor with the following; for new buildings or new use:
1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual
natural or topographic featu res,
2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa-
tions, a certificate of Code compliance from the Architect or Engineer responsible for the building.
5. Submit Piannin§ Board approval of completed site plan requirements where applicable.
For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or
topograph ic featu res.
2, Sworn statement of owner or previous owner as to use, occupancy and condition of buildings.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
C. Fees;
1. Certificate of occupancy $5,00
2. Certificate of occupancy on pre-existing dwelling or land use $5,00
3. Copy of certificate of occupancy $1.00
D ate..~.' .~.....~.,t'..
New Building ... ~.,. ...... Old or Pre-existing Bulldog . .., ......... Vacant Land .............
Location of Property ~ ~ t~ ~ .......... 'T~.~'.~. ~
House No, Street _~ Ham/et
Owner or Owners of Property .... ~, '~.~.~...~~
County Tax Map No. 1000 Section .... ~ ....... Block ..... ~...
.... ~ ......... F,,ed ~ap No. ~ ~/ .... Lot No..~ .........
~armit ~o.~. g~ ~... Dat, o* ~ermit .~. 8~.applicant . .~ ...............
Health Do~t. Approval ........................ Labor D~t. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..... ~ ......... Final Certificate ..... ~ .............
Fee Submitted $ ..... ~. v., ..................
Construction on above described building and perm, it roeets all applje~ble codes and regulations.
Applicant .........................
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
ES JOHN STREET, NEW YORK, NE.W~:YORK 10038
location; ~ Basement ~ 1st FL ~2nd Fl. Section Block ~t
~5~ 24, 1981 and found to be in compliance with the requirements of this Boord.
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANE
OUTLETS SWITCHES FLUORESCENT
39 38
DRYERS
SYSTEMS
NO. OF FEET
OTHER APPARATUS:
3-S~ Detec~cors
2-4.5 ~
1-20.0 ~
NO OF NEUTRALS
4/0
Ale Elec. O~'~t,,
~ox ii& }~'*
Matt:i~t4~k,. N.Y. 11952
lic. 783-E
This certificate must not he altered in any manner; return to the office of the Board if incorrect. Inspector's may be
by their credentials.
COPY.iF ~,UiLDING '. THIS COPY ANY MANNER.
FIELD INSPECTION COMMENTS
FOUNDATION
2.
ROUGH FRAME&
PLUMBING
(2nd)
INSULATION PER N.Y.
STATE ENERGY
FINAL
ADDITIONAL COMMENTS:
Albert A. Sacco, R.A.
SACCO & AHLERS
Architects & Engineers
54655 Main Road
Soulhold, L.I., N,Y, 11071
516-~65.5455
Gordon K. Ahlers, P.E.
INSPECTION AND CALCULATIONS
FOR
DETERMINATION OF
NEW YOt~ STATE
ENERGY CONSERVATION CONSTRUCTION CODE
FOR THE RESIDENCE OF
COMPLIANCE'
Mr. & Mrs. Barney V. Monticello
Basin Road
Southold, NY
A. General:
DATA SUMMARY
1. Number of Stories 2
2. Gross Floor Area 2400
Square Feet
3. Gross Exterior Wall Area
2655
Square Feet
4. Area of Windows & Exterior Doors 640
Square Feet
5. Degree Days for Area
B. Thermal Transmittance Values:
Code
Max. or Min.
Area
Windows & Doors 24.0 ~
Uw of Exterior Walls .08
Ug of Glazing .69
Ud of Doors .40
Uo of Total Wall .22
Uw of Heated Basement N/A
Walls (above grade)
Ur of Roof & Ceiling .05
Uf of Floors Over
Unheated Spaces
R of Slab Edge N/A
(Unheated)
R of Slab Edge
(Heated) 7.0
R of Heated Basement
Walls (below grade) N/A
Calculated Value
24.0 %
· 08
.58
.40
.22
· O4
9.0
Meets Code
yes
yes
yes
yes
yes
yes
yes
C, Certification Requirements:
Item
1. Air Leakage Windows
(0.5 cfm/LF)
Air Leakage Doors
(0.5 cfm/LF Sliding)
(1.0 cfm/LF Swinging)
3. All Water Absorbing
Insulation with Vapor Barrier
4. Basement Vents with Closeable
Damper (Heated Basement)
5. Basement Walls
Insulated 24" Below Grade
6. Insulation Continuity at
Plate & Sill Lines
7. Ud of Exterior Basement Doors
Meets Code
8. Fireplace Dampers
Max. leakage 20 cfm
Fireplace Outside Air Ducts
(150 cfm) With Closeable
Dampers
10. Thermostats Capable of
45°F to 75OF
11. Means to Restrict or Shut Off
Heating or Cooling of Each Zone
12.
Manual or Automatic Means of
Reducing Energy (thermostat
setting) used during periods
of non-use
Yes
X
X
X
N/A
N/A
X
X
X
X
X
X
No
No Data
Available
Item
13. Combustion Heating Equipment
75% or higher efficiency
14. Heat Pumps have a
Minimum COP of 2.5
15.
Water Heaters:
Electric - 20-120 Gal.
12 KW or less
Gas - 20-120 Gal.
75,000 B"TU or less
Oil - 50 Gal. or less
103,875 BTU or less
Automatic Temperature
Controls (max. 140°F)
Storage Tank Heat Loss
Less than 15 BTU/hr
/sF
System Equipped with a
Shutdown Switch or
Valve
16. Heating Ducts and Pipes
Insulated (if required)
17. Switching Provided for
Each Lighting Circuit
18. Swimming Pools (Heated):
Equipped with Controls
to Limit Temperature
to 80°F
Uncovered Units
Equipped with Controls
to Secure Heaters at
Air Temperature
Below 60uF
Yes
N/A
No
No Data
Available
X
X
N/A
N/A
X
X
X
N/A
X
N/^
W^
Conforming and Compliance Statement and Explanation:
Window area ercentage and the resultant [Jo are at the m. aximum
24~ and .22.
~ The roof contains extra insulation with a Ur of. 04.
Energy certification should be used as a compliance specification
check list by the owner and builder.
E. Recommendations for Improving Energy Efficiency:
WILLIAM $. JACOBS ,t
DI~POT LANE
CUTCflOGUE, N.Y. 11935
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N,Y. 11971
TEL.: 765-1803
Examined ................ 19...
Approved ........... [ ...., 19q~.s~t'ermit No ............
·....C~_,_,~_~,~...~ __
Disapproved
a/c
.................... ............
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building
Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of tot and of buildings on premises, relationship to adjoining premises or public streets
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
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 permit
slxall 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 whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
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 buildings for nec~ary inspections.
.........
(Signature of applicant, or name, if ~ corpor~ion)
.......... ....
(Mailing address of applicant)
State whether app~ant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
e .......... ),. ........... ('~; ~n ;he' ;a'x' ;o'Ii ;; idt;;t' ~;id') .........................
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No., ........... . .............
Plumber's License No.~...ff~.....~.~.~ ......... ~ '~'~L
Other Trade's License No ......................
1. Location of !~ on which proposea work will be done, .~..~~...~.~'..~.~._. .................
.... ..... -: ............ ................ ...........
House Number Street Hamlet
County Tax Map No. 1000 Section
.......... Block .................. Lot ...................
Subdivision...~..~~.~)..~~ ..... Filed Map No.~.~. ~./ ....... Lot...~. ~.E ........
2. State existing use and occupancy of !xises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ....~.. ~.....~.. ................................................
b. Intended use and occupancy ...... ~..~~ .......................................
3. j Nature of work (check which applicable): New Building ..... Addition .......... Alteration ..........
Repair .............. Removal .............. Demolition .............. Other Work ...............
4. Estimated Cost ..... ~ Fee :
: (to be paid on filing this application)
5. If dwelling, number of dwelling dnits ............. Number of dwelling units on each floor ..............
If garage, number of cars ..... ; ............ ~. ....................................................
6. If business, commercial or mixedl occupancy, specify natur6 and extent of each type of use .....................
7. Dimensions of existing structure~, if any: Front ............... Rear .............. Depth ...............
Height ................ Number of Stories ........................................................
Dimensions of same structure with alterations or additions: Front ................. Rear ..................
Depth .................... i · Height ...................... Number of Stories ......................
8. Dimensions of entire new construction: Front .... '.~. P. ...... Rear ... '.,tt~ t~ ....... Depth . ~ ..~. ........
Height . ./~. ......... Number of Stories .... ~ ................................. "' %k ...........
10. Date of Purchase .... (~r-~7'... ~'. ~..~. ....... Name of Former Owner .0~...~. ~,"~....~. ·..
11. Z6ne or u,se district in which pre~nises are situated ..... . ................ ~ ...........................
12. Does prbposed constructi,~n violate any zoning law, ordinance or regulation:
13. Willlotberegraded ..~...,~.i ....... ~,..., ..... Will e~.cess fitlbe removed from premises: d Yes I No)
Name of Contractor ......... : ................. Address ................... Phone No ................
PLOT DIAGRAM
Locate 6learly and distinctly all ibuildings, whether existing or proposed, and. indicate all set-back dimensions from
property lines. Give street and block humber, or description according to deed, and show street names and indicate whether
interior or corner lot.
STATE OF NEW/~RK,
COUNTY O~ ·
(Name of individual signingo~fi-tract)
above named.
being duly sworn, deposes and says that he is the applicant
of said owner or owners, and is. duly aut"hori.zed~to..ge~f~orm or have performed the said work and to make and file this
application'; that all statements confained 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 . . ' ' ;
NotaryPu,b}ic, ............... ~~f.. Cou'G ~' 'nty ~ ~ - , / '~. / -- ~
(Signature of apl/ii'ant)
HO, 52.8125850, Suffolk Count3,
Term Fx~lrea M,~.ch ~P ~'~ o~'~
MYLEN .
SPIRAL STAIRS
SHOP DRAWING
'~ '" i~:~ TREADS__~/~ K ,,__DIRECTION DOWN
IMPORTANT: Signature signifies approval of above and dimensions, pLEASE CH~ECK CAREFULLY before
signing, initial any changes in red or call MYLEN if you have on,/questions. If necessqry, new drawings will be
submitted.
SIGNED
DATE
A Rrodu'ct of MYLEN STAIRS. Makers of St,raigt)t and Spiral Stairs ,for Over 25 Years.
650 Washington St., Peekskill, NY 10566. 800-431-2155, In NY .914-739-8486, 212-LU5-6767
SACCO & AHLERS
Architects & E~glnecrs
546.55 M~in II,md
S. ulhold, L.I., N.Y. 11971
516- 765.5455
Revised 27 Oct. 80
BUILDING SPECIFICATIONS
~D~ ~Vermont St. Melville N Y. 11747
~ON OF ;O~ Basin R09d, .~outhold, N.Y..
~]led o~ Jnst~led Jn a~cord~nce wJt~ th~ manufacturers' sp~c~flcatJonm AS work shall comply with ~pplic~ble
~. s~ p~P~oN. .
Remove existing trees and grub areas shown as be~n~ cleared on ~lans.
_.~.l~.~.~_~.~.~.Lah~.lk.~.....~.a.~.~.,.~.~-9~,~..! ~.....~.~u~.~.k,. .......................................................
~!~, d~p~h ~Iow ~ld~ 2 ~ -0" ~oun~iflon tr*nehe~, below ~ e .........................................................................
3, ~OTINGS.
~.~,~. ~ ~QOPSI ~ 2~ d~3~ stone & .Portland cement
~. FOUNDATIONS.
~te~ialt, %hickneam, heisht, ~amp-p~o~ns, finish, etc.
8" P.C. x 3'-0" ~i~h -
]2" ~ 12°' x 3'-0" piers Insulatlo.2" stvrofoam
~. ~ONRY ~OO~ ~D SLABS.
" 6
_ ~' non-skxd P.C.
None
other ...... ~on~ ......................................................................
~. CHIMNEY.
9. CELLAR WINDOWS.
Number,..------~O~e-- ___ Materl~. ........................... Sizes ..................................................................................
10. ~WAYS,
None
n. S~WAG~
t . -it sg~tic tank & cesspools
1~. OTH~ MASONRY WO~. cesspools Sfloo Do0t ~one ...................................................................................................
(~ARPENT~Y
13. GIRDER SUPPORTS.
MaterlaL.~_.one~ --..- ........................... Stze ................... Max.
14. GIRDE~.
~pa ~d ma~al, ~o~e Sl~e ..................... *x ................
~, SIL~.
-. 2 .~ 4 - Dou~la~ Fir -treate~neho~ .~h..~i~..,_.h~.lk~_~.-~2m~.L
~t~l~ .......................................
.l
16. EXTERIOR WALLS.
~hoe, ,,2.** .X...~~.e ............. Platea, .....C9~.-./~.!~....~c....~!.' ~tuda, *-~*~*.r.;.. ~1~, .~..q_.~_..'~
Building paper or felt ..... ~....~....~.~.~- ............ ~ .......................................................................................- =
- Red Cedar s~ding
mnish ~ Woodlife 'to exterior slolng
-.- 3~" fibreglass batt (R=ll)
., ,mcr co~s'r.uc'no~.
Rooters: Mntetl~, . ................................... ~O~ ............................... 81ze ..................... 'x ...............
- ~ ~j";~'~' sZ~"'-""j~ia-'~'~'a'~i:":~(~.~.~.~.,.~ ~ ~:.,. ~ ~:,. ~u~ _~ .....
~l~shi.~ .,a~9,~,~ ~.~ ~.._~.l~Dq.~ ................................................................ ~ ................ {D.~...~I ..................
wo~t~e..,,~,s.~..L~.g.~9~.~ ..................... ~r~o... ..~,~.~ ................................................. ssorm ...h, ..~. ...............
Flashing, ....~,~.~ $.~.~....~ ................................................. Special .........~ .............................................................................
19, ltNI'ItANCE ANT) EXTERIOR DETAIL. ~ 3'4"
~e~ice door; Frame, ..,.~Q~ ......................... Door~ ~.Q.~.~...Q.Q~.~....~QQ~ .................................. ~lckness..._.~_~/
Vinyl-clad wood sliders by Anders~n
m,,,t,s; Door,, ..~.~.~r. aL~.al~,, .................................... 61her, ..~9~. ..............................................................................................
co,,,~,, ...L'.L...~....i~.L..i~.~ ~.~.e~) ......................................................................................................................................................
None
Ornamental iron work .......... .~q~ .........................................................................................................................................................
Porch detail ....... $1a__[:~.~i~.,__&Q~tll,_~l loW_. 9in~....~o.o.d_.dack
Gutler a~d L~ader Material.,..,(~...~l~.~ ............................................................................................................................................................
i U ~r l~vel ce~l~n~s & beams s~lally treated,sSa~Be~
~pec%a ..... ~ ........................................................................................................................................................................
................... ~.~i~h~.l....~i~k..b.iak=~l~.~.~_...!i~i.~.h, ............................................................................................................ ~ .......
Dca las F~r (str~uctural qrade)
Dca las Fir P1 od (struct,)
~ ....... ~ .................................. ~ ...................................................... , ......................................
I "' ,,.I]:~/a 48-- 96 '1
.'3ii:L,._i .................... ~ ......... ~.~.~n~. ..............................................................
Oak T & G . . 2" x 3/4" Stalned & varnlshed
· .............................................. = ................... ..
I_..o~Lm_~_~ ......................................................................................."
L-~..~-.~ .................. I .............. ~ ...............................................................................
[ a~ T ................................ I ..................................................... r .................
['"6'=J'"~'"m '~ 12" x ~/~" Stained &
~" pl~ood 48" x 96" Non-ski~
............................................... ...-.~ ................ ~.,,..~,~
Oak T & G ~. "
..Rg~.~.9~-...~Q~., ............................. ~ .................. ~ain~...a~lant .............
.~.~.~r.~d....~.on~ .................................................... 9.......x....i...._a...l~.8...._.~.~,
~. ~n~ ~n.~n~
~.,.I.~I....~.'.L_~_..~= .................................................... ~.L.~ ......................................
I (21 2" X 4" (21 2" X 4"
...... 2 .......... ~.......~ .................... 16_ e. to c ....... 2 ........ ~...._~ ............. 1.~-...* ~ to e.
Material, ..A!~93~ieai T]]p,_~D.g....g. lg., ....... mz~....2.~ ...... '~.. ,..2.{......'...-~......'m~.
H~: ~pe and th~knesa"~i~t~.~r~i~.t~hi~~i~``S~.
25. INTEBIOR FINISH. i~nl ~all ~a~il~
....... · ,' ..... [ ,, [s~. czfi. I ........ = ...........
~,,,., ~oo, ............. ;; ...................... -I ........... ;; ............. LT'-']']'iZa6]'.ala~.'ai~Z!...iLL~: ..............
,~,,oo,,, h,,,,, ,,. . ................................... ].~=l~........I.~.~..,....~a.,-.....] ........................
l(ltChe. " .[Wall ~ager .]lAs noted) { "._
If piaster walls eno ~lllm~, ~ o~ lath, -.....~/~
aim per Io ~ -..~. ............................ 1 ........... p ·
20, FLOOR FRAMING,
Joists, Material and Grade
Stzu
21. SUBFI~)OR~NG,
Material & Grade ·
~x (s~o:age Room)
Others (Utility Room)
None
Kitchen, ......................................... : ..... 7-'- .....................................................~ ...............................
None
Other. ...................................................................
INTERIOR DOOI~ AND ~I~IM,
TI, p~ of door~, .L.~/.I~......~.%.13~3E,~al~_.IIJ~I'L. ...... Type ol trim, ..~,........}~.....~..........~.~,~l!l~..e.d]~
CABINETS AND INTERIOR D~FAIL
Flakeboard sheathin.g. Yes ~Furnish allowanc.e.J
Kitchen ~ablaete; T~e. ................................................................ Back splash, . .......................................................................
Top a,,d eplash ......
Medlci~t e cabinet{m). ....................................................................
N...o...n_~. ...................................................Recesses z- x 3 -
Chino
Closet equipment, ........ s~elf~ Dole & hooks ,, ...... ,^... Adiustable shelvin__q
....................................................
Treads,
Iai to 2ad; Treade ....................................................... RIsen,
~lad to attic; Trends. .............................................. Riser#, · ........................................................
32.
34.
35.
PLUM~I~G A~D IIEATING
T~pe ...................... f.....~.......'.-~-.!- ............................................................ ' ................................................................................ ~ ..............
~upply line II street connexion, Non~
P~ NO. M~u~turer Size ~r .
All fzxt' res shall De (ohl~ or~merlcan
IIEaTING.
L~st f ' h)
Special electrical eqaipment.....~ ...........................................................................................................................
GROUNDS,
-- 4 conc. walks & SleDS as sho~ on ~lan.
MISCELLANEOUS.
................... ~'~'~"'~'~,'"'~'~r ~d~ lights & master bathroom windows.
'j~" ls~ iloor ~i~ish elevations excep~ storeroom [o be the same.
Contractor