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HomeMy WebLinkAbout16341-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17155 Date AUGUST 2, 1988 THIS CERTIFIES that the buildin~ Location of Propert~ 2750 House No. Street County Tax Map No. 1000 Section 78 Block 2 subdivision WEST CREEK ESTATES Filed Map No. 3848 ONE FAMILY DWELLING GLEN ROAD Lot Lot No. SOUTHOLD Hamlet 42 25 conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 6, 1987 pursuant to which Building Permit No. 16341Z dated AUGUST 18~ 1988 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 OWE FAMILY DWELLING The certificate is issued to JOSEPH & DORIS VERWAYEN (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PENDING PLUMBERS CERTIFICATION DATED 87-SO-23 JLrLY 21, 1988 JULY 7, 1988 7/7/88 GARDINERS BAY PLUMBING & HEATING Building Inspector Rev. 1/81 ~u~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. ] 6 3 41 Z Dote ..~.~.....,/....~. ......... . Permission is hereby granted to: ~ ~ /'1 ....-~.~.~..b..~.~ .................. ! .. .......... ...... ; ............... r-" ..... 'r' ~..~...~...~......-L..~...~....~..: ........................................................................ at premises located at ...,~.~..'~........~..~.~..~ ........ ~ .......................... ......................................................................... County Tex Map No. 1000 Sectio,,r~<:....~....'l..~ ......... Block ...... ..~.....:~.. ...... Lot No....~. ................... pursuant to application dated ...~~..~.........~.....~.~ '~ ........ , 19.~...'J., and epproved by the Building Inspector. Rev. 6/30/80 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL $OUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION ~please print) Plumber ~(?~fe [%~O~[ ~prin~) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. ~'~(p~iumb~r' s signature) Sworn to before me %his Notary Public, ~/~J~ County Notary Public FIETEN IL DE VOE HOTN~ PUBUC, Stste d ~w Yod~ UNDATION ( UNDATION (2nd) UGH FRAME PLUMBiN~ SULATION PER N. Y. STATE ENERGY CODE FINAL FOItM NO~ 11 TOWN OF SOIfl'I.IOLD BUILDING DEPARTMENT TOWN HALL $OU'llHOLD ~ NY DEVEL0 PM~WT PERMIT Pez~ission ia hereby granted %o: Co~y Tax Map No. !000 Section ~. Block pursuant to application dated ~.., 19~.~, and ~pp~'oved by the Building Inspector. Building Pe~It No. I q-I z Building Inspocto~, NEXUS * pantechnology for human development 202 old ridgefield rd. wilton, ct. 06897 (203) 762-9752 July 8, 1987 To: Building Department South-Hold, NY Re: Energy Calculations Joseph J. ~& Doris Verwayen Glen Road South-Hold, NY 11971 Dear Sir: Enclosed please find the "Summary Sheet for Energy Conservation Calculations" prepared for the proposed Verwayen residence. As demonstrated by the calculations, the proposed residence will comply with all Sections of the New York State Energy Con- servation Construction Code. Specifically, this residence is in conformance with Part 6, Thermal Rating Method effective April 1, ~987. If you have any questions or require additional information, please do not hesitate to contact our office. Submitted by, Nexus Eng~ g Associates NEW YORK STATE ENERGY CONSERVATION cONSTRUCTION CODE PART 6 WORKSHEET THERMAL RATING METHOD ONE-' AND TWO-FAMILY BUILDINGS BUILDING Joseph & Doris Verwayen ADDRESS Glen Road South Hold, N.Y. 11971 CONTRACTOR, ARCHITECT OR ENGINEER GROSS FLOOR AREA 3360 NUMBER OF STORIES 1 DEGREE DAYS1 6000 Nexus Engineering Associates 202 01d Ridgefield Rd. Wilton, Lawrence R. Gilman, P.E. TELEPHONE (203) 762-9752 Ct. 06897 If the building does not meet the following pre-qualifying conditions, Part 6 of the Energy Code may not be used. YES NO X Building is one- or two-family residential. Building is detached. X Building is less than 5,000 gross square feet. X X ~ Building is three stories or less. in height. 'Entrance doors have a storm door er certified U value of .40 or less. X . Glazing area/gross wall area is equal to or less than: 24% if 5,000 degree days ** 23% if 6,000 degree days ** 20% if 7,000 degree days 18% if 8,000 degree days 16% if 9,000 degree days If all of the above conditions are not met, either PART 3, PART 4 or PART 5 of the Energy Code must be used. DIRECTIONS: For each component of the propose~ building design enter the design informat!on,, requested such as Areas, "U" or "R" Values. Additional lines are provided for' designs with mor~ than one component construction type. Obtain thermal ratings for each item by consulting ,the appropriate Tables. A, ROOF/CEILING Obtain Thermal Ratings from Table 6-1, 6-2, 6-1E or 6-2E depending upon degree days and heating type. Area: 2~0 U-Value: Square Ft. Area: U''Value: Square Ft. +67 rmal Rating T~rmal Rating B. NET WALLS Obtain Thermal Ratings from Table 6-1 or 6-1E depending upon hea,ting type. Area: 170~ U-Value: Square Ft. __ -30 Thermal Rating Area: U-Value: Square Ft. tV Thermal Rating Note: Net Wall Area = Gross Wall Area minus Basement/Cellar Walls, Glazing Areas and Door Areas. C, GLAZING WINDOWS Area of Glazing: Area of Glazing: SKYLIGHTS Area of Glazing: Obtain Thermal Ratings from Table 6-3 or 6-3E depending upon heating type. 348 U-Value: .30 +64 ~. Thermal Rating 50 U-Value: .235 _ +9 ~. Thermal Rating U-Value: Thermal Rating D1. FLOORS Floor Area: Obtain Thermal Ratings from Table 6-1, 6-1E or 6-4E depending upon degree days and heating type. U-Value: .04 +24 Thermal Rating B2. BASEMENT/CELLAR WALLS Obtain Thermal Ratings from Table 6-4, 6-5, 6-6 or 6-5E depending upon degree days and heating type. Wall Perimeter: 227 Linear Feet Feet .lo6 Inches Exposure Above Grade: U-Value of Wall: Depth of Wall U-Value Below Grade: +2O Thermal Rating Note: Use the above grade U-Value of the wall. The Thermal Rating Tables have been designed to take into account the insulating effect of the earth. D3. SLAB INSULATION Slab Perimeter: Insulation R-Value: Obtain Thermal Ratings from Table 6-7 or 6-6E depending upon heating type. Linear Feet Thermal Rating E. INFILTRATION CONTROL Obtain Thermal Ratings from Table 6-8 or 6-7E depending upon heating type. If the building does not meet the following conditions, enter NA (Not Applicable) for Thermal Rating. YES × NO All windows have an air leakage rate of 0.35 cfm or less per linear foot of operable sash crackl All net wall areas have an infiltration barrier; and X A heat recovery ventilator, which transfers heat -- between the outgoing airstream and the airstream entering from the outside, is installed. Conditioned Floor Area: 23~© ~/~ (Shall not include Square Ft. Thermal Ra tihg basement/cellar flo~r area) ~t F. SOUTH FACING GLAZING Obtain Thermal Ratings from Table 6-9 or 6-8E depending upon heating type. I~ the building does not meet the following conditions, enter NA (Not Applicable) for Thermal Rating. YES NO The building is no less than 1,250 square feet in conditioned floor area; At least 45 percent of all glazing faces within 30 degrees of true south; Al,l, glazed areas in buildings are no,more than U(glazing) : 0.58; South facing glazedareas are free of any site obstructions during the heating seasonl and An area of four-inch thick concrete or masonry is exposed to direct sunlight from south facing glazing. The area of,this concrete or masonry sh~ll be no less than three times~the area of south facing glazing. Conditioned South Glass/Total Glass: % Floor Area: (See Above) Glass Area/Gross Wall Area: ~% Square Ft. Thermal Rating SUMMARY OF TOTAL THERMAL RATING If the Total Thermal Rating is zero (0) or greater, the proposed design for the building envelope complies with the Energy Code. THERMAL TABLE AREA U-VALUE RATING USED A. ROOF/CEILING 2550 .0285 +67 6-1 B. NET WALLS 170~ .064 t~l -30 6-1 D1, D2. D3. GLAZING Window ~48 .~0 +64 ~ Window 50 ,.2~5 .+9. Skylights FLOORS 2550 .04 +24 6-1 BASEMENT/CELLAR WALLS Wall Perimeter 227 Feet Exposure Above Grade ~ Feet Wall U-Value, Depth of Wall U-Value Below Grade', 48" Inche~ +20 6-LF SLAB INSULATION Slab Perimeter Insulation R-Value Feet INFILTRATION CONTROL Conditioned Floor A,rea 2550 Sq. Ft. SOUTH FACING GLAZING South Glass/Total G'lass Gl. Area/Gross Wall Area Conditioned Flo6WArea Percent Percent Sq. Ft. TOTAL THERMAL RATING N~/A +1S-4 THE NEW YORK BOARD OF FIRE UNDERWRITERS -~'~<~: BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK. NEW YORK 10038 DaI~ ~pplicalion No. on,lie THIS CE~IFIES THAT the ~t~ ~u~ment ~ ~ ~ a~ int~ by t~ ~t ~ on the a~ ~t~ ~um~ Jn t~ p~m~s o~ examln~ on and ~o~nd to ~e in cottapllence with the requirement~ o~ this ~RV~ DISCOHNECT S E R V I C E Ne. oF CC, COND. [ A, W, G. ~. m OF cc. co~o. )5650 COt~IWI'RY RI), 48 P~,:CON:~C, NY, 11958 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FQI~ RUlI. DIH6 DEPARTMEHT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MM414ER. 765-1802 BUILDING DEPT.' INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG,. / FRAMING FINAL REMARKS: ~-~~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING ROUGH PLBG. IN~SULATION [~INAL DA~I'E __~~F INSPECTOR, 765-1802 BUILDING DEPT. INSPECTION [~FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FRAMING REMARKS: FOUNDATION ZND [ ] INSULATION [ ] FINAL 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [~/~NSULATION FRAMING FINAL / / DATE ~,,/~./. ~ INSP£CTOR U I~ '~ ,~, 7GS-Z.80;Z BUILDING DEPT. INSPECTION [ ] FOUNDATION IST ~/ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING [ ] FINAL REMARKS: DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [~ROUGH PLBG. FOUNDATION ZND [ ] INSULATION ? ~/FRAMING [ ] FINAL DATE ) INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION ZST [ ] ROUGH PLBG. /~NDATION 2ND [ ] INSULATION FRAMING FINAL DATE~//~/~ INSPECTOR ~~ / ~ 76S-1802 BUILDING DEPT. /~ iNSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: ~/~D , r'~/~, ~/;~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING [,,~AL REMARKS: DATE FORM NO. 10/ TOWN 0F SOUTHOLD BUILDING DEPARTMENT (516) 765--1802 P.O. BOX 728 Southold, N.Y. 11971 Town Hall. Main Road Southold,N.Y. Instructions: The application to the Building Inspector includes (each ~n duplicate) 1. Form No. 10 filled out in ink or typewritten, 2. Sur- vey of premises with elevations above mean sea level, 3. Drawings of pro- posed work. The application must give complete information to show that the proposed can comply to the Local Law No. 1-1980, Chapter 46 of the Code of the Town of Southold known as "Flood Damage Prevention Law" of the Town of Southold. The applicant must submit approvals that any other agency requzres. General Standards as required in Section 46-17 of the law to minimize flood damage: A. Anchoring of structures, including tanks and mobile homes B. Use of construction material and methods C. Design and location of utilities D. Subdivision proposal with drainage, public utilities design and base flood elevations Specific Standards as required in Section 46-18:' A. Reszdent.~al construction B. Non-residential construction ,, ~, C. Mobile homes The applicant must submit plans and specifications as well as any other information requested by the Building Inspector to substantiate the facts that the structure has or will have the lowest floor, including basement/ · cellar, elevated above the base flood elevation or; if permitted by the Federal Regulation, that: 1. such structure is flood proofed in such manner that below the base flood level the structure is water tight with walls substantially and impermeable to the passage of water, 2. that structural components are capable to resisting hydrostatic and hydrodynamic loads and effects of buoyancy, 3o applicant must submit certification by a registered professional engineer or architect that the standards set forth in Section 46.-18B (1) (2) (3) of the Southold Code are satisfied. Coastal_~ig~.~Hazard. area (V Zone) 46-19. Applicant shall submit plans, specifications including the required certifications and such other in- formation as the Building Inspector may require in that the provisions of 46-19 are complied with. Mobile homes are prohibited. The lowest portion of the structural members of the lowest floor cannot be lower than the base flood elevation with all space below open exdept breakaway walls. Sand Dunes. If sand dunes exist on the premises and the applicant pro- poses to alter same, plans and specification must be shown in detailed nature of any alteration submitted. Build~ Permit. A Building Permit is also required for any structure. Both a Development and a Building Permit must be issued before any work can start in a special flood hazard zone. A written disapproval or a permit must be issued within ten (10) working days. During construction, the inspector shall be notified in time so he may make the required inspections. Upon completion, the required certification of the final elevations and work must be submitted before the approval to use or occupy can be approved. (Fill out the form on the back of this sheet 11/85 pplmcatlon Recemved ' 19. Disapproval Issued 19 FORM Nd. 10 Permit ~ 19 APPLICATION FOR DEVELOPMENT PERMIT IN THE TOWN OF SOUTHOLD 1. Type oI Development Proposed: Addition and/or Altleration- Other (specify) i 2. Elevation Data ih relation to above mean sea level of: (a) Lowest floorI elevation, including basement feet (b) In a V Zone,i bottom of lowest structural merab~er 3. FIRM--Flood Insurance Rate Map, Zone designations ~-~ Flood Proof Below Base Flood Elevation-- Hamlet Section ~ ~ Block (3 ~ Filed Map# owner of Premise~ Location of Property: House # ! Street County Tax Map Ng., Dist. 1000, Subdivision New Owner Phone # 6. Permission to be!granted: __ Owner as above __ Under Contract Lessee Contractor Name if not given above Mailing address inches feet inches Lot (s) ?. Approval from other(s) DEC Health Services Building Permit before Permit is issued: Wetlands (Town Board) ~Planning Board ~, ~/.~ , ~he applicant, am the Owner Co-Owner , New Owner Under Contract Lessee ~, , , __, Agent __, Contractor and agree to comply with all applicable sections of the Code of the Town of S~uthold; county, and state and to admit authorized inspectors to premmses authorized to perform or have performed the said work and to make and file thSs application, that all statements contained in this pplmcatmon are ~rue to the best of my knowledge and belief and that the work will be per[ormed iet~ .. pp tmon filed in the manner set orth in the a lica' STATE OF NEW~OR~ SS 'i~,~ ~ , COUNTY OF SWORN TO THIS t~ DAY OF 19 Notary Public Applicant's mailing address and phon9 # if not given abo~e 11/85 HELEN K, DE VOE '~k NOTARY PUBLIC, State of New T~ ~. No. 4707878, Suffolk County ~,~rm Expires M~rch 30, ~.9-...-~ FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE ia to be used for: 1) New/Emergency Program constructio~ in Special Flood Hazard Areas; 2) Pre-FIRM construction after '~eptember 30, 1982; '~) Poet-FiRM construction; and, 4} Other buildings rated as Post-FiRM rules. ., Joseph & Doris Verwayen. 2c.), Duncan Rd.,Hohokus, NJ 07423 BUILDING OWNER'S AODRESS 100O- 078-2-42 ~RO~'lr.~l ~' LOCATION (Lot end Block numbers and address ii available) I'~.ertify that the information on this certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. code, Section 1001. SECTION I ELIGIBILITY CERTIFICATION (completed by Local Community Permit Oftic~al or a Registered Professional Engineer, Architect. or Surveyor) 60813 0078 6/1/87 A-4 1987 °~" ~ "°~'~""g°~ YES NO It is intended that the building described above will be constructed ~n compliance w~lh the community's flood plain [] ordinance. The certifier may rely on community records. The lowest rigor (including basement) will be at an elevation of ft. NGVD, Failure to construct the building at this elevahon may place the building in violatioo of the community's flood plain management ordinance. YES NO The building described above has been constructed in compliance with the community's flood plain management E] E] ordinance based on elevation data and visual inspection or other reasonable means. If NO is checked, attach copy of variance issued by the community, YES NO The mobile home located at the address described above has been tied down (anchored) in comprience with the E] E] community's flood }lain managemenl ordinance, or in comphance with the NFIP Specifications. MOBILE HOME MAKE MODEL I YR. OF MANUFACTURE SERIAL NO, I DIMENSIONS X (Communib/Permil Official or Registered Professional Engineer, Architect, or Surveyor) NAME Ro~erick Van Tuyl, P.O. ADDRESS 218 ~ront St, TtTLI~ T,icensed Land Surve.~m Greenport, STATE New York z~l~1q44 ~;I(~NATURE /'t:~. DATE /~r 1,19~ONe 516--477--0170 SECTION It ELEVATION CERTIFICATION (Certibed by a Local Community Per'it Olficial or a Registered Protessional Engineer, Architect, or Surveyor.) FIRM ZONE Al-A30: I certify that the build~$ aL~he property location described above has the lowest floor (includigg basement) al an eevabon ct //=~ feet N V m G 0 (ean sea level) and the average grade at the building site is at an elevation of feet. NGVD. FIRM ZONES V, VI-V30: I certify that the building at the properly location described above has the bottom of the lowest floor beam at an elevation of feet. NGVD (mean sea leve~), and the average grade at the building site is al an elevalion of feet, NGVO. FIRM ZONES A, Agg, AH and EMERGENCY PROGRAM: I certify that the b~Jilding at the property location described above has the lowest floor elevation of feet. NGVD. The elevation of the highest adjacent grade next to the building il feet. NGVD. FiRM ZONE AG: I ca~ify that the b,.~ild~na a't the property tocatlon desCribed above has the lowest floor elevation of feet, NGVD. The elevatlon of the highest adjacent grade next to the building is feet, NGVD. SECTION III FLOODPROOFING CERTIFICATION (Certification by a Registered Professional Engineer or Architect) I certify to the best Gl my knowledge, information, and ballet, that the building is designed so that the building is watertight, with walls substantially impermeable to the passage of water and structural corn. portents hawng the capab~lit~ of resisting hydrostatic end hydrodynamic loads and effects of buoyancy that would be caused by the flood depths, pressures velocities, impact and uptitt forces aesoc{ated with the base flood. YES El NO [~ In the eve~.t of flooding, will this degree of floodproofing be acl-,ieved with human intervention? (Human intervention means that water will enter the building when floods up to the base flood level oc- cur unless measures are taken prior to the flood to prevent entry of water [e.g., bolting metal shields over doors and windows). YES E] NO [3 Will the building bo occupied as a residence? II the answer to both questions is YES, the floodproofing cannot be credited for ~ating purposes and the actual lowest floor must be completed and certified instead. Complete both the elevation a~d floodp~oobng certiticates~ FIRM ZONES ~. Al-A30, V1-V30, AG and AH: Certified Floodproofed Elevation is feet, (NGVD). THIS CERTIFICATION IS FOR E] SECTION ti ~] BOTH SECTIONS ti AND III (Check One) CERTIFIER'S NAME Roderick VankTuyl TITLE Ll0ensed Land Surveyor COMPANYNAME Roderick Van T~vl,P,C. ADDRESS 218 Front Street LICENSE NO. (or Altix Seal) LS25626 ZIP ~ 1944 PHONE SIGNATURE DATE CITY STATE The Insurance egenl should attach Ihs original copy of the completed lorn to Ihs Ilood I~surance policy appllcagon, the second copy should be supplied to the policyholder and the Ihlrd copy retained by Ihs agent INSURANCE AGENTS MAY ORDER THIS FORM (Building Inspector) 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 APPLICATION FOR BUILDING PERMIT Date ................. 19,.. INSTRUCTIONS . C ^ a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ets 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 ,r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ation. 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 issued a Building Permit to thc applicant. Such permit hall 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 hall have been granted by the B~ilding Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the luilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ~,egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. 'he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on premises and in building for necessary inspections. 3.0... ........ (Signature of ~pplicant, or name, if a corporation) PO Box 604 ..... .s.h..e.l.t.e.r...I.~!a.n..d~..~¥..1!9.65 ............ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. General Contractor. Wame of owner of premises . .. fi..°.~. 9P.h & Doris Verway..en ............. (as on the tax roll or latest deed) applig~t is a corpoj;ation~signature~of duly authorized officer. ............. ~,/ (Name and title of corporate officer) Builder's License No...~ ..................... Phunber's License No. 2256P Electrician's License No...~.8.3:..6.~. ............ '.. Other Trade's License No ...................... [. Location of land on which proposed work will be done .................................................. ~T~ Glen Road ??est Creek Estates llouse Number Street Hamlet County Tax Map No. 1000 Section 0?8 Block ~ Lot...4.~. Subdivisiou. ~e?.~..G?.e..o.k. ?~.~.g..~.t.e.s. .............. Filed Map No..3.8.4.8 ......... Lot .,;2..5 ............ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing nsc and occupancy ..................................................................... b. Intended use and occupancy ....... $±ngle...£amkZ7. £ramb ~ d~.k.~±ng,~. · '. 'J. ................... k( · ' , · 3. Nature of wot check wluch a plicable). New Building ......... Addttion .......... Alteration .......... P, epair .............. Removal .............. Demolition ............ Other Work .... ~ ......... i ' · '~ 0 t ~'.'~J~ (D~scnption) ~ '" (to be paid on filing this application) ' ' ' Z Number of dwelling units on each floor 5. If dwelhng, number of dweB~ng umts ............................... If garage, number of ca~ . .~ .~ ............................. , . , ' ': ' ' ~d fly h typ 6. If business, commercml or m~x occupancy, spec nature and extent of eac e of use ..................... 7 ..... if any: Front Rear Depth . Dtmens~oll$ of existing structures, ............................................. Height Nmhber of Stories ........................................................ Dimensions of same st~cture with ' ' ' Front Rear alterations or add,boas: ................................... pth } He'~t N be fSt ' De ...................... ~ ...................... um re ones ...................... 8, Dimensions of entire new const~ction: Front ...7.~ ~ ........ Rear ...72~ ......... Depth .. 6~.'~ ....... Ileight ...~ ......... Number of Stodes...~ .'. ................................................ 9. Sizeoflot: Front " 1~:~,8~~. . 2 ..... . Depth ..~...:.. 0. Date of Purchase ~.~39/.8.~].. '.~.~. 2. "Rear.5¢.7.,Q6~ ............... ........ Name of Fora, er Owner ~)om[E. '~b~aham ' g~d ~ ......... " 1. Zone or use d strict m which p~em~ses are taunted ..................................................... 2. Does proposed construction vlglat~ any zoning law, ordinance or regulation: .. no ........................... Will lot be regraded ....... ~9 .............. Will excess fill be removed from prenuses 4. Name of Owner oforemisesJ,~D, Verwayen aA~,~ 29 Duncan Rd, Phnna Name of Architect Deck Houa.e Inc. Acton, Mi Nmne of Contractor'~&~'~~'' d 'B~] 'C6h~'~?; ';XX .... S~lt~7 '~;','~' ' :7-~ PLOT DIAGRAM Locate clearly and distinctly MI buildings, whether existing or proposed, and. indicate all set-back dimensions from roperty lines. Give street ~d bloc number or description according to deed, and show street names and indicate whether lterior or corner lot. TATE OF NEW YORK, 'OUNTY OF .......... S.S ......................... ~ ..................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) hove nanled. ' te is the ....... ............................ Y,..Lq'. Contractor, agent, corporate officer, etc.) f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the tork will be performed in tile manger set forth in the application filed therewith. .worn to before me this ..................... day0f... ~. ........... ,19. HELEN K.IDE VOE .............. ' ': ............ I~1'/~¥ POlitiC, Sta~o o~ New Yo~k (Signature of applicant) _ No. 4~07878, Suffolk County ~'~ TBrm Expires Mer~h 30, ]9 ~./ X RODE.,'¢K va. TUYL.,".C. GREENPORT NEW YORK SUFFOLK CO. HEALTH DEPT. APPRov, AL' H.S. NO. STATEMENT OF INTENT THE' WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENEE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERVICES, (si APPLICANT ' SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL Of CONSTRUCTION ONLY j~ l 9 1981 DATE: ~FFOLI( CO. TAX MAP ~$~NAT~N TEST HOL~ STAMP V/KCAN 'r BLDG. DEPT 'TOWN OF ~O[~I~OLD NIAP TO~,CN OF ,50UT*I4OL~, ~. '~-~ P.O. BO~ 604 ,, - [515] 749-0182 $?ATEMENT OF mE WA'L'T~ suf1%Y AN~) IW*/~ ~ '~o 'T~ ST~I:I~I~ O~ T~ SUfi'FOLK CO. TAX MAP D~IGNATION: mST. S~CT. ~C)CK PCL 'oWNERS OI:EO: L.~TE PLUM~ER CEBTIFICA TION :oNLEAD'CONTENTBEFORE cERTIFICATE OF OCCUPANCY UN~WFUL CERTIFICATE ~0~ IFY ~)ILDING DEPARTM~ A '1 II ..~n USbU2'; cAN $oLu~.'; eySTJdW -o/.., A,D. £XC£l:u "' I- Pll',L Fb~, bSW~L, '1- FIN GK~B ~ ~DECK HOUSE; INC L C'f.7 _1. .I I HOUSE, INC, .Phone (617) _Bi, BVzd I~N :1 b~v* ~.) ~t. - ( II. z',~" ,- .... DECK Street, Acton, Mass. ?b,one (~7)125~1'~9~ DECK HOUSE, INC 30 Mare Street, Actbn, Mass. .PhoNe (617) 259-9450 Flo~rl IO,PSF Oe~d ,hq0 PSF Li~e = 5d P'$F ,': ' "', ',: , , ,, , ' 6RaXS AI¢ S~, : DE, Ct; aOUSC COa~ ~, , ' ' . -C ........... ~_..~..._: _. ~__~._~ ....... = 3,1m~ x 1'~ & I3~ ~a~g be~15: O~uglas FUr k . ,, .. . 5 ~ 12, 13~ 16~,. & ~9} lam beams, Doug~s'.~}.r g : '' ' . ' ' : 4x4 posts:], . ' . Ooo'g'las'Fir ~e d:t S~ru'ctura'l . , ,<.. ~ ,,, ~. ~ , ' 2~6~ ~oiSts: : Wes~ePn WHte Standa'r~ & Setter S-D'y . ' ". ,' :'' ~. .~ 2~8 ~OiS~S: .' . . ' ' ' ' ~esteJ:n.'~hite S~nd~rd'.&.Bet~er : .. ', , . .. ' 2xlm) joists: ~' ] ' ] Neste'rh Wh'ite~ S'tand~rU'~ 8ette~ S-Dry '3x6) d~cktngl ' ' a6a ce'air ~aaed, lami6.~qd, tongue 6 qroove ' . '' . . ~' ' Plywood Subfloor: ' . rig/32 APA rated shaa.th ~gL5 ply a~d . Pt~tood Sheaqhing: .' . ;ng ' , ~ , , - ' 15/32 APA fa.ted shedtSing M/5 ply . 15~J2 APR r~ted ~h~athing ~/5 ply ,1×~ red cedar, lx4 white'cedar, or 1: ~ of Ix4 cypr( 3x6 Fir pressure ~rea~ed with Osn~se K-33 2' Foil-faced Themax a~14';~ '