HomeMy WebLinkAbout23770-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO: Z-25637 Date: 04/10/98
THIS CERTIFIES that the building NEW DWELLING
Location of Property: 250 FARMVEU RD MATTITUCK
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 120 Block 3 Lot 8.18
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 4, 1996 pursuant to which
Building Permit No. 23770-Z dated OCTOBER 23, 1996
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 ONE FAMILY DWELLING WITH ATTACHED 2 CAR GARAGE AND REAR DECK AS APPLIED
FOR.
The certificate is issued to RANDAZZO BUILDING CO, INC
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-96-0010 03/20/98
ELECTRICAL CERTIFICATE NO. N439744 12/08/97
PLUMBERS CERTIFICATION DATED 04/04/98 CUTCHOGUE EAST PLUMB
B lding Inspector
Rev. 1/81
FORM NO. 8
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
hT4 23 770 Z Date ........ . oz
.......'�................... 19.1...(-2
Permission is hereby granted to:
........� .. . .. . .. . .1.(1:.x'.�/...7..?..�!
ra./J1�id1 .... . ......... .. ..sfrll ..........................
.. ... ... ... . -
...............................................................
atpremises located at ...................caC.c. .......... i ��o�f ..J�F........................................
1. . f,� .......................................................
.................................................................................................................................................................
County Tax Map No. 1000 Section ......A;J.0..... Block .........ate........... Lot No. A.0.......
pursuant to application dated .............. C '..r .................. 19Y6,, and approved by the
Building Inspector.
Fee $.. d/....
.. ........ ... .................
.... .. ........ ... ..
Building Inspector
Rev. 6/30/80
_ 1n, Form No. 6 y 7.S 6 J `�
D D TOWN OF SOUTHOLD ! J/�fl
BUILDING DEPARTMENT
`��� „ TOWN HALL
765-1802
'r
BLDG.DEPT.
N APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. This application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: 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 a 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 $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Buildine - $100.00
3. Copy of Certificate of Occupancy - .25v..
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15..00, Commercial $15.00
/ Date W-Vfs New Construction. .. Y . . . . Old Or Pre-existing Building. . . . . . .. . . . . . . . . .
Location of Property. J . .Y./LIV.FFi . .. � . . . . MI4' 1.T-.q ' • • • • • •Q =. • • •
House No. Street Hamlet
Onwer or Owners of Property.. � �. . u•CO•�!"•'�. . . . . . . . . . • . . . . . . . . . . . . . . . . . . • •
County Tax Map No 1000, Sepction. .A. . . . . . . .Block. .. . . . . .. . . . . . . .Lot.�f.�o . . . . . . . . . . . . . . .
Subdivision. R v� . . .9F �� �. .. .[� s./Filed Map. . . . . . . . .n. . .Lot. .lp. . . . . . . . . . . . . . . . . .
Permit No. . Q37770. . . . .
.DpDate �O9f Permit. . . Y Y.p. . . . . . .Applicantl�t4 µ'��. . ... • ?... . • .. • • •
Health Dept. Approval. . .l_S0.: . Q V•(.Q• • • • • • •Underwriters Approval. . . . . . . . . . . . . .
Planning Board Approval. . . ..1:(4�A . .. . . . . . . . . . . . .
Request for: Temporary Certificate. .. . . . . . . . . Final Certicate. . J. . . . . . . .
Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
a c . .S X81
PLI . . . . . . . . . . . . . . . . . . .
APC
co�� �37
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THE,_NEW YORK. BOARD OF FIRE UNDERWRITERS PACE 1
,.7000121 BUREAU OF ELECTRICITY
F 8510
STREET, NEW YORK, NY 10038
Date I1GCY''ff7EIt Pfl F l i7 Application No.on file 7197 N ?43g"744
THIS CERTIFIES THAT
only the electrical equipment"described below and introduced by the applicant named on the above application number in the premises of
VITO RFIT71)AZZ0, 1.6 FARWE6d ROAD, LAUREL, NY
in thefollowinq location; ® Basement ® Ist Fl. ❑ 2nd Fl. GAR/OOT .Section Block Lot
woe examined on
I1ECEMBER 02,1997 and.f P 1997 ound to be in compliance with the National Electrical Code.
FIXTUREFIXTURES I RANGES COOKING DECKS I OVENS DISHWASHERS EXHAUST FANS
OUTLETS ECE►TACLE,S SWITCHES INCANDESCENT FLUOIIESCENT OTHER AMT K.W. AMT. K W AML KW. AMT, K.W AMT. (N P.
52 36 JB � Ii1 I 4 G
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS JSPECIALRECTTJ TIMECLOCKS BELL UNITHEATERS MULTI.OUTLET DIMMERS
AMT K.V( OIL H,P. GAS H.P AMT NO. A.W.G. AMT AMP AAV, AMPS TRANS. AMT H.PNSYSTEMS
FEET AMT. WATTS
SERVICE,DISCONNECT NO.OF { ., E R V I C IS
METER 'NO.OF CC COND A W G A W.G A.W.G.
AMI. AMP, ttPE EQUIP. I N TW 1,B'3W J.e JW 3Jr KW PER 8 OF CC COND NO OF HI-LEG OF HI-LEG NO.OF NEUTRALS OF NEUTRAL
1 200 CB 1 7I 1 4/0 1 210
0704ER APPARATUS: ,
PIII11:1IR, PAN'-1
WSRLPOOL�6ATI'1•-4
WMI, MP-1
MOTORS TI-F I4.P1-P H.P.
G,F.C.1:-8
SMOKE DETECTOR r 6
PAUL, R. BURNS TATC..#3897-1 GENERAL MANAGER
PO BOR 1061
SOUTHOLD, NY, 11.97:1-0932 11*5' Per
This certificate must not be altered in any manner; return to the office of the Board if iricorract. Inspectors may be '7d�sntified by their credentials.
COPY FOR BUILDING-DEPARTMENT; THIS COPY OF CERTIFICATE RUST NOTQBE ALTERED IN ANY MANNER. ,
•rcr.. 765-1 aoz .
['O�VN
017 SOUTUOLD
a (•' 1 ' r '� 0[-FICE of 11UIL[)1TtC INiI'[:CI'0[t
uJ' `N '� ' ( r" p.o. llox 1179
p to r `c TOWN! [1,\LL SOU'l HOLD. N.Y. 11971
C E R '1' I P I C 11 r Z N
tate
building Permit No,
Owner �[T���
I p e aae pe r r 1— ,.dsJSC
Plumber
1 rant)
X11
9
I certify thnt the Solder ""(1 in the water supp
° contains less than 2/10 of 1 lead. ly system
Lz
- -- - —
- -- - — 1-plamber!s -signature)
-Sworn to before me tl:is
--/--day of
19 l � .
tiotary Public,SUA//< tary Pu
County KATRINA GORES CUNNINGHAM
Notary public State of New York
No. 4801172, Suffolk County
Term Expires January 27, 2%OV
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN LATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE A CHIMNEY
REMARKS:
DATE (J INSPECTOR
LX / 70
,
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ) INSULATION
[ ] FRAMING [ NAL
[ ] FIREPLACE S CHIMNEY
REMARKS:
DATE INSPECTOR
M-180 '
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN LATION
[ ] FRAMING [ FINAL
[ ] FIREPLAC1 NEY .
REMARKS: w
� ✓
DATE ZINSPECTORL,
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE S CCHIMMNE_Y��
REMARKS:
DATE
f INSPECTOR
ss-zao2
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ j INSULATION
[ ] FRAMING [ ] FINAL
/FIREPLACE A CHIMNEY
REMARKS:
DATE INSPECTOR
2 3-7-70 0
l 1Q) �✓�/►) 92�
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH^P4BG.
[ ] FOUNDATION 2ND [ NSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEYS
REMARKS: C, M � ,
i
DATE INSPECTOR
765-1882
BUILDING DEPT.
-NSPECTION
[ FOU ATION 1ST [ I ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS: %
DATE INSPECTOR
M-1802
BUILDING DEPT.
INSPECTION
[ FOUNDATION 1ST [ ) ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ) FRAMING [-) FINAL
R MARKS:
v
DATE � � I INSPECTOR
y \
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [f--i"R' OUGH PLBG.
[ ]f`FOUNDATION 2ND [ ] INSULATION
[✓ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
I ti --
DATE 1 INSPECTOR
���nJ- Ito
f.) � aF fY� a➢
id IN,
6f� `m.Jll fi
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-±73 — tiv �aAmC " St' G7
Z>, woad vmr
o wood ?7 I I tiff p
r 4.�o rf l� Gly 9
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7r�4-I 1 60 V✓ ZI�.Sq o
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I�r I S M
1
THE LOCATION OF WELLS, SEPTIC
TANKS AND CESSPOOL"", (SI,r.+,VN
HEREON ARF FIELD OB:aLRVAT IONu4i
AND OR DATA OBTAINED FROM OTHERS.
L-4S,aoR 9199a
>�Vti ��7��yelw��rvRfl�A�i
Unauthorized alteration o(addition to thea document is a violation of Section 7209 SURVEY OF: �p—`" It.;,
the New York State Education Law.
Certifications indicated hereon shall run only to the raison for whom it is prepared w . A
and on his behalf to the Tale Company,Governmental Agency antl Lending �V 1�I Q
Instnullon listed hereon,and to the assignees of the lending in
or subse-
quentowners �p ,•''' '��
Caples of this document not bearing the professional's inked seal or embossed /V \A 1 I IT{�1 - I 1 r/w�
seal shell not be dimensions)
a valid true copy. —Ut / _AW { Iw j `/�
The offsets(or os enaiona)shown hereon are stluctures Intended
to the property roes are /"/ (/�(/1 ,l jy T
fora specific purpose and use and therefore are not addition
to
guide the erection er
fences, tion. ng wall9,pools,patios,planting areas,addition to bwltlinga or any other
construction.
The existence of right of ways and/or easements of record,II any,not shown are OF F i''1 $ u 1
not guaranteed . YDATE: I 2.1 Q,9 SCALE: I So
CERTIFIED ONLY TO: DESTIN G. GRAF
MR2G/iYGf�.T L_, I�yt�eET`fFF �" .
LAD SURVEYOR
GaManorlwE :P ¢ N
y r.
P
BY v 73 WOODLAWN ROAD
DESTIN G.GRAF N.Y.S. LIC No.50067 ROCKY POINT,NEW YORK 11778
TAX I.D, No. I g 4 PHONE(516)821-3442
I000 - Lo - D�j - B. Ig
BOARD OF IIRAL'III . . . . . . . . . . . . . . .
FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . .
TOWN OF SOUTHOLD SURVEY
BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . .
. TOWN ❑ALI. SEPTIC FORM . . . . . . . . . . . . . . . . . . .
SOU'IHOLD, N.Y. 11971
TEL: 765- IR02 NOTIFY:
MAIL TO: . . . . . . . . . . . . . . . . . . . .
Appa(vFcl..,��Whvgb, 191 Petnnil No /. D.1•.
......... .......... ...... ......... ..
Disapproveda/c .................................. ......... ............ ............ . ..
. ............ ............................ . .... .......
Ikni ldinl' Inrlgctor)
AP ' .)CATION FOR BUILDING PERMIT
I)aCecd—. (. .p . . . . . . 19,L. .K�
INSTRUCTIONS 1
n. 1hir, applications nest be. conplet.ely filled in by lypewriter or in ink am! sulmiLted fo the Building hnsperlor with
l spin. of Finan, necurale plot: pian to scale. Fee recording to schedule.
Ir. Plot. Ilan showing locnl.hn of lot- and of buildings no Prnnises, relationship to adjoining pranisen or public
slrWit or nrenr, and giving a detailed description, of layond: of properly mist IM drawn on the diagran whicb it Inrl ur
thin apgdicalion.
c. 'Ibe work eovered by thin application Foy not Ila canenx:ed before ismranvo of BoOding Persil .
d. Upon approval of: Otis application, the Ikillding Inspector will issue a Ikdlding PeuvdL to the applicant . Such
permit shall be. kept: on the pretaises nvailafle for insMetial Lhrcnglxut the work,
e. No building shall lm occupied or used in whole or in port. for any purpose whatever until a (krtificate of
%("ti:ax;y shall have leen granted by the Building htapecLor.
AI'PIACA'i'ICN IS UL'.Muly MAUf.to tine Building leparinmul, for the issuance of a Ikrilding Pernit Pursuant to Uwe
Ikcibding 7txe Ordinance of tine 'fawn of Southold, Suffolk Gundy, 1404 Yoric, and OOMI- applicable I.xor, Ordinances or
lQuial lain, for Lle count-rrclion of Inlildings, ndditicns or alteratials, or for rralxalal or dotniition, an herein
rk`scrilred. 'Ihe applicant- agreFf: to coolly with all applicable liar, ordinance,^„ buildingIr4nring axbe, awl
relnd atiaus, anal to mikoil: aulorized Inspectors on pronires laid fit building o r .cesrar it slrFCCi ns.
(Sigrnture of app]icanr-,,,or nrym, if a ro nr al ion)
(Mailing address of algwlicaut)
State wined her alrp Iicant- is Owner, Ie::ree, agent, architect, engine erernl contractor, Lectrician, p urier or builder.
...... ........................./. ......
/.i�..............}n`..... ......................--......................... .. .... ..
/ /
N:>trr' of owner of pre+ni;:es ..,., ........... ,y, c •.
(as on the lax ValI or latest deed)
If appl'rau ' s acor lx Us ion, r'gn"Lure of duly autlxrrized officer.
C, ,
(N:nXI :nxl Lit le of corIx)rrue offic .r') 4 O
G_
Ruilders License No. n
Pluders License Nn.�I ICC¢ -., .�J �.�. , _74➢f:4�-.,`;i .`..',�_';'' ti, .
Elect ricionr 1..1ceuse No. jW140.19 44iz o;:.
Other T(alle's License. No. .................... A
1. lm-at.htu of )aril on which proposed work will le dax•.10 11.1FI w��
Ikune Monier Street IL•mlet
(:onnly 'lax Map No. tnhIXx) ,:/xtctirnn ...1.�.. ..... Iilcx:k ....�..-..Q..,.Ql,of .�.•.....//.rr.--....
Subdivision ..Lr l41�(.�(jh.�✓..... ... ......... Fi Ied FLIP No. �O.d '-...... Int .C.Y?......,...�
(N.tirr)
2. 51 n1e Fxl al,ing,use ntxl cx:cuparey of irerniser, :nil imported uil mxC
se arUtnrx:y of proposed canstruclion:
a. lixisl.ing line and ox•cupxux:y ..., (/r. . ......,.--..................................... .. ..........
b. Intrakxl aro aped ox:cnpnrx:y .....K Colo ./. ..,. � �..,.
i
Rf
1. n unit otank (check %A%Jilt niq)l icubl�)l
1
.,, . ,,,. , l Mnr IAliidinli . . . ... .. Nldlliun .. , . . . .. . . Aller nt inn
4
. . . .. .. . . .
.Iwo lo
Rn
I,, ... Ik,)olit.inn ... .. . ... . .. (11 her Wk . . . .. . .. . . . . . . . . .. . . .. . . ... .< . .. . .
•n Witc.ripl.ion)' . .. .
it . fail IIIGII(?d (:nni . O ..Q. . ....I�.. . fee . .. . ... . .. ... ... .. . . ...... . .
11 (In to laid on (Iili %g III ill app! !cut:inn)
S. If 16a?l Iioli, Ixular of lAwell Inti unite . .l .. ....... IAdx!r of IhxalI Ing our In of, each floor . . . . . .. .. ... . .. .
If Iiaruge, uml>Lr n( non . .. . . . . . . . . . . . . . .. . .. . . . ... .. . . . . . .
G. If holdni fni, coinuincial or nixed occl'lincy, aglecily talus mil (!)Craft( of ench (ylx! of use... . . . ... ... .. .. . . . . . .
7. Dillmnn!(os oI' exisl'ing lit loctwireu, inny: flitch .. . . ... . . . . . . . .. Hour furan . . . . . . . . .. .. . .. ..
Ik!ililll . .. . . . ... . . .... : ... . . .... Um lwr of SI or gas . . .. . .. . . . .. . .. .. . . , .
DG-
himm Of
mle
(1, ❑ . . ewtl : t1l401711hos nr lddi( tnm Froin .. . .Q.-. . .. . . . . . . gear . .. .. . . .. . . .. . .. . .. . .
IbIlli . . . .... .. .... Iwith
Wuxr or 8wrien . . . . .. . ... . . ...
RuchUI' llif 1: V(ol
, .V .. . .. . ._. . !Into. �.V. . . . .. ..... Ik!plll 0. .. . .. . .
Ilaigllt
.jo.... . .. .. . . ... ..... . [Ali yr of til arias . . . . . . . . . .
9, Size of Int : lfrmt �. .. . Rally . .. . . .. . . . . .. . :. .. .p. ftoluth . . .. .. . .. .. .... ... . .
10. Mule of I'u chnne . . . ... .. .... ..... . .L . Ib lr! of Fulmer (',fuer ?. Y �� . . . ... .. . .. .. ... .... . .
It. Mom or usa district in mlich Pl,ermij(!a ere niluated ... . . .. .. . ... .. . . . .. . ... .. . . ... . .... . . . ...... .. .. . . . . . . . . . . . . . .
I2. I)lost plulx)uad toxon llx:llal violate tiny Zoning If", ordiniuoe or rnlgrdntlon: �,�. .. .. . ...... .. ....
I ). Will Int to relirukd .,..4 .... . ... . Will excens fill Ix? rcotov:(1 frau prrenison YES IJ
.... (� T ,yh �^
14. Moms of !.halon of prr^ani ses . .. , r !....�. 1(f.0 tuld rens 1"2 SIdIWA .P2 Y� ( ffa(i//�fjq low! fk)`f!. 470V
Ninr! nl` An:hi(er.L MRR .. . 111rnx! til.
L� TU /. . . ... .. . ..... Mkhene . . . ... .. . . . . . .. . .. . .. .. ..Q �. .. . . . . . . .
IIinA! of (aol raylass/+2-7. Sc,) I—K0 [F `:.Mmok:
h. In (h^u plolauAy Within "1(X) feel of� a IIdal lx�l-land? A YES .
11 . .. .. . . . .
iF YES, fg X III YN 1) 'ItAdt '11111a11Aifi WIWI' MAY BE HWL J1H1±11,
�VI,0 ' DIAGIIAtI
1(x:nle clearly and distinct ly all 1> 111dLngs, (Alelher axial ing or protosed, nml indienre nil ant-back diurnnions
Itiul pullcnly Mlle❑. Give street and block Iudn?r or denrripline according In deedl,nml Am alreel: nmen hid indicate
IAIe(hel hn(nfor or corlyr lot
I
i
R-L/6,y
Gran; INS fait wN+x,
SS
/XXItfIY (N% ... .. ...T.. . .. . . ..��. . . .. ...
. . .. . .. . . . . . .�5"•`�.. .' Xt� � ' . . . . . . .. ... . . . . . .being Only mann, dclosen blit nilys that. he in Ilio npplioant
(Wmr! ul Ilxliy idual slguing ;mwl luta)
illxive Ili MIY4l, Co.�^
lin if; the .. .. . . V.(� ���,�
(Contractor, agent, rulmornle officer, etc..)
of fluid 4mlx;r Ill' IA411(rn, f11d In (fifty fill 1o('ired to ix!rltllll Or have lel loniv I the field ")It( and to lealio and fete Min
❑lilt !kill fold Ilial -Illi lit ilt(vielil if 1:1n al"m III Ulla hili hmi kni ale (11x! to (he lalll of hili kok"ledge unit Is!I icrli mW
I full Ilse Ixnk will lie Ire)Vnmrd In Ilf louver star Ior(If in Ilse 111,1111 cal.ran 111 ed I bel emi lh.
!k,iml til bl'hn uv! Ihill
. . , .. . . . . . . . .day of .. ... . . 19. � . .
fkd any Ih1hI I(: ..J!` --` K N .
r l��
(Siilllim(lue ftf Apel icnul )
HELNE D. HONE
Notary Public,State ofNewyork
64,
Qualified in Suffolk
Commission Expires May 22, 1817
L.
t rl S.UFF..OLLtc CQ. HEALTH DEPT. APPROVAL
MAP OF PROPERTY H.S. NO.
WWrYED
r2ANDAllO BUILDING
' STATEMENT OF INTENT
AT I 4 THE WATER SUPPLY AND SEWAGE DISPOSAL
MATVVV r#TUC SYSTEMS FOR THIS RESIDENCE WILL
! CONFORM TO THE STANDARDS OF THE
X- ;Al� "'C3i N. . j SUFFOLK CO. DEPT. OF HEALTH SERVICES.
4 451
APPLICANT
- t SUFFOLK COUNTY DEPT. OF HEALTH
III
SERVICES -- FOR APPROVAL FOR
CONSTRUCTION ONLY
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DATE:
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SUFFOLK CO- TAX MAP DE64GNATION:
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SERVOCEC
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DO NOT PROCEED WITH
LCCP FRAMING UNTIL suRrEr --
USE �9�iY ®R OF FOUNDATION LOCATION �
USE IS UNLAWFUL
N AWF1L HAS BEEN APPIMM
141THOUT CERTIFICATE AP RIS AS NOTED
DArE: 1 23 B.R>k X3770
CYNOTIFV 6DE AT
755-1802 8 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWOREQUIRED
- FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
o ae� If copper tubing Is used PLUMBER CERT/F/CA /O ALL E COMPLETE FOR C.O. MEET
4. FINAL - CONSTRUCTION MUST
for water distributin BE COMPLETE ION C.O.
system; i in g ON LEAD CONTENT B
Pip g Shell bs CERT/f/GATE OF "ORE THE REQUIREMENTS OF THE N.Y.
Of type6 K e oM QG`CU STATE CONSTRUCTION & ENERGY
NCY CODES. NOT RESPONSIBLE FOR
SOLDER USED IN WAVER DESIGN OR CONSTRUCTION ERRORS
Pn L bUuoiz PLUMBING SUPPLY SYSTEM CAN OT Zf
ALL PLUMBING WASTE EXCEED 2/10 of 1%L
&WATER LINES NEED ai
TESTING BEFORE COVERING 9a/.i a-94>-2
2 x In yt��uh G1�� INS�L 411
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PART.717.3(f)(1)OF 1p; I W s��o ttibN
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PROPOSED
RESIDENCE
- ELEVATIONS
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SUMMARY OF TOTAL THERMAL RATING
NEW YORK STATE
If the Total Thermal Ratmg is zero(0) or greater,dre proposed design for the building envelope complies vnth
ENERGY CONSERVATION CONSTRUCTION CODE the Energy Code
PART 6 COMPLIANCE FORM THERMAL, TABLE
Thermal Rating Method AREA U-VALUE RATING USED
ONE AND TWO FAMILY BUILDINGS A. ROOF/CEILING -3_k(125_025_ 45 6w
B NET WALLS 1769-- 0046_ _798_" _6_1
iILDING ADDRESSLot k 16 Gross Floor area 1750_
C GLAZING
---
vview Estates Number of stories I Windows(Ist flr) _469 _�.5 i -211_ 6_1
Windows(2nd llr.)
dtihnck NY Degree days 6000 Skylights - --
D FLOOR/WALLS
retractor, Architect or Engineer Salavatore Marrese I FLOORS
2 BASEMENT
the budding does not meet the following pre-qualifying conditions, part 6 of the WALLS
orgy Code may not be used. Walt Perimeter Feet
Exposure Above Grade _Feet
ES NO Wall U-Value
x_
Building is one or two family residential Depth of Wall U-Value _Inches
Building is detached Below grade
-% Building is less than 5000 gross square feet 3 SLAB INSULATION
--- Budding is three stories or less in height Slab Perimeter _ _Feet
x
"xJ Entrance doors to have certified U value of() 40 or less Insulation R-Value
'= E INFILTRATION Sq Ft
ENERAL NOTES Conditioned Floor Area _
11 insulation to meet or exceed NYS Code
Wall I- R - 18
Roof- R - 19
Floor-R- 19
J1 doors and windows to meet code requirements for air infiltration TOTAL THERMAL RATING_=32 OK__
'ireplace to conform to code for fresh air and air infiltration requirements.
NAC system to conform to code requirements.
TOTAL THERMAL RATING
Pine total Thermal Rating for this building is32
rhe worksheet that developed this Thermal Rating is attached.
k Thermal Rating of zero or greater indicates that the building envelope complies with the Energy
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Code
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