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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
UPDATED
CERTIFICATE OF OCCUPANCY
No: Z-29205 Date: 01/21/03
THIS CERTIFIES that the building NEW DWELLING
Location of Property: 2235 BRIGANTINE DRIVE SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 79 Block 4 Lot 62
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 23, 1994 pursuant to which
Building Permit No. 22319-Z dated SEPTEMBER 12, 1994
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 OPEN PORCH AS APPLIED FOR. THIS
CERTIFICATE OF OCCUPANCY UPDATES CO #Z-23446.
The certificate is issued to WILLIAM S KELLY & SANDRA L SIKORSKI
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 810940067 12/21/94
ELECTRICAL CERTIFICATE NO. H 044156 01/25/95
PLUMBERS CERTIFICATION DATED 01/05/94 M ALGOZZINO PLUMB & HEAT
Authorize Signature
le ;z_ Z!At
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23446 Date JANUARY 11, 1995
THIS CERTIFIES that the building NEW DWELLING
Location of Property 2235 BRIGANTINE DRIVE SOUTHOLD NY
House No. Street Hamlet
County Tax Map No. 1000 Section 79 Block 4 Lot 62
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 23, 1994 pursuant to which
Building Permit No. 22319-Z dated SEPTEMBER 12, 1994
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 A ONE FAMILY DWELLING WITH ATTACHED OPEN PORCH AS APPLIED FOR.
The certificate is issued to WILLIAM KELLY & SANDRA L. SIKORSKI
(owner's)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R-10-94-0067 12/21/94
UNDERWRITERS CERTIFICATE NO. PENDING
PLUMBERS CERTIFICATION DATED JANUARY 5, 1994 M. ALGOZZINO PLUMB & HEAT
uz- v"2"1,
Building In ector
Rev. 1/81
FORM NO.3
TOWN OF SOUTHOLD
6V\LpU30 pEPARTMENT
TOWN HALL
SOUTHOLD, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Date ..'.?02r 19..':: a..
N® 22319 Z
Permission Is hereby granted t
144 4
dr i V
s
.
-Y 11-f 71
to ....C . 1;~...... /
112 1 11 e
. a.-A--....... ,4
u66 c........r.;.. .z . r~. Y ...a..a.Qor~ .ter/~
d
at premises located at..."V ~.......C6~ ..!>12~......:.... d.e
County Tax Map No. 1000 Section Block ~.4 Lot No. 4i~..2-
pursuant to application dated 19..~ and approved by the
Building Inspector. /
Fee $.J(;, r,
v{..-eZ
liding Inspector
Rev. 6/30/80
1
Form No. 6 "73 Ll - 40 Co 0
TOWN OF SOUTHOLD TI, BUILDING DEPARTMENT TOWN HALL X99
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY ?`S ,iiiav,,
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 Building - $100.00
3. Copy of Certificate of Occupancy - $20.00
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.... ry.~..........
Location of Property... r ZZS ..........tf !c , , ...^,t ~rY 11\ .
House No.?~~~,~ Street Hamlet
Onwer or Owners of Property.l ~711.~(,,,
County Tax Map No 10000, Section. ......Block...... Y........ Lot..... .
Subdivision.
."Y Map............ Lot
Permit No........ 5..15.'.Z Date Of Permit.../.
Health Dept. Approval........ n ................Underwriters Approval.........................
Planning Board Approval..q<:`//`
Request for: Temporary Certificate........... Final Certicate....f
Fee Submitted:
,
Dzef 40
THE NEW` YORK' BOARD OF FIRE UNDERWRITERS PAGE; 1
8050592 BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NEW YORK 10038
Date JANUARY 25 ,199 5 Application No. on file 86123894/94 H 044156
THIS CERTIFIES THAT only the electrical equipment as described below and introduced by,,.theoppikant named on the above application number in the premises of
WTLLTAM S KELLY, 2330 BRIGANTINE DRIVE~SOUTHOL61 Y.
in thefollowinp location; ?X Basement ® lst Fl. X d F1 Section Block Lot
was examined on DECEMBER 28 F 1.994 and found to be in compliance with the National Electrical Code,
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
OUTLETS ECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER AMT. K W. AM} K. W. AM}. K.W AMT (W
AMi H.p
34 51 43 30 4 1 1.2
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIALRECPT TIMECLOCKS BELL UNITHEATERS MULTI-OUTLET DIMMERS
AMT. K. W. OIL H. P. GAS H. P AMT. NO A. W G. AMT. AMP. MIT. AMPS. TRANS, qM}, H p SYSTEMS NO. OF FEET AMT. I WATTS
1 F 1 2/1' - 4 20
SERVICE DISCONNECT NO.OF S E R V 1 C E
AMT. AMP, TYPE METER 1 q RW 1 q 3W 39 3W J,e' dW NO.OF CC. COND A. W. G. NO. Of HI-LEG A W G. NO. OF NEUTRALS A. W. G
EQUIP. PER.e r~4 F CC.COND. OF HFLEG OF NEUTRAL
1 200 CB 1 X 1 / 0 1 2/0
OTHER APPARATUS:
L
MOTORS:2-F H.P.
G,F.C.T:°4
SMOKE DETECTOR:-2
325 BR
WILLIAM KELLY
2325 BRIGANTINE DR
P 0 BOX 1690 GENERAL MANAGER
SOUTHOLD, NY, 11971.
Per
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 FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
Town Hall, 53095 Main Road
.i Fax (516) 765-1823
P. O. Box 1179 4 ro Telephone (516) 765-1802
Southold, New York 11971
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
C E R T I F I C A T I O N
DATE:
Building Permit ~N/o. ~gj9z
Owner: M&a., A hF4LV p~
(please print)
meHAEL ALG07ZINO
Plumber: plumbing &Heating
(plea EACH, NY 1197
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
44 ~
(Pl
umb rs igraLure)
Sworn to before me this
(O -bL ,
_
day of artiU 1gr
Notary Public, County
` JEANTF
BEK
NOTARY PUBLIC STATE OF NEW
YORK
NO. COMMISSfON EX52,707,5900
IRIL 30,19(
San. 6 195 13:19 0000 Glgr,zzino Plmbg. TEL 516-288-5362 P. 1
Town Hall, 53095 Main Road 7 r 3 Fax (516) 765.1823
P. b. Box 1179 ;v Telephone (516) 765.1802
Soulhold, Now York 11971
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
VrL
C E R 'T' 2 P X C A T 1 0 N
0199 L-
$ DATE:
BLDG. D"tl'7. 9
TOWN OF 5OUTF1OLD kk
Building,, Permit ~N/o. E2&j 7z
Owner: Eal kul-;r'.'~it/i f-~ ZY ~ & < ~lc
(please print)
W14AEL ALGOZ7ANQ
Plumber: _ plumbing &Heating
( p lWEAA~~MY 11973
T certify that the solder used in the water supply system
contains lose than 2/10 of 1% lead.
(Plumb`rs ig a ure)
Sworn to before me this
day of 19 -
7
Notary Public, - County
JEANNETTEA'{97
NOTARY pUeG lC S'PAT'E N NEW YORK
fJO, 5T.•7p75pp0
h~o~oS~FFOiK~oGy
o ~
Town Hall, 53095 Main Road °y Z Fax (516) 765-1823
P. O. Box 1179 ~r0 • Telephone (516) 765-1802
Southold, New York 11971 .j. 0!
poi ~ ~a
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
January 10, 1995
Mr. William Kelly
P.O. Box 1680
Southold, NY 11971
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
xx An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
xx The check is not on file. $25.00
No Health Department Approval on file.
No final inspection has been made.
xx No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 22319-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
lELD I;:SP C:IO;J JJDATE COMMENTS
FOUNDATION (1st)
FOUNDATION (2nd)
2. 3 _ C
ROUGH FRAME & r~
PLUMBING y -t
H
3. m
H
INSULATION PER N. Y.
STATE ENERGY (Y .
CODE
x
t
4.
ell
FI;4AL !L s
o
z
ADDITIONAL COMMENTS:
Malt_ 10"
~i
x~
H
Z
I
C7
A
x
h
b
H
f/ M-102
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] 1 ULATION
[ ] FRAMING [ ] FINAL
REMARKS:
r ~
DATE J INSPECTOR
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
ii~
[ ] FRAMING ( FINAL
REMARKS:
hj~te
DATE 3~ INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ I ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
%r~~ "
REMARKS:
DATE it L INSPECTOR `
JUDITH T. TERRY Town Hall, 53095 Main Road
TOVM CLERK P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Fax (516) 765-1823
MARRIAGE OFFICER Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OPPICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 3284-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner KELLY, WILLIAM / SIKORSKI, S.
Mailing Address 1 P. 0. BOX 1680
Mailing Address 2 - 77-7
City St Zip SOUTHOLD NY 11971-0000
Property Address 1 2235 BRIGANTINE DRIVE
Property Address 2
City St Zip SOUTHOLD NY 11971-0000
Owner Telephone No. 516-765-3121
Tax Map No. section 79.00 block 4 lot 62.000
Cross Street NORTH BAYVIEW ROAD
.;.e
Issue Date: 11/21/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
Y tl..
/C st-z ~%~',r'"a,-S„'w°h ,L~7"i'~'^m 1_~~."~4P6.9^,,~~°~ '.:?':~_^~^•Fnr 7"""trr.~;'
Board Of Southold Town Trustees
SOUTHOLD, NEW YORK
it .
PERMITN,O. 4309 DATE:.. April 30, 1994 k'
~s
g JAW TO William Kelly
) 1\~"1 1 i. III \ ~
Pursuant to the provisions of Chapter 615 of the Laws of !I4; 'i
the State of New York, 1893; and Chapter 404 of the Laws of the 1
State of New York 1952; and the Southold Town Ordinance en- !Fa
w~ titled "REGULATING AND THE PLACING OF OBSTRUCTIONS
IN AND ON TOWN WATERS AND PUBLIC LANDS and the
y! REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM
LANDS UNDER TOWN WATERS;" and in accordance with the
M k
Resolution of The Board adopted at a meeting held on April 28,,
19 94 , and in consideration of the sum of $ 150.00 aid b
*il P by
h;
William Kelly
I, of N. Y. and subject to the
yy
Terms and Conditions listed on the reverse side hereof, ,y
of Southold Town Trustees authorizes and permits the followings
to construct a single family dwelling with septic sYstem,drYwel
j excavate and backfill distrubed areas, seed berm pond area.
there shall be a non-turf area between the 15' contour line an&
qi the pond. A staked row of hay bales will be placed at the 15 I,Q,
i' all in accordance with the detailed specifications as presented in
the originating application. contour line. Driveway will be re-
° graded to form a swale to recharge the water.
IN WITNESS WHEREOF, The said Board of Trustees here-
by causes its Corporate Seal to be affixed, and these presents to
(a~ be subscribed by a majority of the said Board as of this date. lid l °
( / e,,l 111
4
,
Trustees ~1..
~i Ji, 4
%
I ~ '
it
TERMS and CONDITIONS
The Permittee William Kelly
residing at Brigantine Dr. Southold ]V y, as
part of the consideration for the issuance of the Permit does understand and prescribe to the fol-
lowing;
1. That the said'! Board of Trustees and the Town of Southold are released from any and
all damages, or claims! for damages, of suits arising directly or indirectly as a result of any oper-
ation performed pursuant to this permit, and the said Permittee will, at his or her own expense,
defend any and all such suits initiated by third parties, and the said Permittee assumes full .&bilfty
with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold
2. That this Permit is valid for a period of 24 mos. which is considered to be the
estimated time required to complete the work involved, but should circumstances warrant, request
for an extension may be made to the Board at a later date.
3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes
to maintain the structure or project involved, to provide evidence to anyone concerned that auth-
orization was originally obtained.
4. That the world involved will be subject to the inspection and approval of the Board or
its agents, and non-compliance with the provisions of the originating application, may be cause for
revocation of this Permit by resolution of the said Board.
5. That there will be no unreasonable interference with navigation as a result of the work
herein audtorized.
6. That there shall be no interference with the right of the public to pass and repass along
the beach between high and low water marks.
7. That if future operations of-the Town of Southold require the removal and/or alterations
in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the
work shall cause unreasonable obstruction to free navigation, the said Permittee will be requited,
upon due notice, to remove or alter this work or project herein stated without expenses to the Town
of Southold.
8. That the said Board will be notified by the Permittee of the completion of the work auth-
orized.
I
9. That the Perrjtittee will obtain all other permits and consents that may be required sup-
plemental to this permit which may be subject to revoke upon failure to obtain same.
I
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONS,nvHIION
DEC PERMIT NUMBER EFFECTIVE DATE
1-4738-00892/00001-0 Afflh June 21, 1994
;,'FACILITY/PROGRAM NUMBER(S) PE MA IT EXPIRATION DATE(S)
Under the Environmental June 30, 1997
Conservation Law
TYPE OF PERMIT ¦ New 0 Renewal ? Modification 0 Permit to Construct ? Permit to Operate
0 Article 15, Title 5: Protection 0 6NYCRR 608: Water Quality ? Article 27, Title 7; 6NYCRR 360:
of Waters Certification Solid Waste Management
? Article 15, Title 15: Water ? Article 17, Titles 7, 8: SPDES ? Article 27, Title 9; 6NYCRR 373:
Supply Hazardous Waste Management
? Article 19: Air Pollution
0 Article 15, Title 15: Water Control 0 Article 34: Coastal Erosion
Transport Management
0 Article 23, Title 27: Mined Land
0 Article 15, Title 15: Long Reclamation ? Article 36: Floodplain
Island Wells Management
B Article 24: Freshwater Wetlands
? Article 15, Tit lp yly:rlj)~d~, 0 Articles 1, 3, 17, 19, 27, 37;
Scenic and Recrd nal Rivers V Article 25. Tidal Wetlands 6NYCRR 380: Radiation Control
0 Other:
PERMIT ISSUED TO .ti o"fTELEPHONE NUMBER
William S. Kelly and Sandra L. Sikorski (516) 765-3121
ADDRESS OF PERMITTEE
2325 Brigantine Drive
Southold, NY 11971
CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER
Same as above
NAME AND ADDRESS OF PROJECT/FACILITY
Kelly/sikorski Property
2225 Brigantine Drive
LOCATION OF PROJECT/FACILITY
Southold
SCTM #SO-40
COUNTY TOWN WATERCOURSE NYTM COORDINATES
Suffolk Southold
LE9QRIPTIOM CF / A-MIZED A71VITY
Construct a single family dwelling, septic system and driveway. All work shall be done in accordance with the attached
NYSDEC approved plan.
By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the
ECL, all applicable regulations, the General Conditions specified (see page 2) and any Special Conditions included as part of
this permit.
DEPUTY REGIONAL PERMIT ADMINISTRA- ADDRESS
TOR:
Bldg. 40, SUNY, Room 219, Stony Brook, NY 11790-2356
Roger Evans
AUTHORIZED SIGNATURE DATE
June 21, 1994 Page 1 of 6
1
GMERAL =ITICrZ
Inspections
1. The permitted site or facility, including relevant records, is subject to in-
inspection at reasonable hours and intervals by an authorized representative of
the Departmrent of Envirom-ental Conservation (the Departmmnt) to determine
whether the permittee is ca plying with this permit and the ECL. Such represen-
tative may order the vork suspended pursuant to ECL 71-0301 and SAPA 401(3). A
copy of this permit, including all referenced maps, drawings and special
conditions, must be available for inspection by the Departmrent at all tims at
the project site. Fai lure to produce a copy of the permit upon request by a
Departmrent representative is a violation of this permit.
Pe rmi t Changes and Flermm l s
2. The Department reserves the right to modify, suspend or revoke this permit when:
a) the scope of the permitted activity is exceeded or a violation of any
condition of the permit or provisions of the ECL and pertinent regula-
tions is found;
b) the permit wes obtained by misrepresentation or failure to disclose
relevant facts;
c) new rreterial information is discovered; or
d) envirommntal conditions, relevant technology, or applicable law or
regulation have materially changed since the permit w.es issued.
3. The permittee rrust submit a separate written application to the.Departrrent for
reneAel, modification or transfer of this permit. Such application must include
any forms, fees or supplarental information the DepartmMnt requires. Any
renenel, modification or transfer granted by the Department crust be in writing.
4. The permittee crust submit a renenel application at least:
a) 180 days before expiration of permits for State Pollutant Discharge
Elimination System (SAS), Hazardous VAbste Nbnagamnt Facilities
(mi), major Air Pollution Control (APC) and Solid V~bste Nbnagamnt
Facilities (S/WF) ; and
b) 30 days before expiration of all other permit types.
5. Unless expressly provided for by the Department, issuance of this permit does
not modify, supersede or rescind any order or determination previously issued by
the Department or any of the terms, conditions or requirerents contained in such
order or determination.
Other Legal Cbligations of Perrnittee
6. The permittee has accepted expressly, by the execution of the application, the
full legal responsibility for all darages, direct or indirect, of whatever
nature and by wharever suffered, arising out of the project described in this
permit and has agreed to indemify and save harmless the State from suits,
actions, damages and costs of every nare and description resulting from this
project.
7. This permit does not convey to the permittee any right to _trespass upon the
lands or interfere with the riparian rights of others in_order to perform the
permitted work nor does it authorize the irrpa i rrrent of;`any rights, title, or
interest in real or personal property held or vested: r~ a perso~~l~f~~ a party to
the permit.
5
8. The permittee is responsible for obtaining any other permits, approvals, lands,
easarents and rights-of -way that may be required for thJs; project,....
e
Page 2 Of 6
10; 4
95-20-6a (7192)-25c
ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15 (Title 5), 24, 25, 34 and 6 NYCRR Part 608 ( FY2SITW8CeY Wetland )
9 That if future operations by the State of New York require an al- other environmentally deleterious materials associated with the
teration in the position of the structure or work herein authorized, or project
if, in the opinion of the Department of Environmental Conservation 13 Any material dredged in the prosecution of the work herein permitted
it shall cause unreasonable obstruction to the free navigation of said shall be removed evenly, without leaving large refuse piles, ridges across
waters or flood flows or endanger the health, safety or welfare of the bed of a waterway or floodplain or deep holes that may have a
the people of the State, or cause loss or destruction of the natural tendency to cause damage to navigable channels or to the banks of
resources of the State, the owner may be ordered by the Department to a waterway
remove or alter the structural work, obstructions, or hazards caused
thereby without expense to the State, and if, upon the expiration or 14 There shall be no unreasonable interference with navigation by the work
revocation of this permit, the structure, fill, excavation, or other herein authorized
modification of the watercourse hereby authorized shall not be com- 15 If upon the expiration or revocation of this permit, the project hereby
pleted, the owners, shall, without expense to the State, and to such authorized has not been completed, the applicant shall, without expense
extent and in such time and manner as the Department of Environmental to the State, and to such extent and in such time and manner as the
Conservation may require, remove all or any portion of the uncompleted Department of Environmental Conservation may require, remove all or
structure or fill and restore to its former condition the navigable any portion of the uncompleted structure or fill and restore the site
and flood capacity of the watercourse. No claim shall be made against to its former condition No claim shall be made against the State of
the State of New York on account of any such removal or alteration New York on account of any such removal or alteration
10 That the State of New York shall in no case be liable for any damage 16, If granted under 6 NYCRR Part 608, the NYS Department of Environ-
or injury to the structure orwork herein authorized which may be caused mental Conservation hereby certifies that the subject project will not
by or result from future operations undertaken by the State for the contravene effluent limitations or other limitations or standards under
conservation or improvement of navigation, or for other purposes, and Sections 301, 302, 303, 306 and 307 of the Clean Water Act of 1977
no claim or right to compensation shall accrue from any such damage (PL 95-217) provided that all of the conditions listed herein are met
11 Granting of this permit does not relieve the applicant of the responsi- 17 All activities authorized by this permit must be in strict conformance
bility of obtaining any other permission, consent or approval from with the approved plans submitted by the applicant or his agent as part
the U.S. Army Corps of Engineers, U S Coast Guard, New York State of the permit application
Office of General Services or local government which may be required. b
12 All necessary precautions shall be taken to prelude contamination Such approved plans were prepared per survey by
of any wetland or waterway by suspended solids, sediments, fuels, Roderick Van Tuyl dated 1111®193 dated 5/20/94
solvents, lubricants, epoxy coatings, paints, concrete, Ieachate or any
SPECIAL CONDITIONS
1. Markers used by this Department to delineate/define the
boundary of the wetland or the extent of the permitted
structures shall be left in place and remain undisturbed for
one (1) year following completion of the project.
2. Any work, disturbance, and storage of construction materials
shall be confined to within the "Limit of Clearing and
Ground Disturbance" as shown on the approved plan.
3. A snow fence or other temporary, project-limiting fence
shall be erected prior to the commencement of any permitted
activities along the upland edge of the designated buffer
area in order to prevent the inadvertent intrusion of
equipment into the protected area. The fence shall be
maintained until project completion.
4. Prior to commencement of any construction activities, a
continuous row of straw bales shall be staked end to end
along the "Limit of Clearing and Ground Disturbance" shown
on the approved plan. The bales shall be maintained,
repaired and replaced as often as necessary to ensure proper
function, until all disturbed areas are permanently
vegetated. The average useful life of a bale is
approximately 3-4 months. Sediments trapped by the bales
shall be removed to an approved upland location before the
bales themselves are removed.
INC PL RMIT NUMBI R
1-4738-00892/00001-0
PROGRAWFACILI ty NUMB[R
Page 3 of SL-
da"o
95de 6f )7I87)-25c NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION vqw
SPECIAL CONDITIONS
24 Freshwater Wetland
For Article (
5. Straw bales shall be recessed two to four inches into the
ground.
6. The driveway must be surfaced with a permeable material.
7. All equipment and machinery shall be stored and safely
contained greater than 100 feet landward of the regulated
wetland or water body at the end of each work day. This
will serve to avoid the inadvertent leakage of deleterious
substances into the regulated area. Fuel or other chemical
storage tanks shall be contained and located at all times in
an area greater than 100 feet landward of the regulated
wetland or water body. If the above requirement cannot be
met by the permittee, then the storage areas must be
designed to completely contain any and all potential
leakage. Such a containment system must be approved by
NYSDEC staff prior to equipment, machinery or tank storage
within 100 feet of the regulated wetland or water body.
8. All areas of soil disturbance resulting from this project
shall be seeded with an appropriate perennial grass, and
mulched with straw immediately upon completion of the
project, within two (2) days of final grading, or by the
expiration of the permit, whichever is first. Mulch shall
be maintained until a suitable vegetative cover is
established. If seeding is impracticable due to the time of
year, a temporary mulch shall be applied and final seeding
shall be performed as soon as weather conditions favor
germination and growth.
9. Suitable vegetative cover is defined as a minimum of 85%
areal vegetative cover with contiguous unvegetated areas no
larger than 1 square foot in size.
10. The permittee shall incorporate the following language as a
notice covenant to the deed:
"Regulated freshwater wetlands associated with NYSDEC Wetland SO-
40 are located on the southeast corner of the properties of
William S. Kelly and Sandra L. Sirkorski and their heirs, assigns
or successors. This property is subject to the provisions of
Environmental Conservation Law (ECL) Article 24, and the conduct
of regulated activities may occur only pursuant to ECL Article 24
if prior approval is given by the New York State Department of
Environmental Conservation (NYSDEC) or its successor(s).
Regulated activities include, but are not limited to clearing of
vegetation; application of chemicals; excavation; grading and
filling; and erection of any structure(s)."
DEC PERMIT NUMBER
1-4738-00892/00001-0
EACH ITY ID NUMBER PROGRAM NUMBER
Page 4 of 6
AMk
95-20 bf (7/8J)-25c NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
SPECIAL CONDITIONS
For Article (
24 Freshwater Wetland
This deed covenant shall be recorded with the Clerk of Suffolk
County within 90 days of the issuance of this permit. A copy of
the covenanted deed or other acceptable proof of record, along
with the number assigned to this permit, shall be sent within one
calendar year of the issuance of this permit to: NYSDEC,
Regional Manager BEP, SUNY Bldg. 40, Stony Brook, New York
11790-2356.
Supplementary Special Conditions (A) through (F) attached
DEC PERMIT NUMBER
1-4738-00892/0001-0
FACILITY ID NUMBER PROGRAM NUMBER
Page 5 of 6
r
SUPPLF.XENTARY SPECIAL, CONDITIONS
The Following Conditions Apply To All TIDAL WETLANDS;
FR SHWATER WETLANDS; CCASTAL EROSION MANAGEMENT; and WILD,
SCENIC, and RECREATIONAL RIVERS PERIMITS:
A. •A copy of this permit, including all conditions and approved
plans, shall be available at the project site whenever
authorized work is in progress. The permit sign enclosed
with the permit shall be protected from the weather and
posted in a conspicuous location at the work site until all
authorized work has been completed.
B. The permittee shall require that any contractor, project
engineer, or other person responsible for the overall
supervision of this project reads, understands, and complies
with this permit and all its general, special, and
supplementary special conditions. Any failure to comply
precisely with all of the terms and conditions of this
permit, unless authorized in writing, shall be treated as a
violation of the Environmental Conservation Law. If any of
the permit conditions are unclear, the permittee shall
contact the Division of Regulatory Affairs at the address on
page one or telephone (516) 444-0365.
C. If project design modifications become necessary after
permit issuance, the permittee shall submit the appropriate
plan changes for approval by the Regional Permit
Administrator prior to undertaking any such modifications.
The permittee is advised that substantial modification may
require submission of a new application for permit.
D. At least 48 hours prior to commencement of the project, the
permittee and contractor shall sign and return the top
portion of the enclosed notification form certifying that
they are fully aware of and understand all terms and
conditions of this permit. Within 30 days of completion of
the permitted work, the bottom portion of that form shall
also be signed and returned, along with photographs of the
completed work and, if required, a survey.
E. For projects involving activities to be undertaken in phases
over a period of more than one year, the permittee shall
notify the Regional Permit Administrator in writing at least
48 hours prior to recommencing work in subsequent years
F. The granting of this permit does not relieve the permittee
of the responsibility of obtaining a grant, easement, or
other necessary approval from the Division of Land
Utilization, Office of General Services, Tower Building,
Empire State Plaza, Albany, Nv-:12242 (516) 474-2195, which
may be required for any encroachment upon State-owned lands
underwater.
DEC PERMIT NO_ 1-4738-00892/00001-0 page 6 of 6
BOARD OF HEALTH
FORM NO.1 3 SETS OF PLANS
AUG 2 31994 TOWN OFSOUTHOLD SURVEY
BUILDING DEPARTMENT CHECK
TOWN HALL SEPTIC FORM
SOUTHOLD, N.Y. 11971
TEL.: 765-1802 t7oTIFY; ~~y-
Examined 0 19 g! CALL . . . . . . .
MAIL TO:
Approved 9// d......., 19Permit No.
Disapproved a/c
7 uil ng Inspector)
APPLICATION FOR BUILDING PERMIT
Date Z..........., 19c7 N
INSTRUCTIONS,
+ a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
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 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 issued a Building Permit to the applicant. Such 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 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 building for necessary i ections.
(Signat f applican me, if a corporation)
47. c..1. ~tl t~ . Alv I&I.. .
(Mailing address of applicant)
State whether applic t is owner see, agent, architect, engineer, general contractor, electrician, plumber or builder.
.
Name of owner of premises .a4L . A..&. At,10l.. d't'.VD..c ~i?~tCP L s. ~ ~~cL, ,
(as on the tax roll or latest deed)
If applic s a corporation, sigpatura-zrf daly authorized officer.
(Name and title of corporate officer')
Builder's License No..1. 5-7 ~..v ~ :E
Plumber's License No .
Electrician's License No .
Other Trade's License No .
1. Location of land on which proposed work will be done .
235......... C~4~fTfnf 3r
House Number Street Hamlet
County Tax Ma~p/ No. 1000 Section Block Lot (=t
Subdivision ..t// ~...44_444TS Filed Map No. Lot !;7
(Name)
2. State existing use and occupancy of pprtemmises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ..../.W4/ .
b. In t e n ded u se an d o ccup ancy ..,'..1,,,,,,,,,,,,,,,,,,,,,,,,,,,
3. Nature of work (check which applicable): New Building Addition Alteration
RP val Demolition Other Work
(Description)
4. Estimated Cost /420/ , Fee S fir.
(to be paid on filing this application)
S. If dwelling, number of dwellip uni s V Number of dwelling units on each floor
If garage, number of cars
6. If business, commercial or mixed occupancy, specify- nature and extent of each type of use .
7. Di ensions qt' exiistin structures, if any: Front N,PA. W Rear ~IOXW Depth
.
. strut ber of Stories
Dept Height . h . . . .ure
Dimensions of same e structure with alterations or additions: Front . /~(..~Q~.......... Rear
Height Numbef of Stories .,~t , .
8. Dimensions of ent}}';~e new construction: Front y8 Rear .'Y6........... Depth .
Height ,V Number of Stories z.................... .
9. Size of lot: Front 14W... Rear . 1W Depth . i? .
1,Q, Date of Purchase IX', • , , , , , , Name of Former Owner
Zone or use district in which promise saresituated..
12. Does proposed construchA~~ violate any zoning law, ordinance or regulation: NO .
13. Will lot be regraded - - • , ..Will excess fill be removed from premises: Yes '
J
14. Name of Owner of premises . { Address .;7. /tk L;17...... Phone No. ZZ5.-.~1.-7-1.. .
Name of Architect ~?lr)7ti~....... Address ~6~ . , Phone No.
z~.. .
Name of Contractor
15. Is thisryes, property • Address 6W711b4U. Phone No. ,7,i~1 , ,
00 feet of a tidal wetland? *Yes...... No.......
*If own Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
ATTAOfi-f-D STATE OF NEW YORK
COUNTY OF. . S'S
• • • • • • • . being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
He is the .4 !vwo
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
application; that all statements contained in this application are true to the best of his knowledge and belief; and that the
work will be performed in the manner, set forth in the application filed therewith.
Sworn to before me 'th~is/
day of 19
Notary Public, County
JOYCE M. WILKINS
Natery Public, State of New York " " " " " ' " " " "
No. 4952248, Suffolk Coun (Si ture of applicant)
Term Expires June 12,195-
SUFFOLK CO. HEALTH DEM. APPROVAL i
MAP OF PQ0PERTY H. S. NO. +
SUIZVEYED FOZ
i_ ce~ss~OL s ~ ---4 • 17
'--9E14ItdG-HOI. I I I ~K~ 1 ! L\••~ `
G, I PP ZIC Y PLAYG2CtJND
_ VACANT) I~ t STATEMENT OF INTENT
I - THE WATER SUPPLY AND SEWAGE DISPOSAL
- hT ,.72 5$ !O E. 206.0 AT SYSTEMS FOR THIS RESIDENCE WILL
0\ th ?w r a, l ! )TfI~~~ CONFORM T .,THE STANDAR OF
THE
` M
( SUFFOLK T. OF A SERVICES.
~ r„- _ wEt•r t p J /JN J~ 7•J ,l F`j:.. C, N.Y
F Imo.°~ °j Q j7^ `
I `v 35 _ v - 0 I APPLICAN
1 e ? PEASE NOTE
~ J v •50ZaKP14. r,
I i ?ym mT 1 SUFFOLK COUNTY DEPT. OF HI-ALTH
y'iJ M- 1J
6C% I gyp, cY , SERVICES - FOR APPROVAL FOR
1`i ti EQ CONSTRUCTION ONLY
W l11 DfLtVB y 0 o i - , I il1p1'F7!acif @ i il1$t
w _ _ icE55t~'A~_5 •n - Cd NON-TURFED AREA / •v t. a v b w1f' iACt DATE: ~S-
''r E F{IIVD L'!5E) .8 F s 0GLOW 15 CaNTOU12 Cn / 7 a11i~ SRWp~] H. S. REF. NO.: D g O 6
s.
O APPROVED:
i - .i I POND 5 ! SUFFOLK CO. TAX MAP NATION:
WE - -0 n+h v {0~ n DIST. SECT. BLOCK PCL.
- Y' 1 W. oon, 079 4
c'PD0L'2EPUrED1 OWNERS ADDRESS:
i . i B~ V i. A -.Y A L- N G N !'li .J'i
w. ,:v614tl ON d 94 v25 BCLIGPN~'~lE DQl'!E
1
II = 1' 1 > ~R UTHO~* .Y 1127
ib 'ti~t'SE
C A cEAr 20,O X . S.F. TEL.l65 312f 1305.73 -
1 T I CJ -M()^+I_j"EK
DEED: L. N/A P.
SI!o`5 0''rE TEST HOL
C P001_ to hid a .
' 'hr)- ~nJELL \ ( Y[.;' _x L] 12N pp., Sratg
to Eaay °I _h8 r•.Sbs^„Ij~
--'POOLS IN FLEA2 WELL _ Rr~! ` s.^er~`a~, 'r-.t
- h ~y
lee
' L t q i zntl
' WELL HO. AMENDED AP2. IZ' -1 :2
-
MAV ZO, 19'94 U. owe -'u
4 - LU
W
i
SEAL
C' POOL
01
LLJ
LV-
N"T E:
LOT NOS f-EFE2TO IvAP OP HA03rQ LIGHT` SEC. 3, A RJEYE~ iC3V.lC
_
FiLEC, N T L ~~i LEC<~'S OFfK,E A5 MAP N0.5147 99
_ RODF•, ICK VAN TUYL. P~C. ` t
LICENSED LAND SURVEYORS
GREENPORT NEW YORK
lauvwwsr NMW
SUFFOLK CO. HEALTH DEPT. APPROVAL
MAP 2F P!2OPEFit H.S. NO.
SJ `-Z~ EYEC F02
~~-BEHINC h-
r~5 I PF„k-
-5L ~I I STATEMENT OF INTENT \
--f-- - THE WATER SUPPLY AND SEWAGE DISPOSAL
100, 72 $ IQ SYSTEMS FOR THIS RESIDENCE WILL
V ot'_, ro vaoa A' ,F'4c: CONFORM TO THE STANDARDS OF THE
f ~ s( k~1 ,o - I wE( , 7 u~ r^ 1 - I SUFFOLK DEPT
W C7 Ir IJ""~ h` i ` : J`ti/, --~--L! :•_t,Y IS SERVICES.
2 L' I APPL
*?5EKOw. O
j ~~K•.' I v I , ?n ~ _ - l~~ ` SUFFOLK COUNTY DEPT. OF HEALTH
50i I a p.; R C% - SERVICES - FOR APPROVAL FOR
) CONSTRUCTION ONLY
U) Li! D2ivf= NON-TU2FEP Af2SA v DATE:
`fin - c
- QEH!NG -•O'J:aE; i.tl ' ^ n 9E1.0v? !S CCN7x72 u}( e. 7 I H. S. REF. NO..
,a. - r
APPROVED:
<
cv
(n
u m I 'oNG R _ 5 SUFFOLK CO. TAX MAP DESIGNATION:
y yL DIST. SECT. BLOCK PCL.
(J 1. 1 I M n -
- IQ^ 079
OWNERS ADDRESS:
i v+ 1O %525 Bicirsh~ r', ~ ,
N =,J TH L l-, Y. ; i
1/` U
-r F,'~'rA Z,/,~ TEL.76? 3;~! BUS. ;3 - C6Q
Y -
t .A
DEED: L. N/A P.
- J
_t
5 ! .O p =r , t TEST HOLE AMP
'D C'P~-DL -
i~
F NY>!A>!d
tot r;i
i o. APPROVED AS PER TERMS e,
AND CONDITIONS OF r~ onl Raa ~ eW'ct
SE Ew
Y H
PERMIT NL q73 41"&J-4 moan law S(~pq
cooisawmw ao the FOC'LS !N 2EAQ 1 WELL DATE 6 ZJ f~( I < amps ~<"aeeaaan`'^4
Guars
F fees
HC. AMENDED A942. 1994
J ~Fa Id, NE: L py~iKh° n t>s
tie awI w h~a be r
lE?. 0 vt AY Zo, r994 ( u Agacieg P2
R£s. r - W tome., -
w
u~ ~
C'PC?L SEAL ^.f
1 E 0?
t/oCV
L 9
7~ AJ Li Ec-
P /Ely EG NOV. IG}i~
n~ rY ,r_ "F' LE{~; ~Fr!,.F r:~ /,~f.C J~, Ci~ ~ - 1 ( ~
RODF,}21CK VANUYL. PC. 3
O
LICEN~ED LAND SURVEYORS 0 gp~Q,~a
! F cAko s~
GREENPORT NZW YORK
la m"* mm N91329
A SUFFOLK CO. HEALTH DEPT. APPROVAL
D~ r'?PPF
C _ ~6~Od
GES°~oa
BENINC HOB ;
- I c- ~ 21994
nch . DEPT.
_ T
' v2ov.8 1 J C \ ° - THE WATER SUPPLY AND SEWAGE DISPOSAL
_ SYSTEMS FOR THIS RESIDENCE WILL
CONFORM TO THE STANDARDS OF THE
}gam S " SUFFOLK CO. DEPT. OF HEALTH SERVICES.
"J ir i u*
- i
p -oNCa. : APPLICANT
FOUNDA. -
(rE`- 7 Ei°~ ELEV TOP SUFFOLK COUNTY DEPT. OF HEALTH
v, 43 - rl,,, g SERVICES - FOR APPROVAL FOR
- - --I"~•- L._ j CONSTRUCTION ONLY
. UR."?E NON-TUQFPED Aran L5 O V IS '1 DATE
3
ei_ow 15 =oNTOU¢ t.~ 2 1774 H. S. REF. NO
q. 1
APPROVED
k1 o A _z
=ctip BLDG. DEPT. SUFFOLK CO. TAX MAP DESIGNATION:
OF q
UT -HOLD DIST. SECT
GJ~ - M n TOW!y
BLOCK PCL
Q _ r `;EPIf~FC, OWNERS ADDRESS:
I
r
DEED. L. /F, P -
TEST HOLE STAMP
I
F. - n a~- -:.n o1
i ..I D,D NoW V041Sh8E
;vY0Y8 otb cons
er.ctlv heEb~ODM191dW8d
i roPK
~ "<:i<::N ~Enk i I wwm ueh ,I r,n 10, ca his Cs~t is `Y
I a I
weu- HC. AMENDEC_ AP2. 12, ;C54
SEAL
JrF _E ~r lU.514_, _ R _ 1~ st'q t i
- ODERICK VAN TUYL. P.C
LICENSED LAND SURVEYORS jf'
GREENPORT NEW YORK i orm
'TELEDYNE LOST N8 a x -t
_ SUFFOLK CO. HEALTH DEPT. APPROVAL
~
-it ?~F PI~..PERT H. S. NO -94-0067
j - ---14
QES.) vl4CArJT; _ r _ 'i
{
STATEMENT OF INTENT
? L'J_
- - THE WATER SUPPLY AND SEWAGE DISPOSAL
G
SYSTEMS FOR THIS RESIDENCE WILL
b
hT• 1 s. 122 58 10 E. pptvY Y ti ti L y t J r"\+ _ u CONFORM CO. HE STANDARDS THE
M+ SUFFOLK . DEPT. OF HEALTH SERVICES.
GAZAVeL-
a r r
w 1
APPLICANT
f~ ~ 3 m 2 SUFFOLK COUNTY DEPT. OF HEALTH
SERVICES - FOR APPROVAL FOR
? CONSTRUCTION ONLY
wE L j
Z_w DATE:
-r? p Mont - u2a ntcEA
LLl H. S. REF. NO.. 2IO 94 OOCo7
eepmv 7n.l~) g6LOW 73 CON Oc12 L~ ( y ` I APPROVED:
-z P SUFFOLK CO. TAX MAP DESIGNATION:
DIST. SECT. BLOCK PCL.
- - Ioc? 779 .4
WEB!./ n h PL-2 ( W
• ? Cl. ,eEPTED < OWNERS ADDRESS.
w _ 5 BRr r"Jr 'JE r `JE
ttt r~ t C
61; } . ;~~~e P.ic~A ~O L`?(: -.F TEL, -3121 BUS. 3 aC,faC
N } nn` DEED: L. NIA
P.
OF
j SUIrr( X COUM'Y DWARTmWT
j rtei±f I i(F'ALl'H EST HOLE AMP
8W%E FAMILY DYVEUJW ONLY,
o C'PO0L of CenebvdodWO"
~a gym,
WELL Ks.PA t a sar.-- _t=an
,
o
The 20"00 Kepwa! and Nn"ar suety f 9t
l+ s'~ase s e^d/ r a-
CAtla Lxswrnhave
C WELL efl I:'...Y~p~/U~~? St'
'VOOLS IN REAQ ~8
chd K.xmd+ tai I'u
W~
vre i HO. AMENDED A~L12, 1
cw
jof&kP.rnav zo, I~?94
(tzES.) wWwaW AUG.22~ I w
_ '
_ POOL SEAL
Or
i
I LOT No cEFEl'~L r MAP ?F 4N, 5r sZ LIG-~ EC 3( rr ;,FiLEL A
N Tf- E _ FF. C.LEQ< JFF!f !E AS MAP t-40 Si4? - n ? ROD,9RRIC ICK VAN TUYL. P.. 3 I
_ . (f? 199 rC
LICENSED LAND SURVEYORS
i EPT. OF GREENPORT NEW YORK
HEALTH SERVICES
wuarnea~r rwu+
i
r
rn
r
Z r
OD
W
Lu aLu
a V/ e
FPAGE DESCRIPTION )N
z
1 OF 9 FOUNDATIN PLAI PLAN co
o
20F9 FIRST FLOOR PL, ?R PLAN ~ _
a
30F9 SECOND FLOOR OOR PLAN w
cn O
40F9 CROSS SECTION MON O w
5 OF 9 FRONT (WEST) El ST) ELEVATION Y oc
c D
ITH) ELEVATION DONOTPROCEED wI7d F2Aml J O Cc Lu
60F9 RIGHT (SOUTH) E UNTIL M SURVEY OF
FOUNDATION LOCATION
z ~d F.
r) ELEVATION HAS BEEN APPROVED NONE
70F9 BACK (EAST) ELI
`n a
80F9 LEFT (NORTH) EL 'H) ELEVATION OCCqU~+PANCY OR J ~
[ISE IS UMA~~IFUL
WITHOUT CERTIFICATE w ~
90F9 WINDOW AND DC 4D DOOR LEDGER OF OCCUPANCY
M
M
A M? WA AS WOM cm
o,Q-E: v L.p.4 223/9
a,
2Eu°i._ DE
I . i n r ; In-i" b-r_cY- I 'JF+1~i.! .1 "-7J kFF`^ IMP IR TLS/I~li tJ ----Y s~e~,9 ~3¢:11.1.n-.1-.L-
I :c:.-so ue.:x n,rviv -c nvi mom one
~I~I-~ c1Jr-!~?~-L.i'~"fl2_"~,1 7"~ ~~IIF~1'" l-~Yya.U Ts.r;'~ F0LLOMNG, INS PECiTIONS. 7 FOUNDATION TWOREQUIRED
FOR POURED CONCRETE
I ROUGH . FRANNNC e, PLUIN6VNc WISPJLATION
I
L'ONSTRUCTION IUIUST
TE FOR c.O, R RCW ALL CONSTRUCTION $HALL V'+1EET v h~~p
THE REQUIREMENTS OF THE N.W.
I STATE CONSTRUCTION & ENERGY
C:;rS;ES. NOT~h, RESPONSIBLE FOR r`
i. r• ,y c, r GEgGN OR CO~ICIST'RUCTION ERRORS
OF NE'N
i ~
SUMMARY OF TOTAL THERMAL RATING O I\\~ I J o
If the Total Thermal Rating is zero (0) or greater, the proposed
design for the building envelope complies with the Energy Code, 0~2~3~ aos~ ~1 F6S ~ n co '~7 LL co
THERMAL TABLE '1 ry AREA U-VALUE RATING USED _
co
A. ROOF/CEILING 1440 .Om. I¢ 6"3- - ~ W W
B. NET WALLS _ .060 24s b-I i,.O 11 ' 0 a F
24'-0• ti r a N D
C. GLAZING 24'-0' Window 29(a 11~9_ 3V !e - I
Window _
Skylights _
Ill. FLOORS 200 .047 0 Ir3._ 12'-0' 12'-0e
02. BASEMENT/CELLAR WALLS
Well Perimeter Feet 00
Exposure Above Grade _ feet Wall U-Value _ 1r-a• 1r-0•
_ Depth of Wall U-Value
Below Grade Inches
03. SLAB INSULATION
Slab Perimeter Feet Insulation R-Value . ~z
z ~ o
E. INFILTRATION CONTROL 4 2X10 JOIST 16' O.C. Conditioned Floor Area _ Sq. Ft. NL tr
F. SOUTH FACING GLAZING q - South Glass/Total Glass Percent
G1. Area/Gres. Well Area Percent K
Conditioned floor Area Sq. F0. 1 2820 4
WIND, l 0 6068 FWDA. a q u
TOTAL THERMAL RATING +292 -o
n ~ I / OTL ~.[IVC Fl.Dr LAL.v-I fol... `c~ .O 7 y
_ O K 1 ON nJW ~J&I X12k C1.Yt4c" O ~
. ~ 11'-0' fgC1'fiWl cr C.'ITN•) tiR'. . • o 0
I 0 N
7,-4e - 8,-0. . W Ox2 WIOx2.:- WioKn~2 i V~
m P1 -01
2820 .0 12'-9' `W
AQi WIND, L tr-9' 11'-3• -o~'
3 ifl O 0
v 11'-4' - UP
13 R cnLon. 'JU °x ylbnx lti~ T
12T W
Y
9/ rJ O I
cri
m Z 0 a
T ~ W %
- ~ z~ !tee 3
' 0
UNDERWRITERS CERTIFICATE 4 v, Mm
REQUIRED 1D W
J C
7l ZSc I"9 - - - N
• ALA Cc7~I°s1Y.t Y~I'Cy~d "iLh 1A~~ ~ N'Y.s, p.Lb ~EY77v $icY~-x.,, Cri~S
. ~ioo P~~S,I, coNG
4 3 Z 4uVriATq-k"'F 4 . Aw CcYVC, ~v ~!N 1~151i7~P-r~P a"7~. f,~' ~ 7^~I P.Y-5
~siur~i~ f Nam VIM
~a~~?{llsl ory
A/F ?C 30 sLr1o I ~'Nf~ ~PF4Y'~ I~-~'- ~E•tQ. Fa€x_~a~~ H,=.i., -~Fr~ca.~
;I.T.wr~ F-It~aNY6 c~ ~ze~y°Z r42T -7Iw l~,y,5'fA~~°
Lb K!ITl' tPtr_RW
nc a'9~,LT1~V
• £b'x <<~' G[x~2rs~ Ccvvc , =nom ~4/ # 4 F_:rARS 1
PLUMBING s4P or
ALL PLUMBING WASTE
b WATER LINES NEED PLUMBER CERTIFICATIONi 97' O
I TESTING SEFORE COVERING ON LEAD CONTENT BEFORE OFtNE'Ny
CERTIFICATE OF OCCUPANCY
SOLDER USED IN WATER
Iyl. kr~ SUPPLY SYSTEM CANNOT
~i~ s, c • r, j EXCEED 2110 OF 1% LEAD.
copper tubing i f s used
water distributing
a> em; Piping shall be
types K or L only
48'-0" U. N T-
of 0 -e r.
W
2a'-0" J W 24'-0" /Q?
a V a IL N C
12'-0" 12'-0" 3'-71/2" 14'-101/2• 5'-6-
Of ol
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a 16" O.C. a z
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8'-8" 6'-8- (4) 2X10 HDR
_.L.._... W W
9 r Cl)
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EDGE OF B CONY ABOVE
U O
13-R 8.1 Y
4 12-T 10" J d er = W
p 3'- S° 4 i J o-0, ~u 9'-2• v z
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48'.0"
24'-0" M N o za'-o•
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3'-7" 11'-0" 5'-6' 3'-0"
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N i
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N ~iF'h1L~R61~_,i - .4
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OPEN TO BELOW DN
13R 'k- Y
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3'-71/2" 5'-4 1/2 5'-41/2" 6'-0" 5'-0• T-6" M
/ or
J O
V V V V
SIN
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N
PORCH BELOW
i
ED q R ~ Rpy~,
F OF NE'N
nnmimlus~`°
VEWED RIDOE
0112 RIDGE SID.
N ASPHALT SHINGLE ROOF
1w COX PLY.
2Xi 2 RAFTER 16' O.C. W / R-30 INS.
9115 COLLAR TIE S' O C.
a 'Q VENTED SOFFIT
T CEDAR SNINOLES OVER 7116" OSR W / TTVEK
2xmi STUDS 16" O.C. W / 141 S INS.
4 ~
ZXi RAFTER l COLLAR TIE _ r A 2ND FLR.
w
T T M
¦ T
SXS SUPPORT COL SOLID FIR
GXS SUPPORT COL.
4
F/ S V L ~4'T~ , ro
2XI O CCA .10157 & SN1• TAO DECK 1 BT FLR ( SEE PAGE 1ST FLR JOIST) W / R•11
d1 Io°/a (2) 2XS CCA SILL PLATE W / TERMITE SHIELD
ORADE
- ..,7,j LAl-L-y Crx_ I 'F j
OXi CCA COL..' O.C. W C /R=LL W / REDAN
S' O.C. NOR.
2. O.C. VER.
Z7C1'X2' FOOTING ~
RN - 1 L'"XS° FOOTING W 12 REIr c~N 2 oNrv~BP ~aryL TRF')
9411 T FOOTINGS W / RESAR MESH
KELLY SIKORSKI HOUSE CROS: :ROSS SECTION eD'A PAGE 4 OF: 9
XCALE 1/411=1'
2330 BRIGANTINE DRIVE SOUTH DUTHOLD, N.Y. N9 131 io~rE DATE r 18/94
F OF NEB
mmmu
i
-
TOP OF CHI NEY
4
a PEAK OF ROOF
TIMBERLINE SHINGLES N
iF
SOT. OF COLLAR TIES
RED BRICK CHIMNEY
1X6 CEDAR FASCIA
1X4 CORNER BRDS.
RED CEDAR SHINGLES 6' EXPOSURE
TOP OF 2ND rLR.
BOT. OF 1ST FLR CEIL
7X6 FASCIA -
6X6 PORCH COLUMN
4 m
0 0 0
PORCH RAIL WITH 7 1/2' X 1 9/2' _
BALISTERS TOP OF 1 ST FLR
7X8 PINE RISERS - u.
PAINTED WHITE - - GRADE
I
ED Aq
KELLY SIKORSKI HOUSE FRONT (WE T (WEST) ELEVATION-~ PAGE 5 OF 9
CALE 1/4" = 1'
2330 BRIGANTINE DRIVE SOUTI- OUTHOLD, N.Y. CP a Foy; DA"iE 8/18/94
qrF 02 OF NE y~``
nwmnno
i
I }
~ BRICK CHIMNEY 12 12
99
TIMBERLINE ROOF
4 Iy`1
1 X6 CEDAR FASCIA
I
i
1X4 CONER BRDS
RED CEDAR SHINGLES 6' EXP. Il~ D
I (I
1 X6 CEDAR RAKE BRD
6X6 FIR HDR.
6X6 FIR COL
-r
PINE RISERS
-r
GRADE
Ul- RADE
i
FOOTING EXTENDED T
L~
KELLY SIKORSKI HOUSE RIGHT (SOU1
. gCF' OH~.°D
;SOUTH) ELEVATION ~EDlint PAGE 6 OF 9
ALE 1/4" .1'
2330 BRIGANTINE DRIVE SOUTHI )UTHOLD, N.Y. ,roes` DATE 8/16/94
211 1
IF OF HS:
"fill
I
i
D
0
m El V
GRADE GRADE
STONE STEPS TO GRADE
EXPOSED FOUNDATION TO BE VENEERED WITH
THIN BRICK -co
GRADE
FOOTING EXTENDED T TO BE BELOW MOST
KELLY SIKORSKI HOUSE BACK (EAS (EAST) ELEVATION PAGE 7 OF 9
v (f ALE 1/4" -1'
2330 BRIGANTINE DRIVE SOUTI- OUTHOLD, N.Y. fry DATE 8 / 18 / 94
g1iF OF NEB R`°
12
~9
0
N CO
12
~4
UFTi
GRADE
(NORTH) ELEVATION Ail PAGE 8 OF 9
KELLY SIKORSKII HOUSE LEFT (NOR E 1/4" = 1'
SOUTHOLD, N.Y. .p„ o~ DATE S/ 18 / 94
2330 BRIGANTINE DRIVE SOUT ~TF OF ll
N
N ROUGH OPENING
WINDOWS DESCRIPTION
VG 2/2 T2 3/8" X 5'9 9/16"
VG 2/2 6'3 3/4" X 5'9 9/16" i
F D MARVIN WDH 3230 DOUBLE HUNG 2/j D MARVIN WDH 3230-2 DOUBLE HUNG 2/.
6'1 1/8" X 6'1 1/8"
D ANDERSEN A21-32 AWNING
TO 5/8" X 2'0 5/8" s
D ANDERSEN A21 AWNING
TO 5/8" X 6'l 1/8"
D ANDERSEN A21-3 AWNING a
DOORS DESCRIPTION N ROUGH OPENING
34" X 83" z
O MORGAN 2868 6 PANEL EXT. T. ~ . z
• 0
72" X 80"
O ANDERSEN 6068 FRENCH PA
Q
37" X 80"
O ANDERSEN 3068 FRENCH ST
MORGAN 2668 RIGHT SWING G 32" X 83" 0
62" X 83"
0 MORGAN 2668 POCKET
)OW & DOOR LEDGER D ARO PACE 9 OF 9 ~pE
KELLY SIKORSK:1 HOUSE WINDOW 2330 BRIGANTINE DRIVE SOU
SCALE 1/4" = it
SOUTHOLD, N.Y. ATE 8 / 18 / 94
y''0m 0 F NEo