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HomeMy WebLinkAbout27733-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28347 Date: 04/19/02 THIS CERTIFIES that the building ADDITION AND ALTERATION Location of Property: 1030 WEST LAKE DR SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 90 Block 2 Lot 3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 19, 2001 pursuant to which Building Permit No. 27733-Z dated SEPTEMBER 26, 2001 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 ADDITION & ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to PRESTON M. HARRINGTON III (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1040805 03/21/02 PLUMBERS CERTIFICATION DATED 04/12/02 MATTITUCK PLUMB.& HEATING Authorized Sig ture Rev. 1/81 FORM NO. 3 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) PERMIT NO. 27733 Z Date SEPTEMBER 26, 2001 Permission is hereby granted to: PRESTON. M III HARRINGTON 256 VALLEY RD MONTCLAIR,NJ 07042 for ADDITION AND ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR WITH NYS DEC & TRUSTEE' S # 5376 APPROVALS INCLUDES $100 . 00 FLD PMT. at premises located at 1030 WEST LAKE DR SOUTHOLD County Tax Map No. 473889 Section 090 Block 0002 Lot No. 003 pursuant to application dated JUNE 19, 2001 and approved by the Building Inspector. Fee $ 250 . 00 Authorized Signature COPY Rev. 2/19/98 Form No.6 U a TOWN OF SOUTHOLD 2 2NO02, i BUILDING DEPARTMENT { -.J TOWN HALL _. 765-1802 {QLD APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of I% 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. Photocopy of Certificate of Occupancy-$0.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy- Residential$15.00, Commercial$15.00 Date. LA- I New Construction: Old or Pre-existing Building: (check one) Location of Property: O 3 o w e s- ' '1 e I ki'c 5c ,�Ve Q , House No. 1 I Ptreet Hamlet Owner or Owners of Property: -� �,v ft3V r i►� Suffolk County Tax Map No 1000, Section Block Lot Subdivision Filed Map. Lot: Permit No. -] 33 Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: 1/ (check one) Fee Submitted: $ a Applicant Signatur 33y� e SBY THIS CERTIFICATE OF COMPLIANCE THE 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 BUREAU OF ELECTRICITY 5 40 FULTON STREET — NEW YORK, NY 10038 5 CERTIFIES THAT 5 5 Upon the application of upon premises owned by c5 5 PAUL R. BURNS PRESTON HARRINGTON S P.O. BOX 1061 1030 W EST LAKE DRIVE SOUTHOLD, NY 11971-0932, SOUTHOLD, NY 11971 5 Located at 1030 WEST LAKE DRIVE SOUTHOLD, NY 11971 5 SApplication Nwnber: 1040805 Certificate Nwnber: 1040805 5 5 Section: Block: Lot: Building Permit- 733 BDC: NS11 5 Described as a Residential occupancy,wherein the premises electrical system consisting of electrical devices and wiring,described below, located in/on the premises at: 5 First Floor,Outside, 5 5 5 was inspected in accordance with the National Electrical Code and the detail of the installation,as set forth below,was �j found to be in compliance therewith on the 21st Day of March,2002. Name OTY Rate Rating Circuit Type Wiring and Devices Outlet 2 Fixture 5 Switch 2 General Purpose Fixture 1 Incandescent 5 Fixture 1 Fluorescent 5 Receptacle 1 GFCI 5 Receptacle 1 20 Special 5 Receptacle 1 30 Special 5 5 S 5 5 S 5 Seal 5 1 of 1 5 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 v town Hall 20.1 a rlfll6 _r �T. J I nx (S If,) 75��-1921 P. U. now, 1tow 't tiIQulrone (515) 7r,5,-i602 Snullrolrl, r- oIk i 1971 ,� •;,/ �,�r'' OFFICE OF 7*1IE BUILDING INSPECTO1l TOWN or SOUTI (OLD G 13 R T I r I C n 'r t o r4 - DA,rr:: l D2 Pui1ding PermlL No. '' owner. : pme60 I,4ar:!_� (please print) CJ / Plumber: .��r,�IL -�- (please print) I certify (:hat the solder u:>ed lit the vwLer supply system contains loss than 2/10 of l % lead. T. i itit t";� � (4 sworn to before me this day of Notary Publics - - U(JIMLy .7� saaw term Expires Jw» �. 03/19/2002 10:17 516-765-5490 G.A.STRANG,ARCHITECT PAGE 01 Garrett A. Strang Architect 1330 Traveler St., Box 1412 Southold, New York 11971 Telephone (631:) 765-5455 VAR 2 5 29 Fax(631) 765-5490 March 19, 2002 E�L.QGDEPT. . nuTHOLQ Sent via "fax" 765 9502 Mr. Bruno Semon Southold Town Building Department Main Road Southold, NY 11971 Re: Permit #277332, Harrington Dear Mr. Semon: This will confirm our telephone conversation of yesterday in connection with the above referenced project: The area in question (Laundry/Pantry) is less than 80 square feet in floor area. Therefore, it is determined by code to be "non habitable space" requiring only a 7' ceiling height. The as built ceiling height is 7' -3" and is therefore code compliant. Thank you for your courtesy with respect to this matter. Very truly yours, Garrett A. Strang, R.A. Architect C: Bob Harrington APPLICATION # PAGE 1 of 4 TOWN OF SOUTHOLD FLOODPLAIN DEVELOPMENT PERMIT APPLICATION This form is to be filled out in duplicate. SECTION 1 GENERAL PROVISIONS (APPLICANT to read and sign): 1. No work may start until a permit is issued. 2 The permit may be revoked if any false statements are made herein_ 3. If revoked, all work must cease until permit is re=issued. 4. Development shall not be used or occupied until a Certificate of Compliance is issued. 5. The permit will expire if no work is commenced within six months of issuance. 6. Applicant is hereby informed that other permits may be required to fulfill local,state and federal regulatory requirements. 7. Applicant hereby gives consent to the Local Administrator or his/her representative to make reasonable inspections required to verify compliance. 8. I,THE APPLICANT,CERTIFY THAT ALL STATEMENTS HEREIN AND IN ATTACHMENTS TO THIS APPLICATION ARE, TO THE BEST F MY ICNO - DGE,TRUE AND ACCURATE. (APPLICANT'S SIGNATURE) DATE SECTION 2 PROPOSED DEVELOPMENT (To be comaleted by APPLICANTI NAME ADDRESS TELEPH NE APPLICANT BUILDER PROJECT LOCATION: To avoid delay in processing the application, please provide enough information to easily identify the project location. Provide the street address, lot number or legal description (attach) and, outside urban areas, the distance to the nearest intersecting road or well-known landmark- A sketch attached to this application showing the project location would be helpful. FDP(93) APPLICATION • PAGE 2OF4 DESCRIPTION OF WORK (Check all applicable boxes): A. STRUCTURAL DEVELOPMENT ACTIVITY STRUCTURE TYPE ❑ w Structure esidential (1-4 Family) [5111A 'tion ❑ Residential (More than 4 Family) Alteration ❑ Non-residential (Floodproofmg? ❑ Yes) ❑ Relocation ❑ Combined Use (Residential & Commercial) ❑ Demolition ❑ Manufactured (Mobile) Home (In Ma-nu- 0 Replacement factured Home Park? ❑ Ycs) ESTIMATED COST OF PROJECT SZ B. OTHER DEVELOPMENT ACTIVITIES: ❑ Fill ❑ Mining ❑ Drilling ❑ Grading Excavation (Except for Structural Development Checked Above) ❑ Watercourse Alteration (Including Dredging and Channel Modifications) O Drainage Improvements (Including Culvert Work) ❑ Road, Street or $`midge Construction O Subdivision (New or Expansion) O Individual Water or'SeW-cor System ❑ Other (Please Specily) After completing SECTION 2, APPLICANT should submit form to Local Administrator for review. ECTION 3 FLOODPLAIN DETERMINATION fTo be completed by LOCAL kDN1INT RATOR) The proposed development is located on FIRM Panel No. Dated The Proposed Development: ❑ Is NQJ located in a Special Flood Hazard Area (Notify the applicant that the application review is complete and NO FLOODPLAIN DEVELOPMENT PERMIT IS REQUIRED). ❑ Is located in a Special Flood Hazard Area. FIRM zone designation is 100-Year flood elevation at the site is: Ft. NGVD (MSL) O Unavailable O The proposed development is located in a floodway. FBFM. Panel No. Dated ❑ See Section 4 for additional instructions. SIGNED DATE APPLICATION # ' PAGE 3 OF 4 SECTION 4: ADDITIONAL INFORMATION REQUIRED (To he completed by LOCAL ADMINISTRATOR) The applicant must submit the documents checked below before the application can be processed: ❑ A site plan showing the location of all existing structures, water bodies, adjacent roads, lot dimensions and proposed development. ❑ Development plans,drawn to scale, and specifications, including where applicable:details for anchoring structures, proposed elevation of lowest floor (including basement), types of water resistant materials used below the first floor, details of floodproofmg of utilities located below the first floor and details of enclosures below the first floor. Also ❑ Subdivision or other development plans (If the subdivision or other development exceeds 50 lots or 5 acres, whichever is the lesser, the applicant must provide 100-year flood elevations if they are not otherwise available). ❑ Plans showing the extent of watercourse relocation and/or landform alterations. ❑ Top of new fill elevation Ft. NGVD (MSL). ❑ Floodproof ng protection level (non-residential only) Ft.'NGVD (MSL). For floodproofed structures, applicant must attach certification from registered engineer or architect. ❑ Certification from a registered engineer that the proposed activity in a regulatory floodway will not result inany increase in the height of the 100-year flood. A copy of all data and calculations supporting this finding must also be submitted. ❑ Other: SECTION 5• PERMIT DETERMINATION (To be completed by LOCAL ADMINISTRATOR I have determined that the proposed activity. A.❑ Is B.O Is not in conformance with provisions of Local Law , 19 . The permit is issued subject to the conditions attached to and made part of this permit. SIGNED , DATE If BOX A is checked, the Local Administrator may issue a Development Permit upon payment of designated fee. If BOX B is checked, the Local Administrator will provide a written summary of deficiencies. Applicant may revise and resubmit an application to the Local Administrator or may request a bearing from the Board of Appeals. APPLICATION PAGE4OF4 APPEALS: Appealed to Board of Appeals? O Yes O No Hearing date: Appeals Board Decision --- Approved? O Yes O No Conditions SECTION 6: AS-BUILT ELEVATIONS (To be submitted by APPLICANT before Certificate of Compliance is issued The following information must be provided for project structures. This section must be completed by a registered professional engineer or a licensed land surveyor (or attach a certification to this application). Complete 1 or 2 below. 1. Actual (As-Built) Elevation of the top of the lowest floor, including basement (in Coastal High Hazard Areas, bottom of lowest structural member of the lowest floor, excluding piling and columns) is: FT. NGVD (MSL). 2. Actual (As-Built) Elevation of floodproofing protection is FT. NGVD (MSL). NOTE: Any work performed prior to submittal of the above information is at the risk of the Applicant. SECTION 7: COMPLIANCE ACTION (To be completed by LOCAL ADMINISTRAMERA The LOCAL ADMINISTRATOR wcomplete this section as applicable based on inspection of the project to ill ensure compliance with the community's local law for flood damage prevention. INSPECTIONS: DATE BY DEFICIENCIES? ❑ YES ❑ NO DATE BY DEFICIENCIES? ❑ YES ❑ NO DATE BY DEFICIENCIES? ❑ YES ❑ NO SECTION 8• CERTIFICATE OF COMPLIANCE(To be completed by LOCAL ADMINISTRATORI Certificate of Compliance issued: DATE: BY: Attachment B SAMPLE CERTIFICATE OF COMPLIANCE for Development in a Special Flood Hazard Area : TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE FOR DEVELOPMENT IN A SPECIAL FLOOD HAZARD AREA (OWNER MUST RETAIN THIS CERTIFICATE) PREMISES LOCATED AT: PERMIT NO. PERMIT DATE OWNERS NAME AND ADDRESS: CHECK ONE: ❑ NEW BUILDING Cl EXISTING BUILDING ❑ VACANT LAND .; THE LOCAL ADMINISTRATOR IS TO COMPLETE A. OR B. BELOW: A. COMPLIANCE IS HEREBY_ CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 19_ SIGNED: DATED: B. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 19_1 AS MODIFIED BY VARIANCE # , DATED SIGNED: DATED: C/C(93) "t��:.��'� 's'``ue.— Y 1 �.��l.r••��� ����.�•-,.,.+ f �� 1 \�: ,,�1�,`� �; r I ,4 11 'i YL . � • . . m i'`t�1��►= � 1.1 1 1 ell . . ,�I` a��,��,1 r L ► � v� w-� t, ��.s !if'Y./�'� 1 .X,1� _ .�I �.'�Y>�/.�.1. P l..I{. � ���� ,�..•�3 ).�... � .�r 7�-•->�,/./..,yrs �> �� '�>???���.. .1 ��y�. ( •_ ••y t' �r�, �/"''-1'.�. }. . TERMS and CONDITIONS The Permittee Preston & Nancy -Harrington A =: residing at 1030 West Lake Drive, Southol , N. Y., 'as part-of the consideration for the issuance of the Permit doesunderstand and prescribe to the fol- lowing: t. That the said Board of Trustees and the Town of Southold are released from any and all damages, or A for damages, of suits arising directly or indirectly as a result of-any open, adoa pe-`tined pursuant to this permit, and the said Permittee will, at his or her ow a expense, defend any and an :rich suits'initisted by third partiM and the said Permittee assumes fall lbbility with respect thereto, to the complete'exclusion of the Board of Trustees of the Town of Southold 2. That this Permit is'vdid for s period of : 24 mm whkh is considered to be the. estimated time-requited to cunplete the work involved, but'should.driistances �rarrant, 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 Petmittee wishes to'maintain the structure or project involved, to provide evidence to anyone concetned that cath odnflon was originally obtained. 4. That the work Im olved will be subject to the inspection and approval of the Board or Its agents,. and non-compliance with.the provisions of the originating application,.maybe case for revocation of this Permit by resolution of the said Board. S. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass long the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or slteradoas . in the location of the work herein authorized, or if# in the oplaim of the Board of Tiustees, the. worlt shall cause unreasonable obstruction to free navigation, the said Permittee wlll be requirA upon duce 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 oomplettoa,of the wont auth- othed. 9. That the Permittee will obtain all other permits and consem &at may be arequiied su - plementd to this permit which may be. subject to-revoke upon failure to obtain tune. .Y ' 27 73 3 � BUILDING PERMIT EXAMINER CHECK LIST leu, ?Iulb i DATE REVIEWED: % /ak /O1 DATE SUBMITTED: 6 hat /01 APPLICANT NAME-3; Qo p- o►J SCTM# DISTRICT: 1.000 SECTION:jo BLOCK: a LOT: _ 414- vat A STREET: C Y. / SUBDIV.NAME: PROJECT DESCRIPTION: ARCHITECT/ENGINEER: _ FAST TRACK? o. SINGLE&SEPARATE CERTIFICATION-REQUIRED? -)o NOTES: LATS 40,000SF-100-24.Lot recognition.(CREATED before June 30,1983),UNDERSIZED LOTS FROM JAN.1997100-25.Merger.(A nonconfornring at any time after 7/1/83) ZONING DISTRICT: i yo CONFORMING? REQ. LOT SIZE:yo.,o0o ACT. LOT SIZE:14,125 4,9 REQ. LOT COV. ��o�o ACT. LOT COV. REQ. FRONT PROP.FRONT_:- 9. REQ SIDE L v ACT. SIDE i-,U, 3 REQ.REAR 3 S PROP. REAR -t os-) +(59.3 WATER FRONT? yL'S DESCRIPTION: L��e��c�"�, PANEL #: FLOOD ZONE: AE ��1 AGENCY PERMITS REQUIRED FOR REVIEW APPROVALS REQUIRED: SUFFOLK COUNTY HEALTH DEPT: YES oriM (BED#): DTT-E::_/ / PERMIT#:R10- ?NEW YORK STATE DEC: PRE-DEC 9/1/75 YES or(o �tle2 1�c�� �cOn. Sir«vea Ictclu, b� �t1 �/�e� SOUTHOLD TOWN TRUSTEES: E 1)(obIN 'T rinn�-r # 53 ? 1'TOWN ZONING BOARD APPROVAL: YESTOWN PLAN. BOARD APPROVAL: YES TOWN HISTORICAL PRE (SPLIA): YES NYS ENERGY: YES OR NO EGRESS (18 H min.?4 sq total) n/4 VENT(SQ.FT. x 4%) ,v/A LIGHT(SQ. FT. x 8%) BUILDING PERMITS OPEN/EXPIRED: BP -Z/C/0 Z- , HAVE PRE CO'S :Y OR N BP -Z/C/0 Z- , NOTES: J rr 7'0 ✓""i� af4! s OIC! S 43 /5 I-Af 7`' S<G FEE STRUCTURE: FOUNDATION: FY SF �� <<( /-r� FIRST FLOOR : I ?-5 SF A,!�_3 SECOND FIR : SF INIT OTHER TOTAL TOTAL: F FEE FEE FEE 3�7 ,,,.�.s� OT / SF)-(_-- SF)= — SF X$ =$ +$ /So +$%O C, =s f 944 �*tAe ry ,k oK FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077 NATIONAL FLOOD INSURANCE PROGRAM Expires July 31, 2002 ELEVATION CERTIFICATE Important: Read the instructions on pages 1 -7. SECTION A-PROPERTY OWNER INFORMATION For Insurance Company Use: BUILDING OWNER'S NAME Pohcy Number Nancy. S. and ,Preston M. Harrington .III BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company:NAIC Number CITY STATE ZIP CODE Southold, NY 11971 PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) 1000-96-02-01 BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use Comments section if necessary.) Residential LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: IJ GPS(Type): ( W-#V-##.W or ##.###I#1 LJ NAD 1927 I—I NAD 1983 LI USGS Quad Map I—I Other: SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP COMMUNITY NAME&COMMUNITY NUMBER B2.COUNTY NAME B3.STATE Southold 360813 f Suffolk I New York B4.MAP AND PANEL B5.SUFFIX B6.FIRM INDEX B7.FIRM PANEL B8.FLOOD B9.BASE FLOOD ELEVATION(S) NUMBER DATE EFFECTIVE/REVISED DATE ZONE(S) (Zone AO,use depth of flooding) 3610300169 G M—r 4 199 AE El. 8 B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in B9. "FIS Profile fJJ FIRM JJ Community Determined J_J Other(Describe): B.11.Indicate the elevation datum used for the BFE i0.B9:4 NGVD 1929 IJ NAVD 1988 JJ Other(Describe): B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? LJ Yes LJ No Designation Date: SECTION C-BUILDING.ELEVATION INFORMATION(SURVEY REQUIRED) C1. Building elevations are based on: UConstruction Drawings* J_JBuilding Under Construction* IKJFinished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number 2 (Select the building diagram most similar to the building for which this certificate is being completed-see pages 6 and 7. If no diagram accurately represents the building,provide a sketch or photograph.) C3. Elevations—Zones Al-A30,AE,AH,A(with BFE),VE,V1430,V(with BFE),AR,ARIA,AR/AE,AR/A1-A30,AR/AH,AR/AO Complete Items C3a-i below according to the building diagram specified in Item C2. State the datum used. If the datum is different from the datum used for the BFE in Section B,convert the datum to that used for the BFE.Show field measurements and datum conversion calculation. Use the space provided or the Comments area of Section D or Section G,as appropriate,to document the datum conversion. Datum Conversion/Comments Elevation reference mark used Does the elevation reference marls used appear on the FIRM? 1_J Yes W No ❑ a)Top of bottom floor(including basement or enclosure) 5 .5 ft.(m) ,3F NEw ❑ b)Top of next higher floor 12 .3 ft.(m) �F. Y C3 c)Bottom of lowest horizontal structural member(V zones only) _ft.(m) m SSP ,'T- "'WriQ �'pf 0*C3 d Attached garage(top of slab) ft.(m) 1s�9' ❑ e)Lowest elevation of machinery and/or equipment _ w servicing the building 5 .5 ft.(m) 9 z� ❑ 0 Lowest adjacent grade(LAG) 9 . ft.(m) O ❑ g)Highest adjacent grade(HAG) 1 0 .5 ft.(m) ❑. h)No.of permanent openings(flood vents)wtthin 1,it,.,above adjacent grade NO 496 J�' O i)Total area of all permanent openings(flood vents)in C3h sq.in. (sq.cm) AND S SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION This certification is to be°signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information. 1 certify that the information in Sections A, B,and C on this certificate represents my best efl'orts 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. CERTIFIER'SNAME John T. Metzger, L. S. LICENSE NUMBER 49618 TITLE President COMPANY NAME Peconic Surveyors , P.C. ADDRESS P.O. BOX 909 CIN Southold STATE NY ZIP CODE 1 1 9 7 1 SIGNATURE DATE 05/02/01 TELEPHONE ( 631 ) 765-5020 FEMA Form 84FIA,AUG 99 v SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS 6� 7x ,33 - - BUILDING DEPT. INSPECTION [ UN TION iST [ ] ROUGH PLBG. OUNDATION 2ND [ ] INSULATION [ j FRAMING [ ] FINAL [ ] FIREPLBCRIMNEY REM Cl i DATE !/ IN8PECT0 c;� ? 733 765-1802 BUILDING DEPT. INSPECTIO [ ] FOUND ON IST [ GH PLBG. [ ] F DATION 2ND [ J INSULATION FRAMING [ ] FINAL [ ] FIREPLACE & HIMNEY REMARKS: ce.J DATE � � � IN8PECT ;2--7 3 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] RO N PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ j FINAL [ ] FIREP & CHIMNEY REMARK DATE INSIDE M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [X] FINAL - [ ] FIREPLACE & CHIMNEY REMARKS- jv DATE -?//9/0L INSPECTORL� ; -7 7 3 ,3 16�' M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 ULATION [ ] FRAMING Ab [ FINAL [ ] FIREPLACE & CRIMNAz� REMARKS: ��� DATE 2--�, N8P Fri i rWill E 1 li t + 1 1 I `:� _ �� �.✓_<_ � - �_ ? _ ice!/� iii `, i , lyFs T � N S , q / N h / qt'po, 0' % at t 3 r '' SURVEY OF N y. 757 0 1Ip• L hSP =M♦ �g L OT 116 CEDAR aEi4CH PARK " lti �2. 96 FLED MC 24M7 AE Na 80 .a o ti AT BA YV/EW �8 3 , TOWN OF SOUTHOL D zop ,, (� SUFFOLK COUNTY, N. Y. c. ® nor 1000 - W - 02- 03 z ti ® Scale. 1"= 20' q Sept. 5, 1996 \- \_/ M s (e� cay Z, 2GU' (e/evaf,o-2_5J 9 S o* 23�0`!Y wooer � t � �• Z . � o` CERTIFIED TO* PRESTON AL HARR/NGTON, 111 sf NANCY S. HARRAVGTON 9 �. �. ao 99s, C �oF NEW y Q w'/ ELEVATIONS ARE REFERENCED TO N.G.V.D. `P� S. METIG 9�j ,Y ^ R f[oao t4pNE F&CM F/2^ (� o 3G.Io3ColGj G MAY 4, 1998 �` ) ANY ALTERATION OR ADDITION TO TMS SURVEY IS A VIOLA MN 1 OF SECTION 7209 OF TIE AEW YORK STATE EnUCA770N LAW � _ QL- EXCEPT AS PER SECT)MV 7209-SL6DI MON 2 ALL CERriFrCA;/TONs _ LIC. NO. 496!8 MWOM ARE VALD FOR TMS AAP AND COPIES TAEREOF ONLY F e SAD AAP OR COPES BEAR TAE APRESSED SEAL OF TAE SURVEYOR WHOSE Sb'yM MW APPEARS IEREOK PcC C. (G3/1 PW (63/) 765 - 1797 AREA = 10,921 sq.ft AONWIVALLY O COWL rp TH SW LAW TrWE�M'AAr R BY' P. o. BOX A"T BE USED BYto tie line OF ANOT ER "VEYORT AAP. rOW SUCH AS %WfCTED'AAD /230 TRAVELER STREET WOLW rr-ro HATE- ARE NOT ry COAPLUNCE W7W TW LAW. SOUTHOLD, N.Y. 11971 96 - 216 REOUIRED- —� PLUMBING APPROMASNOTM PROVIDE OPENINGS FOR ALL PLUMBMH#tlVNSTE ,¢f DA o, s7 3a� OCCUPANCY OR EMERGENCY ESCAPE AS aWATEFlu Et NEED FLOOD ��1M USE IS UNLAWFUL TESTINGB ECOVERING 00I PLYWITHICHAPTEFt o .oe m REQUIRED BY PART. 714 OF /b RMDIyAEEAGEPR6VENTI= NOT EmLDIN 3 DEFARTME TAT WITHOUT CERTIFICATE N.Y. STATE BUILDING CODE. A'a ' YAWN CODE 785- 004 0 AN TO�4 PM FOR THE OF OCCUPANCY - - - - --- - - - -I T�;""P�.�i2T HYj;'� --------- FOU -- . NGINSPECTIONS: I - t. F UNDATION • TWO REQUIRED ', '� "*�"`S:iC: W;. v 'BG'JK.f7' �.xtT;.•I' -air"- .rt�>p"e.r v - F RPOUREDCONCREIE PROVIDE SMOKE-DETECTING I f i /3 W I - " Y.?'.. .k . " Q. Ya 2 R UGH • FRAMING t PLUMBING ALARM DEVICES ¢ 11 i I lSlr" 71 !7S, 3ES�A5. 4 F nL�-ON MOST PROVIDE ANTI-SCALD ARD/011 AS TO PART.G CO B coMPLETEFORC.o. THERMAL'SHOC N.Y.S'BUILDINGCODE. c I ALL CONSTRUCTION SHALL MEET . . ; ,� �' , _ , "^"` � • ¢������������ TH REQUIREMENTS H THE N.Y. 3= t s t tE. 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