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Home My WebLink About28861-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buitdin9 Inspecuoz Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-29998 Date: 02/04/04 THIS CERTIFIES that the buildin9 NEW DWELLING Location of property: 10605 SOHI~DVIEW AVE (HOUSE NO. (STREET) (H~J4LET) County T~x Map No. 473889 Section 54 Block 5 Lot 37.3 S~bdivision Filed Map NO. Lot No. __ SOUTHOLD conforms substantially uo the Application for Building Permit heretofore filed in this office dated OCTOBER 15, 2002 pursuant to which Building Pe~rait No. 28861-Z dated OCTOBER 25, 2002 was issued, and conforms uo all of the requiremenes of the applicable provisions of the law. The occupancy for which this certificate is issued is ONE FAMILY DWELLING WITH COVERED FRONT PO~CH, REAM DECK, SCREENED PORCH AND ATTACHED TWO CAR GAP-AGE AND kTTACHED ONE CAR GARAGE AS APPLIED FOR. The certificate is issued to WILLIAM F & ELIZAMETB R SMITH (OWNER of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ~10-99-0224 ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DAT~u Rev 1 81 10/29/03 1153384 02/02/04 01/26~ 04 WILLI~d~ SCP~AUB FORM NO. 3 BUILDING DEPARTMENT Town Hall Seutheld, N.Y. THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES COMPLETION OF THE WORK AUTHORIZED UNTIL FULL PE~IT~NO. 28861 Z Date OCTOBER 25, 2002 Permission is hereby granted ~o: WILLIAM F SMITH 20 EAST 14TH ST HUNTINGTON. NY 11746 for : CONSTRUCTION OF A NEW SINGLE FAMILY DWELLING WITH TWO CAR GARAGE REAR SCREENED PORCH, DECKS AND COVERED FRONT ENTRY AS APPLIED FOR PER TRUSTEES at premises located at 10605 SOUNDVIEW AVE soUTHOLD County Tax Map No. 473889 Section 054 Block 0005 Lot~No. 037.003 pursuant to application dated OCTOBER 15, 2002 and approved by the Building Inspector to expire on APRIL Fee $ 2,031.90 25, 2004. Rev. s/8/02 COPY A]PPLICATION FOR CERTIFICATE OF OCCLWANCY 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 properw with accurate location of all buildings, proper~y liaes, streets; and unusual natural or top'ogr~ph}c fea-tures. -. 2.~ Final ApPrpVal from Health D ¢pt ; .... ~. ofwater su pp. 1 y and sewera g e-dj sp osal ( S-9fo rna). · : .~pl;¢~,. os ~k,,.~.~ca ..... ta,.,.I,.,fi,, ,B,,..(,o.F, ,I !:,.,",,:nters. 4d Sv ,' s e c " :,,t ,"c,' "i' ,; ', :"t c i t'emc ' ' lead. , . · .................. rt sys. ontams less than 2/10 o£1% (,on:mci:?,[[ bu:Idmg, mdm;i!',',u I~::.,h:v. [,':'.il~:l~l. [v.,m: n~x:,, and similar bmldings andqnstallations, a eertific, ate ( ¢(c( ;.~ ' , : . · · ' · ,o - , il ,..I.,It ~. t , ~.,:,..I,~,~, I..,I.~ ,!-IOIt. ,:rr ttiebuil~nm 6. S * t ' ~ '" k 'd k ' '~ ',' ; I'cd ii *' . . . ·: .... 1, ..... ~ ....... I I,. I I~t .~tremerJt8. B. Fp:r,, ~ [ $a:0£. pHI 9, 1957): non_c0nf~ol:ming ~seh or buildings and ,.pre.existin~. laird llses: . i. ~bo-,¥~g ~I property l/nes,· streets~ ~m!ding and uausualnatural or topographic ' z. .x. .mo., .~""~"t"qmm't?d'::.: · : ~ . ~ , · , ,,;: and a consent to. , respect sig~edbythe avvlicant is domed ~h?l~uqd,',!( In:,m'c,l.~ shall state, the reasons therefor,in~tingto the a6Micant . ~Y. C. Fees 'I ~' S:~ ~ ~p .,';L'.O0 .,\ccc,. ~Thr-l~mr-eoqoo \ddt ~r qtoaecesso~,~buiMl,~,~>qna n--;-~. 3 P: O<Ol},.:[q'('d':l '¢ co cc' oano¥~$025 4. [ !,,:,b~d~.,c,..c, fo.,,, ,,,k',':, ';:.i:":- $50.00 '~ ;, . · 5. [c~ '";:i" ,{. c.,mt';, ;,,, ¢ c 'i' '~cy- Reside'ntafil $15 00 Commercial$t500 Old or Pre-eXisting Building: c/'T.' ." "' ' I.t..'ali, m.ol' 'i..q·9(,,,. t2 t,--..) '~h 0bt'"l t.l V' .... ., I I.;,..,.'.,..,,, No. :,.,.. o....:.,,~ ~.. ,,~...,..,':.',, ,?.,,..:,. F' C'. [~Ca- 2¢;::k. Final Certificate: i/~(c~eck one) Jan ~G 04 O~:llp W & E Town of Southold BUilding Department Town Hall $oUthold, New York, 11971 Re t060S ~mmdview Ave o PERM~ # 2886'IZ January ~, 2004 To whom it may concern: My name is William smith; I am the future homeowner of the house at 10605 Soundview Ave, Southeld. I am writing this letter to state that a walkway will be completed at tho said location. Upon the completion of the walkway, I am assuring you that all the ground level risers will be equal to the rest of the steps. Thank you for Your attention on this matter Thank you, //,,,//" . William smith Fax (516) 765-1823 Te~eonone f51E 765-I802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E RTZ F I CAT I 0 N Buildino Permit NO. C:~OC-~-~ /-~. Plum~er: (please print) (please print) I certi~y that the contains less than 2/10 solder used in the water supply sysnem of 1% lead. (Plumiae s~ S~~ Sworn tc before me this da , of Notary Public Counuy SAAM JALAYER NOTARY PUBLIC, STATE OF NEWYORK QUALIFIED IN SUFFOLK COUNTY NO. 01JA6082854 BY THIS CERTIFICATE OF COMPLIANCE THE YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by FULTON ELECTRIC INC. 8'1 WINDSo~ PLA~E CENTRAL iSEIPi NY 11722, MANZI HOMES PO BOX ~02 ROOKY ~oiNT NY 11778 Located at Section: Described as a SOUND ViEW 5 SOUTHO; D, NY 11971 1153384 Block: Lot: Residential CertificatecNumber:- I153384 Building Permit~,886~12 BDC: NS11 occupancy, wherein the premises electrical System consisting of s and wiring; described below, located in/on the premises at: Basement, First Floor, Second Floor, Attached Garage, Outside, Attic, was inspected in accordance with the National found to be in comptiancetherewith on the 2nd Alarm and Emergency Equipment Sensor 2 Sensor 5 Electrical Code and the detail of the installation, as set forth below, was Day of February, 2004. Rathe Rating Circuit TYpe 0 Carbon Monoxide 0 Smoke Exhaust Fan Air conditioner Wiring and Devices Switch Fall 1 0 1.2 KW 5 0 F.H.P. 2 0 24.000 BIIJ 1 0 18.000 BTU 1 0 30.000 BTU 2 0 Oil 78 0 GeneralPurpose 77 0 Gener~Purpose 72 0 ~candescent 17 0 Fhorescent 1 0 20amp Laundry 1 0 30amp Dwer 60 seal Continued on Next Page 1 of 2 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. BY THIS CERTIFICATE OF COM~PLIANCE THE NiEW YORK BOARD OF FliRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET ~ NEW YORK, NY 10038 CERTIFIES THAT Upon the appliCation of upon premises owned by FULTON:ELECTRIC INC MANZI HOMES 6:1 wINDSoR PLACE PO BOX 702 CENT~L !SLIP; NY 11722~ RQCKY POINT, NY 11778 Located at SQUND V,!EW 5 I'~Y ~d971 SODTHOLD Application Number: 1153384 Certificate Number: 1153384 Section: Bock: Lot: Building Permit;'886~'2z ] BDC: NS1 1 Described as a Residentia! occupancy, wherein the Premises electrical system consisting electriCa~ devices and wiring, described below, located in/on the premises at: BaSement, First Floor, Second Floor, Attached Garage, Outside, Attic~ was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was found to be in compliance therewith on the 2nd Day of February, 2004. Nm'ne Q~/ Rate R_afin~ Circuit GFCI Circuit Breaker 1 0 20 amp R~ceptacle 23 0 GFCI Service i Phase 3W Service Rating 300 Amperes Service Discom~ect: 2 150 cb Meters: 1 · seal 2 of 2 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. BY'tHIS CE,~.TIFiC,t',TE OF COMPLIANCE THE NEVq YORK BOARD OF FIRE UNDER qRITERS BUREAU OF ELECTRICITY 40 FULTON STREET ~ NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by FULTON, ELECTRIC INC. MANZI HOMES 6-l WINDSOR PLACE pO BOX 702 CENTRAL SL P; NY 11722, ROCKY POINT, NY 11778 , Located at SOUND VIEW 5 10605 SOUNDV EW AVE SOUTHOLD, NY 11971 Application Number: 1153384 Certificate Number: 1153384 Section: Block: Lot: Building Permit;,8861Zz BDC: NS11 Described as a Residential occupancy, wherein the premises electrical system consisting electrical devices and wiring, described below, located in/on the premises at: Basement, First Floor, Second Floor, Attached Garage, Outside, Attic, was inspected in accordance with the National Bectricat Code and the detail of the installation, as set forth below, was foUnd to be in Compliance therewith on the 2nd Day of February, 2004.. QTY Rate Rating Circuit T,Fpe Name Miscellaneous I000~54-5-37.3 Alarm and Emergency Equipment S~nsor 2 0 Carbon Monoxide Sensor 5 0 Smoke Appfi~anees and-Accessories Dish Washer 1 0 1.2 KW Exhaust Fan 5 0 F.H.P. Air CondSfioner 2 0 24.000 BTU Air Cond/tioner 1 0 18.000 BTU Air'Conditioner 1 0 30.000 BTU Furnace 2 0 Oil Wiring and Devices Receptacle 78 0 General Purpose S'~vitch 77 0 General purpose Fixture 72 0 Incandescent Fixture 17 0 Fluorescent sea/ Receptacle 1 0 20 amp Laundry on Next Page 1 o£ 2 Continued This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location mdi~cated. BY THiS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 4-0 FULTON STREET - NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by FULTON ELECTRIC INC. MANZI HOMES 6i WINDSOR PLACE PO BOX 702 CENTRAL ISLIP, NY 11722, ROCKY POINT, NY 11778 Located at SOUND VIEW 5 10605 SOUNDV EWAVE SOUTHOLD, NY 11971 ApPlication Number: 1153384 Certificate Number: 1153384 Section: Block: Lot: Building Permit;.8861Zz BDC: NS11 Described as a Residential occupancy, wherein the premises electrical system consisting electrical devices and wiring, described below, located in/on the premises at: Basement, First Floors Second Floor, Attached Garage, Outside, Attic, was inspected in accordance with the Nationai glectrical Code and the detail of the installation, as set forth below, was found to be in compliance therewith on the 2nd Day of February, 2004. Name QTY Rate Ratin~; Circuit Type Receptacle 1 0 30 amp Dryer Paddle Fan 6 0 GFCt Circuit Breaker I 0 20 m-ap Receptacle 23 0 GFCI Service 1 Phase 3W Service Rating 300Amperes Service Disconnect: 2 150 cb Meters: 1 ~ seat : 2 2 This certificate may not be altered in any way and is validated only by the presence of a raised seal at ~ location indicated TM ?.,~T /~_~_~_.~ ~ O.WN OF. S~.~T. HOh~ .PR_OP~RTY ~KECC)RD CARD OWNER STREET ~'~7)~ c,l,,~') ,VI~GE DIS:I:. SUB. LOT ~ ~ ~'Oa~ ~7~ S W ' WPE Of BUILDING RES. S~S. VL. ~// FARM COMM. CB. ~ MICS. Mkt. Volue ~NO IMP. TOTAL DATE 'REMARKS ~ F I '7"- ;' '' " ~' ' t i · Tillable ' FRONTAGE ON WATER W~l~nd FRONTAGE ON ROAD ~ ~ ~/~.~: ~/q~ Meodowlond DEPTH ' ~Z 0 / Totel New York State Depart]. of Environmental Conservati,. Building 40- StJNY, Stony Brod~T~ew York t1790-2356 Telephone (616) 444-0365 Facsimile (S16] 444-0373 ?.,RESHWATER WETLANDS - NON JURISDIC'T[ON 14, 1999 Mr. John Prlzeman JP Modular Homes Inc. 131 Hicks Street Brooklyn, NY 11201 ~e: Application ~1-4738-02421/0000t Prizeman Property 10605 Soundview Avenue, $0uthold, SCTM I000-54-5-37.3 Dear Mr. Prizeman: In response to your request for a freshi~aterwetland determination for the property identified above, the New York State Department of Environmental Conservation has determined that: The parcel is more than 100 feet from reg~hlated, freshwater wetlands. Therefore, no permit is requ/redtznder the Freshwater Wetlands Act (Article 24 of the Enviror~ental Conservation Law). Th/s determination may be subject to modifications due to o hangs in eavironm,antal conditions, a revision tn'the law or new information etc. 'We suggest that you retain this document along with other documents related to this prOpe~rty. Please note that any additional work may require authorization by this Department. Please contact this office if such are contemplated. Please be further advise~ that this letter does not relieve yo~ of the responsibility of obtaining any necessary permits or approvals from other agencies. Sincerely, Permit Administrator cc: ~. Teatom Bureau of Habitat ' John C. Ehlers Land Surveyor ~k ........... ~/.F-'%~ ,~'~, (631)369-8288 Phone il7-.- !:.! ~:~ ~ i~ r;;~ iL~ i~,~ (631i369-8287Fax August 14, 20~1, Mr. Michael Verity Town of Southold Building Department Southold_ NY 11971 Dear Mr. Vedty: We have performed surveying services 0ursuant to the request of Mr. & Mrs. Smith. building oermit applicants with vacant land on Soundview Ave. in Mattituck. The Smith s asked us to obtain set back distances of their neighbors within 300' of their property on Soundview Ave. Our findings in the field are as follows: in a southwesterly direction toward Dogwooc Lane. there are two dwellings within 300' of the subject property along Soundview Ave. The adjacent nome under construction has a set back from the road of 40.2'. The home of Marcelo Sehons on the comer of Dogwood Lane and Soundview Ave. has a set back of +/- 15'. In a northeasterly direction from the subject property there is one dwelling within 300' along Soundview Ave., the home of Vincent Carnag~e which has a set back of 29'. The average set back of these three dwellings is approximately 28'; please advise as to the impact of our findings an Mr. & Mrs. Smith's proposed house set back. If you need further information or have any questions, please don't hesitate to contact this office. Regards, Land Surveyor cc: Mr. & Mrs. Smith Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda Town Hail 53095 RouTe 25 P.O, Box 1179 Southold, New York 11971-0959 Telephone f631) 765-1892 Fax '631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD November 26, 2001 Mr. & Mrs. William Smith 20 East 14m Street F£antingmn Stalion, NY 1174~ SCTM# 1000-54-5-37.3 10605 Soundvie~v Avenue, Southold, NY Dear Mr. & Mrs. Smith: The following action was taken at the Southold Town Board of Trustees Regular Meeting on November 20, 2001 RESOLVED, that the Southold Town Board of Trustees grant a one year extension to Permit #5100. for a new footprint oft he house, including a porch, deck and garage~ and to bring in fill to regrade fi.ont yard and structural fill for foundation, with the condition that hay bales are placed 20' fi.om the deck during construction and gutters and drywells are installed to contain all roof run off alt in accordance with survey dated September 1, 1999 and last revised Augusz I7. 2001. However. this determination is not a determination from any other agency. If you have any questions, please contact our office at 765-1892. Sincereiy, Albert J. Krup~. President, Board of Trustees AJK/cjc Building Department Board Of Southold Town Trustees SOtJTHOLB, N,~W YORK ~ of New Yer~ [952; a~ ~e ~ ~ O~flce ~- d ..... SUb,hold ............. . .......... ~ Y. and. ~jee~ ~ ~e ef ~ To~ T~es a~e end ~ ~e P~nnit Nulnber CheokedBy/Date Proposed New York State EnergY Conservation Construction Code IvlECcheck Software Version 3.3 Release lb Data filenam~. Untitled IIfLE: Smith Residence COUNTY: Suffolk STATE: New York HDD: 5750 CONSTRUCTION TYPE: Detached 1 or 2 Family IJEATING TYPE: Non-Electric DATE: 05119/02 DATE OF PLANS: 8 / 19/02 PROJECT INFORMATION: Smith Residence 10605 Soundview Ave. $outhold, NY COMPLIANCE: Passes Maximum UA = 515 Your Home = 368 28.5% Better Th~n Code Gross Gla~ing Area or Cavity Cont. or Door Perimeter R-VaIne R-Value U-Factor UA Ce'ding 1: Fiat Ce'Ring or Scissor Truss 2110 30.0 0.0 73 Skylight 1: Wood Frame, Double Pane with Low-E 19 0.320 6 Wall 1: Wood Frame. 16" o.c. 2754 19.0 0.0 152 Window 1: Wood Frmme, Double Pane with Low-E 180 0.340 61 Door l: Solid 40 0.200 8 Floor t: All-Wood Joist/Truss, Over Unconditioned 8pace 2060 30.0 0.0 68 COMPLIANCE STATEMENT: The proposed building represented in this document is consistent with the have been designed to/me~t ~ New York ~ Energy ~on Construction Code rt~qffiremants. T~b le I: Minlmm~ lnsula~on Thiclme~ for Circula~ Hot 14rot~ Pipe~ Insulation Thicknes~ in Inches IoV Pipe Sizes Heated Water Non-Circulating Pamouts Circulating Mains and Runouts Temveramm (Fl Upto 1" Up to 1.25" 1.5" to 2.0" Over 2" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 10(Yq30 0.5 0.5 0.5 1.0 Table 2: Minhnum Insulation Thlckness for HVAC Pipea Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping Svstem Types Range(F) 2"Runonls l"andLess 1.25"to2" 2.5"to4" Heating Systems Low Pressure/Tempeiam~ 201-250 1.0 1.5 Low Temperature 120-200 0.5 L0 Stes~n, Conflensale (for feed water) Any 1.0 1.0 CooFmg Systems Chilled Water, Refrigerant, 40-55 0.5 0.5 and Brine Below 40 1.0 1.0 1:5 2.0 L0 1.5 L5 2.0 0~75 1.0 1..5 1.5 NOTES TO YIELD (Building Department Use Only) SMITH RESIDENCE / SOUTHOLD, NY New York State Energy Conservation Construction Code General Notes: 1. Floors: All floors over outside air or unconditioned spaces to have R-19 insulation. 2. Air Leakage: Joints, penetrations and all other such openings in the building envelope that are sources of ak leakage shall be sealed. Recessed lights must be Type IC rated and installed with no peneirations, or Type IC or non - IC mmd installed inside an appropriate ak-tight assembly with a 0.5" clearance from combustible materials and 3" clearance fi.om insulation. 3. Vapor Retat'der: Required on the warm-in-winter side of all non-vented framed ceilings, walls, and floors. 4. MatelqalS identification: M~tterials~ and equipment must be installed in accordance with the manufacturer's inst011ation instruc~ons. ~ats.gnd equipment must be identified so that compliance can be determined. Mamffaeturer manuals for all installed heating and cooling equipment and service wat~heatingequipment must be provided. Insulation R values and glazing U- factors must be clearly marked on the building plans or specifications_ 5. Duct insulation: S~PPly dur~ts in unconditioned attics or outside the building must be insulated to 1'.-8. RetUrn ducts in unconditioned attics or outside the building must be insulated to Supply ducts in unconditioned spaces must be insulated to R-8 Rc~rn ducts in unconditioned spaces (except basements) must be insulated to R- 2. Insulation is not required on return ducts in basements. 6. Duct Construction: All joints, seams, and connections must be securely fastened with welds, gaskets, mastics (adhesives), mastic-plus-embedded-fabric, or tapes. Duct tape is not permitted. Exception: Continuously welded and locking-type longitudinal joints and seams on ducts operating at less 2 in w.g. (500Pa). Ducts shall be supported eve~/I0 feet or in accordance with the manufacturer's instructions. Cooling ducts with exterior insulation must be covered with a vapor retarder. Air filters are required in the return air system. The HVAC system must provide a means for balancing ak and water system. 7. Temperature Controls: Each dwelling unit has at least one thermostat capable of automatically adjusting the space temperature set point of the targes~ zone. 8. Fireplaces: Fireplaces must be installed with fight fitting non-combustible fireplace doors. Fireplaces must be provided with a source of combustion air, as required by the Fireplace construction provisions of the Res~en~ial Code of lVew I~ork Stat~ Service Water lteating: Water heaters with vertical pipe risers must have a heat trap on both the inlet and outlet unless the water heater has an integral heat trap or is part of a circulating system. Insulate circulating hot water pipes to the levels in Table I. 10, Cn'culating got Water System: ~l~.~ate C~ltot ~vater pipes to the levels in table 1. 1I. lte~g and Coo~ PiPing Insulation: FF~rAC piping cenveying fltfids above 105 degrees or chilled fluids below 55 degrees must be insula'ted to the levels in Table 2. ¸9. BUdDiNG pE~ E~NER CHECK L~T APPLICANT: t.D;~W, <:~-a~ru-~ (k~kDr~ SCTM# DISTRICT: 1,000, SECTION: ~ , BLOCK: ~ LOT: ~-~.~ DATE REVIEWED: Io/iq/, DATE SUBMITTED: Io /I~/~ STREET ~.DDP~SS: mac/s ~ CITY: ~:~oon~. ~ SUBDrVISION: STrUATED PROJECT COST:Co. FAST 81NGLE & SEPARATE CERT1F][CATION-REQUIRED? NOTES: LOTS 40,000SF -100-24. Lot recoffait/0n,(CKEATBD before June 30, 1983), DI,~DBRS[ZED LOTS FROM JAN. 1997 100-25, Merg~;(A nonconforming at arty time a:[~cer ZONING DISTRICT: ~-q~ CONFORMING? REQ; LOT SIZE: ~,~oo ACT. LOT SIZE.~ REQ. LOT COV. ~O~o ACT. LOT COV~ REQ: mONT ~o PROP. FRO~. ~N~'q~_~/~3~Q SInE ,~' }'~ A~T. SID~~ REQ. :REAR ~, prop. RE~ ~' REQ. HEIGHT PROP. HEIGHT WATER FRONT? ~1o DESCRIPTION: APPROVALS REQUIRED SUn~OLK comrr¥ m~-*.r~ DEPr: ~ o~ NO, 0~ED #): 2~ CTE: t /$~/o* rEPeaT #:m0- '~ TOWN SEPTIC RECE1PT:(~or N mW ¥OP.~: STATE DEC: ~.~=~,..~orNO m~ SOUTHOLD TOWN T~USTEES: ~orN~O dC/_. Z~*0o~ TOWN ZONING nO~r) APPROVAL: XES or ~ 3~. TOWNPLAN. BOARD APPROVAL: XES ort~> TOWN HISTORICAL PRE (SPLIA): XES or(~ m~s ~mROY: ~aNO: ~,.h% + EGRESS (18 H mira? 4 sq total) VENT (SQ. FT. x 4%). BIYlLDING PERMITS OPEN/EXPIRED: BP~-Z / C/0 Z- ItAVE PRE CO'S: Y OR N BP ~Z / C/0 Z- NOTES: LIGHT (SQ. FT. x 8%). FEE STRUCTURE: FOUNDATION: ~:~, O ~ ~ SF FIRST FLOOR: 9 ~ '~-O"5~ SF SECOND FLOOR: 5~ff cf SF OTI-~R: SF TOTAL: SF 2. ( SF): ( . SF)= SF X $~30 =$ ~_~ i .q0_ +$ SF x $ =$ +$ INIT OTHER TOTAL FEE F~/ -_~ STATE OF NEW YORK ) ) SS: COUNTY OF SUFFOLK ) , being.duly sworn, deposes and says: That depon~, is 9v~ the age of 18 years and ~e~des .at ~at on the ~ day of ~', ,200~ depcnent arc~itec~engineer, licensed by the State of New YoN, hereby states that s/he accepts fall responsibility for the accompanying plans compliance with the New York State Fire.Prevention And Building Code (9 NYCRR);I said plans pertain to property I(~cated at SCTM# 1~00- ~:,'.~' "T 5 -- , street address -/O~r ArchitectJEngineer Swgm to before me;,this -5~'-"day of hl ~' -,).4u~L ,2002f. Rotary ~ublic BARBA~ MULLER ~TARY p U BLIC, ~t~?~ Yo~ No. ~MU Q~ified i~ Suffoik ~oun~ Commission ~ires ~nl ~, cc:: ~plicant ~ 765-1802 BUILDING DEPT. INSPECTION [ _]~ST [ ] ROUGH PLBG. [ ~'~OUNDATION 2ND [ ] INSULATION i ]] ~i~iMNEY[ ]FINAL DATE///~//~-~ INSPEC~O 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHI_MNEY INSPECT~ 765-1802 BUILDING DEPT. ~) "IDANT SPECTION [/]/~OU ION 1ST [ ] ROUGH PLBG. ~FOUNDATIoN 2ND [ ] INSULATION [ ] FRAMING · [ ]FINAL [ ] FIREPLACE & CHIMNEY REMARKS: INSPECTOR 76S-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ~~OUGH PLBG. [, ]~UNDATION 2ND [ ] INSULATION [ P']~RAMING [, ] FINAL [ ~FIREPLACE & CHIMNEY REMARKS~: ~~~ ~-~ ~_~. DATE INSPECTOR~~~ BUILDING DEPT. INSPECTION [[ ] FOUND~t'ION,., 2ND [ .~JNS'~TION ~/~[ ,~aI~MING~ ~ [ ]FINAL [ ] FIREPL~ ~HIMNEY INS 765-1802 BUILDING DEPT. [ ~:~I~OUNDATIO I [ ] O PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ]FINAL [ ] FIREPLACE & CHIMNEY REMARKS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGHP//~j-~ [ ] FOUNDATION 2ND [ ~]~TION [ ] FRAMING [~]/~INAL [ ] FIREPL~//~//~M~ INS DA · co s FOtRYDATION (1ST) FO1., ~, P, ATION R()L.('; [1 YRA_'~IING & PI I.'31BI.'NG I%',11.A'I I0~, PER .\. Y. .','I'A'I 1~. I'\ERGY COI)l.' FLNAI. ,er, ., / /7, ADDITIONAL COMMENTS 'I'OV~'N BE IL DI NC; DE PAI.~TMI:.N~ BUILDING PERMIT APPLICAT~K)N CHECKt JSq Do you have or need the fellowing, befoze applsiug Bu/ldin Boa~d of Ilea[th 3 sets of Bu/lding Plans S~wey Check Septic Form_ _ N.Y.S.D.E.C. Trustees Contact: ~ Phone: Inspector APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS /6'~ ,20o:q a. This al~pi~ti0~t MUST be completely fined in by typewriter or in ink and submitted to the Building Inspector with 3 ~¢ts.of~plan~-.acourate p~.to scale. Fee according to schedule. b. Plot plan showing location of tot and of buildings on prcm~2ses, relationship to adjoining prennses or public streets or areas, and waterways. c. The work covered by this, application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Pcmnit to the applicant. Such a permi~ shall be kept on the premises available for inspectien throughout the work. e. No bu/lding slmn be occupied or used in whole or in part for any purpose what-so-ever until a Certificate of Occupanc is issued by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Perm/t pursuant to the Building Zone Ord/nance of the Town of Southold. Suffolk Co/~ty, New York, and other appl/cable Laws. Ordinances or Regulations, for the conslracfion of buildings, add/tions, or alterations or for removal'or demolition as herein described. The applicant agrees~m comply with ail applicable laws, ord/nances, building code, h, ousmg code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspectio (Signature of applicant or name. if a corporation) · tt7q: t, State whether applicant is owner, lessee, agent, architect, engineer, genera~ contractor, electrician, plumbe/6-r builder (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Elexztricians LicenseNo. O"'"'OC) g- Other Trade's License No. 1. Locatioja of land o~r-v~hich propp~ed work w/ill be done: House Number Street County Tax Map No. 1000 Section Subdivision (Name) Block ~' Filed Map No. Lot ~-/~ Lot Nature of work (check which applicable): New Building Addition Repair . . Removal Demolition Other Work Estimated Cost.3/ ,%~.C¥ ~ 0 O, 0 O Fee we and oecupancy of ltrcmises, ,an_d intqnded use and occupancy of prop6s~tt~o~Qon:'~ · Existing use md oCCUpancy ~NCF' ]-t%Elp ' - If dwelling, rmmber of dwelling ur~.ts If garage, number of cars ~ Alteration (Description) (to be paid on filing tltis application) Number of dwelliag units on each floor If business, commercial or ~dxed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: From Height Number of Stories Rear Depth Dimensions of same structure with alterations or additions: Front Rear Depth Height Dimensions of entire new consrrucrionx From 6~ */~ ti Rear Height O~ ~ Number of Stories ~ Si eof ot:Front /5 O pT' Rear /0/ Pr' Depth 1. Zone or use district ia which premises are sitnated Number of Stories 9£%" D pth 36'0rr 2. Does proposed construction violate any zoning law, ordinance or regulation: 3. Will lot be re:graded k~ Will excess fill be removed from premises: YES 4. ~'4anaes o~ Owner o~ prerrfise , Aaares . Name of AmhitectkYiC'~l:3~._ ('k}~t~{~ Address,5~t ~ ~, ~ N0~/.Si'~ ~J* Name of Contractor Address Phone No.'<" 5. Is this property wittfin 100 feet cfa tidal wetland? *YES NO · IF YES, SOUTHOLD TOWN- TRUSTEES PERMITS MAY BE REQLrlRED 6. Provide survey, to scale, with accurate foundation plan and distances to property lines. 7. If elevation at any point on property is at t0 feet or below, musz provide topographical data on survey. iTATE OF NEW YORK) ~C~SS: .Ot~NTY OF >UW-~) ~ t~iPC~t F, ~ b~g d~y sworn, d~os~ =d sa~ ~t (s)he is ~e app~t ~me of ind~d~ siCg ~n~c¢ above ~. Smei t e OtO/ol ¢-- fCon~actor, Ag?hr, Cg~qrate Officer, 079.) )f said~ owner or owners, and is duly authorized to perform or have performed the said work and to make and file this applicatio~ hat all statements contained in this appllcatkm are true to the best of his knowledge mad belief; and that the work will be )erformed in the manner set forth i~ the application filed therewith. ~wom to before me tkis o~ _ day of CL~h¢ 200'2.. Signature Idf Applicant STEVEN E. LOSQUADRO Notary Public, State of NewYork Reg. No. 20LO5076843 Qualified in Suffdlk County--. Commission Expires April 28, 06-0~-00, C 6-1~00, ~ ~ ~- 0~ - O~-]~-Ol~-]~-OI ~n. 3. ~FFOLK GO ]N~ T~ ~ -~.~ lO00 -- 54 -- ~ -- ~.~, grOUnd water EL - ~+/- · ~ ~ ' _ ELI~ETH ~. ~ITH ~ . ¢'. % · ~~% 7<) ¢ BY H~ .o. o 6 EAST M~ ST~ET N.Y.S. LIC. NO. 50202 ,, , ~0L O~ ¢~APHIO ~CALE I = 40 I .~ ~A~, ~.~. Z Zg0~ ~A~P S~~OS~99-~29~.~o 369-8~88 ~ TOINN: ~PPO _='1' OF PROPER~ ' 50UTROLP )q~Ol.-qq 0¢a~05"00, 08-14-00, POUNOATIO~ LOOATION ]OOO - 54 ~ 5 - ~.~ OERTIFIEO ~LLIAH F. ~HITH ELI~BETH R. 5HITH / / / NOTES= P~ONUiViENT 0 ~IPE AREA: E~q,clqq S.F. OR O.q2 ACRES ELEVATfON~ REFER TO MSL NCVO'2q ~RAPH!O S~ALE I"= 40' JOHN C~ EHLERS LAND SURVEYOR 6 EAST MAIN STREET N.Y.S; LIC, NO. 50202 RBrERHEAD, N.Y. 11901 REF.\~Iio servetSdB?ROS\99-229i.pro 369-8288 Fax369-8287 SUI~',/~'E OF: PROPER'Th' SITUATE' 501JTHOLP TO~: ~UT~LD ~OLK ~~, ~6-0~-00, O~-14-OO O~-~-OL 0~-O5-O, O~-I~-O FINAL O-O2~, SUFFOL~ COUN~ TAX IOOO - 54 - 5 - ~.~ / / NOTES: I · i'-IONUMENT. 0 PIPE AF~EA = ~q,~qq S.F. OR O.q2 AC, F~E5 ELEVATION~ ~EFE~ TO MSL ~RAPHIC 5GALE l"= 40' JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET N.Y,S. LIC. NO. 50202 RIX~ERHEAD, N.Y. 11901 REF.\XHp server\dXPROS\99,229i.pro 369-8288 Fax 369-8287