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HomeMy WebLinkAbout29881-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30294 Date: 07/14/04 THIS CERTIFIES that the building ADDITIONS Location of Property: 2300 BROADWATERS RD CUTCHOGUE (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No_ 473869 Section 111 Block 1 Lot 1 Subdivision Filed Map No_ Lot No_ conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 12, 2003 pursuant to which Building Permit No. 29881-Z dated NOVEMBER 21, 2003 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 TWO STORY ADDITION & DECK ADDITIONS TO EXISTING SINGLE FAMILY DWELLING — AS APPLIED FOR. The certificate is issued to EDNA RICHARDS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 3841 06/09/04 PLUMBERS CERTIFICATION DATED 06/10/04 AN-DE PLUMBING tho ized Signature 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. 29881 Z Date NOVEMBER 21, 2003 j Permission is hereby granted to : EDNA RICHARDS 84-16 85TH DRIVE WOODHAVEN,NY 11421 for CONSTRUCTION OF A TWO STORY ADDITION & DECK ADDITIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 2300 BROADWATERS RD CUTCHOGUE County Tax Map No. 473889 Section 111 Block 0001 Lot No. 001 pursuant to application dated NOVEMBER 12 , 2003 and approved by the Building Inspector to expire on MAY 21, 2005 . Fee $ 366 . 30 Authorized Signature ORIGINAL Rev. 5/8/02 - - -� Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TUIi'N HAIL 765-1802 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 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--Astins buildings-(prio"o-A-pril-9,49-57)-non-c4afor-mingmses, r-buildiRgs-a " re-ecist ng lanil�rsesr 1. Accurate survey ofproperty showing all property lines, streets,building and unusual natural or topographic features. 2- A properly completed application and 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 I. 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,Addition to accessory building$2500, Businesses$50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy-$25 4. Updated Certificate of Occupancy- $50-00 5. Temporary Certificate of Occupancy-Residential$15.00, Commercial$15-00 Date. �g G rf New Construction: Old or Pre-existing Building: (check one) Location of Property: 4 CL* 94013-6Ai/Wr- 5- 12-40. House No. Street Hamlet Owner or Owners of Property: z'o &-6,w 4VW'd_0 5 Suffolk County Tax Map No 1000, Section l/ / Block a Lot Subdivision Filed Map. Lot: Permit No, 9 5/ Date of Permit. `J Applicant: ✓��i✓ LCI��t tSH 9� Health Dept.Approval: Underwriters Approval: f Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted:$ 2 {� 1 L /J -cant Signature b tri �c o `f`t"r �gfMor T*wn k®u,56094 My n Rapp Parc{5161?85 .3 F.Q.6®u 1179 .� _ 7alo�hc�na(516178-1 at Scuihoid.Now Yore t OFFICE OF THE BUILDING th&FECTOR � TOWN OF SOl THOLD 3 R T I F I C A T 1. 0 N I � � t ownar2 57 • z3c) ' Ct t7LI� tpies�a prig G°v�GFf� � Rl iambgr a GtO v , �jya/ `rte'' Jy i A, G' w�G•L , Ipleesa jpr ! aj . r I certify 'Ct�Rlt *e solder teem in the water supply sy�tare i contains logo tksw�t 2/[34 of 18 lead, j p I rt j { sworn to before me tis • f __._(�__• day ref Notary nblic, County EILEEN SCP.;AUDER p �iin.49D4293 4 Flatary Public:Slate of Neva York tluehfled in Suffolk County q j Npy Gommission Expires 08/31/AOO I Zg •,� 9S6t86Z Aar "Aa•A?JINE.JNR33 .WQ1sno We SZ-3F] S®®�c-Z�-FitiC f Nassau Suffolk Electrical Inspections, Inc. 5A Canal Street•Center Moriches, New York 11934 •Tel 631-878-3500 •Fax 631-878-3764 Application: 3841 Date: 6/9/04 E t F Issued to: Richards r' Address:. 2300 Broadhollow Rd Village: Cutchogue Lutroduced By: Puccio Electric Corp. Lic#: 4806-E was examined and approved up to the above date and was in compliance with the NEC AMC 1st Floor F�mderbal® Pod Det Cwaqe gent 2nd flow Cortrrerdal Hot Tub AcUbon s Switches Receptacles Fixtures G.F.I. Range Hood Whirlpool , 11 16 13 4 't F' Fans Dishwasher Washer/Amps DryerlAmps Oven Carbon ! RangelAmps Monoxide [-raniugnr 2 Furnace Oil Gas Heat Zones Smoke Bell Detectors Transformers 11' Meter Amps Phase Motors r ' 4- Other Equipment: Renovation I V - Out,Res ,1 g . This certificate must not be altered Ir . in any manner Permit#:29881 I . `Y- TOWN OF SOUTHOLD PROPERTY _RECORD CAR® OWNER STREET `JJ -- VILLAGEDIST. SUB. LOT J� /7 ra !! 3 9 4- / - ' 'C?Y_' C:-"'° 8"`�". �'"� .,•K'd"- e„� .. "'., �•kCi.c i��".() :9 50 W O`! S et l...,,L+ �C d1 �'d R cF 1�. 0 r�. 13i.. '�V' p O r.6i FORMER OWNER N E ACR" B, 5o c) S W TYPE OF BUILDING RES.r� SEAS. VL, FARM COMM. CB. MISC. Mkt, Value LAND IMP. TOTALDATEDATE REMARKS ,y`rv{ 6 � " ,,,�yy . U G. \'j V� (:/ "� a u° ^� S � �. --- "_,..° m`Y 9&..?;_; ,��✓ .dam... :, +h �,a,`F- E' !- tr,.i 'Y'.. (-1 ( o a... 4- ie ."`.. (., AGE BUILDING CONDITION NEW I NORMAL BELOW ABOVE FARM Acre Value Per Value Acrel Tillable 1 Tillable 2 ���— — •^" """'�'�M� - o-^^ Tillable 3 Woodland Swampland FRONTAGE ON WATER Brushland FRONTAGE ON ROAD i= .� House Plot DEPTH BULKHEAD — Total DOCK C. itt i t y . n TIaT COLOR t ; TRI th i5 7 I _ 1 1 .`. oma'"E Ir ..... M. Bldg. ) ;Zl p m� E - ,r ;?... / ' , ndation F ^;° Bath Dinette -- Extension (Basement - Floors K. Extension ' Exx'�alls i f Interior Finish ;' LR. — S" , r Extension Fire Place Heat T f E. DR. — Type Roof Rooms lst Floor BR. Porch r ' Recreation Room FIN. B.soomsnoor — -- Porch Dormer Breezeway Driveway Garage '' .,�- T� }�„.'0 Patio --- - O. B. Il K Total -- TOWN Oik,_ RW r OWNER STREETVILLAGE DIST. SUB.✓ LOT IV +.., 1dt, . , �i > r �; cA�+ cu y, .. du� ( U' a a t ORMER OWNER N E ACR. S W TYPE OF BUILDING -S. SEAS. VL. FARM COMM. CB. MISC. Mkt. Value LAND IMa: TOTAL DATE REMARKS u` D SdQ AGE BUILDING CONDITION JEW NORMAL BELOW ABOVE -ARM Acre Value Per Value _ - Acre C6 Ci/- (2) illable 1 , c^ .o illable 2 Ilable 3 'oodland oamplond FRONTAGE ON WATER ushland FRONTAGE ON ROAD )use Plot DEPTH C,0"!j . BULKHEAD tal I DOCK New York State Department of Environmental Conservation Division of Environmental Permits Rm 121, Building 40-SUNY Stony Brook, New York 11790-2356 Telephone (631) 444-0365 Facsimile (631) 444-0360 Now Erin M.Crotty Wnnisshier LETTER OF NON-JURISDICTION Edna Richards May 14, 2003 86-07 Jamaica Avenue Woodhaven NY 11421 NYSDEC # 1-4738-02519/00006 Richards Property 2300 Broadwaters Road Cutchogue NY SCTM#1000-111-1-1 Dear Ms. Richards: Based on the information you have submitted, the New York State Department of Environmental Conservation has made the following determination. The property landward of the 10-foot elevation contour interval on a natural gradual slope, as shown on the survey prepared by Joseph A. Ingegno last revised on 3/27/03, is beyond the jurisdiction of Article 25 (Tidal Wetlands). Therefore, in accordance with the current Tidal Wetlands Land Use Regulations (6 NYCRR Part 66 1) no permit is required under the Tidal Wetlands Act. Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundary, as indicated above, without a permit. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and your project (i.e. a 15' to 20' wide construction area) or erecting a temporary fence, barrier, or hay bale berm. Please be further advised that this letter does not relieve you of the responsib moo€obtaining any necessary permits or approvals from other agencies. f VAy truly yours, / JJohn A. Wieland/ Deputy Permit drninistrator CC: Bureau of Marine Habitat Protection File Albert J. Krupski, President ®� �® Town Hall James King,Vice-President 53095 Route 25 Artie Foster O P.O.Box 1179 o Ken Poliwoda Southold,New York 11971-0959 Peggy a. Dickerson ® ®�� Telephone (631) 765-1692 Fax(631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD June 2, 2003 Ms. Edna Richards 86-07 Jamaica Ave. Woodha%,en, NY 11421 RE: 2300 BROADWATERS RD., CUTCHOGUE SCTM#111-1-1 Dear Ms. Richards: The Southold Town Board of Trustees reviewed the survey last dated March 27, 2003 and determined the proposed two-story addition to the existing dwelling, decks, and brick landing to be out of the Wetland jurisdiction under Chapter 97 of the Town Wetland Code and Chapter 37 of the Town Code. Therefore, in accordance with the current Tidal Wetlands Code (Chapter 97) and the Coastal Erosion Hazard Area (Chapter 37) no permit is required. Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundary or seaward of the coastal erosion hazard area as indicated above, without a permit. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction and Coastal Erosion Hazard Area, which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and the coastal erosion hazard area and your project or erecting a temporary fence, barrier, or hay bale berm. However, any activity within 100' of a Wetland line or seaward of the Coastal Erosion Hazard Area would require permits from this office. This determination is not a determination from any other agency. If you have any further questions, please do not hesitate to call. Ff incerely, Albert J. Krulbski, Jr. President, Board of Trustees AJK:lms Permit Number RESelieck Compliance Certificate CheckedBy/Date New York State Energy Conservation Construction Code REScheckSofrware Version 3.5 Release 1 Data filename'Undtled.rck TITLE:Richards Residence COUNTY: Suffolk STATE:New York HDD: 5750 CONSTRUCTION TYPE:Detached 1 or 2 Family HEATING TIDE Non-Elearic DATE: 07/16,103 DATE OF PLANS: July 17, 2003 PROJECT INFORNLATION: Addition to the Richards Residence 2300 Broadwater Road Cutchogue, NY COMPANY[NFORIVLATION: Donald G. Feiler-Architect COMPLIANCE:Passes Rfaximum UA= 140 Your Home UA= 136 2.9%Better Than Code(UA) Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor UA Ceiling 1:Flat Ceiling or Scissor Truss 352 30.0 00 12 Wall 1: Wood Frame, 16" o.c. 867 21.0 0.0 37 Window 1: Wood Frame:Double Pane with Low-E 213 0.350 75 Floor 1:All-Wood Joist/rmss:OverUnconditioned Space 352 30.0 0.0 12 Furnace 1: Forced Hot Air, 78 AFUF: COMPLIANCE STATEMENT: The proposed building represented in this document is consistent with the building plans, specifications, and other calculations submitted with this perm t a ]i tion. The proposed systems have been des mooned to meet the New York State Energy Conservation Construction Co - g ¢et ts� en a Registered Desist Professional has stamped and signed this page, they are attesting that to the best ofd - alee}t and professional judgment,such plans or specifications are in m fiance w this Cod Budder/Designer Dat .7 I 015856 a / OF Ni �J� FROM :DONALD G. FEILER * ARCHITECT FRX NO. :631 298 1360 Nom. 17 2003 01:52PM - P2 DONALD G. FEILER •ARCHITECT 1772 Mdn Rd-Bos 1692-Mcf 4=K W 11952-63i 2993x53-Fp=y98-13� November 17, 2003 Mrs. Patricia Conklin Town of Southold Building Department Town Hall, Main Road, Southold, NY I Re: ProQosed Addition to the Richards Residence 2300 Broadwaters Road, Cutchogue, NY Dear Mrs_ Conklin: In regard to the above mentioned project, the amount of bedrooms will remain the same as presently edsts_ r Donald blerj �E'o�tJ 0 G s `l 01556 9lF OF Mw+l +p4 New York State Department of Environmental Conservation Division of Environmental Permits Rm 121, Building 40-SUNY Am Stony Brook, New York 11790-2356 Telephone (631) 444-0365 Imboo Facsimile (631)444-0360 Erin M.Crotty CanTrissiorie' LETTER OF NON-.TURISDICTION Edna Richards May 14, 2003 86-07 Jamaica Avenue Woodhaven NY 11421 NYSDEC # 1-4738-02519100006 Richards Property 2300 B-madwaters Road Cutchogue NY SCTM#1000-111-1-1 Dear Ms. Richards: Based on the information you have submitted, the New York State Department of Environmental Conservation has made the following determination. The property landward of the 10-foot elevation contour interval on a natural gradual slope, as shown on the surrey prepared by Joseph A. Ingegno last revised on 3/27/03, is beyond the jurisdiction of Article 25 (Tidal Wetlands). Therefore, in accordance with the current Tidal Wetlands Land Use Regulations (6 NYCRR Part 661) no permit is required under the Tidal Wetlands Act. Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundary, as indicated above, without a permit. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and your project (i.e. a 15' to 20' wide construction area) or erecting a temporary fence, barrier, or hay bale berm. Please be further advised that this letter does not relieve you of the responsibbtaining any necessary permits or approvals from other agencies. Very truly yours, John A. Wield Deputy Permit dministrator CC: Bureau of Marine Habitat Protection File p TTT T T!-'� D11`Qr4IT- DEME' !�7�T�!�IT T r Crr A R J1 LDI1��LL LN J`IT�1�L 'Z� �L��. T Applicant/ Date �! 3 Owners Naine: Reviewed: i Architect/ _ Date Engineer: D .Lc4 pe_.. Submitted: ////2-/-3 SCTM #: District: I A0 Section: J!/ Block: �_ Lot: _ Project ,{� � Subdivision Location: -�3 Z q °�_e Name: Single& separate Required certification: (Yes/No) Rcq. Rey. Zoning t)is(ric(:_R�O (Lot size: Yo M Actual: (Lot coverage Proposed.- 71 Req. Req. / i Req. (I=ron(Yard 5 a Proposed: �-- (Side Yard Proposed: y K --J (Rear Yards" Proposed- Project roposed Project Description: -� AGEINCUERMITS Permit . REQUIRED FOR REVIEW NO YES Number Suffolk County Health Dept. 7' New York State D. E. C. J Town Trustees Town Zoning Board approval: Town Planning Board approval: Z� Flood Plane Elevation??? Flood Zone:Not . e • - Z i do NEW YORK STATE CODE COMPLIANCE CHECKLIST CLIMATIC/GEOGRAPHIC DESIGN CRITERIA: Ground Snow Load: 45 Wind Speed: 120MPH Seismic Design Category:B Weathering: Severe Frost Depth:36" Termite:M-H Decay: S-M Design Temp: 11 Ice Shield Underlay:YES Flood Hazards: USE/OCCUPANCY CLASSIFICATION: HEIGHT/FIRE AREA: TYPE OF CONSTRUCTION: DESIGN CRITERIA: ENGINEERED P� RRIPT� FULL FRAMING DESIGN ELEMENTS: Y/N HEADERS: Y/N WALL STUDS: Y/N GIRDERS: Y/N CEILING JOISTS: Y/N FLOOR JOISTS: Y/N ROOF RAFTERS: Y/N LUMBER SPECIES AND GRADE: Y/N DESIGN LOAD CALCULATIONS: Y/N LIVE: Y/N DEAD: Y/N SNOW: Y/N SEISMIC: Y/N WINDOW AND DOOR SCHEDULE: MISSLE TEST REQUIREMENTS.- Y//NN . EGRESS 5.7 S.F.: Y/N LIGHT 8%: Y/N VENT 4%: Y/N NAILING/CONSTRUCTION SCHEDULE: Y/N MEANS OF EGRESS: Y/N PLUMBING RISER DIAGRAM: Y/N f � LOCATION OF FIRE PROTECTION EQUIPMENT: Y/N TRUSS DESIGN: Y/N CERTIFICATION: Y/N ENERGY CALCS: Y/N -yr' TOTAL COMPLIENCE? Y/N (RETURN TO PAGE ONE) k BUILDING DEPT. 1 SPECTION [ FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: < i DATE � Oj -INSPECTOR BUILDING DEPT. PECTION [ ] UNDATION IST [ ] ROUGH PLBG. [ FOUNDATION 2ND ( ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHNNEY REMARKS: DATE 117le INSPECTOR -11L12��l 765-1802 BUILDING DEPT. INSPECTION FOUNDATION IST ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION 7 � [� FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE x `� f INSPECTOR 1 765-1802 BUILDING DEPT. SPECTION [ ] UNDATION IST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & C NEY REMARKS: DATE ` Gr INSPECTOR 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ' OUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ RAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE 0 INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROtjGH PLBG. [ ] FOUNDATION 2ND [ kTolooNSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS- DATE r INSPECTOR J 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 LATION [ ] FRAMING [ FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: f � DATE INSPECTOR l8 if r FIELD INSPECTION REPORT DATE CONINI NTS FOUNDATION(1ST) j ------------------------------------ FOUNDATION(2ND) m z cu 0 0 O cr .j Gym ROUGH FRAiIIING& PLUMBING G 3 INSULATION PER N-Y. STATE ENERGY CODE Ca 1 FINAL ADDITION_U COMMENTS O z m MA v lS� Y o V\ o z m d r y �J 7 ^j a u u"upattt:y ui premises and intended use and occupancy of proposed.eonstruction: a. Existing use and occupancy S I N6 L6 fir�t L.A-2 i7 w Z t_-t NCS b. Intended use and occupancy Sgy� 1. Nature of work (check which applicable): New BuildingAddition x Alteration Repair Removal Demolition Other Work (Description) L Estimated Cost 3C) 6W Fee (to be paid on fling this application) If dwelling„number of dwelling units Number of dwelling units on each floor If garage, number of cars I£business; commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front ZZ Rear 22 Depth '3 3 Height Z6 Number of Stories 2 Dimensions of same structure with alterations or additions: Front Rear 44' 2 Depth 33 ' Height 28 Number of Stories Dimensions of entire new construction: Front ?�V Rear ZZt Depth (6 r Height 25' Number of Stories eZ Size of lot: Front I ZA Rear l `!4t Depth 51 1 0. Date of Purchase ) Name of Former Owner SI �tAJ&1`01RLClk NYJ19S 1. Zone or use district in which premises are situated 2. Does proposed construction violate any zoning law, ordinance or regulation: Mo 3. Will lot be. re-graded NO Will excess fill be removed from premises: YES N® 4. Names of Owner of premises t4W' RVC-OPP05 Address �L) or Phone No. 367546-/80 Name of Architect UmpM0 SEI Lta2 Address Yn-b, rS't Tu eta Phone No 298 - 5453 Name of Contractor Address Phone No. 5. Is this property within 100 feet of a tidal wetland? *YES X NO • IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY EE REQUIRED - Qporto&-o ON 6. Provide survey, to scale, with accurate foundation plan and distances to property lines. - b. j tjEZ!TLQ.'%" f7LHNS 7. I£elevation at any point on property is at 10 feet or below, must provide topographical data on survey. TATE OF NEW YORK) SS: :OUNTY OF L.f�(2- being duly swom, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, i)He is the (Contractor, Agent, Corporate Officer, etc.) C said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; tat all statements contained in this application are true to the best of his knowledge and belief; and that the work will be erformed in the manner set forth in the application filed [herewith. worn o before me this ll _ da f �1CS 0� ml , otary Public Signature o 4P M. NOTARY PUBLDC Stattee of New.York No- DI 806020932 Qualified in Suffolk County Term Expires March 8,<J y Tclwii OF SOUTHOLD riuiLwNu elziow AYPLIL;AK 'LUN C HEC KL15' BUILDING DEPARTMENT Do you have or need the following,before applying TOWN HALL BoardofHealth SOUTHOLD, NY 11971 3 "sets of Building Plans TEL: 765-1802 Survey PERMIT NO. c) C l Check Septic Form --, F; N.Y.S.D.E.C. Trustees Examined l! 3 200-3 ttt� .- Cbntact-- Approved 7 20 I`13 '; _lyi,��^� I 2 GW3 Mail to: ': tbNP-w FiE�1 Len— Disapproved a/c 1DK J692- � MCsIT [TUC Phone: 2q8 5'4[53 A Building Inspector APPLICATION FOR BUILDING PERMIT Date . 20_ 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 pretyises 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 Permit to the applicant. Such a 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 what-so-ever until a Certificate of Occupan is issued 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.coinply with all applicable laws, ordinances, building code,housing pode, and regdlations, and to admit authorized inspectors on premises and in building for necessary, inspections. (Signature o ap licant or name, if a corporation) f�� . Ifog2 . .MSTI-I.TC�C� (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises (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. �'�0 16 6 .. Plumbers License No. Electricians License No. p Other Trade's License No. I. Location of land on which proposed work will be done: Z��tD tj"Pywo-T t:a=, fZop-D C-U Teblorgoe House Number Street Hamlet County Tax Map No. 1000 Section 1 I I Block o f Lot C 1 Subdivision prnejt000 "A of NPssou potNT- Filed Map No. 15-6 r/o Lots 24s,2.4& 2c-7 (Name) 01-FICA LI1 D ' 2 ---- ---------- ---- -- ^ 1 - - - '__- - - - t/7�1hi r 1 � -- MPLY WITH ALL ;QDES OFi o W ,,, ��s Q - - �- NE YORK STATE & O NODES;: ✓ c A /,,,w , Tl _ ASREQUIRE D AND C DITTO SOF SOUTHOLDTO N ZBA SOUTHOLDTO NPANNINGBOAAD y, 1It SOUTHOLDTO TRUSTEES '\ 0, 4 N.Y.S,DEC - --- — — ' PRO-FsD A>`ROTED , `T I'n l a'. C,. ,. 6„ I j DATE: O - --- I� -0 bI n„ ---- FEE: 3E' : r) B :L1- F --- - 765-1802 IFYBUILDINAM G D4 RTMENT PM FORT AT 2 x G LEr-C-aER P1l _1 I•c 12 o ED z1 2kln r s c _ I-- TW REQUIRED 1 FOLLOWING POU EN ON Fi •E � - -- - 10 FLOOD ZONE D G . h -Ir" - - - - -- -_ A � 2. ROUGH - FRAMING d PLUMBING 4 s\ - �",i•``'J-i COMPLY WITH CHA ER "4B" 3. INSULATION I p ri -O 'i7 �- G K. V �_ FLOOD DAMAGE PRIEVENTION 4. FINAL - CONSCOMPLETE FO TION MUST \ U d; oC BE COMPLETE FO C.O. U S/4 " G pN•Mallosn+y r ~'� -= - -_ _ 50UTHOLD TOWN CbDE. ALL CONSTRUCTION HALL MEET THE III -:-`�` REQUIREMENTS OF DES OF NEW 2 r fr. La t v r, '" 2 & ' � ' y L i4 o G,I I L f W4 33G I 5 YORK STAT NOT PO BLE FOR E. I _ _ _- �,/ I f--I E•i DESIGN OR CONSTR to ERRORS. VT - - - � - -- - - - - UNDERWRITER KATE _ - - — ' p WRITER CERTI 'o _ v_ RED RED ITC Eta -r Tc y.,, „ u n {I u - ``gyp (�1PC0 Ole PLUMBER.,CERTIFICFTIO, '�� } / ON LEADCON7ENOCLUF'A x Exrsr Er [n. iii M p<npr . I 1 tJ� CERTIFICATE OFb:4' U � b�E� r 4T - C f"_.i. '� iT �AMIL. f KOC-)— - TE 1 v 6dK , r'wisc- \ I SOLDER USED INCANN 7u P, rt SUPPL Y�TEM 0 a \ VoI`A ICI; �yl11l 1, 2'-q^ EXCE x 100F1% LEA Cp- \y 00 t =� 4AR p CERT CATION OF uaeN -0 I✓I P� 11 1 K I TG1-1 f T I °y P UMBING _ G LUMBING WASE NAILING & NNECTIONS d TER LINES NE D /`1'A-N'a REQUIRED. a TESTING BEFORE COV RING G � �� hG �Ot-rlv(*nor-t �-Irl.i ort �} 16- Y, A" r-c o MEETION SHALL LTHf'N RE U RERUCTMENTS OFT E .�* TW 2602 =Tor 2A ksr ` w 125 a EW YORK STATE. CODES OR ♦♦�� tri► e» Ll a 9 „ •�i Ci 1K Ni - ?I..UMi�ING DIDC-TkL�M � E�- �)c_��� Lica _ 1� L• O � �' L D N Q 5/4 x rp Fit IAMAeZ -- ��1 1 c lS tG cr, sTt2ucnor l — �•. �,-L,. - - 1"_Ir�l, MDUrt'1 C - -- - -o cvl,.+srr:ucllcirl l_ 4"d• verb / —_ _- _ �i x TL+X -� rli+-r jIV,-kT- D�rl Te tafY.l:h•I+SC.N `fy". 1"ddl�aT I t,4,e 'Til�:� 'F'E7'"4{Mer C'P'(i' � f' FW(, FWIa ':.?,[115 l '( T'l�•0 I4K,•FM-V-E- �kTE [�"� rte. FMt-I- G4 2 -� ruT�eT � )!t`tiF uvr u>' F 3roo3cr� G-4c; G 1 � !e x-5/•4, e, -[A-- �-J ITC Ii, T�.c"TC I 1.b .+E t R4 C F 4DS hek� SMC KT.. r�. `1' 1 TUr3 PRS �, 2?,2 6 a I O M Ctr�.,I'l 1 1 *1 D N,J yi tX-.',..- t, "IE,L'C:.( ,y,• 3• Sr 1 T r^t 1 � W by t ... I - � _ _ _ y) cce�_E_•/It, r<:1t „rC+--_ Qr�. �- L`eJ � `� 392 F \vV\ - 3 �{ I . � „ --- �' i✓!k�rt=gym t c, ",9IC.-, • ., �. , 3n' - _ , ! �a0. on ,., 1 � � C� 0 T 1_ 1 r,"1 - �`` �.. 1 I G I--^ T C� (•"`M �� s.(:r,IG FSC-nrz. Acol ;-lol•_I 352 5F USO Us01 - + •11 AMIC '1 _ ._ _—_- - • 4,cfldn ro mnlomi a IIH CARPENTRY _ HA1 H door and baN t�R � rS 2 4 SF 1 All construction q state ' 1. a inG, (r1R,ER L)o 6 mN r I 2, W and arouM INSTAIIATION, Ir, �. -; ' 4 4 5F• /� 1 1 1 to the 2oWBdtdn cope MNpw York'Sta �}Itiutils'1lporlotal,underpa pile oPa2, lAob l6,grapendvel v LLL4444----•+++ ^ I-- se-as salacNa by Owner¢ Y1r_ e }-,t-.t.c•,rI . L.X 1ST. 2>��>♦ end the 2002 Energy,Bomeavea in Con%t[u4wlDn Gpdp"Npw•York 9tpq. E r; oxlo., AIS F 2 ed td lend walla; ` ©, r 2 Contractor o Aactort, fo en all lgodimensons the MM- 7i[p CynirpdtW Ito'nedry pp dppAingp: . . 'Wh-weus-tet over WolidprbwrlR,. BUILDING USE �Resldentfel -3',' theY paroae on the brawinge and , . 2. 'ENGINEE16tiuMsm,Par+iusm PSL and Midrther,LVL, BATH ACg� aoktss BUILDINGAR'EA 392 vi d) U,ii 9PpusGMlona.' - _ Er2Q><t0.'Ps6 D!`'CIus J01s4; BUILDING HEIGHT ' - � - 24' 1) �, - ' Flor Iowa=YntsJdet, 170011.as Aar mfg.p specifications 1 MIRRORS: 114"PodlehedPta/e its".krltscre over vanity TYPE OP"CON�'IRUCTION 1,YPOV 1n�ri 1 r '•� i 1 COKFUSTE,A VAsONRY ! 5, P4'I"AR50D: tNf+Ajl'E+'p#Pdor 4lpe- copper7 ' SHOWERDOORS; pol!ptwd MlY¢,evengddor, `DESIGN GAIT - 'Preq@tiptlYe Design, p Concrete ptrari „3000 pal Qgp,yaYp„ - ' . 4. WAt.L FTASH Ar .c it"- 'aaund mrpl,bs s.'rinfaGetl,; EL BARS.SOAP ti FWER HOLDERS;as selected by Ownem DEADtp D, 4tlD'p9} iW' 5. INSt11:ATipN: ttLttpWlthvt+pal'bMla7,Heated"aWa. 3 TOW Concrete rcodhas to bear on urWiltddlad soil.tin,ltait% too Pat., Mtanarl`vlagaspd� R p �. P� with two s5 sthM ramitrigmabars. 6, BUI Oa'I0 PAPISR Wei R+ TY40k NOV hSM:beIP.' -, SNOW LEAD 45 pat ground ^ V u -d lel 51 J 3 Concrete snelr not be plsEgO when lel[temparaluro fi hWow 40 degrees F. 7. ' R 9HIIJOkp,.B't3eilio431eltekisdnp mRtfbq:IK00{ganln App?ud,- 1 .ELECTRIC SERVICE existing sprvica to be extended la new addition 5EISMI(;'ZONE 8 I ` M ! I=- __ n or when concrete tamperstwq h Ipq Hien 60dearsn F. 01m1'eeb ShadoW.0,ed,3bFi;.11?s/squpre miler,a4 attested by Owner. I1 'I rtl ; 1 Minimum depth pt 16 be 3'A'belgw Grade, 8, RIDa'VE'NT. Cobra Plastic mean-oonimuous over Mks overhang 2 LIGHTING FI%TURES.'a¢aelsetd3 by Owner. WIhtOSRTEEI). 120 mph , I11V ' ' I K� 5 Forting stops th butt 1parallo wbem-*ulmd. - q. SIDING VGlyl',to mptch.e*elft - 3 TELEPHONE a CABLE: HTook locations Nate,an shown On Dramitch separately e r \\ 1 J1 SLI ' ...-- - • _ _,,:. _ ",,-', -,�' ., --. _.. ____-- 7 Exterwr of/ounaadonwaga Pope tlampkofadvrdtt l/a"ihfnkasphalt . AOO Peening lumber, 4 BAct to eATH Heno&T FANlUGHT: Nutone0T1'OpFl,cvntch separatelyP�alta e3 de fS V r•-- EGORY All B New fcundadPn wags t0 he e"th'Idir poured mlgMla,e5 nbar-4d'o/O 10. DECK,514A Philippine Meh7igany aIle,"IMbeYeleel nods; i1 T w 2fy21 n -�~ r!,i ;•yet C+ mantic,from gentle daft M and over to of ' 11 GUTTERS dd,EADERS:Baked-white alumtnum•4 x 3.IQ'quders. alt the In adds aFoe with the Building GOda (� p "no. yygD of New York State &the AmerltBtn'Forest�8 Paper Association 1}N1rr1+ a Extencr of exposed oquN dstktn wails to have troweled M stur4o an,eh: 2'x 3'mnr�etdd4aatltlr# pryY 2 q„ 2• `I r"'^"^ 12. INTERIOR WOQD'TRIM:-Finger Dim Clesi While Pme: Family ) Wood Frame Ci'O5)H!Oi., MenU01 f6r A�Q 8 Tw, Base mouMingt Feldman 83oq"n t'xAdr4'with p422 moulding. , 1 SYSTEM'pnadw and it heeling system to the new adssary dition a and the Family Dwellings(WGFM 98)rylg(h;Wlnd Addllton. SIF bent d N4lidowesatnA 11x74.'x 8 ir2"windows M have 5/4"at4ol, ex,sdrlq oil-fined warm air heating system to the new etldioon a,W lite r,J 13. WODO FLODR: s`7 oommoR'Hetl Oak'wlp,26/"' 2.1rA" existing Second,Floor.toned as follows: WINDOW NOTES. 0 tA. GYPSUM BQARO 712"teAprpd ledge,raplature Meretpnt al BeinRmm Zone 1 First Flmr CLGSET SHELVING. 3x4"RtyKrood'A-A,tt to erdvrood edge: DESIZone 2 Sewnd gsyste d --- -- --'— '- --- 'CbMea' 1 -is`Dhelfend henprdd Lineno 5 shelves,hitt dspth 2 DESIGN' healing system small be dealgntd and guaranteed to maintain 1. /F windows as noted on Floor Plans indicate EGRESS as required for areas as per Ejection 10,of the _ O d SLICING FgEtiCMAND QQ ,AMOMen High-Pertolmanw t10 tlegree6 F he inside and the vMitlPraturs at 72 dcatgrees MPH. the outside temperature 4 2 Light and Va tilafton, all habitable a R303, with an ms's Residential C r Now York Btete. Q -- -- - / P pert+ngPratedttonshallbapro�vided �PlanscgMomllo -- - - - — - 4T t5L11 s shown on Ftopr 1. MtNDOWS aggregate glazing area of gtora than B% white, IO Full RS: Light Gallas,a Mar i'as shown on Drawings t - PLUMBING FIXTURES: lobe selected by Owner, encode shut off valves Glazed Hoof area, and a edtion m If be U areas ar bf the Br3br Cod Y ,,n 2. INTERIOR DOORB: himpson 62 R•panH 0r,.b match existing. on all water limes at all SxWres. 3, wo as pQi the villi di Goth of Now York „+ T'�47 jj 3. HARDWARE:to be seledetl by motet' 3 DOMESTIC WATER SUPPLY. conned to existing. Stets; Section 1809 T.4. AIt'QIISYad ojleningal0 be p7oVlr�ed with ptegA ptyWood ( 1 ' FINIaW R 4, SANITARY SYSTEM, connect piping to existing sanitary system. panels to cover glazed Openm�(4"overlap around openings')'. Attachmenl to be l\J) 2, INTERIOR DOORS dLTRI prime d 1 finish mat Istex list paint. H roll free locations as shown on bre p 9 mod 2 0/C / I 5 OSE BIBS' F - wings. r Table 160 .1.4, 2 1/2 IT8 0 1 . -- as e - " 9creWa `� J E-�C> - ___ T alit,2 orals polyurethane to match • exh0ng. yl/VL-C2Y VVr`�crn�--D . - !- / 3 OAK FLOORING. epntl, 1 mal peeler,2 coals pelyurelhane, satin finreh 1 Nailing Schodulo WFlm 95 HIr.N W,NO POpiT=oN 4Fp J T t_-_y It'-'c) ` I �_I�``�✓ C>fiie¢ u'ioiwinr R..��ul.:,.u�: 3. eJ ria)]nl �yye. V CeLi[Iwu tyrlwl4nmow•(iaroulml :4. ''I�TLLIII' Dd Lp :ol�y T¢mR„YeRf.on II [ uC ror r 12, Ftlm - r � IeuonlJp. emR lY Plw � �� - V1 ,in I I \T 4.W loin:olow(FnY nu: ]Ibl In. �,� f _+. � FL ___- LUZ - _______— -,- E C N --r- !YG ^_ —__ _ __--_- —__.. _ _. __ .r• r .,�I c�a.'m..�amb- um.. �.Irnp e.0 - - _r - uowaN..r . u wrm)n -- T 9 a I — I - - - - --- MJllnrniuum..ua Yu.l oowl .IrwNne. WC wm..:W M.I SYNI W.Jb..rYl)-wu.Y�h y.y.lY utlu.XW.IrruNCuu.nylr.Pyun�u la vwuy mrErp.Wll W ibiSM4.yuutra.om.ud.EvrWa IZmi-f SI'AC5 1 Ws...IY.ulun=..mn nu w. 4 nYiWuvl•Iltlull)u 1LJ �t , _', '"1"1" i �— �� � - � f 'i1f-+r.. - ._ _ _. l --•- i - ____ A K �9 �`��,�� .�.�. � — _ _ -_ I --._ . CROSS SECTION - � � ', , -`-)r I , '� a - III � .� - - _ 'moi 1 I ' i ( I � �-� � it I �' `•� ��, � , i I. i . 1 m. ;/? .�—_ END VIEW 12 tj r � I _�— I —i' I I �Ysa..l I I � ., _ - waa.._ -nmvvrr•.rv.+......_. _• r-3�IU � M, y� �, r1M r•?Z• L•totl fnmlPL e•nn•ctlon• �'� CROSS SECTION END VIEW •�',' � GOriTII�WnII� tC7h6 G't�T�{ ..- 5 pER A� Pp NcFM - 9I --- -'—'-- - - ♦♦ICS H- bU r-1> ad! i m i / I24, x .V C^T IF .f 1!1;r I . �, 6 IST ;n e it I 6t-C- �N NiN E Fr t )n i C .Y s) --. L g1M.JZ I`T . .� I�.=.z.zc uniur ra...mi.n. 2r. Cr- LEGG�E7t (`G( IaJa) �X F --- - _ - - -- - - ( . IC 'I t I C • � � - - - !'<) :: x low .x:N P.eN1 i I� C`t,� - �� TI i T' 10 �Ex GA 2 . 1 vl J 1D — - — - - r �( WbLI To cur oA�ou < � � hl'-n-� � � I li/4' x � Un/PE STrxAP f c� C.4 �' 1.-- $ � -� A.W LIC Lb Ej` IfNC�fr. ILL c(1 �Y _