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Home My WebLink About28981-Z FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISR9 UNTIL FULL COMPLETION OF THE WORK P_UTHOR ZED) PERMIT NO_ 28981 Z Da DECEMBER 6, 2002 Permission is hereby- granted to : j ROBERT F & KIM A ANDERSEN 165 TRUBERG REVENUE PATCHOGUE,NY 11772 for ADDITIONS AND ALTERATIONS TO AN/ EXISTING SINGLE FAMIL`x' DWELLING AS i APPLIED FOR ' at premises located at / 2855 DEPOT LA CUTCHOGUE % County Tax Map No. 4738R%9 Section 102 Block 0001 Lot No_ 008 pursuant to application dated NOVEMBER 27, 2002 and approved by the Building Inspector tp expire on JUNE 6 , 2004 . i Fee $ 205 _20 f' i _ u h ri "ature COPY Rev. 5/8/02 i y FIELD INSPECTION REPORT DATE CONIlYlE1V'TS FOUNDATION(1ST) C FOUNDATION(2ND) O ROUGH FRAMING& y PLUMBING It INSULATION PER N.Y. STATE ENERGY CODE r FINAL ADDITIONAL COIV MIENTS O z m y 0 x d TOWN OF SOUTHOLD BUILDING PERMIT APPLICATTON'CKECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL ` ' " Board of Health SOUTHOLD,NY 11971 3 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502Survey %c// www. northfork.net/Southold/ PERMIT NO. sg1 Check Septic Form N.Y.S.D.E.C. "2, Trustees Examined ,20 Contact: Approved /L 120 y Mail to: Disapproved a/c Phone: Expiration '20 Bu' ding Inspector APPLICATION FOR BUILDING PERMIT Date 0 120 INSTRUCTIONS. a. This,_ cation 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 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 the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim,the Building Inspector may authorize, in writing,the extension of the permit for an addition six months. Thereafter, a new permit shall be required. 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 inspections. �, (Signature of applicant or name,if a corporation) �2gss- ►Je,007 44. �r�� w- 10,11613 (Mailing address of appli nt) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder OGcJ 11 C,� Name of owner of premises e yl 4Ajde1,,Vilern 4. 4,u rlelsPt'1 (As on the tax roll or atest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: House Number Street Handet County Tax Map No. 1000 Section Block Lot Subdivision Filed Map No. Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed(;onstruction: r / • � a. Existing use and occupancy / /".�n ✓ Q�si rh,�'Cw b. Intended use and occupancy S A�'► 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost 41 5, 0 0 0 Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units 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. Dimensions of existing structures, if any: Front 'p, (O Rear G Depth 52 Y Height / 8 ' Number of Stories Dimensions of same structure with alterations or additions: Front a Rear Depth 5.2 r Height / Number of Stories 8. Dimensions of entire new construction: Front 2 (. Rear :�_ io Depth S2 Height / Number of Stories 2- if 9. Size of lot: Front / U D _ 0 a" Rear LO-0 . O 0 Depth 00 10. Date of Purchase /s D _(Name of Former Owner ;DA u/ '6771e1 c/C 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded? YES NO ✓ Will excess fill be removed from premises? YES ✓NO 14. Names of Owner of premises )?obe� �«r�� Address i S-(beoa Zo C,ocT hone No. 3Y-6.2y`� Name of Architect Tk TH �.� Address CG�+-e-e-o eo� Phone No L41 7 -- 1`5" Name of Contractor Address Phone No. / 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO v * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF 4'w n/-t'ri d e rs being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)He is the V(4)yi f,r (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 this day of 200-1— k 00-1— 10tary rublic Signature of Applicant JOYCE M.MKINS Notary Public,State of New York No.4952246,Suffolk County Term Expires June I Z a 0 v3 ENERGY CODE CALCULATIONS CHAPTER 5 SECTION 501 Detached One and Two Family Design Criteria 5750 Degree Days (For Non-Electric Heat) Zone 11B For: �0 6 el, , f PrS 01 Per: Ch n �, 1�'2-3, -3 11 O 4 _ -. .._ ..-_.. i� Dated: o /7 SUBSYSTEM AREA DESIGN CODE DESIGN CODE «U„ «U" UA UA Exterior Walls 1 B yf o. O OPl. 0.14 16'2-?0 z37. 7 41 Ceiling Roof 1/317 a o3o 0.031 12. r o 13 ..3-1 Floor Over Unheated Space0.05 v 3 6a p,o� Heated Slab On Grade 6.5 Unheated Slab On Grade 4.5 Basement Wall 0.1 - - Crawl Space Wall 0.06 NOTES: L-8.3 #7 a Construction shall comply with 502.1.1 moisture control and 502.1.4 air leakage Building Envelope Systems to meet requirements of Section 501 The mechanical systems and equipment including: HVAC Equipment,HVAC Systems,Duct Systems,Ventilation Systems and Insulation of Piping Systems.to meet requirements of Section 503 Service Water Heating Systems&Equipment to meet requirements of Section 504 Electrical&Lighting Systems&Equipment to meet requirements of Section 505 tt of NEW CE O • �� yi To the best of my knowledge, r w belief, &professional'judgement, w these plans are in compliance 032254-1 e�2� with the code. �9°-Ess1o�P�'� ( b 3 l)154 5d-L4 4 .338' GcdC. Ybtfal..� �o �4 Vj ,Ar,faw `. 0 HQoNE F,� .o C-iis survey is a\60la$On of \ �••! �� N \ Section 7208 of the New York State qr L4JCaliOn l.eW 0 yg0 LAND 8 Copies of this survey map not baa no wN� , the iand eurwyors inked Nal or `V V `E�''q/yQ embossed Nal ehali rtdbe o mWered to be a va5d mw copy. GuaranteN Ydeawd hereof).hall nm only a the Peron br whom tfte survey * 7C is prepared.and On Ne beheff b the and V tide company pwmmw dw WIq , lending ktstitudon feted heronIlmLGK ar•�17a�Fa�u-►o 98.3• /, to IM anipneea of#0brd M 11801". Gueranteee are notttansbmble 1 :W/�' 3Q'•� ��Qf.7� tit.y 3 6 to addidortal inadwdons or wbMgwnt 3 e owners , . "�iC�C T��F M E W ,f?NTJ�tl�/Y Yom•LE�i4�t/QIOK�1.t'/• a%�reYf�ae•,�,Gd�QTF��M�.1/pE.�?�t/ Geo��'re.e . p,p..elax 4We G�9R.4,!/TE60 "► F, �t%M�.t/OE�r � � .Q /clG. G�o�r>iAeAr T�oL C•itO/T�►L G'oe�,opl 'og:ogjo� v: BUILDING PERMIT EXAMINER CHECK LIST DATE REVIEWED: h-) /,.3 /02 APPLICANTDATE SUBMITTED: 11 /x/02 SCTM#DISTRICT: 1,000, SECTION: BLOCK: , LOT: STREET ADDRESS:,�S�D OW 64AC CITY: SUBDIVISION: PROJECT DESCRIPTION: ESTIMATED PROJECT COST: ARCHITECT" "': N/!L FAST TRACK ,416 SINGLE & SEPARATE CERTIFICATION-REQUIRED , p NOTES: LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30,1983),UNDERSIZED LOTS FROM JAN.1997 100-25.Merger.(A nonconforming at any time after 7/1/83' ZONING DISTRICT: Ac CONFORMING? No REQ. LOT SIZE:&SACT. LOT SIZE:4&!06 REQ. LOT COV. o �'+► ACT. LOT COV. REQ. FRONT ,..,r"' PROP. FRONT / REQ SIDE 1442S' ACT. SIDE REQ. REAR Off PROP. REAR _.,-� REQ. HEIGHT PROP. HEIGHT WATER FRONT? A& DESCRIPTION: PANEL #: FLOOD ZONE: COMPLIANCE: APPROVALS REQUIRED SUFFOLK COUNTY HEALTH DEPT: YES or(9 (BED#): DTE: /_/ PERMIT#:R10- TOWN SEPTIC RECEIPT: Y( o Flo C_f40 M3 7B NEW YORK STATE DEC: PRE-DEC 9/1/75 YES or SOUTHOLD TOWN TRUSTEES: YES o TOWN ZONING BOARD APPROVAL: YES or TOWN PLAN. BOARD APPROVAL: YES o TOWN HISTORICAL PRE (SPLIA): S o NYS ENERGY: OR NO : EGRESS (18 H J9 4 sq total) ✓VENT(SQ. FT. x 4%) 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: 1 � FEE STRUCTURE: FOUNDATION: Craw SF FIRST FLOOR: SF SECOND FLOOR: MI6 2 SF OTHER: SF INIT OTHER TOTAL TOTAL: FEE FEE FEE 1. ( M4 SF)-(850 SF)=_jb�_SF X$ .` =$ 5. +$ I r(�+$ =$ C)CU 3 2. ( SF)- SF)= SFX$ =$ +$ +$ =$