HomeMy WebLinkAbout30136-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO: Z-30807 Date: 03 08/05
THIS CERTIFIES that the building ADDITIONS/ALTERATIONS
Location of Property: 1150 OAK DR SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 80 Block 2 Lot 5
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 5, 2004 pursuant to which
Building Permit No_ 30136-Z dated MARCH 5, 2004
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 ADDITIONS & ALTERATIONS TO EXISTING SINGLE FAMILY DWELLING AS APPLIED
FOR.
The certificate is issued to FREDERICK & ELIZABETH SCHAEFFLER
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 941111C 01/31/05
PLUMBERS CERTIFICATION DATED 03/03/05 MIKE JACOBI PLUMB.&HEAT.
Authorized Signature
Rev. 1/81
li'„°1 - ? 7 1 —`�2njf
Form No.6
TOWN OF SOUTHOLD j
BUILDING DEPARTMENT
TOWN HALL
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:
I. 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. Corrunercial 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 consent to inspect signed by the applicant. If a Certificate of Occupancy is
denied, the Building Inspector shall state the reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy-New dwelling$25.00, Additions to dwelling$25.00, Alterations to dwelling$25.00,
Swimming pool $25.00, Accessory building$25.00, Additions to accessory building$25.00, Businesses$50.00.
2. Certificate of Occupancy on Pre-existing Building- $100.00
3. Copy of Certificate of Occupancy-$.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy-Residential $15.00,Commercial $15.00
SNewDate. 2 -2 g -as-
New
Construction: Old or Pre-existing Building: X (check one)
Location of Property: IISO O.r/�C
House No. / Street / Hamlet
Owner or Owners of Property: F/e, l L/Z 5,0- /a ej t It/'
Suffolk County Tax Map No 1000, Section ?L/) Block 2 Lot
Subdivision Filed Map. n [ Lot:
Permit No. 3 O 13 6 Date of Permit. 3 - 5- O 4 Applicant: RO 6 C/� � e //1 r _11
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ Z✓r,O 0
pplican azure
00
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. 30136 Z Date MARCH 5 , 2004
Permission is hereby granted to:
FREDERICK JR SCHAEFFLER
1150 OAK DRIVE
SOUTHOLD,NY 11971
for
ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR
at premises located at 1150 OAK DR SOUTHOLD
County Tax Map No. 473889 Section 080 Block 0002 Lot No. 005
pursuant to application dated MARCH 5 , 2004 and approved by the
Building Inspector to expire on SEPTEMBE 20
Fee $ 180 . 30
r
Autho ized Signature
-PrMo� 6Z-���• 5
ORIGINAL
Rev. 5/8/02
4ft I1111! III III
;
Electrical inspection Certificate
Issue Date Electrical Inspection Service, Inc. Application Number
1131!2005 375 Dunton Avenue 94111C
East Patchogue, New York 11772
(6311 286 6642
Issued To: Mr. and Mrs. Frederick SchaeN ar
Street: 1150 Oak Drive
Village: Southold Zip: Town: Southold
Section: Block: Lot:
Contractor: Ice Electric (L) Lic #- 458E-E
Was examined and found to be in coin,name with the National Elbctrica,Code
Commercial ' I NV Defects I Pool 1st Floor ix Indoor basement Hot Tub
Ix Residential _ Det. Garage I Attic iX 2nd Floor x Outdoor k Addition Survey
Switches Receptacles Fixtures GF/ Heaters A/C Fans
11 18 8 1 2
Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps Wrowaves
1 20 1 30
Furnace on Gas Circulators Smoke Detector Hell Transformer
8
I Meter Amps Phase UG/OH Jacuzzi Television CO Detector
1 200 1 X' 1
Bldg. Permit:
Other Equipment _
1 200amp panel with main breaker 44OR
160amp sub panel
1 20/120V a/c receptacle Hugo S. Surdi
President
I Rough Inspe[t,on 11111/2004
Inspector: John Mc Mahon III
Final Inspection. 0 112712005
InSpeCtOr: Juhn Mc Mahon III
MM I 2OlIJ 1 ,�I
Tht not be altered,n any mai ie. Inspectors may be itlen6f ;d Dy tneir cratlentials.
4. . [e m t
flt.OG.DEPT
��o��sUFFOIkcoG
ToVYn Hall,53095 Main goad y Fax (516)765-1823
P. O. Box 1179 - • Telephone(516)765-1802
Southold, Ne*York 11971 t
��jol � dao
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLb
CERT I F I C A 'T I O N /
DATE d --IKS A
8uilding Permit No/, - � 3 � Z-
owneri _S 7
(please print) // --
plumber t r� Y !— -jp ca J i�
(please print)
I certify that the solder used in the water stipply system
contains less than 2/10 of i% lead.
(Plumber ignature)
sworn to before me this
�f day of ?9o)-c5c i -
Notary Pubiic� !--L �c� county
LINDA J COOFL _ mwNQrS-' THO .
NOTARY PUBLIC,State of Nom 'i:
NO.01CO4822563,Suffolk Cougt,
Term Expires December 31,20�
i ,z
TOWN OF SOUTHOLD PROPERTY RECORD CARD -/
OWNER STREET '') VILLAGE DISTRICT SUB. LOT
�Q,riC�C, � -Jiz.A
FORMER OWNER
N E ACREAGE
C S� W TYPE OF BUILDING
I-o1w,01A, r
ZES. �6 SEAS. VL. FARM COMM. IND. I CB. MISC. E'st. Mkt. ue
LAND IMP. TOTAL DATE REMARKS
Z'( 0 o - L - 3-FSacic sl. -lv
ea ev 0
•� c a / ��� 5 d 3 - L 5D-xhq e ll u>r - v ScAaei7,i.,=a
AG BUILDING CONDITION
NEW NORMAL BELOW ABOVE FRONTAGE ON WATER
Farm Acre Value Per Acre Value FRONTAGE ON ROAD
Tillable I BULKHEAD
"illable 2 DOCK
"illable 3
Noodland
swampland
irushland' '
louse Plot
otal
K'� � � .� I I �ro cu i✓
I
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.Q'P', ,""n6s .. . ♦ .�,. .. .. _. -��-�Y�-���'�-ice 'i
M. Bldg. h) y �o o-o ^ Foundation L'ea,ri..Z+c.. Bath
L-f
Extension Basement %y Floors
Extension — Ext. Walls "`r Interior Finish , ,
Extension /�4�iI Fire Place Heat
Porch Roof Type E
/ - - -- -
T Porch Rooms 1st Floor
Patio Rooms 2nd Floor
Breezeway '', _- }
Garage _ rive, —� Dormer
.a - - -
O. B.
Boulevard Planning East, PC.
Architects • Engineers •Construction Management Internet: www.blvdplan.com
32645 Main Road
Cutchogue. N.Y. 11935
PHONE: 631.734.2011
February 7. 2005
Southold Building Department
Town Hall
53095 Main Road
Southold. N.Y. 11971 - 0959
Re: Scheaffler Residence, Permit# 30136
To Whom It May Concern,
I hereby certify to the Department of Buildings of the Town of Southold that I have inspected the
above locations; I have supervised the preparation of the building plans as per State Education Laws;
and I have determined to the best of my professional knowledge and belief that the structural elements
are safe and that the framing, windows, roofing, siding, high wind strapping, and rough plumbing were
installed in conformity, with the filed building plans, the New York Residential Building Code, and
generally approved construction practices.
If you have any further questions, please feel free to call me at any time.
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ahe Nw Cao Sbd I&IG "la+R STANLL•Y J. ISdXSFH Jr
SURVFYM FCR: FRE'OET CM SCNMFF7lER P.O. BOX 791
FRANC. SGLIEFTLER 1qe .r. 195
CJARANICED TO: Caalq of 6d h y awa net b..'he 51 7J=
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rmAci schaef/er nvl to a"dde"d to .s o mW mw d
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Yvl.n of SwthoM NYS No. .027.1 978673
Permit Number
REScheck Compliance Certificate Checked By/Date
New York State Energy Conservation Construction Code
RESche,kSoftware Version 3.5 Release I
Data filename: C': REScheck'r0403-Energy Calculations.rck
TITLE: Schaettler Residence
C'OUN I Y: Suffolk
STATE: New York
HDD: 5750
—CiNS'IRUC I ION IYPE: Detached I or 2 Family
AIING IYPE: Non-Electric
DA I L: 022, 04
DATL OI PLANS February 23. 2004
PROJECI INFORMATION:
Schaeffler Residence
1180 Oak Street
Southold. NY 1 1971
COMPANY INFORMATION:
Boulevard Planning East. P.C.
Arch i tects-Lm_i neers
32645 Main Road
C'utchoeue, NY 1 1935
-OMPLI.ANCE: Passes
Maximum UA - 191
Your Home I IA - 125
34.60b Better Fhan 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 873 30.0 0.0 31
Wall 1: Wood Frame, 16" o.c. 949 19.0 0.0 51
Window 1: VmNI Frame:Double Pane with Low-E 107 0.130 14
Floor I: All-Wood Joist%Truss:Over Unconditioned Space 873 30.0 0.0 29
COMPLIANCE. SFAt E.MENT: The proposed burhtglg represented in this document is consistent with the building plans,
specifications, and other calculatiods su n itted%4it rq ts�CRrrit application. The proposed systems have been designed to meet the
New York State Energy Conserv,�t'ti,C_-OhsA. `truct' � e'r}Ijqirements. When a Registered Design Professional has stamped and
signed this page,they are attest' g tlfa to t htg. r6owledge, belief,and professional judgment,such plans or
',cificatiuns are in complianc 'I t
0 2 Z
Ruilder'Desiener ; � Date
O '
REScheck Inspection Checklist
New York State Energy Conservation Construction Code
RFScheckSo tware Version 3.5 Release I
DATE: 112_3114
TI FLF.: Schaefler Residence
Bldg.
Dept.
Use
Ceilings:
I I I. Ceiling I: Flat Ceiling or Scissor Truss, R-30.0 cavity insulation
Comments:
I
Above-Grade Walls:
[ ] I. Wall I: Wood Frame, 16"o.c.. R-19.0 cavity insulation
Comments:
Windows:
[ I I. Window I: Vinyl Frame:Double Pane with Low-E. U-factor: 0.130
For windows without labeled U-factors,describe features:
a Panes _ Frame Type_ Thermal Break? [ ] Yes [ ] No
Comments:
Floors:
[ I I. Floor 1: All-NW'ood Joist/Truss:Over Unconditioned Space, R-30.0 cavity insulation
Comments:
Air Leakage:
[ I Joints, penetrations,and all other such openings in the building envelope that are sources of air
leakage must be sealed.
1 Recessed lights must be I)Type IC rated,or 2) installed inside an appropriate air-tight assembly
with a 0.5^clearance frorn combustible materials. If non-IC rated,the fixture must be installed with a
3" clearance from insulation.
I Vapor Retarder:
I I I Required on the"afro-in-winter side of all non-vented framed ceilings,walls,and Floors.
I
I Materials Identification:
[ 1 I Materials and equipment must be installed in accordance with the manufacturer's installation instructions.
I ] Materials and equipment must be identified so that compliance can be determined.
[ ] Manufacturer manuals for all installed heating and cooling equipment and service water heating
equipment must be provided.
[ J Insulation R-values and glazing U-factors must be clearly marked on the building plans or specifications.
I
Duct Insulation:
[ ] Supply ducts in unconditioned attics or outside the building must be insulated to R-8.
[ J Return ducts in unconditioned attics or outside the building must be insulated to R4.
I ] Supply ducts in unconditioned spaces must be insulated to R-8.
r Return ducts in unconditioned spaces(except basements)must be insulated to R-2.
Insulation is not required on return ducts in basements.
Duct Construction:
[ J I 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.
6sceptiun:Continuously welded and locking-type longitudinal joints and seams on ducts
operating at less than 2 in. w.g.(500 Pa).
f I Ducts shall be supported every 10 feet or in accordance with the manufacturer's instructions.
[ ] Cooling ducts with exterior insulation must be covered with a vapor retarder.
Air tillers are required in the return air system.
r I fhe IIVAC system must provide a means for balancing air and water systems.
Temperature Controls:
[ tach dwelling- unit has at lesat one thermostat capable of automatically adjusting the space
temperature set point of the largest zone.
I
Electric Systems:
J Separate electric meters are required for each dwelling unit.
Fireplaces:
[ 1 Fireplaces must be installed with tight fitting non-combustible fireplace doors.
[ ] Fireplaces must be provided with a source of combustion air,as required by the Fireplace construction
provisions of the Building Code u(Nem, York.State , the Residential Code qJ New Fork.Siate or
the :Vein York 011 Building Code ,as applicable.
Service Water Heating:
[ J 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.
t J Insulate circulating hot water pipes to the levels in Table 1.
I
Circulating Hot Water Systems:
[ ] Insulate circulating hot water pipes to the levels in Table I.
Swimming Pools:
[ J All heated swimming pools most have an on,off heater switch and require a cover unless over 20%
of the heating energy is t'rom non-depletable sources. Pool pumps require a time clock.
Heating and Cooling Piping Insulation:
[ ) I IVAC piping conveying fluids above 105 T or chilled fluids below 55 T must be insulated to the
levels in Table 2.
Table l: Minimum Insulation Thickness for Circulating Hot Water Pipes.
Insulation Thickness in Inches by Pipe Sizes
Heated Water Non-Circulating Runouts Circulating Mains and Runouts
Temperature( F) Up to I„ Up to 1.25" 1.5" to 2.0" Over P'
170-180 0.5 1.0 1.5 2.0
140-160 0.5 0.5 1.0 1.5
100-130 0.5 0.5 0.5 1.0
Table?: Minimum Insulation Thickness for HVAC Pipes.
Fluid Temp. Insulation Thickness in Inches by Pipe Sizes
'ping System hypes Range F 2" Runouts I" and Less 1.25' to 2" 2.5 to 4"
..,sting Systems
Low Pressure Temperature 201-250 1.0 1.5 1.5 2.0
Low Temperature 120-200 0.5 1.0 1.0 1.5
Steam Condensate(for Teed water) Any 1.0 1.0 1.5 2.0
Cooling Systems
Chilled Water. ReGigerant. 40-55 0.5 0.5 0.75 1.0
and Brine Below 40 1.0 1.0 1.5 1.5
NOTES TO FIELD (Building Department Use Only)
pf SO(/l�o�
3ol 3 6 z—
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING/ ?FINAL
[ ) FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
11
C�
44n= n
r
DATE °� �� �� s INSPECTOR /G
OF SOpl�o<o
3o 13( Z
�ourm,�
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ FINAL
r
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS.
ol
ATE
3 INSPECTOR
IN PE TOR
D
BUILDING PERMIT EXAMINER CHECKLIST
DATE REVIEWED: �/ Z/04
APPLICANT: \.er — DATE SUBMITTED:,,:? /04
SCTM#DISTRICT: 1,000, SECTION: , BLOCK: 2 , LOT:S SUBDIVISION-4J.— cyl,_-6
ADDRESS: )16-0 (Ja� �n CITY ,L, ��ZONINGDISTRICT: CONFORMING?
BUILDING PERMITS OPEN/EXPIRED: PRE C Y OR N
BP -Z/ C/0 Z- , INFO /BP -Z/ C/0 Z- , INFO
BP -Z/C/0 Z- , INFO /BP -Z/C/0 Z- , INFO
SINGLE & SEPARATE CERTIFICATION-REQUIRED NOTES:
LATS 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
REQ. LOT SIZE: ACT. LOT SIZE:/� (� Q. LOT COV.�.�a L ACT. LOT CO✓V,
REQ. FRONT 3—PROP. FRONT �tEQ S E �a/>>� ACT. SIDE
REQ. REAR PROP. REAR 27 REQ. HEIGHT PROP. HEIGHT
PROJECT DESCRIPTION:
ESTIMATED PROJECT COST: ��i NGINEER: 5)94L4 Picf'
WATERFRONT? DESCRIPTION: ANEL # FLOOD ZONE:
APPROVALS REQUIRED
SUFFOLK COUNTY �P:HEALTH YES or O, BED #): DTE: / / PERMIT#:
TOWN SEPTIC RECEIPT: Y 0
NEW YORK STATE DEC: PRE-DEC 9/1/75 YES or DTE: / / PERMIT #:
SOUTHOLD TOWN TRUSTEES: YES or DTE / / PERMIT #:
TOWN ZONING BOARD APPROVAL: YES or DTE: / / PERMIT#:
TOWN PLAN. BOARD APPROVAL: YES or DTE / / PERMIT#:
TOWN HISTORICAL PRE (SPLIA): YES or
NEW YORK STATE CODE COMPLIANCE (SEE PAG C- Yp)
or NO
NOTES:
FEE STRUCTURE: FOUNDATION: — SF
FIRST FLOOR: 70 SF
SECOND FLOOR: SF
OTHER: SF INIT OTHER TOTAL
TOTAL: SF FEE FEE FEE
G / _ I �o�3
1. ( 11 i SF)- ( ob _SF)=__Vj_� SF X $ 56 =$ �' +$�+$ _$
2. ( SF)- (SF)= SFX $ =$ +$ +$ _ $
3. ( SF)- ( SF)= SFX $ =$ +$ +$ _
FINAL TOTAL: $ 1 D``p�
��
NEW YORK STATE CODE COMPLIANCE CHECKLIST
CLIMATIC/GEOGRAPHI ESIGN CRITERIA:
Ground Snow Load: 45 Wind Speed: 1271 Seismic D gn Category: B
Weathering: Severe Frost Depth: 36" Termite: M-H Decay: S-M
Design Temp: 11 Ice Shield Underlay.YES ✓ Flood Hazards: ✓
USE/OCCUPANCY CLASSIFICAT N:
HEIGHT/FIRE AREA:
TYPE OF CONSTRUCTION:
DESIGN CRITERIA: ENGINEERESCRIP E UN►C �
FULL FRAMING DESIGN ELEMENT :
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 CALCULATIONS6/N
LIVE: Y/N DEO:Y/N SNOW: Y/N SEISMIC: Y/N WIND: Y/N
WINDOW ANIS DOOR SCHEDULE:
MISSLEST RE UIREMENTS: Y/N
EGRESS 5.7 S.F.&N
LIGHT 8%e'/N
VENT 4%:hN
NAILING/CONSTR/UCTION SCHEDULIO/N
MEANS OF EGRESS&N
PLUMBING RISER DIAGRAM/I' N
LOCATION OF FIRE PROTECTION EQUIPMENT: Y/N
TRUSS DESIGN: Y/N
CERTIFICATION: Y/N
ENERGY CALCS:q/N
TOTAL COMPLIENCEOi/N (RETURN TO PAGE ONE)
FIELD INSPECTION REPORT DATE COMMENTS
b
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FOUNDA7(lST)------------------
FOUNDATION(2ND) c
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ROUGH FRAMING& �
PLUMBING
4
INSULATION PER N.Y.
STATE ENERGY CODE
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FINAL n
ADDITIONAL COMMENTS
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL Board of Health
SOUTHOL6, NY 11971 3 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 Suney
«�«v. northfork.net/Southold/ PERNIIT NO. 30Check
Septic Form
N.Y.S.D.E.C.
Trustees
Examined , 20 Contact:
Approved ,20 Mail to:
Disapproved a c
Phone:
Expiration , 20
Bu ding Inspector
S
MAR 3 2004 APPLICATION FOR BUILDING PERNHT
Le rINSTRUCTIONS Date MaroA , 20404-
--�
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3
sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or
areas, and 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 1 Z 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 issuancb 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 regul s, and to admit
authorized inspectors on premises and in building for necessary inspections.
(Signature of applicant or name, if a corporation)
3.�6�fS "/,7 1 41,ACJ a 1,,e
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
�tn
Name of owner of premises FrAvL &I/=eDG s t
(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.
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
I/SO 04 Dart Sur, o eC
House Number Street Hamlet
County Tax Ma
pp No. 1000 Section so Block Z Lot S
Subdivision RAyolon S4eras Filed Map No. Lot 9 p
—� (Name)
'_. State existing use and occupancy of premises and intended use and occupancy of proposed constrttction:
a. Existing use and occupancy A4olg&n a L t---
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building Addition X Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost j7Sf 'g00 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 /V/A d
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. AIM
7. Dimensions of existing structures• if any: Front 42,,2 Rear 41 ,2 Depth 27
Height Number of Stories /
Dimensions of same structure with alterations or additions: Front 42 2L, !?year 91_2
Depth 27 Height 29- Number of Stories_
8. Dimensions of entire new'construction: Front Rear Depth
Height Number of Stories
9. Size of lot: Front Rear q Depth 6s
10. Date of Purchase Name of Former Owner q
11. Zone or use district in which premises are situated 9- 40
0
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO X
13. Will tot be re-graded? YES_'' /NO_Will excess fill be removed from premises? YES—NO X
14. Names of Owner of premises �hae#Te/' Address//San Dal! lP fIy4 Phone No.
Name of Architect�r� l�/onwp� f�+Sf Address.?? /lf� r gd Phone No 73 0-?0//
Name of Contractor B).�to/ IDb.rw.us 5 Address Phone No. '734-;2 O/ I
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO JC
* 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 X
* 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 )
Ro D e/ P t-,&Y///
a er 0 being duly sworn;deposes and says that (s)he is the applicant
(Name of individual signing contract)above named,
(S)He is the A-en
(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.
Swom to before me this
L/ day 20f
c-TIPF
otaryPtli�!t s'n ✓ ature pp icant
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SAAOICE DETECTOR I" 'I
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ANDERSEN
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GENERAL NOTES -- ----
ADDITIONS
1
N 20°11 '20'1 E 90.0' & ALLTERATIONS
TO THE
- - - - - - - - - - - SCHAEFFLER
RESIDENCE
I I
m
8 EJ. HW
1150 OAK ST.
2z
@ 2G"p D. N N m f a I SOUTHOLD, NY 11971
NJN
I I
Fx1sr1NG DOILER LOT 8 1 I LOT 10
CHIMNEY EXISTING
OREMAIN 6 8GIRDER
CELLAR 50' S.C.'T.M. # 1000_080-02-05
UNEXCAVATED - - - - - - - - -�r - - - -
O I SIUEYARU
SUBACK
ai� P seo o REVISIONS DATE;
CRAWL ' 9* T I" I A5 PER FIELD 2-24-05
SPACE 123&o � 24.0' CONDITIONS
20 23B'
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LLJ
0 O m D
N aotj ro
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N Q
N z
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I N 20°I 1 '20" E 90.0'
10'-O' 32-4" 1 243.50'
OAK DRIVE
42'-4"
PLOT"PIAN
EXISTING FOUNDATION PLAN scALF = 1° = 20'-0°
SCALE = 114" = I'-0'
_______ WALL TO BE REMOVED
WALL TO BE REMAIN
NEW WALL CONSTRUCTION SITE AND ZONING DATA
ZONING REQUIREMENTS R-40 EX15TING CONDITIONS PROPOSED CONSTRUCTION
LOT'AREA MM. 40,000 S.F. 14.8505.F 14.850 S.F. ,-1)OI�b
FRONT YARD SETBACK 50.0 FT 51 3 FT. 5 I.3 FT.
1 REAR YARD SETBACK 50.0 FT' 86.7 FT 86.7 FT.
2 BIDE YARD OETBACK 15.0 FT 23.8 FT. 23.8 FT.
TOTAL • BOTH BIDES 35.0 FT 47.8 FT. 47 8 FT
MMAX.GROBB FLOOR AREA 20% 1091 88 5.F. 7.4% 1091.88 5.F. 7.4%
AXIMI➢9 WOMW 35.0'FT 19.0 FT `_25.6 F1'
ip t7 c) THERE ARE NO GRADE CHANGES,EXCAVATION,FILLING, AND/OR CLEARING DONE TO T1418 PROPERTY
N
U
U U p U
O U DU lDp
O
1 aU`_° EXISTING
`D EXISTING EXI5TING
MASTER BEDROOM DEN @?
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