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HomeMy WebLinkAbout29141-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30875 Date: 04/21/05 THIS CERTIFIES that the building ALTERATION Location of Property: 11600 MAIN RD EAST MARION (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 31 Block 14 Lot 1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 5, 2003 pursuant to which Building Permit No. 29141-Z dated FEBRUARY 5, 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 ALTERATION TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JENNY BLOOM (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 2048640 04/12/05 PLUMBERS CERTIFICATION DATED 04/05/05 CUTCHOGUE EAST PLUMB&HEAT i A hor i7 d Signature Rev. 1/81 =)I %5 • Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL U 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY DEF'. � This application must be filled in by typewriter or ink and submitted to the Building Department with the followin 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 2i 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 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 $25.00 Accessory bnilding$.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 Date. /� /v New Construction: TT Old or Pre-existing Building: _ (check one) Location of Property: !i V X ' / "' i W '" House No. I Street Hamlet Owner or Owners of Property: r 't . ` l , / c) Suffolk County Tax Map No 1000, Section Block J Lot Subdivision Filed Map. Lot: Permit No. Dale of Permit. 2 / yl Applicant. t_ / y7� Health Dept. Approval: Underwriters Approval: Planning Board Approval: / Request for: Temporary Certificate Final Certificate: ✓ (check one) Fee Submitted: $ Z v,I't Applicant Signature Co it 3O�S75 ,Y� / c1I O rJ�rJ�rPrJrPr rL3r3rL3J�cl�r�rJ�rPrJ�rJ�rJ�rJ�rJrJA1rJ@frPrJ�rJ�PrJ�rJ�rJ�rJ�rJ�rJr�r�rJ�rJ� rJ�rJRcFL3FL3Pr rL3r3rL395 J�cPcPcPrJ�r�rJ�rJ�rJ�rJ�rJand O 5 BY THIS CERTIFICATE OF COMPLIANCE THE C7 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 BUREAU OF ELECTRICITY C5 S 40 FULTON STREET — NEW YORK, NY 10038 5 5 5 5 CERTIFIES THAT CSU Upon the application of upon premises owned by e5 55 DOROSKI ELEC. INC JENNY BLOOM 5 5 P.O. BOX 781 11600 MAIN ROAD 5 5 CUTCHOGUE, N.Y. 11935, EAST MARION, NY 11939 r5 Located at 11600 MAIN ROAD EAST MARION, NY 11939 5 5 Application Number: 2048640 Certificate Number: 2048640 reSj Section: Block: Lot: Building Permit: BDC: ns11 5 Described as a occupancy, wherein the premises electrical system consisting of 5 5 electrical devices and wiring, described below, located in/on the premises at: 5 5 Basement, First Floor, Second Floor, Outside, �5 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed rj 5 herein, was conducted in accordance with the requirements of the applicable code and/or standard 5 5 promulgated by the State of New York, Department of State Code Enforcement and Administration, or other 5 5 authority having jurisdiction, and found to be in compliance therewith on the Day of 5 12th April 2005. 5 Name (QTY" Rate Ratine Circuit TUC 5 Miscellaneous 5 5 total renovation 5 Alarm and Emergence Equipment 5 5 Sensor 2 0 Carbon Monoxide C 5 Sensor 4 0 Smoke 5 5 Appliances and Accessories 5 Exltatl]l Fall 2 0 F.H.P. 5 Oven 2 0 7.2 KW 5 rrr+++ Dish Washer 1 0 1.2 KW Wiring and Devices 5 5 Outlet 35 0 Fixture 5 5 Fixture 34 0 Incandescent 5 Fixture 1 0 Flourescent �5] Outlet 55 0 General Purpose L; 5 Receptacle 35 0 General Purpose 5 5 Switch 19 0 General Purpo.=.e 5 Receptacle 1 0 20 amp Laundry seal 5 Receptacle I 0 30 amp Dryer [5 5 Continued on Next Page 1 of 2 e5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 S )- 1 `1 - I 5 o �s�LPd�LL3P[M1 ����� ��� ���� ���� LEI O rJPLLPLrL3PLr3rL3 J'rfar�rJ�rJU�r>nrJ�rJrJrJ�clrJrJcPrJrJrJrPrJ�rJ ar�rPrJ ar�rJ rJ arJ arJ�cPrJ�rPcPrJ arJ arJ�r>nrJrJ�rJd�rJ�rJ�rJr�cPrJrJ�r�rJ arJrJL RI 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 BUREAU OF ELECTRICITY cS 5 40 FULTON STREET — NEW YORK, NY 10038 S 5 CERTIFIES THAT 5 Upon the application of upon premises owned by S rr5 5 DOROSKI ELEC. INC JENNY BLOOM 5 P.O. BOX 781 11600 MAIN ROAD CUTCHOGUE, N.Y. 11935, EAST MARION, NY 11939 5 r5j Located at 11600 MAIN ROAD EAST MARION, NY 11939 C5 Application Number: 2048640 Certificate Number: 2048640 r� �5 Section: Block: Lot: Building Permit: BDC: ns11 5 P, Described as a occupancy, wherein the premises electrical system consisting of 5 electrical devices and wiring, described below, located in/on the premises at: 5 5 Basement, First Floor, Second Floor, Outside, 5 5 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 5 5 herein, was conducted in accordance with the requirements of the applicable code and/or standard 5 5 promulgated by the State of New York, Department of State Code Enforcement and Administration, or other 5 5 authority having jurisdiction, and found to be in compliance therewith on the Day of 12th April, 2005. Ca 5 Name QTY Rate Rating Circuit Tvoe 5 Dimmers 6 0 r5 5 Receptacle 7 0 GFCI 5 5 PaddleFan 3 0 5 5 An as built visual inspection,of the delineated electrical installation,determined that an obvious hazard is not present and the installation is 5 5 believed to be in comfomtance with the applicable reference standard for the estimated period of construction of the premises wiring system. 5 5 5 5 5 5 5 5 5 115 5 Sea/ Mi 55 5 2 of 2 5 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. S 5 55J D rJ�r PcPr�cllJ�PrJ�rPrlrJ�rJ@PrJ a�far PrJ�r� r lrlcJ�cP[J�rJ@PrlarJ�rJE�fa rl a r fcP[frJ�rPcPrJrJ�[PcP cP rP r1rJ�[P rJ arJ�r fa r�rJ 0 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. 29141 Z Date FEBRUARY 5 , 2003 Permission is hereby granted to : BRYAN P DOWNEY 11600 MAIN RD EAST MARION,NY 11939 for ALTERATION OF AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. THIS PERMIT REPLACES 27074 . at premises located at 11600 MAIN RD EAST MARION County Tax Map No. 473889 Section 031 Block 0014 Lot No. 001 pursuant to application dated FEBRUARY 5 , 2003 and approved by the Building Inspector to expire on AUGUST 5 , 2005 . Fee $ 443 . 70 �. Authori Signature ORIGINAL Rev. 5/8/02 'awr Matt. 69085 Main Roan! Far (516; 756.19.23 P.0. Baa 1179 Taeicvhane (516) 766.1902 9autnow, New York 11971 A04.air OFFICE OF THE BWLDINQ INSPECTOR TOWN Or- SOUTHOLD C V R T Y V R C A 'T II_0 Ni OATH Ll L K.�� J tetild3nq Permit No. em- ILI�'- Owner t R �O I'"\ .�. . eame pr nt l llerise`printj x certify that the molder u0nd in the wator n:appiy 3yet;emo contains .loan titan 2/10 4f it load. " P .c 9ior.ad torr ) JANET V.STEWART NOTARY PUBtJC,S4:ia of Now Ytxk No. 52-46633485 Qu~in Sworn to before me 4.hia Con bdon EwlrataM 30 20 O Notary Public, _ Count"/ 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 THEWORKAUTHORIZED) Ve PERMIT NO. 27074 Z Date FEBRUARY 16, 2001 Permission is hereby granted to : ATHENA SELLIS 223-11 59TH AVE BAYSIDE,NY 11364 for ALTERATION OF AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. at premises located at 11600 MAIN RD EAST MARION County Tax Map No. 473889 Section 031 Block 0014 Lot No. 001 pursuant to application dated NOVEMBER 15, 2000 and approved by the Building Inspector. Fee $ 270 . 80 Authorized Signature ORIGINAL Rev. 2/19/98 TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET / `, VILLAGE DIST. SUB. LOT — FORMER OWNER N_ E_ ACR. S., W TYPE OF BUILDING �' TJX 1r1 j't{ r p ;, r, GtY 4fl:': - , //�L , /`1 � .t Zi• , _ RESa/� SEAS. J VL. FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS/J /4 '�c g L- p? ;? �;.?,', 7ZP: e ; JLI /U. .J iJ1, .. (^ J / i ��✓U � :J �' � / �% '— - tr7J7J' I� ' �� a Pr._ ;!.;, ���, , ; i. `-'-`1.-- A f n0 9 _ z / O J ..+ )bra/ t T+ T— f G J AGE BUILDING CONDITION NEW NCRMAL BELOW ABOVE FARM Acre Value Per Volue Acre — Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD Meadowland _ — DEPTH —� House Plot � BULKHEAD Total DOCK ^i COLOR „�(. / TRIM / + rt 1 rt — �F4 -i' TSI - - -' -- M. Bfdg. Iz 5 3V s � - � Extension — Ya Extension \ !I� �-- rT ! --�—I T -"—��----Y- Extension Foundation ^ 1 Both Dinette Porch Basement �" K. Porch / -1 S' L— <<� ,� ,Ext. Walls j `-' 'r 1" Interior Finish LR. r Breezeway ! Fire Place t; Heat DR. Garage Type Roof Rooms 1st Floor BR. Patio (Rooms 2nd Floor 1 FIN.Recreation Room -- C. B._ ,� or, , ormer — Dri ivewoy I . — + —�— — Total � 7 1 76S-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ROUGH PLBG. [ ] FO�JNDATION 2ND [ ] INSULATION [ ✓J/FRAMING [ ] FINAL ( ] FIREPLACE & CHIMNEY REMARKS: !)o t f DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTIO [ ] FOU DATION IST [ ROUGH PLBG. [ ] UNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: - > DATE INSPECTO 7(z 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] :SULATION UG LBG. [ ] FOUNDATION 2ND [ [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: c DATE D INSPECTO p2 70 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ]�ROIH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE IMNEY REMARKS: � .DATE INSPECTO 765-1802 BUILDING DEPT. SPECTION [ XIOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE CHIMNEY REMARKS: DATE � PECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ROUGH PLBG. [ 7] F NDATION 2ND [ ] INSULATION 'P � [ FRAMING [ ] FINAL [ J FIREPLACE A CHIMNEY REMARKS: �•y S DATE IC /0,7 [03 INSPECTOR 765-1802 BUILDING DEPT. I NSPEC I [ ] FOUN ION i ST [ ] ROUGH PLBG. [ ] F NDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY 17 DATE D INSPECTO ,65_1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] RO PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: / DATE _ NSPECTOR i 0 /w& 76S•1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ INAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: co DATE INSPECTOR -- J 1 9 M E R Y L K R A M E R a r ,. h i t e c t Southold Building Department Attn:John Bufus Box 1179 Southold, NY 11971 VIA FACSIMILE 765-1823 RE: SELLIS/DOWNEY RESIDENCE 11600 MAIN ROAD EAST MARION, N.Y. 11939 SCTM# 1000-31-14-1 Dear John, This letter is to certify the following changes to the exterior wall construction: Existing wood siding to be removed. 11/2"furring strips to be added to the exterior face of stud wall to allow 2"solid core insulation with an R value of 14.4. Wood sheathing will be 5/8"plywood and finish face will be 8"cedar clapboard. These changes will not affect the project's meetingthe requirements of the energy code. I hope that this satisfies all of the questions regarding this renovation. Should you have any other questions or concerns, please do not hesitate to call me. Sine REIDA NCO HL F� Lo 124 BROAD STREET GREENPORT , NY 11944 631 . 477 . 0826 S-). FIELD-INSPECTION=REPORT DATE _ COMMENTS_________ ( � ---- -------- - ---- ==i�='- -===ii -- _------- -----__------ ___'- ---------_-------- ro Zrrh II it � 'TT (i0 FOUNDATION OST) ii c� FOUNDATION (2ND) II II II JI - II ROUGH FRAME & C, PLUMBING ii ii maw C3 III _J ..� Ir-- INSULATION PER N. Y. STATE ENERGY CODE ii Ii3ry n I II II II _ �I A li�jj H II II I _ FINAL --- - -- p r, Y ADDIT O�NAT. COMMENTS: ` 3 O/ CLpRe[�.�r .i l[c ,a<--� i¢u . O�• /r r e �.J'` �-,� CJ� q<..-� / A'NrNPir.•wT is /moi ur.< 7'i r n DEQ aQ-'f p l Tw<� 0�5 � ra C3 o, Tr v �aG i � Z aZ Gi7 ro H 16-2001 6: 18PM FROM MKRAMERARCH 6314770826 P. 1 M E R Y L K R A M E R a r c h i t e c t Y Southold.Building Department Attn:Bruno Semon Box 1179 Southold,NY 11971 VIA FACSIMILE 765-1823 RE SELLIS RESIDENCE MAIN ROAD EAST MARION,N.Y. SClM#=0O 31141 Dear Bruno, This letter is to certify the following: 1. The room marked"Bedroom"onto secondtioor will now.be labelled as.unhabiteble Space The owner has been made aware of this and will adjust her plans for the use of the space accordingly. 2. The existing windows In the house are to remain and have a clear opening of 24'x 26"(more than 4 sq.fL),and have al'-10'sip height 3. The owner will be providing now batt insulation.in the walls and ceilings,and a new heating system that will meet the requirements of the energy code 7815. 7801 I hope that this satisfies ail of.the questtona.regarding.thisrenauatioa. Shmm you have eny questions,please do not hesitate to Call me. Sincerely. / Meryl R.Kramer /Jaa`��ukJ�fatJle riJ 124 8 R 0 A D STREET GREENPORT, NY 11044 e91 . 477 • ea46 BOARD OF HEALTH FORK NO. 1 3 SETS OF PLANS ... ... . ........ TOWN OF SOUTUOLD SURVEY ............. .... ...... .. BUILDING DF.PARTHENT CIIECR ............. . . . . . . . . . . . . TOWN HALL SEPTICFORF .... .. .. . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TSIs 765-I R02 NOTIM CALL $ryan. .Qownag Exanined... /z...... ,JIS�3Cb1 NAZI. TO=�. -2211 r Approvtd.�-)!JPenniCNo.�.LY.�.4..G+. ........ l (o-+ .... ..%9`..... . . Disappruved•a/c ......................,............ ................................... . .... ........:.... (lliilding Inspector) 5 L OO APPLICATION FOR BUILDING PERMIT i •Date. J`iOYemher. .C 6. ,t9c2000 i I INSTRUCTIONS a. 'Dila application must be completely filled in by typewriter or in ink and sulanitted to the Building Inspector wi 3 sets of plans,.accurate plot plan to scale. Fee according to schedule. b. Plot plan allowing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, arca giving a detailed description of layout of property must be drawn on the diagram dildi is part of this application. c. 'Bie work covered by this application ray not be conmenced before issuance of Building Permit. d. Upon approval of this application, the Milling Inspector wilt issue a Building Permit to the applicant. Such permit shall be.kept on the premises available for inspection throughout the work. e. No building almll be occupied or used in Aiole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Ikhilding Inspector. APPI.ICNI710H IS IEMM Df 11f= to tine Building Department for the issuance of a liuilding Permit pursuant to the Isuilding zone Ordinance of the Tam 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 an premises and in building for necessary Inspections. (Signature o •appl/scant.-dor name, tf a c'or(poration) (Falling address of applicant) State uiwther applicant Is caner, lessee, agent, architect, engineer.'general contractor, electrician, plumber or builde .................�.QPAVact//.��XQrM M................................................................................. Nan: of owner of premises ..1 i:. e:LLIS ........................................................................... (as an Use tax roll or latest dead) If applicant is a corporation, signature of duly authorized officer. .......:1.11 ......................................... (came and title of corporate officer) D:,ilders t.icense tb. ( self.) ..... Pludhers License No. Electricians License No. ..................... Other Trade's License Ib. .................... 1. lucotion of land on which proposed work will be done.............................................................. ................I................ ....... R a .1...................... ... ............. louse timber Street Hamlet Cdunry Tax Fop No. IOM Section ....�'�.f.:....... Block .... ........ Lot ...�)l.......... Sulxlivision ...(1?.d r?e-r)....................... Filed Map No. ................ Lot ............... (Name) 2. State existing use and occupancy of premises sold intendad use and ocenpsney of prdpsa d Mweraetionr a. bdating we and oacgwty ..........JwM O&PAP............................y..........,,.,,........... h. Intended use and occupancy ..........�sidr;n�e..tl7,th.ItltRlr�t�.oris.............................. 3. Nature of work (d Bildt applicable)a NW Building ......... Addition x Alteration . Itcpair ..?:........ &moral ]fc;1%!ff V Y ikmoliticn , .......... Other Work ..... ................ .. ... G .. . . . . . 1 (Description) 4. Lsclnetel Coat ....� i.> �iU./ . ��S /JtYee .. 7/27/0. (to be paid at filing this application) ' 5. if dt4elling, txtdter of dwelling unite SiWU-tam.. Umber of dwelling unite on eadi floor .. . . . . .. .. .. . .. . Ifgurage, tttnber of cern .N/A ............................... 6. If Ixishieee, mnnercial or mixed occupancy, "at!!y nature and extent of each type of use...... . .. ). Ulmenslons of existing structures, if anyt Front................ hear ............... nepilt ............ ..... Iluigiat ......................... !#niter of Stories ...................... lllnensloos of sem atrtidturn with alterations or'atklitionst Frontm.daazza..... neer no. change. ... Iepth .................I.. lklghtt .................... Number of Stories ............... S. Diuensions of entire new construction: Front ................ hear ............... Depth . . . . . . . . . . .. .. Ileight ......................... limiter of Stories ..................... r . g. Size of Iota Front ...1�Q... ...... Rear 1Q�0:Jr I......... Depth ..��... VCtiz i44 e Irl. little of Ptrdtase ..(pend..9)........ tion of APSKWE (star ...�T...�•�e.l.�c�...... .......... 11. Zona or use district in Wait premises are situated ........R-40 Residential ....................................... ...... . . ... . ... 12. Goes proposed construction violets any rontng leu, onlinatice or reguladont .....NO ................... 13. Will lot be regraded ,...NA............. Will excess fill be removed from limnisest M NO 14. Name of &FAWi3f premises .... Ackireas .............................. None NO.734211 . .... 124 Broad St Green rt 477-0826 Nam of ArclritectS} ..gratusr...................... Acklreea ..............t....... 1°..... Nati lb. .......... Name of Contractor ............................ Address ...............................None No. .......... 15. Is title property within 300 feat,of a tidal mdandl * YRS .......... NO .........N/A *IF PIES, SCEIII[ID ma "IMIS1 mmrr MAY RR m1un Im. PLOT DIAGRAM locate clearly and distinctly all buildings, whether existing or proposed, and indicate all. set-back dimensions from property linen. Give street and block number or description according to teed, and sow street ranee enl inlicate %ketlter Interior or comer lot. A list of proposed changes is attached, with three sets of architectural diagrams, and recent survey. SI-NII; Uta tali YORK, SS Qxrtt17 (it i�-ILF ......... ........... .1rul . ....................beicgl duly scant, deposes and says Utat Ire in Lite nppl.iumi. (Nate of hxlividual signing contract) alxtve Wiled, Slle in Lite ....... ......... ............................................... (Contractor, agentreorporate officer, etc.) of said (iaxtr or timers, and in truly authorized to perform or have performed lite said work mxl Lo crake and file this al)pIIcWLiott; Lhnt• till statements contained in this application are true to the hest of his Wxa+ledge nttd b6lief; mxl that the work will be performed in lite miter set forth In Lite application filed therewith. 9attnh to befure me this J.Q�........day of ..:Ju/�.....:14Q.. Notary PublicG?1 {. Notary public , State of New York (SigtaUtre of Appl.icattt) County of Suffolk #01K04524771 Linda F . Kowalski Comm . exp . 11/30/ 00 BUILDING PERMIT REVIEW CHECK LIST DATE REVIEWED: APPLICANT NAME: S e, A, DATE SUBMITTED: SCTM# --- DISTRICT: 1,000 SECTION: BLOCK: /4 LOT: PROJECT LOCATION STREET: CITY: �• , /V�,/a,-SUBDIV. NAME: ARCHITECT/ENGINEER: K rr.*.-4_1r FAST TRACK: YES o SINGLE & SEPARATE CERTIFICATION-REQUIRED: YES OR O NOTES: ZONING: PERMIT E IMATE AMOUNT: $��.00 �O�►.�x ZONING DISTRICT: 4R80 AC CONFORMING: YES o REQUIRED LOT SIZE: SQ] WHERE ACTUAL LOT SIZE FROM?TAx CARD ACTUAL LOT SIZE: 34&IS SQ REQUIRED /uE REQUIRED oo E REQUIRED A,- FRONT: ¢O 'PROPOSED: *9 ' SIDE YD: /5"'/ 3 ' PROPOSED:S2,2 '/ ?¢ ' REAR:$O ' PROPOSED:/SO ' LOT COVERAGE: ALLOWED: 26 % EXISTING: sf % NEW: sf % TOTAL:_*,1d sf2 0 CORNER? YES OR O WAT ER FRONT? YES OR O DESCRIPTION: LOTS 40,000SF --100-24. Lot recognition. (CREATED before June 30, 1983), UNDERSIZED LOTS FROM JAN.1997 100-25. Merger. (A nonconforming at anytime after July 1, 1983.) PROJECT DESCRIPTION: ADD.AL1'�ACC oR NiD: X lyr� AGENCY PERMITS REQUIRED FOR REVIEW NEED TOWN SPETIC PERMIT: YES o SUFFOLK COUNTY HEALTH DEPT: YES o (BED #): DTE:—/_/ PERMIT #:R10- NEW YORK STATE DEC: PRE-DEC 9ni75 YES or N SOUTHOLD TOWN TRUSTEES: YES o TOWN ZONING BOARD APPROVAL: YES or TOWN PLAN. BOARD APPROVAL: YES o FLOOD COMPLIANCE ZONE: PRE-FIRM 3/18/80 EL #: !94 FLOOD ZONE:_, NYS ENERGY: YES OR NO EGRESS: VENT: LIGHT: NOTES: 9752- /;.j- /,-,,-, % 111,10t 2,a;pfo / *r4eevA <s ,,4 - S,og to As aK -w,fla 3)11.0 41.� 16ecK 5e4— ��crc� — 67" C>A 0r�ry�.vy 9/p�p /rf4 t.A �fP.(�'e.v: /!�S FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR ,/97 SF SECOND FLR 012 SF INIT OTHER TOTAL TOTAL: / &z9 SF FEE FEE FEE TOT( SF)- ( kSd SF)= SF X $ ,20 =$ /SSS+$ 7 +$ c'�- _ $ 2,2040 1 SURVEY OF PROPERTY - - -- - --- --- - -- -- - SITI EAST MARION TOWN: 5OUTHOLD SUFFOLK COUNTY, NY SURVEYED II-1-2000 I SUFFOLK COUNTY TAX u 1000-31-14-1 S6 Al \ 40 o Oji � CERTIFIED TO: D I11 -�'?983p� 1 l BRYAN DONNEY rn '1- -_. p\ I 1 JENNY BETH DONNEY D ',I ° FIDELITY NATIONAL TITLE IN5URAN - GE COMPANY Z \ Jp . �...... o D F Z o Orn v u� DI 5� . •�� 6 All �I r 4 � •a s - FE n ti n 3.n 5 , P - -- -- - -- --- To'er., w PIIIIIIb N M c sa � CIP = N W WAI m zm rn O Ln 4ec �CJ Ii/ V m E I I G S a n _� d 8 9—T7 z O J � DA � N n 3Go O I 20 > a w I w F N ,a �D Q �N V G Z L i 4 - L Fw ° w a ° ARA6G 100 6A4 v ` GnF ]AE 00 G O O I � I - - W 5706KADE FEN-E w ry FG'T 6 RA'Lp FrppGE _1''" �/ —p—p �—p 56405 50 W 106.54 LAND NOW ,,)R FORMERLY OF EDWIN R. 5C.HAFER CL OF NEk, NOTES: ® PIPE FOUND �\ - DEED REF. L. 8804 cp 3'73 4 - JANO SUP AREA = 36,015 SF OR 0.83 ACRES JOHN C. EHLERS LAND SURVEYOR UVryO R —GRAPH G SCALE I 6 EAST MAIN STREET N.Y.S. LIC. N0.50202 I RIVERHEAD,N.Y. 11901 REF.\\HP SERVER\D\PROS\20-281.pro - -- - -- _--_— - — 369-8288 Fax 369-8287 ---------------- I W o V � ZW Wz Liz o to EXISTING EXISTING Q LIVING DEN > O ROOM z EXISTING `{ CRAWL EX15TI NG 5PAGE Q BASEMENT EXISTING FOUNDATIONO H (2)2x10 N W 2" THK Z0 _z EXISTING FLOOR CONCRETE ALIGN NEW ~ z N O N O RELOCATED SLAB � O ;• w N EXISTING 0 FOUDATION v F _ N ® Ib" OG X w - IL — ` v AN ' WALL WITH u K w ® ` O — ® m EXISTING WALL N ® w O N = N (3)2X6 EXISTING cV I NEW ABOVE 0 Z N V O ® rt1 POST DRAWL SPACE ml I CRAWL EXISTING WALL PROVIDE I/2" AIR EXISTING PROVIDE 32" WIDE SPACE ABOVE TO BE SPACE AT ROOF WALL TO BE m REMOVED BETWEEN PLYWD REMOVED 24" HIGH ACCESS 1?" AND BATT RELOCATED aED OPENING IN EXI5TIN6 NEW FLOOR `': x EX1571N6 6 �5 P� T FOUNDATION ( JOISTS 0 -" ',: NSULATION FOR WINDOW m P AIR CIRCULATION pNj �� o 2X8 g it,,, NEW NEW PROVIDE NEW OG CLOSET BATHROOM SOFFIT VENT 4 NEW CONCRETE NEW SOFFIT TOli FOUNDATION 8" MATCH EXI5TIN6 TFC 02g4 CoQ THICK ON 8"x24" OFN FOOTING 3'-b" NEIN 2xb EXTERIOR STUD WALL WITH R-19 BATT ALIGN NEA BELOW GRADE ON INSULATION WITH EXTERIOR 51DIN6 AND INTERIOR DATE. 4 / 22 /03 EX I STING UNDISTURBED TI N NALL '- " FOUDA O L FINISH TO MATCH EXISTING 8 O PLATE HT FOUNDATIONWITH EXISTING GRADE 1l2" SCALE: = 1 -0'. J D FOUNDATION WALL NEW ROOF RAFTERS ABOVE WITH NEW R OFI G N ON 30# BUILDING PAPER ON 5/8" EXT OR PLYWD W/ BATT SHEET TITLE: INSULATION AND CEILING FINISH TO MATCH EXISTING PARTIAL PROVIDE 1: 12 MIN ROOF PITCH FOUNDATION & FIRST FLOOR PLANS PARTIAL FOUNDATION PLAN P SHEET" PARTIAL F SCALE: 1/2" = 1'-0' IRST FLOOR P LAN SCALE: 1l2" = 1' •0" � �I tEPEDAgC ���, u ,T,tc �YSLiC .I,u� mow.+ cMEra APPROVED AS NOTED REQ DATE: :F21 B.F.p FEEA .Y70.53 0 BY: NOTIFY BUILDING DE ARTMENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: t. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMIt:G & PLUMBING PL UMBER CERT/F/CA 3. INSULATION OJ+/LEAD CONTENT BEFj/QOR p;/ 4, FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. C--87-1F/CA7E OF QCCUPA1V ALL CONSTRUCTION SHALL MEET ;g(�jT�g: THE REQUIREMENTS OF THE N.Y. "p,, . RUSED/NWATEe, STATE CONSTRUCTION & ENERGY "' Te'VSY TEN3CAIVl+u`1�T CODES. NOT RESPONSIBLE FOR y'., ",L-t7 :'/YO (J'F DESIGN OR CONSTRUCTION ERRORS /°'a L i,,l OCCUPANCY OR PROVIDE ANTI-SCALD AND/OR USE IS UNLAWFUL THERMAL SHOCK PREVENTING �1iITHOUT CERTIFICATE DEVICES ASTO PARI N•C STATE BUILDING CODE. f ' OF OCCUPANCY UNDERWRITERS CERTIFICATE REQUIRED PROVIDE SMOKE-DETECTING ALARM DEVICES PLUrt,JBING AS TO PART. 7211 ALL PLUMBING WASTE N-YS BUILDING CODE. TES&MATER LINES NEED TING BEI ORE COVERING PROVIDE OPENINGS FOR EMERGENCY ESCAPE AS If Capper tubing is used REQUIRED BY PART. 714 OF sforrws`er distributing CODE. Y t �e piping shall be N.Y. STATE BUILDING . of types K Dr L anlY - UNDERWRITERS CERTIFICATE REQUIRED NOTA: A�ZGI-}ITFi;-�- IS KES�oNS113LE AOR STfZUGTURAL 0 GGNSRAL I✓ICDIF-IGo4T-IpNs 12EMrn/ EXIST WL's l- Paws MOUSE. �FFiG+I, WILL NOT BE VIDt NEYN �'T.'ANN� W SF'ON OGLE =OFi G6N��T"RllriT AJM 1,111 L�12G{{. A"r SUNT�rlivl_ I S NOT i5PON51 b FO2G�k d Ta pW� v NEW GEo {ERMAL t PNG Z SYSTEv ! 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Wim- A5 MED DIREa�ION 017- P F J,� I I v+% �✓LI�ING �7ooR ` ", _ Exrot', t sT, laxS +�l� T io IzEMDVE x G.tK� T Z W Lu LLJ <lN }�.�ITAF3�1 E S GL hoUeL� RR'S AFIJKF> D VI NC, FODM NEW SK-1 i.IC,I -r N 1 "Tq," 15 t . OF � 7,-r_- T SdJRM, WA PROVI4�E'f�MP, , GLA�T EXIS?" S1"AI(L 4-�n2. 4- P 1s7 �L IzEM�I J- ON 72 t3ATH a Co °° �iL'�IN6 navRs FOUND. FD`( RAIU DTOFEN SIDEf� f 1�IE!'J InIINDOVJ CLO�,ET NEN t+ bz3 -- ¢ _2�4, POST-ro C7PLNOOF-CoNG, PAD TD GONG PADF�kD NOT1;S — —1 —Jf NEACKR-�= t ; FJ PEfZPENDIGiLPIZ- � -2xlo az —NEW N B . Z / NEF��4pE2++2 W 2- 2Xg, W/, V2^ x7' STL FL e' pP6Nl C� _ u � I a F�, PaR?,LLEL - 2 -2x1 Cb N n REM©VE Ex. NDpW I / ��`' I � +4fE Dawn o2 : F1. PERP�NDIGU _ 4- �iq l,q LVL OR r} u W J IC1 �-GHEN ?�MDvE 61. NIN'DON - 2 2w12 WVN/ 11 1 '2 /2 ' 5TLFF- u1 2 0 �-7 12 -0 eW t>ootZ.Sh' o^ WIMP FJ P Rf�LL� V '3 /qx ly L L 012 w F q 2xCo Y� - MIDI. _ a HEADER* 3 '• '3 I �/¢ ICo LVL o�l¢5 �. 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