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Home My WebLink About31209-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31111 Date: 08/16/05 TNIS CERTIFIES that the building NEW DWELLING Location of Property: 3795 MAIN BAYVIEW RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 78 Block 2 Lot 15.2 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 20, 2005 pursuant to which Buildin~ Permit No. 31209-Z dated JL~gE 20, 2005 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 SINGLE FAMILY DWELLING ON EXISTING FOUNDATION AS APPLIED FOR. The certificate is issued to PETER F FOSTER of the aforesaid building. (OWNER) SUFFOLK COUNTYDEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL C~KTIFICATE NO. N-47060 11/06/98 PLUMBERS C~TIFICATION D~£~u3 06/22/05 GREENPORT PLUMB.&HEATING Authorized 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. 31209 Z Date JUNE 20, 2005 Permission is hereby granted to: PETER F FOSTER PO BOX 896 SOUTHOLD,NY 11971 for : CONSTRUCT ONE FAMILY DWELLING ON EXISTING FOUNDATION AS APPLIED FOR PER DEC & TOWN TRUSTEES. THIS PERMIT REPLACES 24302. at premises located at 3795 MAIN BAYVIEW RD SOUTHOLD County Tax Map No. 473889 Section 078 Block 0002 pursuant to application dated JUNE 20, 2005 and approved by the Building Inspector to expire on DECEMBER 20, 2006. !. S ~. Lot No. 015.002 ORIGINAL Rev. 5/8/02 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPAN( This application must be filled in by typewriter or ink and subnfitted 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 fi'om Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of I% lead. 5. Commercial building, industrial building, multiple residences and sitrfilar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for tile building. 6. Submit Plamting 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 shmving 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 wntmg to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00. Additions lo dwelling $25.00, Ahcrations to dwelling $25.00, Swinuning pool $25.00, Accessory building $25.00, Additions to accessory building $25.0U. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Cop}' of Certificate of Occupancy- $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00. Conunercia[ $15.(}0 New Construction: Location of Property: House No. Owner or Owners of Property: Suffolk County Tax Map No 1000, Subdivision Old or Pre-existing Building: (check one) Ilamlet Section Pemtit No~/~O~-- ~._ Date of Pennit. Health Dept. Approval: Block Lot Filed Map. Lot: Applicant: Underwriters Approval: Plmming Board Approx al: Request for: lemporaw Certificate Fee Submitted: $ Final Certiticate: (check one) Applicant Signature I;UIIlll Il I'll ' THE NEW YORK BOARD OF FIRE UNDERWRITERS i.."' ' BUREAU OF ELECTRICITY F~ 40 FULTON STREET, NEW YORK NY 10038 THIS CERTIFIES THAT only the electrical equipment as described below and introdnccd by the ~pplicant t~ reed on the abow, application ntt~nber is in the i,'etniges of in the following location; [] Basement [] 1st Fl. [] 2nd Fl. 3 ,'.' Section Block was examined on ~'Y,i~i ~.~ ,t?,-.. l_q?~ and,found to be i~ compliance with the National Electrical Code. Lot FIXTURE FIXTURES RANGES COOKING DECKS OVENS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES FLUORESCENT OTHER DIMMERS OTHER APPARATUS: i:4;/DUI,!~2': H h£ ...... _,-121: . ~t~. O,.~ _ t I{ F--I!UNCY H{~t!Ee-. !!UNCY ?A~ ]. NO' OF "I'LEG o~ .,-LEG : .o O~.~UT.~LsJ ~.wo. !193q_2453 GENERAL MANAGER Per This cerfificofe must not be altered in any monner; return to the office of the Boord if incorrect. Inspectors moy be identified by their credenflols. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. Toxvn Hall, 53095 Main Road P.O. Box 1179 Southol& New York 11971-0959 Fax (631) 765-9502 Telephone (631) 765 - 1802 BUILDING DEP,~RTMENT TOWN OF SOUTHOLD CERTIFICATION Date: Bnilding Pem~it No. Owner: /Zve: 7t r: (Please print) Plumber: (131ease print) I certi~, that the solder used in the water supply system contains less than 2.'10 of 1% lead. Sworn to before me this Notary Public, ~"~County (Plumbe~:s Sigfl~ure) PROFESSIONAL ENGINEER 1725 HO~ART ROAD / PO Box 616, SOUTHOLO, NEW YORK 11971 .~EL631-765-2954, FAX63~14-3516 · e-mail: ioseph~s~et~.com Date: July 26, 2005 Reference: Permit 31209Z Building Inspector Town of Southold Main Road, Southold, NY 11971 Dear Sir, I have inspector the crawl space at the dwelling at 3795 Main Bayview Road in the Village of Southold and certify the following: The batt insulation is installed in the ceiling of the crawl space. The cracks visible ia the foundat~ml cracks. Joseph Fischetti, P.E. 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ] INSULATION [ ]FRAMING [~L._FINAL ~ [ ]FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE. ~'-- ~''- ~"~ INSPECTOR 3/~-o~I 7__ 765-1802 BUILDING DEPT. INSPECTION ] FOUNDATION 1ST [ ]ROUGH PLBG. I FOUNDATION 2ND [ ]INSULATION ]FRAMING ~FINAL [ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION REMARKS: ~ -~~ DATE 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 2ND [ ] INSULATION FRAMING [~__.FINAL FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ~FINAL [ ]FIREPLACE&CHIMNEY[ ]FIRESAFETYINSPECTION REMARKS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY DATE t/~/,~ INSPECTO~ · New York State Department of Environmental Conservation Division of Environmental Permits Building 40 - SUNY, Stony Brook, New York 11790-2356 Telephone (516) 444-0365 Facsimile (516) 444-0360 John P. Cahill Commissioner August 11, 1997 Peter Foster PO Box 361 Peconic, NY 11958 RE:1-4738-01699/00001 Dear Permittee: In conformance with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing regulations (6NYCRR, Part 621) we are enclosing your permit. Please read all conditions carefully. If you are unable to comply with any conditions, please contact us at the above address. Also enclosed is a permit sign which is ~o be conspicuously posted at the project site and protected from the weather. Very truly yours, MEP/j r enclosure File ar%ly~ E. Peterson Environmental Analyst I DEC PERMIT NUMBER *1-4738-01699/00001 FACILITY/PROGRAM NUMBER(S) NEW YORK STATE DEPARTMENT DF ENVIRONMENTAL CONSERVATION PERMIT Under the Environmental Conservation Law EFFECTIVE DATE August 11, 1997 EXPIRATION DATE(S) August 31~ 2001 TYPE OF PERMIT · Mew [] Renewal [] Modification [] Permit to Construct [] Permit to Operate [] [] m [] [] Article 15, Title 5: Protection of Waters Article 15, Title 15: Water Supply Article 15, Title 15: Water Transport Article 15, Title 15: Long Island We[ts Article 15, Title 27: Wild, Scenic and Recreational Rivers [] 6NYCRR 608: Water Quality Certification [] Article 17, Tit[es 7, 8:SPDE5 [] Article 19: Air Pollution Control [] Article 23, Title 27: Mined Land Reci~tion [] Article 24: Freshwater Wetlands · Article 25: Tidal Wetlands [] Article 27, Title 7; 6NYERR 360: Solid Waste Management [] Article 27, Title 9; 6NYCRR [] Article 34: Coastal Erosion Article 36: Floodplain [] Articles 1, 3~ 17~ 19, 27~ 37; 6NYCRR 380: Radiation Control [] Other: PERMIT ISSUED TO Peter Foster TELEPHONE NUMBER 516-765-1815 ADDRESS OF PERMITTER PO Box 361 Peconicr NY 11958 CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER Same NAME AND ADDRESS OF PROJECT/FACILITY Foster Property Bayview Road LOCATION OF PROJECT/FACILITY Sou[hold COUNTY Suffolk TOWN IWATERCOURSE Sou[hold Goose Creek DESCRIPTION OF AUTHORIZED ACTIVITY NYTM COORDINATES Reconstruct on existing foundation, a (521X 251) single family house. AL[ work shall be in accordance with the attached NYSDEC approved plan. By acceptance of this peri, it, the permittee agrees that the permit is contingent upon strict compliance with the ECL, ali applicable regulations, the Genera[ Conditions specified (see page 2) and any Special Conditions included as part of this permit. PERMIT ADMINISTRATOR: George W. Hammarth HEP AUTHORIZED SIGNATURE ADDRESS Bldg. 40, SUNY, Roolll 219, Stony Brook, NY 11790-2356 DATE 8/11/97 Page i of s (~ttERAL I Ospect ices 1. The permitted site or .facility, including relevant records, is subject to in- spection at reasonable hours and intervals by an authorized representative of the Cepar~'~nt of Enviro[~,enta[ ~nser~atian (the Ceparw,'ent) to deten'nine~ whether the permittee is cu~plyingwith this permit and the I:~_. Such represen- ter ire may order The vv3rk suspended pursuant to ~ 71-0:301 and SA°A 401(3). A copy of this permit, including all referenced maps, dra~vings and special conditions, must be available far inspection by the Deparb~nt at all tin'es at the project site. Failure to produce a copy of the permit upon request by Dedar~rent representative is a violation of this permit. Permit ~ ard Fla~uals 2.. The Depar~,,~nt reserves the right to rr~dify, suspend or revoke this permit ~hen a) the scape of the permitted activity is exceeded or a violation of any condition of the permit or pr~visions of the ~ and pertinent regula- tions is four~; b) the permit v~s obtained by misrepresentation or failure to disclose relevant facts; c) ne/vrraterial infom'ation is discovered; or d) envira.,~ntal conditions, relevant technology, or applicable I~v or regulation have material Iy changed since the permit was issued. The permittee trust sub-nit a separate written application to the Depath~t for renal, rmdification or transfer of this permit. Such application rrust include any fom~, fees or supplu3untal info,.ation the Department requires. ~y renege I, rmd i ficat ion or t ransfe r granted by the 1:3epa r ~,, unt trust be i n wr i t i ng. The permittee must sul3"nit a rene~l apol ication at least: a) 180 days before expiration of permits for State Pollutant Discharge Et imination Systm~ (S=CES), Hazardous ~aste ManagaTent Faci. I ities (~I:), major Air Pollution G3ntrol (AF~) and Solid V~ste M~nagu~'ant Facilities (SIX/F); and b) 30 days before expiration of all other permit types. 5. Lhless expressly provided for by the Cepar~ent~ issuance of this permit does not m3dif~, supersede or rescind any order or determination perviously issued by the Cepar,,unt or any of the terrrs, conditions or requirements contained in such order or determination. ~ther Legal 0~1 igatior~ of Perm/tree 6. The permittee has accedted expressly, by the execution of the application, the~ , full legal responsibility for all damages, direct or indirect, of v~atever nature and by v~u~ever suffered, arising out of the project described in this penmit and has agreed to inda'.',ify and save harmless the State frcm suits, actions, damages and costs of every r,,~,u and description resulting from this pro ject. This permit does not cor~/ey to the pen~nittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted v~rk nor does it authorize the inq3ai[.~nt of any rights, title, or interest in real or personal property held or vested in a 3erson not a party to the pe rmi t. 8. The permittee is responsible for obtaining any other permits, approvals, lands. eas~'~nts and rig~ts-af-v,~y that may be required for this project. Page 2 of ~DDITIONAL GENERAL CONDITIONS FOR ARTICLES 15 (Title 5), 24. 25. 34 and 6 NYCRR Part 608 ( r~.(~], r~Tet]_a~.~ ~aters or rlood flows or endanger the health, safety or welfare of and floodcapac~t¥ofthewatercourse No claim shall be made against 111 That the State of New York ,,hall m no case be liable for an,,, damage by or result from future operattons undertaken by the State for the Grantln~ of th~s permit does not relieve the applicant of the responsi- the U $. ~.rmy Corps of Engineers, U S Coast Guard. New York State Office of General Serwces or local government which may be required pt ant wetland or waterway by suspended solids, sediments, fuels, ) proiect. 13 Any material dredged m the prosecution of the work hereto permitted shall be removed evenly, without leaving large refuse piles, ndges across the bed of a waterway or floodplain or deep holes that may have a 14 There shall be no unreasonable interference w~th navigation by the work If upon the expiration or revocation of this permit, the project hereby authonzed has not been completed, the apphcant shall, w~thout expense any portion of the uncompleted structure or fill and restore the site to its former condition. NO claim shall be made against the State of 16 If granted under 6 NYCRR Part 608, the NYS Department of Enwron- mental Conservation hereby certdies that the subject project will not Sections 301. 302. 303. 306 and 307 of the Clean Water Act of 1977 (PL 95-217] prowded that all of the conditmns listed hereto are met. w~th the approved plans submitted by the applicant or his agent as part Such approved plans were prepared by SI'IL~ ,,,To~q~ . on S/30/cJT' SPECIAL CONDITIONS Roads, driveways, and/or parking areas shall be graded to direct runoffaway from tidal wetlands and protected buffer areas, There shall be no disturbance to vegetated tidal wetlands or protected buffer areas as a result of the permitted activity. During construction, concrete or leachate shall not escape or be discharged, nor shall washings from U'ansit mix trucks, mixers, or other devices enter tidal wetlands and or protected buffer areas. The storage of construction equipment and materials shall be confined to within the project work site and or upland areas greater than 75 linear feet from the top of the bank boundary. All areas of soil disturbance resulting from this project shall be stabilized immediately following project completion or prior to permit expiration, whichever comes first. The approved methodologies are as follows: stabilization of the entire disturbed area with appropriate vegetation (grasses, etc.). 10. 25 For Article (_ SPECIAL CONDITIONS Tidal Wetlands temporarily stabilized with straw or hay mulch or jute matting or other similar natural fiber matting within 1 week of final grading. Temporary stabilization shall be maintained until a mature vegetative cover is established. All disturbed areas where soil will be temporarily exposed or stockpiled for lodger than one (1) week shall be contained by a continuous line of staked hay bales/silt curtain (or other NYSDEC approved method) placed on the seaward side between the fill and wetland or protected buffer area. Tarps are authorized to supplement these approved methods. If seeding is impracticable due to the time of year, a temporary mulch must be applied and final seeding performed at the earliest opportunity when weather conditions favor germination and growth, but not more than six months after project completion. Necessary erosion control measures i.e., haybales, silt fencing, etc. are to be placed on the downslope edge of any disturbed area. This sediment barrier is to be put in place before any disturbance of the ground occurs and is to be maintained in good condition until thick vegetative cover is established. Roof nmoff must be directed to drywells a minimum of 75 linear feet landward of the most landward edge of the top of the bank, and be installed a minimum of 2 feet above seasonal high groundwater. This permit does not authorize any alteration, expansion or replacement of existing septic systems. Supplementary Special Conditions A thru F Attached .].-4738-m 699/'0{x~1. Page 4 of 5 SPECIAL CORDiT£ONS The following conditions appl~ to all Tidal Wetlands; Freshwater Wetlands; Coastal Erosion Management; and Wild, Scenio, and Recreational Rivers Pel-mits: A copy of this permit, including all conditions and approved plans, shall be available at the project site whenever authorized work is in progress. The permit sign enclosed with the permit shall be protected from the weather and posted in a conspicuous location at the work site until all authorized work has been completed. The per~ittee shall require t. hat any contractor, project engineer, or other person responsible for the overall supervision of this project reads, understands, and complies with this permit and all its general, special, and supplementary special conditions. Any failure to comply precisely with all of the terms and conditions of this permit, unless authorized in w~iting, shall be treated as a violation of the Environmental Conservation Law. If any of the permit conditions are unclear, the permittee shall contact the Division of Requlatory Affairs at the address on page one or telephone (516) 444-0365. If project design modifications become necessary after permit issuance, the permittee shall submit the appropriate plan changes for approval by the Regional Permit Administrator prior to undertaking any such modifications. The permittee is advised that substantial modifioation may require submission of a new application for permit. At least 48 hours prior to co~encement of the project, ~he permittee and contractor shall sign and return the top por~:ion of the enclosed notification form certifying that they are fully aware of and understand all terms and conditions of this permit. Within 30 days of completion of the permitted work, the bottom portion of that form shall also be signed and returned, along with photographs of the completed work and, if required, a survey. For projects involving activities to be under~:aken in phases over a period of more ~_han one year, the permittee shall notify the Regional Permit Administrator in writing at least 48 hours prior to recommencing work in subsequent years. The granting of this permit does not relieve the permit-tee of the responsibility of obtaining a grant, easement, or other necessary approval from the Division of Land Utilize=ion,' Office of General Services, Tower Building, Empire State Plaza, Albany, N~f 12242 (516) 474-2195, which may be required for any encroachment upon State-owned lands underwater. DEC .Permit No. /-%~7~-O/~q]/~-~-W-~/ Page ~--of~ New York State Department of Environmental Conservation NOTICE The Department of Environmental Conservation (DEC) has issued permit(s) pursuant to the Environmental Conservation Law for work being conducted at this site. For further information regarding the nature and extent of work approved and any Departmental conditions on it, contact the Regional Permit Administrator listed below. Please refer to the permit number shown when contacting the DEC. Permit Number Expiration Date Regional Permit Administrator NOTE: This notice is NOT a permit Board Of $outhold Town Trustees PERMIT NO. ISSUED TO . SOUTH~W YORK DATE:. 6130197 PETER FOSTER Xutl orizati u Pursuant to the provisions of Chapter 615 of the Laws of the State of New York, 189~1: and Chapter 404 of the Laws of the State of New York 1952: and the Southold Town Ordinance en- titled "REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS:" and in accordance with the Resolution of The Board adopted et a meeting held on 6/25/9?. 19 97, and in consideration of the sum of $ 150.00 paid by PETER FOSTER. of . . Southolcl N.Y. and subject to the Terms and Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes end permits the following: Wetland I~ermit to reconstruct a single family dwelling using existing sanitary system, well and foundation, approx. 50' away from wetlands and within the same limit of clearing as previous. all in accordance with the detailed specifications as presented in the originating application. by IN WITNESS WHEREOF, The said Board of Trustees h~re- causes its Corporate Seal to be affixed, end these presents to subscribed by a majority of the said Board as of this date. Albert J. l(.fllpski, President John Holzapfel, Vice President Jim King Martin H. Garrell Peter Wenczel Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 June 30: 1997 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Peter Foster Bayview Road Southold NY 11971 Re: SCTM #78-2-15.2 Dear Mr. Foster, The following action was taken by the Board of Town Trustees during its regular meeting held on June 25, 1997, regarding the above matter: WHEREAS, PETER FOSTER,applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated June 11, 1997, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on June 25, 1997, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation snb~itted concerning this application, and, WHEREAS, the structure complies with the standard set forth in Chapter 97-18 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW T~R~EFOREBE.IT, RESOLVED, that the Board of Trustees approves the application of PETER FOSTER to reconstruct a single family dwelling using existing sanitary system, well and foundation, approx. 50' from wetlands and within the same limit of clearing as previous. Located: Bayview Road, Southold. away BE IT FURTHER RESOLVED that this determination should not be considered a determination made for any other Department or Agency which may also have an application pending for the same or similar project. Permit to construct and complete project will expire two years from the date it is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Two inspections are required and the Trustees are to be notified upon completion of said project. FEES: None Very truly yours, Albert J. Krupski, Jr. President, Board of Trustees AJK/djh cc. DEC Dept. of State Bldg. Dept. Telephone (516) 765-1801 Town Hall, 53/)95 Main Road P.O. Box 1179 Southold. New York 11971 SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL The following recommendation was made at the meeting of the Southold Town Conservation Advisory Council held June 23, 1997: No.' 10,67 RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL of the Wetland Permit Application of PETER FOSTER 78-2-15.2 to rebuild a single family dwelling. Septic system and well already exist. Bayview Road, Southold e. ~ ~ I' O.M.B. NO. 3067-0077 ELEVATION CEFITIFICATE t ,6 FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ATrENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only to provide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to determine the proper insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR). Instructions for completing this form can be found on the following pages. SECTION A PROPERTY INFORMATION STREET AD ant OTHER D etc.t and/or Bldg. Number) OR RD. ROUTE AND BOX NUMBER FOR INSURANCE COMPANY USE POLICY NUMBER STATE ZfP CODE SECTION B FLOOD INSURANCE RATE MAP (FIRM} INFORMATION Provide the following from the proper FIRM (See Instructions): 7. Indicate the elevation datum system used on the FIRM for lBase Flood Elevations (IBFE): ~NGVI) '29 ~ Other (describe on back) 8. For Zones A or V, where no BFE is provided on the FIRM, and the community has established a BFE for this building site, indicate the community's SFE: ~ I i ! I i,J~ feet NGVD (or other FIRM datum-see Section lB, Item 7). SECTION C lBUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best describes the subiect building's reference level ~. 2(al. FIRM Zones Al-A30, AE. AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation of i i ~_L~J .[_~J feet NGVD (or other FIRM datum-see Section B, Item 7). (bi. FIRM Zones V1-V30, VE, and V (with IBFE). The bottom of the lowest horizontal structural member of the reference level from the selected diagram, is at a'A elevation of I___ J I I I.l_j feet NGVO (or other FIRM datum-see Section lB, Item 7). lc). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is [_~_I. L~ feet above L~ or below ~ (check one) the highest grade adjacent to the building. Id). FIRM Zone AC, The floor used as the reference level from the selected diagram is ~. ~_l feet above ~_~J or below ~ (check one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference level) elevated in accordance with the community's floodplain management ordinance? ~ Yes ~r~ No [~} Unknown 3. Indicate the elevation datum system used in determining the above reference level elevations: ~ NGVD '29 ~ Other (describe under Comments on Page 2). (NOTE: If the elevation datum used in measuring the elevations is different than thai used on the FIRM [see Section B, Item 7], lhen convert the elevations to the datum system used on the FIRM and show the conversion equation under Comments on Page 2.) 4. Elevation reference mark used appears on FIRM: ~ Yes L~No (See Instructions on Page 4) 5. The reference level elevation is based on: ~ actual construction ~ construction drawings (NOTE: Use of construction drawings is only va/id if the building does not yet have the reference level floor in place, in which case this certificate will only be valid for the building during the course of construction. A post-construction Elevation Certificate will be required once construction is complete.) 6~ The e~evati~n ~f the ~wast grade immediate~y adjacent t~ the bui~ding is: ~- ~ ~ ~[~ L ~Zj feet NGvD (~r ~ther FIRM datum-see Section B, Item 7). SECTION O COMMUNITY INFORMATION 1. If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item 1 is not the "lowest floor" as defined in the community's floodplain management ordinance, the elevation of the building's "lowest floor" as defined by the ordinance is: [ I I -[_~_l.b~J feet NGVD (or other FIRM datum-see Section lB, Item 7). ~.. Date of the start of construction or substantial improvement FEMA Form 81-31, MAY 93 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION SECTION E CERTIFICATION This certification is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to certify elevation information when the elevation information for Zones Al-A30, AE, AH, A (with BFE),V1-V30,VE, and V (with BFE) is required, Community officials who are authorized by ~ocat law or ordinance to provide floodplain management information, may also s~gn the certification. In the case of Zones AC and A (without a FI=MA or community issued BFE), a building official, a property owne~, or an owner's representative may also sign the certification. Reference level diagrams 6, 7 and 8 - Distinguishing Features-if the certifier is unabte to certify to breakaway/non-orea~,away wall, enclosure size, location of servicing equipment, area use, wale openings, or unfinished area Feature(s~, ti s) not included in the certification under Comments below. The diagram number. Section C, Item 1, certify that the information in Sections B and C on this certificate represents my understand that any false statement may be punishable by fine or ~mprisonment under t 8 U.S. ( CERTIFIER'S NAME TITLE COMPANY NAME ~s ...... -- - ; ~T~ ----~ -- -- ST~ S~XTU RE ' " - ~AT~ - ~HONE /, The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones. Elevations for ali A Zones should be measured at the top of the reference level floor. Elevations for all V Zones should be measured at the bottom of the towast horizontal structural member. Page 2 TOWN OF SOUTHOLD PROPERTY P~CORD CARD OWNI:R STREET · .~ , ,,' VILLAGiE DIST. suB. LOT FORMER OWNER N E I ' . ACR. I ("" s w ~w~ oF BU,LD,N~ RES.~/~ S~S. VL. FARM COMM. CB, MICS. Mkt. Volue - ._ Tillable FRONTAGE ON WATE~ W°~land FRONTAGE ON ROAD - Meadowland 'DEPTH House Plot BULKHEAD - Totol ,[. ~~t~_' .~ ~' Exten~ion Extension /Zxtension Foundation , _/.~' ~.~, Porch Porch Breezeway Garage Patio O.B. Total Ext. Walls Fire Place Type Roof Recreation Rooo- Dormer Bath Floors Interior Finish 5/r Heat ~. ( Rcoms 1st Floor Rooms 2nd Floor Driveway Dinelte K. LR. DR. BR. FIN. B C^TIOII F(III Illlll.l)lll(l I'1~.1t111'1' I1(I/~111) IIF IIl~./~l.'l'll ............... 3 SIUI'~ ()P I'I.AIlII .............. IiIIIIV I~.¥ ........................ I;III~.CK ......................... .~1~. I"1' I Il PI)IIII ................... lin I.e ................ , 19 .... (ltd I Jlql I~M~.nn of nl~)l h:md ) JJtitl! I)J~ (~flK~r ()J~ Jll(~lllJll~8 ............................................................................................. (n~ t~ the t'n. roll or Intent deud) (rl~.,.~ ;,.I Lit le .F CO~lX)l'nte officer) lld hle~, I.l(:m~l~ flu .......................... .,,,.,..,. ,.,,:.,,,,~ .o .... 2~.7.2..-...P.. ..... ]~.,~,:td,:i,,,,, [.i~,,,,, ~,. ':~/~.~ .7..:..(. .... ,,,,,~,..,.,,.,~,.,.,,:~,,,.,.,,, ..................... .~,~ .¢.~ .f:~ '~)/,.,," P.(...4.~.,.(.(..~..r.¥~..~....~(.~ ................................................. . ..... .................... ~,..,,.~.,,..,,,~. ,,,,~ ~,:,,,., .... :z? ...... ,,,.~,.;.~.,,,~ ,,, .......... ,~, ,~,~...I..., .L~" e be ............... lot ......... : ..... (~.,~) ~, ~;, , . ,,.,: ,...~ . :~/~: h ........... ,,. ,,,,,,,,,~, ,,,~, ,,,., ,~,:,,,,,,,~, ....... ~.(6..V.'i ~ ~ ..... ~/¢. ~ ~ ~ ......................................... EXI~DTIN¢ CON.~. BLOC, K FOUNDATION I,"',IALL (-r"fP.) SEE ~ETAIL OF ~TEP, 5UPPL'r' INSULATIN~ oONDUIT EXISTIN~, POL'f'ETN'¢LFNE ~A. TER. PiPE ON EXISTIN~ CONC. SLAB ~liTH INSULATION ON TOP AND SIDES (MIN. t;,-¥ALUE OF "T.) ALL C, OV~ED E~¥ 2.~." OF OLEAN FILL ("r"r'P.) I /~ iI// iI // / / ! / / / / / / / / t / /.// / / / ! / //! / / ! / / ~! /! / / ! / / ! / ! / / ! / ! / / ! / / ! / I // I / / / I / I / / / // / / · / // / / / / / / / / / / 28' 52'-0" I=XIDTIN~ FOUNDATION PLAN 5CAGE 1/4" = I'-0" Michael Drake, P.~. 14 Captree 181and, Box 4619 Babylon, New York 11702 (616] 893-9213 MR. ~ETER FOSTER PROJECT NO. DRAWINg. FO~TERI ~,4EET 1OF 2 ooME~TIC~ HOT ~LUt~ ANO ;t~.E~t 'FO¢ OF INSULATE~ CoN~UIT TO BOTTOM OF ALL PIPE~ A[TH PII=E ~NSULATION LONGITUDINAL ¢EC, TION 514" = I'-0" Michael Drake, p.'l~,. 1 14 Captreo Ill;and, Box 4619 Babylon. New Yolk 11702 (518) 888-9213 . ~ FOSTER REI~DENCE ~785 BAYVI~W ROAD BOUTHOI. D, NEW YORK 11B71 ~I055 5EC, TION MR. PETER FOSTER PECONIC, NEW YORK I196~ ALEXANDER F. TREADWEL~ STATE Of NEW YORK DEPARTMENT OF STATE ALBANY, NY 12231-OOOI 'September 30, 1997 Mr. Robert Hoffman Director of Engineering Muncy Homes, Inc. PO Box 246 - Route 442 East Muncy, PA 17756 Dear Mr. Hoffman: Re: Approval No. 01387 Manufacturer No. M 1387 Dear Mr. Hoffman: Your request for an extension of the expiration date of Factory Manufactured Home Approval No. 01387, applicable to a system for one and two family dwellings, is hereby granted subject to the conditions of the initial approval. In addition, the manufacturer shall be responsible for assuring that homes or components bearing insignias issued during the extension period atso comp)y with the current requirements of the NYS Uniform Fire Prevention and Building Code. This extension will expire on November 10, 1997. A copy of this letter shall accompany plans or specifications submitted for a building permit and be deemed a duplicate original. I am hopeful that you will find this extension of assistance. Very truly yours, .-, /' D' ctor, Codes Divisiod NO TES: 1, SURVEY OF PROPERTY SITUA TED A T BAYVIEW TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-78-02-15.2 SCAL£ 1"=50' MAY 30, 1997 AREA = 40,247.97 sq. ft. 0.924 oc. EXISTING ELEVATIONS SHOWN THUS:~-~ ARE REFERENCED TO N.G.V.D, 1929 DATUM EXISTING CONTOURS SHOWN THUS: .... 4 ARE REFERENCED TO N.G.V.D, 2. TC = TOP OF CURB BC = BOTfOM OF CURB TF = TOP OF FOUNDATION 5. FLOOD ZONE: A-4 (ELEV. 8.0) CERTIFIED TO: 1929 DATUM PETER FOSTER THE EXISTENCE OF RIGHTS OF WAY ~.S. Lic. No. 49668 Joseph A. Ingegno Land Surveyor PHONE (516)727-2090 Fox (516)722-5093 97-241A - ~z_ DEC 0 ~, 1977 The sewage disposal and faoillties for this inspected by this departm~n~ APPROVAL ~[TE0 TO ;'. NOV - 3 199i FACTORY I~[JILT PORTION PLP~T .t - ~L~IC¥ HO~,E$ O[VI$[0N, P.0. ~OX 325, RT. ~.q, 2 E~T, /'~UNCY, P~ 17756 I I52'-0" I-`.6~-6' 72" VINYL .1 I 11'-2 1/2" w3030 ~ (O~N TO fl~OVE) 15'-6" .~-9,25"x15'-10 1/2' LIVING F M. 20'-6" 4257 '*257 F35'-6 1/2" .CR34 oO B/WF3 ~ 12'-9" J KITCHEN F16'-i 1/2" 3037 BATH F6'-6,, 72" VINYL 12'-0" 2-9.25"x15' ML 12'-0" 12'-0" ¢8" `*8" 36" `*257 L`*8,_0,, L`*0,-0,, L33,-9,, L2r_3,, New York Note: To the best of my knowledge, belief and professional .ax:igernent 1. this Iractory tienuleactured ~ CF/IH) plan has been al~.roved from a system ~et or FmH plans pre*iougy approved by DI"~R, Rppkcatio, No. 1.387, Manufacturer's No. 1387o Expiration Date 1.0-1.0-g7, ~d~ch has not. been modified in any manner. 2. the e~ergy port~ of ~ F't~-I plan has been prepared usin9 Pat1. .5 of U~e New York StaLe Energy Coeservation Construction Code :Energy Code} end is in full co,%(diance with the Energy Code". NOTE.' 2`*'-0" WIDE SIDEWALL= 2x6 CLG. HGT.= 8'-0" DESIGN SNOW ZONE= `*0 OEST.= S. HAMPTON, NY LIMm~D 1111 P.O. Bo~ 337 ' ~mcy. Pa ;7756 ' ~717) 5~6-a9~ 97 ~11~- 97 DM 10-23-97 DM FUTURE SURR. / FOSTER 32937 FLOOR PLAN 000 ELECT. J S3 6 I iI 7~ 7 ~ ~) 535 To the best of my k.o~ledge, belier and professional j~lgement 1. th~ Factory t~enurectured Pome [F/~H~ plan has been ~p~oroved rro~ a system set of F/~hm plans previoushy eD~roved by Oh~%R, ~Rpi)lk:.a~c~.~ ~__o. 1387, ,~anut'aclurer's No. 3387, 'Exp;ra~on 2. the. eneegy portion of this F/fill p~en has been prepared uSa~g Part ~ of' the Nay York State E~ergy Conservation Construction Code (Energy Code) and is ie rd ¢omp~ence ~nth the Energy Code". 6 FACTORY BUILT PORTION, REMIER UILDER$ P.O. ~ ~7 ' ~. ~ r7~ ' ~rzl ~6-~ FUTURE $URR. / FOSTER mt~ ~: 32937 ELECT. PLflN ~ ~ 000 ~ -2.-~7 1/4"=U-~",i~ ~0~ ,} TyP. FLOOE PLRN FLOOR PLRN NOTES MF~STER SERIES FLOOR pLP, N, EL£V~TIOe~$ & NOTES "i ELECTRIC CIRCUIT SCHEOULE I I DO{JR SCHEDULE WINDOW SCHEDULE , , , j INSULATION SPECIFICRTIONS- ~ ~o~c~ .~.. ,m .? "To ~he be*t or' my ~noCedge, belief e.~d ~*e'~O'~l juc~eme~t, t.~,,~ p~en ~ k~tc~ ~o the o~r~! ~ ~ NAb Oh¢_.~ e~d ~s not been m~ed ~ s~ mam~,r". ;~N BYt DA?£ I $C-~'_"- ~EV. 5HT. the I Pt.U~E~NG FIXTUI~E ~C$. ELECTR[CRL $'F~8OL$ NOV - .5 1997 · FACTORY BUILT PORTION rlRSTER SERIES . ~LL mOO~L$ ~'" ~ ~.'~ ~ ' tll ~ I ~RSTER SE~EES JGGESTED STAIRS, SUGGEST~'D STAIRS, WINDERS TTP. FOUNDATION WALL CENTER COLUMN TYP. FOUNDRTION PLI:tN C~AWL SPACE DETAILS -/ Tie vi~ DH[~ and STEEL COLUMN SPACING aax. TYPICAL I ~LECTR[CAL LAYOUT TYPICAL ELECTRIC HEAT LAYOUT ! ! "R" BOX BOX "R" 80x "8" BOX I "B" 80X TYPICAL HYDRONIC HERT LAYOUT ::": Ii :: FACTORY BUILT PORTION Cnr~ t~OC~L$ ELECTR[CP4- & i"i~AT L~YOUT 3eN 8ri Dn?E 5CP, L~ I~Sv. ~T. NC G .7 CLOSET CONFIGLJRATIONR sen. s: ~/,'~:'-o' FACTORY BI, III.'I' PORTION SIN NOV - 3 1997 ~N s'rI Dnrs ] SCr~L-- I ~.~v. f- $ SNOW ZOHE: d0 PSF, 60 PSF,'g0 PSF- N¥5. $'rnrF{ D~_T r ..:,ri4 j OET~HL "H" OETC~fl "B" DFT~[I "[" TYP_ (:ROSS SECT[ON 1 TYP. CRAWL SPP~CF CROSS S~'CT[ON ~es n~t been ~cr ¥,~5sTM FACTORY BUILT PORTI NOTFS 1'15 ~ ;-.)Il{ /~ASTER SERIES CRO~5 SECT[ON SN~ ZC~'~: ~0 P~. 60 P5¢'. ~0 PSt IN.'r.$.l ~E~TR[L 'ct_ ~ O~'TC~IL "~" DETA[L 't~" OPT-fON~L 9/12 12/t2 I~OOF' W/JO[ST ~AFTEI~ ST~,TEM DETAIL "F" 24-' not been n~:x~n%<i In am/ me, teat". FACTORY BUILT PORTION NOTF5 t-tcq$ TE~ PORCH RO0~ PT ~" S~T~ON THRU OFFSET ROOF TTP[CC~L ~BGE VENT DFT~[[S ALT FLOOR JOIST DETAILS SNOW 70NF: 4-0 PSF, 60 PSF, 90 PSF- N]T.S. TYPICAL OQR~E~ BFTAiL ~_-': TRUSS TO TOP PL~T£ CONNECTION - N.Y.5. 0NLT TTP ATTIC ACCESS AND S~~Ni ~ASTER 5ERIES ALL ~,COE-$ _~.~ SNOW ZONE: 40 PSF, OPT[0NAL 5,'t? 0f~ 7/I2 ROOF II ~~' ~R[SED BOOV PO~CH OPTION RLT, ~00F PO~CH OPT[ON T'Fm SECTfON T~:I~U P~OW the ~es~. o~' my }no',,k~dge, belief' ~d CmFee~::~l judgement, no; ~ mc, dit"i, ec~ ~n eny m~.' ~' r- ~ ~ v ~ w FACTORY BUILT' P~.~ t~RSTEB SERIES ~LL /~OOEL$ t NOTF.: r' Cri~LET P[ ~N t-I,/WqLF..WqT OCCUPANCY - ~ USE fS UNLAWFUl ._:h~tHout CER.~jC~£~ ~? ~. j O~OCCUPANCYl .. " ~- .... ~ ~1~,,- DA~: ~ FRAMINg ~N~L SU~ N~ BUI~ING AT 765-1802 9 AM ' PM FOR ~E OF FOUN~IO~ ~10~ FOLLOW~N~ ~SP=~O~S: H~ BEEN ~ ~. ~OU~OAT~O. - ~0 3 :NSULATION 4, FIHAL - CONSTRUCTION MUST ~E~tB~ff ~ CO~=~L~ FO~ C.O. AL~ CO~S~Um~O. S~L~ ~~ T~E REOUIREMENTS OF THE N.y. C)D~S HOT RESPONSIBLE FOR PLUMBER CERTIFICATION ~/~~/~ .~ o~ ~ co~z~ ~o~ SUPPLY SYSTEM CA~NOT EXCEED 2/~0 of ~ I FAD. PLUMBING o~-~ ~ ' ~ ~ ~R EN~ NEED ~NG BEFORE ~ERING i ~ / If coif tubing Is u~ .~ ~ ~ ' : -' ~m; p ping shall be I ~ ~ K or L onl[ " i: ~.¥. 032254-1 I 'Ir PROVIDE OPENINGS FOR EMERGENCY ESCAPE AS REQUIRED BY PART. 714 OF N.Y. STATE BUILDING CODE.