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HomeMy WebLinkAbout30619-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31117 Date: 08/16/05 THIS CERTIFIES that the building ALTERATIONS Location of Property: 2095 THE STRAND EAST MARION (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 30 Block 2 Lot 52 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 8, 2004 pursuant to which Building Permit No. 30619-Z dated SEPTEMBER 8, 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 ALTERATIONS TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ROBERT & PHYLLIS DIANGIO (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 2066122 08/11/05 PLUMBERS CERTIFICATION DATED 08/12/05 K&K PLUMBING & HEATING ----z - 1-1'f-4 th ize Signature Rev. 1/81 t L -, ;- Form No.6 TORN OF SOUTHOLD T1 BUILDING DEPARTMENT yV,� TORN HALL t 72005 J, 765-1802 f �: APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or int: 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 front Board of Fire Underwriters. 4. Swor statement from plumber certifying that the solder used in system contains less than 2;10 of 1440 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: t. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic leas ures. 2. A properh completed application and consent to inspect signed by the applicant. if a Certificate of Occupancy is denied, the Building hmspector 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 Date. 0 5 New Construction: Old or Pre-existing Building: _Z_C [(checckk one) Location of Property: _�Q�_ _Z (= a r� C Q��CI-l�t on House No. Street Hamlet Owner or Owners of Property: l __I�s_ quo Suffolk County Tax Dlap No 1000, Section (�_�_Q Block C)� _ I of Subdivision]Peke_1 ( h �(ym 5Filed 14ap. _�z j _ Lot: Permit Peit Na. Date of Penuit._ �1 l }$1 V 1 Applicant:_ Health Dept. Approval: _�_ Unden�vriters Approval: Planning Board approval: Request for: l empoi an Certificate __—___Final Certificate: _ 1✓ (check one) Fee Submitted: 5 2 51 00 r AI licam Signature C0 X311 ) 7 E SBY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY S40 FULTON STREET - NEW YORK, NY 10038 C 5 CERTIFIES THAT 5 r5 Upon the application of upon premises owned by PHYLLIS S r5j DANGIO PHYLLIS DANGIO P.O BOX 185 5 EAST MARION. NY, 11939 90 THE GREENWAY—AKA 5 295 THE STRAND EAST MARION, NY 11939 5 Located at 90 THE GREENWAY--AKA 295 THE STRAND EAST MARION, NY 11939 E Application Number: 2066122 Certificate Number: 2066122 E E Section: Block: Lot: Building Permit: BDC ns11 Described as a Residential 600-1199 square R. occupancy, wherein the premises efectrical system consisting of electrical devices and wiring, described below, located inion the premises at: Basement, A visual inspection of the premises electrical system, limited to electrical devtces and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration. or other authority having jurisdiction, and found to be in compliance therewith on the I Ilb Day o` August---W5 Nanclel' Rak Roung C tap{ miscellaneous as built-2004 Appthaces sad Accessories Exhaun Fan 1 0 F.H.P. VAtftg sald Desires (yaNef - -- - - __ -7 t-. . - ..--- -:.. Fixture 5 Fixture 7 0 Incandescent Outlet 15 0 General Purpose Receptacle 10 0 General Purpose Switch 7 0 General P[rpase Dirtoners 2 0 Receptacle 1 0 GM -kn as bull[%must inspeane,of dtc dchat sed eloctr ad imteRown.derder®A dol an obvions iaatd is amt fissions sat de batiso s belie ed a be is comformmm wiat the tip bc"%%trance stsdad for the a period of of k pttiittira sw"t4laso- seof 1 of I This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 10 X11[ �gOfFOL/C �o w Town Hall,53095 Main Road O Fax(631)765-9502 P.O. Box 1179lTelephone(631)765-1802 Southold,New York 11971-0959 41 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Date: �^ Building Permit No.-* 3oQ) I q � -z- Owner: k+-A�4 U5 �1A'1 1 Q (Ple a print) Plumber:WIJI / � "t�� n (Please nt) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plumbers Signature) Sworn to before me this(2_ I day of 20iffs- 61 LYNDA M BOHN NOTARY PUBLIC,State of New York NO.0180 Z Suffolk County Tam E*ft March 0.204Z7 Notary Public, County 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. 30619 Z Date SEPTEMBER 8 , 2004 Permission is hereby granted to: ROBERT & PHYLLIS D'ANGIO PO BOX 185 EAST MARION,NY 11939 for ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 2095 THE STRAND EAST MARION County Tax Map No. 473889 Section 030 Block 0002 Lot No. 052 pursuant to application dated SEPTEMBER 8 , 2004 and approved by the Building Inspector to expire on MARCH 8 , 2006 . Fee $ 150 . 00 u� or ed Signature ORIGINAL Rev. 5/8/02 FIELD INSPECTION REPORT DATE COMMENTS b O m FOUNDATION(1ST) -- ------------------------------------ FOUNDATION(2ND) 0 Ti ROUGH FRAMING& PLUMBING H INSULATION PER N.Y. -- 3 STATE ENERGY CODE -- FINAL - d Z b ADDITIONAL COMMENTS - oY iC lO l m rn W op O z m a 0 b H 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ wrfiNAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE 2-2 INSPECTOR 765.1802 BUILDING DEPT. INSPECTION [ ] FOU TION 1 ST [ j ROUGH PLBG. [ ] F DATION 2ND [ ] IN ION [ FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: zke 79 C .3 DATE < "�� G INSPECTOR ENERGY CODE CALCULATIONS CHAPTER.5 SECTION 501 ° 7 2004 Detached One and Two Family Design Criteria 5750 Degree Days (For Non-Electric Heat) //Zone 11B For: .D � .f A Fra Per: /Pen n. L. b°_ ', 2 S 0 Dated: //7v y SUBSYSTEM AREA DESIGN CODE . DESIGN CODE ecu„ "U" UA UA Exterior Walls s 0 ( U. 1131 0.14 Ceiling Roof 0.031 Floor Over Unheated Space 0.05 Heated Slab On Grade 6.5 Unheated Slab On Grade 4.5 Basement Wall y 70 0 .,, 983 0.1 y 1, .2 c y 7, o � Crawl Space Wall 0.06 NOTES: /0 2 ,/ 7 , `7 Construction shall comply with 502.1.1 moisture control and 502.1.4 air leakage Building Envelope Systems to meet requirements of Section 501 The mechanical systems and equipment including: HVAC Equipment,HVAC Systems,Duct Systems,Ventilation Systems and Insulation of Piping Systems to meet requirements of Section 503 Service Water Heating Systems&Equipment to meet requirements of Section 504 Electrical&Lighting Systems&Equipment to meet requirements of Section 505 i4pE NE» To the best of my knowledge, W belief, &professional judgement, these plans are in compliance acrrsstoNr� with,the code. ,� TOWN OF SOUTHOLD �yy� BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT 1 4 M Do you have or need the following,before applying'! TOWN HALL Board of Health______ SOUTHOLD, NY 11971 3 sets of Building Plans_____ TEL: (631) 765-1802 — — — ---1 Planning Board approval FAX: (631) 765-9502 Survey www. northfork.net/Southold/ PERMIT NO. Check _ Septic Form_===— N.Y.S.D.E.C. Trustees---- Mail f 30_ Contact: L��II �f Approved-o—, '0 . Mail to: Il`^1IL 4 g 'D/ivG iu - — -- Disapproved ac7y B-,y- iks Cs4S"t MA[+at7 o-,y m3l _ Phone:_0 7 4 7 7 1-- Expiration_ , '0 4 Build' g Spector APPLICATION FOR BUILDING PERMIT Date 20 INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining 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 applicatior, the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date.if oto zoning amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in,.vriting, the extension of the pen-nit for an addition six months. Thereafter, a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws,Ordinances or Regulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The applicant agrees to comply with all applicable laws, ordinances,building code,housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant or name, if a corporation) PC C &Y ISS EASTr9r 00A) N Y [Mi (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder Name of owner of premises �I•y lG s d ed OLI21 iD ► AA;i is (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 onwhich proposed work will be done: T / House Number Street Hamlet County Tax Map No. 1000 Section 30 Block a. F Lot Subdivision /7cb6/� &4,:g FAems Filed Map No. 4A66 _Lot //0 (Name) 2. State existing use and occupancy of premises and intendeKse and occupancy of proposed construction: a. Existing use and occupancy (Rqs r n cuc a �/ 9r45 k7A a u T b. Intended use and occupancy_ Q,:r s t p--,v c 3. Nature of work(check which applicable): New Building Addition Alteration L-'— Repair Removal Demolition Other Work (Description) 4. Estimated Cost Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front 60 C1rrt�CE Rear Depth Height Number 8. Dimensions of entire new construction: Front 6o C r' ear Depth Height Number of 9. Size of lot: Front Rear Depth 10. Date of Purchase Q /`� Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO t/ 13. Will lot be re-graded? YES_NO ✓fNill excess fill be removed from premises? YES NO t%,?6K if-s- 14. Names of Owner of premises 19.9tace AvIt, 'IMPAIddress my 14/ Phone No. daW V77 F 7 7 )' Name of Architect A6-0e Qw Yg(S ^Address a Y E u�acet Phone No 6 3 f 4077 0 4v o Name of Contractor T Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF ) being duly swom, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the (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. Swo to before me th s day of i Notary Public Signature of Apt ant LYNDA M. BOHN NOTARY PUBLIC,State of New York No.01606020932 Qualified in Sutiolk CourdV Term Expires March 8,20 • :.:t'A tidATx,;ats.•'f;N's+l�ll ' 'fiY:{L'CS',de1i "�i•S•'!'"' : IL,,'� ..DEPART EHlr. ' t, Yr ' T DF AUR T '85 JUN 12 PM .12 51. r ;• \�` PCO e. 5 - 4 - NHNRk�` EPti *rAy }5r • 'aAy�4 D$NR �� \ . 61 s `A4 COO / ` •p4 TL 9Yr � ". li , ' ^ �•-5 6geYg 10 104 T E Ra •o ,L SUFFOLK 000SPIr''JMALTR DZPARTMRNT SURVEY FOR „ DArs JUN 2.11985 e. D. Rn. o-i9F SAII HANAUER LOT ND. 110, "PEBBLE BEACH FARMS " MAY. 29,1985 The Bea'a9a disposal sold "ter st'yF1Y AT EAST MAR/ON "''`oA7E�"i•SEPT.'22 1981 facilities fol- this location have been TOWN OF 3QUMOLD 'SCALE- /,a + 50' Lnspected by this department and found SUFFOLK COUNTY, NEW YORK NO. 83= 787 LO be iatiafaatol'r }• 'p1� r..}.�. c sUNAY TNORIE EO AL TERM TI OM ON AD 01 TION M MIS GVARANTfED.TO+ ,$ 0., L,= P.E. AVRYP e A VIOLATION OF SECTION it OS OF THE COMMONWE D TITLE Chief Of Os oral gnginserla{ NEW FORK STATE EDUCATION LAW +COPIES O THIS SURVEY NOT REMAINS THE LAND VSUNA 66ANEW P I Services lURVryORf INKED SEAL OR EMEOSECO SEAL MALL Ht O NOT B[CONSIDERED TO SCA VAL 10 TRU[COPY 4P of 9H, KOYAMANTCES INDICATCO HEREON MALL RUM ONLY TO 4'Ov IEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT THF PERSON FOR WHOM THE SURVEY IS FREPARED * rKAM '•:!Yfy:U^ ICM AND a HIS BEHALF TO THE TITLE C011PANYI COVENN-HLAREAT RATIO e11N MI.E RSOURCE OF WATER' MIVarE PUBLIC R MENTAL AGENCY AMD LEMOINB INSTITUTION LISTED'IIfF CO. TAR MAP OmT�,Q SECTIOM➢34_BLOCK-I—LOi�.L HEREON,AMD TO T1[ ASlIOMLEf OF TX[LFMDIMEARE HO WELLIMS WITHIN MO FEET OF TW!PROPERTY ITS TIDOITIONRI IMANTUTMNIS OR SUBT[OUFJTXER THAN THOSE SHOWN HEREON,TRE WAT/R SUPPLY AND IEMSC INSMIAL SYSTEM FOR MIS R[SIDCNC[ OWNERAtiUuY++ 0 1 RILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT ROI STANCES SHOWN MERLON FROM PROPERTY LINES N HEALTH SERVICES. TOE.ISTIMS f7MUCTURES MF I" ASPECIFIC Dir LMLICANT• PVRPOSF AND AMC NOT TO BE USED TO CSTASLISM "TeL 0 I]aNb OOy PROPERTY LINES OR FOR THE [RECTION OF FENCES-' '�R tgLlF' •DOR[E! TIL' 11 (, I 'A'/� OD NDER AVENUE YOUNG a YOUNG RIVERHEAO,NEW YORK roTE . ■ •MONUMENT 0 STAKE ALDEN W.YOUNO,PROFESSIONAL ENGINEER SUNWISION YAP PILED IN TMEOFRCL M ME CLEAN O SUFFOIx OOUNTYON+UNE 11,ISIS AS FILE Mo. SEM AND LAND SURVEYOR N.Y.S.NGENs NO.12845. :THE LOCAr,W ai WPLLIwI,uPT¢uNKpTLc[»Foou(pI SHOWN MERCER! HOWARD W.YOUNG, LAND9UAVf OIK� t"'''�-"" r.`+'''•I% + :141 T fN:, •�,.: . +E FROM FIELD aIERMITIONF AMO OR DAT• OBru MID FROM OTHERS N YS,LICENSE NO.I Sae?•""'•,F.1`.',1,!.�?:a;:_;�%,'" - - I II i I - - PIR5TFLOORJOISTS TO REMA,I ELEVATION - I HEADER HEIGHT SCALE: 1 /4" = 1 '-0" EXI5TING WINDOW �l TO REMAIN 4 EXISTING TING FOUNDATIONrO I, - I ¢I allW To GRADE � � SLAB FLOOR HEIGHT : �— - --__ — - - - - - --33�_IIJEE IIsi UNDERWRITERS CERTIFICATE r I REQUIRED f 0 j nn OI � 7Q I � O, f— _ W'W � rYl A{{P��/R9VED AS NOTED �, — EX15rwG GOGa – ap // p a�(Y i, 5LIDER TO REMAIN � I-/p"IW, I,- I DATE: B P.!t 2"X 4' CCA 5TUD5 PROVIDE R-I 1 �r 018 it i- !V111 Ems-FEE: ` z INSULATION IN WALL R z lLu 76°5-0 02 BBIAM�TOSM1 rPM OR THET N _7 _ __-_ W/R I O NAICDUOr o -TyP. ALL AREAS _ __ __ __ —__ _ _ FNE �O'���I � W'. 50 fY ARTMENT 1 BOA 2' FOLLOWING INSPECTIONS. N .�0 W Y 1. FOUNDATION - TWO REQUIRED EXISTING e"CONE. WALLS FOR POURED CONCRETE FOOTINGS F FRAME7O REMAIN z o 2. ROUGH - FRAMING & PLUMBING ! N 10 EXISTING BASEMENT EXIgg TING 244GW4020 PROVIDE R-19 TO REMAIN ( v r INSULATION IN �„ 3. INSULATION � � �i WINpOW TO REMAIN FINISH BASEMENT � C� � w i _ 4. FINAL - CONSTRUCTION MUST _ _ _ _ _ ( r- 8E COMPLETE FOR C.O. T-7"c.n cEIUNG (il'PJ n, xto ALL CONSTRUCTION SHALL MEET THE - - -- o�aF65SID � : W r REQUIREMENTS OF THE CODES OF NEW ' YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. _ -- C�/ '�' D z EX15T1NG3 2"X 12" _ _ /1 Y co 2 GIRDER TO REMAIN V b Y1 DR �qa.,n tv Q Z o 4"P CONC. 5LAB ON « I COMPLY WITH ALL CODES OF x ° COMPACTEDFIuro NEW YORK STATE & TOWN CODES III EXISTING STRUCTURAL REMAIN: COVER V✓/CARPET S _ 2"X 4"CCA STUDS 9 �h NFIL AS REQ I ED AND CONDITIONS OF R-'1 a INSULATION d COLUMN FoorlNGs « z v GIRDER YO REMAIN: m L,6 NEW WALL TO BE M SOUTHOLD TOWN ZBA _ CON5TRucrED UNDER to j I p) EXISTING GIRDER UP r'- SOUTHOLD TOWN PLANNING BOARD SOUTHOLD TOWN TRUSTEESIT I 1\ I- 3068 . N.YS,AEC Lori© Iib FTL�MG V 's.l r I z OCCUPANCY OR USE IS UNLAWFUL �wew BAT7 7 C H PROVIDE R- x F R'S.C.WITHOUT CERTIFICATE NSDIA"DN " Y3DI/ TING 5"CONC. WALLS. 2'X A CCA 5TUD - / l9 FOOTINGS <FRAME TO REMAIN I W OF OCCUPANCY FO E PLAT W.2�r )D. . f` .� FO INSULATION'; a PPIL] . IIP" DRYW I I v U PLUMBER CERTIFICATION — " — — EX15TtNG GARAGE — — r! U ON LEAD CONTENT BEFORE a' / _ To REMAIN r-+ Z_wo CERTIFICATE OF OCCUPANCY EXI5TING 4" 1)I CERTIFICATE 1 PLUMBING TO REMAIN EXISTING 3- 2"X 12" Q GIRDER TO REMAIN U. SOLDER USED IN WATER _ ___ : . _T. _ .___ ,__ J I U. SUPPLY SYSTEM CANNOT 4° P CONG. sLAB oN EXCEED 2/10 OF 1%LEAD. EXISTING BASEMENT COMPACTED FILL_IW II TO REMAIN ALL CONSTRUCTION SHALL I I LAO 4-I;?4fC{; � O MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. PLUMBING fQUNDATIC7NPLAN ALL PLUMBING WASTE &WATER LINES NEED TESTING BEFORE COVERING SCALE I /4" I Y I O N lJ � f n. LA l iJ LiJ 1 LL/1 1 iJL. I V-r APPLICANT: c.� DATE SUBMITTED: d ly 104 SCTM# DISTRICT: 1,000, SECTION: 3 rte, BLOCK: , LOT: 'S'Z SUBDIVISION: G ► ADDRESS: �f'O C--,�iesZ.�.r�uart CITY: IF ZONING DISTRICT: '---CONFORMING?"' BUILDING PERMITS OPEN/EXPIRED: PRE CO: Y 0 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: LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30,1983),UNDERSIZED LOTS FROM JAN.1997 100-25.Merger.(A nonconforming at any time all REQ. LOT SIZE: ACT. LOT SIZE: REQ. LOT COV. ACT. LOT COV. REQ. FRONT PROP.FRO REQ SIDE ACT. SIDE REQ. REAR PROP. AR REQ. HEIGHT PROP. HEIGHT PROJECT DESCRIPTION: 1" 43 rd ESTIMATED PROJECT COST: ARCBHECT/ENGINEER: WATER FRONT? DESCkIPTION: PANEL # FLOOD ZONE: APPROVALS REQUIRED SUFFOLK COUNTY HEALTH D : YES or D#): DTE:_/ / PERMIT#: TOWN SEPTIC RECEIPT: Y — NEW YORK STATE DEC: PDEc 9nn5 YES o DTE: /_/_ PERMIT#: SOUTHOLD TOWN TRUSTEES: YES o DTE _/_/_ PERMIT#: TOWN ZONING BOARj�APP IROVAL: YES o DTE: /_/_ PEF-MIT#: TOWN PLl"1. BOARD APPROVAL: YES or DTE__/_/_ �'ERMIT#: TOWN HfSTORICAL//PRE (SPLIA): YES / NEW YORK STATE CODE COMPLIANCE (SEE PAGE 2(YE5 or O NOTES: FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR: SF SECOND FLOOR: SF OTHER: SF INIT OTHER TOTAL TOTAL: ? SF FEE FEE FEE 1• (—SF)- SFX$ _$ +$ . +$ _$ 2. ( _SF)- (--SF)= SFX$ _$ +$ +$ _$ 3. (___----SF)- A SF)= SFX$ _$ +$ +$ ,- ..y..e FINAL TOT . $ �� NEW YORK STAVE CODE COMPLIANCE CHECKLIST CLIMATIC/GEOGRAPHIC DESIGN CRITERIA: Ground Snow Load: 45 Wind Speed: 120MPH Seismic Design Category: B Weathering: Severe Frost Depth: 36" Termite: M-H Decay: S-M Design Temp: 11 Ice Shield Underlay:YES Flood Hazards: USE/OCCUPANCY CLASSIFICATION: HEIGHT/FIRE AREA: TYPE OF CONSTRUCTION: DESIGN CRITERIA: ENGINEERED/PRESCRIPTIVE FULL FRAMING DESIGN ELEMENTS: Y/N HEADERS:Y/N WALL STUDS:Y/N GIRDERS.: Y/N CEILING JOISTS:Y/N FLOOR JOISTS:Y/N ROOF RAFTERS:Y/N LUMB R SPECIES AND GRADE:Y/N DESIGN LOAD CALCULATIONS: Y/N LIVE: Y/N D , Y/N SNOW:Y/N SEISMIC: Y/N WIND:Y/N WINDOW AN�;P. OR SCHEDULE: MIRp'IS`I'REQUIREMENTS: Y/N ESS 5.7 S.F.: Y/N sHT 8%: Y/N VENT 4%: Y/N l . 4 NAILING/CONSTRUCTION SCHEDULE: Y/N MEANS OF EGRESS: Y/N PLUMBING RISER DIAGRAM: Y/N LOCATION OF FIRE PROTECTION EQUIPMENT: Y/N TRUSS DESIGN: Y/N CERTIFICATION: Y/N ENERGY CALCS: YIN TOTAL COMPLIENCE? Y/N(RETURN TO PAGE ONE)