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HomeMy WebLinkAbout30509-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-31137 Date: 08/25/06
THIS CERTIFIES that the building ADDITIONS & ALTERATIONS
Location of Property: 9900 SOUND AVE MATTITUCK
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 122 Block 2 Lot 8.2
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 12, 2004 pursuant to which
Building Permit No. 30509-Z dated JULY 26, 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 & FIRE REPAIR TO EXISTING SINGLE FAMILY DWELLING
AS APPLIED FOR.
The certificate is issued to ERICH MOENIUS & CAROL SULLIVAN
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 2029689 04/18/05
PLUMBERS CERTIFICATION DATED 08/18/05 EME PLUMBING & HEATING
Authorized Signature
Rev. 1/81
22
C.t S,ij
' Form No.6
TOWN OF SOUTHOLD
-- C'`D BUILDING DEPARTMENT
TORN 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:
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 2.10 of 1°%o 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 Planting 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:
L Accurate sunVe)'of property showing all property lines, streets, building and mensual natural or topographic
features
2. A properl,, 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 writine to the applicant.
C. Fees
I. Certificate of Occupancy- New dwelling $25.00, Additions to duelling $25.00, Alterations to dwelling 9.25.00.
Swinuning pool $25.00, Accessory building$25.00, Additions to accessor} building,. $25,00, Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building- $100.00
3. Copy of Certi ovate of Occupancy - $.25
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial .$15.00
Date. —IC�OS New,ConstructionOld or Pre-existing Building: (check one)
Location of Propem : _ DD ejp i.IJ� � %_ 1 TVG� —------—
House No. Street I hamlet
Owner orOwneisofProperty: � G /y�C�iN9L,X;--4- ^t4 -- —Q,--
Suffolk County Tax DQap No 1000, Section 7i2- Block_ OO ZZ Lot �(lch 002-
Subdivision
OZSubdivision z — — —__ Filed Niall. — --- Lot: ---—,—
P6mdtNo. 3oGJo�1 -_-_ 12ate-ofPennit.-_7 2(f OT=Applicant: C'P%K_Vb ' I,L .LI_VA,4,J
Health Dept. Approval: _— Underwriters Approval:
Planting Board Approval.
Request for: Temporary Certificate Final Certificate: V (check one
Fee Submitted: 9
I r/ C6 A Applicant Signature
co o r
O cJ�rJ�rJrJ�rJ�c frJ�rJ�rJ�rJ�rJ�rPrPr�rll?Pr�rJ�rJ�rPrJ� IJrJ�IJrJ�cPr�cP�LlI>nr Pr1111?PI @P o10c
21 , 1 BY THIS CERTIFICATE OF COMPLIANCE THE
5 NEW YORK BOARD OF FIRE UNDERWRITERS 5
5 BUREAU OF ELECTRICITY e5
5 40 FULTON STREET — NEW YORK, NY 10038 5
CERTIFIES THAT 5
Upon the application of upon premises owned by
5 REP ELECTRIC ERIC/CAROL MOENIUS/SULLIVAN 5
5 P.O. BOX 635 9900 SOUND AVENUE
C5 MATTITUCK, NY 11952, MATTITUCK, NY 11952 5
C� Located at 9900 SOUND AVENUE MATTITUCK, NY 11952
Application Number: 2029689 Certificate Number: 2029689 e�
5 Section: Block: Lot: Building Permit: 30509 BDC: ns11 5
5
5 5 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
,,,
BasementFirst Floor,OutsideAttic,
5
5 55
5 5 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 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 Vt6mpliance theAWAR2 he Day of 5
5 Name OTY Rate Ratine Circuit Typerj
5
Miscellaneous
5 whole house renovation
5 Alarm and Emergency Equipment
5 5 Sensor l 0 Carbon Monoxide 5
Sensor 3 0 Smoke [5
5 Appliances and Accessories
5 Oven 2 0 50 Amps 5
5 Dish Washer 1 0 1.2 KW
5 Furnace 1 0 Gas 5
5 Wiring and Devices
5 5 Outlet 24 0 Fixture 15
Fixture 24 0 Incandescent Lj
55 Outlet 47 0 General Purpose 5
Receptacle 25 0 General Purpose 5
5 Switch 29 0 General Purpose 5
Dinuners 2 0
55 Paddle Fan 6 0 seal 1
Receptacle 5 0 GFCI 5
Continued on Next Page I of 2
5
This certificate may not be altered in any way and is validated only by the presence of hii
a raised seal at the location indicated. 5
55 5
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5 ' BY THIS CERTIFICATE OF COMPLIANCE THE 5
5 NEW YORK BOARD OF FIRE UNDERWRITERS 5
5 BUREAU OF ELECTRICITY C5
5 40 FULTON STREET — NEW YORK, NY 10038 5
5 CERTIFIES THAT 5
Upon the application of upon premises owned by S
5 REP ELECTRIC ERIC/CAROL MOENIUS/SULLIVAN 5
5 P.O. BOX 635 9900 SOUND AVENUE 5
MATTITUCK, NY 11952, MATTITUCK, NY 11952
C 5
C� Located at 9900 SOUND AVENUE MATTITUCK, NY 11952
Application Number: 2029689 Certificate Number: 2029689 5
5 Section: Black: Lot: Building Permit: BDC: ns11 5
5 30509
5 5 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
Basement, First Floor,Outside,Attic,
C5
5 5 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 5
herein, was conducted in accordance with the requirements of the applicable code and/or standard
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 Vt$ ompliance the*962A�he Day of
5 Name OTY Rate Rating Circuit Type 5
Service �5
t Phase 3W Service Rating 200 Amperes 5
Service Disconnect l 200 cb
5
Meters: 1
5
5 5
5 5
5 5
5 5
5 seal 5
5 2 of 2 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.
5 5
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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. 30509 Z Date JULY 26, 2004
Permission is hereby granted to:
ERICH MOENIUS
10020 SOUND AVENUE
MATTITUCK,NY 11952
for
RECONSTRUCTION OF A FIRE-DAMAGED SINGLE FAMILY DWELLING AND
ADDITIONS AND ALTERATIONS AS APPLIED FOR
at premises located at 9900 SOUND AVE MATTITUCK
County Tax Map No. 473889 Section 122 Block 0002 Lot No. 008 . 002
pursuant to application dated JULY 12 , 2004 and approved by the
Building Inspector to expire on JANUARY 26 , 2006 .
Fee $ 926 . 70
t
A nature
ORIGINAL
Rev. 5/8/02
l,' o�gpFFO(,�co
3 2005 L.'1
Town Hall,5309M,,VRoad-- O LW Go
1W Fax(631) 765-9502
P.O. Box 1179 y�ol Lt Telephone (631)765-1802
Southold, New York 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATION
Date: 5/,3 ZD5
Building Pennit No. 3 0
Owner: Mocl1 l S ICLI� - 1 ✓RN
(Plea e print)
Plumber: h e / I-
^ C
(Please print)
I certify that the solder used in the water supply system contains less than 2/10 of 1%
lead.
C (Pkt Signature)
Sworn to before me this
day of 2009
Notary Public, Jy\iU`\C County
BONNIE J.DDROSM
11e"PubRo,State OI New lbdl
No.OID06095328,SuNoonly
Term Expires July 1,20
�g11FF0(,�
h�0
Town Hall,53095 Main Road wG
�i' Fax (631)765-9501
P.O.Boz 1179 1 �a 'r ^ 205 Tt;ephone(6311 .765.1802
Southold.New York 119'1-0954 1# _ J [ UJ
L �
BUILDING DEPARTMENT �
TOWN OF SOUTHOLD
CERTIFICATION
Date: / it /D S
Building Permit No. '305-02 27___
Owner. eR lGff IIOL5/V V GAZOz,—<UGC i /Akf
(Please print)--�
Plumber: ��/ K �N��/✓_ /U1� /
41(1
(?lease print)
I criTify that the solder used in the WEter supply system contains less tharl 2.110 of 1°/
lead.
(Pltunbers Signature)
Swrom to before me this 1�
day of—a-LA-c1-q
0 D —
C_Cr Jv* L_�l t/C. Lv/i c
Notary Public, _Cuunty
JANIE.S.I. DEERK(>SKI. P.E.
260 Deer Drive
Nlattituck, N.Y. 11!).52
(631) 298-7116
To: Town of Southold
Re: Insulation Inspection 1 r _
Nloeni -Sullivan
9900 Old Sound Ave.
Nlattituck, NY 11952
Permit# 30509% �� r
To Whom It Mav Concern:
An Insulation Inspection was preformed at the above mentioned property; all insulation
was installed as per Plan and meets all State tmd local Building Codes. .Ntty questions
please feel Irec to call.
NE Y
D _P
e� Sit •crelN,
r
CTi
` Jame. , . -�oski P.L.ND• 0725
�FESSIQ
765-1802
BUILDING DEPT.
INSPECTION
[/FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CfHIMNEY [ ]AFIRE SAFETY INSPECTION
REMARKS: II ' UtY�"� rooT'"
Ili
5 01..E Pc u orf
DATE $ [ o INSPECTOR G� g
765-1802
BUILDING DEPT.
INSPECTION
[ ] OUNDATION 1ST [ ] ROUGH PLBG.
[ FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
DATE 3 Z� ° INSPECTORLAItA I `�
765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [G/ 1ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:T �
cr
G �
l.'
1 � /
R
DATE i '� INSPECTO ' "` Y
1
-5�0I 765-1802
BUILDING DEPT. /✓`"`�
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG. / ..�
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
�k /l
DATE S _ aS INSPECTOR
S �
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
DATE g — o j�r INSPECTOR
0 _ �a 1 _ TOWN OF SOUTHOLD PROPERTY RECORD CARD I -
OWNER STREET VILLAGE DIST. -SUff.— LOT
recf) M n.�S
To CK
FORMER OWNER N E ACR.
S W TYPE OF BUILDING
RES. v /O SEAS. VL. FARM COMM. CB. MISC. Mkt. Value ✓ 5
LAND IMP. TOTAL DATE REMARKS
1? L/Lb
��/� ]10111GfL �r�Ayy�Ylw}�•�
2P p
Svo ota oro ✓ 7 c, n. �-'✓ _
.$ / Gv
eo X967
�yEo') 0 7 301`/E B So 73 - 12 j2p igLe"s
L 0 0 GCRY - - ►'Clore ni'fA,5
Z, 0 5,00 00
///09 OV
Tillable 1 G a ' n X I
Tillable 2 W - 2- b P a5 �q 0 S 6%A'% 4 Sid — (JO c4
Tillable 31QQ
Woodland '1j IOa'D
Swampland FRONTAGE ON WATER
Brushland FRONTAGE ON ROAD S rs
!k O - S 9
s!C-�
House Plot DEPTH �5
BULKHEAD
Total DOCK
too
o
a �
COLOR
w:. -rU 5 i
TRIM
0000i
00
L
Bldg. / / Foundation Bath ,r� %y Dinette
70
xtension (0X ,gyp p Basement Floors ( 4 /C. K.
xtension
�7. a j 1 s y/ 9 Ext. Walls (Jc� , Interior Finish LR.
.xtension / _ S oo 44 oel Fire Place Heat 2 DR.
Type Roof Rooms 1st Floor BR.
'orch Recreation Room Rooms 2nd Floor FIN. B.
orch Dormer
3reezeway Driveway
,arogeT9 . .2 V, V
'atio
J. B.
•otol
pr.��irk „F •�_�.
r /7/f %r�
Permit Number
REScheck Compliance Certificate Checked By/Date
New York State Energy Conservation Construction Code
REScheckSoflware Version 3.5 Release le
Data filename: C:\Program Files\Check\REScheck\9900 07.10.04 Lang
PROJECT TITLE: Moenius Residence
COUNTY: Suffolk
STATE: New York
HDD: 5750
CONSTRUCTION TYPE: Detached 1 or 2 Family
HEATING TYPE:Non-Electric
DATE: 07/10/04
DATE OF PLANS: July 10,2004
PROJECT DESCRIPTION:
9900 Sound Ave.
Mattituck NY 11952
COMPLIANCE: Passes
Maximum UA= 348
Your Home UA=327
6.0%Better Than 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 1290 0.0 30.0 40
Ceiling 2: Cathedral Ceiling(no attic) 325 0.0 30.0 10
Wall 1: Wood Frame, 16"o.c. 180 19.0 0.0 9
Window 5: Vinyl Frame:Double Pane with Low-E 15 0.380 6
Window 6:Vinyl Frame:Double Pane with Low-E 15 0.380 6
Wall 2: Wood Frame, 16"o.c. 54 19.0 0.0 3
Window 7: Vinyl Frame:Double Pane with Low-E 5 0.420 2
Wall 3: Wood Frame, 16"o.c. 225 19.0 0.0 10
Window 8: Vinyl Frame:Double Pane with Low-E 15 0.380 6
Window 9: Vinyl Frame:Double Pane with Low-E 15 0.380 6
Door 1: Solid 25 0.390 10
Wall 4: Wood Frame, 16'o.c. 234 19.0 0.0 12
Window 10: Vinyl Frame:Double Pane with Low-E 10 0.380 4
Window 11: Vinyl Frame:Double Pane with Low-E 10 0.380 4
Window 12: Vinyl Frame:Double Pane with Low-E 10 0.380 4
Window 13: Vinyl Frame:Double Pane with Low-E 10 0.380 4
Wall 5: Wood Frame, 16"o.c. 66 19.0 0.0 2
Door 2: Solid 25 0.390 10
Wall 6: Wood Frame, 16"o.c. 143 19.0 0.0 7
Door 3: Glass 21 0.410 8
Wall 7: Wood Frame, 16"o.c. 275 19.0 0.0 14
.Door.L Glass 20 0.410 8
Door 5: Glass 20 0.410 8
Wall 8: Wood Frame, 16"o.c. 143 19.0 0.0 7
Door 6: Glass 20 0.410 8
Wall 9: Wood Frame, 16"o.c. 112 19.0 0.0 6
Window 14: Vinyl Frame:Double Pane with Low-E 15 0.380 6
Wall 10: Wood Frame, 16"o.c. 291 19.0 0.0 14
Window 1: Vinyl Frame:Double Pane with Low-E 15 0.380 6
Window 2: Vinyl Frame:Double Pane with Low-E 15 0.380 6
Window 3: Vinyl Frame:Double Pane with Low-E 15 0.380 6
Window 4: Vinyl Frame:Double Pane with Low-E 15 0.380 6
Floor 1: All-Wood Joist/Truss:Over Unconditioned Space 1290 0.0 19.0 55
Floor 2: All-Wood JoistiTruss:Over Unconditioned Space 325 0.0 19.0 14
Boiler 1: Gas-Fired Steam, 75 AFUE
COMPLIANCE STATEMENT: The proposed building represented in this document is consistent with the building plans,
specifications,and other calculations submitted with this permit application. The proposed systems have been designed to meet the
New York State Energy Conservation Construction Code requirements. When a Registered Design Professional has stamped and
signed this page,they are attesting that to the best of his/her knowledge,belief,and professional judgment, such plans or
specifications are in compliance with this Code.
Builder/Designer Date 2
w
FIELD INSPECTION REPORT PATE COMMENTS
€1 i O• T. LBA"r4 N
FOUNDATION (IST)
l-enf
--------------------------------------
FOUNDATION
-----------------------------------FOUNDATION (2ND) - m
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ROUGH FRAMING&
PLUMBING
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INSULATION PER N.Y. - 3
ST ATE ENERGY CODE
C O
FINAL
ADDITIONAL COMMENTS
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTM VNT Do you have or need the following,before applying?
TOWN HALL Board of Health
SOUTHOLD,NY 11971 4 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 Survey
www. northfork.net/Southold/ PERMIT NO. check
Septic Form
N.Y.S.D.E.C.
Trustees
Examined 6 20 y Contact:
Approved 7T24 20-4— Mail to:
Disapproved a/c
Phone:
Expiration 26 20
Building In a for
r-
`APPLICATION FOR BUILDING PERMIT
I �
JUL 1 4 Date Jy LY 200
INSTRUCTIONS
` nn
Thi 'tm be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3
sets of p ans, 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 cpmmenced before issuance of Building Permit.
d. Upon approval of this application,the Building hector 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 par. for any purpose what so ever until the Building Inspector
issues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the
property have been enacted in the interim,the Building Inspector may authorize, in writing, the extension of the permit for an
addition six months. Thereafter, a new permit shall be required.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County,New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The
applicant agrees to comply with all applicable laws,ordinances,building code, housing code, and regulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
(Signature of applicant or name,if a corporation)
( C -cel l l'llt A,6
j G,)Wt , i TLc;`L
(Mailing address of applicant) •'Ile-/
J
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises ��60 /1/IoeyI ltf,�? , CAK--O ,-
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title ofgcorpoorate officer)
Builders License No. Z I l -0
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
'1116'0 1j70V rJ✓J A-y G Al K-rl Tu CK—
House Number Street Hamlet
County Tax Map No. 1000 Section Z Z Block 2 Lot ' Z
Subdivision Filed Map No. Lot
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of ppropoid construction:
a. Existing use and occupancy ✓PV%4.er
b. Intended use and occupancy l Glk til I L �2�G/1 V7��GE
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work�rl(
��Gj.0O0 L pN1& (Description)
4. Estimated Cost Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units 1 Number of dwelling units on each floor
If garage, number of cars ihrl r4&- NO W ViK
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
�1 I I
7. Dimensions of existing structures, if any: Front �l"/'� Rear l Depth 40-v2
Height U.0 ' Number of Stories 1 • O
I yl
Dimensions of same structure with alterations or additions: Front qg�7•jr;7 Rear
Depth 4'e2'v-21 Height 2I O ' Number of Stories 4'd
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
9. Size of lot: Front zJ Rear
13• ue r Depth l ( 3•�'� E s G 'go'w
10. Date of Purchase 7i Name of Former Owner—�O KMA.� LYD K 5
11. Zone or use district in which premises are situated I`
12. Does proposed construction violate any zoning law, ordinance or regulation? YES >L NO
13. Will lot be re-graded? YES_NO)LWill excess fill be removed from premises? YES NQ)�'
eA6:11 AMMI06' �n MkY1T I19h2
14. Names of Owner of premises GA1�61. htIIMVM Address 1DOU hOUW&P Phone No. _�l?g1h��TJr✓
Name of Architect Address Phone No
Name of Contractor M,07f f:Pl"('G. ( 2 Address fO� Phone No. (131 7,18 • 77
MAt�I-Guotl- wv�tlggZ
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NOX
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIltED.
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 )
('l�KCl- `%)i LI ti A-7 heing duly swom, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the [ L UIL
(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
day of 20OO Y
of Pub rc Signature of Applicant
JOYCE M.WILKINS
Notary Public,State of New York
No.4952248,Suffolk County
Term Expires June 12,,;L-002
AIL
SOUND AVENUE
(NORTH ROAD
EDGE OF PAygMENT
NY1654
7_()_o N89'44'30"E 85.63'
.\ (DEED N89'41'E 85.00')
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DATE: JUNE 1, 2002
SCALE: 1"=20' gym`; (DEED 7]t'"
JOB NO: 2002-270
�N;? S?4'3 DQE
CERTIFIED TO:
CAROL SULLIVAN fO�me�\y
pow /°\ S�� �won
O
Co
Survey for:
CAROL SULLIVAN
< � at
Mattituck
DA� OX N.Y.S.L.S. #50234 Town of
PDX LAND SURVEY/NC Southold
PO BOX 224
SPEONK, N.Y. 11972 Suffolk County, New York
(531) 325-2902
'„° - - - "r1E - - -"N cr S.C.T.M.: 1000-122.00-02.00-008.002
-- --- - -�E - - -
rvD -IPvEYGPc _ - EEIL
n.LL "_T 2E _.."_i:En EJ T.VdEL: .,,, I E c_c
NOTES:
----- - •11 -PES - - - -
FER'SGI--_ - - - E - k,E: ' EI-REE.= - - ;�S 1. AREA = 13.551 S.F.
eE— �- —L 7IL � JN.En",}EN L En'
� =T'nr -'`�`�FE`E"" .11 CN T"- 2. ■ = MONUMENT FOUND, • = PIPE FOUND.
-.EE_ 111 LENu - '+PGS
':E N'T M--I,=FEIe°-E T-- "'s TI` ",'` 3. REFERENCE DEED L. 11921 CP.809
DWG: 2002-270 `
^ .v
SOUND AVENUE
(NORTH ROAD
EDGE Of PAVEMENT � A
\ 5
N T 654
-0-
\
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DATE: JUNE 1, 2002 ` � 514'49'+11 7 '
SCALE: 1"=20' Pic toE 3
JOB NO:2002-270
S� 33•p0 FENOE'
CERTfFIED TO: � w? h' aDST pE
CAROL SULLIVAN cp O( \
C m Qny
Yyc a:s f\OW Or O\ SU
� per\ 0�� /
Survey for:
� 1 CAROL SULLIVAN $d r
( xJl At
Mattituck
DAVID H. FOX N.Y.S.L.S. #50234 Town of
FOX LAND SURVEYING Southold
PO BOX 224
SPEONK, N.Y. 11972 Suffolk County, New York
(531) 325-2902
IsUTHDRED FLTERgON GR ADDin GN TO THIS suRrw S.C.T.M.: 1000-122.00-02.00-008.002
>C ¢ n.tOl=n Ory cESECTIGry Taus cF 1HE NEn YORK s"E
EGVC>nGu LWPIFS G TFIS 5 RJFY B11 NJT BIIBING
THE TtNDSVRVEYGR 5 INNeD SELGR EI.IBGSSED sE+L
NnT BE CGNSGEFEO TO BE ^ joLiO MUE CCP
NOTES:
CERTFICAION INGICRIEO HEREON SILL RUN ONLY TO THE
PERSOr FOR M GM TME SNB'Er s PREIIBED I"D GN HIs 1. AREA = 13,551 S.F.
BEH.,LF TO TIE PTFE GO'rERNMENTPL +GENCY
we LENOINO IN=_nnnGN usTEO MEREOry ANG Tc TME 2. = MONUMENT FOUND, • = PIPE FOUND.
4-SIGNEES OE TIE LENDING INSITJnON CEBIFICSnONS
:.RE NGT TRANSFERABLE TG TDCIIpN.L ffiT ,n ONE 3. REFERENCE DEED L. 11921 CP.809
OB SUBSEGVErvT GWNEFS
DWG: 2002-270
COMPLY WITH ALL CODES OF
AP ROVED AS NOTED NEW YORK STATE &TOWN CODES f
DATE: B.P.s >3d51 a AS REQ IRED AND CONDITIONS OF
"126 �oL� sounlIXnTowNtea
A• � dITS
NOTIFY BUILDING DEPARTMENT AT AI 111 80SWTOMPLAIIIING801IRD "
765-1802 8 AM TO 4 PM FOR THE SOOIHOIATOWNTRUSTEES 5©U N,I] A VEN U E
FOLLOWING INSPECTIONS: P Z SLI
1. FOUNDATION - Th'0 REQUIRED IIY.S•DEC (NORTH ROAD V'
FOR POURED CONCRETE
90a Ol VWEMEHi
2. ROUGH - FRAMING 8 PLUMBING O
3. INSULATION
4. FINAL - CONSTRUCTION MUST OCCUPANCY OR NYT 04
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET THE USE IS UNLAWFUL �-
REQUIREMENTS OF THE CODES OF NEWN!q'44'30"E , A'✓r7 YlE'r611.817LA 1.)
YORK STATE. NOT RESPONSIBLE FOR WITHOUT CERTIFICATE
OCCUPANCY 3
a {ouuNtra•res.ua) 71713.3':tx9 wrG4-fOIF•I','pl� .
DESIGN OR CONSTRUCTION ERRORS. OF OCCb s� 00 p
p
-a P
ALL CONSTRUCTION SHALL A �p
MEET THE REQUIREMENTS OFTHO PLUMBING : °�t ";1y' 'A'"
6•Q
CODES OF NEW YOFiI(_STATE„,,, ALL PLUMBING WASTEAll
F `� �i� (��IOiz ��C�O"rOH�Oi
$WATER LINES NEED %, �
TESTING BEFORE COVERING II d7 4rD N
A ,�j IJJIWI444 6WTloklq
PLUMBER CERTIFICATION
ON LEAD CONTENT BEFORE RETAIN STORM WATER RUNOFF F�� A'b br'AILE% 4k4ripl.l e pjjlWl
CERTIFICATE OF OCCUPANCYPURSUANT TO SECTION 45-10C ;1
SOLDER USEPtW WATER OF THE TOWN CODE. q x Dena L Eb �L�� D r4 FM
SUPPLY SYSTEM CANNOT J 9 c NWS a �''� f712(AI L� �iF/'r'OHI C M, PN'Rk
EXCEED 2110 OF 1%LEAD. , mow. s�^" `�W,r rlgfW Lq7 � t w e rIYIIdT
e V a
CERTIFICATION OF �� c , �• 7"1�'fi" , , ,� ^ KIA�Otkis �al�'T'
NAILING 6 CONNECTIONS 8
REQUIRED. © o a % /
!- ''
NOT PROCEED WITH
FRAMING UNTIL SURVEY,
OF FOUNDATION LOCATION a
HAS BEEN APPROVEp,, N
FLOOD ZONE
COMPLY WITH CHA ER 46"
UNUERWAITERSCEATIFICA FLOOD DAMAGE PREVENTION 3 ` J Ip,R f 10•G �'
SOUTHOLD TOWN CODE.
REQUIRED a
4:1
K xthh Y �, i
L. .
RATE: 4VNE 1. 2$02 , ps,N's4"i0
iSCAIE: 1x.20• �• a
Joe W.2602-270
CERTIFIED TO, S�*+53 .s"t`
CAOL SUL04AN 'P tOTCnCt1y .
A 0Q* of 5u11i�o�
Gota1
I
Survey for:
CAROL SULLIVAN
At
Matttituck
DAVID H. FOX N.r.S.L.S• X50234 Town of,
- FOA- LAND SOA19iYlNC Southold
IZ 04 (�16n �o1z QUIT
I % 24
$3a 325-2902
y Now York
sPEON1c, Nr. 119n Suffolk-1zz.GD-o
County,
��.bird.h .y u>EN+nrn nr ape,tww r rx,t swat. S.C.T.M. 1 200 OOd002
' eoue ��� r�errf°w m�4'k�a°fri ow"xvr w.eFae.�
NOTES: � ,
..°. °x. .a MOEN1US RESIUDENCE,
^ m,x+i°u , g .. .p rAer","xmx.xn ai�u 1. AREA - 13 951 S.F.
AA ro m°"nn° w'. ' a ,N
uxo-xr mmun°,a,+w H. . x. ° �1x i 2. ■ - MONUMENT FOUND, PIPE, FOUND. 400 SOF3ND AVRNU&
t.. [ Rxuxc,xshTlTd Gflln R� LHS
.,c x°.Em.N:ren+nt,°a.'.nwo�,ns�vii'Ex 3. REFERENCE DEED L. 1{921 CP,$09 .(
,' "" �"'"'"�'• - MATTITUCK,NY 17952
DWG: 260-270 .
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Foundation Notes:
r_______________________________________________________ r____________________-______________-__________________,
The contractor is to verify all measurements in the field and any discrepancies are
I (------------ - ----------------------------------------------
-------------------� i I I to be brought to the attention of the Engineer prior to construction.
I i i I
--9',4" 1 -All concrete 3,500 psi after 28 days minimum.
5'-7"
I
r- --7----, 2-All rebar ASTM A-615 Grade 60.
----------------------------- I ---------------------------- 3.5x11.8752.0ELVL
� ------------------------------------- I I 3- Footings are to be installed on undisturbed virgin soil.
r______ ______________________________ - � ___________________________
r __ J I I
----------------------------
__J _ the bottoms of all footings are to be installed a minimum of 3'below grade unless
i indicated otherwise.
____________ I 3.5"0 Std. Wt. Grade 53$ Pi s
- Existing Column Footings are ---J ut Opening For Stair ut Pocket for Girder 4-The Engineer is to be contacted if unacceptable or quest onable soil is encountered
ut Opening For Stair to be Removed or Cut to Make " " ""I- // CC P 9 v during excavation. Unacceptable soil is soil containing clay and/or organic material.
4'x 4' x 12" Footin '•. ----------- / o Grout Block Solid LL
Room for New Footings 9 ,(X to o
r With No. 4 Rebar �I 5-Backfill along foundation walls are to be installed is to be clean material and is to be
See Detail Below °D mechanically compacted in 6 inch lifts.
` , -1 x 6-Dowel new foundation walls to existing foundation walls with No.4 rebar.
'.;;:: ::>t"7•:',;i :°, 1„ - —8,-9„ 8.0a, 83, �„ t---"------ ":. ��utPockel(orGirder
8 ---- o Grout Block Solid
+ 3.5"0 $1 . It. Grade A-53S Pipe o
t 3.5"0 Std. Wt. Grade A-53 Pipe
Design Loads:
Roof-Live Load -35.5 psf
Ir----?----, r-----I----, ----------, - -----, Based on ASCE-7 and Pg=45 psf
I
5.25 x 11.875 2.0E LVL
- - - - - - -i- - - - y - -� -I- —L_ +-- - -I - - } �- —r Per Figure R301.2(5)
Dead Load- 15 psf
------J ----" ---J 3.5"0 Std. Wt. Grade A-53S Pipe 3.5"0 Std. Wt. Grady - $S Pipe
ut Pocket for Girder Attic- Live Load-20 psf
- Dead Load - 10 psf
Grout Black Solid
4' 'ix 12" Footing 4�3" 4'-3"x 12 Footln
Ni tj No. il Reber—//
ebar 11'- Be With No.4 Rebar 4'-3"x 4'-3" x 12"Footing First Floor - Live Load-40 psf
i Detail Below Locale Below Bearing Wall With No. 4 Rebar
� I See Detail Below I I i I i i - Dead Load- 15 psf
I iSee Detail Below
I I
Exterior Deck-Live Load-40 psf
ill op eh nf with CMU S-� A Dead Load- 15 psf
______________J
`------------ -------------- ----
L ----------------------- Wind Loads- 120 mph-ASCE-7
--------------------- MWFRS - Method 2
----------- ------------------- --- ;--------------- --- ------ -- - ------------------------------ r l Component and CladdinDetails from
7.43„ WFCM TABLE 3.8
j
rout Block Solid 9
rout Block Solid
Design Criteria - NYS Residential Code R301.2.1.1 and utilized they methods and procedures stipulated in
Below Steel Column Chapter 2 Engineered Design and Chapter 3 Prescriptive Design in the American Forest and Paper
Below Steel Column I :` I I
From Above
Association Wood Frame construction Manual for One and Two Famoily Dwelling Units-High Wind
From Above Addition and ASCE 7.
—Break-up and Remove
13' ExistingConcreteSteps
". Framing Notes:
Backfill with Clean Sand
B ..:;
=. Mechanically Compact
I ,. , 5-1 i The contractor is to verify all measurements in the field and any discrepancies are to be brought to the
attention of the Engineer prior to construction.
. I I
7-All lumber is to be No. 2 or better Douglas Fir Larch (N)with the following minimum specifications:
'•, _ __ _ _ ___ __ li 2x8 CCA Sill
L___ _ __ ---------------------------
L __ «:•
<.: ! .•` . .. •..y r'
--------------------------------------------------------------y JI Fb 825psi
-----
:7
--- Fv=
Fc perp=625 psi
25'-2" /" Galy. Anchor Bolts-6'OC E= 1,600,000 psi
8-All Laminated Veneer Lumber is to have the following minimum specifications:
x8x16 CMU Fb=2,900 psi
Foundation Wall rade Fv=290 psi
Fc perp=650 psi
E= 2,000,000 psi
9 -All straps, connectors, plates, bolls, nails, etc, are to be galvanized or stainless steel. Designated
;774 (2) No.4 Rebar connectors, strap etc. on these drawings are made by Simpson unless indicated otherwise.All
rade T-6" Min. connectors, straps etc. are to be nailed/bolted as indicated by Simpson.
10-All Floor sheathing is to be %"AC type plywood,tongue and groove,with an APA span rating of 48/24.
11 -All wall sheathing is to be Y inch plywood.
12 - solid blocking Is to be installed ever 8' max or mid span of all floorjoists.
1*�� OF NEW
��➢
4'-/„
2" Rat Slab No. 4 Rebar g y P 1 � S 4'
Dowels See Note 6
3'-6" Min. �n1 Foundation Detail 13- Double joists are to be installed below parallel walls.
srAre: ur=ra•
F
.. . .,,.... .., . •y.. .. . ... .... .,
4' ,-3„
�^ ESSI
CLIMATIC AND GEOGRAPHIC DESIGN CRITERIA
1'
Z-13�
Ground Snow Load Wind Speed Seismic Weathering Frost Line Termite Decay Winter Design Ice Shield Flood Hazard
No. 4 Rebar—,.,, No. 4 Rebar Depth Temp. Underlayment
No. 4 Re ar 4'-3" Re aired
45 psf 120 mph B Severe 361i Moderate Slight to 11°F Yes
to Heavy Moderate
New to Existin Foundation Detail
Sup,,t,,=r-0^ Plans are prepared by Condon Engineering,P.C. It is a violation of the New York stats
No. ear owe
Educatlon Law,Aricle 145,Section 7209,for any person unless acting under the
6" into Existing Footing--" 10" 11" direction of a licensed Professional Engineer,Architect,or Land Surveyor,to alter any
item In any way.It an Item bearing the seal of an Engineer,Architect,or Land Surveyor is
3'-3" 3' 3.3"
NOTES: altered,the altering Engineer,Architect,or Land Surveyor shall affix to the Item hisMer
seal and the notation"Altered by"followed by hislher signature and the date of such
General
alterations,and a specific description of the alteration.
1 ' 1
1 - Occupancy classification -Residential Group R-3
n�Step Footing Detail 3 31 3"
Bute, ue•=r.er 2-Types -WDDd framed construction to be utilized. Condon Engineering, P.C. Moenius Residence
Reinforced Footing Detail 3 - Building height- 21', fire area-1,345 s.f. Drawn by:JJC 1755 Sigsbee Road 9900 Sound Avenue
sate, uz^=rn° S m i
Mattituck,New York 11952
Date: 5-21-04 (631)298-1986 Mattituck, New York
,o
2x1 16"OC
rn
J
J
w
O
N
(2) 20 x �'
m
(3) 2x4 Column
2xle CJ ^oc �' to Attic Beam
s S,
o
/ ED
(2) 2x6 (2) 2x6 (2) 2x6 (3) 2x8 (3) 2x8 / ( 2x4 Column to Double off` }^?'
Attic Floor Joist o h
\ (3) 2x4 Column X ?
3 2x4 umn o
\ � to Cellar Beam A N Double 3) 2x4 Cal n t
Id I" I 8-3 Double Atti FI rJo
of o ,I E 3I (2)1.75 x 11.875 AE LVL St ct.Ridge
o
c —
O p r �-
0
�pIL
_ �0 3) x6 Column to Attic Floor m
A L " l N
8a I I \\ 2) 1.75x11.6752.0ELVL
oad Bearing Wall (2)2x12 / 3) 2x6 Column o
to Attic Floor Beam
(2) 2 6 (2) 2x /?���S
--Load Bearing Wall o
Frame Attic Joists Flush ���'''
with Simpson LUS28 / Cc?
/ rime Attic Beams Flush 3) 2x6 Column to Attic Floor Beam
ith$msonGLTV5.511
X
M 2x10 RR 16"OC
N
lr)
(2) 2x6 (2)2x6
5.2 i x 11.875 2.0E LVL
7
TS x 4 x 3 6 Column t Foundation 7)3x 1
T
aXD N I L _
N QSE OF NEW JJpjj9
Strap Top Plate Strap Top Plate
% (2) 2x8 (2) 2x8 See Detail A See Detail A
r z 4
Simpson HST5 Strap Tie Roof Framing
Bend and Bolt to Top Plate s�o 1684
With 12-%" Lag Bolts �g9FESS10h�
Attic Floor Framing Plans are prepared by Condon Engineering,PC It isa violation oJNa New�Y�o kS ate
Educatlon Law,Article 145,section 7209,for any person unless acting under the
direction of licensed Professional Engineer,Architect,or Land Surveyor,to alter any
Item In any way.If an Item bearing the seal of an Engineer,Architect,or Land surveyor is
altered,the altering Engineer,Architect,or Land Surveyor shall affix to Ne Item hlsrher
seal and the notation"Altered by'followed by IrWher signature and the date of such
alterations,and a specific description of the alleral
e
Wall Corner Strap Detail
� SCAIE; N15
SCALE: 1/4" V-0 Condon Engineering, P.C. Moenius Residence
Drawn by:JJC 1755Ne Road
Mattituck,Now York 11 k11952 9900 Sound Avenue S-2
Date: 5-21.04 (631)298-1986 Mattituck, New York
STA30 Strap
3 -- 3 — — —
���VVV SIMPSON LSTA36
STRAP
Ridge/Rafter Tie Detail
[ — — — — O Typical Window and Door Header
Y 3 O Strapping Detail Each Corner
O O O O NTS
2) 1.75 x 11. .0 E LV 2x10 Rafter
STuct. Ridge
OI O
3
O
(D 3) 2x4 Column Simpson MTS-30 Rafter Tie Detail
O
ZONE1 ZONE2 ZONE3
FIELD 12" O.C. 12" O.C. 4" O.C. /—Double 2x8 Joists
1 O 3 PANEL EDGES 6" D.C. 6" In r-. 4" O.C. at Point Loads
3 2x8 Ceiling Joist
ZONE 1 -Within 4 Feet of Corners
ZONE 2 - Interior- More Than 4 Feet of Corners ontiuous 2x6 Studs
ZONE 3- Gable End Wall Rake Overhangs Nail Ceiling Joists to Sides of Studs
O OAdd 2x6 8 locking Between Studs
Wall Sheathing Nailing Requirements for at
120 MPH, 3 SEC. Peak Gust ,
with 112 inch Plywood Sheathing and
8d Common Nails 2x6 Studs 16"oc
1
O
O %" Plywood Sheathing
LSTA30 Straps
Studs to Plate
DETAIL A-TYPICAL ATTACHMENT OFPLYWOOD TJ1350I11.875Floor Joist /
WBID Strap Under
O
OPENINGS PROTECTION TO WOOD-FRAME BUILDING / and Around Plate
O O
3"No 8 SCREWSiT'OC
FRAMING
Single Squash Blocks Each Side of Joist
2 2 LIGHT WOOD-FRAME WALL Double 2x4 Squash Blocks at Point Loads
WASHER QYP) •
3.5"0 Std. Wt. Grade A-53S Pipe
Nailing Zones for Roof Sheathing in 120 �x'PLYWOOD
MPH Peak Gust Wind Zone GLASS
SCALE: 114=1'-0"
Zonal Zane2 Zane3
PLASTIC-COATED PERMANENT
Fldd A"O.C. 4"OA. 12'O.C. WOOD SCREW ANCHORS
Penal Ell 6"O,C. CO.C. 6"0.6 GLASS SEE
DE AIL
Nailing Requirements for 120 MPH, 3 Sec. Peak Gust, Yx"PLYWOOD A
2"Thick Roof Sheathing with 8d Common Nails FRAMwc
PROTECTION OPENINGS
S�PSE OF NI r09�
DEPENDS ON WINDOW OPENING
WASHER(TYP.) WIDTH Io nllWad Path Detail
3"No.6 SCREWS 170C O 051 �"lV
�aFESS10Na'
NOTE: IN LIEU OF SCREWS,LUGS WITH NUTS AND ''r�_p�'
WASHERS MAY BE USED Plans are prepared by Condon Engineering,P.C, it viol tolrof Ue Ne'h York Slate
Education Lew,Article 145,Section 7209,for any person unless acing under the
Alternate to 120 MPH Certified Window direction of a licensed Professional Engineer,Architect,or Lend Surveyor,to altar any
item In any way,If an item bearing the seal of an Engineer,Architect,or Land Surveya is
Installation altered,the altering Engineer,Architect,or Land Surveyor shall All to the item his/her
seal and the notation"Altered by"followed by his/her signature and the date of such
Plywood Panel Window and Door Protection Bill and o specific description Ortho alteration.for Wood Framed Buildings
N.T.S.
Condon Engineering, P.C. Moenius Residence
Drawn by:JJC 1755eRoad 9900 Sound Avenue S=3
Mattiluck,New New York 11952
Date: 5.21.04 (631)298-1986 Mattituck, New York
�I,�a�caL �'%I�'Jt1LE J�ix"fJit-6 TYPE'
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BUILDING PERMIT EXAMINER CHECKLIST
DATE REVIEWED: a /ZZ /04
APPLICANT: 6yw,1ArJ DATE SUBMITTED: / /L/04
SCTM# DISTRICT: 1,000, SECTION: 2� BLOCK: Z , LOT: ZSUBDIVISION: =S'r
ADDRESS: °1100 SQU&A ANN , CITY: �AA4;*ue lL ZONING DISTRICT: 210 CONFORMING?
BUILDING PERMITS OkEN EXPIRED: PRE CO: Y OR N
BP2,!' 0 -Z/ C/0 Z- \,rINFO /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 LATS FROM JAN.1997 100-25.Merger.(A nonconforming at any time after 7/1/83
REQ. LOT SIZE: 4•k ACT. LOT SIZE: 12alOEQ. LOT COV. ACT. LO C -.
REQ. FRONT !SS PROP. FRONT REQ SIDE 0 ACT. E +✓'L
REQ. REAR 3f PROP. REAR o REQ. HEIGHT
PROJECT DESCRIPTION: conuCe� o� ��r! A,M,npAl
'I1`
ESTIMATED PROJECT COST: ARCHITECT`�� -a...T' 1 ePPb6#j
WATER FRONT? 40 DESCRIPTION: - -- PANEL # FLOOD ZONE:
APPROVALS REQUIRED
SUFFOLK COUNTY HEALTH DEFT: YES or NO, (BED #): ZDTE: / / PERMIT#:
TOWN SEPTIC RECEIPT: Y orV
NEW YORK STATE DEC: PRE-DEC 9/1/75 YES o DTE: / / PERMIT #:
SOUTHOLD TOWN TRUSTEES: YES or DTE / /_ PERMIT #:
TOWN ZONIN(/ BOARD APPROVAL Y r DT .
TOWN PLAN./ BOARD APPROVAL: Y or DTE / / PERMIT#:
TOWN HISTORICAL PRE (SPLIA): YES or
NEW YORK STATE CODE COMPLIANCE (SEE PAGE 2): YES or NO
NOTES: �� ° 1 M►i
FEE STRUCTURE: FOUNDATION: SF
FIRST FLOOR: q SF
SECOND FLOOR: SF
OTHER: SF INIT OTHER TOTAL
TOTAL: ?, 9 SF FEE FEE FEE
1. SF)- ( _SF)= SF X $ - 3U =$ �'�6 9+$ = s
2. ( SF)- ( SF)= SF X $ _$ +$ +$ = $
3. (-SF)- ( SF)= SF X $ =$ +$ +$ _ $
FINAL TOTAL: $
NEW YORK STATE CODE COMPLIANCE CHECKLIST
CLIMATIC/GEOGRAPHIC DESIGN CRITERIA:
Ground Snow Load: 45 Wind S d: 120MPH Seismic Design Category: B
Weathering: Severe Fr epth: 36" Termite: M-H Decay: S-M
Design Temp: 11 Shield Underlay: YES Flood Hazards:
USE/OCCUPANCY CLASSIFICATION:
HEIGHT/FIRE AREA: `
TYPE OF CONSTRUCTION:
DESIGN CRITERIA: ENGINEERS Vj
FULL FRAMING DESIGN ELEMENTS: Y
HEADERS: Y/N WALL ST S: Y/N GIRDERS: Y/N
CEILING JOISTS:Y/N FLO OISTS: Y/N ROOF RAFTERS: Y/N
LUMBER SPECIES AND GRADE: Y/N
DESIGN LOAD CALCULATIONS: Y/N
LIVE: Y/N DEp,: Y/N SNOW:Y/N SEISMIC: Y/N WIND: Y/N
WINDOW ANP.DOOR SCHEDULE:
MISSLEIEST REQUIREMENTS: /N l
EGRESS 5.7 S.F.:&/N
LIGHT 8%'.&N.
VENT 4%ADN
NAILING/CONSTRUCTION EDULF&�)
MEANS OF EGRES .
. PLUMBING RISER DIAGRA4/N
LOCATION OF FIRE PROTECTION EQUIPMENT: VeIN
TRUSS DESIGN: Y/N
CERTIFICATION:
ENERGY CAL;j. Y
TOTAL COMPLIENCE? Y/N (RETURN TO PAGE ONE)