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Home My WebLink About31913-Z FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31589 Date: 05/30/06 THIS CERTIFIES that the building ALTERATION & ADDITION Location of Property: 2545 (HOUSE NO.) County Tax Map No. 473889 Section 110 WEST CREEK AVE (STREET) Block 5 CUTCHOGUE (HAMLET) Lot 1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 13, 2006 pursuant to which Building Permit No. 31913-Z dated APRIL 17, 2006 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 "AS BUILT" ADDITIONS & ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR & AS PER CONDITIONS OF ZBA #5817 DATED 2/2/06. The certificate is issued to GREGG & KATHI ROBERTS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 2074353 10/07/05 PLUMBERS CERTIFICATION DATED 01/19/06 GREENPORT PLUMB.&HEATING Rev. 1/81 Form No.6 TOWN OF SOurnOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 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 I % 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: I. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. G 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. New Construction: Old or Pre-existing Building: V '"' 5 ,/ r /.1 I. A Location of Property: ..<- T ~ V'-" S ., c: r, c.. f<, ve House No. Street (check one) c<<,;. t. 0,,/,,- ~ 4 Hamlet Owner or Owners of Property: ~ re..e 6> c;.. F' K ,It ,,..1, 7f.o.BE:'/!-f>;: Suffolk County Tax Map No 1000, Section J 10 Block 5 Lot / Subdivision ~ Filed Map. Lot: Permit No. 3" I '} :c Date of Permit. 'i /171 0 ~ Applicant: 11 f<)A- e-r Health Dept. Approval: Planning Board Approval: Underwriters Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ ~ S .cr-Cl a...~ 70;j, I r, C.O.::c 3\5~ Applicant Signature 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. 31913 Z Date APRIL 17,2006 permission is hereby granted to: GREGG & KATHI ROBERTS CUTCHOGUE,NY 11935 for "AS BUILT ADD & ALTS TO AN EXISTING SINGLE FAMILY DWELLING PER ZBA DECISION #5817 AS APPLIED FOR at premises located at 2545 WEST CREEK AVE CUTCHOGUE County Tax Map No. 473889 Section 110 Block 0005 Lot No. 001 pursuant to application dated APRIL 13, 2006 and approved by the Building Inspector to expire on OCTOBER 17, 2007. Fee $ 300.00 t;L'-O~ CJt- / Authorized Signature ORIGINAL Rev. 5/8/02 l!l~.l!l ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ Located at ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ I ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~l!l BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by KATHIROBERTS 2545 W. CREEK AVE CUTCHOGUE, NY 11935 KATHI ROBERTS 2545 W. CREEK AVENUE CUTCHOGUE, NY 11935 2545 W. CREEK AVENUE CUTCHOGUE, NY 11935 Application Number: Certificate Number: 2074353 2074353 Section: Block: Lot: Building Permit: BDC: ns11 110 5 1 Described as a Residential 0-599 square ft. occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: First Floor, kitchen reno, Outside, A visual inspection of the premises electrical system, limited to electrical devices 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 7th Day of October, 2005. Name OTY Rate Ratine: Circuit ~ Miscellaneous as built-I 998 Appliances and Accessories Dish Washer Disposal Wiring and Devices Outlet Fixture Outlet Receptacle Switch Dimmers o o 1.2 KW F.H.P. Fixture Incandescent General Purpose General Purpose General Purpose 3 0 3 0 6 0 6 0 3 0 3 0 I 0 GFCI Receptacle An as built inspection, of the delineated electrical installation, detennined that an obvious hazard is not present and the installation is believed to be in comformance with the applicable reference standard for the estimated period of construction of the premises wiring system. seal 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. ~ ii!/E!Ji!Ii1!E!IilUii:!nif6E!~~ -----. Town Uall. 5.1095 ~.,..in Road 1'.0. Ilux 1171) Soulhold, New York 11971.09~\I FctA (hJ 1) 765~9S(J.2 rdeph\.uu~ (6:\1) '165.: HO::: llUILDlNO DliPARTMENT TOWN OF 80Ul'HOU) C F R T ! F I (; A 'J ,L9Ji L\~t(' . . LjL'Z/a.6. _.. BUlldiug l't:nnil No. ___ Owner_ c:;,~.~:~9_j;{1j;7Jf( ~~~?.tf3. . (Please prilit I . ~$'~S Wi'~t eN" (c. Avv e.. ../:-d...o i <<-e .LY I ( 'I 'J c;:' PlumocLILJ/AJ.t'ii:.(?..,L!:U.t:C.Ze..h/5/<,; (6.a.=..e<:h j/orT /:J/c./ ,..,4; h') (Please print) 1 ce,11ify Ihal the solder ,,:>ed inlhe waler supply 'y"kllll<llllaJll' It:S$ than 2/1 () or 1% lead, . .~~ ;?.?.?"" '.J-L-~..::,~- (I'llIInbers Signature) Sworn to betorc me this jJ.._ r,-"'~,~;':-.' "--'--' " _ .,0- day of ~. n' 20../16. 1 Nota~~~I~G~~t~Ro~~~Y'~ - - ~ : No OlC05G17852 //. \ OlJsl:lled Hl Sutfo!~ County -4t2- ~.__J~__~.~=::xPIf:sS"tI3:~O 1 -.. t' , I I I I i ! Nolary Public, .. :otlnly l!I ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ Located at ~ ~ ~ ~ ~ ~ ~ = = ~ ~ = = = = = ~ = = = = = = ~ = ~ = ; ~~l!I = ~ ~ = ~ ~ ~ = = ~ ~ ~ ~ ~ = ~ ~ ~ ~ ~ ~ ~ ~ Amount = ~ $0.00 = = = ~ = = = = = = = ~ ~ ~ = ; ~~~ -' BY THIS CERTIFICATE OF; COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS 40 BUREAU OF ELECTRICITY FULTON STREET - NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by KATHIROBERTS 2545 W. CREEK AVE CUTCHOGUE, NY 11935 KATHIROBERTS 2545 W. CREEK AVENUE CUTCHOGUE, NY 11935 2545 W. CREEK AVENUE CUTCHOGUE, NY 11935 Application Number: Certificate Number: 2074353 2074353 Section: Block: Lot: Building Permit: BDC: ns11 110 5 1 Described as a Residential 0-599 square ft. occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: First Floor, kitchen reno, Outside, A visual inspection of the premises electrical system, limited to electrical devices 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 the7th Day of October, 2005. Name OTY Rate Rating Circuit ilJ1;. Miscellaneous as built-I 998 Appliances and Accessories Dish Washer Disposal Wiring and Devices Outlet o o 1.2 KW F.H.P. Fixture Incandescent General Purpose General Purpose General Purpose 3 0 3 0 6 0 6 0 3 0 3 0 I 0 GFel Fixture Outlet Receptacle Switch Dimmers Receptacle Invoice Total An as built inspection, of the delineated electrical installation, determined that an obvious hazard is not present and the installation is believed to be in comfonnance with the applicable reference standard for the estimated period of construction of the premises wiring system. seal Continued on Next Page I of 2 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $85.00 ~ ~E!ffi!l!I f!1~~~~~~f!1 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ Amount ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ I iiml!Iii!iiml!Iii! f!1 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ I Located at ~ Application Number: I Section: 110 Block: 5 ~ I .~ ~ A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed ml 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 the7th Day of October, 2005. ~ Name OTY Rate Rating Circuit ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ I ~ BY THIS CERTIFICATE OF .COMPLlANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by KATHIROBERTS 2545 W. CREEK AVE CUTCHOGUE, NY 11935 KATHIROBERTS 2545 W. CREEK AVENUE CUTCHOGUE, NY 11935 2545 W. CREEK AVENUE CUTCHOGUE, NY 11935 2074353 Certificate Number: 2074353 Lot: Building Permit: BDC: ns11 1 Described as a Residential 0-599 square ft. occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: First Floor, kitchen reno, Outside, seal THIS IS YOUR RF.CF.IPT 2 of 2 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 3L'1I3>c TOWN OF SOUTH OLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [] ROUGH PLBG. [ ] FOUNDATION 2ND [] ~iATION [ ] FRAMING I STRAPPING [v(FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: " . DATE 'f j; if /0 r;, I ( INSPECTOR <.. .... . . -~ FIELD mSPECTION REPORT DATE COMMENTS . uJ.." - "" FOUNDATION (1ST) ..f'~ - :::j lJ-'.. ------------------------------------ fo cf FOUNDATION (2ND) c?-'" r -tV"" U - zi- p ~'" ROUGH FRAMING & V\~ ..c:."" PLUMBING '-'\.., , r . . ~ INSULATION PER N. Y. ~~ STATE ENERGY CODE ? <;LIp/I. , In r-~ L... r" /J [ I II gJj -I...... r- .......... ... 0 . II F#," . r_ <1, ,/ -/ f'. // l / J /} _V ~ t FINAL '-'-/# .J '" . ADDmONAL COMMENTS 7'D . t~ z (/I m ;:0 OJ '. -- "" (J ><I I ::l ::51:: I .., o - ~~ . = "" L~ 3;-; I'l .." ~ ,-, \::\1 _\('-1\\ \ " I ,~ ' \ , , ,,-' \ \ ____ .----4=INDINGS, DELIBERATIONS AND DETERMINATION MEETING OF FEBRUARY 2, 2006 APPEALS BOARD MEMBERS Ruth D. Oliva, Chairwoman Gerard P. Goehringer James Dinizio, Jr. Michael A. Simon Leslie Kanes Weisman http://southoldtown.northfork.net \" ZONING BOARD OF APPEALS TOWN OF SOUTHOLD Tel. (631) 765-1809. Fax (631) 765-9064 ,J , LU \ 0' \ " " .----' ZB File No. 5817 - Gregg and Kathi Roberts Property Location: 2545 West Creek Avenue, Cutchogue Mailing Address: Southold Town Hall 53095 Main Road. P.O. Box 1179 Southold, NY 11971-0959 Office Location: Town Annex /First Floor, North Fork Bank 54375 Main Road (at Youngs Avenue) Southold, NY 11971 CTM 110-5-1 SEQRA DETERMINATION: The Zoning Board of Appeals has visited the property under consideration in this application and determines that this review falls under the Type II category of the State's List of Actions, without an adverse effect on the environment if the project is implemented as planned. PROPERTY FACTS/DESCRIPTION: The applicant's 13,667 square foot parcel has 79.50 feet along West Creek Avenue and 182.72 feet along Dicks Point Road in Cutchogue, and is improved with a 1-1/2 story frame house, as shown on the sketched July 8, 1991 survey prepared by Roderick VanTuyl, P.C. BASIS OF APPLICATION: Building Department's October 6,2005 Notice of Disapproval, citing Section 100- 243A and 100-244, in its denial of an application for a building permit concerning the as-built enclosure of an existing porch (addition and alterations), at less than 35 feet from the front yard lot line, which constitutes an increase in the degree of setback nonconformance. FINDINGS OF FACT The Zoning Board of Appeals held a public hearing on this application on January 26, 2006, at which time written and oral evidence were presented. Based upon all testimony, documentation, personal inspection of the property, and other evidence, the Zoning Board finds the following facts to be true and relevant: AREA VARIANCE RELIEF REQUESTED: The applicants completed certain alterations to their home (replacing new windows and related type of improvements for their porch and existing kitchen), as shown on the applicant's rough site survey date-stamped December 2, 2005 by the ZBA Office. The porch is 23 feet from Dicks Point Road, at its closest point. REASONS FOR BOARD ACTION: On the basis of testimony presented, materials submitted and personal inspections, the Board makes the following findings: 1. Grant of the variance will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. The construction area maintains the degree of existing nonconformance at 23 feet from the road, instead of 35 feet. Being on a corner, the house lot has two front yards, each facing a 50 ft. wide town street. The nonconforming setback exists oniy on the side street, Dicks Point Avenue. 2. The benefit sought by the applicant cannot be achieved by some method, feasible for the applicant to pursue, other than an area variance. Page 2 - February 2, 2006 ZB File No. 5817 - Gregg and Kathi Roberts eTM No. 110-5-1 3. The variance granted herein is not substantial, inasmuch as it permits only the enclosure of a porch that has existed in its present location since the house was built in 1948. 4. No evidence has been submitted to suggest that a variance in this residential community will have an adverse impact on the physical or environmental conditions in the neighborhood. 5. Grant of the requested relief is the minimum action necessary and adequate to enable the applicant to enjoy the benefit of alterations and addition, while preserving and protecting the character of the neighborhood and the health, safety and welfare of the community. RESOLUTION OF THE BOARD: In considering all of the above factors and applying the balancing test under New York Town Law 267-B, motion was offered by Member Simon, seconded by Member Dinizio, and duly carried, to GRANT the variance as applied for, as shown on the sketched July 8, 1991 survey prepared by Roderick VanTuyl, P.C. date-stamped December 2, 2005, and construction diagram prepared by Joseph Fischetti, Jr., P.E. dated 9-23-05. This action does not authorize or condone any current or future use, setback or other feature of the subject property that may violate the Zoning Code, other than such uses, setbacks and other features as are expressly addressed in this action. Vote of the Board: Ayes: Members Oliva (Chairwoman), Dinizio, Simon and Weisman. Member Goehringer was absent. This Resolution was duly ~d (4-0). , ~,~ .C]~<r, Ruth D. Oliva, Chairwoman 2/4 106 Approved for Filing TOWN OF SOUTHOLp:;:r;;---:-'------' BUILDING DEPARTM. ~'\ '.. ".'..777::,( I TOWN HALL . . "'- / i, SOUTHOLD, NY 1197,1 '. f~- Ok. ' TEL: (631) 765-1802 I I FAX: (631)' 765-9502 { '. ....._ ',;;- '~-.. J www.northfork.netlSotim-ufdi . ~ERMIl1 N_<L_.; 3/7/3-e.-- BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying') Board of Health 4 sets of Building Plans Planning Board approval Survey Check Septic Form NYS.D.E.C. Trustees Contact: Examined Approved Disapproved alc Iff (J 'fill , 20.2L.. ,20 0;' /0(( 7,2oli- I OJ)~ Mail to: /20:L S ...'-", C,'rc(e ?i/rf V'/'?'tTtJA J'f." "''t'1f77f;p Phone: (,3/' '1-7 <I -0 7 r 7 Expiration IC-&~ Bililding Inspector APPLICATION FOR BUILDING PERMIT Date (Pc h 6(I J , 20 os' ~ INSTRUCTIONS t a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and waterways. , c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. , e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 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 ofthe 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) /.2.0:{ S'~r4. C ;"'e(e. ,P~rf -if' IhncYI.,S'-r......j..(j./( NY ((77& (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder tJWIi.U Name of owner of premises ~ kif'-: h6~r7f (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (3 r& 11 (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: JSfS" Wt.cf tru--K: 1ft/I. House Number Street tulutt1ftt-t <7 Hamlet County Tax Map No. 1000 Section Subdivision iff) Block Filed Map No. !5 Lot Lot / (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existinguseandoccupancy I.eS;d~,L.;;d US b . / L-/ - "I\s/.../I w,'ft,'" i..Js ."or"~ fA...( '7.-J b. Intended use and occupancy ~.r,de,,-6'a- "lOrV' ;" D i k" {'&...; {'._f - f:.._r ~ c. ~~v Addition Alteration Other Work 3. Nature of work (check which applicable): New Building Repair Removal Demolition 17.5C1/!J.- (Description) 4. Estimated Cost Fee 5. If dwelling, number of dwelling units / If garage, number of cars (To be paid on filing this application) Number of dwelling units on each floor 6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use. ~ ~ 'fM( 7. Dimensions of existing structures, if any: Front ,f {) . Rear 3 0 ' Depth Height I 7 ' Number of Stories I ) C" oG _) I Dimensions of same structure with alterations or additions: Front 3 0 Depth d- 3 . Height L 7 ( Number of Stories Rear 30' , 8. Dimensions of entire new construction: Front J{)' Rear 30' Depth Height / l' Number of Stories / 9. Size oflot: Front 71.S' Rear (P7' Depth /10 ' 10. Date of Purchase ,r/, /119/ Name of Former Owner *1 (tJ At , ( :l~ ' ~ t II. Zone or use district in which premises are situated tee,-'/' '1. 4,... ( 12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO L 13. Will lot be re-graded? YES_NO -t- Will excess fill be removed from premises? YES_NO_ &"'<-11 ~ r..1/I." JW'Z- ~4-r1l- t:.-Irv{~ 14. Names of Owner of premises 1U6vrl~ Address If~/~"".,.;'r Phone No. (, '31-~7f -&71 '7 Name of Architect !;Jee;> d4A.foroA. Address ;;'S-o I/A...rf.A. UPhone No ,,3, -73'1"'.. .:J 7 T '/ Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES _NO --Y- * 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$' vfoj.,,{ IC) G-f(~) R.u b<-r h '/0 r-c... fi.: f!..CI h, uN being duly sworn, deposes and says th~ is the applicant (Name of individual signing contract) above named, ~;;~ OW/N/1 (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. Sworn to before me this . / /" 3 fJL l LA-?LJs Notary Public iture of Applicant THERESA Notary Pu'~'_ f. EDWARDS ~! """ )t~:t,? of N Q , ,/"0, 5' '3J ew York Com . yaM/co" '. 4 mISSIon 1::,'" ".1':..,: C I.;;){,i :I{~"- , oUnty r- ....:) /lth.:l.l(;n 29 {; ~ .20~ 1--'--- '-, c , " f , '. .'.."': , .'.:2! .- ~; ~ '.';i:,J..'r:' ---.-j I I 1----." '-'- -^-, '/ / / .~, . t I: . 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I" . ) Ul I 'I.L I , \, \." . , " r' " ..... \~) : I, I " , -~ iJR I 7 Permit # Permit Date L._~;.\, _:')~-Q- RES check Software Version 3.7.3 Compliance Certificate Project Title: Roberts As-Built Report Date: 04/17/06 Data filename: C:\Program Files\Check\REScheck\Roberts.rck Energy Code: New York State Energy Conservation Construction Code Suffolk County, New York Detached 1 or 2 Family Non-Electric 18% 5750 Location: Construction Type: Heating Type: Glazing Area Percentage: Heating Degree Days: Construction Site: Owner/Agent: Gregg Roberts 2545 West Creek Cutchogue, NY Designer/Contractor: Eileen Santora . $. toi; Assembly ..... Ceiling 1: Flat Ceiling or Scissor Truss: Walt 1: Wood Frame, 16~ c.c.: Window 1: Vinyl Frame:Double Pane: Door 1: Solid: Wall 2: Wood Frame, 16" a.c.: Floor 1: All-Wood JoistITruss:Over Unconditioned Space: 785 45.0 0.0 21 824 14.0 0.0 49 180 0.350 63 21 0.350 7 152 19.0 0.0 9 785 19.0 0.0 37 permit application. The proposed systems have been designed to meet the New York State Energy Conservation When a Registered Design Professional has stamped and signed this page, they are attesting that and professional judgment, such plans or specifications are in compliance th this ode. 1- 17 '00 Company Name Date Roberts As-Built Page 1 of 1