HomeMy WebLinkAbout25514-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26515 Date: 06/18/99
THIS CERTIFIES that the building ADDITION
Location of Property: 7020 GREAT PECONIC BAY BLVD LAUREL
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 126 Block 11 Lot 6
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 7, 1998 pursuant to which
Building Permit No. 25514-Z dated FEBRUARY 2, 1999
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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING "AS BUILT"
The certificate is issued to ASTRID GADDIS
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. H-062446 12/15/98
PLUMBERS CERTIFICATION DATED N/A
//161
il Ing I \spector
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. 25514 Z Date FEBRUARY 2 99
Permission is hereby granted to:
FREDERICK & PATRICIA COULTER
86 WOODEDGE ROAD
PLANDOME,NY 11030
for
CONSTRUCTION OF A DECK ADDITION & 2ND STORY RENOVATIONS "AS BUILT"
FOR AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR.
at premises located at 7020 GREAT PECONIC BAY BLVD LAUREL
County Tax Map No. 473889 Section 126 Block 0011 Lot No. 006
pursuant to application dated DECEMBER 7 98 and approved by the
Building Inspector.
Fee $ 178.60
Author ed Signature
ORIGINAL
Rev. 2/19/98
TOWN OF SOUTHOLD PROPERTY RECORD CARD
WNER STREET O " VILLAGE DIST. SUB. LOT
ORMER OWNER N E� ACR.
p.C. P�LhtER Soo I
/ y S W _ TYPE OF BUILDING / ! � / .1.-1 �re ,
113
S. 2`p SEAS. VL. i!t
COMM. CB. MISC. Mkt. Value ff� � fC f
LAND IMP. TOTAL DATE REMARKS Clo 6�� C4/�0� �
46U vl0 001.0 ?I/ n ✓o D/ 2�i� ;Z
/z��7 a, « ��9Sao C'a »e
G 4e_
AGE BUILDING CONDITION
dEW NORMAL BELOW ABOVE
=ARM Acre Value Per Value
Acre
illable 1
illable 2
Ilable 3
'oodland S U Cz
Nampland FRONTAGE ON WATER `
rushland FRONTAGE ON ROAD 6
louse ^ DEPTH ( �
BULKHEAD
>. i DOCK _
■■■■■■ ■■■■OM■■M=ON■■■■M■■
■MESON ■SGMU■ m■■■■■■■■NEEM
P`i�W�mm
�. E■■ME ■ rr__.._r■EMENN■MEMEME
fflu ■■■■■ ■n��m■■■M■mM■■■■EM■■■■■
.ism MENEM MEMO
ENOS
E■iE■l■■ u■■■■u■E■■M■■■■■■■E
No on MEN......
ME iNSMEiiOSEENEM ■
BUILDING DEPARTMENT IUVA\. ti- VIJ�-V
TOWN HALL -?_98-6080
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. This application must be filled in by typewriter OR ink and submitted to the buildir
inspector with the following: 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% lead.
5. Commercial building, industrial building, multiple residences and similar buildi
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 a
'-'pre-existing" land uses:
1. Accurate survey of property showing all property lines, streets, building and
unusual natural or topographic features.
2. A properly completed application and a consent to inspect signed by the applican
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Buildine - $100.00
3. Copy of Certificate of Occupancy - .25i�.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date .X .�. � . . . . . . . . . . . . . . . . . . . .. . . . . . .
New Construction. .. . . . .. . . .. Old Or Pre-existing 22Building
�. . . . . . . . . . . . . . . . .
Location of Property ' . .7V?U. . �y: ��.�. .lJ lik_vo�. . . . . . . . . .�.,�U�^ �. . . . .
House No. b Sheet Hamlet
Onwer or Owners of Property . . ..R5.1 AD . . . . .4TADJ?.I.S. . . . . . . . . . .. . . .
County Tax Map No 1000, Section. . 1. . . . ..Block. Al. . . . . . . . . . . . .Lot. Y
. . . . . . . . . . . . . . .
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . ....'. . . . . . ....
Permit No 2-5.5 .1. `]j-. . .Date Of Permit. . . . . . . . . . . . . . . .Applicant. .C-�yNa. . .co'A,.T5
Health Dept. Approval. ./14.. . . . . . . . . . .. . . . . . . .Underwriters_Approval. . .Nl.A. . . . . . . . . . . . . .
Planning Board Approval. .Ni A. . . .. . . . . . . . . . . . . /
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . .
Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
G
p [ 0 b ( ANT
Co �GS�S
New York State Department of Environmental Cone11 !an
Building 40 - SUNY, Stony Brook, New York 11790-2366
Telephone (516)444-0365
Facsimile (616)444-0373 ---�
DEPT
NOW
Jahn P. Gahm
Commissioner
LETTER OF NONJDRIADICTION TSDAL WETLANDS ice"
January 26, 1999
Re: 1-4738-02147/00001
coulter Property
Construct deck
Frederick & Patricia Coulter
86 Woodedge Road
Plandome, NY 11030
Dear Mr. & Mr. Coulter:
Based on the information you have submitted, the Naw York State
Department of Environmental Conservation has determined that:
The property landward of the bulkhead which was constructed prior
to September 20, 1977, as shown on the survey prepared by VanTuyl
& Son dated June 25, 1971, is beyond the jurisdiction of Article
25.
Therefore, in accordance with the current Tidal Wetlands Land Use
Regulations (6NYCRR Part 661) no permit is required under the Tidal
Wetlands Act . Please be advised, however, that no construction,
sedimentation, or disturbance of any kind may take place seaward of
the tidal wetlands jurisdictional boundary, as indicated above,
without a permit. It is your responsibility to ensure that all
necessary precautions are taken to prevent any sedimentation or
other alteration or disturbance to the ground surface or vegetation
within Tidal Wetlands jurisdiction which may result from your
project. such precautions may include maintaining adequate work
area between the tidal wetland jurisdictional boundary and your
project (i.e. a 15' to 201 wide construction area) or erecting a
temporary fence, barrier, or hay bale berm.
,
ZO' d £00' oN ZT : OT 66. TO 933 TZ69Z8b9TS: QI 1,11d32J N33-139
Please be further advised that this letter does not relieve you of
the responsibility of obtaining any necessary permits or approvals
from other agencies.
Very truly yours,
George W. Hammarth
CAF Permit Administrator
cc:
£0' d £00' ON 8T : OT 66, TO 933 TZ69Z8b9TS: QI Ai-lH38 N33I39
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
g0737'a13 BUREAU OF ELECTRICITY
F 40 FULTON STREET, NEW YORK, NY 10038
Date DECEMBER 15,1998 Application No. on file 17337098/98 if 062446
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of
FREDERICK T. COULTER, 7020 PSCO14IC BAY BLVD. , LAUREL, NY
in the following location; ® Basement ® Ist Fl. ® 2nd Fl. OUT Section Block Lot '
was examined on DECEMBER 07,199- and found to be in compliance with the National Electrical Code.
FIXTURERECEPTACLES SWITCHES FIXTURES RANGES COOKING DFCKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENTI FLUORESCENT I OTHER I AMT. I K.W. AMT. I K.W. AMT. I K.W. AMT. N.W. AMT. N.P.
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECTI. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
AMT. K.W. OIL N.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMi. WATTS
SERVICE DISCONNECT NO.OF S E R V 1 C E
TYPE
- MET R NO.Of CC GOND. A.W.G. A.W. Of NEUTRALS OF EUTRAG. A.NW.G.
AMT. AMP. EQUIP. 10 2W 1 0 3W 3 0 3W 3 0 dW PER 0 OF CC.GOND. NO.OF HI-LFG OF HI-LEG NO. L
OTHER APPARATUS:
ENTIRE PRE17ISE5- 1
ANO VISUAL DEFECTS: "Pm electrical
survey has been made of the exposed
electrical equipment in the
premises indicated. "No obvious
unsatisfactory condition was found.
L
FREDERICK T., COULTER
85 WOODEDGE ROAD GENERAL MANAGER
IMNHA.SSET, NY, 11030
Per
This certificate must not be altered in any manner; return to the office of the Board If Incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
K
�' �c/,'✓now� sKyCI'yl�f � N# or, flN•L� 20 3/4
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PROVIDE SMOKE-DEFECTING —
P ALARM DEVICES
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LV3 SWLDING CODE. N pr►
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e P a55 IL
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F`':_l OWING INSPECTIONS:
� ` z nn.TroN - Two REQlIM1ED
r .. CONCRETE
R PLUMBING OCCUP NCY OR
� tr '..OR ttST
USE IS UNLAWFUL
WITHO T CERTIFICATE
CO N,v RU SPO F E OF OC UPANCY
'- CGDE NOT RESPONSIBLE �. `
DESIGN OR CONSTRUCTION ER .)R:: sKyL r'f
U DERWRITERS CERTIFICATE
' REQUIRED
sky Li'y b� PROVIDE OPENING$ FOR
C
i EMERGENCY ESCAPE AS L
N
KEiaXyl�i �a6
REQUIRED P PART.714 OF —
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765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ 7] 1 ULATION
FRAMING [ AL
[ ] FIREPLACE & CHIMNEY
REMARKS: �G��
- �� �✓
DATE INSPECT0
4. BOARD OF HMTB •..•..•....
FORM NO. 1 3 SETS OF PIANS .. .. ... ....
TOWNOF SOUTHOLD SURVEY ................ ........
BUILDINGDEPARTMENT. CHECK .........................
TOWN BALL SEPTIC FORK ........ . ... . ......
SOUTHOLD, N.Y. 11971
TEL: 765-1802 NOTIFY:
CALL ..... .. .... . .. . . . .
Examined.................. 19.... I MAIL TO:. ..... . ... . .. . . . . . . .
Approved.................. 19.... Permit No. S s� ...................................
Disapproved a/c .... .. .... ............... ...................................
D Q Iding inspector).. .....
7 199 KATION FOR BUILDING PERMIT //hh Q Date../�f:��.. . . . ..,19/.
ELCG. DEPT. INSTRUCTIONS
WN OF SnUTHOLO '
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector wi
3 sets of plans, aoaaate plot plan to scale- Fee according to ad*dule• premises or public
b. Plot plan showing location of lot and of buildings on Mm'ses, z ti idraw on theinggrm�chicfi is part of
streets or areas, and giving a detailed description of layout of property
lust be this application.
c. The work covered by this application say not be commenced before iasumhoe of Building Permit.
d. *Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such
permit shall be,kept on the premises available.for inspection duu4 ut the work-
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of
Occupancy shall have been granted by the Building Inspector.
APPIICcm IS BMW MALE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk Canty, New York, and other applicable Laws, Ordinances or
Regulations, for the coostruction of buildings, additions or alterations, or for removal or demolition, as herein
described. Time applicant agrees to comply with all applicable laws, ordinances, building code, booming code, and
regulations, and to admit authorized inspectors on premises and in buildbW for nneo'es/s/wry
... . . fes!.. 9- *if*a*corporation)*(Signauue of appli
...................................................
Qiailing address of applicant)
State whether applicant is owner, lessee, amt, architect, engineer, general contractor, electrician, plumber or builder
....o wNjoz ................................................./....................................................
Name of awner of premises .. � � /�l�G. ..� :.. U f -:&& ..........................................
(as on time tax roll or latest deed)
i
If applicant is a corporation, signature of duly authorized officer.
(Name a� title of corporate officer)
Builders License No. .........................
Plumbers License No. .........................
Electricians License No. .....................
Other Trade's License No. .................... �i ]
1. Inc-ation of land which proposed work will be d/ooe....l.�9.I Q ... .F� C1 k! ................
1[�f �...:/. . . ..f...............................
House Number S q / H/aamlet
Canty Tit Map No. 1000 Section ..f�S �:. ..IC.
....... Block .......... Int .....06 `/FP....
Subdivision ...........................:.......... Filed lisp No. ............... lot ...............
(Name)
2. State existing use and ooatpan y of premises and =tended 7e and of proposed cons ion:
occupancy
a. Erastinguseaodocahpency A�r✓// 11/
i/V�.... �Rtl .[e t4l.-C... �cr �h. t�d9.In 1 ....:.....
b. Intended use and ocxihpmhsy''. ./) rt'V �....�}�v'J. !(C /... .. r...........
1
1. Nature of work (dw&which applicable): Hum Budding .......... Addition P4.. Alteration
Repair ............ Removal ............. Demolition ............ Other Work ......••
Q �/r� (Description)
�. '1.4 a0
'�. Estimated Cost .... .... ...�... fee ..............................................
(to be paid on filing this application)
5. if dwelling, number of dwelling units .../....... umber of dwelling units on each floor ................
Ifgarage, amber of cars ......................................
S. If business, eco ercial or mixed o=Vmxty, specify nature and extent of each type of use......................
7. Dimensions of existing structmces, if any: Front.... ".Y I.. Rear .. '? 7...... Depth ....�+�s!'./...
height ... amber of Stories ...1.. ............... /
Dimensions of same -trucbure with alterations or additions: Front ....2 lotT.-
larfl. ............
Depth .....,V-,L4j...... Haight ...... _i/ _ ....... amber of Stories .. ??�
8. Dimensions of entire Dena Construction: Front ................ Rear ........ ith ..............Hei t Number of Stories ...........9. Size of lot: Front ........:.. ... Rar ...x9�'h. ...... Depth .. ....T10. Date of Rm9xaseY. 9 ..... Name of For er Owner .......�9 Y ..r .............
11. Zone or use district in which premises are situated ................................//................................
12. Does proposed construction violate any zoning law, ordinance or regulation- ....'�l.m..............
13. will lot be regraded ... ............ Will excess fill be resoved from res: YES �j ��
14. Names of Owner of premises G.s..E.�l:�(�►.�i4fL.(t��(Bddreas �? tei'.�P. ...°?.�..
Name of Architect .................................... Address .............................. Phone No. ....•.........
New of Contractor ................................... Address ...................i...........Phone No. .............
15. Is this property within 300 feet of a tidal wetland? * YES .......... ND ...........
*IF YES, SOMBOLD 10Id1 TRDSIFffi FEWr HAY W 16QUI t®.
PLOT DIAGRAM
Locate clearly and distinctly all buildinga, wbetber etdsting or proposed, and indicate all set-hack dimensions
fram property lines. Give street and block amber or description according to deed. and show street names and indicate
whether interior or corner lot.
SU ev Evil
SCAB Or NEW IOIZtC, SS
Omly or wswe--,5j,► ".:....... t
,: . .. ........'.................being duly sworn, deposes and says that be is the applicant
(fare of individual signing contract)
above named,
Ile 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 harmer set forth in the application filed therewith.
Sworn to begme this
L- q
. .........may . . .19 `
Notary Public .... ......MAP BIIC,State ad[NewY �r
o. 30-4839402 (Signature of Appli
Qualified in Nassau County
Commission Expires Dec.31,1999
2" *6" EXTERIOR GRADE LUMBER
NEW DECK
24'-9"
::.:::::. .Wry::::::v::::.:::.:::::::.a.::nn....:n.n..........n.n..n.. .:w. .:.................. :.
2 �1
-2
0
- MAS +... .... ....
-. : ......
v : v: :
v: i
......
26
-4.Boom. v
<...
Dining room r 4"*4" POSTS (42)
91-6"
I 7'-699
L New Opening Head r -2 -2"*12"
/Double 2" *4" at each end
Bedroom
Living Room Area TM 1 -1 F-1
Nord
XISTING STAIRS TO REMAIN
Kitchen Bathroom Bedroom
NEW 20"44 SKYLIGHT a I. r
New 2" " sister to exi ing 2" * 5" to ridge bean R
FEB 1 9199'.9
i .
i 70wBOF�D
i
Double 2" * 6 "- F si en with TECO connectors- Cut 1 rafter to fit
8'-3"
Alterations to property for Certificate of Occupancy
7020 Great Peconic Bay Boulevard, Laurel New York
2'-6" District 0100-Section 126.00-Block 11- Lot 6
g�v.FES Scale : As Shown
PLAN OF GROUND FLOOR u� Date: February 18,1999
t Drawn By: Marc G. Levinn, P.E.
Scale a
Drawing 1 of 4
New 2" *6" sister to existing 2" * 5" to ridge beam
3'-7-
3'-6"
4""44" Skylight-Cut 2 rafters to
" * r _
Fasten wituble h TECO connectors
9'-7" NEW 2'-6"DOOR
North
5H R CLOSET
BATTERY OPERATED S O E DETECTOR
33 "
6-10 "
V
Bedroom
Bathroom
CLOSET
31-11 2" 12'-6"
we 7'-?"
PLAN OF SECOND FLOOR
Scale
0 1 2 3 4 5 6 7 8 9 10
NOTES
CONTRACTOR TO VERIFY ALL DIMENSIONS
UPON COMPLETION OF WORK SONTRACTOR TO SECURE A CERTIFICATE OF COMPLETION FOR NEW WORK
NEW WORK INCLUDES:
EXTERIOR WOOD DECK
THREE NEW SKYLIGHTS
NEW BATHROOM ON SECOND FLOOR
REINFORCEMENT OF ROOF RAFTERS
CONSTRUCTION OF CLOSET AND KNEE WALLS ON THE SECOND FLOOR
TrU
WIDENING OF THE DINING ROOM ENTRANCE TO LIVING ROOM Q
REPAIRS TO FRONT STEPS AND NEW DECK STAIRS OF EXTERIOR LUMBER
ALL NEW STUDS WALLS TO BE 2 411 CONSTRUCTION
FEB I 0 iggq
ALL NEW TIMBER TO BE DOUGLAS FIR FB 1200 PSI.
CONCRETE POST FOUNDATIONS FOR DEC TO BE 2500 PSI Fc CONCRETE - AIR ENT INE s� -
PLUMBING WORK TO BE PERFORMED BY A UCESED PLUMBER
ALL PLUMBING WORK TO BE TO LOCAL CODE OR STATE BUILDING CODE WHICH EVER IS MORE STRINGENT
CONTRACTOR TO DOUBLE ROOF RAFTERS WITH A 2' *6 " TIMBER
ALL ELECTRICAL WORK TO BE APPROVED BY UNDERWRITTERS LABORATORY.
WATER SUPPLY FOR THE BATHROOM IS FROM THE EXISTING WELL AND THE WASTE IS DRAINED TO EXISTING
SEPTIC SYSTEM. Alterations to property for Certificate of Occupancy
7020 Great Peconic Bay Boulevard, Laurel New York
District 0100-Section 126.00-Block 11- Lot 6
Scale : As Shown
pOFESs�
U=y,Go'^�iLeE oft Date: February 18,1999
rawn By: Marc G. Levinn, P.E.
a� Drawing 2 of 4
4"*4 "POST
* 8„ 2' * 6 ' DECKING
2' *8 " TRIM BOARDS
2'-3" MAX SPAC
3'-5"+/-
63/4 +/-1 / IV
2, *8„
0 4„*4„ POSTS - 42 REQUIRED
0 11
4'-3”TYP
6 RISERS AT 6 3/4"+/- 1 /8” 10 " DIAMETER CONCRETE FOOTINGS
3'-2"
+
ALL TREADS 11 /
SECTION THROUGH DECK- AGE OF CONSTRUCTION 19+/- YEARS
BUILDING ENTRANCE LEVEL 2' *12" TREADS
30"
CONCRETE LANDING
7 1/2" RISER AL
FRONT ELEVATION OF KITCHEN ENTRANCE STAIRS
70 !
LDGDNFSO
Alterations to property for Certificate of Occupancy
7020 Great Peconic Bay Boulevard, Laurel New York
District 0100-Section 126.00-Block 11- Lot 6
pp.OFE8g�0 Scale : As Shown
PO T Date: February 18,1999
S �
2 Drawn By: Marc G. Levin, P.E.
Drawing 3 of 4
COLD WATER
HOT WATER SH ER
i sir
0, I ALL SUPPLIES W ARE 1/2" COPPER TUBING
i
00
X000 0 00 iI FIRST FLOOR
HOT WATER SUP
WC
I I
I
B NT FLOOR
PLUMBING SCHMATIC
WELL- COLD WATER ALL VENT LINES 11 /2 INCHES
' EXTEND HEIGHT TO 2' ABOVE
OPERABLE VENTING SKYLIGHT
' I
1 1 1/2" DIAMETE I WASTE
SHOWER 3" DIAMETER WASTE
I I I SECOND FLOOR
I I
LAV
FIRST FLOOR
1 I
I
WC
4" DIAMETER WASTE
CON 0 SEPTIC SYSTEM WASTE LINE
BASEMENT FLOOR
DRAINAGE SCHEMATIC
� 1,
la3a•imeN101
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6661 6 183
Alterations to property for Certificate of Occupancy
7020 Great Peconic Bay Boulevard, Laurel New York
District 0100-Section 126.00-Block 11- Lot 6
�ppFES Scale : As Shown
2 s n Seo Date: February 18,1999
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Drawn By: Marc G. Levinn, P.E.
Drawing 4 of 4
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BUILDING PERMIT REVIEW CHECK LIST
Application Name: CDS LtS-
Architect/Engineer: Date Submitted:
SCTM #: District: 1.000 Section: Z6 Block: h Lot:
Subdivision Name:
Req. Req.
Zoning District: [Lot size: Actual: ] [Lot coverage Proposed: ]
Req. Req. Req.
[Front Yard Proposed: ] [Side Yard Proposed: ] [Rear Yard Proposed: ]
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Project Description: FSS oc),ct Dea-
AGENCY PERMITS Permit
REQUIRED FOR REVIEW N.A./ NO YES Number
Suffolk CountY p Health Dept.
New York State D. E. C.
Town Trustees t► �
Town Zoning Board approval: I�
Town Planning Board approval:
Flood Plane Elevation ???
Flood Zone: I/
Notes:
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03 va
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�'--�-- PROVIDE SMOKE-DETECTING
ALARM DEVICE -- ------
� I/y AS TO PARt 721.1
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X.Y.S BUILDING CODE. N P�►a"1
APPROVED AS NOTED ri
DAM B.P.# a55 I`I
FEE: 1 -7 g. Q-a 9Y:..� D W E IZ
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NOTIFY B NILINI lt3 1011111FAMMIff AW
7A5-1802 9 AM TO 4 PM FCM THE
— F-' J OWING INSPECTIONS:
j r �Tf�ly - TWO REQUIRED
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CONCRETE �+►(� p ���: PLUMBING �LIIIUf ��V 1 OR
or,�► USE IS UNLAWFUL
WITHO T CERTIFICATE
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NO RESrON'�',T. OCCUPANCY
DESpGN OR CONSTRU"T iON ER, '.,W,..
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Ut DERWRITERS CERTIFICATE
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REQUIRED
PROVIDE OPENINGS FOR
�i�4' s{,yr�v XS�1�j EMERGENCY ESCAPE A3 yy%X y�% ��� YJAl
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REQUIRED BY PART.714 OF �`
N.Y. STATE I UILPING CODE. _ -- _---
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