HomeMy WebLinkAbout31858-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32260
Date: 03/27/07
THIS CERTIFIES that the building NEW DWELLING
Location of Property: 570 MAPLE
(HOUSE NO.)
County Tax Map No. 473889 Section 107
AVE
(STREET)
Block 3
MATTITUCK
(HAMLET)
Lot 3.1
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
MARCH 15, 2006 pursuant to which
Building Permit No. 318S8-Z
dated
MARCH 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 SINGLE FAMILY DWELLING WITH ATTACHED TWO CAR GARAGE, COVERED FRONT
PORCH & REAR DECK AS APPLIED FOR.
The certificate is issued to SCOTT & MICHELLE EDGETT
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-0S-008S
02/11/07
ELECTRICAL CERTIFICATE NO.
2101260
02/20/07
PLUMBERS CERTIFICATION DATED
02/16/07 CUTCHOGUE EAST PLUMBING
h -~.
~ized Signature
Rev. 1/81
." 'AR 6
Form No.6
TOWN OF SOUTHOLD
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:
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 Depl. of watcr supply and sewerage-disposal (S-9 fonn).
3. Approval of electrical installation li-orn Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains less than 2/1 0 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 IIses:
1. Accurate survey of property showing all property lines, streets, building and unusual natunll 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 slate the reasons therefor in writing to the applicant.
C. Fees
I. Certificate of Occupancy - New dwcll1l1g $25.00, Addittons to dwelling $25.00, Alterations 10 dwelling $25.00,
Swinuning pool $25.00, Accessory building $25.00, Additions 10 accessory huilding S2)'(lO. Rusillt',"scs $50,00.
2. Certificate of Occupancy on Prc-existing Building - $] 00.00
3. Copy of Certificate of Occupancy - $.25
4. Updated Cel1ificate of Occupanc\' - $SO.OO
5. Temporary Cel1ificate o!'Clccupancy - Restdcntial $15.00. COlllmercIal $15.00
3L(,. ~J~_
Dak.
Ne\v Constnlction:
/
_ Old or Pre-existing Building:
(clIeek one)
1d4.1h_:tc..,-z__
rr amici
~A,j>(L 1A,t-Ir
HOllse No. Street
Owner or Owners of Propcl1y ~_ E-j)J.::o,.~tL_ .__S'c.,1t---'- ,.;(, c../"'~/'(m
Location of Property:
. S": 7_(;1
Suffolk County Tax Map No 1 ()()(), Scctinn
1<>1__ Block
6"3>
Lot '3 J
--,---
Subdivision
Filed Map. 101
Dak o~pelllll~ ~~r_ qr"- Applicant 9~" ~ _ mt<!~ll
Underwriters Appro\',,1
Pennit No. 3.1 8 ~
Health Dept Appro\'a!:
Planning Bmrd Approval'
Request for:
Tempor<lr}' Ccrtificak ______
Final Ccrti1ic;dc:
(check one)
Fec Submitted: $
z.c--
----~-- --- --
6vu-.12D 50
co -c 3Jd.4C
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.
31858 Z
Date MARCH
17, 2006
Permission is hereby granted to:
BENNETT (EDGETT)
330 E. LEGION AVE.
MATTITUCK,NY 11952
for :
CONSTRUCTION OF A NEW SINGLE FAMILY DWELLING WITH ATTACHED TWO
CAR GARAGE, COVERED FRONT PORCH & REAR DECK AS APPLIED FOR
at premises located at
570 MAPLE AVE
MATTITUCK
County Tax Map No. 473889 Section 107
Block 0003
Lot No. 003.001
pursuant to application dated MARCH
15, 2006 and approved by the
Building Inspector to expire on SEPTEMBER 17, 2007.
Fee $
1,763.40
I; .. /Jd.
?l (A_....,.~ CO ~
Authorized Signature
ORIGINAL
T. 5/8/02
l!I..
~ ?/"c-g-
~ BY THIS CERTIFICATE OF COMPLIANCE THE cJ () ,)
~ NEW YORK BOARD OF FIRE UNDERWRITERS
~ BUREAU OF ELECTRICITY ~
~ 40 FULTON STREET - NEW YORK, NY 1 0038 ~
~ ~
~ CERTIFIES THAT /cJ 7. -5- 3.1 ~
i COO" ,", ",,,,,C'"" 0' "oo" "",w; ~"," "" I
~ PLATINUM EAST ELECTRIC SCOTT EDGETT ~
~ 1320 KENNEY'S RD 570 MAPLE LANE ~
~ SOUTHOLD, NY 11971, MATTITUCK, NY 11952 i
~ Located at 570 MAPLE LANE MATTI TUCK, NY 11952 ~
~ ~
~ Application Number: 2101260 Certificate Number: 2101260 ~
~ ~
~ Section: Block: Lot: Building Permit: BDC: ns11 ~
~ Described as a Residential 3000-4000 square ft. occupancy, wherein the premises electrical system consisting of ~
! electrical devices and wiring, described below, located in/on the premises at: ~
~ Basement, First Floor, Second Floor, Attached Garage, Outside, Attic, ~
~ 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 20th Day of February, 2007. ~
~ Name OTY Rate Ratin2: Circuit ~ ~
~ Alarm and Emergency Equipment ~
lID Sensor 2 0 Carbon Monoxide ~
~ Sensor 5 0 Smoke ~
~ Appliances and Accessories ~
~ Dish Washer I 0 1.2 KW ~
~ Exhaust Fan 2 0 F.H.P. lID
~ Furnace 2 0 Gas ~
~ Air Conditioner 2 0 20 Amps ~
~ Wiring and Devices ~
~ Outlet 56 0 Fixture ~
~ Fixture 56 0 Incandescent lID
~ Outlet 105 0 General Purpose ~
F.!I Receptacle 59 0 General Purpose F.!I
~ Switch 65 0 General Purpose ~
~ Receptacle 2 0 20 amp Laundry ~
; ~~:~:~::l~t ~ ~ 60 amp ~~c~onditioner seal I
~ Service ~
I ~",;"""',, N~, - "' , 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. ~
l!I.l!I
@].@]
I BY THIS CERTIFICATE OF COMPLIANCE THE I
~ NEW YORK BOARD OF FIRE UNDERWRITERS ~
~ BUREAU OF ELECTRICITY ~
~ 40 FULTON STREET - NEW YORK, NY 1 0038 ~
~ CERTIFIES THAT ~
~ ~
~ Upon the application of upon premises owned by ~
~ ~
~ PLATINUM EAST ELECTRIC SCOTT EDGETT ~
~ 1320 KENNEY'S RD 570 MAPLE LANE ~
~ SOUTHOLD, NY 11971, MATTITUCK, NY 11952 I
~ Located at 570 MAPLE LANE MATTITUCK, NY 11952 ~
~ ~
~ Application Number: 2101260 Certificate Number: 2101260 ~
I Section: Block: Lot: Building Permit: BDC: ns11 I
~ Described as a Residential 3000-4000 square ft. occupancy, wherein the premises electrical system consisting of ~
~ electrical devices and Wiring, described below, located in/on the premises at: ~
~ Basement, First Floor, Second Floor, Attached Garage, Outside, Attic, ~
~ 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 20th Day of February, 2007. ~
~ Name OTY Rate Rating Circuit ~ ~
~ I Phase 3 W Service Rating 200 Amperes ~
~ Service Disconnect: I 200 cb ~
~ Meters: I ~
~ ~
~ ~
~ ~
~ ~
~ ~
~ ~
~ ~
~ , ~
~ ~
I ~~ I
~ ~
~ 2 of 2 ~
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. I
@].@]
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/Ji (
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
Bob Ghosio, Jr.
Town Hall
53095 Route 25
P.O. Box 1179
South old, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
CERTIFICATE OF COMPLIANCE
# 0190e
Date: March 27, 2007
THIS CERTIFIES that the restoration of the buffer within 100' of the wetlands and existing
hav bales to permanentlv remain in place along the 50'non-disturbace buffer line.
At 570 Maple Lane, Mattituck, New York
Suffolk County Tax Map #107-3-3.1
Conforms to the application for a Trustees Permit heretofore filed in this office
Dated 02/21/07 pursuant to which Trustees Permit # 6537 A Dated 03/21/07.
Was issued, and conforms to all of the requirements and conditions of the applicable
provisions of law. The project for which this certificate is being issued
is for restoration of the buffer within 100' of the wetlands and existing hav bales to
permanentlv remain in place along the 50' non-disturbance buffer line.
The certificate is issued to Scott Edgett owner of the
aforesaid property.
ro<~
Authorized Sig\lature
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971-0959
r:-EB ,6?
Fax (631) 765-9502
Telephone (631) 765-1802
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATION
Building Pennit No.
[)atc__~mk
Owner '~. 0 i1 E D (.... t- +t-
(Please print)
Plumber ~clc G I<)~~;'J ! Cv t~L, iJC
(Please pri~
E. P-H-. /lriC-
2.'ff/7-f
lead.
J certify that the solder used in the water supply system contains less than 2/1 0 of 1%
Sworn to before mc this __~~
day of=l~ ' 20k'~
$~t;Z~
Notary Public,
County
1/~4 ·
(Plumbers Signature)
SU$Art'J '~~l:iY
NNolary PUblic State of New va ..
0.4896735 " r.
Qualffiad in Suffolk Coun
Commission Expiras May\o!Z:7
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
Bob Ghosio, Jr.
~fSO~
f~~.~\
~. ;J
~ ~~
r,fCOUN1'I,\\~ .
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fa~ (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
TO:
Building Dept.
FROM:
James King, Presid
Board of Trustees
DATE:
March 23, 2007
RE:
SCOTT EDGETT
570 MAPLE LANE, MATTITUCK
SCTM#1 07 -3-3.1
Please be advised that the Board of Trustees has issued an Administrative Permit to Scott
Edgett to replant the buffer within 100' of the wetlands, and Mr. Edgett has agreed to plant
the area on Tues., March 27, 2007.
Our department has no objection with your department proceeding with the issuance a
Certificate of Occupancy.
Please contact our office if you have any questions.
,
\ ~
/
Condon Engineering, P.C.
New York State Licensed Professional Engineers
1755 Sigsbee Road
Mattituck, New York 11952
631-298-1986
Fax 631-298-2651
February 8, 2007
Mr. Michael Verity
Principal Building Inspector
Southold Town Building Department
54375 Main Road
Southold, New York 11971
Re : Building Permit # 31858
Dear Mr. Verity:
I inspected the footings, foundation, and foundation damp proofing at new building at 570 Maple
Lane in Mattituck. I found all of the work to be in accordance with the filed and approved plans
and to the best of my knowledge, is in accordance with the New York State Building Code.
If you have any questions regarding this letter, please call me at 298-1986.
Yours truly,
"I 'VW .
. '\ " hi.
. -<\f- '. ,~. d"- "1~
. S' "" I co..... 'I ..
i 1$-" IVO~' . . .'~,
7 0 t- 1-, '.
I (,'" ~.,... ' ..\ <>= I
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',~ \ ': .,~ . / <:: '
,/?~",,:::,
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~:!!OFf.SS\O~~\.
Albert J, Krupski, President
James King, Vice-President
Artie Foster
Ken Poliwoda
Peggy A. Dickerson
Town Hall
53095 Route 25
P,O. Box 1179
Southold, New York 11971-0959
Teiephone (631) 765-1892
Fax (631) 765.6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
August 5, 2005
Mrs, Deborah Bennett
20 Lion Head Rock Rd.
East Hampton, NY 11937
RE: 570 MAPLE AVE., MATTITUCK
SCTM#107-3-3.1
Dear Mrs. Bennett:
The Southold Town Board of Trustees reviewed the survey prepared by Joseph A.
Inge9no last dated June 1,2005 and determined the proposed construction of a single-
family dwelling, deck, sanitary system, and driveway to be out of the Wetland
juriSdiction under Chapter 97 of the Town Wetland Code and Chapter 37 of the Town
Code.
Therefore, in accordance with the current Tidal Wetlands Code (Chapter 97) and the
Coastal Erosion Hazard Area (Chapter 37) no permit is required. Please be advised,
however, that no construction, sedimentation, or disturbance of any kind may take place
seaward of the tidal wetlands jurisdictional boundary or seaward of the coastal erosion
hazard area as indicated above, or within 25' landward from the top of the bluff, without
further authorization from the South old Town Board of Trustees pursuant to Chapter 97
and/or Chapter 37 of the Town Code. 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 and
Coastal Erosion Hazard Area, which may result from your project. Such precautions
may include maintaining adequate work area between the tidal wetland jurisdictionai
boundary and the coastal erosion hazard area and your project or erecting a temporary
fence, barrier, or hay bale berm.
However, any activity within 100' of a Wetland line or seaward of the Coastal Erosion
Hazard Area would require permits from this office.
KIERAN M. CORCORAN
ASSISTANT TOWN ATTORNEY
kieran.corcoran@town,southold.ny.us
SCOTT A. RUSSELL
Supervisor
PATRICIA A. FINNEGAN
TOWN ATTORNEY
patricia.finnegan@town.southold.ny.us
Town Hall Annex, 54375 Route 25
P.O. Box 1179
Southold, New York 11971-0959
LORI HULSE MONTEFUSCO
ASSISTANT TOWN ATTORNEY
lori.montefusco@town.southold.ny.us
Telephone (631) 765-1939
Facsimile (631) 765-6639
OFFICE OF THE TOWN ATTORNEY
TOWN OF SOUTHOLD
February 8, 2007
To Whom It May Concern:
The case of the Town v. Scott Edgett, case number 06-070270, one count of clearing
without a trustee permit in violation of Town Code 997-20 has been disposed of by a plea
of guilty. The case is closed as of February 8, 2007. There are no outstanding cases or
investigations concerning this property.
~,
Lori Huls
(631)765-
tv'.
I
,
.1
New York State Department of Environmental Conservation
Division of Environmental Permits
Rm 121, Building 40-SUNY
Stony Brook, New York 11790-2356
Telephone (631) 444-0365
Facsimile (631) 444-0360
.....
~
Denise M. Sheehan
Commissioner
LETTER OF NON-JURISDICTION
February 2, 2006
Mr. Scott M. Edgett
330 East Legion Avenue
Mattituck NY 11952
NYSDEC # 1-4738-03562/00001
570 Maple Avenue
Mattituck NY
SCTM #1000-107-3-3.1
Dear Mr. Edgett:
Based on the information you submitted, the New York State Department of Environmental
Conservation has made the following determination.
The portion of the referenced property landward of the 25 foot elevation contour interval, as shown
on the survey prepared by Joseph A. Ingegno last revised on 1/26/06, is beyond the jurisdiction of
Article 25 (Tidal Wetlands).
Therefore, in accordance with the current Tidal Wetlands Land Use Regulations (6 NYCRR 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 20' wide construction area) or erecting a
temporary fence, barrier, or hay bale berm.
.-------------
Please be further advised that this letter does not relieve you of the responSibility of obt~i;;lhKany
necessary permits or approvals from other agencies. / \\
\
\
/
John A. Wieland
Deputy Permit Administrator
CC: Deborah J. Bennett
Marine Habitat Protection
file
3 1 ~ ~6 Z-
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TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
] FOUNDATION 1 ST [ ] ROUGH PLBG.
] FOUNDATION 2ND [ ] INSULATION
] FRAMING I STRAPPING M. FINAL
] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS: CZ1,v-r:'uJ:;(1 ~Q.h-t~~~ , i At
.1J~ (4-/t if-. M ~;G(),^-- ~d2~)
V'.. --).~iff,",,- O~ ' cI- 1 31 ~ ,~
tF~~r ~~- oLrUvr ~~
I 7 ' r
~d: ~ ct, rJ- rr7'- {:t c 01- (j
1:\ d.-Y. <' u., !7J1/tL I/VS7: L5 Ok.
A~~~,
DATE ~ - , - 0 7
INSPECTOR ~. ~
3Igs-rz-
TOWN OF SOUTH OLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [] INSULATION
[ ] FRAMING/STRAPPING JX4FINAL ~t~~-#
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS, ~~A
J~ ~ d-J.- ~. 11/e~ C~
~~k~~~~, ~~
~ ~) ci-~-c~~ ~~,
DATE /() ~ J --,11
INSPECTOR ~~. ~
3Its-r2-
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST )X(ROUGH PLBG.
[ ] FOUNDATION 2ND [] INSULATION
J><j FRAMIN~ I STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
;V~
, --f4- M-
~
(!:;-Jt ~f?1 if-- #,~~'-Z
I 0 /'
CULL ,
.r~~ L4-0K,
DATE 7--1/---oh
~~
INSPECTOR '
3/fS-?c
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FpONDATION 2ND [] INSULATION
[~RAMING~PPIN~ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS: rJJ~b ~ S~ ~-
.
DATE
'( }-%,
!
INSPECTOR
3lls-r L
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND A INSULATION
[ ] FRAMING I STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
1lIJ--q{ -tc-
~j(--I~ h.L,,-,p./~~
!~ ~ [> f::;:: p
.
DATE
7'-/ tf-o (,
INSPECTOR ~~
New York State Department of Environmental Conservation
Division of Environmental Permits
Rm 121, Building 40-SUNY
Stony Brook, New York 11790-2356
Telephone (631) 444-0365
Facsimile (631) 444-0360
~
~
Denise M. Sheehan
Commissioner
LETTER OF NON-JURISDICTION
February 2, 2006
Mr. Scott M. Edgett
330 East Legion Avenue
Mattituck NY 11952
NYSDEC # 1-4738-03562/00001
570 Maple Avenue
Mattituck NY
SCTM #1000-107-3-3.1
Dear Mr. Edgett:
Based on the information you submitted, the New York State Department of Environmental
Conservation has made the following determination.
The portion of the referenced property landward of the 25 foot elevation contour interval, as shown
on the survey prepared by Joseph A. Ingegno last revised on 1/26/06, is beyond the jurisdiction of
Article 25 (Tidal Wetlands).
Therefore, in accordance with the current Tidal Wetlands Land Use Regulations (6 NYCRR 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 20' wide construction area) or erecting a
temporary fence, barrier, or hay bale berm.
Please be further advised that this letter does not relieve you of the responsibility of obtaining any
necessary permits or approvals from other agencies.
?l
Q40..
. -~.
John A. Wieland
/ Deputy Permit Administrator
//
CC: Deborah J. Bennett
Marine Habitat Protection
file
.
\
FIELD INSPECTION REPORT DATE
"
COMMENTS
FOUNDATION (1ST)
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FOUNDATION (2ND)
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ROUGH FRAMING &
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INSULATION PER N. y,
STATE ENERGY CODE
FINAL
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ADDITIONAL COMMENTS
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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLn~NY 11971
TEL: (6,1) 765-1802
FAX: (631) 765-9502
www.northfork.net/Southold/
BUILDING PERMIT APPLICATION CHECKLIST
PERMIT NO.
3/ g C; '6 1:
Do you have or need the following, before applying?
Board of Health _~_
4 sets of Building Plans
Planning Board approval
Survey
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
Examined
51 17 , 20&1>_
/3/ / 7 ,20~
Approved
Disapproved aie
Mail to:
Expiration
r / 7 .20-.!?2
f I
---f W 1/<- -~-
uilding Inspector
Phone J. 9 ~ I O~ S-
O,~ ~(c\(Y\+- ~ cK
APPLICATION FOR BUILDING PERMIT
/: /) c:: /
Date'-6/~()::J -0(0
,20d
INSTRUCTIONS
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 Irom 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 Pennit 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.
c
pplicant or name, if a corporation)
yo!.
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
&It#/ , k#()/~ OUJ/!rll
Name of owner ofP~mises ofl6J.&/?/lrl-ll-
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized otlicer
(Name and title of corporate officer)
Builders License No. 11(;//9711
Plumbers License No.
Electricians License No.
Other Trade's License No.
I. Location of land on which proposed work will be done:
:770 /J?qn4? &/21'
House Number Street
/J h 1I7;1c/(7~:
. Hamlet
County Tax Map No.1 000 Section
Subdivision
/07
Block (J..J
Filed Map No.
.,.
Lot 3i
Lot
'.
,
.,
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy 1/8074/ cCl/JrJ
b. Intended use and occupancy C);/}f:;tf &/7//0 )o/1U7
U {/
3. Nature of work (check which applicable): New Building / Addition Alteration
Repair Removal Demolition Other Work
.
,
4. Estimated Cost J dJO}/j . 000 - ~;.;
,
(Description)
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. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front________ Rear_
Height Number of Stories
Depth
Dimensions of same structure with alterations or additions: Front
Depth Height Number of Stories
Rear
8. Dimensions of entire new construction: Front 7.Lj' /
Height (~n7 /6// Number of Stories ,-;)
Rear /(j';?"
'75/
Rear _
Depth
,7t)'
9. Size ofIot: Front
/[
/t:?J
Depth 575 /
.1-;6il~ /J/7f'ff
10. Date of Purchase
Name of Fonner Owner
I I. Zone or use district in which premises are situated ,.f'- (,/{)
12. Does proposed construction violate any zoning law, ordinance or regulation? YES_ NO /
13. Will lot be re-graded? YES NO V Will excess fill be removed from premises? YES NO
- - --
14. Names of Owner of premises
Name of Architect
Name of Contractor
Address
Address
Address
Phone No.
Phone No
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.e. PERMITS)vfA Y BE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES ~ NO_
* IF YES, D.E.e. 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 . )2111011< )
(f(l~)f-l ~('II- being duly sworn. deposes and says that (s)he is the applicant
(Name of individual sig ing contract) above named.
(S)He is the
~)m-/Qc-lor. /cJttJ<<7 C)(e)/Jf.7r
(Contnictor. Agent, Corporate Officer. etc.)
of said owner or owners, and is duly authorized to perform or have perfonned 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.
S o?'l-\? before me thirr.!l. .'
S . day of --L1JU.X d.,
^ {I fl Vl,fJ-:vf( ;
20 L\ (,
!
MELANIE DOROSKI
NOTARY PUBLIC, State of New York
No. 01004634870
Qualified in Sutfolk County .
COllVllission Expires September 30.~) b
'\R I 5
Permit Number
REScheck Compliance Certificate Checked B,/Date
New York State Energy Conservation Construction Code
RESchn-kSollware Version 3.(, Release 1
Data filename: C:\Program Filcs\Cheek\RESeheek\edgett-bennel1.rek
PROJECT TITLE: Edgell-Bennett Propel1)
COUNTY: Sunolk
STATE: New York
HDD: 5750
CONSTRUCTION TYPE: Detached t or 2 Famil)
HEATING TYPE: Non-Electric
WINDOW / WALL RATIO: 0.1.'
DATE: 01/27/0(,
DATE OF PLANS: Janua!} 28. 200(,
DESIGNER/CONTRACTOR:
John 1. Condon. P.E.
Condon Engineering. P.c.
COMPLIANCE: Passes
Maximum UA ~ 50 I
Your Home VA == -l(l_'
7.(,%. Better Than Code (UA)
Ceiling I: Flat Ceiling or Scissor Tluss
Wall I: Wood Frame. 1 (," o.e.
Window I: Vinyl Frame:Double Pane with Low-E
Door I: Glass
Wall 2: Wood Frame. 1(," o.e.
Windovl" 2: Vinyl Framc:Doublc Pane with Low-E
Door 2: Glass
Wall 3: Wood Frame. 1(," o.e.
Window 3: Vinyl Frame:Doublc Pane with Low-E
Wall ~: Wood Frame. 1 (," o.e.
Door 3: Solid
Floor I: All-Wood Joistrrmss:Over Uncondilioned Space
Gross
Area or
Perimeter
1572
832
109
31
839
108
7(,
526
50
7(,5
II
1572
Ccl\;it) ConI.
R-Value R-Value
GI;ving
or Door
V-Factor .llA
30.0
15.0
0.0
0.0
:'5
53
O._~50 ,X
11..150 11
50
0.350 38
0.350 27
17
0.350 18
5K
IU50 ~
N
15.0
0.0
15.0
0.0
15.0
0.0
19.0
0.0
COMPLIANCE STATEMENT: The proposed building represented in this document is consistent with the buitding
plans. specifications. and other calculations submitted with this permit application. The proposed systems have been
designed to meet the New York State Energ)- Conservation Constmction Code requirements. When a Registered Design
Professional has stam
professional judgme
and signed this page, they are attesting that to the best of his/her knowledge, belief and
. s h plans or specifications arc in compliance with this Code.
Builder/Designer
'~-2.>
Date 2---3-06
REScheck Inspection Checklist
New York State Energy Conservation Construction Code
REScheckSoflwnre Version 3.G Release I
DATE: 01127/06
PROJECT TITLE: Edgell-Bennell Property
Bldg.
Dep!.
Use
Ceilings:
I. Ceiling I: Flat Ceiling or Scissor TlUss. R-10.0 cavit} insulation
Comments:
Above-Grade Walls:
I. Wall I: Wood Frame. 16" o.c.. R-15.0 cavity insulation
Comments:
2. Wall 2: Wood Frame. 16" o.c.. R-15.0 cavily insulation
Comments:
1. Wall 1: Wood Frame. 16" o.c . R-15.0 cavity insulation
Conuncnts:
~. WaIl~: Wood Frame. 16" o.c.. R-15.0 cm.it) insulation
Comments:
Windows:
I. Window I: Vin) I Frame:Double Pane with Low-E. U-faclor:
For windows without labeled U-factors. describe features:
# Pancs_ Fnullc T)-pc Thermal Break? I
Comments:
2. Window 2: Viml Frame:Doublc Pane with Low-E. U-factor:
For v.'indows ,"'ithout labeled U-factors. describe features:
# Pancs_ Frame Type Thermal Break'? l
Comments:
1. Window 1: Vin)1 Frame:Doublc Pane with Low-E. U-factor:
For windows without labeled U-factors. describe features:
# Pancs_ Framc Type Thcrmal Break.' I
Comments:
O..15f)
I Ycs I I No
0.350
IYcsl INo
IJ..150
I Ycs I I No
Domos:
I. Door I: Glass. U-factor: 11..150
Comments:
2. Door 2: Glass. U-factor: 0.150
Comments: ~~_
1. Door 1: Solid. U-I"ctor: IJ..150
Comments:
Floor.s:
I. Floor I: All-Wood ]oistfTlUss:Over Unconditioned Space. R-19.0 cavity insulation
Comments:
Ail. Leakage:
Joints. penetrations. and all other such openings in the building envelope that arc sources of air
leakage must be sealed.
Recessed lights must be I) Type Ie rated. or 2) installed inside an appropriate air-tight assembl)
with a O.51! clearance from combustible materials. If non-Ie rated. the fixture must be installed with a
3" clearance from insulation.
Vapor Retarder:
Required on the warm-in-winter side of all non-vented Ji-amed ceilings. \\'alls. and nODI'S.
Matcdals Identification:
Materials and equipment mnst be installed in accordancc with the manufacturcr's installation instmctions.
Matcrials and equipment must be idcntificd so that compliancc can be determined.
Manulacturcr manuals for all installed heating and cooling equipment and service ,",'atel" heating
cquipment must be provided.
Insulation R-valucs and glazing V-factors must be clearly marked on the building plans or specifications.
Duct Insulation:
Supply ducts in unconditioned allics or outside the building must be insulated to R-8.
Return ducts in unconditioned allics or ontside the building must be insulated to R-~.
Supply ducts in unconditioned spaces must be insulated to R-8.
Return ducts in unconditioned spaces (except basements) must be insulated to R-
Return ducts in unconditioned spaces (except basements) must be insulated to R-2..
Insulation is not required on return ducts in basements.
Duct Construction:
All joints_ seams. and connections must be securely fastened with welds_ gaskets. mastics (adhesi\'es).
mastic-plus-embedded-fabric. or tapes. Tapes and mastics must be rated UL 1~IA or UL 181B.
A\n;,plicJ/J: Continuously welded and locking-type longitudinal joints and seams on ducts
operating at less than 2 in. w.g. (500 Pal.
The HV AC system must provide a means for balancing air and water systems.
Temperatul.e Cont....ls:
Each dwelling unit has at lesat one thermostat capable of automatically adjusting the space
temperature set point of the largest zone.
Elec";c S)'stcms:
Separate electric meters arc required for each dwelling unit.
Firel,laces:
Fireplaces must be installed with tight fitting non-combustible fireplace doors.
Fireplaces must be provided with a source of combustion aiL as required by the Fireplace conslI1lction
provisions or the nuitdm? C':ude u/Seu' York Slate. the Resu/ellliat Code ofYn\" York Slate or
the Self York Ci~\i Hui/dill}!, ('ode _ as applicable.
Senice Water Heating:
Water heaters with vel1ica) pipe risers must have a heat trap on both the inlet and outlet unless the
water heater has an integral heat trap or is part of a circulating system.
Insulate circulating hot water pipes to the levels in Table I.
CiI.culating Hot Water S)'stems:
Insulate circulating hot water pipes to the levels in Table I.
Swimming Pools:
All heated swimming pools must have an on/off healer switch and require a cover unless over 20~/o
of the heating energy is from non-depletable sources. Pool pumps require a time clock.
Heating and Cooling Piping Insulation:
HV AC piping convey ing nuids above 105 "F or chilled nuids below 55 "F must be insulated to the
levels in Table 2.
Healed Water
Tcmneraturc ( F)
170-180
1~0-160
IOO-PO
lilh1c I: Minimum In,sulation Thicknessfor Circulating Hot Water Pipes.
Insulation Thickness in Inches by Pioc Sizes
Non-Circulatin~ Runouls Circulatinl! Mains and Runouls
Un 10 I" Un to 1 25" 1 5" to 2.0" Over 211
0.5 1.0 l.5 2.0
0.5 0.5 1.0 1.5
0.5 0.5 0.5 1.0
Tah!e]: Minimum lmmlation Thicknes.s for H"~4C Pipe.~.
Fluid Temp. Insulation Thickness in Inches by Pine Si/.es
Pipiu2' Syslcm TyDCS Ran1!c ( F) 2t! Runouls 111 and Less I 25" to 2" 2.511 10 .+Tl
Healing S)SlemS
Low Pressureffempcrature
Lo\\- Temperature
Steam Condensate (for ICed water)
Cooling S)'slems
Chilled Water. Reti-igeranL
and Brine
201-250 1.0 1.5 1.5 2.0
WI-200 0.5 10 1.0 1.5
An) 1.0 1.0 1.5 2.0
~O-55 0.5 0.5 0.75 Iii
Below ~O 1.0 1.0 1.5 1.5
NOTES TO FIELD (Building Department Use Unl))
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llIHlWlIW SEPTIC TANK CAPACITIES rOR A 1 TO . BE[)ROOIol fiOUS[ :S 1.000 GALLONS
I T,I,NK; II' LONG. ,,'-,3- WIOE, ,'-J" DEEP
.. IolINIIrotUW LtAC..IMO SYST[W FOR A 1 TO .. 8EDROOW HOUSE IS JOO .q 11 SIDEWALL AREA
1 POOL; '2' OEEP, s' dlo,
@Pfl~~rXl'>>I'IjOl'lffiClL
o PROPOSED U4CHIHa POOL
GlPIIOPOSED SEPOC T...HK
5 'HE LOC,U:ON or WEl...5 -"NO CESSPOOLS SHOWN HU~[O~ ">ll ,RO.,,! nnn
OBSUY,HtoHS .4.NOjOR DATA OBTA,NED FROW onm~s
6 SLO,H.$. RErrR[NC[ ~, Rl0-1t9-0021
,j' ~
, '1/,,-0 :y
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EXCAVATION INSPECT ~ REQUIRED
FOR SANiTARY 5' rEM
BY HEALTH DEPART
~
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SURVEY OF PROPERTY
SITUATED AT
MATTITUCK
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
s.c. TAX No. '000-107-03-3,'
SCALE 1 "::50'
OCTOBER 15, 1998
w.~C?,J, ~ l&J'~~Nt
FfBR'UotRr 14, 200J ~D PROPOsal 'lOLSE
JLtOE',200i5!>J;XlE:OPlAlUCW"TER
JA,NUolrR't' 16, 100e REVlSED PROPOSED HQl./Sf
""u _llO,nl.13 ~ ft
i-ruT'f'..!~1.13CK:.
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rXIST1NG ntvAT1OH5 AIlE SHOWN 'TliUS,
EXlsnHG COHTOU~ (JNU Mtr S~OW"l n<L'S'
DATUt.I
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2 r~ooo ZOME IHrOR......TION TAKEN flilOW:
r~ooo IHSUftAHCE ItJ,TE lU,p 1040. 3&10JC01...l G
lONf I\f:: f\AS( FlOOD ELLVATIQNS DEl'ERtoIINE[;
lQ/Ij!)' AREASOf'3(l(l-'1'E}.RFlOOO.AREASOf 'vO--"EARrJ}on~H..,.[R"'-G,
O(PTI-'Of'LESS 1'"HAN' rOOT OR '11m< ~R."'-I~A.RO.S L(SSDiAN 1 SQUil,Rf
l,l1LE:: Mm ARE.O.S PROTECTED B'I' LfYE[:> '1'IOl,l '00. \"EAR fLOOC
A.RfAS DfTERWtNED 10 Be: ourslDE ~-"UIl r~OODP:..AIN
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SUFFOLK COUNTY DEPARTMENT OF HEAL
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TEST HOLE DA TA
: (iE57 t'OJ Dc G BY M!.J)!2IY.A.l..Q_Ql.Q-.SDLl:KL Q/', ()[ U MBCR f1.;;. : 998
PERMIT FOR .\.'1',,0"/" GFCONSTRU
.)'lNGLB FA.lV\.f~V r~,~iJ)EN'CE ONL
DATE <6:/7405'11& i"o.IIJJr:
APPROVED ./7N2_uf':,(l?Y'0
mIRES 1lIREE VE, '{S FROM DATE OF APPRO
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J.'EBIlFIED TO
SCOTT EOGETT
Exph-es
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UNAUl"HORllED AlTEAATION OR ADOIT1OIoo
to THIS SUR'vtl' 's A 'IlOLATION Of
SECl10N 1209 Of THE NEW ~K ST"TE
EDIJCAT10N LAW
PREPAi'lEDINACC
i:.ii....ri:"'..OS;'O;.
c,"
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DANCE WIn< THE l,lINlloIulIl
SURVEYS /oS ESTABUSHf.D
AP~D AND ADOPTED
T'Hr~YORKSTAT(~D
"
~\,
Joseph A. Ingegno
Land Surveyor
1
COPlES or THIS SURVEY IMP NOT ~(ARING
n1E LAND SUR\<f'rOR'S INI<ED SEAl OR
EMIlO5SED SEAl. SHAU NOT BE: CONSIOERED
TO BE A VAun TRUE COP'V
CERTlFlCAT10NS INDlO.TEO HEREON SHALL RUN
ONLY TO rnE PERSON FOR WHOt.I lllf SURVfY
IS PIlEPMED. AND ON HIS !lElW}" TO THE
TITlE COt.lP,t.NY, GCNERNloIENTAl "'-CENCf ANO
LLNOlNG INSTmJTION USITD HEREON. "NO
TD Tl-lE ASSGNEES OF THE LENDING INST1~
TUnoN CfRTIF1CATlONS ARE "lOT Tltf\NSftlWJLE
""-.;
,
Title Su<veys - SubdivisiOn! - Site Pions
Constr:Jchon Loyout
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PHONE (63')727.2090
Fox (631)72'--1727
IJAJUNG ADORE:5S I
P,O. Bo. 1931 I
Ri.emeod. ~e'll York 11901..0965 II
26- OGJ
THE EXISTENCE OF RIGHT or WAYS
"'ND/DR (ASEWEHTS or RECORD. If
ANY. NOT SHOWN "'RE NOT GUARANTEED.
~o_ "9668
omCfS LOCATED AT
322 ROmOKE AVENUE
RNERHOO. New Yo'* 11901