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HomeMy WebLinkAbout32715-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32303 Date: 04/18/07 THIS CERTIFIES that the building ADDITION/ALTERATIONS Location of Property: 1345 (HOUSE NO.) County Tax Map No. 473889 Section 38 SHIPYARD LA (STREET) Block 1 EAST MARION (HAMLET) Lot 14 Subdivision Filed Map NO. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 12, 2007 pursuant to which Building Permit No. 32715-Z dated FEBRUARY 12, 2007 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 PORCH ADDITION & ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to DENNIS & JEAN T DELORME (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 2018652 09/16/04 PLUMBERS CERTIFICATION DATED 09/30/04 RBT.VANETTEN PLUMBING ~~~'"""'"'" Rev. 1/81 ,. 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 witb tbe following: A. For new building or new use: I. Final survey of property witb accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Healtb Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Swom statement from plumber certifying tbat tbe solder used in system contains less than 2/1 0 of] % 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: ] . 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 applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons tberefor in writing to the applicant. C. Fees I. 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 - $25.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. ~// 7";0 7 New Construction:'/ Old or Pre-existing Building: Location of Property: / .J tiS JJ" :1'<1 rd La ~ c House NO. Str et Owner or Owners of Property: ..zl-, )oJ n IJ l2- L 17 r m e- Suffolk County Tax Map No 1000, Section fl' t7 3 Ii (check one) /:. .nL}li? r In, Hamlet Block (J'tJ 0/ Lot O/!j Subdivision Filed Map. Lot: UjJ/"ar / / Permit No. .:;/(7/,) 7fll/n Date of Permit. .2/12 tJ 7 , Applicant: :04 ,." ~/ hI C I, ~ v Healtb Dept. Approval: A/,f Underwriters Approval: dP'> fJe Planning Board Approval: k A Request for: Temporary Certificate Fee Submitted: $ Final Certificate: v (check one) "'A~.lc/;~,~ Applicant ignature hE4J~ iliA IL /tJ ./Jf,f' ZJ.E'K/V// OE-LI7A'Ht! /3//5 J'..t'IPl1R/.} L.4/fL' E-1Jr;'1'+/?/I)"j/ ".y. Y 1/139" &...u... 7) 0 16.,5 C. 0 -c3,;r3~3 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. 32715 Z Date FEBRUARY 12, 2007 permission is hereby granted to: DENNIS & JEAN T DELORME 1345 SHIPYARD LANE EAST MARION,NY 11939 for : PORCH ADDITION & ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. THIS PERMIT REPLACES 30413. 1345 SHIPYARD LA EAST MARION at premises located at County Tax Map No. 473889 Section 038 Block 0001 Lot No. 014 pursuant to application dated FEBRUARY 12, 2007 and approved by the Building Inspector to expire on AUGUST 12, 2008. Fee $ 150.00 ORIGINAL Rev. 5/8/02 ... ....... ~ 'l-7 r$ .@] 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 ~ ~ ~ ~ PAUL R. BURNS DENNIS & JEANE DELORME ~ ~ P.O. BOX 1061 1345 SHIPYARD LA. ~ ~ SOUTHOLD, NY 11971-0932, EAST MARION, NY 11939 I ~ Located at 1345 SHIPYARD LA. EAST MARION, NY 11939 ~ ~ ~ ~ Application Number: 2018652 Certificate Number: 2018652 ~ I Section: Block: Lot: Building Permit: BDC: ns11 I ~ Described as a Residential 0-599 square ft. occupancy, wherein the premises electrical system consisting of ~ ~ electrical devices and wiring, described below, located inion the premises at: ~ ~ First Floor, Outside, PorchlDeck, ~ ~ 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 andlor 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 16th Day of September, 2004. ~ ~ Name DTY Rate Ratina Circuit ~ ~ ~ Appliances and Accessories ~ ~ Dish Washer I 0 1.2 KW ~ ~ Wiring and Devices ~ ~ Outlet 8 0 Fixture ~ ~ Fixture 8 0 Incandescent ~ ~ Outlet 13 0 General Purpose ~ ~ Receptac Ie 6 0 General Purpose ~ ~ Switch 7 0 General Purpose ~ ~ Paddle Fan I 0 ~ ~ Receptacle 4 0 GFCl ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ e~ ~ ~ ~ ~ I cl I ~ ~ ~ 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 00.00 Town Hull, ."i30\jS M~iJl Ruad 1'.0. Box I J 79 S""lll<lld, N,',w Y il,k 11 Y71.0959 Fax {(".:\1) "76'i-t)~{12 Tt.lephonc: (ri~~ I) 7tj5-l~ BUILDING DEPARTMENT TOWN OF 80UTHOLD OCT - 5 ~iJu'# CERTifICATION "~I --",,_.~.." ',.'" Dllte:_$~~__~gr-.Qi- / Building Pennit No. _ ....~____ ~ ~.J 1$ Owner ___~_~lQ~-'^0.&_.._._____ -- (Please print) Plumber __lR_o_b~+, V~ry8.1't--~ . ' 7yTease pnnt) / II (~~ ) / , , , I certify lhalthe solder used illlhe water supply SYSll'1I1 (:l,nlains le~s thall 2/10 of 1% !. .:. lead _~Y.u-:Y~' (Plumbers Signature) Swam 10 before me this ._~__ dayof~____, 20Q_'l .__.:.':.&:f2~)A J N~tary PUbli~_COUU1Y JANET E. srAPlES Notary Public, StatB of Naw 'tbltl No.4831949 Suffolk CountY c- Commission Ejplres July 31, 211 b.::.J u_ ___ ~_ __~~____ - ~),7f ~~ ......".."...-~-~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] FOUNDATION 2ND [ ] FRAMING I STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRUcnON [ ] ROUGH PLBG. [ ] IN~TION [~NAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION REMARKS: DATE 01/J ftJ 7 INSPECTOR ~ 3'd'L \ :) -e- ~~ 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1 ST [] ROUGH PLBG. [ ] FOUNDATION 2ND [] I~TION [ ] FRAMING [ YfFINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION DATE INSPECTOR ~ ? ')."1 IS (Q.j\J 765.1802 BUILDING DEPT. INSPECTION .... 'f'- DATE INSPECTOR 3~'J')i:!;J 765-1802 BUILDING DEPT. , INSPECTION I~UNDATION 1ST [. ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY REMARK\.:: - ~t ~. j)Lv I..JSS' [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL o,l( q: \ \~ hNSPECTO~ ~ DATE 13'21 \-S 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [4H PLBG. [ ] ~NDATION 2ND [ ...nNSULATION [vfFRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMAp, /;~6 ~ O.A. er-~ c;;C~ DATE INSPECTOR " ., ~y~gg PROFESSIONAL ENGINEER -" -, -) , JUN \ 42.illlil 1725 HOBART ROAD I PO Box 616, SOUTHOLD, NEW YORK 11971 TEL 631-765-2954 , FAX631<i14-3516 . ..mail: joseph@fischetti.com I "r 1 ,_~ J Date: Reference: June 3, 2004 1345 Shipyard Lane / DeLorme Southold Building Department Main Road Southold, NY 11971 Dear Sir, Please be informed that an egress window made by Andersen 30410 will be installed in the Master bedroom of the above referenc d p perty. This letter shall be an addenda to the plans submitted for the renovation. If you have any q stions egarding this matter, please do not hesitate to call. Ocl..orroo-lcutranwlnoow.OOc FIELD INSPECTION REPORT DATE ~ IIID I~, o......c:..-t. FOUNDATION (lSn r-----------------___________________ FOUNDATION (2ND) COMMENTS ~ +Oo+''''V o. \c, (c-r) v j, J ,,"--, P7tJol 'V ~~ ~. I Ij , ~jI~ j/<'1 L-<..U4 ,VC- . , I ,0 ~ 4- 11/r.. - , ...-ff,X L /? . .... ROUGH FRAMING & ~mmING ~ INSULATION PER N. Y. STATE ENERGY CODE FINAL \-. '. ~/r1 If) s/ -Jh .d~...... -..U..I./' rl. f;:/. d... /../1 .lX-/;' " I I A \ L . /l1~ 'fit..... 8iJ.+-f'hf. JtN~ PM l"o.W,'Lo... t./.u -"L ///". 7'-~ /C.fL<. ,..... j '/"" v' // A~/-:/A IrI" ~ u^~hLd - ~ // "/'-/ V Bil..:::z--,o. -;T- -., '_~<L'/V #";:"1.1- : .dL// /1 ( L / !/A.K_'L v ~ " , ADDmONAL COMMENTS , , ~ , \ -..... .. .' ~"'~ fJ~ ~""rlf\. Y""I"" , .A.1 1> ~' ""'a ~ .~i-. '2: -9 ,c.v ..c.... v! r:n ;,.., .~ I ft II ;;j --r' "" ""\. . ~ :; ~ ~ S;-5 ~') ~ ~ ~, :5 \:) (\1 5 ~. "^ ~O '" ~ z l:Y~ ........ I:'l IV ~ ~~ Q ::! -\ 0 z ::c I~ ,.., ::c c I:'l '" :-' "- ,-", - )h -s? ~ JOf/JDW.[;te . ES.;,2 10 . SEAS. VL. LAND IMP, TOTAL TOWN OF SOUTHOLD PROPERTY RECORD CARD . 'otU -.j' OWNER STREET VILLAGE DIST. 'SUB. LOl] I Cr V,', J...u;. e.. ~, -3 ACR.I '.3 TYPE OF BUILDING FARM DATE 300 o oV .5- ?-8 ~ ~ '" <> AGE BUILDING CONDITION NEW FARM NORMAL BELOW ABOVE Acre Value Per Acre Value -illable 1 "illable 2 'illable 3 Vaadland wamplond rush land FRONTAGE ON WATER FRONTAGE ON ROAD / I) () 'P'" ~ --= t '9-0 louse Plot DEPTH BULKHEAD It.. 'atal DOCK . COLOR i i 81 Uk , ; ... . ~, TRIM II- iiillii ;] ... .;' rr i wHt,~ , \ I R i I, .. 1)- 1,.1 .2 ~ ~~ I . n. .;. "- .. I '- '1 .. i ' , M. Bldg. .24/'v.JjI;: ..J' t') ./ Foundotion C B , Both / Dinette Extension /<>~:l."""': '>'1;,199;1 .:/# D ..:J9i'..t. ~ement ("vi-I-. Floors I) ,q I( K. . Extensj~c .. rl ~/I.-''' I~ 2~ ' t,S""" Ext. Wolls .../1) SHIN!. . Interior Finish 5IIIETfo C I:. LR. Extensio";;- Fire Ploce Alo Heat H0 DR. Type Roof t"::~o.U: Rooms 1st Floor ! BR. Porch Recreation Roon Rooms 2nd Floo FIN. B. Porch >I~/9.- ?bJ 26" I-q. ,96rmer Breezeway , Driveway Garage /;a>/. / " 2?3 / /- " ,,273 / Pati~ ~~If- 0'1<2-0= 100 \~ 2-S- '''--/ O. B. Total 1./7';' ,; ~~~ ~(t~?J /"- " - r -\....--. " OI~T~K...-p.. IOoc::;> 4!PeeTJON.. o'!J.8 t!lol-OCK'" 01 l....OI.. 14 '3 <i ~ Q II' ~ o ~ ~ [ ~ ~ ~ L_~ -"~-~- ....~-. I I I I ~ ~ ~ ~ ~ ~ A/Al/# Ro,9.D o&?_J2'. '2<=; PA.Ve!.D R'OA..O - cPob~ j:;Z_O_,"",--,_ \ I ~I .. ~ ~ , J ..v........ 012 ;0,e~/!!'"~c..Y / ,e fl#tt:.,o 37' ?OEr ....041...U:>............,1c-1 /<;;?.fc fll'" ~ ~ :r ~ ~ 3 0 a ~ II ~ II :r ~ ~ II. . Z \. ~ J'1f"! ;, ~ . ; , .,;s' ~~~ 1< ~. ... It- ~ ~ ~ ~ ~~ "~~ ,",'~ "'M' l>-\ ---_ ~ r./:..__ - ....,14~---- =-- c:c>fo.lC_ ~........= 2/' ~ ~4R. a> -\1' ~ ~ . a ,"l lrl :; " ~ rf '.. '. \1;~1i l>> t ~h "" . ep t ~':::: " "d. . " 'fJ. y- i!!~ ~ , , o::lo411'1Nef It. ~ 0$''; ~o.!J17' ~o~"... ~I:'- ~ '" .\ <:,. l ~.#7'A!'~.Y - u.c/,tVS"tE</ /4> 7. 5~ I #~ ~/i! ,HE OffSETS (OR DlMENSrONIJ SHOWN IlEREQN filuM THi ST~:JcruREs TO iHE PIiOPEP.TY LINES ARE fOil A Sr~{;:t;l p.J~ POSE AlHi USE AN;) T;;~p.HOjn !\.!lEr;l1! It,it;;lii.., III (;UiOE ,hE EilECi:;:;~ VI m,CEs, HE fA!;W~G IWllLS,POOlS.P,\T!OS "U;:,lliil.i AH<:.AS, AOUlTlOt! TO 8UJ_~lJl\if.I:; OR AN.Y orHg ';\!Nil.UtIION . ; :~t~1 herr.nn ~~.!!U run only to tile "-.: '! ~;;l) ~iJrv,O~' is ilfi!l!<ll'ed, and 00 hili ", j~;:~ <.d1!1:>:l.:lj', i;o;'t'mmeillal 3,geill:r ',.,; j;,:';;Hitun lij:ed he/eon . . Cerlificationii . :,~;!:- ,.:);" ioJ ad;:1!lional insiiitutiol1i OJ ...... .i.... -,' (j~.-;,,:. 11COR TITI.E GUAR'''''1EE COM?ANY (516}127-ZS00 1".-,.".-,,".' .... .~;. ~ :" ,3dditi?:-l D,f I~i~ SUfV::1 .il ..':::0:1: t.::LI c-f t,\~r;i:','/ YGrk::':aie ';"---'!..' ~'h." i')i:,," 111lEI !.J-?/-tJl0-tfo r;~i;'i,;:: ,., . .~ ~!, :"';' ::~(':~ r.~! bt!~r::-lg t~C' l:)r.~ :,:'~'.-'~~i::': ,:;,,(:1 ',:. ~ ':: i:t:~~,~:_~,j ~~d $11,,:: ,:c.i ~: ";;:'~!:':~I~i.i i.j Go; <i ;'';;:."0 t,-~.~ (;0;':1. c::: <::.c:::._.,....-:.l~~. UP~""""T'e:!..... 3LJJro"J6 17, 1""1.., I RE.DATED, .9~~-8<!T.e ~ /7~.s> OO"-JALO .J. TA'=>E. L.C:.. ''''''u..:=ce.~JC. .--n:::;l-- MAP OF PROPERTY .,TUAn: _ _ EA7sT .--!Y-1?R/o/V TOWN CW _,.:?J?qJ#,;?C~ SU,","OI." COUNTY, 101:. y, SURVETEO .-9.PR..-C /~ ~ d' "Oft ~N~J10 ~ .JSA.t."J 'T_ t:?e':Lo~ME- ~-lICTl"'JeD "'n::I-.(~ ~~~L..E) ----, --?:.c-,--'''-'--c=.--d~A'j TTJt. f..c,RM S7'~"""c '::oJ '-/E; ..-j J<:- ~-"'K' .'Y;'r;..J2T~ ...c... 6- 4~cj/ -;. <c--.- ~-c...o,~:.r.<.':":~,;,:C''''':i7''''t..''''e: C-c. OB No_~20--l#c~ SLJRVEY IS N~1.~o. /?E-~S- ;;3 <?_2..e.J;:NSfER!,-_8!;~; ,cJ.~TtUAVEt.2 RICHARD WILHELM AND ASSOCIATES LAND SURVEYORS Center Moricha, N. Y. 11934 TeL 878-0120 .Af1~/k ';.. "\~~.IQlN"'TU..--'-' ~.' . "'::-^~;;nlill.1.NT. u. .. n....u:U.ilID ~ ,"'=Al.fl ,. = 30 ~ lOIO"'UMtWTa SHOWN THUS _ . .TAK!:. SNOW.. THUS _'_ __ .. . PO L..fI. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN J;lALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www.northfork.net/SouthoIdf PERMIT NO. 3'l'l lS (~ ~~-. 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 N.Y.S.D.E.C. Trustees Contact: Examined $/1 ,2oL ~f{'ir , 20~ . Approved Disapproved alc Mail to: Phone: Expiration /,,2/1 JY , 200S- r~ Building Inspector r , I ~tI'I 28 '200' APPLICATION FOR BUILDING PERMIT 1 G~' ,l,,__ . " .,."'r:; \ .... :',' ~ -- ;"_..--- - Date ,20d INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. . b. Plot plan showing location oflot 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 of the permit for an addition six months. Thereafter, a new permit shall be required. APPLICA nON IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of South old, 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. l?tf'J.<;I/;t?f~DUt. E. tjlWofl/.AJfI/tEJ . (Mailiog address of applicant) I State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder - Name of owner of premises DE: "-) 1\)1 s q'ld St'=O A ~ \ T. Del.. La R Nt (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. ~8Lj3&' f.j. Plumbers License No. 3oo'i'? - {) Electricians License No. 3'iSC/ 7 C. Other Trade's License No. '"" I. Location of land on which proposed work will be done: tJ /345 'Stl,P\/I],eij VI/Vb ;::f1-5T nlhf'ltJlIl House Number I Street ' Hamlet t.. ... Block tyrr~'~' Filed Map No. .~ ~'I'- q F4::i ~ County Tax Map No. 1000 Section Subdivision D38 Lot Lot (Name) ., 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: . . . a. Existmg use and occupancy , b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost l::: Q50,Ooo,- Addition Other Work x Alteration >< (Description) Fee 5. If dwelling, number of dwelling units If garage, number of cars I (To be paid on filing this application) Nnmber of dwelling units on each floor 6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front 5?0 Height Number of Stories I f Rear J ,")~ Depth ,,2.-L! / I Dimensions of same structure with alterations or additions: Front ,"57" c.. Rear. Depth Height Number of Stories 8. Dimensions of entire new construction: Front Height Number of Stories Rear Depth 9. Size oflol: Front Rear Depth 10. Date of Purchase /CN/ "-- Name of Fort.er Owner :5n<;,v#'},(osK:: " II. Zone or use district in which premises are situated /LJOD . 12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO X 13. Will lot be re-graded? YES _ NO_Will excess fill be removed from premises? YES_NO_ 14. Names of Owner ofpremises])Etl/III/<,'rS'EA1JT. ~i14)!~ress 13115 Si:!lfhjllf.l.Jl, C.Jf~one No. l.!.l-I-?>l",(;, Name of Architect Address' one No Name ofContractorJJF\1\JHoL ~.",. hhle.. Address DR,6t.."ff: AlII Phone No. . I IS a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES _NO X. * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MA Y jEQUlRED.' b. Is this property within 300 feet of a tidal wetland? * YES_NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF ) being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. SwomJo before me thi1,\f\ _. A-I j ~dayof j. 'C~, ~ Q...J,l<- m. u_ '-if Notary Public LYNDA M. BOHN NOTARY PUBLIC, State of New York No. 01 B06020932 Oualified in Suffolk Co'!.~--. Tern, Expires March 8, 2V<.L(' ~/iJIll'i:~ . Signat of Applicant Penn it Number REScheck Compliance Certificate Checked By/Date New York State Energy Conservation Construction Code RES check Software Version 3.5 Release Ib Data filename: Untitled.rck TITLE: Delonne - Garage Converson COUNTY: Suffolk STATE: New York HOD: 5750 CONSTRUCTION TYPE: Detached I or 2 Family HEATING TYPE: Non-Electric DATE: 05/19/04 DATE OF PLANS: 5-6-04 PROJECT INFORMATION: Garage conversion screened porch COMPANY INFORMATION: Eileen Santore COMPLIANCE: Passes Maximum UA = 80 Your Home UA ~ 76 5.0% Better Than Code (UA) Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor UA Ceiling I: Flat Ceiling or Scissor Truss 315 30.0 0.0 11 Wall I: Wood Frame, 16" O.c. 424 19.0 0.0 20 Window I: Wood Frame:Double Pane with Low-E 75 0.350 26 Door I: Solid 21 0.450 9 Floor I: All-Wood Joist/Truss:Over Unconditioned Space 315 30.0 0.0 10 COMPLIANCE STATEMENT: The proposed building represented in this document is consistent with the building plans, specifications, and er calculations submitted with this pennit application. The proposed systems have been designed to meet the New York State En r y Conservati truction Code requirements. When a Registered Design Professional has stamped and signed this page, th e attesting hat to th his/her knowledge, belief, and professional judgment, such plans or specifications are in pliance wi t' Date ~JJ 1 / rYf Builder/Designer 0