HomeMy WebLinkAbout32850-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32503
Date: 08/06/07
THIS CERTIFIES that the building ADDITION
Location of Property: 1115
(HOUSE NO.)
County Tax Map No. 473889 Section 98
ARROWHEAD LA
(STREET)
Block 3
PECONIC
(HAMLET)
Lot 7.1
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
MARCH 27, 2007 pursuant to which
Building Permit No. 32850-Z
dated
MARCH 27, 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 SECOND FLOOR ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to WOODS LIVING TRUST
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
3040098
07/23/07
PLUMBERS CERTIFICATION DATED
07/02/07 THOMAS AZZARA
~.~
Authorized Signature
Rev. 1/81
Form No.6
TOWN OF SOUTHOLD
, __~ BUILDING DEPARTMENT
_:_ - '" -r-"r Iii \, TOWN HALL
(~ ItS' It : \
n IS "f, .'_;' --, 765-1802
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\~~~:-- MIl: _ \ '{:'J1 ~QP~ ICATION FOR CERTIFICATE OF OCCUPANCY
,(' ' ~ I\U" '
Thl ~:P~~i'~:~~ti,~~\ In b typewriter or Ink and submllted to the Building Department with the folloWIng
~1\;"~ v ___
'iiitITding or new use:
Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or
topographic features.
Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 fonn).
Approval of electrical installation from Board of Fire Underwriters.
Swom statement from plumber certifying that the solder used in system contains less than 2/\ 0 of t % lead.
Commercial building, industrial building, multiple residences and similar buildings and installations. a certiticate
of Code Compliance from architect or engineer responsible for the building.
Submit Planning Board Approval of completed site plan requirements.
QAu d-1'6 q e:,q 'f,
A.
1
2
3.
4
5.
6.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "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 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.
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 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. 7/23/07
Dormer addition
New Construction: XXXXX Old or Pre-existing Building:
Location of Property: 1115 Arrowhead Lane
House No. Street
( check one)
peconic
Hamlet
Owner or Owners of Property:
John & Susan Woods
Block 3
Filed Map,
Lot 7.1
Suffolk County Tax Map No 1000, Section 98
Subdivision Arrowhead Cove
3810
Lot: 6& 7
Pennit No.
32850
Date of Permit.
3/27 /07
Applicant: In] "no Homp"
Health Dept. Approval: N/A
Planning Board Approval: N/A
Underwriters Approval:
Request for:
Temporary Certificate
Ap lieant Signature
Fee Submitted: $
~\) ~ '5 :;.S-03
f2.a.c 1d1i~7
.. .,'. ~ .:"':':c::--;-._,
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, New York 11971
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Fax (516) 765.1823
Telephone (516) 765.1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
C E R T I FIe A T ION
DATE:
? !Z)CJ7
, I
Building Permit No.
Owner: 10"'~ I\- <;u~bN~
(please print)
3 2..,%51) - z..
\.0~~cL~
Plumber: #'40 fi'tCi C; A-2-2--t?/L.~
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
~
< (Plumbers
~/1~~
Si ture)
Sworn to before
day of
~;/
~M
Notary Public,
County
BAflBAflAJ. B H
Notary Public. State of New York
No. 52-0513575. Suffolk Coun~p q
Commission Expires Octoberap; /
@I.@1
; BY THIS CERTIFICATE OF COMPLIANCE THE 91, - .3 - 7./ ;
; NEW YORK BOARD OF FIRE UNDERWRITERS ;
~ BUREAU OF ELECTRICITY ~
~ 40 FULTON STREET - NEW YORK, NY 1 0038 ~
~ CERTIFIES THAT ~
~ ~
~ Upon the appl ication of upon premises owned by ~
~ ~
~ JIM SAGE ELEC. INC. JOHN WOODS ~
~ PO BOX 38 1115 ARROWHEAD LANE ~
~ GREEN PORT, NY 11944-0038, PECONIC, NY 11958 ~
~ Located at 1115 ARROWHEAD LANE PECONIC, NY 11958 ~
~ ~
~ Application Number: 3040098 Certificate Number: 3040098 ~
I Section: Block: Lot: Building perm361 '3'SZ> BDC: ns11 I
~ Described as a occupancy, wherein the premises electrical system consisting of ~
~ electrical devices and wiring, described below, located in/on the premises at: ~
~ Second Floor, 2nd floor addition, ~
~ 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 23rd Day of July, 2007. ~
fffi Name OTY Rate Ratinll Circuit ~ ~
~ Alarm and Emergency Equipment ~
~ Sensor 1 0 Carbon Monoxide ~
~ Appliances and Accessories ~
~ Exhaust Fan 1 0 F.H.P. @!
~ Wiring and Devices ~
ffil Outlet 12 0 Fixture ~
~ Fixture 12 0 Incandescent ~
~ Outlet 28 0 General Purpose ~
~ Receptacle 19 0 General Purpose ~
~ Switch 16 0 General Purpose ~
~ Dimmers 2 0 ~
~ Paddle Fan 2 0 ~
~ Receptacle 1 0 GFCI ~
~ ~
~ ~
W seal ~
~ ~
~ 1 of 1 ~
~ ~
; 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.@1
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.
32850 Z
Date MARCH
27, 2007
permission is hereby granted to:
WOODS LIVING TRUST
1115 ARROWHEAD LA
PECONIC,NY
for
2ND FL. ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED;
4 BEDROOM LIMIT
at premises located at
1115 ARROWHEAD LA
PECONIC
County Tax Map No. 473889 Section 098
Block 0003
Lot No. 007.001
pursuant to application dated MARCH
27, 2007 and approved by the
Building Inspector to expire on SEPTEMBER 27, 2008.
Fee $
233.60
~~
! Authorized Signature
ORIGINAL
Rev. 5/8/02
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JAMES 1. DEERKOSKI, P.E.
260 Deer Drive
Mattituck, N.Y. 11952
(631) 298-7116
Date: March 26, 2007
To: Town of South old Building Dept.
Re: Bedrooms
Woods
IllS Arrowhead La.
Peconic, NY
To Whom It May Concern:
The plans for the above mentioned addition will end up with a four bedroom layout, and
the plans will show this. Also a door was removed from the upstairs hobby room. Any
other questions please call.
Sincerely
3l9--~So'::z-
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING I STRAPPING jX.FINAL A;
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS:
p~ ~. ~ t::)-k-
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DATE 7,- t?-s -" '1 INSPECTOR ~ ~
-'~"~".",.~..".,,-;::i',,,~.. '''-.-''~
:3?-Y SO:Z-
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESISTANT CONSTRUCTION
[ ] ROUGH PLBG.
[ ] INSULATION
V\ FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRATION
REMARKS:.. ~
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DATE 7.-:;-f.-o7 INSPECTOR ~~
3'~1 S-o L
TOWN OF SOUTHOlD BUilDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESISTANT CONSTRUCTION
REMARKS:
[ ] ROUGH PlBG.
~NSULATION
[ ] FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRATION
~~
Ca- tJk ~ ~41
DATE '~If- 07
INSPECTOR ~ ~
3~gS() Z-
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST M ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING I STRAPPING [] FINAL
.:W!1~r_FIIl"" r 181" [] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS: f)t,,~ ~
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DATE
INSPECTOR ~~
31--gS0 :L
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1ST P1ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
~ FRAMING I STRAPPING [] FINAL
-- ~
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS: .~~ /
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DATE S - J--~- 0--7 INSPECTOR A~
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COMMENTS
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FIELD INSPECTION REPORT DATE
FOUNDATION (1ST)
FOUNDATION (2ND)
ROUGH FRAMING &
PLUMBlNG
lNSULATIONPERN. Y.
STATE ENERGY CODE
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ADDITIONAL COMMENTS
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TOWN OF SOUTHOLD PROPERTY RECORD CARD
STREET II I ;::::
VILLAGE
DIST.
SUB.
LOT
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FORMER OWNER
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TYPE OF BUILDIN
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RES.
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SEAS.
VL.
FARM
COMM. CB.
MISe.
Mkt. Value
LAND
IMP.
TOTAL
DATE
REMARKS
Acre
Tillable 1
Tillable 2
Tillable 3
Woodland
i
i Swampland
Brushland
Hause Plat I, OJ;
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Value Per
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mil,,"! dv..dh~ ~'p/alls It) dv{JIAy-(f' .
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FRONTAGE ON WATER
FRONTAGE ON ROAD I 'I 0
DEPTH
BULKHEAD
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Total ~ .
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DOCK
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- COLOR
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y 13 =" ,'K2/
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Extension - Ext. Walls . Interior Finish LR. I
. > l'7 Z/;?J 0, j--, 71
lto ~ :t - ~t " I
Extension - Fire Place VES Heat DR.
1i.6~ = ~ Type Roof Roams 1st Floor BR. if
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~N~, - No I 201 (;;) I' ;.,.,~ '1 r-'.'P,., Recreation Roam Roams 2nd Floor FIN. B.
Parc 11<,,,,.1 I~x 17 - -z.-, '/ v 0"
fc,f{[h'P 5'/ ;1 %' 70 .6D Js Dormer
J e;C-K I'2-XI'l- 2't-'l:l') 330 11fJ' Sv Driveway
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Garage r.;;t:J 7, IH.F .
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Permit #
Permit Date
RES check Software Version 3.7 Release 1b
Compliance Certificate
Project Title: woods
Report Date: 03/12/07
Energy Code:
New York State Energy Conservation
Construction Code
Suffolk County, New York
Detached 1 or 2 Family
Non-Electric
4%
5750
Location:
Construction Type:
Heating Type:
Glazing Area Percentage:
Heating Degree Days:
Construction Site:
1115 Arrowhead La.
Peconic, NY
Owner/Agent:
Designer/Contractor:
Compliance' Passes Maximum VA' 134 Your Home UA' 90 -> 32.8% ~etter ;than Code {UA}
Assembly
......
.: - .'. . .. . . . . ~".
Ceiling 1: Flat Ceiling or Scissor Truss:
Wall 1 : Wood Frame, 16" o.c.:
Window 1: Wood Frame:Double Pane with Low-E:
Window 2: Wood Frame:Double Pane with Low-E:
825
870
26
7
30,0
19,0
0,0
0,0
0,350
0,290
29
50
9
2
Statement of Compliance: The proposed building represented in this document is consistent with the building plans, specifications,
and other calculations submitted with this permit application. The proposed systems have been designed to meet the New York
State Energy Conservation Construction Code requirements. When a Registered Design Professional has stamped and signed this
page, they are attesting that to the best of his/her knowledge, belief, and professional jUdgment, such plans or specifications are in
compliance with this Code.
JA~T~12Il$~
Builder/Designer
~
Company Name
woods
Page 1 014
REScheck Software Version 3.7 Release 1 b
Inspection Checklist
Date: 03/12/07
Ceilings:
o Ceiling 1: Flat Ceiling or Scissor Truss, R-30.0 cavity insulation
Comments: .
Above-Grade Walls:
o Wall 1: Wood Frame, 16" a.C., R-19.0 cavity insulation
Comments:
Windows:
o Window 1: Wood Frame:Double Pane with Low-E, V-factor: 0.350
For windows without labeled V-factors, describe features:
#Panes _ Frame Type Thermal Break? _ Yes _ No
Comments:
o Window 2: Wood Frame:Double Pane with Low.E, V-factor: 0.290
For windows without labeled V-factors, describe features:
#Panes _ Frame Type Thermal Break? _ Yes _ No
Comments:
Air Leakage:
o Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed.
o Recessed lights must be 1) Type IC rated, or 2) installed inside an appropriate air-tight assembly with a 0.5" clearance from
combustible materials. If non-IC rated, the fixture must be installed with a 3" clearance from insulation.
Vapor Retarder:
o Required on the warm-in-winter side of all non-vented framed ceilings, walls, and floors.
Materials Identification:
o Materials and equipment must be installed in accordance with the manufacturer's installation instructions.
o Materials and equipment must be identified so that compliance can be determined.
o Manufacturer manuals for all installed heating and cooling.equipment and service water heating equipment must be provided.
o Insulation R-values and glazing U.factors must be clearly marked on the building plans or specifications.
Duct Insulation:
o Supply ducts in unconditioned attics or outside the building must be insulated to R-8.
o Return ducts in unconditioned attics or outside the building must be insulated to R-4.
o Supply ducts in unconditioned spaces must be insulated to R-B.
o Return ducts in unconditioned spaces (except basements) must be insulated to R-
o Return ducts in unconditioned spaces (except basements) must be insulated to R-2.
. Insulation is not required on return ducts in basements.
Duct Construction:
o All joints, seams, and connections must be securely fastened with welds, gaskets, mastics (adhesives),
mastic-plus-embedded-fabric, or tapes. Tapes and mastics must be rated UL 181A or UL 1818.
Exception: Continuously welded and locking-type longitudinal joints and seams on ducts operating at less than 2 in. w.g. (500
Pal.
o The HVAC system must provide a means for balancing air and water systems.
Temperature Controls:
Page 20f4
o Each dwelling unit has at lesat one thermostat capable of automatically adjusting the space temperature set point of the largest
zone.
Electric Systems:
o Separate electric meters are required for each dwelling unit.
Fireplaces:
o Fireplaces must be installed with tight fitting non-combustible fireplace doors,
o Fireplaces must be provided with a source of combustion air, as required by the Fireplace construction provisions of the Building
Code of New York State, the Residential Code of New York state or the New Ytrk City Building Code; asappJicable.
Service Water Heating: .1
o Water heaters with vertical pipe risers must have a heat trap on both the inlet ald outlet unless the water heater has an integral
heat trap or is part of a cirCUlating system,
o Insulate circulating hot water pipes to the levels in Table 1.
Circulating Hot Water Systems:
o Insulate circulating hot water pipes to the levels in Table 1.
Swimming Pools:
o All heated swimming pools must have an on/off heater switch and require a cov r unless over 20% of the heating energy is from
non-depletable sources, Pool pumps require a time clock, l
Heating and Cooling Piping Insulation:
o HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 de rees F must be insulated to the levels in Table
2.
Page 3 014
Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes
Heated Water
Temperature (OF)
170-180
140c169
100-139
Insulation Thickness In Inches by Pipe Sizesl
Non-Circulating Runouts Circulating Mains a~d Runouts
Up to 1" Up to 1.25" 1.5" to 2.0" I Over 2"
0.5 1.0 1.5 I 2.0
0.5 0.5 1.0 1.5
0.5 0.5 0.5 1.0
Table 2: Minimum Insulation Thickness for HVAC Pipes
201-250
120-200
Any
Insulation Thi kness in Inches by Pipe Sizes
2" Runouts 1" and kess 1.25" to 2.0" 2.5" to 4"
--r-
1.~
~j
1"
I
I
I
I
I
I
I
1.0
0.5
1.0
1.5
1.0
1.5
2.0
1.5
2.0
Piping System Types
Heating Systems
Low PressurefTemperature
Low Temperature
Steam Condensate (for feed water)
Cooling Systems
Chilled Water, Refrigerant and
Brine
Fluid Temp.
Range('F)
40-55
Below 40
0.5
1.0
0.75
1.5
1.0
1.5
NOTES TO FIELD: (Building Department Use Only)
Page 4 of 4
I
TOWN OF SOUTHOLD
BUILDING PEI'ARTMENT
TOWNHALL .
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.netlSouthoId/
I
BUIJDlNG PERMIT APPLICATION CHECKLIST
I
PERMIT NO. ~~,-o..:t:-
I
I
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:
54~' 20JrL
, ,20M
Examined
Approved
Disapproved alc
Mail to:
1 /6 bo 015
Phone: 298 9696
Expiration
Building Inspector
r-"-'-r:;:;.-~T:~.'~:l~~~f,'''- R l~~"I ~
! c. I'C' I[ L . 1\. i '"\ II
MAR I 3 2Qcg'+PLICATIONFORBUlLDINr: PERMIT
! Date '.:) J J ~
'_~I INSTRUCTIONS I I
a. This application MUST be completely filled in by typewriter or in ihk and submitted to the Building fuspector with 4
sets of plans, accurate'plot plan to scale. fee according to schedule. I
b. Plot plan showing location oflot and of buildings on premises, relationship to adjoining premises or public streets or
areas, and waterways. I
c. The work covered by this application may not be commenced beforb issuance of Building Permit.
d. Upon approval ofthis application, the Building fuspector will issuela Building Permit to the applicant. Such a permit
shall be kept on the premises available for inspection throughout the work. I '
e. No building shall be occupied or used in whole or in part for any p~rpose what so ever until the Building fuspector
issues a Certificate of Occupancy. I
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 zOFg amendments or other regulations affecting the
property have been enacted in the interim, the Building fuspector may authori'fe, in writing, the extension of the permit for an
addition six months. Thereafter, a new permit shall be required. I
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 r~moval 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. :
I '
Inland Homes
I (Signature of applicant or name, if a corporation)
PO Box 117,Mattituck,N.Y.
1~952
I
,20~
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, genl'ral contractor, electrician, plumber or builder
Builder
,
Name of owner of premises John & Susan Woods I
(As on the tax roll ~r latest deed)
If applicant is a corporation, signature of duly authorized officer '
Robert Hiltz
(Name and title of corporate officer)
Builders License No. 19736-HI
Plumbers License No. 2941-P
Electricians License No. 3635-E
Other Trade's License No.
I. Location of land on which proposed work will be done:
1115 Arrowhead Lane,Peconic,N.Y.,11958
House Number Street
County Tax Map No. 1000 Section
Subdivision Arrowhead Cove
(Name)
98
Block '.3 I..
Filed Map ~o.
Hamlet
3810
. Lot 7.1
Lot 6&7
I
2. State existing use and occupancy of premi.ses and inten<:led use and ofcupancy of proposed consyuctio.r:
a. Existing use and occupancy Slngle famlly dwelllng \
b. Intended use and occupancy
Single family dwelling
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
Addition
Other Work
Alteration
xxx
4. Estimated Cost
$65,000.00
(Description)
Fee
5. If dwelling, number of dwelling units
If garage, number of cars
1
(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.
7. Dimensions of existing structures, if any: Front
Height 25' Number of Stories
85.2'
Rear
85.2
Depth
61.4
1
Dimensions of same structure with alterations or additions: Front 85.2
Depth 61 .4 Height 25 ' Number of Stories
Rear 85.2
2
8. Dimensions of entire new construction: Front
Height Number of Stories
Depth
Rear
9. Size ofldt: Front
256
Rear
290
Depth
169
10. Date of Purchase
Name of Former Owner
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO-xxxx
13. Will lot bere-graded? YES XX NO_Will excess fill be removed from premises? YES_NO XX
14. Names of Owner of premises
Name of Architect
Name of Contractor Inland Homes
Address
Address
Address
Phone No.
Phone No
Phone No. 298 9696
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES _NO XXXX
* 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 )
Robert Hiltz being duly sworn, deposes and says that (s)he is the applicant
(Name of individual siguing contract) above named,
(S)He is the
r'nnt-rrlrt-nr
(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 koowledge 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 day of . m cvu.L. 20 0 7
~d, ~ ~~)
Notary ublic
LINDA J COOPER
NOTARY PUBLIC, State of New York
NO. 01C04B22563, Suffolk COfbly
Toem Expires December 31,20
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971-0959
Fax (631) 765-9502
Telephone (631) 765-1802
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
July 27,2007
Inland Homes
PO Box 117
Mattituck, NY 11952
RE: Woods, 1115 Arrowhead Lane, Peconic
TO WHOM IT MAY CONCERN:
We are unable to complete your Certificate of Occupancy because of the following reasons:
~ An application for Certificate of Occupancy is not one file. (Enclosed)
~
No Electrical Underwriters Certificate on file.
The check is (not on file) $25.00
Final Health Department approval not on file.
No final inspection has been completed.
~ No Plumber Solder Certificate on file. (All permits involving plumbing issued after
4/1/84)
Certificate of Compliance from the Trustees.
Final Planning Board approval
Final Fire Inspection from Fire Marshal.
BUILDING PERMIT: 32850-Z
SOUTHOLD TOWN BUILDING DEPT.