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Home My WebLink About32710-Z FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32511 Date: 08/07/07 THIS CERTIFIES that the building ADDITIONS Location of Property: 240 GREAT (HOUSE NO.) County Tax Map No. 473889 Section 145 PECONIC BAY BLVD (STREET) Block 2 LAUREL (HAMLET) Lot 1. 5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 7, 2007 pursuant to which Building Permit No. 32710-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 ADDITIONS & ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOHN C & HOLLY M DILLER (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 3034222 07/31/07 PLUMBERS CERTIFICATION DATED 07/16/07 BURTS RELIABLE ~~ Authorized Signature Rev. 1/81 FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32512 Date: 08/07/07 THIS CERTIFIES that the building ACCESSORY Location of Property: 240 GREAT (HOUSE NO.) County Tax Map No. 473889 Section 145 PECONIC BAY BLVD (STREET) Block 2 LAUREL (HAMLET) Lot 1. 5 SUbdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 7, 2007 pursuant to which Building Permit No. 32710-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 ACCESSORY GARAGE WITH ATTACHED 8 X 12 SHED IN THE REQUIRED REAR YARD AS APPLIED FOR. The certificate is issued to JOHN C & HOLLY M DILLER (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 3034222 07/31/07 PLUMBERS CERTIFICATION DATED N/A ~~ Authorized Signature Rev. 1/81 r;;_~ -R~1i0 ~Rliw . R i;," I 15 l"J l5 . ~ l~" Il~ ~~:-7~C' \W I L- OLD". DEP '. LJp_WN.QL.S0UTHOLD 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 topo graphic 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 2/1 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 Apri19, 1957) non-conforming uses, or buildings and "pre-existing" land uses: I. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied; the Building Inspector shall state the reasons therefor in writing to the applicant. 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 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Corrunercial $15.00 Date. 3 /" /v 7 New Construction: ,--- Old or Pre-existing Building: (check one) Location of Property: ;20-" J?6CONlC i3.F'I ~c...(/t). House No. Street Owner or Owners of Property : OhIfltJ (.:;1'.,IJC. ,,::)J>tLL~ Suffolk County Tax Map No 1000, Section ,~ Block i./JI/ 1l6L.. Hamlet 6"2... Lot / . '1 Subdivision Filed Map. Applicant: Lot: Pennit No. ,) '2.. '1/0 Date of Pen nit. Health Dept. Approval: Underwriters Approval: / Plmming Board Approval: Request for: Temporary Certificate Final Certificate: / (check one) Fee Submitted: $ t-'S -- a~. V1 </S CO 't: 325 II ~~ App . Signature , t- " Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 5\\0- d-~O - II~ m~~-;~}~lW ,"'c '" I [II) I T WN QI5i1ill!:tQ~ . APPLICATION FOR CERTIFICATE OF OCCUPAN 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 nse: 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 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 bnildings 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. I /, /0 7 , Old or Pre-existing Building: / (check one) New Construction: Location ofproperty: 015'0 fJt.Ct>N 1<::" BiJ-'1 ~LVf). House No. Street Owner or Owners of Property: ,1DJ.lAJ (lAC;:') J)/LC.6-<... Suffolk County Tax Map No 1000, Section I ""5 Block ,t.,iJ I//2..U_ Hamlet 02.. (.5 Lot Subdivision Date of Pennit. 1-/' to /0 '7 , t Filed Map. Lot: Applicant: 1 :J:t, $, 1<:1,""'15' :J;., Pennit No. :J 2.. ? 10 Health Dept. Approval: Plalming Board Approval: t//4 f.//14 Underwriters Approval: Request for: Temporary Certificate Final Certificate: /" ( check one) Fee Submitted: $ "'1..5 &x- 7.:2.' Lf4 Coz 3"a,S ).2. ~.~ ~ ---------- ppl1cant SIgnature FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 32710 Z Date FEBRUARY 12, 2007 permission is hereby granted to: JOHN C & HOLLY M DILLER NASHVILLE TN, 37205 for : ADDITIONS & ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR AND CONSTRUCTION OF AN ACCESSORY BUILDING. 2 COS REQUIRED. at premises located at 240 GREAT PECONIC BAY BLVD LAUREL County Tax Map No. 473889 Section 145 Block 0002 Lot No. 001. 005 pursuant to application dated FEBRUARY 7, 2007 and approved by the Building Inspector to expire on AUGUST 12, 2008. Fee $ 304.80 ORIGINAL Rev. 5/8/02 /LIs, - ,,(, - I . 3"""'" @]~.@] ~ BY THIS CERTIFICATE OF COMPLIANCE THE ~ ~ 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 ~ ~ ~ ~ G & S ELECTRICAL CONTR. JOHN DILLER ~ ~ P.O. BOX 215 250 PECNIC BAY BLVD ~ ~ SOUTHOLD, NY 11971, LAUREL, NY 11948 ~ ~ Located at 250 PECNIC BAY BLVD LAUREL, NY 11948 ~ ~ ~ ~ Application Number: 3034222 Certificate Number: 3034222 ~ I Section: 145 Block: 2 Lot: 1.5 Building Permit: BDC: ns11 I ~ 3.;t, I 0 ~ ~ Described as a occupancy, wherein the premises electrical system consisting of ~ ~ electrical devices and wiring, described below, located in/on the premises at: i ~ Basement, First Floor, addition + garage, Detached Garage, Outside, ~ ~ A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed ~ ~ herein, was conducted in accordance with the requirements of the applicable code and/or standard ~ ~ promulgated by the State of New York, Department of State Code Enforcement and Administration, or other ~ ! authority having jurisdiction, and found to be in compliance therewith on the 31st Day of July,2007. ! ~ Name OTY Rate Rating Circuit ~ ~ ~ Alarm and Emergency Equipment ~ ~ Sensor I 0 Carbon Monoxide ~ ~ Sensor 2 0 Smoke ~ ~ Appliances and Accessories ~ ~ Water Heater I 0 4.5 KW ~ ~ Air Conditioner I 0 30 Amps ~ ~ Panels I 30 3 ~ ~~~~ ~ ~ Outlet 14 0 Fixture ~ ~ Fixture 14 0 Incandescent ~ ~ Outlet 18 0 General Purpose ~ ~ Receptacle 6 0 General Purpose ~ ~ Switch II 0 General Purpose ~ ~ Lighting track 120ft ~ ~ Receptacle I 0 20a Laundry ~ ii!I Receptacle I 0 30a Dryer seal jij] ~ Disconnect I 0 60a Air Conditioner ~ ~ Continued on Next Page I of 2 ~ ~ ~ ~ This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. ~ ~ ~ @].@] ffiI ~ BY THIS CERTIFICATE OF COMPLIANCE THE ~ ~ 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 ~ ~ ~ ~ G & S ELECTRICAL CONTR. JOHN DILLER ~ ~ P.O. BOX 215 250 PECNIC BAY BLVD ~ ~ SOUTHOLD, NY 11971, LAUREL, NY 11948 F.!l ~ ~ ~ Located at 250 PECNIC BAY BLVD LAUREL, NY 11948 ~ ! 3034222 3034222 ! ~ Application Number: Certificate Number: ~ ~ Section: 145 Block: 2 Lot: 1.5 Building Permit: BDC: ns11 ~ ~ ~ ~ Described as a occupancy, wherein the premises electrical system consisting of ~ ~ electrical devices and wiring, described below, located inion the premises at: ~ ~ Basement, First Floor, addition + garage, Detached Garage, Outside, ~ ~ A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed ~ ~ herein, was conducted in accordance with the requirements of the applicable code 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 31st Day of July, 2007. ~ ~ Name OTY Rate Rating Circuit illli; ~ ~ Receptacle 5 0 GFCI ~ ~ Service ~ ~ I Phase 3 W Service Rating 200 Amperes ~ F.!l Service Disconnect: 200 ch ~ ~ Meters: I = ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ I seal ~ ~ ~ ~ 2 of 2 ~ ~ ~ ~ This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. ~ ffiI.ffiI C E R T Fa~ (510 765 'f~: TElepnC)n':'I::1G:'"'C,~ " r (,)'tI'! f1all, 53095 Main Q'J.lj P 0, 80>: 1179 SC',-'II',Qld, New Yorl<. 1 \~71. OFFICE OF THE B TOWN 0 Date: 1/&/01 I Building Permit No, 3~'11t) %- Owner: y~V\ ~ff/e. 77 INC- -.:r;; 4n ~, r rrl'J' h- Cot? fr~ '~r- (please print) :Ja c /t' ,t// ;//t' r (;ISo .-PcCon,l;. <5/9'1 81",1 Lar/(c/ Plumber J3urh "'I"Jllible.. Inc I (please print) I certify that the solder used in the water supply system conta'n less than 2/10 of 1 % lead, (plumbers signature) Sworn to before me this County ~L~ /Vo~ PlJbhc /I 'IJ''IfJilJ ~dayof JJ\~ Notary Public, Su+n,tK. 20fLl..- BERNAOETIE L. TAPLIN NOTARY PUBLIC Jl4844893 Stale of New York Residing in Suffolk County Commission Expires ~~t JlJ, 11']_ tJl'JIJ7,CI'/ 3 ';-1/0 :z-. TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION ] FOUNDATION 1 ST ] FOUNDATION 2ND ] FRAMING I STRAPPING ] FIREPLACE & CHIMNEY ] FIRE RESISTANT CONSTRUCTION [ ] ROUGH PLBG. [ ] INSULATION [~INAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION REMARKS: r~ ~K:~ ~~~\ DATE 7'-- ?-~,--tO-'7 INSPECTOR ~~ 3 'J--7/D :2- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] FOUNDATION 2ND [ ] FRAMING I STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRUCTION [ ] ROUGH PLBG. [ ] INSULATION M FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION DATE 7 -- )-t; .-- tJ 7 INSPECTOR *~ 3 ~1}0:z... TOWN OF SOUTHOlD BUilDING DEPT. 765.1802 INSPECTION ] FOUNDATION 1 ST ] FOUNDATION 2ND [ ] FRAMING I STRAPPING n FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRUCTION REMARKS: [ ] ROUGH PLBG. ~NSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION rf- > DATE h--r>t?7 INSPECTOR ~, ~ 3'11/0 -?- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [KfFRAMING I STRAPPING [ ] FINAL ,. ... . ~ [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION , 'tr- ~Dkj DATE .5 ~/I --D7 INSPECTOR ~<~ 3-;-7/0 J!- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. f><f FOUNDATION 2ND [ ] INSULATION [ ] FRAMING I STRAPPING [] FINAL [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: ~ ~. ~D , } ~ DATE '+~ -r{,- -07 INSPECTOR ~ ~ ~'"" ~,.-,,,,,,- --~ 3 'J--7 /07- TOWN OF SOUTH OLD BUILDING DEPT. 765.1802 INSPECTION ~ FOUNDATION 1ST [ [ [ [ [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION REMARKS: cVLL 0. / ~~ t1 -tF- ~A DATE 'f--lr---o 7 INSPECTOR ~ ~ , '." . n~!" . FIELD INSPECTION REPORT DATE COMMENTS \ "', \)J . ~ /() t1 J ~ ,~ JJ, _/..A ,L., ,:iJ! JJ J -JI-:_ '> ~ ~ IJ.- ':'p~1 ./1 ..'- '''J ~T?J(;'~'i ~ . P'[,~ ~ ~ / ~ /~ 'V >'] ~)A ~ {ff'-f1I:.. JA ~.-' Tv , ~~.J:' 7l, ~ 'lIo ------------------------------------ \of,.., % ~ I-fvij j (J ~ . I W I11t -+;;... :.., l. ")I ~);,.. FOUNDATION (2ND) ok '2.-~ 1-,- 4 ~ ^ ~ '-. jJ~ f) ~- 1=ti 1.-.". GA_ ~ D.O 1'\1] ..<l.. "flP.J \JI v- r u v. z 5-11- '7 F-}f..~" \1- ~~ IL..-. -">0:1".", Q.j? II 117d, .CfA./lln ~ dhi"',.-..0 ''5" t7 )) () 7) If:... t:!.-'.J ~IJ t (/ C/ FOUNDATION (1ST) . '" ~~ f>'J ",' ~ ,f _ ~~ 4->'] ROUGH FRAMING & PLUMBING . . . . ffJJ~ -c ? ~ " ...I!. A . V "'YIJ ..L vi.. 'f _f) A /JiArL t{) N 1.///fL/tf ...-' </ P -\./ I' INSULATION PER N. Y. STATE ENERGY CODE ~ p 17.. ... 1111 "1 r;;, (J hu. a..e-;.. -.. tf-L-v.. 7/1 ,.. . .~) . .fL-.:,~. nnJ! -ZA.I'JI. ::J-;:"A~ / ,.. 9-1- J~...!:-A d/, .-0 ,,1'/ /I/~JJ./ .0 (/^--" II .A: '",# /\UU /IlL '~-c:d"<.J""""" .. FINAL D q"W....17 :;:::,-.U JL -~ ---.. /'Jrrt .,t:r~lJn.A<_f)./~' . A'" ....J..-I--' AOa'-JI ~_.///) I -.......-""" -J (Xv ......O~.L/ . . v . I . ADDITIONAL COMMENTS ~ 31;: "'(17 /llrJr.Dft1A5 3'is.~o -h,,, i::1v.~/A"""'tN'\ Pet 3-~r,((7 &~1'X11A< r It I~ 01 -;r-.~ ~...:+.- ~ ~..r' "J.. \li( 'rl!. l:\. It 1 0.,. ~ .... ~ o ~~ ~~.. ::> - . . .' o oO~ \ :;; -52 f/ >'] \ - 00 ceZ " . . . . . . . . . = t'l A,~ ~ >,,; :-'l . . . . BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planuing Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to:~.j::::EI t..e:t2-- 'l:o'l- l~'1.z. I 1Y)~1T1 TClc..~ Phone:~8 . 545"? TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL . SOUTHOLD, NYU971 TEL: (631) 765-1802 FAX: (631) 765-9502 www.northfork.net/Southold! PERMIT NO. \. 8-Q::r {O ?::.- Examined Approved Disapproved ale ,20-1:t ,20~ Expiration ,20~ .,.,.-",-/., --------' .~-'" ;; r/ -'-i-R~J \'~ ~. \ c, \ \ ' , ' ,l'~' . '\APPLICATIONFORBUlLDINGPERMIT .-tD 1 ?GGT ' . n:.v . Date ___.J INSTRUCTIONS ,20~ J~L'=~"".-,-~ a. Thi[)pplicatiDhMDST be completely filled ill by typewriter or in ink and submitted to the Building Inspector with 4 sets ofp~accurate plot plan to'scale. Fee according to schedUle. " ,'. b. Plot plan showing location oflot arid 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 month,s. Thereafter, a new perrn,it shall be required. .APPLICATION IS HEREBY MADE'to the Building Department for the issuance of a Building Permit pursuant to the Building 'Zone Ordinance of the Town of Southold,Suff~lk 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,ng code, and re ations, and to admit authorized inspectors on premises and in building for necessary inspections. V~ (Signature of applicant or name, if a corporation) ~'f:- \ (0'\ 1. f'I).p... 1\1 \Uq::.-. (Mailkg address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ~Orf\lFq- --JoHN Name of owner of premises D L.L-~ (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. R::NDI N b Plumbers License No. ' Electricians License No. .. Other Trade's License No. .' 1. Location of land on which proposed work will be done: -:250 rE.Co~Ic.- ~y ~v() I House Number Street - L~REJ- Hamlet County Tax Map No. 1000 Section Subdivision 1+5 Block ()~ Filed Map No. TH3H:J!fl M:llRTAq 1l1;~1 wetli ~o B!r,',.:',?, bil~c;:r ;!1f:,lo~1 I!i11 i i -:~, ,',L~'.,~ ~ ~~lifHhi~.l ~k1'trl""',~!~b~?(~' '11 U/"f,l,F_' - ','.' '," ,0 ?l'qlf~:~'\ "",,'?:i"'iti" ". (Name) 2. State exist~ng use and occupancy of premises and intended use and occupancy of)roposetl construction: a. EXIsting use and occupancy ::3\ N Go L :F. ~ I L. Y l)~ G"LL.I We;. b. Intended use and occupancy ~s 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost~O 01)D . Fee Addition Other Work v' Alteration (Description) 5. If qw.ellip.g, ,11,umber qfdIYelling units If garage, number pf cars , (To be paid on filing this application) Number of dwelling units on each floor 6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front 2. "Z- Height I 5 Number of Stories I Rear "2..--z.... Depth ?4 Dimensions of same structure with alterations or additions: Front '2."2- Depth .1-2- Height 16 Number of Stories "f Rear J,.,. IM'~.' 2"2.. 8. Dimensions of entire new construction: Front 'Z-'Z... Height I" Number of Stories ~ }" 9. Size oflot: Front oq Rear 1-r.+ IS Rear 'Zoz Depth ~ -z... Depth -42~\ 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 1Z4o 12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO ~ 13. Will lot be re-graded? YES_NO ~ Will excess fill be removed from premises? YES ~ NO_ ~ Address zs, Pee. ~ ewo Phone No. Address rn"'Il~. P'lPrr-1~Phone No Address' Phone No. 14. Names of Owner of premises ...IDl:\tl Ol~ Name of Architect IJON~ Fe\U")'I...... Name of Contractor fel'lO ,I\l 6 Zlj It!, . ~'t1V '2..-'1 e - 54-'5~ 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES L NO _ / * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMIT} 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 surve):', to scale, with aC,curate foungation plan and distances to property lines. fttrr fl..AJ oN OW~S. 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 ) ~ \'J P<v<) ~ ~'" be~~ duly s~om, deposes aod says that (s)he is the applicaot (Name of individual sigrung contract) above named, (S)He is the MC+1 \-r:EC1 (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, aod is duly authorized to perform or have performed the said work and tq make aod file this application; that all statements contained in this application are true to the best of his knowledge aod belief;' aod that the work will be performed in the manner set forth in the application filed therewith. Sw= '" ""f== tllli; -!:it ~.~ ~ ~a- NotarY Public PATRICIA RICHERT NlltalY:l!ltbl. H:A,S._.of NeW,,' YOlk "~'3e-174~l' 154' . QYalif!ed.in.:l'!as~a!l1 '~~f!r1.' COmmiSSIOn. Expires / I, . I .. , iJ.Ja~ . . '- .,' Signature of Applicaot . . TOWN" OF SOUTHOLDPROPERTY RECORD CARD , . I, o -.-. /7k;;; ~ J.,"~ jU". ., /i.j"-':J - "7-'" ...."('- OWNER Of\C-. .. i IIe.r FORMER. OWNER 1.5 STREET 2 L! D ::-Pecor) ,'e- N /5/ vd VI LLAGE it/tlr&-I DIST. SUB. LOT , I 'of- /1 ACR. 0.4 CJ CODE .. -p40 DATE OF CONSTRUCTION . ~j~' J7;;C;/j,u'1t; LAND S /3cv lJ/tlcI I fer"'I' H.,.. I IJ, E lOt> IMP. TOTAL REMARKS 9tio ..? I tJ)'t> 9 g..() / 2".,,,<.) / Il,..l.:lcJ / Z-"7 00/ c:Ju-c \ d. ."~ 'k1 f.'L '2~ 475' Tillable I FRONTAGE ON WATER 'J~ FRONTAGE ON ROAD" 5-:, ttf I Ci' /" ..':' / ~/ ~<C) ,~ . Woodland ;;.. -.5 "' /;<5 Meadowland House Plot DEPTH BULKHEAD I 0--0 Totol __~-'I t'tfh,h rfy~ c I~ 'J,O Ie l< ..... \~ ;2 I< .4- 1/, jl , ; / 1'1 If Ii /i I 1- ~ M. Bldg. .4-1Y'?<!'e:' 5~~ :2, '25' /18;?,/ Foundation c..,i3" Bath / ,-",I,,,.,,, / Basement I',JOW,,- Floors / Exte~~g!;t 'l 0 x: "Z.C> '" 2",,,,, /.$0 3000 /""fr Extension Ext. Walls <9 tIe,l ~~ / I nterior Finish .5 ., , ,) ,,( , /~, Extension Fire Place - Heat - i , , If .f , , Porch 9 f;? .:? ,,50 '/9 . Pool Attic , '/ '" I Deck Patio Rooms 1 st Floor Breezeway Driveway Rooms 2nd Floor Garage O. B. '. J s/lY7/ Permit Number REScheck Compliance Certificate Checked By/Date New York State Energy Conservation Construction Code REScheckSoftware Version 3.5 Release I Data filename: C:\Prograrn Files\CheckIREScheck\Diller Residence - Addition.rck TITLE: DILLER RESIDENCE COUNTY: Suffolk STATE: New York HDD: 5750 CONSTRUCTION TYPE: Detached I or 2 Family HEATING TYPE: Electric (includes heat pumps) DATE: 01/30/07 COMPANY INFORMATION: Donald G. Feiler - Architect COMPLIANCE: Passes MaximumUA~71 YourHomeUA=71 0.0% Better Than Code (VA) Gross Area or Perimeter Cavity Cont. R-Value R-Value Glazing or Door U-Factor UA Ceiling I: Cathedral Ceiling (no attic) Wall I: Wood Frame, 16" O.c. Window I: Wood Frame:Double Pane with Low-E Floor 1: All-Wood Ioist!Truss:Over Unconditioned Space 440 522 76 396 38.0 21.0 0.0 0.0 0.320 12 25 24 10 38.0 0.0 COMPLIANCE STATEMENT: 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 ofhislher knowledge, belief, and professional judgrn~ch plans or specifica . ns ,are in compliance with this Code. n I., I _.... Builder/Designer U. Date~ _.-.--_._.------'--~--" -,.-.----;--r:,~---~~.--~- :-,~ '\ \ " i MM 2. 3 20U{ .. ,':, DONALD G, FEilER . ARCHITECT \ 11725 Main Rd. Box 1692. Mattituck, NY 11952.631.298.5453. Fax298.1380 I . , '-I -~'-,,-; ~'r>IOLD _I \ .'n' ........::~'..~-~fi~'7;,/-t-co, il' '.'-U.;;..',.--,,-,"~- -.,.)'. .---- Date ~. To ~O"it-\-6LO IDIJI N -=E::>u 1I...O'^,,6 Dpr. Re -DILL..E:'!2- :RES'~ ~LC ~ =&-JO I \J:>.u~ - Pages to follow ~ Ser-::::>' 'W-\ NT S / For your review ~ As requested _ Please call at your convenience . Comments: ~'P. NO' ". 37..110 Z _tzel t s\ 0 ~ "2. IN c..t..-u OS -JjoUSE. - .E:t....cC1~C ~I~~ Ib ~ \2.ei'U.PC€;O WI m N,b:r, G.~ ~Tl ~ ~ STeY1 J .~~E' NEW ~ ~ l' --/ 3 0 .1 f/ ( /2 t -!( Permit Number REScheck Complianc:e Certificate Checked By/Date New York State Energy Conservation Construction Code REScheckSoftware Version 3.5 Release 1 Data filename: C:\Program Files\Check\REScheckIDiIler Residence - Addition.rck TITLE: DlLLER RESIDENCE COUNTY: Suffolk STATE: New York HDD: 5750 CONSTRUCTION TYPE: Detached 1 or 2 Family HEATlNG TYPE: Non"Electric DATE: 02/15/07 DATE OF PLANS: 10/15/07 COMPANY INFORMATION: Donald G. Feiler - Architect COMPLIANCE: Passes Maximum UA = 86 Your Home UA = 79 8.1% Better Than Code (UA) Ceiling I: Cathedral Ceiling (no attic) Wall I: Wood Frame, 16" o.c. Window I: Wood Frame:Double Pane with Low-E Floor I: All-Wood JoistlTruss:Over Unconditioned Space Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor UA 440 30.0 0.0 15 420 21.0 0.0 18 102 0.320 33 396 30.0 0.0 13 COMPLIANCE STATEMENT: 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 Cons ction Code requirements. When a Registered Design Professional has stamped and signed this page, they are attesting that to the est of hislher knowledge, belief, and professional judgment, sucb plans Or specifications are in om liance. . s Cod :l.. / /J?-, I~.-, Builder/Designer Date~