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Home My WebLink About32221-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32788 Date: 12/14/07 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property: 60 ROGERS (HOUSE NO.) County Tax Map No. 473889 Section 66 RD (STREET) Block ~ SOUTHOLD (HAMLET) Lot 19.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 18, 2006 pursuant to which Building Permit No. 32221-Z dated JULY 19, 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 ADDITION/ALTERATION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to STEPHEN G & JOAN LATHAM (OWNER) of the aforesaid building. SUFFOLK COUNTk' DEPAR'I.'MBlIIT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 3012588 09/28/07 PLUMIlRRS CERTIFICATION DATED N/A Rev. 1/81 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 J'f'i, \ r~~ ~ ff,; ~ ~ W ~ i"' , j ,'--'1\ \ n 3> I~ ~ ~ ___' ----.-J L- ." ".u~ .~~!J1QI,-9-- 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 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 April 9, 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, Commercial $15.00 Date. ()<2,:3 ;(~07 , New Construction: Old or Pre-existing Building: Location of Property: to J:OGF es ~t4-b House No. Street ;C ( check one) S') 1.JT7..kJ L.. b Hamlet Owner or Owners of Property: S-n:::;oH'E A./ "t "'0 qJJ Suffolk County Tax Map No 1000, Section & {, Lit '77IA-H Block ..;? Lot 19. / Subdivision Filed Map. Lot: PermitNo_3..<..2"; I ~DateofPermjt. 7//1100 Applicant: :5~H2=,u L-9mA~ Health Dept. Approval: ~'___"__ Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: .X (check one) Fee Submitted: $ (O€w<fg 0~ 735)9 ~~~L~ , . Applicant Signature ",. - ~ - I q, I [!).[!) ~ 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 ~ ~ ~ ~ ROSLAK ELECTRIC S. LATHAM ~ ~ PO BOX 164 60 RODGERS ROAD ~ I CUTCHOGUE, NY 11935-2453, SOUTHOLD, NY 11971 I ~ Located at 60 RODGERS ROAD SOUTHOLD, NY 11971 ~ I Application Number: 3012588 Certificate Number: 3012588 I ~ Section: Block: Lot: Building Permit: BDC: n511 ~ ~ 302~~' ~ ~ Described as a occupancy, wherein the premises electrical system consisting of ~ ~ electrical devices and wiring, described below, located inion the premises at: ~ ~ First Floor, sun room, 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 28th Day of September, 2007. ~ ~ Name OTY Rate Ratin. Circuit ~ ~ ~~~~ ~ ~ Outlet 6 0 Fixture ~ ~ Fixture 6 0 Incandescent ~ ~ Outlet 8 0 General Purpose ~ ~ Receptacle 7 0 General Purpose ~ ~ Switch 3 0 General Purpose ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ seal ~ ~ ~ ~ 1 of 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 [!)~.[!) 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. 32221 Z Date JULY 19, 2006 Permission is hereby granted to: STEPHEN G & JOAN LATHAM PO BOX 595 SOUTHOLD,NY 11971 for : ADDITION & ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING PER ZBA DECISION #5904 AS APPLIED FOR at premises located at 60 ROGERS RD SOUTHOLD County Tax Map No. 473889 Section 066 Block 0002 Lot No. 019.001 pursuant to application dated JULY 18, 2006 and approved by the Building Inspector to expire on JANUARY 19, 2008. Fee $ 150.00 LCu~ / Authorized Signature ORIGINAL Rev. 5/8/02 3 J-2---2- ( ~ TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ [ ] ~NDATION 2ND [ [--1 FRAMING I STRAPPING [ [ ] FIREPLACE & CHIMNEY [ REMARKS: ~. S"-f7IJ ~, ] ROUGH PLBG. ] INSULATION ] FINAL ] FIRE SAFETY INSPECTION ~ INSPECTOR ~2-2--2-1 C TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] FOUNDATION 2ND [ ] FRAMING I STRAPPING [ ] FIREPLACE & CHIMNEY [ ] RRE RESISTANT CONSTRucnoN REMARKS: [ ] ROUGH PLBG. [ ] ~LATION [,1FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION ... DATE ~ P '/ () 7 INSPECTO 3222-(-2 TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1ST [] ~PLBG. [ ] FOUNDATION 2ND vrlNSULATION [ ] FRAMING I STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: ~!~ ~AAJ ~ 76 C~~'-- DATE I tic! oCe t I :3 2-2-1-1 &- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FO DATION 1 ST [] ROUGH PLBG. [ OUNDATION 2ND [] INSULATION [ ] FRAMING I STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE INSPECTOR '6 )'2--~/-t- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [~TION 1ST [ [ ] FOUNDATION 2ND [ [ ] FRAMING I STRAPPING [ [ ] FIREPLACE & CHIMNEY [ ] ROUGH PLBG. ] INSULATION ] FINAL ] FIRE SAFETY INSPECTION REMARKS: INSPECTOR DATE ~ . FIELD INSPECTION REPORT FOUNDATION (1ST) FOUNDATION (2ND) " ROUGH FRAMING & PLUMBING . INSULATION PER N. Y. STATE ENERGY CODE FINAL , '- . - c COMMENTS ~ L ,~. ~ ~'.d. ~ ./.....{ ') ~~ / / '// /\ 'l7~ 7 .~~ 7 ./ "'-~ /7 . ~ G'/l1hV-. filA .A '.'" dtf ~ ~.i~H"4..j/ XV_/' ~ " '''{ / 7\ I (//7;/ ~ / . JV ~~ j ....-,.Z /A~' /' t1 ~ r./ . T ~ UA'~. ~ () .... V..eu Q ~ 77 7'Z //,,~ d:_ ';','~r-. / j f ~ ~. ~.., ~./:f.\r~ ~ w~/ ,/7 ., A/,./ i ~ $0 lb . DATE gh.1.I/. '/ I . . I." . 117il?it, ...v... .,-:- of-- bJ ("".0. ~ V-./ I It'-j;?'/ ~y~ ~ (~~ . . Cfl; r1 ? ') ~ Ln. (L7 'I I 7 // cO'h~. cJ-. // / V . o~ .. - . )'l \.n7J/~ 'i/ / .. / / . ADDmONAL COMMENTS ,~ ~ ~ . " ~ ( 0 .. :E ~: " ~ S ~ I - ~ -..~ .:q ~. '-.., I ~o Z -c- := <-~ -.., ~; ~ . ." ~ -c- . . . . 07/14/2e06 16:12 6317659064 ZBA !"AGE e~ .. APPEALS BOARD MEMBERS RuUl D. Olivll, Cha.twOllWl Ge.rard P. Ooehringer Jame. Dini,io. Jr. Michael A. Simon Leslie Kanel Weilman Mailil'll Ad~~~: Southold ToWll Hall 5309Hfllin Road . PO. Box 1179 Soutbokl. NY 1197HlSl59 Offic~ T .l'\C'lltinn= Town Annex IFIrot Floor. N'ortll ForIe Bank 54375 Maln RI)Id (It 'Youngs Avenue) Soutllold. 'IY ! 1971 hllp:ll.oulholdmwn .norrhfork.nct ZONING BOARD OF APPEALS TOWN OF SOUTHOLD Tel. (631) 765-111011' fax (631) 7(\5.9064 FINDINGS, De~IBEiRATIONS AND DETe~MINATION MEETING OF JUNE Zg, 2008 ZB File No. 5804 - Stephen and JOlIn Latham Property Location: 80 Rog.. ltoad, Soulhold CTM 66.2.111,1 ('orme~y 18" 19) ~RA DETERMINATION; me Zoning Board 01 Ap~"11 1'118 v:slted thB property undel' consideration in this .~plication Bnd determine. that Ihla review fall. under the Type II category of the StaIB'. List of Actlona, without an edverss sWeat on the envlrDnment "the ~roject II ImlllemB"lBd as ;Jlanned, I"ROPERTY FACTS/DESCRIPTION The IIPPlieanll' 16,553 square foot IISreal Ie Improved w~h a two.story frsme house wilh IJlIIge !Il'1d pOrCh, II lnown on Juna 21, 1994 lUrvey, amandud May 12, 1995 by Roeerick VenTuyl.P.C. BASIS OE.m~ICATION' Buildin; Depsr1ment'a April 28, 200EI Notice of DisspplOval am,,"dtcI May 12, 2006, Cili'lg Sucllona 100.242A and 10()'244. In 111 cIlInlal of an app!loellon for a buldirlg perml to construct a prOlltlMd lIddltlon and alte..tlona to 8n existing dwelling, T~e r~ atated by tile Building Inapeetor I~ the d.,.,Ial Is t~at the eddltlon(s) and .lteratiOnl Df1 1hill nonconforming lot will incrllllBe the deg," of nonconlmllanca with reglrd to the reer yard le\tleck Df 31 feet Instelld of thl codel1lqlJlred 35 feel. FINDINGS OF FACT The Zoning Board of Appeals held a publiC hearing on lIlll appllc8tlon or. JUIlI 22. 2008, at Whic;h time written and oral evider.ce were pre..nted, Sattd upon ell IlIlItlmony, dOCumentation, perwonal Inlpactlo~ of the propart~, end other evidence, the Zoning Board findl lIle following facll to be true end ralevant: AREA VARIANCE RELIEF REQUESTED: The appllcana wiah to .nclol. a 396 aQ, ft, portion Of an exlatlr.g duck at ltIa relr of 1I1e dWell~l1. The I.!beck will not be elD81r than 31 fait ID the raer p'operty line and is shown or tha alta m'll prepared by F'aMy Lumber 5-6-2008. REASONs FOR BOARD ACTION: On the beall Of IlIstimony pr...nted. 'TIataria. submitted and pel'1lOOa' Inlpectioos, tile BoIIrd m... the foftowing ftndr.gs: 1 Grant of the varlarlce Will not produce an undesirable change In the chlrlCter of the neighborhood Of a detriment to nearlly propel1lel. Thie addition Is a fIlI.lr to endoaa an op.n 1IplICl8 (ClICk) \\tI1eh _ g..n*l by 111. Zonll'lQ Board r:JI Appeals unCle, Fila -"219 end 1Il4315. Thalll1ClDMd IIddldon wi. not extend,...",., Into the frtlnt yurd ancI Will maintain the same 31'I!l" setbllck that hal txlatltcl over the years. 2, The beneftt soUltt by !he ep~licants Cln'Iot be eChleved by sCll'I\e method, feeaible fot tha a"olleents to pursue. other than en ar. val'ilrce. The hol'\18ls p'e.antly set beck 31'S"ro.'1l lI1e rlIIIT lot line, 3 Tn. variance granlad "arein Is not .ubslential. Tha appllcanll request Is minimlll. ~7/14/2~e6 16:12 6317659064 2M PAGE 02 ~ . Page 2 - JUMe 29, 2008 ZB File "10, 61lO4 ~ SlIopI'Ietl & Jo'" 1.8"'.m CTM No. 86-2.19.1 4. Th. difficulty hll been self-atlllled Ilnee the setbacks hlv' remllned nonco~formlng.t 31 '6. 5, No evidence hes bMf' submitted to suggelt tIlat 8 verllnee In tIlll resldll'ltlal community will heve In adverse impeet 011 the physical or environmental oonlltionlln the neighbort'lood. S. Granl of the ,.q1ll8l8c relief is the Minimum 8CtiOn _ry and lIdequata to _bit the epplicert III enJoy the benefit of en enclosura (lddIllOll). while ,:lfllerving and protecting tI'l. dl'llIder of the neighborhood end Ihe h.allh, IIIfety W1Cl wel1llra Q/ the community. BEiOLUTION OF THE BOARO: In con,idering III of the lbove fectors and epplyinr; the 111l8nclng tesl under N_ York Town Law 287-&, IIlOtion _ offered by Member Goehring.r, _ded by Member O'JvI, end duly CII'I'IId, to GRANT the veriance a5 applied for. 8S shown 011 the 1_ plll'l "'lIP d. ~y 8. 2OO~C: lIhown on Ihl conltruction dlagrlm ,:lfI,:llfld 2-2-2008 by ~enny L~mblr. ~ Any dtvlltion from the vlll'illnce gillen audl as exte'llionl, or dlmolltlona whieh Ira nOl ahown on Ihe eppllcanfl dl.graml or WrYly ,Ita mlf)S, ... not IUthOriZIC! under III. ePf)'i~lon when involving nOnconformillle Ul'ldeI tll. zoninG code. Thil acllon doe. nOI 8\:ti'lOl'lze or condone any currant or future UN, setbllCk or oltlet feature of tha IUbjec:t properiy thai may violete the Zoning Code, Oilier then IUoh Ull8ll, IItblClCe .nd~" fIIlll"" lI.ra 'XI)r.llly IcldrI8,ecl in thIS ectton. Vote of the Iloard: Aye" Members lII8 (CIl8lfwQmCln). Goehrlnger. Oinlzio. and Simon. Abtenl was Member Welemln. Thla ReeoMion _ opr.c (~). Ruth 0 Olive 7114106 Approved for Filing .-";' .j ,~-..;'''-.' . ~--:-~ - . 1 ,'" '" '\ 'b I.t "- 'lit -______.'.~_t""--,..............,--~,..-~~-:.:::::-:''''..-- ',-'. ,"} 6 i'+.o ,..... .-..'"""\ \ I>l \j.) ~;z.o Or.z..OEa ' ..~ ,ltt4-f;'-4fJ. ' N.4 . ',' \' ~, N ~ 0. @ "'i~ ," .. '() ~'C::, o . li' $.6r:rZ0'4Cw." 1/t6.() _.' , \ J' " ~ " ... Q. ..,. -~ ,~.' ..e. Q ~O .-.'-, _.,- (iJ ~ ,- ~. ~a"rdonoriclctilbt folhllaurwylsavlolatlonof ~7208ottheNewYorkSllte Education Law, Copies of this survey, map not beamg the, Il!lnd surveyol'S inked HlI or . embossed .,nl not be conaIdMd ~. /;,10 be ~ valid true copy. :. :..'.<' ~uaram.es'lndIi:md"""""ahalINn OJ:' ~,. onljtolhe j)nOn.forVlhom Ihe~ to; .prepar8CI...ctonhl8behalftothe ...---"'-.... t \'_lilI'Ka'lglndudonlllttidheraGnlftd ;,10................ -- ',-,' tutIon. GuaIWIIeeI.... noIl!_.A.MI ',,'ito:actCDn.I ~ oraubllqulnl J\~ ;t." '!.-:,:. ~ \ . -. " ('- 'z) !. 'd'm. -. --~a ~18 >"at -..1 14....",.R> ~. . :4" h-f,.":tP QP ;:.~'('. o Pi::: P' i' 'or' ~__..~. - '4'_"~"_""~_ "'_'''.''-''''.'~''''''''_' ""_ S'(,/*,,~v,-:' 'r'e () ~::: O>.€. SrCZPHE,\/ LAJ'HAtv1 -~~~ .~.-,- _.._......_,.,--..,..---...~ ...-- ..'...-...,.~-~-. -..----+-- SaV7'J-Iol..o. N., ~< .:.---.---....--....... ..~---------.- ._-----~-- $vffc/L ca,tmiy rtilX PCl,..:~i.s It>OC - 0" ~ Z - 111.1 (9 :;'i.:-ni" I:ltUVDer", ;'f!u;uvn r4f~r foo ...IfJ.!C(;i/:.4-i;Jff '~M12~ o/86/XfIl.:;l>:lH .~>...~t,,::t'I"4s,'ut'/~4 "" Jt.!/fnlJ(. cJ(). ,:/:<i;krt'$.cfft(;f4 4~ ntd1? t1('U'/7Z.. \ ",~ "I1'JQIUI!fttZ nt- . '(3 '" pflu , .' ...._.~.~~-r-.---..,..,"l">"'-:..,':~.,.,...... :._-._......r-_ .1r ~ r: ..-:, /..-s': 40":: /" Q.........-.f:.;Jt- -.... ----- ~_.--. .. '~ . '~ l:) ~ C ~ G\ W '" e ~ ~ . ~ ?\j ~ () ~' ~ :b \J ! - , '1-'3B'~ j I I I bP N:ilt.' nw..p A.MEt..U)fEP' A.PR; 17..; ~~ .. . ""''1'12.__ ~ (r0-;--;rr}' Sttrye ge l'i JUI1 e "".:?/..19f-t L '7 Ie 4>detift:J;,vcrll'JI!:..!,;;kC. (1"" fr ./it'. V'. .. .'. " . ~, L/~C;~4~.:~1~;.~~~~p~.f .$ ~..../;.,'rl,. ^'~ ,'>;',: , . [-, 1 _,"k' 't._ ~'T"._~_...,... ._..-".._ "'Of~~-",.,_" -...-_...-... ff .~-.......~.~,. "ll -' PERMIT NO. 3,);),)/ bs' BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the followng, before apply!' ? . ng. Board of Health 4 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: TOWN OF SOUTHOLD ... BUILDING DM>ARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www.northfork.net/Southoldl 7!i9 ,20~ ~fi1rO~ I / If/I, 20f2L Examined Approved Disapproved ale ~ Mail to: , , \. c Phone:/"""; . ~(,. 0 I Expiration , BUilditn~ c ,. , , ~~Vt6 ~ J): '. . I....y~ .. . it. 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 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. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance ofthe 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. , 0 ,L/<~ . ,:' (Signature of applicant or name, if a corporation) " v' !J.t), b~y: ~ -'s;O TJIoI.-O AI ( ailIng address of applicant) APPLICATION FOR BUILDING PERMIT Date ~o ,20~ INSTRUCTIONS State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ()OJ)JG!2... Name of owner of premises .5iz--;1<7/'17;'AI -< .,.J6r/V L ft77-lM--( (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. 6,41 ckE~ AU/~Dt.7eS Plumbers License No. AI / f/ Electricians License No. /:!oSEL...4t<. Uc(l,Tel(V Other Trade's License No. Ai / A I. Location of land on which proposed work will be done: to ~GEe5 ~~D House Number Street -:5D uT1fcJ u-:J Hamlet County Tax Map No. 1000 Section Subdivision f;t Block ,tl , Filed Map No. t Lot Lot o < (Name) tmg se and occupancy of pr ises. and intended use and occupancy of proposed cOnstru~tion: 2. State exis . " a. Exi~il1g use and occupancy "l Intended use and occupancy. 1!G""5I?),g--/J(l. (..,= , 3. Nature of,work (check which applicable): New Building Repair Removal Demolition Addition Other Work x . Alteration " ; 4. Estimated Cost ~~5'v--rJ--O - (Description) Fee . _ 5. If dwelling, number of dwelling units If garage, number of cars 0<. I (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 f.., f Height Number of Stories df Dimensions of s?me structure with alterations or additions: Front ~ of Depth ij:Z2 Height Number of Stories Rear ~'I Depth /0 Rear ;: I ~ 8. Dimensions of entire new construction: Front .2 .)... Height Number of Stories / Rear ;2~ Depth i If' 9. Size oflot: Front /3).. ;27 10. Date of Purchase 1.1i7 Rear /,;27 Depth,.er /3/,~.r;- u= 1/&. Name ofFormer Owner ;./0 eH /h.J II /;LL./~ 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO L 13. Will lot be re-graded? YES_NO L Will excess fill be removed from premises? YES L NO_ 14. Names of Owner of },lremises.S/TII tv-JO.9IJLA.7JfA-r Address ~6"fP ~<.J7Joh"l> Phone No. 7t-~ --3 <a <:) ( Name of Architect f'EN,v~(/ ~.e AddresiflfllJ f)tf$l )/h":" Phone No J./17 - 0 </" 0 NameofContractor6fy -'CK. ;'L.I')E.e-s. Address~o)/'t.o..2 @o~PhoneNo.""'" 73./- fa'2.70 -AJy M3~ fa3/- 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.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 OM-OLt..) -J04-A.J L /f 711 ~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the 6w)j~C- (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. 2066 ~~ I Signature of Applicant MELANIE OOROSKI NOTARY PUBLIC, State of New '!llIlc No. 01004634870 Qualified in Suffoik County "-i\l'\b Conunission ExjJires September 30~ FLOOR SPAN TABLES Not all products are available in all markets. Contact your ilevelrepresentative for information. i I I I Ll rill" 1r I 9W VB" 11118" 14" ~ TlI@ 110 Joists Ll IW t r25/16" L/480 Live Load Deflection Depth we 40 PSFliveload/l0 PSF Dead Load 40 PSF Live Load /20 PSF Dead Load 12"0.c. 16" D.C. 19.2" D.C. 24"0.c. 12" D.C. 16"0.c. IS.2" D.C. I 24" D.C. Sv,- 110 16'-5" 15'-0" 14'-2" 13'-2" 16'-5" 15'-0" 13'-ll" 11'-5" 230 17'-8" 16'-1" 15'-3" 14'-1" 17'-8" 16'-1" 15'-3" 14'-1" llO 19'-6" 17'-10" 16'-10" lS'.S"1ll 19'-6" 17'-3" 15'-8" 14'-0"11) ll1f." 230 21'-0" 19'-1" 18'-1" 16'-10" 11'-0" 19'-1" 18'-1" 16'-3"111 360 11'-ll" 10'-ll" 19'-8" 18'-4" 21'-ll" 10'-ll" 19'-8" 17'-1O"m 560 16'-1" 13'-8" 11'-4" 10'-S" 26'-1" 13'-8" 11'-4" 20'-9"(l) 110 11'-1" 20'-3" 18'-9" 16'-9'01 11'-8" 18'-9" 17'-1"111 14'-]"(11 14" 230 23'-10" 11'-9" 10'-6" 19'-1" 13'-10" 21'-8" 19'-9" Il'-1"m 360 16'-0" 13'-8" 11'-4" 20'-9"11) 26'-0" 23'-8" 22'.4"[1) 17'-10"11) 560 19'-6" 16'-10" 15'-4" 13'-6" 2S"-6' 26'-/0' 25'-4"m 20'-1l"l\) 230 16'-5" 14'-1" 21'-9" 20'-]"(\1 26'-5" 13'-1" 2I'_2OIl) IT-I"m 16' 360 28'-9" 26'-3" 24'-S"(]) 21'-S"W 28'-S" 26'.3"11l 22'.4"11) 17'.lo"m 560 31'-8" 19'-8" 18'-0" 25'-2'01 32'-8" 2S'-8" 2G'-3'm ZO'-l1"m t W I L/360 Live Load Deflection (Minimum Criteria per Code) Depth TJI~ 40 PSF Live Load /10 PSF Dead Load 40 PSF Live Load /20 PSF Dead Load 12'D.C. ill" .~ IS.2'D.C. 24"0.c. lro.c. 16"0.c. IS.2"D.C. I 24" D.C. 9V2" 110 18'-1" 16'-7' 15'-3" 13'-8" 17'-8" 15'-3' 13'-ll" 11'-5" n30~" 19'-7" 17'-ll' 16'-ll" 15'-9" 19'-7" 17'-8" 16'-1" 14'-5" 110 11'-7' 18'-ll" 17'-3" IS'_SOIl) 19'-ll" 17'-3" 15'-8" 14'-O"W 11V." 230 13'-3" 11'-3" 19'-ll" 17'-9" 23'-0' 19'-ll" 18'-1" 16'-3"(1) 380 15'-4" 13'-1" 11'-10" 20'.4"11) 25'-4" 23'-2" 21'-IO"m 17'-10"(\1 560 28'-10" 16'-3" 14'-9" 13'-0" 28'-10' 26'.3" 24'.9" 10'-ll"11I 110 13'-9' 10'-6' 18'-9" 16'.9"(lI 11'-8" 18'-9" I7'-1'm 14'-]"m 14' 230 26'-4" 13'-9" 11'-8" 19'-4"(1) 25'-0' 11'-8" 19'-9" IT-I"m 360 18'-9' 16'-3" 24'-S"1l) 21'-5"11) 28'-S' 26'-3"(1) 22'.4"1ll 11'-10"01 580 31'-8" 19'-9" 18'-0" 25'.2"(1) 32'-8' 29'.9" 26'-3"(1) 20'-11"(1) 230 19'-1' 15'-5" 13'-1" 20'.]"01 26'-S' 13'-1" 21'-2"11) IT_l"1l) 16' 360 31'-10" 19'-0" 26'-10"(\} 21'-S"1l) 3/'-10' 26'-10"(1) 22'.4"11) 17'-1O"m 560 36'-1' 31'-ll" 31'.0"11) 25'-2'01 36'-/' 31'-6"(IJ 26'-3"(1) 20'-11"(1) ~ 9Vl 1IVs" 14' 16' ~ TlI@ 230 Joists Ll ll\" t r2Y16" long term deflection under dead load, which includes the effect of creep, has not been considered. Bold italic spans reflect initial dead load deflection exceeding 0.33", mWeb stiffeners are required al intermediate supports of contin 1I0lls-span joists when the intermediale bearing length is less than 51A" and the spall on either side of Ihe intermediate bearing is gr eater than the following spans: TJliII 40 PSF Live Load /10 PSF Oead Load 40 PSF Live Load /20 PSF Oead Load 12'D.C_ I 16' D.C. I IS.2' D.C. 24"0.c. 12' D.C. I 16' D.C. IS.2" D.C. 24"o,c. 110 N.A. N.A. N.A. 15'-4" N.A. N.A. 16'-0' 11'-9' 230 N.A. N.A. N.A. 19'-2" N.A. N.A. 19'-ll' l5'-I1" 360 N.A. N.A. 14'-5" 19'-6" N.A. 14'-\, 20'-4" 16'-3" 560 N.A. N.A. 19'-10" 13'-10" N.A. 19'-10" 14'-10" 19'-10" How to Use These Tables General Notes I w IlVs" 14' 16" ~ 1. Determine the appropriate live load deflection criteria, 2. Identify the live and dead load condition, 3. Select on-center spacing. 4. Scan down the column until you meet or exceed the span of your application. 5. Select TJI~ JOISt and depth. live load deflection is not the only factor that affects how a floor will perform. To more accurately predict floor performance, llse Ollr T}-Pro"" Rating System. . Tables are based on: - Uniform loads. - More restrictive of simple or continuous span. - Clear distance between supports (l %" minimum end bearing). . Assumed site action with a single layer of 24" on-center span- rated, glue-nailed floor panels for deflection only, Spans shall be reduced 6" when floor panels are nailed only. . Spans generated from ilevel'M software may exceed the spans shown in these tables because software reflects actual design conditions. . For loading conditions not shown, refer to software orto load Iableson page 5. TJI@ 360 Joists Ll IW t r3Vl 4 I 11l6' llW 14' 16' ~ 4 ilevel Trus Joist' TJI' Joist Specifier's Guide TJ-4002 April 2006 TJI@ 560 Joists