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Home My WebLink About32098-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32975 Date: 04/14/08 THIS CERTIFIES that the building ADDITIONS/ALTERATIONS Location of Property: 290 MIAMI (HOUSE NO.) County Tax Map No. 473889 Section 67 AVE (STREET) Block 6 SOUTH/PEC (HAMLET) Lot 15 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 12, 2006 pursuant to which Building Permit No. 32098-Z dated JUNE 12, 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 ADDITIONS & ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to SEYMOUR & FRANCES BROOKS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 2032552 10/04/05 & --- 86340C 06/14/05 PLUMBERS CERTIFICATION DATED 07/20/05 PAUL K. SWEENEY ~ed~ Rev. 1/81 . . Form No. b TOWN OF SOUTHOLD HUlI,DING DEPARTMENT TOWN HALL 765-1802 JUL20 7 APPLICATION FOR CERTIFICATE OF OCCUPANCY -.-..j rhis application must be tilled in by typewriter or ink and submitted to the Building Department with the tllllowing: A. For new building or new use: I. Finat 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 electricat 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. H. 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 J. Certificate of Occupancy. New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $2500, 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 Certiticate of Occupancy _ $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00/ Date. I /7k7 New Construction: Old or Pre.existing Building: --\:-- Location of Property: 2. "f(t) mlA-/'Y7; AY'-t: House No. Street Owner or Owners of Property: ~e1 /77' liT "t- Fk IhUc!..c'S Sut1'olk County Tax Map No 1000, Section 473'iJ%7 /l:) tdJ Block I ( check one) FeCt'J Nt' ~ Hamlet Subdivision ~~OE)k:'i &)~t; Lot Olr- Pennit No. -3. Q D ~ f ;c Date of Permit-d0N-e Ilealth Dept Approval: Filed Map. 0-, ~CApplicant: , Lot: SeY/hfIJO r "l3r&>& Js Underwriters Approval: Planning Board Approval: -~~--- Request for: Temporary Cel1iticate .. Final Certificate: +- (~)2 Applicant Signature Fee Suhmitted: S ~S, 00 ~lI.C./tj )/1 Ccl-z.. ".2i7S 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. 32098 Z Date JUNE 12, 2006 Permission is hereby granted to: SEYMOUR BROOKS & ANO 605 7TH STREET BROOKLYN,NY 11215 for : ADDITIONS AND ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. THIS PERMIT REPLACES BP 29932. at premises located at 290 MIAMI AVE SOUTH/PEC County Tax Map No. 473889 Section 067 Block 0006 Lot No. 015 pursuant to application dated JUNE 12, 2006 and approved by the Building Inspector to expire on DECEMBER 12, 2007. Fee $ 468.30 .--,.-- ORIGINAL Rev. 5/8/02 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT PERMIT NO. (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) -k_'J3.:l C '(6 29932 Z Date DECEMBER 10, 2003 Permission is hereby granted to: SEYMOUR & ANO BROOKS 605 7TH STREET BROOKLYN,NY 11215 for : ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 290 MIAMI AVE SOUTH/PEC County Tax Map No. 473889 Section 067 Block 0006 Lot No. 015 pursuant to application dated DECEMBER 10, 2003 and approved by the Fee $ 468.30 Building Inspector to expire on JUNE ORIGINAL Rev. 5/8/02 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ I Located at ~ Application Number: i Section: 067 Block: ~ ~ ~ ~ ~ ~ ~ ~ - ~ - ~ - - - - - - ~ - - ~ - i lil~ ~~~~~lil ~ - ~ - - ~ ~ - ~ ~ ~ - - ~ ~ ~ - ~ - - - ~ - - - - - ~ ~ - - - - - - - - - ~ ~ - mJ ~lil BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by PECONIC ELECTRIC CORP 2195 STANLEY ROAD MATTITUCK, NY 11952, SEYMOUR BROOKS 290 MIAMI AVE PECONIC, NY 11958 290 MIAMI AVE PECONIC, NY 11958 Certificate Number: 2032552 2032552 Lot: Building Permit: 29932 BDC: ns11 0006 015 Described as a Residential 600-1199 square ft. occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Second Floor, 2nd floor add., 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 4th Day of October, 2005. Name OTY Rate Ratin. Circuit ~ Alarm and Emergency Equipment Sensor Appliances and Accessories Exhaust Fan Wiring and Devices Outlet Fixture Outlet Receptacle Switch Paddle Fan Receptacle 3 0 Smoke 1 0 F.H.P. 1 0 1 0 19 0 14 0 9 0 3 0 1 0 Fixture Incandescent General Purpose General Purpose General Purpose GFel 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. Electrical Inspection Certificate Issue Date 6/14/2005 Electricallnspeclion Service, Inc. 375 Dunton Avenue East Patchogue, New York 11772 (631) 286-6642 Application Number 86340C Issued To: Street: Village: Section: Brook 290 Miami Avenue Peconic Block: Zip: 11958 Lot: Town: Southold Contractor: P. O. B. Electric Inc. Lie. # 4473-E Was examined and found to be in compliance with the National Electrical Code. Commercial NV Defects ~ Residential Det. Garage ------- Switches Receptacles 26 210 Dishwasher Washer/Amps 1/20 1 20 Furnace Oil Gas 1 X Meter Amps Phase UG/OH 1 100 1 ' 'x Pool ,)(, 1s1 Floor ix, Indoor Basement Attic i>l 2nd Floor II Outdoor I"i Addition Hot Tub Su rvey _____.._n_ Fixtures GFI Heaters 28 6 Dryer/Amps Oven Range/Amps 1 30 1 40 Circulators Smoke Detector 2 2 Jacuzzi Television AlC Fans 1/30 Microwaves 1/20 Bell Transformer CO Detector 2 Bldg. Permit: Other Equipment 11100/226Vmain 11 20/220V well 11 20/120V air handler u__m__1 I(~~; Hugo S. Surdi President Rough Inspection: 04/08/2004 Inspector: John Me Mahon III Final Inspection: 06/09/2005 Inspector: John Me Mahon III This certificate must not be altered in any manner. Inspectors may be identified by their credentials. I I I ; ; I ; ; ; I ~ Located at I ~ I BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by ~ ~ ~ ~ ; ~ ~ ~ ~ ~ ; ; ~ . ~ ~ ~ ~ ~ ~ I I ~ ~ ~ . . ~ I ; ~ ~ ~ ~ ~ ~ I ~ 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 4th Day of October, 2005. Name OTY Rate Ratin. Circuit ~ Alarm and Emergency Eqnipment Sensor Appliances and Accessories ~ Exhaust Fan ~ Wiring and Devices 1m Outlet ~ Fixture ~ Outlet ~ Receptacle ~ Switch I Paddle Fan I Receptacle ~ i I ~ PECONIC ELECTRIC CORP 2195 STANLEY ROAD MA TTITUCK, NY 11952, SEYMOUR BROOKS 290 MIAMI AVE PECONIC, NY 11958 290 MIAMI AVE PECONIC. NY 11958 Application Number: Certificate Number: 2032552 2032552 Section: Lot: Building Permit:29932 BDC: ns11 Biock: 067 0006 015 Described as a Residential 600-1199 square ft. occupancy, wherein the premises electrical system consisting of eiectrical devices and wiring, described below, iocated in/on the premises at: Second Floor, 2nd floor add., 3 0 Smoke o F.R.P. 1 0 1 0 19 0 14 0 9 0 3 0 I 0 Fixture Incandescent General Purpose General Purpose General Purpose GFCI seal I 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. ~ '''11, $309$ Maltl RoIld P.O. Bole 1179 SovdleId. ~ York 11971./l9S9 Fu: (631) 765,1823 T~ (631) 76S.tllOZ BUILDING DEPARTMENT TOWN OF SOl1rHOLD CER TIFICA TION Date: 7 10 hoos- I ' Building Permit No. ~CI.'1~~1- i-k. \-~:..l.l"I'b Owner: ~~)\ \\ Yi(C~ ~[()'?~ (please print) Plumber: tv' I'. <;:EEPE'-/. (please print) / I certifY that the solder used in the water supply system contains less than 2/10 of 1 % lead. ;21 t s-P (plumbers Signature) Sworn to before me this !to day of~j Icf DEBORAH A. NICOLA Notary ~~~{~~J8~6~r Yoc1l qua.lified i~ Suffolk Couh 19\J6 20 IDI;. CommlsslOII Expires Marc . _ 3~D~V -Z- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING I STRAPPING [>( FINAL [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION ~~~~ . ,;,a, /J""';- _ // .j- ~, ( DATE 7~b-1J 7 . cn--- ~ INSPECTOR ~~ ~~, /1 --:")' c \ 'L.c'/1 :J' 1..1 '-, ~{1J(f-.z TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [] ROUGH PLBG. [ ] FOUNDATION 2ND [] INSULATION /f~ [ ] FRAMING I STRAPPING j/{FINAL ~ [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: ~ if~ if- ~~ r~ + .J .. ~~ ~~~~f2'~~~ (~ ~~~)7~~o;f DATE ) )-/ v=- oS INSPECTOR ~~. - ~, //-< , )-'\1)1- ') ---:'~F (I ~.<) /.-- /'.\' 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1 ST [] ROUGH PLBG. [ ] FOUNDATION 2ND [] ~SULATION [ ] FRAMING [v{ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: ~o ~I LJ.-t, ~ // ~ DATE INSPECTORJ:,trtAA iillii JSf~3 2- ~ ) ,). ,--' Cj ls I <:l /'-- 765.1802 BUilDING DEPT. INSPECT ON ROUGH PlBG. ] INSULATION ] FINAL ] FIRE SAFETY INSPECTION [ ] FOUNDATION 1 ST [ [ ] FOUNDATION 2ND [ [ ;F~NG [ [ ~REPLACE & CHIMNEY [ REMARKS: DATE f:o (9 ((J r t t INSPECTOR d-f932-C H-l-) ") ^ ( I - I 765.1802 BUILDING DEPT. INSPECTION [ ~GH PLBG. ] INSULATION ] FINAL ] FIRE SAFETY INSPECTION [ ] FOUNDATION 1 ST [ ] ~DATION 2ND [ [P(F~ING [ [ ,{FIREPLACE & CHIMNEY [ "" DATE d9J/1 3 U- ~,' ~j).. c) ~ 765.1802 BUILDING DEPT. INSPECTION [ ] FOUND ION 1ST [~H PLBG. [ ] FO DATION 2ND [] INSULATION [ =.FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION DATE -5 It) /0 'f I { INSPECTOR dq73 RJ- k, 1 -3 '), c) ,) L 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL / vJ~!)! '[. S' ~ ~~fl~ [ ] FIREPLACE & CHIMNEY ~- Ak; DATE . ~ /'09/ () f INSPECTOR )9{\ j ~ J).-c c) '>s r L,' 765-1802 BUILDING DEPT. NSPECTION [ ] FRAMING [ ] FIREPLACE & CHIMNEY ~ ~~;L-r; [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL or- / DATE jujer: INSPECTOR ~ DONALD G, FEILER . ARCHITECT .' . 11725 Main Rd . Box 1692 . Mottiluck. NY 11952 . 631-298'5453 . Fax 298, 1380 , " August 14, 2007 Mr. George Gillen Southold Town Building Department Southold Town Hall Main Road, Southold, New York Re: Additions & Renovations to the Brooks Residel1ce 290 Miami Avenue. Peconic, New York BP # 29932Z Dear Mr. Gillen: In regard to the above mentioned project, I can certify that installation of insulation and the pressure tests of waste & water feed was done in accordance with and conforms to the requirements of the Residential Code of New York State. , . . . .~orz~ Jto;{dtt:;vc: $e(!8 PROFESSIONAL ENGINEER 1725 HOBART ROAD I PO Box 616 SOUTHOLD, NEW YORK 11971 TEL: 631.765.2954. FAX: 631.614.3516 . e-mail:joseph@fischetti.com Date: March 3, 2008 Reference: 290 Miami Avenue Southold Building Dept PO Box 1179 Southold, NY 11971 Dear Sir, Bwoh..FPcc11_,h>l;X . ' .J~N~ AND SON, INC. PrOfeSS~DV'v~L ReV\.1..0c;jeLi.VLg - CustOVVl "E'>uLLdL/I'_g TeV'~ wLLcox ,AvelAue - SuLte ::: Cejl\,ter MovLcVies, I'-IY 11}34 b31-R.TS:-$?06:2 Tel. C,31-R,TR-4942 FCJx December ]4, 2007 Town Hall Bui]ding Department P.O. Box] ] 79 Southold, NY 1]97]-0959 Re: Building Permit #32098-2 Dear Sir or Madam: My firm contracted with Seymour and Frances Brooks to construct an addition to their home at 290 Miami Avenue, Peconic. The construction included the installation of a Lennox, Direct Vent, Spectra Aeries (Mode] #LSS-40CP), propane fireplace. In support of their request for a Certificate of Occupancy, I can attest to the fact that, under my supervision, the fireplace was installed as per the manufacturer's specifications. Should you have any questions, please fee] free to call me at the number listed above. ~ .' . .- FIEtD:iNsPECnON Rl!:P.6Irt. DATE m H>>/i.I(~ , FOUNDATION (1ST) -,- FOUNDATION (2ND) R.OUGH:ilR .NJ!oTG &: PLUMBING '. lNSlJLA.TION:Pll:R.N. Y. STATE~COJ)E .j FINAL - Lf-2/-0'\ [" M . ," - . - . ':~ . . coMMEl'fi'S . ~ d. ~_ .'.../.-/ I ~ , 11 ~(^~ . ~-L_\~ 'N~/' .,~ t ~ ~ ~ .-" ,_. . J L . / A' .~_v-y or/ P' J . 2: . ? 1(1 111 ( /-h' ~... .-7' /. T:iL,'" (d;'/".J. . <, P ,. /'( 1 ./oJk.z.. '" I; ~rT fAJ... h_.LJ kD .., ' / /I /.' >' /iJ'lh:; ~ ~ .~//tJ) lio- ~ ....) OJ- ,d 7 ._fA'.. -.I. ....f> ; r / ''/~...A.d '....r-/./~ ./" t: ... " / 'J A j /1/ ., ......./ / ~ I L17~)p 1(<(' L / / ~ R7' /. -<1- '/~./... ' I (, r(L""..1T c.1:-{ 1/ H 7f . /J.R~./ "/ II / 7/ ~~ / ./ t'/t?/p~ O. ./.7:' f M n..~ a< . (J 'f (' '. . . ,;....'...../. ---- / _ 4....l A/. ./ ~ '/.' Jl...n /. ~rv- _h/ .' l/) / /'. / ~. I / 1/' '> 1? .~ /' , ) ~ ... '" / ~~ 1''//3 ~;, NO ACC.n"r l~) 1'1-1-10,'" ,'r;, !...Ii. c.e--..t:, h A7i 1 A'. ;-~ 1-1;;-,.,1 , fIf- ~ d- ~k..e. .' A.._ "'~... ~~ J J.I.... A'P_ .A rI--' 17. .. J .=h.. -/. ~ . .\ ~ ~ ~ .A'; A A~~' . ....~ 7F ,_ ~ , ~ . . ~ ~4 d/.v..'~ .1l..J-, ,; A/AA./ '. ~ ~'JC> (' . ''7-~ 0 j::::'~..Q ~ olr. i:::'''~"l...''V /J.l CMl-11J~\J. H/l,.} I(J! ",.,.,r;y...".",-Z..A , '. ~. .....J .. .7';.rlor . If AJ)J)mONAL COMMENTs' , . ~/ ','WI ~A..J (TA ".".- . ., v ,.., 12 ~ f/) . " . ~ ~ "". !/ ~ . " ~ "\ . ~~v I<fj" ~ V > ::3 I\vtz j -- ., . ~ -:....- I i ~ -.. -::-. - '- "" '---- OWNER -IS TOWN OF SOUTHOLD PROPERTY RECORD CARD STREET 2- Cf D VILLAGE DIST.. SUB. RES. 2- 10 LAND AGE NEW FARM Tillable 1 Tillable 2 Ti liable 3 Woodland Swampland B rush land House Plot Total - SEAS. IMP. ,5"... ./ 'J.-Fo-o I NORMAL Acre N S VL. TOTAL DATE 2- (r1J / .3 5tT"O I BUILDING CONDITION BELOW ABOVE Value Per Acre Value - /I lie . fJa4e, E ~. . ~c;.... LOT: , c: Ie) 1-, . :!VA,..~.;~. "__. CR. .,.iSJ. TYPE OF BUILDING W ~. ~- COM~ CB. MISe. Mkt. Value REMARK~ FRONTAGE ON WATER FRONTAGE ON ROAD DEPTH BULKHEAD (!7~7." DOCK -- -,- , ~ .~ i: ~,:'~. ',' ~;;' ,:', \ )/;41; , ~~/,. , , ; '.,l :'j " ' .' y ar"., , COLOR " '.... ...." . '" \'. .' ','i t.. : )')~f ' .... ",' ~ v" , ,~ . , , - , . ( TRIM 8,,1....... , ' L - , i ;; i i , 1/- ! M. BJile5[ ..:l C,< 34 -' 9..3t ..3~ ].-f'dI Foundation pC, Bath / Dinette Extensio~ Basement - Floors {p- IA;. K. ( - Extension Ext. Walls J./ .<:.. Interior Finish <)', ,( LR. I Extension Fire Place , - Heat "1-iU/ DR. Type Roof Rooms 1 st Floor BR. 'J,. Porch Recreation Roan Rooms 2nd Floor FIN. B. Porch Dormer Breezeway Driveway Garage , Patio t O. B. , ~g Total >" " \., T (JWH OF 'OU1110LO BUILDING DEPARTMENT TOWN lIALL SOUTHOLD, NY 11971 TEL: 765-1802 tlUij..,JJ!.NU t'b1<MH AJ:'1"WCAflUN CliliCKLlS' Do you have or need the following, before applying Board of Health 3 sets of Building Plans Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: tcN~ tel L6l'L fo eo~ I 1.. (Y) A. m i'VC-I'- cS~54S3 -0 ),-- Cj li-2 PERMIT No.Ji 1'~ z-- r; Examined {;{IO J ,20_ ,20-1- (0 Phone' ~ ')(\~ Building Inspector \ . , . . . A~PLICATION FORHUlLDlNG PERMIT J Date - - INSTRUCTIONS 12/10 ,20 6'; . a. This application MUST be completely filled in by iypewriter or in ink and submitted to the Building Inspector with 3 sets of plans, accurate plot plan to scale. Fee according to scnedule. . .. b. Plot plan showing location of lot and of buildings ?n'premises, relationship to adjoining pre~ses 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 througho\lt'the work. e. No building shall be occupied or used in whole or i!l part for any purpose what-so-ever until a Certificate of Occupan is issued by the Building Inspector. APPLICATION IS HEREBY MADE to the Buildi.ng 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, oFaIterations or for removal or demolition as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, sing code, and re lations, and to admit authorized inspectors on premises and in building for nece~sary inspections. (Signature of applicant or name, if a corporation) fb ~~ l ~'1'2-- vYJ/:>.. ~ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ,&RCJt\-1 \~ Name of owner of premises 5EI.f mo.J~ ~. ~ ~Ot::.S (as ?n 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. p~ N(, Plumbers License No. ~. Electricians License No. k Other Trade's License No. ~ I. Location of land on which proposed work will be done: ~c:;O I"YlIAm/ ...~ue House Number Street PeeD"'I'- Hamlet County Tax Map No. 1000 Section Subdivision fe,.., . Block G, Filed Map No. JIIimllM.f !~g """"" '0 sl~!~ "1,,,'1''''''''' tl~uo:l ~j;)llut ,m~m'. c: 'J .~" -r:or 01, t t1f'\;9'iijtl '''''' Lot (Name) !. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy. SI ~ICLe F:A-m, LY D~l.-l ~ .,. .b. Intended use and occupancy SI>t"Yle. l. Nature of work (check which applicable): New Building Repair Removal Demolition Addition )(, Other Work Alteration (Description) k Estimated Cost 200. C\lZl. , Fee If dwelling, number of dwelling units If garage, number of cars (to be paid on filing this application) Number of dwelling units on each floor >. If business, commercial or mixed occupancy, specify nature and extent of each type of use. ~ Dimensions of existing structures, if any: Front . 3 C; Height , c... Number of Stories I Rear DE:. Depth 25" I Dimensions of same structure with alterations or additions: Front BGo' Rear Depth "!:>.., , Height tz.. 5 ' Number of Stories "2. Dimensions of entire new construction: Front ~ c:.. Height '2... '5 ' Number of Stories Rear "0 ~ '2. Depth !J 7 , Size of lot: Front IDO Rear /00 Depth l"'fa - O. Date of Purchase Name of Former Owner .. 1. Zone or use district in which premises are situated R4C7 2. Does proposed construction violate any zoning law, ordinance or regulation: IoJ 0 3. Will lot be re-graded ~o Will excess fill be removed from premises: YES NO -- 4. Names of Owner of premises 5eTIWQ1L ~"'S Address miAmi /We' ~hone No. ,f.,S. t+'" Name of Architect 'Ool'O>\.lQ FeIU3'l.- Address m,6.."'tr" rruC1<- Phone No '2.'l8. - 'S "T53 Name of Contractor ~D\Nb Address Phone No. 5. Is this property within 100 feet of a tidal wetland? *YES NO )<. . IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAYBE REQUIRED 6. Provide survey, to scale, with accurate foundation plan and distances to property lines. - ON ~'~t..- 'r~c;. 7. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. TATE OF NEW YORK) ss: :OUNTY OF ) . ~ N ~ . fu (~____ being duly sworn, deposes and says that (s)he is the applicant ame of individual signing contract) above named, ~~ (Contractor, Agent, Corporate Officer, etc.) ;)He is the f said owner or owners, and is'duly authorized to perform or have performed the said work and to make and file this application; lat all statements contained in this application are true to the best of his knowledge and belief; and that the work will be erformed in the manner set forth in the application filed therewith. 200) , IlOIlIIIE J. DlIROSII IIeIIty Publ1C. StIlI or..."" We. 01006095321. ~~_I. """ &pns lIlr 7.20........ Pennit Number REScheck Compliance Certificate Checked By/Date New York State Energy Conservation Construction Code REScheckSoftware Version 3.5 Release 1 Data filename: C:\Prograrn Files\Check\REScheckIBrooks Residence.rck TITLE: Brooks Residence COUNTY: Suffolk STATE: New York HDD: 5750 CONSTRUCTION TYPE: Detached 1 or 2 Family HEATING TYPE: Non-Electric DATE: 12/09/03 DATE OF PLANS: July 23,2003 COMPANY INFORMATION: Donald G> Feiler - Architect COMPLIANCE: Passes Maximum UA ~ 382 Your Home UA~ 368 3.7% Better Than Code (UA) Gross Glazing Area or Cavity Cont. or Door Perimeter R- Value R-Value U-Factor ~ 1440 30.0 0.0 50 660 13.0 0.0 54 1288 21.0 0.0 53 322 0.330 106 42 0.510 21 432 30.0 0.0 14 87 5.0 70 Ceiling 1: Flat Ceiling or Scissor Truss Wall!: Wood Frame, 16" o.c. Wall 2: Wood Frame, 16" o.c. Wmdow 1: Wood Frame:Double Pane with Low-E Door 1: Solid Floor 1: All-Wood loistlTru..:Over Unconditioned Space Floor 2: Slab-On-Grade: Unheated Insulation depth: 2.0' Boiler 1: Other (Except Gas-Fired Steam), 80 AFUE COMPLIANCE STATEMENT: The proposed building represented in this document is consistent with the building plans, speci1lcations, 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 Proressional has stamped and signed this page, they are attesting that to the best oJ:' er knowledge, belief; and professional judgment, such plans or specifications are in co~ce ~him Builder/Designer_~~ d .' Date /1-~O I ~ ..- ,- Permit Number REScheck Compliance Certificate Checked By/Date New York State Energy Conservation Construction Code REScheck Software Version 3.5 Release I Data filename: C:\Program Files\ChecklRESchecklBrooks Residence.rck TITLE: Brooks Residence COUNTY: Suffolk STATE: New York HDD: 5750 CONSTRUCTION TYPE: Detached I or 2 Family HEATING TYPE: Non-Electric DATE: 12109/03 DATE OF PLANS: July 23,2003 COMPANY INFORMATION: Donald G> Feiler - Architect COMPLIANCE: Passes Maximum UA ~ 382 Your Home VA = 368 3.7% Better Than Code (VA) Ceiling I: Flat Ceiling or Scissor Truss Wall 1: Wood Frame, 16" O.C. Wall 2: Wood Frame, 16" o.c. Window I: Wood Frame:Double Pane with Low-E Door 1: Solid Floor 1: All-Wood Joist/Truss:Over Unconditioned Space Floor 2: Slab-On-Grade:Unbeated Insulation depth: 2.0' Boiler I: Other (Except Gas-Fired Steam), 80 AFUE Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor .!M. 1440 30.0 0.0 50 660 13.0 0.0 54 1288 21.0 0.0 53 322 0.330 106 42 0.510 21 432 30.0 0.0 14 87 5.0 70 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 oJ:' er knowledge, belief; and professional judgment, such plans or specifications are in co~ce ~m Builder/Designer~~ (} .' Date 11-~O I ~