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Home My WebLink About31726-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-33119 Date: 06/24/08 THIS CERTIFIES that the building ADDITIONS/ALTERATIONS Location of Property: 1360 SOUTH (HOUSE NO.) County Tax Map No. 473889 Section 75 HARBOR RD (STREET) Block 7 SOUTH/PEC (HAMLET) Lot 1. 2 subdivision Filed MaP No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 11, 2006 pursuant to which Building Permit No. 31726-Z dated JANUARY 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 ALTERATIONS AND ADDITIONS, INCLUDING COVERED ENTRY AND ROOFTOP DECK TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to BRONWYN M GUTHRIE & MATILDE BUSANA (OWNER) of the aforesaid building. SUFFOLK COIJlIlTY DEPARonmNT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE I!IO. 3042300 01/25/08 PLUMBERS CERTIFICATION DATED 01/22/08 JOSEPH TUOMEY Rev. 1/81 (D.." .- "4 'Ji!'..". qt7- -6fJi, ~'70 I Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ...' -, '---- '~/i ' <8 ........, .""\, { '.,\ 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 2/10 of] % lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9,1957) non-couforming 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 ]. 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'~d (check one) New Construction: ./ 2s. r "1e08 Old or Pre-existing Building: Location of Property: I '3 b 0 SO \J it--! -H i<>r-R.~ 0 Ia. 'RJ), House No. Street ~Oc:JIHOLD Hamlet Owner or Owners of Propeliy: $~ n IV "'Jot lJ 41.1 '7U R LEt Suft(,lk County Tax Map No 1000, Section 1 S' I f\-f 1/1-"(1 L.O E'" Block 0 7 1?us~Nb.. Lot I . 2- Subdivision SoLl Tf-fD L..D Filed Map. Pennit No. '"' 1'7 2 (.,._~ Date of PennitL I /1.../0 Go Applicant: I Health Dept. Approval: Underwriters Approval: Lot: Planning Board Approval: Request for: Tempor.;y C~ate Fee Submitted: $ L.--<) cJo -2. 33 I \ 9 ~c..- '/ Y ~ ;}.)., Final Certificate:'/ (check one) ~A 1-'- S h. ~ /, ~ure -- l @)~~@) /1r _. ~ 1_' , - '-;' ,;( ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ I ~@) - - - ----:r-- ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ I Located at ~ Application Number: I Section: ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 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 prem i ses owned by HUBBARD ELECTRIC 178 HUBBARD AVE RIVERHEAD, NY 11901, GUTHRIE BROWYN 1360 SOUTH HARBOR RD SOUTHOLD, NY 11971 1360 SOUTH HARBOR RD SOUTHOLD, NY 11971 3042300 Certificate Number: 3042300 Block: Building Permit: ~l BDC: ns11 3,J.lp(} Described as a occupancy, wherein the premises electric system consisting of electrical devices and wiring, described below, located in/on the premises at: Lot: Basement, First Floor, Second Floor, 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 25th Day of January, 2008. Name OTY Rate Ratio. Circuit ~ Alarm and Emergency Equipment Sensor Appliances and Accessories Exhaust Fan Dish Washer Panels 2 0 Carbon Monoxide 1 0 1 0 1.2 F.H.P. KW 100 5 Wiring and Devices Outlet Fixture Fixture Outlet Receptacle Switch Dimmers 61 0 55 0 6 0 59 0 31 0 30 0 16 0 3 0 I 0 6 0 Fixture Incandescent Flourescent General Purpose General Purpose General Purpose Paddle Fan Receptacle Multi Outlet System 20a ft Laundry seal 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. I p " rn.rn ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ I Located at ~ Application Number: I Section: ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ rn~~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~~~rn 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 HUBBARD ELECTRIC 178 HUBBARD AVE RIVERHEAD, NY 11901, GUTHRIE BROWYN 1360 SOUTH HARBOR RD SOUTHOLD, NY 11971 1360 SOUTH HARBOR RD SOUTHOLD, NY 11971 3042300 Certificate Number: 3042300 Block: n511 Lot: Building Permi!: BDC: Described as a occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Basement, First Floor, Second Floor, 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 25th Day of January, 2008. Name Ory Rate Ratin. Circuit ~ Receptacle 16 0 General Purpose 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. ,il ...\ ' /./// " " ", .( ~<c9 .....""...)1. f, , " / '....."'-.. CER TIFICA TION Date:~l '2- '"L ( 0 ~ Building Permit No. 3 \ 7 ). ~ Owner: ~ -hIck C?><.AS"",^", , ~Jo,-'''''''(", C; u \.k.v""': "- (Please print) Plumber: -:rnsp,~'" \UCWII\ev\ (Please print) ----r I certify that the solder us~ in the water supply system contains less than 2/10 of 1% lead. ~ )ilAAA~/ (plumbers Signature) y Sworn to before me this :2;),..4 day of Notary Public, 5L..~/k County l1NIlI\~~ Ntbryl'ublic. No, 01 "" lNalif""'''' Commis_ Elp"" 3,' ':::Ai / j 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. 31726 Z Date JANUARY 12, 2006 Permission is hereby granted to: BRONWYN M GUTHRIE 60 SUTTON PL SO APT 3 NEW YORK,NY 10022 for : ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 1360 SOUTH HARBOR RD SOUTH/PEC County Tax Map No. 473889 Section 075 Block 0007 Lot No. 001.002 pursuant to application dated JANUARY 11, 2006 and approved by the Building Inspector to expire on JULY 12, 2007. Fee $ 593.40 . gnature ORIGINAL Rev. 5/8/02 SUfFOLK C UNTY DEPARTMENT OF HfALTHSEl1VIC3 , '" 'SINGLE FAMILY DWELLING ONLY . DATilllLi..8J9S9H,s. REf, No, jll SO IS,!! The ssiv"e~ pisposal, and \Yarer Surply facilities for this loc.tion t1"v~ lleen inspected by this D,'lIartmen! and/or . u\lier C'alld tfl:d t.~tiV!~Y.' QI BwetlU 01 Wastewater Managomel1t '!- ~ '; '. ':..!",-" " : 1f"''-'; ," .',,' , I I ' : a" . 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" ..~ . > "".' i?:/, - <"'/10' i.a~H'a~ rli~ t;;.-i' ii~i~8~gii III 60s ~!IIt-f: ., ~.;" II ' 3 ~ ~ i! ., 11" g;:;\ ~ 'I " , ~~~ij:i; !t~~ i~!~' . ~~!.,~il~" hl:t.,<l.:~ ~.<l.:.~Pl ~!i'i ,'ip ~'5!i~lh "ih ili~, ~hi!Lh~ ,rl~ ~~~hg~~ tor f !"~i~~g.!= t} i tJ ..4~ 0 ~ a 'j' ilJ i,:l!~ " , '," ".: ,'. , ; ," . ".' ~'! ': . ,'" ,.,,' ~'.,.. Ji..., ".1." " .. ..~..' ,,~~:',~.~~:,..'t:- >. . 'I' - .-,: ',,', - " ' .- ,,'," . "'VI' c: ""If ." ~ '" ~ x~ - y, ~ ... aX . III :ll g> .~~. .,. ,.' -<C3!7~ -C- TOWN OF SOUTH OLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] FOUNDATION 2ND [ ] FRAMING I STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRUCTION [ ] ROUGH PLBG. []~U~ [vfFIN~ [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRAnON REMARKS: DATE / /; r;, /0 f' I I INSPECTOR J/7J-loc TOWN OF SOUTH OLD BUilDING DEPT. 765.1802 INSPECT N [ ] FOUNDATION 1ST [ [ ] ~DATION 2ND [ [>v1FRAMING I STRAPPING [ ] FIREPLACE & CHIMNEY [ ] RRE RESISTANT CONSTRUCTION [ ~ ] INSULATION ] FINAL ] FIRE SAFETY INSPECTION ] RRE RESISTANT PENETRAnON ~ DATE r//7 !o7 I I' INSPECTOR ---.~ 311~~Z TOWN OF SOUTH OLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] FOUNDATION 2ND [ ] FRAMING I STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRUCTION W [ ] ROUGH PLBG. ,P<fINSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION E~ ' ~ -3V V\iLrJ- " J. , o.AJrfT '" l- ~;;.. -tJ 7 DATE INSPECTOR ~~ J VJ t--fp c TOWN OF SOUTH OLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] FOUNDATION 2ND [ ] FRAMING I STRAPPING [ ] FIREPLACE & CHIMNEY [ ] RRE RESISTANT CONSTRUCTION REMARKS: [ ] R~H PLBG. [ ,.rfNSULATION [ ] FINAL [ ] FIRE SAFETY INSPEcnON [ ] RRE RESISTANT PENETRAnoN '- < , INSPECTOR DATE 1/;3 j(} 7 t I ~- 3f720c TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I~ATION [ ] FRAMING I STRAPPING [vrFINAL [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] FIRE RES~ANT CONSTRUCTION [ ] FIRE RESISTANT PENETRAnON REMARKWj;f.J}V~~ S;~t- fL ~~') Ch r!!!J:- f/!i ~ H h,f:!-~ @~)/ If.Jt-C 87J Jv.i( ~4/~,{;ii:r:::Ii:;*j~~r:-~r 'fp-J ftr1i. ~rzJut-rlL- Si1H1lS I~~"'-' J- t::::- o-r . ~~...fJ <DO ~~T ~ ~ DATE I Y( H r 0 7 INSPECTOR ' " 3172-b 2:.- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I~LATION [ ] FRAMING I STRAPPING [0'FINAL [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRAnON @ - RE;;;~Z;~~J~~ ~'7~ kYl?- //)- f ,) p,J ~_ / DATE / INSPECTOR JAMES]. DEERKOSKI, P.E. 260 Deer Drive Mattituck, N.Y. 11952 (631) 298-7116 , I..~' ~- 25 L. - Date: March 25, 2008 To: Town of Southold Re: Strapping Inspectiorn ( I _ Busana L9-U-~ South Harbor La. Southo~ Permi~ J~1 i /u To Whom It May Concern: This letter certifies that all wind strapping on the above mentioned project is in tact, and meets all state and local building codes. Any questions please feel free to call. ".,~,'. '-<:-'~-;.:'~'," ~~..;.;; 0 ,,~ l'J (.: iV 'i-;' ':~;:~;'rT;;:r!:;1:2?;", -./.~, ~..;,.~ '" ';/') of, , :"'.' I .I ,. ~kOili PE , JAMESJ. DEERKOSKI, P.E. 260 Deer Drive Mattituck, N.Y. 11952 (631) 298-7116 Date: June 23, 2008 To: Town of Southold Building Dept. Re: Insulatio9 Inspection Busana I Ci. U IH{?IG 1360 South Harbor Rd. Southold, NY 11971 Permit# 32470 To Whom It May Concern: .,' "~1 r !i',} 24 I L. ... ! L-.1:Q:._ . f-- .J j ~.:.,":':;:..0.-=2t_D ------ u An Insulation, Fire Caulk, Fire Blocking Inspection was preformed at the above mentioned properly; all Insulation, Fire Caulking, and Fire Blocking was installed as per Plan and meets all State and local Building Codes. Any questions please feel free to call. ~~li PL JAMES J. DEERKOSKI, P.E. 260 Deer Drive Mattituck, N.Y. 11952 (631) 298-7116 Date: January 4, 2007 To: Town of South old Building Dept. Re: First & Second Foundation Inspections Bushana S. Harbor Rd. Southold, NY 11971 Permit#31726 To Whom It May Concern: First and Second Foundation inspections was preformed at the above-mentioned construction site, and the damp proofing was installed correctly and meets all state and local building codes. Any other questions please call. .;< 00 N~l-V)>i' / '\ '<- ...-;"--:'", (..", ;;;:.... , \. OE;;!Y,.~<';r) ~. <ii' '. "t""., ~ .' " i " \ ~ , ~ \ ,~', ,',"? "i tt \ c: lw ", () I Z ',,~ " / (-;:; ~'...." 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(;), r, '". ~"./Jn{'- / ~ ;l.L,().' ;"" I. .j~,.J ,~ ./ /t,/ .J '- FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION (1ST) /' I.AA" \.... /' /A"P l \ ,.o.~ ~ FOUNDATION (2ND) . . \ '"u. vV-.J ROUGH FRAMING & PLUMBING Itff17JJ1 E..: u 7f, nr.2L.~ 7lJ (A' ...-- r. 1.\ (~ I' , )f'rL.M' . / /. __I r ~h:t-:' ./././. n .. / rJ~_,_/ I.e, r; +'4Yr.l; './I.' .I. il~_ ;y~~ ~". / J. ~ ~J. ~ ~ A. U.I ... '/~.J INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS 10/27"- I \111/T1- I 1/ A..... c'Y ^ ~O -,. I Ill' L\n".L L / , - a>/.... - """'P!2 ~ " ~~ n~ 0 Qh....., ~. -l'1x rr 1-y.-"07 rJ,-'d fF ~, k', /Ri~~ /II~, {/ I (\'S fl' (.0 r.. JA n "f-.- h(,l. (J u.) ,I: '" I rf - tp[i:'1~D~ 14-c.'c) PE UA-t f:if- u . )~ - , 1J.i.... - l"l ~~ r::i 'It -y ..p~ - c: -t 5>>", J'V't'J ~ vJ' c- o '" ""' ~~ (' ""' ( 1 (i) ~ t. (II 0 ::E t"Nffi a ;0 :, , "'::' r'-- ::s .t'J --.J;.< \ .... '-- - IV !:: , ""' o 0 --.J z == l"l ~~ ----""' -:p; l"l .... ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www.northfork.net/Southoldl PERMIT NO. :~/:; "p~.:c BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning ~ approval Survey / Check ,/ Septic Form N.Y.S.D.E.C. Trustees Contact: /' I Examined 20 , '- 20L Approved Disapproved alc Mail to: Expiration Phone~- :J. / q '-{ .~~ <- 'I : IAN I I APPLICATION FOR BUILDING PERMIT , , , I I L ,- ~-~"--- .--"-' .;.' I ," ___': _=J,0__J Date ~AI(o.l>AI J/ ,20~ INSTRUCTIONS a. 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 oflot and of buildings on premises, relationship to adjoining premises or public streets or areas, and waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. . e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an addition six months. Thereafter, a new permit shall be required. 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 removal or demolition as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, d regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant or name, if a corporation) f 0 ~oI- IIILr. [;DUTI-{oL{j J.J'( /ler 7/ (Mailing address of applicant) State whether applicant i~wn~essee, agent, architect, engineer, general contractor, electrician, plumber or builder r1 /d/rJC HAil LDE.. 80'SPM Ai F:f!:ON V/'rIy. C; ur f..li3/&" Name of owner of premises (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. Plumbers License No. Electricians License No. Other Trade's License No. I. Location of land on wjJjch proposed work will be done: J 3&0 ';:5Q..Jr j.) j.Mlel'30lu ;eD House Number Street Hamlet County Tax Map No. 1000 Section Subdivision 0'16 Block 'l Filed Map No. Lot f!fEJ I.:L Lot (Name) - 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy f?c-s I fJEfll/T5 b. Intended use and occupancy ~-s' /.)t.-l\Jrs 3. Nature of work (check which applicable): New Building Repair Removal Demolition Addition ,/ Other Work Alteration /00, OOtJ. ,(JO (Description) 4. Estimated Cost Fee 5. 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 6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front? e.. ' Height U I Number of Stories Z Dimensions of ~rrye structure with alterati9J;ls..-Qr ad9itions: Front 4 Z3 I {p II Depth C~ Height ~. / '- (t? ' Number of Stories 8. Dimensions of entire new construction: Front I (p: W~ Rear 44- I Height Number of Stories 2cO' 32' LL.:;>..' / _ Ii Depth -'"J U' Rear Rear 4g: (/ -"'/ /"" 45f Depth Depth 400 t20p;eer ~ I 9. Size oflot: Front 2m I Rear 10. Date of Purchase Name of Former Owner PeT7IT 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO X 13. Will lot be re-graded? YES_NO l Will excess fill be removed from premises? YES_NO ~tj;1 fdll-?M . J..1ifT ( L.D~ PJifAl-JA, <po ~ II 14- 7f.flP;; ~ /. Pj 0. L), 14. NamesofOwnerofpremtses AddreSS~(~ Phone No. v;J"'J / Name of Architect 6I~~l-I ?Alt1OJt4 Address f?tJ /)/J Phone No 7'1 'I"'t?04' Name of Contractor Address Phone No. 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 OF ) f0'AT (L-PC "Bv "SAN A being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the OJr)/-"")E e (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. Sworn to before me this 1/ daYOf?~Lb- 20~ a. ;:;'b~~ fEf) (" 1Y/ ~4'./ Notarypu lie " ( .s:> -- Signature of Applicant EILEEN S. SANTORA NOTARY PUBliC, Stale of NMr laJI No. 30-4916018 Qu~llfl.d .in ~~//" CommISSIon ExpII1lS ~~ y~ ?c;8cd8 PROFESSIONAL ENGINEER 1725 HOBART ROAD I PO Box 616, SOUTHOLD, NEW YORK 11971 TEL 631.7652954' FAX 631.6143516 . e-mail: joseph@fiscl1etti.oom Date: Reference: January 11, 2006 1360 South Harbor Road South old Building Department Main Road Southold, NY 11971 Dear Sir, I have inspected the subsurface sanitary system for the above referenced home. The system consists of precast septic tank of 1000 gallons and (1) 8 foot diameter leaching pool 12 feet deep. The system in accordance with Suffolk County Health Department regulations this system is adequate for a 4 bedroom home. / BU<III1-"'4llicUl'l,oo<; L\CJAHi..i CE'HT!FILD ;~,'THI)CTU[~r\, Et'JCINEF.H Permit # Permit Date REScheck Software Version 3.7.3 Compliance Certificate Project Title: Susana Addition plan date 9/11/06 Report Date: 09/21/06 Data filename: C:IProgram FileslChecklRESchecklbusana.rck Energy Code: New York State Energy Conservation Construction Code Suffolk County, N_ York Detached 1 or 2 Family Non-Electrlc 19% 5750 Location: Construction Type: Heating Type: Glazing Area Percentage: Heating Degree Days: Construction Site: Owner/Agent: Designer/Contractor: Joseph Fischetti. PE ( 1I11pll 1I1( l Passes . 1 ll'l'll \ 336 II II II l 111\ 268 20 2% Better 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: Door 1; Glass; Floor 1: All-Wood JoistlTruss:Over Unconditioned Space: 850 38.0 0.0 26 2088 19.0 0.0 102 344 0.260 89 50 0.450 23 850 30.0 0.0 28 Date Project Notes: Previously saved project information: New Addition Eileen Santora Busana Addition plan date 9/11/06 Page 1 of 1 Permit Number REScheck Compliance Certificate Checked BylDate New York State Energy Conservation Construction Code REScheckSofiware Version 3.5 Release Ib Data filename: Untitled.rck TITLE: Busana Addition COUNTY: Suffolk STATE: New York HDD: 5750 CONSTRUCTION TYPE: Detached I or 2 Family HEATING TYPE: Non-Electric DATE: 01/03/06 DATE OF PLANS: 12-15-05 PROJECT INFORMATION: New Addition COMPANY INFORMATION: Eileen Santora COMPLIANCE: Passes Maximum VA ~ 327 Your Home UA ~ 259 20.8% Better Than Code (UA) Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor UA Ceiling 1: Flat Ceiling or Scissor Truss 901 38.0 0.0 27 Wall I: Wood Frame, 16" O.c. 1856 19.0 0.0 90 Window 1: Wood Frame:Double Pane with Low-E 298 0.260 77 Door I: Glass 50 0.450 23 Floor I: All-Wood 10istlTruss:Over Unconditioned Space 1261 30.0 0.0 BuilderlDesigner the COMPLIANCE STATEMENT: The proposed building represented in this document is consistent w' specifications, and other cal