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Home My WebLink About30307-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33214 Date: 08/12/08 THIS CERTIFIES that the building ADDITIONS/ALTERATIONS Location of Property: FOX AVE (HOUSE NO.) County Tax Map No. 473889 Section 6 (STREET) Block 5 FISHERS ISLAND (HAMLET) Lot 5.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 10, 2004 pursuant to which Building Permit No. 30307-Z dated MAY 12, 2004 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 OUTDOOR SHOWER STALL, DECK AND SUN PORCH, TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to FISHERS ISLAND RESIDENCE TRUST (OWNER) of the aforesaid building. N/A SUFFOLK COUNTY DEPAR'DmNT OF HEALTH APPROVAL 08/11/05 ELECTRICAL CERTIFICATE NO. 2030612 07/29/05 JOSEPH D HIRSCHFELD PLUMBERS CERTIFICATION DATBD Rev. 1/81 7~f -71/1 F.orm No.6 TOwN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 r:~r" -0' Ii '!~ , . ... , ~ , . :~, .-, ~ " ;.... ' JUN -2 0 , , \ , This application must be filled in by typewriter or ink and submitted to the Building Department Willi'the following: APPLICATION FOR CERTIFICATE OF OCCUPANCY __J 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. ...;. 0\\Orll S~akr..lent from plulllber cerLfying that the soLler used ia s:ysten:s contains less than 2/10 of 1~/0 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: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topogr3phic 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. New Construction: Old or Pre-existing Building: ~ (check one) Location ofproperty: t07 / ~(J b Co f-6.~.o .p /:f C 4L ~h~G.",f) A). Yr House No. Street Hamlet Owner or Owners of Property: ~YJn/ fJc..(Qf7{"(' &- JluO^ rnC~<- il7] ( ~ Suffolk County Tax Map No 1000, ection 0') b Block 0:0.:> Lot ~ ~,r'1') z... Subdivision Permit No. ~307 Filed Map. Lot: Date of Permit. .q;O/ZOeJt{- Applicant: 15, a t&~/(;'( ';?/1C . Underwriters Approval: Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ 2..), Vi) o 2;- 3'~d- I i ~0 ,Ltjb 1 [!J~~~[!J I BY THIS CERTIFICATE OF COMPLIANCE THE I ~ 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 ~ ~ ~ ~ BD ELECTRICAL CO INC HENRY MCCANCE ~ ~ 102 GREENWICH AVE LOT HOX AVE. ~ ~ GREENWICH, CT 06390, COTTAGE PLACE ~ i\ll FISHERS ISLAND, NY 06390 i\ll I Located at LOT 1 FOX AVE. COTTAGE PLACE FISHERS ISLAND, NY 06390 I ~ Application Number: 2030612 Certificate Number: 2030612 ~ I Section: Block: Lot: Building Permit: BDC: n511 I ~ Described as a Residential 3000-4000 square ft. 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, 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 11th Day of August, 2005. ~ ~ Name OTY Rate Ratin. Circuit Ix!ll< ~ ~ Alarm and Emergency Equipment ~ ~ Sensor 3 0 Carbon Monoxide ~ ~ Appliances and Accessorics ~ ~ Furnace 2 0 Gas ~ ~ Dish Washer 1 0 1.2 KW ~ ~ Exhaust Fan 6 0 F .H.P. ~ ~oven 2 0 12.0 KW ~ ~ Pump Motor 1 0 1 H.P. ~ ~ Air Conditioner 1 0 30.000 BTU ~ ~ Air Conditioner 1 0 36.000 BTU ~ ~ Air Conditioner 1 0 42.000 BTU ~ ~ Hydro Massage Tub (Therapeutic 2 0 ~ ~ Wiring and Devices ~ ~ Outlet 126 0 Fixture ~ ~ Fixture 11 0 0 Incandescent ~ ~ Fixture 16 0 Flourescent ~ ~ Outlet 164 0 General Purpose seal ~ ~ Receptacle 84 0 General Purpose ~ ~ Continued on Next Page of 2 ~ 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 [!J~E!ffi!E!ffi!Iii!E!ffi!ffi!E!ffi!~[!J [!].[!] I BY THIS CERTIFICATE OF COMPLIANCE THE I ~ 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 ~ ~ ~ ~ BD ELECTRICAL CO INC HENRY MCCANCE ~ ~ 102 GREENWICH AVE LOT 1 FOX AVE. ~ ~ GREENWICH, CT 06390, COTTAGE PLACE ~ ~ FISHERS ISLAND, NY 06390 roJ ~ Located at LOT 1 FOX AVE. COTTAGE PLACE FISHERS ISLAND, NY 06390 I ~ Application Number: 2030612 Certificate Number: 2030612 ~ I Section: Block: Lot: Building Permit: BDC: n511 I ~ Described as a Residential 3000-4000 square ft. occupancy, wherein the premises electrical system consisting of mJ ~ electrical devices and wiring, described below, located in/on the premises at: ~ ~ ~~~~~~~ ~ ~ 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 11th Day of August, 2005. ~ ~ Name OTY Rate Ratin. Circuit Ixnl< ~ ~ Switch 61 0 General Purpose ~ ~ Dimmers 39 0 ~ ~ Receptacle II 0 GFCI mJ ~ Receptacle I 0 20 amp Laundry ~ ~ Receptacle 2 0 30 amp Dryer ii!I ~ GFCI Circuit Breaker 3 0 Appliance ~ ~~ ~ ~ I Phase 3W Service Rating 400 Amperes mJ ~ Service Disconnect: 2 200 cb ~ roJ Meters: I roJ ~ ~ ~ ~ ~ ~ ~ ~ ~ seal ~ ~ ~ ~ ~ I This certificate may not be altered in any way and is validated only :y th:f pr:ence of a raised seal at the location indicated. I I ~_..._~ ---~ Towa "l1li,$309$ Mt.ID (l,oII4 P.o.S.UllI Sellllt.oId, *" YOIle lI971.0tS9 Building PennitNo. Jo3 07 Owner: I1l/;>o)l) ~,.J/J~ f!efJlf-<.r' (please . ) Plumber: JOse rZ 0.)/ ;t5Ct.-kfJ (please print) BUILDING DBPAKI'MIlNT TOWN 01' sourHOLD CER TIFICA TION Date: '7~9~f- I Fa (631) 165.1lW T111,b_ (631) 16S-18O;& I certify that the solder used in the water supply system contains less than 2/10 of 1 % lead. Sworn to before me this ,;< I}& dayof~ 20&.. G?~~ ~H/d'ft Notary Public,. j" (J~ COWlty ROXANNE SPAULDING NOTARY PUBLIC, STATE OF NEW YORK NO.01SPfil1:194? aUAllIlIlllN SUI I 01 K CllUN I Y MY CUMMISSION LXI'IHLS A1Hi. !J, ?!iDe }4?~ 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. 30307 Z Date MAY 12, 2004 permission is hereby granted to: HENRY F & ALLISON MCCANCE 10 MILL STREET DOVER,MA 02030 for : ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at FOX AVE FISHERS ISLAND County Tax Map No. 473889 Section 006 Block 0005 Lot No. 005. 002 pursuant to application dated MAY 10, 2004 and approved by the Building Inspector to expire on NOVEMBER 12, 2005. Fee $ 418.20 ure ORIGINAL Rev. 5/8/02 ~ .. f ....... TOWN OF SOUTHOLD PROPERTY RECORD CARD }n,A. 1fl~ _ '~_. OWNER STREET VILLAGE DIST. SUB. If '/ E \,SI W TYPE OF BUILDING rD .,.~ CCiv"M. CB. MISe. Mkt. Value '-- LAND IMP. TOTAL DATE REMARKS J . If'Y>-n, '/ LOT ~ f c'LD . "..,... ;t ?"(' N\nor-SU~~.'~-rDI:'lq~ 7- ~ (! (' 411(!.(/=' t- H~~;:;.rJ;C- , 2-'~~tay)uPi) Ncfon&fotJ() 'Co.trt;Sbj rillable 2 rillable 3 r e...cf~ ~ J J)(1 7~;';'1.-/t?~ {Y\cCQ./\CX A Naodland ;ause Plat -- 000 FRONTAGE ON WATER FRONTAGE ON ROAD --.s::f'~ DEPTH ~. -7;-e. Ilvl-€. ;wampland lrushland - .- BULKHEAD ratal CJ6/D DOCK Rooms 2nd Floo -~ 1( ~"~~~,t ~ ~ :'i11 - - --:- :.~ , i , I COLOR ~.I I I TRIM i - eua! I' ~ ,~ '.... lD" I . I I} M r- .[~, - ";if ". ~_.>"-,.. . .' 4.S ^. -='-;~;;~~,< M.Bldg. 34KY~ 7--'Utj /Y'Ot./yf' t..../VLlJ'Youndation Extension I f' 1 )-v ;l.- ~ '5 6, (;) II '10 Basement Extension lti"~A j~>y O;CJ 2-b~':) _ -"] 9), Ext. Walls Extension /3 Y '} J~ J= I~ ' . 3 tS- 'I~~f, I I Fire Place. I~ /9X3j:fI ",.- 74-1 ..If tl-p-t4 Ty~eRocif Porch 12..1-'1/ I 'J 'I. ).. '('. ~. '5 YS"' . 11f' it) Recredtiori Roar Parch I;fe (/~)( y I OrtlfJ AA ;;l- I 0 ~~~ Dormer l:...N J/vuL l v. '1-1 ~l '/It. ?, -1' '" W Driveway L}.- . . . [.;nrng.. .L..~.. iX/3,,/a4, 3.1"' ~Xi -.-L ~r '5A.....I . ~ lA, ' to.. If /)l) f2, ..,.'P,e YS 'P11-/'7" w(S~. <:2----' Hu:) :;;1" Patia O. B. Total 1100" / A~..5, . if ~"l'- 'J , ~ ., .-.,. ----., > . ~ .i.. H . . ~ 1/ f?r .j;;!i .J l- e-- ~. .,,,, ~ h1/ , '. . " ~rzr 1 hi" 'A Bath ~ ~ Dinette 7 rlf( K. :;; f:!i.. LR. /"1/ CJ,;0~R. 7 BR. -7.-. _~IN~~~_. .-- Floors Interior Finish Heat Rooms 1 st Floor PERMIT NO. ,<:J,(P,,{):+-=it , HUlLUlNli PhKMlT APPLICATIUN CllliCKLlST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: N UJ<' SUUTHULIJ DING DEPARTMENT WN HALL . UTHOL,D, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www.northfork.net/Southoldl Examined Approved Disapproved ale 611'2- ,20~ "}I1-- ,20-i- G2 Phone: Expinltion 11/11-- ,20L .--/ APPLICATION FOR BUILDING PERMIT Date MA'f '1 ,20~ INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 sets of plans, accurate plot pIan 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. APPLICA nON IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Sonthold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the constmction 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 in~"Borrpremises and _in building for necessary inspections. : , .~ , ",/r'If MAY I J) 2004 Bo DF:"5/6N. /NC. (Signature of applicant or name, if a corpollllion) I L, --..:....;. 71 t=.. ?vrNAM Al/F. t:,12f:f:J<.1I1J1//.-! r l' (Mailing address of applicant) , o{,617) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder A~t" 11:€c-r (NY L< ( . ,,'l.-""''l'q ) Name of owner of premises \\"..."-'1 N.<CA"'<.-E (As on the ~or latest deed) If applicant is a corporation, signature of duly authorized officer \ ~ j1,At-l9~LI A-f-:olAl~ Prl.o\CL--t 'D~"/~"-.\.-C6L I (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: ~d)O( A:\J~\...'ll)F s.. Cc:>T1A.c.-E t'l-/a..c.t House Number Street >'\"kE-fZ-~ \<;L.-~"-In Hamlet County Tax Map No. 1000 Section D (), Subdivision t,,'1.Ao,,"'H " M< ""...u iU;v 'I" 11" (Name) Block ? Filed Map No. Lot S'.002- Lot 3. Nature ofwolk (check which applicable): New Building Repair......- Removal Demolition Addition Other Work Alteration 0.- 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy j,,,,"ce FAt"",,'" D"'''-'''''>-\.D .",.LL '''''~ b. Intended use and occupancy C;h...ibu~ t==AMIL'1 t).CfA!.kf"9 Ow€l.LI~lS (Description) 5. If dwelling, number of dwelling units If garage, number of cars Nt>. -t 170.'- (To be paid on filing this application) Number of dwelling units on each floor ..,. 4. Estimated Cost ~ ~.o,t!Oo Fee 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front I. t.. ' Height 7.-1..-' Number of Stories -z...- Rear 10'1. I Depth 6.'7' Dimensions of same structure with alterations or additions: Front ." 1.- ' Depth 1.1' Height 7-2' Number of Stories Rear I" 'L' ~ 8. Dimensions of entire new construction: Front Height Number of Stories Rear Depth 9. Size oflot: Front 100 -t. Rear '3o';!- 1-, (<''ikl-of",''r Pepth '310' -t ,",l.j>.'~kl-d-f"'''-y 10. Date of Purchase Name of Former Owner E~I'MBHI-\ F. ....rCA..!"" 11. Zone or use district in which premises are situated l< . So 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 ~ 14. Names of Owner of premises H.,,~'1 "",C,,"'LC Name of Architect BD O.~l"" ,,,,,-. Name ofConttactonD "-.,,,.&u<"/,. IU'troj!.,V(,." Address I' ,<;HElL' "........D Address I>a......."',t.t\ t..."T Address .G.""-'wi"" '<>-f , . Phone No. 18 I '1.1. - 1.'lAo PhoneNo ""'... q8'3-.o~, Phone No. ....... q~, -1.02>"> 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 ofa 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 S/lfFo/..k) RANDA U A. N /I-J 41 being duly sworn, deposes and says that (s)he is the applicant ~ame of individual sigmng contract) above named, (S)He is the ~'WA.. + (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly anthorized to perfonn or have perfunned 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 perfunned in the manner set forth in the application filed therewith. Sworn to before me this ~(I- o day of {Y\AY 20Qx Q~~Q(~ - Notary Public CATHJ::P',"E: T I' N"'"" "r:" "' Jr-t MYC0 :::.'.., ". fJBl:'IC ~.\.. .~'... ~ E.'(-'!nZS 2~P. 30, 2004 -:fZM~- FIELD INSPECTION REPORT , FOUNDATION (IS1) ------------------------------------ FOUNDATION (2ND) ROUGH FRAMING & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL DATE COMMENTS /~~ -rA/f''',.w-~;t./ /~ ~p~ A:I~" e:. A/eal /' AEuI- F",,--, ';/!f'~ S/#/IU -~., / JIN//'I fp-IlPed'I,.A-' CJ,J: -"- . /r /~ b"V'~...vI , / b" 6/P~/,!/'f /~ ~ / '-- A )10'#1/ ~.U-- 'z1fI.!/6(l//p ,F &/pp;V~ ~ "'/~ . / ',~., I: !/ I A /Af. .., ;V ;.;J/t'.j /' , -t:~ ./J/",$IA ,. 71ii/iii" .~I/^~.J (/ ", ...../ '" j~ , .//A-/p,." Z'1V/lv/-t;I//;t/ . ......'"'AP~~ ~~~/~) '/ '" , v .- 0" ~J;a//Jt / " k;'e" ,,.. '" H // r...?-,~A ~Jk Ft!-<...-- ~4>c:/Z'C.M DJ"O CJI"l \}J~ 0::; -...\"" ~~ j: I.'''' ':;;0: p dI~ r<- . g; ~ J>'" (i ~ t"" I"l '" !\ ~ \l\ '\..... ~ tJ\ t'M "'. 'I-JptA/. &7-;,{, f~?~,R~ C ,. ,...-:: .....l t /~. ~..;r.. \ U \. --- t/J.J.JI ;:J,vJ;L. .// ADDmONAL COMMENTS \ "" . \ :3 o f: :J i6 _0 :E z t~ ..J _2 -I"l l ~ - ::s d( ~ o '" - ~<) 0 :;;0: == I"l > t"" '" == o I"l "0 :-l . Permit Number REScheck Compliance Certificate Checked BylDate New York State Energy Conservation Construction Code REScheck Software Version 3.5 Release Id Data filename: Untitled.rck COUNTY: Suffolk STATE: New York HDD: 5750 CONSTRUCTION TYPE: Detached I or 2 Family HEATING TYPE: Non-Electric DATE: 05/03/04 COMPLIANCE: Passes Maximum UA = 173 Your Home UA = 171 1.2% Better Than Code (UA) K: Flat Ceiling or Scissor Truss BR3: Flat Ceiling or Scissor Truss KS: Wood Frame, 16" o.c. KW: Wood Frame, 16" o.c. KE: Wood Frame, 16" o.c. BR3E: Wood Frame, 16" o.c. BR3W: Wood Frame, 16" o.c. BR3S: Wood Frame, 16" o.c. Basement Wall I: Masonry Block with Empty Cells Wall height: 8.0' Depth below grade: 7.0' Insulation depth: 4.0' 3x 3244: Wood Frame:Single Pane Arch: Wood Frame:Single Pane Arch: Wood Frame:Single Pane Ix 3244: Wood Frame:Single Pane Ix 3244: Wood Frame:Single Pane Door I: Solid Boiler I: Other (Except Gas-Fired Steam), 89.6 AFUE Air Conditioner I: Electric Central Air, 10 SEER Gross Area or Cavity ConI. Perimeter R-Value R-Value Glazing or Door U-Factor UA 236 48.0 0.0 6 157 35.0 0.0 5 210 25.0 0.0 6 161 25.0 0.0 5 161 25.0 0.0 7 79 48.0 0.0 3 79 48.0 0.0 3 71 25.0 0.0 3 472 0.0 10.0 38 29 62 62 9 9 20 0.500 0.500 0.500 0.500 0.500 0.400 15 31 31 5 5 8 COMPLIANCE STATEMENT: The proposed building represented in this document is consistent with the building plans, specifications, and other calculations submitted with tltis permit application. The proposed systems have been designed to meet the New York State Energy Conservation Construction Code requirements. When a Registered Design Professional has stamped and signed this page, they are attesting that to the best of . s/her knowl dge, belief, and professional judgment, such plans or specifications are in compl' ce IS Code. Builder/Designer Date~ REScheck Inspection Checklist New York State Energy Conservation Construction Code REScheck Software Version 3.5 Release ld DATE: 05/03/04 Bldg. Dept. Vse Ceilings: I. K: Flat Ceiling or Scissor Truss, RA8.0 cavity insulation Connnents: 2. BR3: Flat Ceiling or Scissor Truss, R-35.0 cavity insulation Connnents: Above-Grade Walls: I. KS: Wood Frame, 16" o.c., R-25.0 cavity insulation Connnents: 2. KW: Wood Frame, 16" O.c., R-25.0 cavity insulation Connnents: 3. KE: Wood Frame, 16" o.c., R-25.0 cavity insulation Connnents: 4. BR3E: Wood Frame, 16" O.c., R-48.0 cavity insulation Connnents: 5. BR3W: Wood Frame, 16" O.c., R-48.0 cavity insulation Connnents : 6. BR3S: Wood Frame, 16" o.c., R-25.0 cavity insulation Connnents: Basement Walls: I. Basement Wall 1: Masonry Block with Empty Cells, 8.0' htl7.0' bg/4.0' insul, R-IO.O continuous insulation Connnents: Exterior insulation must have a rigid, opaque, weather-resistant protective covering that covers the exposed (above-grade) insulation and extends at least 6 in. below grade. Windows: I. 3x 3244: Wood Frame:Single Pane, V-factor: 0.500 For windows without labeled V-factors, describe features: # Panes_Frame Type Thermal Break? [ ] Yes [ ] No Connnents: 2. Arch: Wood Frame:Single Pane, V-factor: 0.500 For windows without labeled V-factors, describe features: # Panes_ Frame Type Thermal Break? [ ] Yes [ ] No Connnents: 3. Arch: Wood Frame:Single Pane, V-factor: 0.500 For windows without labeled V-factors, describe features: # Panes_Frame Type Thermal Break? [ ] Yes [ ] No Connnents: 4. Ix 3244: Wood Frame:Single Pane, V-factor: 0.500 For windows without labeled V-factors, describe features: # Panes_ Frame Type Thermal Break? [ ] Yes [ ] No Comments: 5. Ix 3244: Wood Frame:Single Pane, V-factor: 0.500 For windows without labeled V-factors, describe features: # Panes_Frame Type Thermal Break? [ ] Yes [ ] No Comments: Doors: 1. Door I: Solid, V-factor: 0.400 Comments: Heating and Cooling Equipment: 1. Boiler I: Other (Except Gas-Fired Steam), 89.6 AFVE or higher Make and Model Number 2. Air Conditioner I: Electric Central Air, 10 SEER or higher Make and Model Number Air Leakage: Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. Recessed lights must be I) Type IC rated, or 2) installed inside an appropriate air-tight assembly with a 0.5" clearance from combustible materials. If non-IC rated, the fixture must be installed with a 311 clearance from insulation. Vapor Retarder: I Required on the warm-in-winter side of all non-vented framed ceilings, walls, and floors. I I Materials Identification: I Materials and equipment must be installed in accordance with the manufacturer's installation instructions. I Materials and equipment must be identified so that compliance can be determined. I Manufacturer manuals for all installed heating and cooling equipment and service water heating I equipment must be provided. I Insulation R-values, glazing V-factors, and heating equipment efficiency must be clearly marked on I the building plans or specifications. I I [ [ [ [ Duct Insulation: Supply ducts in unconditioned attics or outside the building must be insulated to R-8. Return ducts in unconditioned attics or outside the building must be insulated to R-4. Supply ducts in unconditioned spaces must be insulated to R-8. Return ducts in unconditioned spaces (except basements) must be insulated to R-2. Insulation is not required on return ducts in basements. Duct Construction: All joints, seams, and connections must be securely fastened with welds, gaskets, mastics (adhesives), mastic-plus-embedded-fabric, or tapes. Duct tape is not pennitted. Exception: Continuously welded and locking-type longitudinal joints and seams on ducts operating at less than 2 in. w.g. (500 Pal. [] Ducts shall be supported every 10 feet or in accordance with the manufacturer's instructions. [] Cooling ducts with exterior insulation must be covered with a vapor retarder. [] Air fIlters are required in the return air system. [] The HV AC system must provide a means for balancing air and water systems. Temperature Controls: . ' Each dwelling unit has at lesat one thermostat capable of automatically adjusting the space temperature set point of the largest zone. Electric Systems: Separate electric meters are required for each dwelling unit. Fireplaces: Fireplaces must be installed with tight fitting non-combustible fireplace doors. Fireplaces must be provided with a source of combustion air. as required by the Fireplace construction provisions of the Building Code of New York State, the Residential Code of New York State or the New York City Building Code. as applicable. Service Water Heating: Water heaters with vertical pipe risers must have a heat trap on both the inlet and outlet urtless the water heater has an integral heat trap or is part of a circulating system. Insulate circulating hot water pipes to the levels in Table 1. Circulating Hot Water Systems: Insulate circulating hot water pipes to the levels in Table 1. Swimming Pools: All heated swinuning pools must have an on/off heater switch and require a cover urtless over 20% of the heating energy is from non-depletable sources. Pool pumps require a time clock. Heating and Cooling Piping Insulation: HV AC piping conveying fluids above 105 OF or chilled fluids below 55 OF must be insulated to the levels in Table 2. , ' Heated Water Temnerature ( F) 170-180 140-160 100-130 Table I: Minimum Insulation Thickness lor Circuloting Hot Water Pipes. Insulation Thickness in Inches by Pine Sizes Non-Circulating ROllouts Circulating Mains and ROllOUts Un to 1" Un to 1.25" 1.5" to 2.0" Oyer 2" 0.5 1.0 1.5 2.0 0.5 0.5 1.0 1.5 0.5 0.5 0.5 1.0 Table 2: Minimum Insulation Thickness lor HV AC Pipes. Fluid Temp. Insulation Thickness in Inches by Pine Sizes Pining System Tvoes Range ( F) 2" ROllOUts I" and Less 1.25" to 2" 2.5" to 4" Heating Systems Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate (for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water, Refrigerant, 40-55 0.5 0.5 0.75 1.0 and Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD (Building Department Use Only) l . SUFFOLK CO{ JNTY DEPARTMENT OF HEALTH SERVICES CERTIFlCA TE OF CARBONMONOXIDE 'ALARM INSTALLATION , I -------------: r----- iIe~~,1il1sp_~E'iol1 Asenc / r(~WIl Eleclricai!.!'.'!E.!E!!!!------c---.---1' i Bu,iness N.;;e-&A(idrcsr-- ~ ~ec'13 ~u.~ \ flY,&ffltP M' fi'~ rI~ tJl&l~ "f~;';:- ---j l____ A/q IJ.~___ . 'Z.!z~?:'J1-37~t> ___J , . : Health Department Rderence Numbof: i Tax Map Number: Di'tric, 1-1 Section Dwe:~~ Localion AJdreslI Ht ~ 1/ ()...,!'~.,.u'~;:'~:1t Pf;:~l':._:.:~:''..:.;:~', ! I Blo~K(S) Lol.(s) I 0;~;um~I:l~ 6{ 0.~'------------- --,' II ?/ 'V 0< I CE~TIFY THAT ALL 01<' THE FOLLOWING ARE l'RUE: . Carbon Mono:ddt: Alarms have bi}ell installed on each level where bleeping quarters are lm~l.\tcd. AND . All alarms hJ\'~ bct'11 installed ill 4ccordan~:e wHh Article 10 ofthe Suffolk County Sar.i~.ary ;':,>de Jud the Carbon !-.1ooo\iJe .Yam1 Stand",rds. im:!ujing: i .:. All i1~a:'n\s are UL2034 listed (Lill':it Edition}, ha\t: a Jigiul ,JijpJay, have a re:-.;et lunc:l, and hav~ a feature to llisp1J.y It!.: ma:tj,nufll ,;:ubcn monO}..~de conc.:nt;,ation recorded since::: the feature was last n:set, AND ... All ulanr:; have been dlf~Ctly conn(~cted to the lighting,. cirvuil ,,,\,tth no intervening s\vitches, AND ',' All ."am,; ha\e been tc,led and rU'llld tu b" opcIatlOnal. AND / ~:... 1 ~rn elnpl0J'cd by an a~ency thlt IS curr~ntl) approveJ to ~\erform eledll.:.d w:.pellmns In theJ.'ownlVtll.lg~ ha'lIng Jllnsdlctl\111 . 11 thl$ ceruf1cJte b 'or a MULTlIJLE D"\VELLING1 Ca:bllfl ~Dlh)X!~~ AlatEl1s h,lve be,~I) Ul,,'Hlkd' .:. In .tll3leepng rooms screed by a ct'ntnltlcd system stlpplyJng :lit fO"l.:OOllI~g, hC,ttl'~';. JI "entilatlDrl, AND .:. In,each slt'eping room c~ntaining 3 f'Je:1 fl.rc:.d app~;i.lnc.:. AND .:+ In all dwdling units Jr-d '.:Ilceping; unit.'i sharing a cowmon wall with, or !(ll.:aled directly above or b~low, [.L m,lnl (;OJlti.linlng a centralize.o ruel~nred appliance. AND ':. In :J _orriJJr s"r"lng dWflling t'.mb or sleeping arca; within I<'fty (40) fcet or all duurs '0 thos" UflilS alld the Cl>ITldor a'.S(, ser\'c..; a f',)-,ml ~Dnt:U:lI1:a a fuel..firt,.'J appliance, _(2A~l _ d~ ~<:_ _fl~-&~--- ---~~- f~:, \lll"sp~ct"f). I. 1//:f!f, i.Prmteo Nam~) _ . (LIcense Numb<lJ raise slalf'nl(';\l~ n,;,ilde hcrtJn art' lurushable a~ a Class A nll.Sdemfalll1t ,ursuant to Sel'twn 210.4" lIe the New York Stale Penul L.iW .' . . . . ... . I CERTIFY THAI TillS D"lLLlNG IS EXEMPT FROM THE REQIJIREME:\T TO INSTALL CARBON MONOXIDE ALARMS m{CAUSE ALL OF THE FOLLOWING ARE TIWF: . TilCre are n(' iJd l~unillg applial~.,~es instJi;td, AND , . Tiwre ~1;'"e nt. .:;J.la~~e,; ,Hbched 1O Ithe dweiLng, AND .. The: u\v(:~\ir.,? uStS 2n electrical hfating s)':>tL:m I ---------------------- j.. - ---.------- --------.---------- .------.- .------.---- (Slgn;.Huh~ lit illSp~cl.or ) (Date) :.,_ : _ _.' __,-' \~:','.::~(Printed Name) (License Number) F:llse statemellt.;: GUIde herdn iU'4;~lJunish;able as a Class i..,misdemealHlr'l}UCSwant to S~d.inr! 210.45 I!r the New York State Penal Lit"'" THE tJRIGI~UL SIGNI1]) COpy OF THIS.l\qRM l',WS'~/Il:E,SliBMITTE[) TO TIlE SUFFOLK COUNTY DEPARTME"1'l' OF HE,>, LTII SERVICES IN OHD(l;R TO RECEIVE F1~;AL APPROV AI. ! ' ,- ,;.,;'''',.-'', 'd,"5:i. )".'''2' W\\M-Q75 ::le.... 10100 COUNTY OF SUFFOLK " .,~, ~ ~..'," "." ,n :,: ,,' .... ~,' i QEPARTMENT OF HEALTH SERVICES CARBON MONOXIDE ALAR---Ml'ACT SHEET AND I . i CERTIFICATE OF INSTALLATION I . 011 June )(:,,! 1999, Ihe Board of l1eiih11' aiLopted new slandard~[O theSuffoTICC6uhly Sanit,uy Code for ciu'bon monoxide (CO) alanns. Effective October l. 1999, CO alamls are required in all new ~ne-fal1lily dwellings, ,two.family dwellings and multiple dwellings. I i Carbon mOl1oxide alarms installed to s,ltisfy this code must be certified by a natiollally recogniztd testing laboratory to conform 10 Underwriters Laboratories Standanl UL 2034. The alar$s must also be equipped with a digital readout of CO concentration and a hUllOll to indicate tl,/: njaxin,um CO coficentratitin since the feature "'liS last reset. I .. . ~ <... -', :'.. " ".. .. '....... ':, ...... ..: -'," ," .'........ , :" : .". '-.., "..'" ' Carbon moqoxide alarms 'In' new 'resldential conslr~ctiori rriu;rb~directly connected [0. the. 'l.ig~.t.in.g.:ci(.C. yjt. ,'Xith.,. ".IO.i.n. ~..rv. C.t.I,i.n... g w..aI.I. sw. .i.tC.h. .....I:in"e.C?rd.......co....~n~~\~.?~.,..pi~e~t P.I..u.g-in. and batlery.powe(e~.alll.l1TlsarenotaJ;~pta"!e. '. Carhop monoxld~al.arms. are reqUired on ~adlleveJ' of orie-f4rhilY;lwo;family andmuliipledwellingso!,\ which sleeping qUart~rsare located. installalio~ of co alanns for lIew c91!;tmction shall be certified by an Elecirical b"]Jection Agency or Municipal Official dltly uwh9rizec1 or appru\'ed by the murllcipality having jurisdiction ~ver the blli/ding consm,ctioll, S"bfmssion of a completed Certificate 9f installation (foundfll the buck of this inslructi9n sh~l) is required as proof of cumpliance. The 'LriKinal certiJlf:ate must be submitted to the SCDllS before final approval to occupy the dwelling will bel issued. I F"lCh alarm Jhall he Jllollnted in accordap..::~with the manl1f.,u.:tur~r's instructions. Alarms shaH bl.: mounted In !alllocal.ions as wqu) red by Suff01k County [)t.'paI1ltlcIH of Ht.:ullh Servict:s. Car bOll Monoxide Alarm Slandards. , i Carbon mOl,bxide alarms are not Inandated for existing one and two family homes, but they ar~ strongly redomrnended if the home has "0 ~ttached garage or <illY type of fuel burning applianc~s For mo~ information, call the Office of Pollution Control al (631) 854-2540. Fot a (act sket on CO poJi~oning, call the SCDHS CO Hotlme at (631) 853-2,911,. , I . . . . '1'Il~; OIU1;lI,.AL SIGNED COpy OF THIS FORM must be completed by an Electrical In,pectin" Aeenniorinoh"use Electrkal ImpeetoraPl'r\lvcdt!y, l'let9i".".or~~1Iagc.,ef j urisdklioll to. pc (f~rm,c1ectricalcompli'l"ce; jjlSI'!:"t!?,,~o ;rhi~ 0 ri~ i, I at Certitic~ t~ '!,,!:,s,l b,c SUb111itti'p t.()>theSqPl{S~efor" {ina! llPproYlll t<,lroccupy tbe d",cUi!I~)rill b.eis;s,\I~<;I. " ,.' . .' ,~. , ".-.:: l]:-.:, ?:: :'.~-:' ".1 ;;/'::." ,',' '.:' ..' ,. ,;' '..' :'j' '_ .... '_':" :': "".: .. '," ",: ..--' '," .......,' ,",,: ,_'0" SUFFOLk COUNTY DEPAlftMI~NT Of' HEALHl. SERVICES' ! m'nCE OF WASTEWATER MANAGEMENT j "IUHRHEAD COUNTY CENTER. .ROOM S~2.38 I RIVERHEAD. NY 11901 __.._. ____~.____ __~__'_ ,___._.__.__._ __u ... __ ~.___..._ _._ _ _.___.__ _ -_ _,.,.___ W',VM.Oi; (Rev. ;0/01)