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HomeMy WebLinkAbout31780-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPA=RTMENT Office of the Building Inspector Town Hall Southold,. N.Y. CERTIFICATE OF OCCUPANCY No: Z-33393 Date: 11/14/08 THIS CERTIFIES that the building ADDITION/ALTERATIONS Location of Property: 4510 GREAT PECONIC BAY BLVD LAUREL (HOUSE NO.) (STREET) County Tax Map NO. 473889 Section 128 Block 4 Lot 21 subdivision Filed Map No. __ Lot NO. __ (HAMLET) conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 1, 2006 pursuant to which Building Permit NO. 31780-Z dated FEBRUARY 7, 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 ENTRY STAIRS, TO AN EXISTING ONE F~uMILY DWELLING AS APPLIED FOR AND PER ZBA # 5804 DATED 12/27/05. ·"ne certificate is issued to MONTE & CAROLYN REDMAN (OWNER) of the aforesaid building. SUFFOI~KCOL~N~"fDEPARTIWE~FF OF ~I~%LTHAPPRO%'AL N/A EI~EC'~RICAL CERTIFICATE NO. 2091186 05/27/08 CERTIFICATION DATED 03/19/08 VINCENT BORDASH thorizedSignature Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled iu by typewriter or ink aud submitted to the Building Department with the following: A, For new buildiug or new use: l. Final sulwey 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 coutains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Pla~ming 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 smwey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupaucy - New dwelling $25.00, Additions to dwelling $~5.00~ Alterations to dwelling $25.00, Swixmniug pool $25.00, Accessory building $25.00, Additions to accessor3~rTfiilding $25.00, Businesses $50.00. 3. 4. 5. New Construction: Old or Pre-existing Building: Location of Property: z/.~ /ff/ ]O~f~_O01*C House No. / Street Owuer or Owuers of Property: /~/". q'/q]f3. County Tax Map No 1000, Section Suffolk Subdivision Cmlificate of Occupancy on Pre-existing Building - $100.00 Copy of Certificate of Occupancy - $.25 Updated Certificate of Occupaucy - $50.00 Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. J (cbeck one) Date of Permit. ~:,O ./// Permit No. ~ q ~0 Health Dept. Approval: Planning Board Approval: Request for: Temporary Cetlificate Fee Submitted: $ _c~, ~ Hamlet Block q Lot Filed Map. Lot: //~ Applicant: ,]/]9f 'q Underwriters Approval: Final Certificate: / (check one) t.--,- Alf/{iicant'lS~ature 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 APL ELECTRIC 63 FALLWOOD PARKWAY FARMiNGDALE NY 11735 * REDMAN 4510 PECONIC BAY BLVD LAUREL, NY 11948 Located at 4510 PECONIC BAY BLVD LAUREL, NY 11948 Application Number: 2091186 Certificate Number: 2091186 Section: 128 Block: 0004 Lot: 021 Building Permit: 31780 BDC: ns11 Described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: First Floor, 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 27th Day of May, 2008. Name QTY Rate Rating Circuits Type Appliances and Accessories Exhaust Fan 2 0 F.H.P Oven I 0 40 Amps Panels 1 90 19 Wiring And Devices Dimmer 6 0 120 V Fixture 6 0 Low Voltage Fixture 23 0 Incandescent Receptacle 10 0 Gert, Purpose Receptacle 10 0 GFCI Switch 23 0 Gen, Purpose seal ! or ! This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated, MAR 23,2008 16:38 16316968287 Page 2 ~:1,, ,I~TIF'.I¢"A, rlON MAR 23,2008 17:44 6316968287 16316968287 Page 2 Office Location: Town Annex/First Floor, North Fork Bank 54375 Main Road (at Youngs Avenue) Southold, NY 11971 http://southoldtown.northfork.net Mailing Address: 53095 Main Road P.O. Box 1179 Southold, NY 11971-0959 BOARD OF APPEALS TOWN OF SOUTHOLD Tel. (631) 765-1809 Fax (631) 765-9064 FiNDIN. N.~, DELIBERATIONS AND DETERMINATION ~. ~ -~, , . ~ .....MEETING OF DECEMBER 27, 2005 ZB File~o~MQNTE and CAROLYN REDMAN Property't"'ocation: 4510 Peconic Bay Boulevard, Laurel CTM 128-4-21 SEQRA DETERMINATION: The Zoning Board of Appeals has visited the property under consideration in this application and determines that this review falls under the Type II category of the State's List of Actions, without an adverse effect on the environment if the project is implemented as planned. PROPERTY FACTS/DESCRIPTION: The applicant's 42,601 square foot parcel has 100 feet along Peconic Bay Boulevard and is improved with a two-story, single-family dwelling as shown on the January 29, 1986 prepared by Roderick VanTuyl, P.C. BASIS OF APPLICATION: Building Department's August 29, 2005 Notice of Disapproval, citing Section 100- 244, in its denial of an application for a building permit to construct proposed additions and alterations. The reason stated by the Building Inspector in the denial is that the new construction will be at a side yard setback of 10 feet, instead of the code-required 15 feet, and at 15 feet for both side yards (total combined), instead of the code-required 35 feet total. FINDINGS OF FACT The Zoning Board of Appeals held a public hearing on this application on December 15, 2005 at which time written and oral evidence were presented. Based upon ail testimony, documentation, personal inspection of the property, and other evidence, the Zoning Board finds the following facts to be true and relevant: AREA VARIANCE RELIEF REQUESTED: The applicants wish to construct an interior conversion of part of the existing garage (addition and alterations) 9'3" by 19'6" and for a new 4' x 10'8" step area, replacing the previous steps, all as described on the plan date-stamped October 31, 2005 and November 17, 2005, prepared by Leo Pyzynski, Architect. Although the Building Department notes in the Notice of Disapproval that the side yard setback will change from 14 feet to 10 feet, the only change is a replacement of the step area with a 10'8"x4' step area. The setbacks to the dwelling will be unchanged, maintaining the existing 14 ft. on the east side and 5 ft. on the opposite side, for a total 19 ft. combined side yard setback area. REASONS FOR BOARD ACTION: On the basis of testimony presented, materials submitted and personal inspections, the Board makes the following findings: 1. Grant of the variance will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. The entrance is proposed to be rebuilt with a new side door flush with the side of the existing home and interior renovations. The porch area is 4'x10'8", and does not change the existing nonconforming setbacks that have existed for years. Page 2 - December 27, 2005 ZB File Ref. 5805 - Monte and Carolyn Redman CTM 128-4-21 2. The benefit sought by the applicant cannot be achieved by some method, feasible for the applicant to pursue, other than an area variance. The home has existing in its current location with nonconforming setbacks for many years, and any major alterations or addition would not be permitted without a variance in these areas. 3. The variance granted herein is not substantial. 4. The difficulty has been self-created in that it is known that the setbacks for the existing dwelling have been nonconforming. 5. No evidence has been submitted to suggest that a variance in this residential community will have an adverse impact on the physical or environmental conditions in the neighborhood. Most of the Peconic Bay area in Laurel has similar conditions and buildings with preexisting nonconforming setbacks. 6. Grant of the requested relief is the minimum action necessary and adequate to enable the applicant to enjoy the benefit of interior alterations and minor entrance, while preserving and protecting the character of the neighborhood and the health, safety and welfare of the community. RESOLUTION OF THE BOARD: In considering all of the above factors and applying the balancing test under New York Town Law 267-B, motion was offered by Member Goehringer, seconded by Chairwoman Oliva, and duly carried, to GRANT the variance as applied for, as shown on the plan date-stamped October 31, 2005 and November 17, 2005, prepared by Leo Pyzynski, Architect This action does not authorize or condone any current or future use, setback or other feature of the subject properly that may violate the Zoning Code, other than such uses, setbacks and other features as are expressly addressed in this action. Vote of the Board: Ayes: Members Oliva (Chairwoman), Orlando, Goehringer, Dinizio, and Simon. Resolution was duly adopted (5-0). Ruth D. Oliva, Chairwoman 1/~'/06 Approved for Filing This 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. 31780 Z Date FEBRUARY 7, 2006 Permission is hereby granted to: MONTE & CAROLYN REDMAN 69 THIRD STREET GARDEN CITY,NY 11530 for : ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR PER ZBA APPROVAL #5804 at pren~ises located at County Tax Map No. 473889 Section 128 pursuant to application dated FEBRUARY Building Inspector to expire on AUGUST 4510 GREAT PECONIC BAY BLVD LAUREL Block 0004 Lot No. 021 1, 2006 and approved by the 7, 2007. Fee $ 150.00 ized ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND ~INSULATION [ ] FRAMING/STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE -~ ~-/~ - ~ ~ INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST /~ROUGH PLBG. [ ] FOUNDATION 2ND [ ] FRAMING / STRAPPING [ ] FIREPLACE & CHIMNEY ] INSULATION ] FINAL ] FIRE SAFETY INSPECTION REMARKS: DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ~)~FOUNDATION 1ST [ ] ROUGH PLBG. [ ] ~,~,,~--.~'-'- [ ]INSULATION [~FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ] INSULATION [ ]FRAMING / STRAPPING ~)~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRUCTION REMARKS: [ ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION DATE ~'--~'-~"--~ ~ INSPECTOR FO~DATION (1ST) PL~B~G ~SULATION PER N. Y. STATE ENERGY CODE ~DITION~ COMMENTS S~qolk Coun~ Executive's O[fiee a£ Consumer Al[aim VETERANS MEMORIAL HIGHWAY * HAUPPAUGE, NEW YORK DATE ISSUED: 5/5t04 SUFFOLK COUNTY Master Plumber Lwense No. 34971-MP NOT VALID WITHoErr SISAL AND A CURRL~T CON~ A~'PAIR.~ iD CARD PRODUCER 631-242-2422 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CONSULTING INSURANCE AGENCY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1350-33 DEER PARK AVENUE ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ~ NORTH BABYLON, NY 11703 COMPANIES AFFORDING COVERAGE COMPANY A AMERICAN HOME ASSURANCE COMPANY INSURED COMPANY MITCO CONSTRUCTION INC. B 1941 ALLISON DRIVE COMPANY BELLMORE, NY 11710 C COMPANY I D cOVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAIDCLAIMS~ I POLIOYEFFECTIVE IPOLIOYEXPIRATIONI TYpE OF INSURANCE POMCY NUMBER DATE (M M/DD/YY) DATE {MM/DD/YY) GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL LIABILITY PRODUCTS - COMP~P AGG $ I CLAIMS MADE ~ OCCUR PERSONAL & ADV INJURY $ OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ FIRE DAMAGE (Any one fire) $ MED EXP (Any one person) $ AUTOMOBILE LIABILITY -- COMBINED SINGLE LIMIT $ ANY AUTO ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person)I $ HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ -- PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $  UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM $ WC STATU- A WORXERS COMPENSAT,ON AND 113011095 04-13-05 04-13-06 ITORYLIM,TSI EMPLOYERS' LIABILITY EL EACH ACCIDENT $ 100,000 EL DISEASE- EA EMPLOYEE I $ 100,000 OTHER DESCRIPTION OF OPE RATION~/LOCAT~ONS~'ERICLESlSPECIAL ITEMS CERTIFICATE HOLDER CANCELLATION : : SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE TOWN OF SOUTHOLD EXPmAT;ON DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL BUILDING DEPARTMENT 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, TOWN HALL vv~-, ,v.~C)HT~C~/r~, NY 11971 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR UABILFrY OF ANY KIN[~-UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. ACORD 25-0 (1/95) RPORATION 1988 CERTIFICATE OF LIABILITY INSURANCE[= Oo._, 04/12/05 PRODUCER Three Village Bennett Agcy Inc 300 Main St. Suite 2 East Setauket NY 11733-3831 Phonet631-941-3850 Faxt631-941-3823 INSURED Mitco Construction, Inc. 1941 Allison Drive Bellmore NY 11710 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURER B: INSURER C: INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE E, EEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR POLICY EFFECTIVE POLICY EXPIRATION LTR TYPE OF INSURANCE POLICY NUMBER DATE (MM/OD/YY) DATE {MM/DDIYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 A X COMMERCIAL GENERAL UABIUTY ~q.71206960 02 06/29/04 06/29/05 FIREDAMAGE(Anyoneflre) $250,000 I CLAIMSMADE ~] OCCUR MEDEXP(Anyoneperson) $ 5000 X Blanket Add~l Ins PERSONAL&ADVINJURY $1000000 GENERALAGGREGATE $ 2000000 GEN'LAGGREGATELIMITAPPUESPER: PRODUCT$-COMP/OPAGG $ 2000000 PRO- AUTOMOBILE LIASIMTY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY SNJURY SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON~WNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY ~ EA ACCIDENT ANYAUTO OTHERTHAN EAACC $ AUTO ONLY: AGG EXCESS MABILrrY EACH OCCURRENCE $ ] OCCUR [] CLAIMS MADE AGGREGATE $ $  DEDUCT/SLE ! $ RETENTION $ WC STATU- WORKERS COMPENSATION AND I TORY LiMiTSI I('~' EMPLOYERS' LIABILITY EL EACH ACCIDENT $ E.L DISEASE EAEMPLOYEf $ EL. DISEASE - POLICY LIMIT $ OTHER A ProDerty Section ART1206960 02 06/29/04 06/29/05 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER I N I ADDITIONAL INSURED; INSURER LETTER: __ CANCELLATION Town of Southold Building Department Town Hall Southold NY 11971 TOWNOFS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~[ 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT~ BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.~,~ ,~. Virginia McOrat~ ©ACORD CORPORATION 1988 ACORD 25-S (7/97) TO: Leo Pyzynski for M & C Redman 4510 Peconic Bay Blvd. Laurel, NY 11948 FORM NO. 3 NOTICE OF DISAPPROVAL DATE: August 29, 2005 September 12, 2005 Amended Please take notice that your application dated August 19, 2005 For permit to make alterations & additions to a single family dwelling at Location of property: 4510 Peconic Bay Blvd., Laurel, NY County Tax Map No. 1000 - Section 128 Block 4 Lot 21 Is returned herewith and disapproved on the following grounds: The proposed construction to a single family dwelling, on a 42,601 sq. ft. lot in the R40 zone is not permitted pursuant to the Bulk Schedule. Upon construction, the side yard setback will change from 14' to 10'. The minimum side yard setback is 15'. The required side yard setback is 35' combined. The proposed combined side yard setback upon construction will be 15'. Amended to reflect proper section of the code. / Authorized Signature FORM NO. 3 NOTICE OF DISAPPROVAL DATE: August 29, 2005 TO: Leo Pyzynski for M & C Redman 4510 Peconic Bay Blvd. Laurel, NY 11948 Please take notice that your application dated August 19, 2005 For permit to make alterations & additions to a single family dwelling at Location of property: 4510 Peconic Bay Blvd., Laurel, NY County Tax Map No. 1000 - Section 128 Block 4 Lot 21 Is returned herewith and disapproved on the following grounds: The proposed construction to a single family dwelling, on a 42,601 sq. ft. lot in the R40 zone is not permitted pursuant to Article XXIV Section 100-244 which states: "This section is intended to provide minimum standards for granting of a building permit for the principal buildings of lots which are recognized by the town trader 100-24, are nonconforming and have not merged pursuant to 100-25." Upon construction, the side yard setback will change from 14' to 10'. The minimum side yard setback is 15'. The required side yard setback is 35' combined. The proposed combined side yard setback upon construction will be 15'. Authorized Signature 07/21/D5 11:~2 FA/ $18 826 7532 ldlTCO CO ~01 ReceiptCopy Page 4 of 4 SUFFOLK COUNTY OFFICE OF CONSUMER AFFAIRS PAYMENT RECEIPT I RECE, PT .0, 1.,~,4 I Rec'~ From: DIll'A: Date: MITCHELL ~IITCO CONSTR INC 5/30/2.005 11:41:00 AM ~ Cash NO~ Drown On: ~ Chec~ 5510 DIME SAV ~ Money O~der ~ AM~ ~ Master. rd ~ Visa Cat~o~ Se~i=e Fee VIoletion Slip No Remarka - H,I Coni~ctor C -Lic. Renew ~00~ - H I Contracto~ ~ $UFF~ COUN~ EXE~NES I HOME ~MPROVEMENT I CONTRACTOR LICE~E [~A[O MITCHELL RfiC'O BY: Licen~eg: DCRANN K)TSON 932! ~OTAL: Remarks 500,00 CUStomer copy ht'.p: f/su £fo lkca/receiptcopy aspx?lD= 16:1514 6/30/2005 TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER LOT FOR~P.'OWNER ~t'~" ~' /u'~ RES.,~./? SEAS. VL. LAND IMP. Till~b.le 1 Tillable 2 Tillable 3 /o. ~oo - Woodland Swampland Brushland ~ ~.~ House Plot STREET VILLAGE DISTRICT SUB. / TOTAL DATE , ~ REMARKS ,.j:, /. , .' / /,. . . ., , / ~, ?~ ~i 4~P'°v~ . L~., p~ ~. ,. ~ x.,"--~, ,. V.,.e /.,'; ? Tara I M. Bldg. Extension Foundation Basement IExtension l:xtension Ext. Walls Place Porch Porch Patio Driveway jBath Floors Interior Finish Heat Attic Rooms 1st Floor Rooms 2nd Floor II II ~WNER STREET VILLAGE DIST. ~UB. LOT ACR. REMARKS TYPE OF BLD. PROP. CLASS LAND IMP. TOTAL DATE FRONTAGE ON WATER TILLABLE FRONTAGE ON ROAD WOODLAND DEPTH MEADOWLAND BULKHEAD HOUSE/LOT · TOTAL ~5 COLOR TRIM ~,,,C ~C~ · r~, 6 · ¢, & CR~)WL Floors Kit. Extension /,~ ~' ,2 L/: ~ ~' ~ S. ~-'~ I ~ ~ Basement SL*, Ektension / 3 ~ f 3 = / ~ ~ ~. ~o l~ ~ ~ Ext. Walls, Interior Finish L.R. ~w~'~ Fire Place ~6~ Heat ~ Porch', ~ 5 ~; ~Go .~° [~O Dormer Fin. B. f~.~,~ I?~ :?,91~ ~/~ ~.?~ /~C~ RoomslstFIoor Garage 5.aa - 6~ > 50~ /,) ~" 3~ O Driveway Rooms 2nd Floor SUFFOLX ~UNTT.qEjOARIMENT OF HERLTH SERVIO~ ~-~LLFA¥11LY DWELLING OHLY OAT~un ~ RItlIKS. R~. NO. ~:~-~v') -?~ The sewage dist~sal an8 water St!DpT? [aci~.i~.~ f~ this leca Ii~ have I~en iflspected by tfli~ DoPar,'ment and/or other agonies and,~oued~lL~e sa~llry Chi~'i of Bm'eau of Wastewat~r Managemeflt ,7, ~rAV£~£N~ Or iNTE.T CONFORM TO THE STANDAR~ O~ THE SUFFOLK CO. DE~. OF HEALTH SERVICES. ~LICANT SI~FFOLK COUNTY O~T. OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY A~OVED: ...... I i SU~k CO. T~X'~"lo[slS~T~O~: DI~. ~CT. ~K ~L. O~NEES ADDR~: ,,, ,~' TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval eck Expiration ~/~ , 20~__ Building Inspector Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: Phone: ~ ~- APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS ,20o~' 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 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 issu, es 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, Nev¢ 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. (.~ (S~t~e of applicant or name, ifa corporation) (Mailth~ address of applicator) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises I (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Location of land on which proposed work will be done: HOuse Number 'Street Hamlet Filed Map No. Lot County Tax Map No. 1000 Section Subdivision (Name) 2. State existing use and occupancy of premises and intended use.~an[l occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy 114-~lBx,-rhnt. - 3. Nature of work (check which applicable): New Building. Repair Removal Demolition 4. Estimated Cost ~ ~.eI ~ 5. If dwelling, number of dwelling units d4 If garage, number of cars PA Fee Addition ~/ Alteration Other Work ,,~'rt.~,,~ A~'rt~t.~'l}~e~ (Description) (To be raid on filing this application) Number of d~elling un{~t~.~ch floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Rear Height '~,~ Number of Stories -~. Depth _ Dimensions of same structure with alterations or additions: Front Depth, Height Number of Stories Rear 8. Dimensions of entire new construction: Front vJ~- Height ~,~ Number of Stodes 9. Size oflot: Front loc, Rear 10. Date of Purchase Name of Former Owner Rear dm Depth 1 I. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES 13. Will lot be re-graded? YES __ NO / Will excess fill be removed from premises? YES 14. Names of 6wner of premises "~ap*'J~C~J Address/~C/~9 ~OXt~2~o Phone No. Name of A~chitect A~ ~2. ~u~.~.o_C/O' Address ,¢~/-,~,,z~,~,,,~J/,~4~,~fPhone No Name of Contractor I~lx~ tt.~,* sr~ Address a~-~ on~ ,v?Phone No. NO / '79a- 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 OFl,.~,('/~o ) ~ .~ t~_~/r.oy{ ~lh being duly swom, deposes and says that (s)he is the applicant (Name of individual signidg contract) above named, $:)He is the (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are tree to the best of his knowlodge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this . [(9 dayof ~O~ '~ot 'ary Public WAYNE ULRICH Notary Public, State of NeW Yo~ No, 9411880 Qualified In Nassau County Commission Expires Sept. 30, 2008 2o0,5'- 02/06/06 09:3**4 F.t.Z. 516 826 '7532 :D~H FRX h~. Morvin S'l*ormPlus'~ NY Produ¢'l*s ~IT¢O CO ~:,,~.... danuc~f 20X33 134~ge 2 ot 6 02/06/06 09:14 FA][ 516 826 7532 gITCO:iCO FROM :DP~H rV/OrVIA ~TOrt'TII-'IU$*~ NY HrooucT$ Feb,. 05 ~03 P~ I-lung (al~o avak~le as Single H~ng) '~tad Uhlmate Double - Hung ~c~ and CJacl After CN3028, up to CN$232 CN66g.0 Plclum up tc ~78 T~ ~ ~ ~6075 CN3672 Pt~-~,,~s up to Ch7272 +&5/-40 ~ +40/-5O +4~"501:~. H-LC40 H-LC35 H-ICaO H-LC36 1R-LCSO ~-LC~O C-CIO AP-CIO r-.c4o F.,C40 F--AW4~ Jonu~'y 2003 02/06/06 09.14 FAX 516 826 7532 ~ ~ZlTCO FI~OP1 : DRSH F~X RO, ; Matin ormP us NY Products ~]04 P5 ~ and c~ u~m~'a IOut~g F~erx;h Doo~ Up t~ CN~SD +40/-50 5'l'on'nPlu.s NY Fecrlums grid ~eneflt~ - Compliant, S~e, ~ ae~mtfful · Cedified to New Yc~ ~tato l~ldlng cocle reClUlrel'~nfs for Iml~ct ami energy, ~o you can be su~ Vou are In compllanoe, · laminated Cli~nCl - cen~fled to '~dthstand Impact pre. ute, P~otects fne bullctlng envelope ou~n~ a I~unlcane ~ I=x~lng gk'~' In unlt, · . Energy efflck~'~t - heil~ homeowr~ sa~e on he~lh,g and coOIl~ col~ StOl/T1PIU~ N~' glazing consist~ of lwo I:x~r~s Of Ola.~ ~'nl~e~ m~tg~or ancl laminated Intmlo~). Wllh/.ow E Il wt~ ~ eptlon, eluull~ ~o~ Ek~a~v St~® · ~tolm d~ fo m~-u~e the ~ du~ng vtolenf we~h~' ~lli~m. ~om e~m ~, (~R~ ~ ~ H~ and ~g~ Hu~ ~ o~.) ~ng and h~ ~ ~ ~ ~O~ ~ flOm ~. , ~ g~ end ~w [ II ~e ~ ~n~ ~ m~ ~ ~cfl~ ~1~ f~lna of ca~ a~ ~le, dartuanf 2OD5 02/06/06 09:14 FAX 516 826 7532 MITCO CO R-e~uent~ ~M : DP~SH Marvin StormPlus~ NY Products [~o$ c~ a h~e In ~e g~ ~ ~ all~ a 3-Inch ~h~e to ~ ~h, or o ~ear ~ combh~ ~ ~w E II ~' ~on Permit Number Checked By/Date REScheck Compliance Certificate New York State Energy Conservation Construction Code REScheckSoflware Version 3.5 Release lb Data filename: C:~rogram Files\Check~REScheck~edman - Laurel -Leo, rck COUNTY: Na~au STATE: New York HDD: 4910 CONSTRUCTION TYPE: Detached 1 or 2 Family HEATING TYPE: Non-Electric DATE: 08/08/05 COMPLIANCE: Passes Maximum UA = 51 Your Home UA = 27 47.1% Better Than Code (UA) Gross Gla~ing Area or Cavity Com. or Door Perimeter R-Value R-Value U-Factor UA Wall 1: Wood Frame, 16" o.¢. 288 21.0 0.0 Window 1: Wood Frame:Double Pane with Low-E 16 Door 1: Solid 20 Floor 1: All-Wood Joist/Truss:Over Unconditioned Space 200 30.0 0.0 Floor 2: All-Wood JoistfFruss:Over Outside Ak 14 30.0 0.0 14 0.330 5 0.067 1 7 0 COMPLIANCE STATEMENT: The proposed building represented in lhis document is consistent with the building plans, specifications, and other calculations submified with this permit application. The proposed systems have ~ designed to meet the New York State Energy Conservation Construction Code requirements. When a Registered Design Professional has ~am.,~xl and signed this page, they are attesting that to the best of Ms/her knowledge, belief, and professional judgment, such plan~ or specifications are in compliance with this Code. Builder/Designer ..~-~---x///} A m~,_ Date REScheck Inspection Checklist New York State Energy Conservation Construction Code REScheckSoftware Version 3.5 Release lb DATE: 08108/05 [ ] [ ] [ I [ l [ ] [ ] [ ] [ ! [ l [ ] [ ] [ ] [ ! [ l [ ] [ ] [ ] Above-Grade Walls: 1. Wall 1: Wood Frame, 16n o.c., R-21.0 cavity insulation Conunents: Windows: 1. Window 1: WoudFrame:DoublePan¢ withLow-E, U-factor: 0.330 For windows without labeled U-factors, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ Comments: ] No 1. Door I: Solid, U-factor: 0.067 Couunents: 1. Floor 1: All-Wood JoistdTruss:Over Unconditioned Space, R-30.0 cavity insulation Comments: 2. Floor 2: All-Wood Joisl/Tmss:Over Outside Air, R-30.0 cavity insulation Conunents: 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 1) 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 3" clearance from insulation. Vapor Retarder: Required on the warm-in-winter side of all non-vented framed ceilings, walls, and floors. Materials Identification: Materials and equipment must be installed in accordance with the manufacturers installation instructions. Materials and equipment must be identified so that compliance can be determined. Manufacturer mantlalS for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R-values and glazing U-factors must be clearly marked on the building plans or speciticarions. Duct Insulation: Supply ducts in unconditioned attics or outside the building must be insulated to R-8. Return ducts in unconditioned aaics or outside the building must be insulal~xl to R-4. Supply ducts in unconditioned spaces must be insula~d 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 permitted. Exception: Continuously welded and locking-type Iongitudinnl joints and seams on ducts [ [ [ [ ] [ l [ I [ l [ I [ I [ I [ ] operating at less than 2 in. w.g. (500 Pa). Ducts shall be supp(med every 10 feet or in accordance with thc manufacturer's instructions. Cooling ducts with exterior insulation must be covered with a vapor retarder. The HVAC 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 arc required for each dwcllin§ unit. Fireplaces: Fireplaces must be installed with tight fitting non-oombustible 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 unless thc water heater has an integral heat trap or is part of a circulating system. Insulate cirodating hot water pipes to the levels in Table 1. Circulating Hot Water Systems: Insulate eirodafing hot water pipes to the levels in Table 1. Swimming Pools: All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of thc heating energy is from non-dcpletable sources. Pool pumps require a time clock. Heating and Cooling Piping Inflation: HVAC piping conveying fluids above 105 °F or chilled fluids below 55 OF must be insulated to thc levels in Table 2. Table 1: M'mlmum lns#iation Tidelmess for Circ~t~ng Hot Woter Pipea Insulation Thickness in Inches by Pipe Sizes Heated Water Non-Circulating Ranouts Temperature (F) Up to 1' Up to 125' 170-180 0.5 1.O 1.5 2.0 140-160 0.5 0.5 1,O 1.5 I00-130 0.5 0.5 0.5 1.0 Cirollating Mning and Runouts 1.5" to 2.0' Over 2" Table 2: Minimum lnsulotion Thiclmess for HVAC Pipea Fluid Temp. Insulation Thickness in Inches by, Pipe Sizes PioingSvstemTvoes Range(F) 2"Runouts l"andLess 1.25~to2" 2.5"to4" Healing 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 ¥11~LD (Building Department Use Only) CELLAI~. PLAN .-GC^LE: 1/4" '= ,I'-0" j, F~ITCHEN E?(i~T. 6ELLAP- NEI, N NE~ I/4" = I'-0" LINE OF 2NID ~=LOOR LINE OF FLOOP. - EXIDT. ENLAP.~ED DININ~ ROOM I/4" = I'-0" ~, ~ p~ ~e 20~ ~el~j~l ~0~, ~ york ~ ~P ~LIAN~B ~TA~T INF~MATt~N ~E ~IDTIN~ 'P~[~;~5~ ~ G~A~ OF H~EI~ ~E I~ED LOAD5 OF ENLAI~.~EI2 KITCHEN I ,I ' APPenD AS NOTE~ .' ,; ']~F ' iD 5ND~ICoNDITIONS OF I ' ,II 1, FOUNDATION TWO REQU RED FOR POURED CONCRETE DON01~i FRAMING 2 ROUGH - FRAMING &IpLUMI~[NG 3. INSULATION I "J. ' I ' 4. FINAL - CONSTRUCT[ON MU~T , P..EhdO~['~':L.~,'~PLETE FOR C,O, I--I-~ E~AT~TRUCTION SHALL MEET THE REQUIREMENTS OF TRE OODESIOF NEW HAS NOT R~SPONSIBLE,~= FOR CO~l~ , I RETAIN STORM WATER RUNOFF' P-.OOM \ , PLOT PLAN PUR~IUANT TO SECTION 4D100 OFT I : IJNDER~ITEfl$' APPROVED. I ' ;CUPANCY OR ElS UNLAWFUL CERTIFICATE' ,' OCCUPANCyI JMEET THE REQUIRE ENT~ comPLY ~XH CH~T~ "46~ FLOOD DAMAGE'PREVENTION CERTIFICATION OF NAILING a CONNECTIONS REgU RED FLooR JOIST - C, Er, rTER OUTS FLOOR JOIST - ~ND GUTS D,'~- M,,,x I NfdlLTIPLE FLOOR TIE BID LEI,~TH POST ATTAF-,,HHE!T II ~~ ~lJI' DE. DMA./'i m~lmcJ'tCr__ - PRAMI/IG PETAIL~ J ,ll~r ~, ~J~',,,,,~J./'~J~ ~j A/IU TME AM~.RICA/N FORPJT A/N{? PAPER ,~/J'OCIA I]0/1 J~P'J,~'"')~JJ~ ~/'l~,~, J~/I~J~l~ 1995 EOITIO/1 OF THE WOOD FRAME CO/$FFRUCTIO~ M/U~UAL II '.'~1l~?¢-~ 11PYZY/1./iq AJ'J'OCIATE.,r ARCHITrCTUREI r-J;T [I ~ JJ 821FI~/N~I/1AVE J'UIT~209 GARFEdCI1Y 11550 L/L.I J L J J PHO/tE 51~ 7,¢.2-J788 FAX 51(5 742- 787