HomeMy WebLinkAbout33816-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33501 Rte: 01/23/09
THIS CERTIFIES that the building ALTERATIONS
Location of Property: 2350 DEEP HOLE DR MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax ~4ap No. 473889 Section 123 Block 4 Lot 7
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 11, 2008 pursuant to which
Building Permit No. 33816-Z dated APRIL 11, 2008
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 TO AM EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to ERIC KLODNICKI
of the aforesaid building.
(OWNER)
S~IFFOLKCO~I~fDBPAR~T OF }~ALTHAPPRO¥1~L N/A
ELB~-£RICAL CERTIFICATE NO. 4003711 11/14/08
PLI]MB~ CERTIFICATION DA'£~D 12/08/08
PERFECTION PLU~4BING
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 in by typewriter or ink and submitted to the Building Department with the following:
A. For new building or new use: 1. 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 o f Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains 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 Planning Board Approval of completed site plan requirements.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land nses:
1. 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 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 CertificateofOccupancy- $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
New Construction: Old or Pre-existing Buildit~ (check one)
LocationofProperty: 7.-~ ~ /~'f~ g~/o/t" . Dff] I~'~-.~ ([
HouseNo. ~ v Street -- ' ' Hamlet
Owner or Owners of Property: __ ~/~ ( ~F_..- ~__fOC~t. q t.C'¢.[^
Suffolk County Ta~r Map No t000, Sectiou /2,_~ Block ¢) c~ Lot O ?
Subdivision Filed Map. Lot:
Permit No. ~ ~/_ b Date of Permit. Applicant:
Health Dept. Approval:
Underwriters Approval:
Plamfing Board Approval:
Request for: Temporary Certificate Final Certificate:
Fee Submitted: $ c~ q~ ~'' O
/
Cmo B 55o I L
} (check one)
Applicant Signature
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. 33816 Z Date APRIL 11, 2008
Permission is hereby granted to:
ERIC KLODNICKI
2350 DEEP HOLE DR
MATTITUCK,NY 11952
for :
ALTER3~TIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR;
FLOOD PERMIT INCLUDED
at premises located at
County Tax Map No. 473889 Section 123
pursuant to application dated MARCH
Building Inspector to expire on OCTOBER
2350 DEEP HOLE DR MATTITUCK
Block 0004 Lot No. 007
11, 2008 and approved by the
11, 2009.
Fee $ 730.40
Authorized ~ignature
ORIGINAL
Rev. 5/8/02
TOWN OF $OUTIIOLD
OFFICF. OF BUll.DING INSPECTOR
P.O. BOX 728
ToWN IIALL
SOUTIIOLI), N.Y. 11971
cERTIFICATION
TEL. 765-1802
Date i ~/~/~-
Building Permit No. ~ ~
([)lease print)
(please print)
I certify tbak the solder used in the water supply system
contains less than 2/10 of 1% lead.
(plumber'S signature)
Sworn to before me this
....... day o~ ......... ,
count
Notary Public,
Notary public
VICKI TOTH
Notary Public.State of New York
No. 01T06190696
Qualified n Suffo k County _
Commission Expires July 28 20 {?
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
G & S ELECTRICAL CONTR.
P.O. BOX 215
SOUTHOLD, NY 11971,
Located at
Application Number:
4003711
Section: Block:
ERIC KLODNIKI
2350 DEEPHOLE DR
MATTITUCK, NY 11952
2350 DEEPHOLE DR MATTITUCK, NY 11952
Certificate Number:
4003711
Lot: Building Permit: 'A~J~l ~o BDC:
338,t~ 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, 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 the14th Day of November, 2008.
N{Ime QTY Rate Rating Circuits Tyl~
Alarm and emergency equipment
Sensor
Appliances and Accessories
Air Conditioner 1
Dish Washer 1
Exhaust Fan 3
Furnace 1
Oven 1
Service
Service Disconnect: 0
ServicelPhase3w Service
Rating200Amperes
Wiring And Devices
Dimmer 9
Fixture 49
Outlet 49
Outlet 83
Paddle Fan 4
Receptacle 1
Continued on Next Page
0
0
0 Above 1500 BTU
0 1.2 KW
0 F.H.P
0 Oil
0 50 Amps
200 cb
Carbon Monoxide
0 120V
0 incandescent
0 Fixture
0 Gen, Puq~ose
0
0 20a-laund~ Appliancaea!
1 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.
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
G & S ELECTRICAL CONTR. ERIC KLODNIKI
P.O, BOX 215 2350 DEEPHOLE DR
SOUTHOLD, NY 11971, MATTITUCK, NY 11952
Located at 2350 DEEPHOLE DR MATTITUCK, NY 11952
Application Number: 40037,11 Certificate Number: 40037,1.1
Section: Block: Lot: Building Permit: 33819 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, 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 14th Day of November, 2008.
N~m~ QTY Rathe Rating Circuits Tv~e
Receptacle I 0 30a Dryer
Receptacle 7 0 GFCI
Receptacle 45 0 Gen, Purpose
Switch 43 0 Gert, 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.
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ]FOUNDATION 1ST
[ ]FOUNDATION 2ND
[ ]FRAMING / STRAPPING
[ ]FIREPLACE & CHIMNEY
[ ]FIRE RESISTANT CONSTRUCTION
REMARKS:
[ ] ROUGH PLBG.
[ ] INSULATION
/~ FINAL
[ ] FIRE SAFETY INSPECTION
] FIRE RESISTANT PENETRATION
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND ~"i'NSULATION
[ ]FRAMING / STRAPPING [
[ ]FIREPLACE & CHIMNEY [
[ ]FIRE RESISTANT CONSTRUCTION [
] FINAL
] FIRE SAFETY INSPECTION
] FIRE RESISTANT PENETRATION
REMARKS:
DATE
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
] FOUNDATION 1ST
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESISTANT CONSTRUCTION
~"ROUG H PLBG.
[ ] INSULATION
[ ] FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRATION
REMARKS:
DATE
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG,
[ ]INSULATION
[ ] FINAL
[]FIREPLACE&CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUe/~ [ ] FIRE RESISTANT PENETRATION
REMARKS: (,~/6 ,'.~ //G-L~"~
DATE
FEELD I~NSFECTION REPORT DATE COlVllV[ENTS
FOUNDATION (1ST)
FO[ ~qDATION (2ND)
ROUGH FRAiVIJ2NG &
PI U~'V[BI2N G
LN'SI?L.& [JON }'ER N. T,
ST,4 FE ENERGY CODE
ADDITIONAL COM3/IENTS
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www. northfork.net/Southold/
Examined
Approved
Disapproved a/c
I,20 O~
t, 200
PERMIT NO. .~ d'~/~ ~
Building Inspector
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying'?
Board of Health
4 sets of Building Plans
Plalming Board approval
Survey
Check
Septic Form
N.Y.S.D.E.C.
Tmstees
Contact:
Mail to:
Phone:
APPLICATION FOR BUILDING PERMIT
Date ,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 of lot and of buildings on premises, relationship to adjoining premises or public streets or
areas, and waterways.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector
issues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the
property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an
addition six months. Thereafter, a new permit shall be required.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance 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, 1).gusing code, and regulations, and to admit
authorized inspectors on premises and in building for necessary inspections. 4 /~4~ /~
I (Signamr% oYapphcan'"~"t,~ame, ifa corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
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)
r,..:,.~ .... License No. ~t~iiiP<.
Plumbers License No. (pulo~ ,,~') '
Electricians License No. ,,
Other Trade's License No.
Location of land on which proposed work will be done:
2. 5o t-k,t. Detve_.
House Number Street
Hamlet
County Tax Map No. 1000 Section
Subdivision
(Name)
Block <::~
Filed Map No.
Lot ,O'-]
Lot
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ~'a,Y~L.ro [~/~.~t.~
b. Intended use and occupancy ,~/v6G~, ~'vvx~l,)4, ID¢4~t.k.l~
3. Nature of work (check which applicable): New Building Addition Alteration ~>~
Repair Removal Demolition Other Work
Estimated Cost~ ~ ~0~
Fee
(Description)
(To be paid on filing this application)
If dwelling, number of dwelling units [ I~Wo~,a,r~. Number of dwelling units on each floor
If garage, number of cars
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 '~'~ Depth
Height 1~ Number of Stories
10. Date of Purchase ,,T,~lq, O. gT~
Dimensions oftsame structure with alterations or additions: Front ~'l~
Depth ~'~ Height_ I, 6' Number of Stories I
Dimensions of entire new construction: Front (~ ~L~v~'h Rear Depth
Height Number of Stories
Size of lot: Front lt~~ Rear ~,-~1 _Depth /L~ot (~
Rear
Name of Former Owner I'll'/'x~k,P~'l /~,.I~>1~2:>
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES__ NO >~
13. Will lot be re-graded? YES
14. Names of Owner of p,.remises
Name of Architect
Name of Contractor
__ NO X Will excess fill be removed from premises? YES NO ~
Address ~', ¢'~. ~$~ Phone .
Address~Phone No ~$~ ~ ~- ~BB
Address ~, ~ ~ PhoneNo. ~$l~-~i~
15 a. Is this property within 100 feet eta 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 ,5<, 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 )
~'~5> ~;~ being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the ,/~ffo~.~4"~'/,,~1~0¢~ t~
(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 knowledge and belief; and that the work will be
performed in the manner set forth in the application filed therewith.
Swong to belbre me this
~ 4..,2- day of /~/4/~o'~
PHILIP J. DeDORA JR.
Notary P.blic, State of ~low York
No. 4884325
20 o'~
Signature o f~7~plicant
U.S DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Managemenl Agency
National Flood Insurance Program
ELEVATION CERTIFICATE
Important: Read the instructions on pages 1-8.
OMB No 1660-0008
Exoires February 28. 2009
SECTION A - PROPERTY INFORMATION ~ For Insurance Company Use:
A2. Building S ree~ Address ( ncluding Apt., Unit, Suite and/or Bldg NO.) or P.O. Route and Box No. Company NAIC Number
A4 Building Use (ag. Reside/If/al, Non-R,esidenlial. Addition, Accessory etc.)
A5 Lafilude/Longilude: LaL ~ ~Z~)¢ 5~' /~4, ~-~'- Long..~) ~'72 ¢' ~.~ ' ~/*, ~' :' Horizontal Oalum: [] NAn 192;' [] NAD 1983
A6. Agach at least 2 pholographs et lhe building if the Cerlgicale is being used to obtain flood insurance.
A7 Building Diagram Number ~'
A8. For a building with a crawl space or enclosure(s), provide:
aJ Square Pamge of.aw~ space or end,os.re(s) /~ ~1 sq. Ag. Eot a bu,ding w,h an attached garage, provide:
a) Square tootage et attached garage q fl
b) No. of permanenl flood openings in lhe crawl space er //~..]~.~ b) No ofpermanenlfloedopeoingsh) file allached garage
enclosure(s) wails within 1.0 toot above adjacent grade walls within 1.0 foot above adjacenl grade
c) TolalnetareaoffloodopeningsinA8.b -- sgin c) Totalnelareaoffloedopenfi)gsinAg.b -- sqin
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NF Corn unity Name & Community Number
B4. Map/Panel Number BS. Suffix B6, FIRM Inbox ] B1. FIRM Panel
B10. Indi~le lhe sou[m of lhe Base Floed Bevatied {BF[) dala o[ base flo~ deplh enle[ed in Ilem B9.
~ FIS Profile ~FIRM ~ Commungy Determined D Olher (Describe)
B8 Flood
Indicate elevation datum used for BFE in Ilem B9: [] NGVD 1929 [] NAVD 1988 [] Other (Describe)
is the building located in a Coaslal Barrier Resources Syslem (CBRS) area or OIhenNise Protected Area (OPA)?
Designation Date [] CBRS [] ePA
[ B9 Base Flood
i o; ebas °°ddep")
[] Yes ~] NO
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C2
Building elevations are based on: [] Construction Drawings* [] Building Under Consbuclion* J~
Finished
Construclion
*A new Elevation Cedificate will be required wbe~ construclion of the building is comptele.
Elevations Zones Al-A30, AR, AN, A (wilh BFE), YE, Vl -V30. V (with BFE), AR, AR/A, ARIAE, AR/Al-A30, AR/AH, AR/An. Complete gems C2a g
below according to the building diagram specified in gem A7.
Benchmark Utilized Vertical Datum
a) Top of bottom floor (including basement, crawl space, or enclosure floor)
b) Top et Ihe nexl higher floor
c) Bottom of Ihe lowest hodzontal structural member (V Zones only)
d) Attached garage (top of slab)
e) Lowest elevation of machinery or equipmenl servicing Ibe building
(Describe type of equipment in Comments)
f) Lowest adjacent (finished) grade (LAG)
g) Highest adjacent (finished) grade (HAG)
Check Ihe measuremenl used.
feet
tee:
[] meters (Puedo Rico only)
[] meters (Puedo Rico only)
[] meters (Puedo Rico only)
[] meters (Puelto Rico only)
[] meters (Puerto Rico only)
[] meters (Puedo Rico only)
[] meters (Puerlo Rico only)
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This cedification is to be signed and sealed by a land surveyor, engineer, or ardlilect authedzed by law to certify elevalion
information. I certify that the infotTnatpan on this Certificate represents my best efforts lo interpret the data available
I understand that any Paise statement may be punishable by fine or imprisonment under 18 U.S Code, Section 1001
,~Check here if comments are provided on back of form.
Ce'ifier" Name dY'"';')/¢¢,' ~'7-~' -~'O'a kse ~(, ,,7~ t'ce"se Numbesu V'(~
FEMA Fo¢~ 81-31, February 2006 / / See reverse side for continuation.
Replaces all previous editions
IMPORTANT: In these spaces, copy the corresponding information from Section A. ] For Insurance Company Use:
Building Slreel. A~dre~ss (including Apt., Unit. Suile, and/~q~ldg. No.) or P.O. Route and Box No.
.... _
City . State ZIP Code
Policy Number
Company NAIC Number
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Cedifl?le for (I) communily official, (2) insurance agenl/company, and (3) building owner
Signature /Z // A/ ~ %// Dale .~ ~' ~OOw~
SECTION ~ - BUILD~LEVATION~ORMATION (SURVEY NOT REQUIRED) FOR ~ONE AD AND ZONE A (WITHOUT BFE)
For Zones AD and A (without BFE), complete gems El-E5. If the Cedificate is inlendnd 1o support a LaMA or LOMR-F request, complele Sections A, B,
and C. For Items El-E4, use natural grade, if available. Check lhe measurement used. In Puerto Rico only, enter reelers.
E 1 Provide elevalion information for tile following and check Cie appropdale boxes Io show wllelher the elevation is above or below tile highest adjace~l
grade (HAG) and Ihe towesl adjacent grade (LAG).
a) Top of botlom floor (including basemenl, crawl space, or enclosure) is. [] feet [] reelers [] above or [] below the HAG
b) Top of bogota Poor (including basemenl, crawl space, or enclosure) is [] feel [] melers [] above or [] below Ihe LAG
E2. For Building Diagrams 6-8 wilh permanent flood openings provided in Secflqn A flems 8 and/or 9 (see page 8 of fl)slrucflons). Ihe nexl higher floor
(elevation C2.b in Ibe diagrams) of the building is . . [] feel E~] reelers [] above or g~below lhe HAG.
E3 Attached garage (top of slab) is __ [] feet [] reelers [] above or [] below lhe HAG.
E4 Top of platform of mactgnery and/or equipmenl servicing Ihe building is __ [] feet [] reelers [] above or [] below the HAG.
E5. Zone AO only: ~fn~ddepthnumberisavai~ab~e'islhe~p~f~heb~t~mfl~reIeva~edinacc~rdancewiththecommuni~y~s~ndp~ainmanagerhent
ordinance? [] Yes [] No [] Unknown ~'he local official mnsl cedifylhis informabon in Seclion G
SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The properly owner or owner's aulhorized representative who completes Sections A, B, and E for Zone A (without a FEMA~issued or communfly-lssued BFE)
or Zone AD must sign here, The stateme~ts in Sections A, B, and E are conect to the best of my knowledge
Property Owner's or Owner's Aulhodzed Representative's Name
Address City Stale ZIP Code
Signature Dale Telephone
Commenls
[] Check here it aflaclmmnts
SECTION (} -COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized by law or ordinance 1o administer the communily's floodplain management ordinance can complele Sections A, B, C (or El,
and G of this Elevation Certiflcale. Complete lhe applicable item(s) and sign below. Check lhe measuremenl used in flems G8. and
Gl, [] The informalion in Section C was taken Eom other docementalion Ihal has bee~ signed and sealed by a licensed surveym, engineer, or arcbitecl who
is authorized by law to certify elevaPon informaPo~. (fltdicale the source and date of the elevalion dale in the Comments area below.)
G2. [] A communily offidal compleled Section E for a building Iocaled in Zone A (wilboul a FEMA-issued or communily-issued BFE) or Zone AD.
G3 [] The following information (Items G4.-Gg.) is provided for communily Pondplain managemenl proposes.
G7. This permil has been issued for: [] New Conshucflon [] Subslanflat Improvement
Gfl. ElevaPon of as built Iowesl floor (including basemenl) of the building: [] feel [] reelers (PR) Datum
Gg. BFE or (in Zone AD) depth of flooding al lhe building sfle: [] feet [] meters (PR) Datum
Local Official's Name Title
Community Name Telephone
Signature Date
Comments
[] Check bere if agad~menls
FEMA Form 8%31, February 2006 Replaoes all previous editions
Building Photographs
See hrsbuctions for Item A6
If using the Elevation Certificale lo obtain NFIP flood insulance, affix al leasl Iwo building pho[ographs below according to
the inslrucfions for Item A6 Idenlify all photographs with: date taken; "Fronl View" aed "Rear View"; and, if ~equired, "Right
Side View" and "Left Side View" tf submilling more photographs than will fit on ibis page, use the Conlinualion Page,
following
U S DEPARIMEN[ OF IIOMELAND SFCURIIY
Federal Emergency Management Agency
ELEVATION CERTIFICATE
ImpodanI: Read/he inst~uclions orr pages
· SECTION A - P, ROPERTY INFORMATION I For Insulal~ce Company Use:
- ~ I' . Z :~1 I
A2 Building SJreel Address (including Apt UuiL Suile m~dlor Bldg No ) or PO R0uie a;~d ~0~ ~: ' ~ CompmW NAIC Number
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B~I~F I~ C m nunily Name & Communily N~umber - B2. Counly Name ::c~:~- .... ] ~,~.. §i~i~ ......... /~. :~ ]
[--. . [ 1./ D~,~. ] F flecflvelRevised Dale
~ FIS Ploffie ~ FIRM ~ Communily~lemgned ~ Olbe, (Desclibe)
B11 Indicale elevalion d~h.n used fo~ BFE in gem Bg: ~ NGVD 1929 ~ NAVO 1988 ~ Olbef (Describe)
B12 Is Ihe building Iocaled in a Coastal Banim Resounds Syslem (CBRS) ama or Olbmwise Prolecled Area (OPA)? ~ Yes ~ No
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
Cl. Building elevalions are based on: ~J Conslrucflon Drawings* J~ FJuilding Under Consllucflm]* J~ Finished Conslrucflol~
'A new Elevation Cedificale will be requi~ed when consbuclion o[ Ibc building is complete
C2 Elevalions - Zones A1 A30, AE. AH, A (wilb BFE). YE, VI v3g, V (wilb BITE). AR, ARIA. AR/AE, ARIA I A30. AR/Al I. AR/AD Complele gems C2 ~ d
below according Io the building diagram specified in Ilem A7
a) Top of bottom floor (including basement, c~awr space, ()l ellclosure floor) -:;' . ~ [] feel
b) Top Of Ihe ,exl higher floor - ---- ~] ,eel
d) Agacbed garage (lop of slab) ?J~ ~LJ~ feel
0 Lowest adj~ceut (.nisbe~) g,ade (1 AG) _~ feet
g) Higbesl adjacenl (,nisbed) grade (I lAG) 1 ~ [eel
[] reelers (Puerto Rico only)
[] meleis (Puello Rico only)
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certificalion is Io be signed and sealed by a land surveyor, engineer, of arcbilecl aulbodzed by law Io cerlify elevation
informalion I ceflify that the infolmalion on #tis Cediflcale mplesents my best effods Io inleq)rel tim data available J
~ Check here if conlmenls ale ixovided on back of lUlII]
FEMA Forfi~l 31, February'2006 / ' See reverse side for ~n~inualion Replaces all previou~ edilions
Copy boll) sides of Ibis Elevation Cerfificale fei (1) communily ollicial, (2) im]su~auce ageul/compa~y, and (3) building owner
~i~7~uYe ...... Daie .....
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zones AO arid A (wilhout BFE). complete Ilems E1 E5 If the Cedilicale is inlended to support a LOMA o~ I.OMR F lequest, complele Secflous A, B,
and C For [terns E1 E4, use natural grade, il available Check lbo measulemenl used. I~l Puedo Rico only, artier meters
a) iopofbollomfloof(il,cludingbasemetd, c, awlspace, ofencDsule) is ~leel ~melets ~above(,r ~l,eluwlhellAG
b) Top of bollom floor (includillg basemenf, crawl space, of enc;lusure) is ~ ~- ~ feel ~ Illelels ~ abuve or ~ below Ihe I.AG
E2 For Building Diagrams 6 8 with pe,ma,]enl Ilood o )enings p~ovided In Se; i~f~ ~;~ an(/or g see ~qe 8 o st tctio ~s) flm nexl higbe, floor
(elevation C2.b in tim diagrams) of Ibe buildfl~g is · ~ feel ~ reefers ~ above or ~ below Ibe HAG
E4, Topofplalfo~moftnachineryand/o~e(it~ipmet~lse~vidnglhebuildiogis .... . ..... ~feel ~melers ~aboveor ~belowflmtlAG
SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owner or owner*s authorized representalive who compleles Seclions A, B, and E for Zone A (wilhoul a FEMA-issued or community issued BFE)
or Zone AO musl sign here Tile slatenrenfs ill Sect[oils A, B, arid E a~e col~ecl to tile best of my knowledge
Properly Owu~er%s or Ow~]er's A~il~f-zed Repre~e;dalive%s Name,
- Addr~es~-
Cily State ZiP Code
Sigrlalure
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
and O of Ihls Elevalion Cedi~cate Complete Ibe applicable ilem(s) and sign below. Check Ibe measurement used in Items G0 and G9
GO. BFE or {in Zone AO) depth of ~oodlng al the building site: ~ feet
Lo~l Official's ~¢~ .... l ifle
FEMA Form 81-31, February 2006 Replaces all previous editions
RPR-OT-2008 08:25 From: To:16~17659502 P.3/4
IMPORTANT: In Iheg~ Spaces, COpy tile correepOltdin~ infommtlo~ fi'u. Sect o A
~cu I~ON E - BUILDING ELEVATION INFORMATION (SURVEY NOT REClUIREIO) FOR ZONE AO AND ZONE A (WITHOUT 8FEI
.) Top of bou~ floo~ (b~dh~g bo~.m.I. ~ sp~e, or e~.e) ~ ~ I~1 ~ ,,mlm~ {"] ~ ~ ~ be~w Ihe 14AG
E3, Atlpched g~r~ ((~ d 5~b) I~ ..... ~ fill ~ n~gr$ ~ a~ ~ ~ ~ lira ~
O~tn~t~? ~ Ye~ ~ ~ OUt~llOwft 'll~-~ofl~Nimlslt~ltilylldsi,l~,i~tln~km(~
SECTION F - PROPE. RTY OWNER ~OR OWNER'S..~..--- .~PRESENTAI:IVE) CE.RTIFICATION - --
The prope~y ewe. ar m* owner's ou{horAed ~ep~e~enIMIve who c~mlplMe~ .Re~ms ^. I~. ond E I~ Zu,a A [~lmu( ~ r EMA.I=s~ ~ ~m,,,~.i~.+~ RF F}
SECTION G -COMMUNITY INFORMATION (OPTION/M.)
........ gJ loel [] ,~c,,~ {PH) l}alum
(~g EiFE or (i~ ZOP~ AO) deplh of floudtrtg el Ihe building silo:
Lvcgl Olli~isl's Nome
FEMA Furm B1-31, Februa~/'2O~6
Replaces nil provious edilions
0~-07-2008 09:01 SOUTHDLD BUILDING DEPT 1631765950~ PRGE3
WEBER
52 NOYACK PATH. ~O BOX 1374), WATER kILL, ~ YOI~ 11976
41 EAST h,4APLE ROAD, C.-REEhLAWN, NEW YORI(, 11740
TEL. 631.754-5555
FAX 6~1- 26'I'-10&4
qPR-O?-2008 08:25 From: To:1631TG59502 P. lx4
52 NOYACK PAI'H, ~0 B~ i;~'4~ WAll~ IdU., NEW YOltK II976 · '~.
4! EB~'T I~E ROAD, ~EII~I.A~
FAX:
gROM:
Fl~ ~n~P~ICK P~ WEB~
04-0?-2008 09:00 SOUTHOLD BUILDING DEPT 16317659502 PAGE1
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION WAS ADOPTED B'Y THE
SOUTHOLD TOWN BOARD AT A REGULAR MEETING HELD ON AUGUST 24,
RESOLVED that the Town Board of the Town of Southold hereby adopts
two (2) new forms to be used under tfie Flood Damage Prevent regulations
o1~, the Code of the Town of Southold: "Floodplain Oe~elopmen..t Permit
?pplicalion" [FDP[93)I, and ,;.'Cer,irica.. Compliance ?'v Oeve~.'~ment in
Special Flood Hazard Area [~./C(93)}.
; .f 3 ,ii
B LL, G. O~.gT
Southold Town Clerk
August 2~, 1993
TOWN OF SOUTHOLD
APPLICATION #
PAGE I o1' 4
FLOODPLAIN DEXrELOPMENT PERMIT APPLICATION
This form is to be filled out in duplicate.
SECTION 1: GEl'fERAL PROVISIONS (AP?LICANT to read aod/i~:
t. No work may start umil a permit b bsued. -
2. Thc permit may be rcvokeA ff any fab¢ statcmcnt~ ~c made herein.
3. [f rcvokeA, all work mtut caas¢ uatil permit L~ r¢-bsueA.
'L Dcv¢lopmaat shall not be u.scd or o¢oJplcd until a Certificate of Compli~_ac~ b iz. sucd.
5. Thc permit will cxpir.e if ti'o work Ls commenced within six moot~ of issuance.
6. Applicant L* bercblt informed that other permit~ may bt required to fulrdl local, state a~nd federal reglflatory
requircmcnt.~.
7. Applicant hcrcbIt give~ consent to thc Local Administrator.or hi~/her rcpr~¢otativ~ to malco
iaspeclloo~ requited to ve4~ compllance.
8. I, THE ,4.PPLIC. AjNrT, (,;t:KTIFY THAT ALL STATEMEIqT~ HEREIN AI'/D l]q A'I~ACI'rtM .EIq'I~ TO
.THis.,.uc^ o. To ..
,/ ./ i /
..- SECTIQN l: PROPOSED DL-Z/ELOP.,MEblT fT,o.-~¢ completed by ^PPUC ,'T}
NAME AX)DRESS -[or.TELEPHONE
AJPPLI~
pROJECT LOCATION:
To avoid delay ia proce.~iag thc applicadoa, please provide eaougJb izdormadou to easily ideutkfT thc project
}OCatiO~L Provide the street addre~, lot number or legal d~cfiption (aHach) and, ou~Jdc urbaz~ arr~ax, the
distance to thc, aearcst bier:icc'ting road or wcll-k~aow~ [~dmark_ A sketch attached (o ch~ application showing
thc projccl IOCaLioo would be hclpbal.
FOP(93)
DESCRIPTION OF' WORK (Check all appl3cable boxcs):
A .~TRIJCTURAL DEVELOPMENT
AJ~PLICATION ~
PAGE '~ OF 4
~CTIVFI-Y
STRUCTURE TYTE
[] Hew Structure
[] Additioo
~ii~,/~Jtcr atioa
[] Relocation
[] Dcmdlidoo' '
[] Replacomcnt
~ Residential (1-4 Family)
[] R~idcntial (more than 4 Family)
[] Noo-rcsidenlial (Floodproo['mg? [] Yes)
[] Comb[ned Usc (Residential & Commercbfl
[] Manufactured (Mobile) Home (In Manu-
factured Home Pazk?. [] Yes)
ESTIMATED COST OF PROSECT
B. OTHER DEVELOPMEIqT ACTIVITIES:
I~ Fdl [3 Mil~ng [] Drilling [] Grading
Q Excavation (Except for Struaural Development Checked Above)
' [] Watercourse Alteration (Including Dredging and Ch~ruael .Modkqcatinn~
[3 Drayage Improvcment~ (Including Culvert Work)
) E) Roa;k Street or Bridge C~astrucfioa
[3 I~lividua~ Water or Sewer System
EJ Oiber (Fle~se Sped/y)
After completing SECT]OH Z, A_PPLICAJqT shotfld submit form to Local Admbabtrator for review.
SECTION 3: FLOQDPLAF/q DETERMINATION (To be completed bY LOCAL ADbflNISTRATOR)
Thc proposed development b lo.cared ou ~ Panel No.
Thc Proposed Development:
, Dated
[3 b ~ located b a Special Flood Ha?~,d Area (Notify the appUc.~nl that thc appllcatiou
rwfiew k complete and NO FLOODPLALH DEVELOPMENT pE. R2vffT iS REQUIRED).
O L~ Ioc~tcd ia a Special Flood Haz.,~d Aa-ca.
FIRM Zone de.'cignalion b
tOO-Ye;u' flood elevation at ibc site i~:' Ft. NGVD (MSL)
[] Unavailablc
Thc proposed development is Iocalcd ia a floodway.
FBk-M P~cl No. Dated
[] Sec Sccdon 4 fo~ addhional instr,clions
SIGNED
DATE
APPLICATION
PAGE ] OF 4
SECTION 4: ADD TIONAL INFOIU'dATION REQUI RED (To bc completed bv LOCAL ADMINIST'RATOR]
Thc appiiCam must submit thc documents checked bclow before Ibc application] ca] bc processed:
CIA site pia~ showing the location of all chStlag struaures, water bodies, adi~ccut roads, lot
dimensions and proposed development.
[] Dnvclopmenl plans, ckawn In scale, and sp¢cificatkous, iocludin§ where applicable: details for
anchoring structures, proposed elevation of lowest floor (~ndudb:g basement), q, pe4 of water
r~istant materials used below the first floor, details of floodprooFmg of utilities located below
the £ust floor and details of enclosures below thc Cu-st floor.
,&bo,
C] Subdivbioa or other development plans (ff thc subdivision or other development exceeds 50
lots or 5 acres, whichever is the lesser, the ~pplicmat must provide tOO-y¢~ flood elevatiob, s
if they are not otherwise available).
{] Plum showing the extent o~' watercourse reloe, atien and/~r landlorm alterations.
C] Top of new fdl elevation Ft. NGVD (MSL)-
El Floodproo£mg protection level (noo-rcsldcutial only) Ft.:HOVE) (MSL). For
floodproofcd sCructurcs,?~ppiicaot must attach certilication from registcrcd cugi~cc~ or
ID Certification [rom a-rcg3stnrcd eogi.aecr that the proposed acli~t in a regulator~ floodway
~ aol result in a~y k~crease ia thc height of ~he 100-ye~ flood. A copy ol' all data and
calcuJadom supporting ttti~ I'mding must also be submitted.
Other:
~ECTIOH 5: PERMIT BETERMIHATION (To bc completed bt' LO",:AL ADMINII[VFRATQR}
I hive determined that the proposed activity:. A. ID Lq
B. [1 Is ant
in o0nforma~]ce with provisions of Local Law ~. ,1.9__. Thc permit ii ksucd subject to th* coDdltions
attached to and made pm of this permit.
SION~D . DXTE
L(BOX A i~ checked, Ibc Local Admirds~ralo[ may i~suc a Development Permit upon payment of desiEmatcd
If BOX B i~ checked, ibc Local Administralor will provide ~s wri(tco summary of deficicncins, Applicanl ma)'
revise and resubmil ~ appticalion m thc Local Adminislralor or may rcqucsl a bearing from thc Boazd of
AppcaJs
APPEALS: ^ppcdcd to Boud of Appeals? 0 Yes [] No
H¢~'ing da(c:
^gpcals Bu..,d D,.,.;-;~- --- A-ppmw~J~. ,~ ;%.,
Cood. Jdoo.s
APPLICATION
PAGE 4 OF a
SECTION 6: AS-BUILT ELEVATIONS fTo be submillcd by APPUICMtT before Cert~c~l¢ of Compliance
Ls issufd~
Thc following i~fformadou must be provided for project structure. ~ section mUst be completed t~y a
registered profc.~io~al engineer or a liccuscd la~d sttr~¢yor (or attach a cx:rdficadon to tiffs application).
Complete I or 2 below.
Actual (As-Built) Elevation of thc top of ~hc lowest floor, including bascmcnt (ia Coastal Hith Haza'rd
Areas, bottom of Iowcsl s~ucturifl mcmbcr of thc lowest floor, excluding piling and column, s} ix:
FT. N~VD
Z. -, Actual (A~-Built) Elevation of floodproofmg prot¢ctioo ks FT. NGVD (MSL).
N Any work performed prior to submittal,Of thc above imrormatioo is at Ibc rksk,Of thc Ap ?cant.
/ /
· .qECTION 7: COMPL, IAJ'qCE ACTION (To be coml)lctcd ~)v L,~CAJL ADMINISTRATOR]
Thc LOCAL, ADh'I[N[b~ERATOR will complete this section as applic, ablc based on iaspctaion of thc projcci to
cusure eomplianc~ with the commRuit]~s local law for flood damage prevention.
tONS:
DA~E BY DEFIC[EIqCIES? [3 YES C] NO
DATE BY DEFICIENCFES? E] YES [3 NO
DA'liE BY DEFICIENCIES? E3 Y'ES [] NO
SECTION 8: CERTIFICATE OF COMPLIANCEFYo be comolcted by LOCAL ADM'INISTRATOR]
Certificate of Compliance L~ucd: DATE: BY:.
Attachment B
Development in a Special Flood Hazard Area
TOWN OF SOUTHOLD
CERTIFICATE OF COMPLIANCE
FOR DEVELOPMENT IN A SPECIAL FLOOD HAZARD AKEA
{4~-~ MUST _ ,'R~T_J~N IFf ATE
PR~MISES LOCATED AT:
PERMIT NO.
PERMIT DATE
OWNERS NAME AND ADDRESS:
CHECK ONE:
~ ~ BUILDING
~EXISTIN~ BUILD II~G
C] VACANT LAND
/ /
THE LOCAL ADMINISTRATOR IS TO COMPLETE A. OR B. BELOW:
COMPLLad~CE IS HEREBY
LOCAL LAW # , 19
SIGNED:
CERTIFIED WITH THE I:LEQUIREMENTS OF
DATED:.
COMPLIANCE IS HEILEBY CERTIFIED WITH T}~ ILEQUIILEMEIXfI'S
LOCAL LAW # , 19__, KS MODIFIED BY VARIANCE
DATED
SIGITED: DATED:
OF
C/C193)
WEBER
59 NOYACK PATH, ~0 BOX B74l, WATI~ IvlL.L, ~ YOi~ 11976
41 EAST IvlAF'LE ROAD, ~AWN, NEW YORK, '11740
May 19, 2008
Town of Southold Building Department
PO Box 1179
Southold, NY 11971
FLOODPLAIN DEVELOPMENT PERMIT
ERIC KLODNICKI
2350 Deep Hole Drive
Mattituck, NY 11952
SCTM # 1000-123-04-07
TEL 6,31. 754-5555
FAX 631 · 261-10tM
Attention Pat Conklin:
Attached please find an Application for Floodplain Development for the renovation to the
Klodnicki House.
Please include in the Permit file. Thank you very much.
FREDERICK R. WEBER, R.A.
WEBER
52 NOYACK PAll-I, IPO BOX 1374), WATI~ ~ ~ YC~K 11976
41 EAST MAPLE ROAD, C~AWN, ~ YOR~, I1740
TEL. &.~,l o 754-5555
FAX 6~1 o 261-108,4
March 10, 2008
Town of Southold Building Department
PO Box 1179
Southold, NY 11971
BUILDING PERMIT
ERIC KLODNICKI
2350 Deep Hole Drive
Mattituck, NY 11952
SCTM # 1000-123-04-07
Attention Building Department:
Attached please find an Application for a Building Permit for a renovation to the
Klodnicki House. Also included are the following items:
1- Four (4) copies of the Drawings (Al-A3 & E1 dated 3/10/08)
2- Four (4) copies of the survey
3- Blank check to "Town of Southold" for Application Fee.
Please review the enclosed application and process for a Building Permit. Please contact
me with any questions or comments. Thank you very much.
FREDERICK R. WEBER, R.A.
MA~FITUCK
AIRPORT
thold
~IE X
ZONE X
~NE AE
(EL B)
ZONE X
ZONE
ZONE
ZONE
7..(~IE X
ZONE
X
ZONE X
COASTAL BASE FLOOD ELEVATIONS
APPLY ONLY LANDWARD OF O.O NGVD
Z
1983
~ 513
~M7
®M1.5
**Referenced
EFf
Refer to the FLC
determine when
tions or depths
To determine i!
insurance agent
OWNER
TOWN OF SOUTHOLD PROPERTY RECORD CARD
FORMEP~ ~)WNER,
IcL ,,-:', ,~'
STREET ?~"-"~'~0
VI LLAGE
SEAS.
ACR.
IMP.
VL
TOTAL
SUB. LOT
BULKHEAD
Total DOCK
Swampland
Brushland FRONTAGE ON ROAD
House Plot DEPTH
Tillable , 1
Tillable 2
Tillable 3
Woodland
AGE
NEW N O RMA L
FARM Acre
~o o
~"1oo
! ,.-- · ~ / ~-~ ,\
~' ~ I ' - ', ' ~ A
FRONTAGE ON WATER ' ~0~' ~ }?~X/07
Value Per Value
Acre
LAND
/ TYPE OF BUILDING /
COMM, CB. . M~C. Mkt. Value , , ,
DATE
REMARKS / / , . .
COLOR
' :' · TRIM :
M. Bldg. ~ ~ ~ ~ ~ O ) ,foundation.~ ~ ' ~;,/ ,~ ~ Bath ~ / Dinette
Extension /~ ~ ~ O ~ ~h& 0 ~/~ ~,,¢~ ~,5~ Basement ~ Floors ~O~l~ K.
Extension / ~ ~ / ~: ,.~ ~ ~ j Ext' Wails ~C'bf ~ .
~ ~)~ Interior Finish '~/~'/7(~LR.
Extension Fire Place ~'Z~C Heat ~ ~ /$ ~ DR.
Type Roof ~ fi/e R~ms 1st Floor BR.
Porc~
.Z~ / ~ z f/ , ~ ~ ~ Recreation Room Rooms 2nd Flool FIN. B.
~e~ ~L~ /~ Dormer
t~v ~' 7~~ Z ~ .~
Breezeway Driveway
Garage /~ ~Z~ ~0~ / z~
Patio
Total ~,, ~z ~ L
~EEP' HOLE DRIVE
DESERIBED PROPERTY
MATTITUCK, TOWN OF $OUTHOLD
SURVEYED 'FOR ~fARI..~Y ~. ARNOLD
(~U,~RAN TEED TO
SURVE!~'D BY
Building Photographs
See h~sbuclions for Item A6
If usin¢ the Elevalion Cedifica[e lc~ eb[~ain NFIP flood instum~ce, aflix at least lwo building pholog~aphs belt~w ac;coCdin9 to
the instructions for liem A6 Identify ail pholoCrophs with: do~ l~k~n; "Front View" ond "Real View"; nnd, if reqtli~ed, "Right
Side View" and "[ eft Side View" If submilling moJe t)hologlaphs lhal~ will fit o1~ Jills page, use tl~e Continuatiorl Page,
following
/
/
I
/
/
/
/
/
/
/
t
/
/
/
/
/
\
N
N
N
N
'O
X/o
330'
HOLE
8
E
/
/
/
/
I
/
/
/
/
~×lStln~
D~tVe~ag
(To Remain)
I
/
\
N
N
N
N
\
X
N
\
CODE iNFORMATION:
OCCUPANCY:
HEIGHT:
CONSTRUCTION:
FRAMING ELEMENTS:
SINGLE FAMILY DEIELLING [Exmting)
I STORY (Exlatmg)
UJOOD FRAME (Ex~stm~)
EXISTING FRAMING ELEMENTS TO REMAIN (FLOOR JOISTS,
ILIALL STUDS, CEILING JOISTS ~ ROOF RAFTERS)
Note: Proposed Construction is predomlnamtl§ an ~terlor R~no~attom.
~rowde "Hurmcane Chps' ~S~mps0n H2) to 5trap All ~x~stm~ and New ~oof
~after5 to Ex~t~n~ Top Dali ~/EJoo~ Studs (Dhe~lnterror Fmmh ~ ~emoved)
ProvMe I/2" Pl~ood "Shear Dalls" as Indicated on the Drammgs.
WINDOWS:
All New Windows Shall have I/2" 'Thick Pl!jmood Panel~, Cut to Window
'-Si,ze (Oversize for Attachment to Casm~) with 2 I/2 ~8 Wood Screws.
I/-' cc for Spans up Lo /-' and 12" cc for Spans tSetween &' and 8' Labe
Panels and Store rn Utdit~j Room for Instaliat*on Prior to Hurricane Force Wmds.
PROPERTY OWNER:
ERIC KLODNICKI
SITUATE: MATT]TUCK
TODN OF SOUTHOLD
SUFFOLK COUNTY, NED YORK
SURVEY INFORMATION:
STANLEY 15AKSEN
PO BOX 2fl4, NED SUFFOLK, HY
SURVEYED: JUNE 13, l~q
5CTM~t 1000-123-04-03
LOT AREA (TOTAL):
ZONING: R-40
FOR ZONING SETBACK5 ON
"NONCONFORMING LOTS" 5E~CODE SECTION
LOT AREA ~0,000 TO $ff,~l 5F
LOT COVERAGE~ 20%
YARDS; IPRINCIPAL)
FRONT 40'
51DE (ONE): IR'
51DE ~BOTH):
REAR: SO'
HEIGHT dlAX.): SE', f2) 5TORE5
SIT PLAN
I" = 20'-0"
NORTH
ENERGY CODE:
WINDOWS:
WALLS:
FLOOF~5:
CEILINGS/ROOFS:
All New Windrows shall be Provided with Low-E, insulated Glads.
All Existing 2x4 LUalls to be Insulated w~th 5 I/2" F.G. ESatts
R-lB (High Densltg Insulation) mhe, ~ Intemor LU,,all FInmh ~s RemOved
All New 2x(. Walls to be Insulated with E I/2 F.G. Batts.
R-21 fHIg~ Dens~tg Jnsulabon)
All EXlStm~ ~x& f,J. shall be Insulated ~fth B I/2" F.G. ~atts,
R-21 fhlbb ~ensrtg Insulatmn)
All Ex, sing
REQUIRED
PLUMBING
ALL PLUMBING WASTE
& WATER LINES NEED
TESTING BEFORE COVERING
PLUMBER CER TIFICA TI
All Exlstm~ (Cedmg dolst/Atuc 5paces Shall be Insu atea with the q , ON
Maximum Thick'-ness of High Denait~ Insulation Allowed b Construction O, I LEAD CONTENT BEFORE
Maintaining am 11/2' Air 5pace ~,etween hlsulatlon an~ ~oof 5heatb~: i';)'~ICATEoFoccUPANCY
...................................... m .......................................................................................................
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
:zI)ER USED fN WATER
· > L'IIbFI Y SYSTEM CANNOT
EXC, 'LD 2/IO OF 1% LEAD.
AP?ROVED AS NOTED
DATE: ~__.~i. B.P. # ~
ALL CONSTRUCTION SHALL
I. %: ¢ Bt LDING DEPARTMENT AT
MEETTHE REQUIREMENTSOFTHE 7,, ,;r,': ~l t~M TO ~ PM FOR THE
CODES OF NEW YORK STATE.
CERTIFICATION Of
NAILING & CONNECTIONS
REQUIRED,
jiL$" ALL COh[J£r;.CTION SHALL MEET THE
........................................................................ ~OU~RE, I~NTo OF TNE CODES OF NEW
"!'
r ......... r ............ 1 ......
Bath 2 i Bath I I Powder
II 'T :2 2" I I,~2" 2I/,2" 11~2" 11,~2" 11.~2" 2
.......................................................................bt Fbor ~=~...~= .~_ _~_.._____L-h~ 1
....................... ~_': ......... J_~:'_ ........ I~2 .................... tE .....
, , , ----[-'--[- ........
'fORK STATE, ~IOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS.
RETAIN STORM WATER RUNOFF
PURSUANT TO CHAPTER 2;36
OF THE TOWN CODE,
Kitchen
3:'. ............................... .:_': .....
.......................................... cOupLy'Wif~0~m ,,~6. I --
Cra~, 59a~, ............................................. FLOC---- AM GEppE/~.NTiON
i SOUTHOLD TOW ',
PLUMESING SCHEMATIC.
ARCHITECT
T
J
DI~AIIIING TITLE=
51TE PLAN
RENOVATION
KLODNICKI HOUSE
'23~O DEEP HOLE DRIVE
MATTITUCK, NY
TOWN OF 8OUTHOLD
8CT/'ltt IOOO-123,-O,4-O1
ARCHITECT..
I=EEDERICK R. [IJEB, ER
~1 EA.~T MAPLE ROAD
GREENLAI/JN. NY 11'140
~;2 NOYAC PATH
mATER HILL, NY Il91&
TEL ~/,~11~4-ti~GG
FAX
SEAL:
DATE: t=ED 12. 2008
:SCALE : I" = 20'
JOB NO: ul2OO8OI
DI~AmlNG NO.
O~
8" Cone. BL
Found· Wall
21'-O"
Access.
2xlO F.J.. lC' cc
Exmtln~j ~x4
Girder ~
Found, Wa
UNEXD
Existing P. Cone, 51ab
~.~ ¢-4"
^1
I Existing
P. Cone. Pier
Pour New
,?.
Wall/Post
2xL 5leapers, lC' cc %
\
'
2'-8" x 1'-4"
Mod~tg Opening,
Instal[ New Flood
Vent, 5e¢ Detail
A~Flood Plain: AE8
fEx:~tlng Flnmhed F!oor or
~, House = ~I +10.OI
[~ Crawl Space Area = 1340 S~. F~
~ ProvMe ~ Mstall N~ Plo~d Vents
~ ~/ a HI,mum Area or 13~O Sq. In¢h~
fTgp.)
Cone. BI.
Found. Wall on
I&"xd" P. Cone.
Footing
8,1
Cone. BI.
Pound. LUall
- Sill ~
B~mt, Window
Modlf§ Opening,
· Instalr Nero Flood
Exl~tlrlg Deck Above
EXISTING
FOUNDATION PLAN
Cone. BI.
I/4" = I'-O"
N(ORTH
T
2T-O" g'-O" 12'-O"
Ne. 4~) Nero (~) 3'-4" 4'-O" 2'-O" x 2'-O"
Remove E~1~tlng Nero f3)(~
2'-O" x 3'-d" 2'-O" x 12) 2'-IO" x
Dbl. Hung t~lndow Dbl. Hung I~lnd~ Obi. Hung ~llndo~s A~nlng UIindom
1~3~11~ =- u ~". '~ :.'':.~ ':.,: ,
, ., . , ,,
I[ I~l D0mn tO .." l;l% Ex~stlm FI~. Floor
'.[ ~ m m ,. rms. Openmg~ ~ Trimmed Ope,lng
Db Hung Bmdoa PICture Blndoa Dbl. H~g Blndoa PaLco ~oor
2'-&" x 4'-¢
DbL Hung Bmndo~ 32'-0"
WINDOW
Model :~ I~.O.
LUPDH~22/, ~'-I ~/g"x ~'-I 3/1¢
DPDH2822 2'-fl ~/g"x 4'-5 ~/1~"
gJPDH2. 2'-g 1/8"x 4'-g S/IL"
~JPDH2022 2'-I l/g"x 4'-~ S/lC'
WPDH2818 2'-fl 1/8"x
LUPDH2g]~ 2'-'=1 'f/g"x
LUPDH2OIf~ 2'-I 'f/g"x
~A2'124-ll 2'-O I/2"x 2'-] I/2"
SCHEDULE
Model Numbers Refer to JeldUJen". UJood. Simulated
Drvlded Lite, Lo/E2 Glaas, Provide, Label and Store
I/2" Plywood Impact Panels ~/ Scre~ Fasteners
DOOR SCHEDULE
Jnit Model ~ IUldth t He;ght
(~ Front Door 3'-O"x C-8" [Door
(~) "deldWen". WISLUT2~48
IIn~ung Patio) 2'-&"x ~'-8"
~ "JeldDen", DISDT2&&8 ¢-8"
~ Utility Room Door 2'-~'x ~' - 8" [Door)
~ "Jeld~en". ~GPDT4048
(Gh&ng Pabo) E-0"x P-8' (Doar)
FREDERICK
ROBERT
ARCHITECT
FRAE[lING TITLE:
FOUNDATION
FIRST FLOOR
JOB:
RENOVATION
KLODNICKI HOUSE
23SO DEEP HOLE DRIVE
MATTITUCK, NY
TOUJN OP SOUTHOLD
8CTH~ IOOO-123-O4-O1
DATE: FE~ 12. 2008
8CATE : ]/4" = I~-O"
JOB NO: e2OO8OI
NOTE: EX
TO REP DRAWING NO.
PROPO
FLOUT FLO0 PLAN NORTH A2
I/4' I'-O"
O~
:ISTING BUILDING FOOTPRINT
IN "AS 15", EXISTING THREE
CCH HOUSE TO BECOME
!D TUJO f2) BEDROOI1 HOUSE.
ARCHITECT.'
41 EAST HAPLE ROAD
GREENLA~N. NT 11140
E2 NOTAC PATH
· ATER ~ILL, NY
~2~1-1084
SEAL:
~und. W~II
P. Cone. 51ab
Exmtln~ C.J. $
Ratter 5pace mi
New 8 I/'t" R-30C
H~gh Dens,t§ Fiberglass
Batta
'roflle ot Living Room!
Cellmg IEe~ond)
Floor
2xlO F.J., E~tlng 13) 2x8 I 2x4 F.J., .ExlsLm 'JxG
oc F.J..
Insulate Exlstmg ')x/,
.Floor Jomst,,Sbace m/
Ne~ ~ 1/2 R-2I
R.R. and
12) II 918" LVL
Girder Between
Dmlng/LlVlng Room
New 2x8 C.J.
$14"
E~tlng
G~rdcr~ FIll Craml '~"
\
Crawls
Comp
Sand
SECTION AA
.Poat Existing Purlms Nam LVL Girder
AdJacent Grade
114" = I'-O"
Prowde New "Hurmcane R.R.
on All Ratters LUhere ,
Wall Flnmh m Removed
SECTION BB
Header
Brick
Chlmn~
Chmmne~
12
(±)
~'ZZZZSZZZZZSZZZZZZZZ$'~ .....
Deck and
Crawlspace Elev
Lomest Adjace
I Vent Flood --
Chmmne§
WEST ELEVATION
I/4" = I'-O"
Alternate: Replace Existing Wall Shingles (Etrm?d, 14" Exposure).
m/ Nam Red Cedar Shingles, Pre-Dipped m/ ~ Exposure.
SOUTH ELEVATION
I/4" = I'-0'
-- Drmck
Chlmne~
12
B ~±)
[Patch Wall
[~/ Ne~ Red Cedar Shingles, Pte-D~pped e/ 4" Exposure.
I/4" I'-O' I/4" = I'-O"
FREDERICK
ROBERT
~EBER
ARCHITECT
DRA~ING TITLE=
ELEVATION5
5ECTION.~
RENOVATION
KLODNICKI HOUSE
23SO DEEP HOLE DRIVE
I'IATTITUCK, NY
TO[UN OF 5OUTHOLD
5CTII# IOOO-123-O4-O1
ARCHITECT=
FREDERICK R. rdJEBER
41 EAET PIAPLE ROAD
GREENLAWN, NY 11140
~12 NOYAC PATH
IIIATER I~ILL, NY 1191&
FAX ~,31 2&1-1084
DATE= FEB 12, 2008
SCALE: 114' = I'-O'
JOES NO= ,2OO8OI
DRAIUlNG NO.
OF AD
ELECTRICAL NOTES:
I- SWITCHES TO BE TOGGLE, RECEPTACLF. 5 TO BE DUPLEX, ILEVITON). COVER PLATE5 TO BE METAL.
2- DIMMER5 TO BE SLIDE CONTROL.
5- ELECTRICIAN TO SCHEDULE "WALK-THRU" WITH OWNER PRIOR TO BEGINNING WORK.
4- ALARFI CONTRACTOR SHALL PROVIDE, INSTALL AND EIIRE ALL SMOKE, HEAT, CO AND LOD T~MP~RATURE
DETECTORS PER CODE [HINIHUH) A5 DELL A SECURITY AL~RH 5YSTEH. PROVIDE CENTRAL STATION HONITORING.
B- ON SHINGLED WALLS. WALL MOUNTED FI:(TU~E5 TO BE MOUNTED ON C~DA~ WALL PLATE.
~- ELECTRICIAN TO VERIFY ELECTRICAL REQUIREHENT5 OF ALL APPLIANCE5 t EQUIPMENT.
ELECTRICAL FIXTURES:
OWNER TO PROVIDE THE POLLOLUING FIXTURE5 (INSTALLATION BY CONTRACTOR):
I- CHANDELIER5 (DINING)
:2- KITCHEN PENDANT
5- BATHROOM DALL SCONCES
4- SURFACE MOUNTED PORCH CEILING FIXTURES
~- ALL DECORATIVE INTERIOR AND EXTERIOR FIXTURES
4- PATH AND POST LIGHTS (120V. Line VolLa~e)
TRIM f Wh¢.e)
APPLrANCES:
OWNER TO PROVIDE THE POLLOUJING APPLIANCES, INSTALLATION t ALL
I- RANGE:
2- MICROWAVE;
S- REFRIGERATOR:
4- DISH LUASHER:
~- KITCHEN HOOD:
4- WASHER/DRYER:
UTILITY CONNECTIONS BY CONTRACTOR
PLUMBING NOTES:
I- PLUMBER SHALL TEST ALL DRAIN LINES AND ALL WATER SUPPLY PIPING BEFORE EH,CLOSING WALLS.
2- ALL EXPOSED FEEDS AND ESCUTCHEON PLATES FOR WATER CLOSET5 SHALL BE CHROME PLATED BRASS.
S- INSULATE ALL HOT EIATER PIPING PER ENERGY CODE AND ALL COLD WATER PIP[NG TO PREVENT SWEATING.
4- ALL HOSE BIBS SHALL BE "FROST FREE" t~ITH 5HUT-OFP VALVES IN CRAtUL SPACE..
Ex
Hose
Ex
To
L
Chandelier
ELECTRICAL
FIR,5 T FLOOR
PLAN
I/4" I'-O'
NORTH
ELECTRICAL .SYMBOLS
~ DUPLEX RECEPTACLE
~r,F~ DUP.REC.-GROUND FAULT
[] DUP.REC.-PLOOR
(~) SHOWER LIGHT (Wet L~cat~on)
UNDERCAB. FIXTURE
~ ~ DOO~BELL/CHI~E
~ EXHAUST FAN
IPI ATTIC FAN
~ THERMOSTAT
~ 5MOK~ DST~CTOR
~co CAR~ON MONOXID~ D~T~CTOR
Ex
FREDERICK
ROBERT
ILIEE, ER
ARCHITECT
III
DRAWING TITLE:
ELECTRICAL
fPLUMEMNG)
FIR,ST FLOOR
JOB=
RENOVATION
KLODNICKI HOUSE
25~0 DEEP HOLE D~VE
HATTITUCK, NY
TOWN OF SOUTHOLD
ECTH~IOOO-133-O4-O3
ARCHITECT=
FREDERICK R. WEBER
41EAST MAPLE ROAD
GREENLAWN, NT 11140
SA NOYAC PATH
WATER llfl1&
~ILL, N¥
TEL &SI 1E4-$BSl;
FAX &3,1 2~1-1084
SEAL=
MAR IO, 2008
REV.: FEB 1~,2008
DATE: FEI~ 12, :2008
SCALE: I/4' = I'-O"
dOIS NO: ~2OOEOI
DRAWING NO.
OF El