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HomeMy WebLinkAbout35441-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34272 Date: p4/14/10 THIS CERTIFIES that the building HEATING SYSTEM Location of Property: 1140 CARRINGTON RD (HOUSE NO.) (STREET) County Tax Map NO. 473889 Section 111 Block 6 subdivision Filed Map No. Lot No. __ CUTCHOGUE Lot 10 (HAMLET) conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 31, 2010 pursuant to which Building Permit No. 35441-Z dated APRIL 6, 2010 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 HEATING SYSTEM IN AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. {SEASONAL ALTERATION TO YEAR ROUND) The certificate is issued to EILEEN F DEBANY (OWNER) of the aforesaid building. SUFFOLK CODlqTYDEPARTMENTOFHEA~THAPPRO~-AL ELB~-rmlCAL C~TIFICATE NO. PLUMBERS c~KTIFICATION DA-i-~U N/A N/A //t hor~ed Signature Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANC3 This application must be filled in by typewriter or ink and submitted to the Building Depart A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, stre{ 3. 4. 5. topographic features. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form Approval of electrical installation from Board of Fire Underwriters. ;, an(~ unusual natural or L BLDG. DEPT. TO,tN OF' SOI.ITHOL9 Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 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 topographic featums. 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, Com~nercial $15.00 New Construction: Location of Property: Old or Pre-existing Building: House No. Street Owner or Owners of Property: 3e ~)~ t? ~( Suffolk County Tax Map No 1000, Section ' /// Subdivision ?,) 0 Permit No. fi ~'-7 F// ~ Date of Permit. Health Dept. Approval: Date. ~2~ /d) (check one) Hamlet Block Filed Map. .,~,/~5:://0 Applicant: Underwriters Approval: Lot ,/0 Lot: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Final Certificate: (check one) Applicant Signa~ti~'~:~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ] ROUGH PLB~- [ ~:I:INAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT FENETRATION DATE INSPECTOR FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUII&)ING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 35441 Z Date APRIL 6, 2010 Permission is hereby granted to: for : "AS BUILT" EILEEN F DEBANY 1140 CARRINGTON ROAD CUTCHOGUE,NY 11935 HEATING SYSTEM AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 111 Block pursuant to application dated MARCH 31, 2010 Building Inspector to expire on OCTOBER 6, 1140 CARRINGTON RD CUTCHOGUE 0006 Lot No. 010 and approved by the 2011. Fee $ 400.00 J ~uthori~d Signature COPY Rev. 5/8/02 REScheck Software Version 4.3.0 Compliance Certificate Project Title: Debany Residence Energy Code: 2007 New York Energy Conservation Location: Construction Typo: Heating Type: Glazing Area Percentage: Heating Degree Days: Construction Site: 1140 Carfington Road Cutchogoa, NY 11935 Construction Code Suffolk County, New York Detached I or 2 Family Non-Electric 18% 5750 Owner/Agent: Compliance: Maximum UA: 277 Your UA: 277 Designer/Contractor: John Cond~n Condon Engineering, P.C. 1755 Sigsbee Road Matfitack, NY 11952 631-298-1986 Floor 1: Ali-Wood Joist/Truss:Over Unconditioned Space FIcor 2: Slab-On-Grade:Unheated Insulation depth: 1.0' Ceiling 1: Flat Ceiling or Scissor Truss Skylight 1: Wood Frame:Double Pane Ceiling 2: Cathedral Ceiling (no attic) Ceiling 3: Flat Ceiling or Scissor Truss Wall 1: Wood Frame, 16" o.c. Window 1: Wood Frame:Double Pane Door 1: Solid Wa~l 2: Wood Frame, 16" o.c. Window 2: Wood Frame:Double Pane Wall 3: Wood Frame, 16" o.c. Window 3: Wcod Frame:Double Pane Wall 4: Wood Frame, 16" o.c. Window 4: Wood Frame:Double Pane Door 2: Glass Boiler 1: Other (Except Gas-Fired Steam) 85.5 AFUE 898 19.0 4, I 35 44 0.8 43 897 32.0 0.5 29 8 0,500 4 70 19.0 1.0 4 173 19.0 0.5 8 374 11.0 5.2 20 64 0,420 27 20 0.170 3 194 11,0 5.2 12 23 0.420 10 194 11.0 5.2 10 45 0.420 19 374 11,0 5.2 21 28 0.420 12 40 0.500 20 The proposed building represented in this document is consistent with the building plans, specifications, and other calculations submitted with this permit application. The proposed systems have been designed to meet the 2007 New York Energy Conservation Constru~on Code requirements. When a Registered Design Professional has stamped and signed this pai~.~ln ey are at. sting that to the best of his/her knowledge, belief, and professional judgment, such plans or specificati~ns~j~[~prj~,l~'~this Code. N~-me- ~'itle ~'-'- ~ --/Sico~ Da~ee - -/! - Project Title: Debany Residence Report date: 03/29/10 Date fllename: C:\Program Files (x86)\Check~REScheck\Devany.rck Page 1 of 5 REScheck Software Version 4.3.0 Inspection Checklist Ceilings: Ceiling 1: Flat Ceiling or Scissor Truss, R-32.0 cavity + R-0.5 continuous insulation Comments: ~1 Ceiling 2: Cathedral Coiling (no attic), R-19.0 cavity + R-t.0 continuous insulation Comments: [] Ceiling 3: Flat Ceiling or Scissor Truss, R-19.0 cavity + R-0.5 continuous insulation Comments: Above-Grade Walls: Wall 1: Wood Frame, 16" o.c., R-11.0 cavity + R-5.2 continuous insulation Comments: [] Wall 2: Wood Frame, 16" o.c., R-11.0 cavity + R-5.2 continuous insulation Comments: [] Wall 3: Wood Frame, 16" o.c., R-11.0 cavity + R-5.2 continuous insulation Comments: Wall 4: Wood Frame, 16" o.c., R-11.0 cavity + R-5.2 continuous insulation Comments: Windows: Window 1: Wood Frame:Double Pane, U-factor: 0,420 For windows without labeled U-factors, describe features: #Panss Frame Type _ Thermal Break? Comments: Yes __ No Window 2: Wood Frame:Double Pane, U-factor: 0.420 For windows without labeled U-factors, describe features: #Panes Frame Type __ Thermal Break? Comments: Yes No Window 3: Wood Frame:Double Pane, U-factor: 0,420 For windows without labeled U-factore, desedbe features: #Panes Frame Type __ Thermal Break? Comments: Yes No Window 4: Wood Frame:Double Pane, U-factor: 0.420 For windows without labeled U-factors, describe features: #Panes Frame Type __ Thermal Break? Comments: Yes No Skylights: Skylight 1: Wood Frame:Double Pane, U-factor: 0,500 #Panes Frame Type Thermal Break? __ Yes Comments: No Doors: [] Door 1: Solid, U-factor: 0.170 Comments: Project Title: Debany Residenco Report date: 03/29/10 Data tilename: C:\Progrem Files (x86)\Check\REScheck~Devany.rck Page 2 of 5 {~ Door 2: Glass, U-factor: 0.500 Comments: Floors: [] Floor 1: Ali-Wood JolsV'l'mss:Over Unconditioned Space, R-19.0 cavity + R-4.1 continuous insulation Comments: [] Floor 2: Slab-On-Grade:Unheated, 1.0' insulation depth, R-0.8 continuous insulation Comments: Slab insulation extends down f~om the fap of the slab to at least 1.0 It. OR down to at least the bottom of the slab then horizontally far a total distance of 1.0 It. Extedor insulation has a dgid, opaque, weather-resistant protective covering that covers the exposed (ahove~rade) insulation and extends at least 6 in. below grade. Heating and Cooling Equipment: Boiler 1: Other (Except Gas-Fired Steam): 85.5 AFUE or higher Make and Mode[ Number: Air Leakage: [] Joints, penetrations, and all other such openings in the building envelope that ara sources of air leakage are sealed. [] Recessed lights are 1 ) Type lC rated, or 2) installed inside an appropriate air-fight assembly with a 0.5" clearance from combustible materials. If non-lC rated, fixtures are installed with a 3" clearance Eom insulation. Vapor Retarder: [] Installed on the warm-in-winter side of all non-vented framed coilings, walls, and floom. Materials Identification and Installation: [] Materials and equipment are installed in accordance with the manufacturer's installation instructions. [] Insulation is installed in substantial contact with the sun'ace being insulated and in a manner that achieves the rated R-value. [] Materials and equipment are identified so that compliance can be determined. Manufacturer manuals for all installed heating and ccolldg equipment and service water heating equipment have been prov~led. [] Insulation R-values, glazing U-factors, and heating equipment efficiency are ctaady marked on the building plans or specifications. Duct Insulation: [] Supply ducts in unconditioned attics or outside the building are insulated to at least R-8. [] Return ducts in unconditioned attics or outside rite building are insulated to at least R~,. [] Supply ducts in unconditioned spaces are insulated to at least R-8. [] Return ducts in unconditioned speces (except basements) are insulated to R-2. Insulation is not required on return ducts in basements. Duct Construction: [] AIl joints, seams, and connections ara securely fastened with welds, gaskets, mastics (adhesives), mastic-plus-embadded-fabric, or tapes. Tapes and mastics are rated UL 181A or UL 181B. Exceptions: Continuously welded and locking-type longitudinal joints and seams on ducts operating at less than 2 in. w.g. (500 Pa). I~ The HVAC system provides a means for balancing air and water systems. Temperature Controls: [] Each dwelling unit has at least one thermostat capable of automatically adjusting the space temperature set point of the largest zone. Electric Systems: [] Separate electric meters e)dst for each dwelling unit. Fireplaces: [] Fireplaces are installed with fight tiffing non-combustible fireplace doors. [] Fireplaces have 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, es applicable. Service Water Heating: [] Water heaters with vertical pipe dsers have a heat trap on both the inlet and outlet unless the water heater has an integral heat trap or is part of a circulating system. Circulating Hot Water Systems: Project Title: Debany Residence Report date: 03/29/10 Data fl[ename: C:\Program Files (x86)\Cback\REScheck\Devany. rct( Page 3 of 5 [] Cimulating hot water pipes are insulatad to the levels in Table 1. Heating and Cooling Piping InsulaUon: HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to the levels in Table 2. Swimming Pools: All heated swimming pools have an on/off heater switch and a cover unless over 20% of the heating energy is f~om non-depletable sources. Pool pumps have a time clock. Project Title: Debany Residence Report date: 03/29/10 Data tilename: C:\Program Files (x86)\Check~REScheck\Devany. rck Page 4 of 5 T~ble 1: Minimum Insulation Thickness for Circulating Hot Water Pipes · Insulation Thickness In Inches by Pipe Sizes Non-Circulating Runouts Circulating Mains and Runoute Heated Water Up to t" Up to 1.25' t.5' to 2.0' Over Temperature (°F) 170-180 0.5 1.0 1.5 2,0 140-169 0.5 0.5 1.0 1.5 100-139 0.5 0.5 0.5 1.0 Table 2: Minimum Insulation Thickness for HVAC Pipes Piping System Types Fluid Temp. Range(°F) Insulation Thickness In Inches by Pipe Sizes 2" Runouts 1" and Less 1.25' to 2.0' 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 t.0 1,0 1,5 Steam Condensate (for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water. Refrigerant and 40-55 0.5 0.5 0.75 1.0 Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD: (Suikiing Depadment Use Only) Project Title: Debany Residence Report date: 03/29/10 Data filename: C:~F'mgram Files (x86)\Check~REScheck~Devany,mk Page 5 of 5 FOUNDATION (IST) FOUNDATION (2ND) ,~'~ ROUGH ~G & pL~G - STA~ g~R~ CODE ~D~ION~ COUNTS 0 TEL. (631) 765-1802 ~ ~t0~ '~ FAX: (631) 765-9502 SoutholdTown. NorthFork.net PERMIT NO. _4 3-~r~/ Examined t~/~ ,20 (O Approved Disapproved a/c t~/6, ,20 [0 Expiration I 0/~b, 201! BUILDING PERMIT APPLICATION' CHECKLIST 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. Trastees Flood Permit Storm-Water Assessment Form Contact: Mail to: Phone: Building Inspector ACATION FOR BUILDING PERMIT Date _, 20 INSTRUCTIONS etely 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 Inspect6r may authorize, in writing, the extension of the permit for an addition six months. Thereafter, a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ALL CONSTRUCTION SHALL OCCUPANCY OR MEET THE REQUIREMENTS OF THE USE IS UNLAWFUL CODES OF NEW YORK STATE. w ,, ERTIFICATE (Signature of applicant or name, if a corporation) (Mailing address of applicant') State whether applicant is owner ~e~e~ ~'fii;':fi'~i~)~ngineer, general coI~ ~J~fflqr~l~ber or builder ~NDER~RS ~RCA~ ' DATE: 0~( ~[OUIREO' , ~ '..~-. ~[ _ N~e of own~ of praises ~$~y NOTIFY BUI~i')IN~- (As on ~c tax rol1 ~t~d~ TO 4 If app]ic~t is a co~oration, si~tur~~cr FOLLOWING INSFEc'i*~ON3: :~i~ iKiG,~ ¢~:,~%~. 1. FOUNDATION. ~0 REQUIRED ~e ~d title of co~or~QUiRED; ' Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Locatign of,l, and on which prop~osed work will be done: House Number Street County Tax Map No. 1000 Section Subdivision FOR POURED CONCRETE 2. ROUGH . FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O, ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPC;qSIBLE FOR DESIGN OR COnSTrUCTiON ERRORS. / Hamlet Blockac,:: , ,Lot Filed M,aP No? i:~? ,-, Lot State existing use and occupancy of premises and intended use and occupancy of propo, ed construction: a. Existing use and occupancy .5"~.,q ff~l./r'TL ~9toU~£ '7 7'~c9 yr~/q£ I~Ot.Z/t)J3 b. Intended use and occupancy Nature of work (check which applicable): New Building. Repair Removal Demolition Estimated Cost If dwelling, number of dwelling units If garage, number of cars Addition Alteration Other Work /~tCf/l,~ r %-'~{' f-~ff P 9 (D~scription) Fee ~ ,p/o~ .fl9 (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each tYPe of use. Dimensions of existing structures, if any: Front Rear _Depth Height. Number of Stories ~'~':: "' ' ','i "' ~ Dimensions of same structure with alterations or additions: Front ~i:i ,, r: ' R~'a]-', ,,: Depth Height Number O, flStones ' ~ 8. Dimensions of entire new construction: Front Height Number of Stories 9. Size orlot: Front c~ Rear 0;/ Rear .Depth Depth '/~.~' 10. Date of Purchase /~-9- '70l. Name of Former Owner ~'~e ~ ~' ~- 11. Zone or use district in which premises are situated /ql$; 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO / 13. Will lot be re-graded? YES__ NO t// Will excess fill be removed from premises? YES__ NO 14. Names of Owner of premises / ., w,O e M/Address ,4aq Phone Name of Architect ' - ! Address .~hone N Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES__ * 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. NO 16. Provide survey, to scale, with accurate foundation plan and distancps to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data On survey. 18. Are there any covenants and restrictions with respect to this property? * YES · IF YES, PROVIDE A COPY. STATE OF NEW YORK) COUNTY OF ~ A.~lut~,: (Name of individual signing contract) above named, (S)He is the NO t./ being d~ .~-~,t~2~3~'s4~lit~says that (s)he is the applicant (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this o~$" day of J~45j, J~ 20 tO ~O[[~,./..t~. Fo~ne Heaney ~1~11 m I~1 Ihll~, State of New Y-& Not~ Pub/ic ~ - -' ~6.'4~2~ ~ ' n ~pim~ Mamh ~, ~i~nature of Applicant FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPkRTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 35441 Z Date APRIL 6, 2010 Permission is hereby granted to: EILEEN F DEBANY 1140 CARRINGTON ROAD CUTCHOGUE,NY 11935 for : "AS BUILT" HEATING SYSTEM AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 111 pursuant to application dated MARCH Building Inspector to expire on OCTOBER 1140 C~RRINGTON RD CUTCHOGUE Block 0006 Lot No. 010 31, 2010 and approved by the 6, 2011. Fee $ 400.00 Authorized Signature ORIGINAL Rev. 5/8/02 REScheck Software Version 4.3.0 Compliance Certificate Project Title: Debany Residence Energy Code: 2~7 New York Energy Conservation Construction Code Location: Suffolk County, New York Construction Type: Detached 1 or 2 Family Heating Typo: Non-Electric Glazing Area Percentage: 18% Heating Degree Days: Construction Site: Owner/Agent: 1140 Can~ngton Road Cutchngue, NY 11935 Compliance: Maximum UA: 277 Your UA: 277 Designer/Contractor: John Condon Condon Engineering, P.C. 1755 Sigsbee Road Mattituck, NY 11952 631-298-1986 Floor 1: All-Wood Joistrrmss:Over Unconditioned Space Floor 2: Slab-On-Grade:Unheated Insulation depth: 1.0' Ceiling 1: Flat Ceiling or Scissor Tress Skylight 1: Wood Frame:Double Pane Ceiling 2: Cathedral Ceiling (no attic) Ceiling 3: Flat Ceiling or Scisso~ Truss Wall 1: Wood Frame, 16' o.c. Window 1: Wood Frame:Double Pane Door 1: Solid Wall 2: Wood Frame, 16" o.c. Window 2: Wood Frame:Double Pane Wall 3: Wood Frame, 16" o.c. Window 3: Wood Frame:Double Pane Wall 4: Wood Frame, 16" o.c. Window 4: Wood Frame:Double Pane Door 2: Glass Boiler 1: Other (Except Gas-Fired Steam) 85.5 AFUE 898 19.0 4.1 35 44 0.8 43 897 32.0 0.5 29 8 0.500 4 70 19.0 1.0 4 173 19.0 0.5 8 374 11.0 5.2 20 64 0.420 27 20 0.170 3 194 11.0 5.2 12 23 0.420 10 194 11.0 5.2 10 45 0.420 19 374 11.0 5.2 21 28 0.420 12 40 0.500 20 The proposed building represented in this document is consistent with the building plans, specifications, and other calculations submitted with this pormit applicetion. The proposed systems have peen designed to meet the 2007 Now York Eneq~y Conservation Construction Code requirements. When a Registered Design Professional has stamped and~gned this pa~.~hey are attesting that to the best of his/her knowledge, belief, and professional judgment~ such plans or specifications.4r~J~ cp~lpl~mcL~h this Code. Name - Title Report date: 03/29/10 Project Title: Debany Residence Data filename: C:\Progmm Files (x86)\Check\REScheck\Devany. mk Page I of 5 REScheck Software Version 4.3.0 Inspection Checklist Ceilings: Ceiling 1: Flat Ceiling or Scissor Truss, R-32.0 cavity + R-0.5 continuous lasulatlan Comments: [] Ceiling 2: Cathedral Ceiling (no attic), R-19.0 cavity + R-I.0 continuous insulation Comments: [] Ceiling 3: Flat Ceiling or Scissor Truss, R-19.0 cavity + R-0.5 continuous insulation Comments: Above-Grade Walls: [] Wall 1: Wood Frame, 16" o.c., R-I 1.0 cavity + R-5.2 continuous insulation Comments: [] Wall 2: Wood Frame, 16" o.c., R-11.0 cavity + R-5.2 continuous insulation Comments: [] Wall 3: Wood Frame, 16" o.c., R-11.0 cavity + R-5.2 continuous insulation Comments: [] Wall 4: Wood Frame, 16' o.c., R-I 1.0 cavity + R-5.2 continuous insulation Comments: Windows: [] Window 1: Wood Frame:Double Pane, U-factor: 0.420 For windows without labeled U-factors, describe features: #Panes Frame Type Thermal Break? __ Yes Comments: No Window 2: Wood Frame:Double Pane, U-factor: 0.420 For windows without labeled U-factors, describe features: #Panes Frame Type Thermal Break? Comments: Yes No Window 3: Wood Frame:Double Pane, U-factor: 0.420 For windows without labeled U-factors, describe features: #Panes Frame Type Thermal Break? __ Yes Comments: No Window 4: Wood Frame:Double Pane, U-facton 0.420 For windows without labeled U-factors, describe features: #Panes Frame Type __ Thermal Break? Comments: Yes No Skylights: Skylight 1: Wood Frame:Double Pane, U-factor: 0.500 #Panes Frame Type __ Thermal Break? Comments: Yes No [] Door 1: Solid, U-factor: 0.170 Comments: Project Title: Debany Residence Report date: 03/29/10 Data filename: C:\Program Files (x86)\Check\REScl~ck\Devany. rck Page 2 of 5 Door 2: Glass, U-factor: 0.500 Comments: Floors: [] Flour 1: AlI-Woud Joist/Tress:Over Unconditioned Space, R-19.0 cavity + R~r.1 continuous insulation Comments: Floor 2: Slab-On-Grade:Unheated, 1.0' insulation depth, RA).8 oontinuous insulation Comments: Slab insulation extends down fi'om the top of the slab to at laast 1.0 f. OR down to at least the bottom of the slab then hedzontally for a total distance of 1.0 ft. Extedor insulation has a dgid, opaque, weather-resistant protective covedng that covers the exposed (above~Jrade) insulation and extends at least 6 in. below grade. Heating and Cooling Equipment: [] Boiler 1: Other (Except Gas-Fired Steam): 85.5 AFUE 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 are sealed. [] Recessed lights are 1) Type lC rated, or 2) installed inside an apprppdata air-fight assembly with a 0.5# clearance from combustible materials. If non-lC rated, fixtures are installed w~th a 3" clearance from insulation. Vapor Retarder: [] Installed on the warm-in-winter side of all no~-vented framed ceilings, walls, and floors. Materials Identification and Installation: Materials and equipment are installed in accordance with the manufacturer's installation instructions. Insulation is installed in substantial contact with the surface being insulated and in a manner that achieves the rated R-value. [] Materials and equipment are identified so that compliance can be determined. [] Manufacturer manuals for all installed heating and couling equipment and service water heating equipment have been provided. [] Insulation R-values, glazing U-factors, and heating equipment efficiency are clearly marked on the building plans or specifications. Duct Insulation: [] Supply ducts in unconditioned attics or outside the building are insulated to at least R~. [] Return ducts in unconditioned attics or outside the building are insulated to at least R-4. Supply ducts in unconditioned spaces are insulated to at least R-8. [] Return ducts in unconditioned spaces (except basements) are insulated to R-2. Insulation is not required on return ducts in basements. Duct Construction: [] All joints, seams, and connections are securely fastened with welds, gaskets, mastics (adhesives), mastic-plus-embedded-fabric, or tapes. Tapes and mastics are rated UL 181A or UL 181S. Exceptions: Continuously welded and locking-type longitudinal joints and seams on ducts operating at less than 2 in. w.g. (500 Pa). [] The HVAC system provides a means for balancing air and water systems. Temperature Controls: [] Each dwelling unit has at least one thermostat capable of automatically adjusting the space temperature set point of the largest zone. Electric Systems: ~1 Separate electdc meters exist for each dwelling unit. Fireplaces: [] Fireplaces are installad with tight fitting non-combostibls fireplace dours. [] Fireplaces have 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 have a heat trap on both the inlet and outlet unless the water heater has an integral heat trap or is pert of a circulating system. Circulating Hot Water Systems: Project Title: Debany Residence Report date: 03/29/10 Data filename: C:\Program Files (x86)\Check\REScheck\Devany. rck Page 3 of 5 · ~ Circulating hot water pipes are insulated to the levels in Table 1, Heating and Cooling Piping Insulation: [] HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to the levels in Table 2. Swimming Pools: All heated swimming pools have an on/off heater switch and a cover untess over 20% of the heating energy is from non~epletable sources. Pool pumps have a time clock. Project Tit~e: Debeny Residence Report date: 03/29110 Data fllename: C:\Program Files (x86)\Check\REScheck\Devany. rck Page 4 of 5 , T~ble 1: Minimum Insulation Thickness for Circulating Hot Water Pipes Insulation Thickness In Inches by Pipe Sizes Non-Circulating Runoute Circulating Mains and Runouta Heated Water Up to 1# Up to 1.25" 1.5" to 2.0" Over 2" Temperature (°F) 170-180 0.5 1.0 1.5 2.0 140-169 0.5 0.5 1.0 1.5 100-139 0.5 0.5 0.5 1.0 Table 2: Minimum Insulation Thickness for HVAC Pipes insulation Thickness in Inches by Pipe Sizes Fluid Temp. Piping System Types Range(OF) 2" Runouts 1" and Less 1.25" to 2.0" 2.5" to 4" Heating Systems Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperatam 120-200 0.5 1.0 1.0 1.5 Steam Condensate (for feed water) Any 1.0 1.0 1 Cooling Systems Chilled Water, Refrigerant and 40-55 0.5 0.5 0.75 1.0 Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD: (Building Department Use Only) project T'~e: Debany Residence Report date: 03/29/10 Data filename: C:~Progmm Files (x86)\Check~RESchec~)evany.mk Page 5 of 5 BUILDING DEPARTMENT ""~:, ~d '[~.~'~ TOWN HALL · 5~~ ~' ~ SOUTHOLD, NY 11971 ~ g~~ TEL: (631) 765-1802 { ~ FAX: (631) 765-9502 SoutholdTown.NorthFork.net PERMIT Examined q~ ,20 (O Approved Disapproved a/c Cb ,20 [0 Expiration ) o ] ~b, 201/ BUILD1NG PERMIT APPLICATION CHECKLIST 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 Flood Permit Storm-Water Assessment Form Contact: Mail to: Phone: Building Inspector LICATION FOR BUILDING PERMIT Date _, 20 INSTRUCTIONS :tely 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 lo the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, lbr 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. ALLCONSTi.':'-' NSHALL OUUU'-'mi, u MEET THE REQUIREi 'ENT$ OF THE USE tS UNLAWFUL CODES OF NEW 'YORK STATE. 0 u3t/, ,r Name of owner of premises State whether apphcant is owner, leSsee, agent, architect, 'enDneer, UNDERWR RS CE IFIC, T (As on the tax roll pp ic=t is a co.oratio., 6 cer ~&ll (Name and title of co¢or~EQUiRED' (Signature of applicant or name, ifa corporation) (~ailing address ~f applicanO general co~cto~6~,,~ber or builder ["?,Tr/: ~:?. ' NOTIFY BU[~i., 1. FOU DA FOR POUF:D n'" ,~ ...... 2. ROUGH- FR3 v~n. . '~. E PLL,~.IN~ m ~, Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. Locatign of land on which prop.qosed work will be done: House Number Street 3. INSU[ AUON 4. FINAL - CONST;%ICIDN BE COMPLETE FOS C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF TFE ¢:3~i7' e?.= NEW Hamlet County Tax Map No. 1000 Section /// Block ' ~' · Lot Subdivision Filed Map No. ._. Lot State existing use and occupancy of premises and intended use and occupancy ofpropo.~ed construction: a. Existing use and occupancy ff'~,q 5r)~d/]d- ~rgMtJ~£ ~7 '7~ ~F2~t~ /~©~-;~ b. Intended use and occupancy Nature of work (check which applicable): New Building. Repair Removal Demolition 4. Estimated Cost 5. If dwe!!ing, number of dwelling units If garage, number of cars Fee Addition Alteration Other Work (Description) ('Fo be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front ................ Rear Depth Height. Number of Stories .... Dimensions of same structure with alterations or additions: Front Rear Depth Height_ Number of Stories 8. Dimensions of entire new construction: Front Height Number of Stories 9. Size of lot: Front c~5'~) Rear <:,25'-/ Rear _Depth Depth /~..~ 10. Date of Purchase /fl - ~- q~,l Name of Former Owner ~-' e"~: ¢" ~- fi, 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 __ NO 9/' Will excess fill be removed from premises? YES__ 14. Names of Owner of premises E',,c,~_ ~0~: j~,qJb~/Address ~?/-/)c7'~2,O ,qd-t Name of Architect ! Address Name of Contractor Address Phone No Phone N o _-J-_/_~_~3 ~_: Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet ora 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. 18. Are there any covenants and restrictions with respect to this property? * YES · IF YES, PROVIDE A COPY NO STATE OF NEW YORK) COUNTY OF being du~y sw0~,,deP0s~s hn~l says that (s)he is the applicant (Name of individual signing contract) above named, . ",; (S)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 true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworu to before me this dayof Notary Publ'ic 20 lO Fortune Heaney Na~_~ n.h~. State of New Yc~ No. 4923496 Qualified in Nassau C,;ur,:}/ C0~ Expires March 7, 20_/.0 ~iknature of Applicant ~_