HomeMy WebLinkAbout36331-ZTown of Southold Annex
54375 Main Road
Somhold, New York 11971
CERTIFICATE OF OCCUPANCY
1/18/2012
No: 35399 Date: 1/18/2012
THIS CERTIFIES that the building RESIDENTIAL ADDITION
Location of Property: 170 EMORY ROAD, CUTCHOGUE, NY l 1935,
SCTM #: 473889 Sec/Block/Lot: 103.-4-32
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
4/6/2011 pursuant to which Building Permit No.
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:
Additions to a Single Family Dwelling: Foyer & One Car Garage, as applied for.
filed in this officed dated
36331 dated 4/19/2011
The certificate is issued to
LISA JACOBS
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
36331 1/9/12
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, NY
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit #: 36331
Date: 4/19/2011
Permission is hereby granted to:
LISA JACOBS
170 EMORY ROAD
CUTCHOGUE N.Y. 11935
To:
Additions to a Single Family Dwelling; Foyer & Garage, as applied for.
At premises located at:
170 EMORY ROAD, CUTCHOGUE, NY 11935
SCTM # 473889
Sec/Block/Lot # 103.-4-32
Pursuant to application dated
To expire on 10/18/2012.
Fees:
4/6/2011
and approved by the Building Inspector.
CO - ADDITION TO DWELLING
SINGLE FAMILY DWELLING - ADDITION OR ALTERATION
Total:
$50.00
$498.80
$548.80
Building Inspector
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 of 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 amhitect or engineer responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses:
1. Accurate survey of property showing all property lines, streets, building and unusual natural or 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 $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00,
Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
New Construction: x/
Location of Property: Hous/~ No.'7~)
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section
Subdivision
Date.
Old or Pre-existing Building: (check one)
Street Hamlet
/~ ~ Block ~ Lot ~ ~
Filed Map. Lot:
Applicant:
Unde~hters Approval:
Permit No.
Health Dept. Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $ .:5"0 .~"~D/.,.,~
Date of Permit.
Final Certificate: w//~ (check one)
Applicant ~i4g n a{~e
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, NY 11971-0959
Telephone (631 ) 765-1 $02
Fax (631) 765-9502
ro,qer, richertC, town.southold.ny, us
BUILDING DEPARTMENT
TOWN OF I~OUTI-IOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: William Jacobs
Address: 170 Emory Rd City: Cutchogue St: NY Zip: 1193
Building Permit#: 36331 Section: Block: Lot:
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Roslak Electric Inc LicenseNo: 3677-me
SITE DETAILS
Office Use Only
Residential ~ Indoor ~ Basement ~ Service Only ~
Commedcal Outdoor 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 3 ph Hot Water GFCI Recpt
Main Panel NC Condenser Single Recpt
Sub Panel NC Blower Range Recpt
Transformer Appliances Dryer Recpt
Disconnect Switches Twist Lock
Other Equipment: 200a overhead service
Ceiling Fixtures [~ HID Fixtures
Wall Fixtures Ill Smoke Detectors
Recessed Fixtures~] CO Detectors
Fluorescent Fixture ~_~ Pumps
Emergency Fixturesl~ Time Clocks
Exit Fixtures ~ TVSS
Inspector Signature:
Date: Jan 9 2012
81-Cert Electrical Compliance Form
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
/INSPECTION
[ L..]~-POUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND
[ ] FRAMING / STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] INSULATION
] FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (FINAL)
[ ] ELECTRICAL (ROUGH)
REMARKS:
DATE
INSPECTOR
TOWN OF SOUTHOLD BUILDING DEPT.
765-t 802
INSPECTION
[ ] FOUNDATION 1ST [
,~FOUNDATION 2ND [
] ROUGH PLBG.
] INSULATION
] FINAL
] FIRE SAFETY INSPECTION
] FIRE RESISTANT PENETRATION
] ELECTRICAL (FINAL)
[ ] FRAMING / STRAPPING [
[ ] FIREPLACE & CHIMNEY [
[ ] FIRE RESISTANT CONSTRUCTION [
[ ] ELECTRICAL (ROUGH) [
REMARKS:
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING/STRAPPING [ ] FINAL
FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATIOH
~],~ECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS:
DATE
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FO/~iDATION 1ST [ ] ROUGH PLBG.
[ ]/~/OUNDATION 2ND [ ] INSULATION
[I/] FRAMING/STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS: //c~.~.~__~ .* .~
DATE ~ INSPECTOR
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
FOUNDATION 1ST [ ] R/OI~H PLBG,
FOUNDATION 2ND [ ~"~NSULATION
[ ] FRAMING/STRAPPiNG [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINALt
REMARKS._
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ] INS~LATION
[ ]FRAMING/STRAPPING [/~I=INAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRK~AL (FINAL)
REMARKS: ~ ~,~'/T~¢~: ~
DATE
INSPECTOR.~~
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [,,] I~LATIoN
[ ] FRAMING/STRAPPING [t~]' FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH)
REMARKS:
[ ] ELECTRICAL (FINAL)
DATE
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST
[ ] FOUNDATION 2ND
[ ] FRAMING / STRAPPING [
[ ] FIREPLACE & CHIMNEY [
[ ] FIRE RESISTANT CONSTRUCTION [
[ ] ELECTRICAL (ROUGH)
REMARKS:
[ ] ROUGH PLBG.
[ ] INSULATION
] FINAL
] FIRE SAFETY INSPEOTION
) FIRE RESISTANT PENETRATION
ELECTRICAL (FINAL)
DATE
INSPECTOR~i~ i.~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
.--Disatypm wd
PERMIT NO..~ ~ ~--~ /
BUILDING PERMIT APPLICATION CHECKhlST
Do you have or need the following, before appl> rog7
Board of Health
3 sets of Building Plans _ _
Planning Board approval
Survey.
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
Mail to:
Building Inspector
Phone:
APPLICATION FOR BUILDING PERMIT
Date
INSTRUCTIONS
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3
sets of plans, accurate plot 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 strcct~
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 lnspec;or
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 i~ot 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 m
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 prmnises and in building for necessary inspections.
(signature o~..~pli~nt or name. ifa corporation)
%-0 (%,n
I / (Mailing address ofapplica~it) [ lq
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Nameofownerofpremises ~[~ ~, SO CO /~,
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No. ~ 6~ 7 7 M ~'
Other Trade's License No.
Location of land on which proposed work will be done:
House Number Street ~
~amlet
County Tax Map No. 1000
Subdivision
(Name)
Section
Block
Filed MapNo.
Lot
2. ,State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy / ,~-,,~zX4'zZ/a,'
b. Intended use and occupancy ~--~,I//-{'O'I-%/C.~
3. Nature of work (check which applicable): New Building Addition
Repair Removal Demolition Other Work
Estimated Cost
Fee C2~ g 7,,~
If dwelling, number of dwelling units
If garage, number of cars ,~
Ir-./ Alteration
(Description)
(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
Height_ IS" Number of Stories I
Dimensions of same structure with alterations or additions: Front
Depth. l~' 4-- 7~2 '.,. ~5~' Height l~' NumberofStories
9. Size oflot: Front
10. Date of Purchase --I/h4' [5}77
1 I. Zone or use district in which premises are situated
Dimensions of entire new construction: Front _~O Rear
Height [ ~' ' Number of Stories I
Rear [ ( ~2' Depth
Depth
Rear
Depth
Name of Former Owne~ .
12. Does proposed construction violate any zoning law, ordinance or regulation? YES __
13. Will lot be re-graded? YES__
NO
NO ¢ Will excess fill be removed fi.om premises? YES__NO
14. Names ofOxvnerofpremises/--lS,r4 -/~r_r)(5g Address (70 ~-Mt'q~/
Name of Architect ~/, '~-a~ (<,~1~--¢ Addressl)~"~P,.[~_
Nmne of Contractor Address Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES * 1F YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet eta tidal wetland? * YES__ NO
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
NO
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
17. It' 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 )
~ //t~t/2 ~ 4''~' ~/~-Cr~t/"6 ~ beingdulys~vom, deposesandsaysthat(,~V)heistheapplicant
(Name {b f fr~dividual signing contract)-al~ove named,
0~iqe 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 knowledge and belief; and that the work will be
perfbnned in the manner set forth in the application filed therewith.
Sworn l,O betbre me this ~ _ /
IX~a/-y Public
BONIqlE I. DOROSKI
~ota~ public, State Of New'f0rk
01I)06095328, Sufl01~ C~0unt~t
lerm Ex~ires July 1,20 ~
REQUESTED BY:
~mp~ny Name:
Name'.
IJcerme No.:
BUILDING DEPARTMENT
APPklCATION FOR ELECTRIq;AL INSPECTIQN
INFORMATION: (*Indicates required information)
~ame:
*Address:
'Cress Street
*Phone No.:
Block:
Lot:
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
(Pleaee Ck~le Ail That Appej)
*Is ~ reedy for k'~l~ctJk~:
*Do you need a Temp Certtttcate:
Temp Inlorm~lon IR needed~
3Phase
· Service Size: ~
· New Service: Re.connect
100
Underground
Numbm' of Metem
p.~yt~.~T OU~ WfT~ ~
300 350 400 Other
Change of Sew~e Ove~e~
BLDG OEPf.
TOWN OF SOUTHOLD
BUILDING PERMIT EXAMINER CHECKLIST
Applicant: ~A] ~ ~ Owner:
Architect/Engineer:
i SCTM# 1000-- 103-- q' -- ~-~ Subdivision:
*Date Submitted: ~- 6 ~1[ Date Reviewed:
Property Address:
Building Permits (Open/Expired): Bp__
BP__-Z/C/OZ-__ Info: BP
-Z / C/O Z-
-Z / C/0 Z-
City: ~~"-'K~ Pre COs?~
BP__-Z / C/0 Z-__., Info:
, Info: BP__ -Z / C/0 Z-__~ Info: __
Single & Separate Search Required? Y~o~Determination:~
REQ. Lot Size: ,doM- co/~ ~,__ACT. Lot Size: (~t~x) / ~/a4, REQ. ~t Coy. ~ ~ACT: ~t Cov.o ~
~Q. Front ~ACT. Front ~o4 ~QSide [~ ~CT. Side ~ ~Q. Re~ PROP. Re~ O~
~Q. Height~ ACT. Height 6~ ~. ~ 51b~5 ~ ~ ~T~
Project
Descri~ion:
Waterfront~ qo~-~y / / ' e
Ify~, water body: Panelg ~ Flood Zone: - Bul~ead/BluffDistance:
ADDITIONAL APPROVALS REQUIRED
Suffolk County Health: Y or (~J- If yes, *Bed#: *Date: ~/__/__ *Permit#:
- If no, certification required: Y or N Received: Y or N By:
NYS DEC: PRE-DEC 9/1/75 Y or~- Date:
Southold Trustees: Y orO- Date: /
Southold ZBA: Y or0- Date: / /
Southold Planning: Y or~)- Date: /
Town Landmark C of A: Y o~)TE:
Town Septic: Y or~
/ Permit #:
/ Permit #:
Permit#:
/Permit #:
//
or NJ Letter - Notes:
or NJ Letter - Notes:
- Notes:
- Notes:
*NYS CODE Compliance (page 2)0or N
Notes:
Fee Structure:
Foundation: SF
First Floor: '7/[7 SF
Second Floor: SF
Other: SF
Total: SF
Calculation:
-~.5'-0 , o 0
+ Initial Fee: $
+ Additional Fee ( ): $
SF X $ :$
+ Initial Fee: $
+ Additional Fee ( ): $
~1~oo,o O
TOTAL: $
NEW YORK STATE CODE COMPLIANCE CHECICLIST
CLIMATIC/GEOGP, A~HIC DESIGN CRITERIA: O~
.Grounlt Snow Load: ~.0.
Weathering: Severe __
Design Temp: 11. 'Ice Shield Underlay: YES
USE/OCCUPANCY CLASSIFICATION:
- HEIGHT/FIRE AREA:
TYPE OF CONSTRUCTION:
DESIGN CRiTERiA: ENGINEERED/PRESCRIFT1VE
FULL FtLaAcIING DESIGN ELEMENTS: Y/II 0
ItEADERS: Y/N WALL sTUDS: Y/N
CEILING JOISTS: Y/N FLOOR JOISTS: Y/Iq
LUIV[BER SPECIES AND GRADE: Y/N
, Wind Speed: 120MPH__ SelsmlcDesign Category~ B .
· Frost Depth: 36" __ Termite: M-H Decay: S-M
Flood Hazards:
GLRDERS: Y/lq
ROOF RAI~TERS: Y/bi
WYNDOW AND DOOR SCHEDULE:
,[VI[ISSLE TEST REQUIREMENTS: Y/N
EGRESS 5.7 S.F.: Y/N
LIGHT 8%: Y/N
~rENT 4%: Y/N
NAILING/CONSTRUCTION SCHEDULE: Y/N
MEANS OF EGRESS: Y/N
PLLrMBING RISER DIAGRAM: Y/N
LOCATION OF FIRE PROTECTION EQUIPMENT: Y/N
TRUSS DESIGN: Y/N
CERTYFICATION: YfN
ENERGY CALCS~N
TOTAL COMPLIENCE.~ (RETURN
TO PAGE ONE)
HOME IMPROVEMENT
CONTRACTO~
LICENSE
VILLIAM H MILNER
e,~-,~,~,~ ~'~ 11/01/2011
REScheck Software Version 4.4.1
Compliance Certificate
Project Title: Jacobs
Energy Code:
Location:
Construction Type:
G~azing Area Percentage:
Heating Degree Days:
Climate Zone:
Construction Site:
170 Emory Rd.
Catchogue, NY 11935
2010 New York Energy Conservation
Construction Code
Suffolk County, New York
Detached 1 or 2 Family
2%
5750
4
Owner/Agent:
Designer/Contractor:
Compliance: 8.2% Better Than Code Maximum UA: 49 Your UA: 45
Ceiling 1: Flat Ceiling or Scissor Truss
Wall 1: Wood Frame, 16" o~c.
Window 1: Vinyl Frame:Double Pane with Low-E
Door 1: Solid
150 19.0 0.0 8
362 19.0 0.0 18
6 0.340 2
60 0.280 17
Compliance Statement: The proposed building design described here is consistent with the building plans, specifications, and other
celculations submitted with the permit application. The proposed building has been designed to meet the 2010 New York Energy Conservation
Construction Code requirements in REScheck Version 4.4.1 and to comply with the mandatory requirements listed in the REScheck Inspection
Checklist.
Name - Title
q
fO
COMPLY WITH ALL CODES OF
NEW YORK STATE & TOWN CODES
AS REQUIRED ¢~U:;[~;~;~F
SO'OLD TOWN ZBA~""
~///'J SOUTH~NNIN~BOARD
RETAIN STORM WATER RUNOI:F
PURSUANT TO CHAPTEB 236
OF THE TOWN (;ODE,
CERTIFICATION OF
NAILING & CONNECTI{)NS
, ~ REQUIRED.
ELECTRICAL
INSPECTION REQUIRED
PLUMBING
AU. PL~HltaG w*S~
WATER UNE$'NE
APPR~/VED AS NOTED
NOTIFy BUILDING DEPARTMENT AT
765-~802 8 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1 FO UNDATION - TVVO REQUIRED
FOR POURED CONCRETE
2 ROUGH- F~MING, PLUMBING,
STRAPPING, ELECTRICAL ~ CAULKING
3. iNSU~T~ON
4 FINAL ' CONSTRUCTION & E~CTRiCAL
MUST BE COMPL~ F~ C.O.
ALL CON.RUCTION ~L ~ ~
REQUIREMENTS OF THE C~E8 ~ ~W
YORKSTATE, ~T~S~I~'F~ . ,~
DESIGN ~ ~NB~ E~.
OCCUPANCYOR
USEIS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
,I
I
/
RODERICK VAN TUYL P.C.
LICENSED LAND SURVEYORS
GREEN~ORT NEW YORK
SUFFOLK CO HEALIH DEPT, APPROVAL
S*STmS FOR T.~S RmDENCE W~LL
CONFORM TO THE STANDARDS OF THE'
SUFFOLK CO DEPT OF HEALTH SERVICES
APPLICANT
SUFFOLK COUNTY D~'PT DF HEALTH
SERVICES - FOR APPROVAL OF
CONSTRUCTION ONLY
APPROVED
SUFFOLK CO TAX MAP DESIGNATION, 1'
DIST. SECT BLOCK PCL
,~.~,.-¢-r /a2- ~ '- ~--
OWNERS ADDRESS'
cu-/-c~? u ~ ~,'~.
DEED. L. ,~J/'~%
TEST HOLE
SEAL
3
Nr.J.C,
P
Z
SUFFOLKCO HEALTH DEPT APPROVAL
/ /
RODERICK VAN~TUYL P C,
LICENSED LAND SURVEYORS
GREENPORT NEW YORK
STATEMENT OF INTENT
'HE WATER SUPPLY AND SEWAGE DISPOSAL
SYSTEMS FOR THIS RESIDENCE WILL
CONFORM TO THE STANDARDS OF THE
SUFFOLK CO DEPT Of HEALTH SERVICES
APPLICANT
SUFFOLK COUNTY
CONSTRUCTION ONLY
DATE'
APPROVED: _
SUFFOLK CO TAX MAP DES GNATION
DIST. SECT BLOCK PCL
OWNERS ADDRESS'
DkPT Of HEALTH
APPROVAL OF
TEST HOLE gTAMP
SEAL
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PLAN OON'FENTS=
~OOP FRAh41N6 NAILIN6 ~,CHEOULE:
CLIN/ATIO ~ ~EO~,I~,~PHIC., I~E~I~N CRITEt~.IA:
F'4ALL F~AMIN~ NAILIN® 5C. HED~L.ILE,
NOiE~
~E NO'T'E~ ~ ONLY' TO BE ~..; ~.~J;,E~2 TO IP HENTIONED ~..HEDULE N~l~-~, ONLY.
ROOF 5HEATHIN~ NAILIN¢ 5,C..HE~[2ULE:
FLOOF~ 5HEATHIN~ NAILIN~ 5,C. HEDIJLE=
I~F.._~k~]~;~_B~.ONLy 1'o BE ~-r-~,q~2 TO IF NPEI, iTIONE~ ~
_~ ~:TER/RIDGE/RAFTER VMTH CT
~'~RAFTF r.'JRIDGE/RAFTER w/ocr
SUBFLOOR
~JM BOARD
1 ST FLOOR WALl-
FLOOR '1 0 FLOOR
RAFTER~ RAFTER
Sit,°SOft H8 OR PE.5
TOP PRATE TOP pLATE
SIMPSON H SIMPSON CS20 18' LONG
WALL $31JD
(~RAFTEPJPLATE/STUD
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PLATE/STUD
KING STUDS
STUD
HFJ~DER
SIMPSON R3
SIMPSON CS20 12' LONG
JACK
HEADE~dSTUD HEADER/JACK
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(~STUDIPLATE/SILL
1ST. FLOOR'
SUBFLSOR
RIM BOARD
(~STUD/PLATE
PLATE/SILL
· lY& OR 2X4 - 16' O/C COLLAR ~IES MIN,
SIMPSON CB SERIES
P.C. FOOTING
(~POS r ANCHOR ~oR COVERED PORCHES
(~POS1 ANCHORS ~oR DECKS