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28522-Z
Town of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 4/7/2012 CERTIFICATE OF OCCUPANCY No: 35521 Date: 4/7/2012 THIS CERTIFIES that the building Location of Property: 1945 Village Lane, Orient, Sec/Block/Lot: 25.-3-11 SCTM #: 473889 Subdivision: ACCESSORY ALTERATION Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 7/1/2002 pursuant to which Building Permit No. 28522 dated 7/2/2001 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: alteration to an existing accessory building with partially heated storage. The certificate is issued to Judith Woodard & Myrna Banks (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 2/22/12 3863 12/2/03 Mattituck Plumbing & Heating FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 28522 Z Date JULY 2, 2001 Permission is hereby granted to: JUDITH WOODARD 2005 VILLAGE LANE ORIENT,NY 11957 for : CONSTRUCT ALTERATIONS (REPAIRS TO EXTERIOR WALL OF AN EXISTING ACCESSORY STOP~AGE BARiq AS APPLIED FOR. (REPLACES BP #19632-Z) at premises located at County Tax Map No. 473889 Section 025 pursuant to application dated JULY Building Inspector to expire on JAiqUARY 1945 VILLAGE LA ORIENT Block 0003 Lot No. 011 1, 2002 and approved by the 2, 2003. Fee $ Aut ho r~e d S ~a~t ur e OKtI4~INAL Rev. 5/8/02 TOWN OF $OUTHOLD IUILDING DEPARTMENT TOWN SOUTHOLD, N. Y, BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) o J~-- ~ . N_1 9 ~ ] 2 Z Date .....//....~...~ .................................. , 19.~./. Permission is ~m~ gmnt~ ~: . ~ // ~ . ~ ~~.~.~.....~....~ .......................... Z ...... _ . ............ ,~..., .... ,..~ ................ ~ ., z ........ .~...~...., ..... m ..... ~ ............ ~ .... ~ ..... ......................................... ~ ~,,, ,~,te ~ ....Z~....~~~....../~ ........................................... i~Jr~uant ~ a~llcatlo~ d~'~l ...... ~.-~ ............................... , 19.?.~..., amt al~,mv~l I~ Building Inspector. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD B~JILDING 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 architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to iuspect signed by the applicant. Ifa Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees I. Certificate of Occupancy - New dwelling $50.00, Additions to dwelling $50.00, AIteratious 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 Date. New Construction: Old or Pre-existing Building: Location of Property: [qt~/~- V'[ Il i~ ~ House No. Street Owner or Owners of Property: ~"~/(_~,_~//-x ~fi,)O ¢~ Suffolk County Tax Map No 1000, Section ~ Block Subdivision Filed Map. Permit No. ~gF2~- Date of Permit. Applicant: (check one) Hamlet Lot: Health Dept. Approval: Underwriters Approval: Plamaing Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~' Final Certificate: (check one) 7_ 5 regi weile architect ~2~east22nd street.new york lO010 212-982-4884 box223,east marion, new york11939 631-477-9735 Town of Southold Department of Buildings Town Hall Southold, New York 11971 22 April 2003 RE: Pen~it # 28522Z 2005 Village Lane, Odent, New York Certification of Completed Work THIS IS TO CERTIFY THAT THE FOLLOWING WORK HAS BEEN COMPLETED, AS INSPECTED BY MYSELF, ON THE ABOVE SITE, ACCORDING TO MY SITE REVIEW REPORT AND SUBMISSION DATED 14 March 2003 and here attached. Structural mpaim and changes: Steel suspension rods and hangers have been correctly mir, stalled. All wood bracing at roof and roof trussed systems have been completed to insure structural integrity. Teco joist supports have been Installed at fie-ins to headers and girders at stair opening as required by configuration of new work. Double Zee clips have been ins~lled at perimatm' connecting roof rafters to plate to wall studs as per code requirement. Insulation: Insulation has ben installed as per the following: Ceiling/Roof has received R30 Rigid Insulation with air space above. Extedor Walls have received R19 Barf insulation through-out Sheetrock: All walls and ceilingS have received 5/8" Firecode 'C' Sheetrock, Work has been taped and sanded and prepared for painting. Electrical: All required electdcai work has been completed including installation of three smoke detectors. Underwriters Inspection Certificate to follow. Plumbing and Heating: In Process. If you have any questions regarding this work completion memo please contact me at the above number. Th~nk YO~,./ Re~i Waile, Architect FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING 3. INSULATION PER N. Y. STATE ENERGY CODE 4. FINAL I Nassau Suffolk Electrical Inspections, Inc. 5A Canal Street * Center Mofiches, New York 11934 * Tel: 631-878-3500 * Fax: 631-878-3764 Application: 3863 Date: Issued to: Woodward Address:. 2005 Village Lane Village: Ohent 12/2/03 Introduced By: WEB Electric Lic#:4682-E was examined and approved up to the above date and was in compliance with the NEC /~tic 1st Roof'[] Residential [] Pool Der Garage ~ ~'x:[ flo~' Cza [[[t,Tda[ ~ Tub Ad(~on Switches Receptacles Fixtures G F I Ele¢lric Heat Whirlpool 10 17 3 1 34Ft Oven Carbon Fans Dishwasher Washer/Amps Dryer/Amps Range/Amps Monoxide Smoke Bell Furnace Oil Gas Heat Zones Detectors Transformers 3 Meter Amps Phase Motors Other Equipment: Barn Renovation Out,Res Permi~ 28522 This certificate must not be altered in any manner DUILDINd'DE?ARTMENT TOVFN OF SOUTHOLD CERTIFICATION ~ , (Please.pyinl) (Please piti hi) ~ t certify lhal lhe solder used in [he waler supply system comams less than S,sor~ Io before me Ihis ~ ~x'... o'~~ , 20 '~,:? ~rv Publ~' Counly 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ]INSULATION [~MING [ ]FINAL DATE INSPECTOR BUILDING DEPT. INSPECTION [ [ [ [ ] FOUNDATION 1ST ] FOUNDATION 2ND ] FRAMING [ ] ROUGH PLBG. [ ].,~ULATION [ I/]' FINAL ] FIREPLACE & CHIMNEY 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [~ ]//INSULATION [ ] FRAMING [' ] FINAL [ ] FIREPLACE & CHIMNEY , DATE: ~INSPECT~O~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] INSULATION_ [ ]FRAMING [ ~'~INAL [ ] FIREPLACE & CHIMNEY REMARKS: ~ DATE ~:~//,/~ ~ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION I ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY RK.MARKS: [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL i I/Ir~---~'--- i It OWN OF SOUTHOLD ~!L).4 .,,,., ~ ~lQn, ~ ~ BUILDING DEPARTMENT · ; ~ ~ SOUTHOLD NY 11971 ~UG~_ "~ ~ ' ' ' ~ ~~~; ~ TEL: 765.1802 Exami~...r~.~ ...... , , ~approved a/c ..................................... ................. ....... . ~PPLIC~TIO~ FOB BHILDI~G INSTRUCTIONS BOARD OF HEALTH ....~........ 3 SETS OF PLAN~.'~,'''''''. SURVEY SEPTIC FORM NOTIFY Date / .~..~ ...<~..;.. .......... l~?(. · a. '[']tis application must be completely filled in by typewriter or in ink and submitted to thc 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 streets ot areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of th.is appli- cation. 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 issued a Building Permit to the applicant. Such 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 spy purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector· 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, ad~ditions or alterations, or for femoral or demolition, as herein described. Tile 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 i.n, spections. (Signature of applicant, or name, if a corporation) (Mailin= address of applicant) State whether, applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... ~'e,~:,f..d. / t o~ Name of owner of premises ..... (as on the tax roll or latest deed) If applicant is a corporation, signature of duJ.v authorized officer· ·/'..~.,,,f?~..: ~ , ./-//w: , o,. / l 3 ;W. Builder's License No ........ / ............... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... I Location of land on which proposed work will be done ' ' House Number Street Hamlet .......... ...... .............. :.. Lot // County Tax Map No. I000 Section ~ Block Subdivision ..................................... Eiled Map No ............... Lot ........ (Name) ......· 2. State existing use and occupancy of pr, qmises and intended use and occupancy of proposed co-~truction: a ~ ' · ~--'S,O,--7,?//' / . c ~:/~'~e,..,.., .,...~¢.<'x/. . · ~:x~stmg use and occupancy ... z ............................... .;..~ b. Intended use and occupancy ............................ '. ;~" . ...... , ~ ~ · · · .A,o; ~ ~'~:'.~'0 .... ., ......... 4. Estimate'd Cost ~/.~..0.~. c p. Q ~ : (Description) ~ (to be paid on filing this application) $, If dwelling, nmnber of dwelling units ..... If garage, number of cars . ~ ........... Number of dwelling units on each floor. ~ ........ 6. ~.bustn~ss Commercial or n~i'xed'occupancy, specify n-ture an'd' ~-~: ' ~' '"' ": .............. ~ ............... 7. u~mens~ons of existing structures ifa · e.,tent O[eacn tye o,.f use ... .. ..... ny. Front... ~";~ ., ~,~ P? , · .... , .......... n.e~.ht .... ~. ~. ........ Num bet o f Stones ...... 77.~,.o.... · ........... Depth . ~.~.~.,(. ........ D~mensmns of same structure with alter-~; ....... . ........ :: ....................... ...... , or auumons. Front ... ~.~/?ff. ....... Rear . ,Y..z4/?~ ........ Depth ...... Y.~. ,~.e. ......... tleight ....5'd.~..e . , ..... · ............. $- Dimensions of entire new construction. Fr nt ' ~o'r .......... t~um°ere°l~t°nes"'~"'~'~-~-.......,~.. . · · o ................. Rear . ~'g -Y · ~eight ... ~. O. ...... :. Number of Stories 7-c~ o · ............. Depth . .~..~. f./. ~ ' 9. size prior: Front 9o ' ',~ .......... ~,' :,.~ .................. ' ...... ....................... Kear . ~'C~' .- - ' 9Y'& '~ ............. 10. Date of Purchase .................... ptt~ ................ ' I 1. Zone or use distri,-; ].~ ].]~:~', '--'-'- ' '- ...... .' ........ .,~Jam,e of Fgrmer Owner .......... ....... -.,-- laem~ses are situated . .~(.q~et~.~.t,~l/ ................ 12. ~,~ .my zoning law, ordinance or regulation: . ../~..~. ................ ~''' Does proposed Construction vio~. ...... · ' ' . .................................... ' ' ' 13. '" Will lot be regraded .... ~. ..................... Will excess fill be oved rom premises: . Yes )< No 14. Name of Owner of premises..'~-.~.o~..~.o?:0.~.~. ~. .... Address ,,P.o..o9...(,I/./.r~..aT~.d.ff.,. , Phone No.. ,~ -~}.~..~ ~ ./.~. Name of Architect ............................ Name of Contractor . .5'q.~?.,<.,~,, .~'.~'.,~e,,.y./C~.... Address, "3~i~ ............ Phone No ............... ............. Address a~ .... ~ .~.~..3..... Phone No -,3e9..3..-.~'~"~ ' 15.Is this property located ~ithi~00 feet of a tidal we~'l'~nd? *YE'I;' ' n~'~,~ .... · If yes, Southold Town Trustees Permit may be required. ' .......... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate interior or comer lot. whether STATE OF NEW K'O-RKI~/, /z COUNT)g Or.....-.~'~(.,..~ ~..~. S.S ..... ........... ( amc of nd~v dual signing contract) above named. being duly sworn, deposes and says that he is the applicant co;porate offi;;r 'et; ') .......................... said owner or owners, and is duly authorized to pe, rform or have performed the said work and to make and file this ~Pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the eork will be performed in the manner set forth in thc application filed therewith. ;worn to before me this .............. ~e,dL°7' ' '" 19'~/ Hydro-Sil 4123-A Rose Lake Drive Charlotte, NC 28217 1-803-548-6747 9/02/03 Sirs: This check number 3822 for $1,225.85 is for heafingun!~s to be sent to the following address: Judith Woodard 2005 Village Lane Orient, NY 11957 631-323 -3714 The order was for: 3 of the 8 foot hydro-sil baseboard heating units @ $279.00 each 1 of the 3 foot hydro-sil baseboard heating units @ $189.00 each 1 of the HBT2 Thermostats @ $ 24.95 each $ 837.00 $189.00 $ 24.95 2 of the TEMP-1-PTS thermostats Plus shipping Plus Shipping @3 boxes @ $ 59~95 each @ $ 10.00 @$ 15.00 each $ 119.90 $ 10.00 $ 45.oo Total $1,225.85 Thank You Please call with any questions Judith H. Woodard Hydronic-Silicone l'le~ P.O. Box 662 Ft. Mill, SC 29715 803-548-6747 Installation Instructions and RENEWAL'PARTS IDENTIFICATION Electric/Hydronic Baseboard Heaters ,NSTALLER I HHB SERIES PLEASE READ AND FOLLOW THESE DIREC- TIONS. LEAVE INSTALLATION INSTRUCTIONS FOR USER TO READ SPECIFICATIONS Modal Volts Watts Amps Length 28" HHB504D 240 500 2.08 (71 .lcm) 34" HHB754D 240 750 3.13 (86.4cm) 46!' HHB1004D 240 1000 4.17 -~1.i7m) HHB1254D 240 1250 5.21 (14.7m) 70" HHB1504D 240 15~0~ , 6.25 · ~1.78m) 2~ 94"' I'IHB2004D 240 8.33 (2.39m) WARNING THIS INSTRUCTION SHEET CONTAINS VITAL 3. INFORMATION FOR THE PROPER INSTALLA- TION, USE AND EFFICIENT OPERATION OF THE HEATER. CAREFULLY READ THE MANU- AL BEFORE INSTALLATION, OPERATION, OR 4. CLEANING OF THE HEATER. FAILURE TO 5. ADHERE TO THE INSTRUCTIONS COULD RESULT IN FIRE, ELECTRIC SHOCK, DEATH, SERIOUS PERSONAL INJURY OR PROPER"FY 6. DAMAGE, SAVE THESE INSTRUCTIONS AND REVIEW FREQUENTLY FOR CONTINUING 7. SAFE OPERATION AND INSTRUCTING FUTURE USERS. WARNING: HAZARD OF FI~I~ OR ELECTRICAL 8. Do not Irtstall baseboard heater against paperboard or Iow der~slty fiberboard sur- faces. Do not recess heater In wall. The Installation must c0mply with applica- ble local, and NarWhal Electrical Code and utility requlremente, Do not remove or by-pess thermal cutoat. - To reduce the risk of firs, do not store or use gesollne or other flammable vapors and liquids In the vicinity of the heater. Personal Injury or death could result from SHOCK: ~ eleetHc shock. Disconnect all power to heater at ma n pane before attempt ng to 1. Keep all electrical cords, foam filled artl. ~ ' ' II or ....... '~lns[a esrVIca tnla amr. cles, drapes, bedding and other household furnishings away from contact with heater. 9. SUp~ v0~age~ be the same as heater It is recommended all Items be kept a m~l- voltage. Check heater nameplate and sup- mum of slx (6") (l~2mm)-I~~ ' plyVoltagebl~nerglztng. heater ~ o ~.~ ~:1~ Supply wiring muS~ suitable forg0 C. 2. Do not Install baseboard heater I:~. trlcal convenience, receptacles (outl~~." i~ ~ ~,i,, ', ~,~" TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET VILLAGE DIST. SUB. LOT j . RES..) ~ / O S~S. VL. FARM COMM. CB. z MISC. Mkt. Value ~ND IMP. TOTAL DATE REMARKS , AGE BUILDING CONDITION N~ NORMAL BELOW ABOVE FARM Acre Value Per Value Acre Tillable Tillable 2 Tillable 3 Woodland Swampland FRONTAGE ON WATER Brushland FRONTAGE ON ROAD House Plot DEPTH ~ - ' BULKH~D Total DOCK M. Bldg. Extension Extension COLOR TRIM Foundation Basement ?7/6/r' ,~ Bath p& ~.?. Floors 2_ Extension Porch Porch Breezewa Garage Patio O.B. Total Ext. Walls Fire Place Type Roof Recreation Room Dormer 1 Driveway Rooms 1st Floor Rooms 2nd Y / / /~ oo- ~--,~-// TOWN OF SOUTHOLD PROPERTY RECORD CARD )WNER ~ STREET I ~,Z~,C~ VILLAGE DIST, SUB. LOT : ER N , N E P I~' ~ ~E - ~D~E ACR.I i'r ' ' ' ' S P~Rf~' -- ~0~,' W ~PE Of BUILDING / ,.. ~ND IMP. TOTAL DATE REMARKS AGE BUILDING CONDITION 3/2o/~7-8P~ 2V~7- / / I 4~ NOeL BELO~ ABOVE :ARM Acre Value Per Value Acre liable ' 1 liable 2 liable 3 ~land ,ampland FRONTAGE ON WATER ~hland FRONTAGE ON ROAD )use Plot DEPTH ' ~ BULKH~D tel DOCK COLOR TRI6A M. Bldg. Extension Extension Extension ?x// . ?9' Porch 7 ~' 2 ~ Porch Breezeway Garage Patio O.B. Total Foundation Basement Ext. Walls Fire Place Type Roof P, ec reotion Dormer Bath ~ ,2._ Floors Interior Finish Heat Rooms 1st Floor Rooms 2nd Floo~ Y COLOR TRIM _M~B_I~,. Z[~Y..~'- 7~ ~] ~ ~ ~7~ Foundation ,UL~ Bath Dinette Extension ~ t %2 ~ = H~ ~ ~ Basement CRAWLs~.~ Floors ~ ~ ~'~it. ~_~,( i n ~ ~ I~ ~ ~ ~ ~ Ext. Walls ~ ~ Interior Finish %,~ ~5~ ~. Extens on ~ ~ ~ ~ 2~ ~ 6~ ~ ~ Fire Place ~ BR, .a.o ~: ~ ~ ~~~ Woo~,ove ~ ~ ~ Fin. B. .ors, _ Deck ~ 0 ~ Attic Br~zeway ~, ~ ~ Rooms 1st Floor Garage ~ ~ ~ = ~0 ~ ~ ~ © Driveway Rooms 2nd Floor OWNER TOWN OF SOUTHOLD PROPERTY RECORD CARD STREET ACR. TYPE OF BLD. PROP. CLASS LAND IMP. TOTAL DATE I VILLAGE I ~T1 REMARKS FRONTAGE ON WATER FRONTAGE ON ROAD DEPTH BULKHEAD SUB. LOT TILLABLE WOODLAND MEADOWLAN HOUSE/LOT TOTAL TOWN CLERK OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION WAS ADOPTED BY THE SOUTHOLD TOWN BOARD AT A REGULAR MEETING HELD ON AUGUST 2~, 1993: RESOLVED that the Town Board of the two (2) new forms to be used under tlie of the Code of the Town of Southold: Application" [FDP(93)], and "Certificate Special Flood Hazard Area [C/C(93)]. Town of Southold hereby adopts Flood Damage Prevent regulations "Floodplain Development Permit of Compliance for Development in BLDG. DEFT.. TOWN OF SO.~'HOLD . Terry Southold Town Clerk August 25, 1993 APPLICATION # PAGE ! of 4 TOWN OV SOUTHOLD FLOODPLAIN DEVgLOPMENT PE[UMIT AP?LICATiON This form is to be filled out in duplicate. SECTION I: GENERAL PROVISIONS (APPLICANT to read and sign]: 1. No work may start until a permit is issucd. 2. Thc permit may be revoked il' any false statements are made hereto_ 3. If revoked, all work must cease tmtil permit is re-issued. 4. Dc'~:lopment shall not be used or occupied until a Certificate of Compliance is ksued. 5. The permit will expire if no work is commenced within six months of issuance. 6. Applicant is hereby informed that other permits may be required to fulfill local, state and federal regulatory requlrcmcnts. 7. Applicant hereby gives consent to thc Local Administrator or his/her representative to make/easonable inspections required lo vorigy compliance. 8. I, THE APPLICANT, C~RTIFY THAT ALL ~TATEMENTS HEREIN AND IN ATTACHJvI~ TO TRUE AND ACCURATE. SECTION 2: PROP(~ED DEVELOPMENT (TO be completed bv APPLICAN'I] NAM E~'"'""---.~ ADDRE$$ APPLICANT -~'--~....,,~~ BUILDER TELEPHONE PROJECT LOCATION: To avoid delay ia proofing the application, please provide enough information to easily idcutify the project Iocatlom Provide thc street address, lot number or legal description (attach) and, outside urban areas, the distance to the nearest intersecting road or well-known l~dmark. A sketch attached to this application showing the projec~ [ocatiou would be helpful. FDP(9]) APPLICATION PAGE 2 OF '~ DESCRIPTION OF WORK (Check all app[icabtc boxes): A STRUCTUILAL DEVT. LOPMENT ACTIVlTY ~TRUCTURE _TYPE [] New Structure [] Adctltion [] Alteration [] Relocation El Demolition [] Replacement [] Residen6al (14 Family) [] Residential (More than 4 Family) [] Nou-residen6al (Floodproo£mg7 [] Yes) [] Combined Usc (Residential & Co-~merdal) [] Manufactured (Mobile) Home (In Manu- factured Home Park? [] Yes) ESTIMATED COST OF PROJECT B. OTHER DEVELOPMENT ACTIVITIES: 0 F~I 0 Mining [3 Drilling [] Grading [] Excavation (Except [or Structural Development Checked Above) - 0 Watercourse Alteration (Including Drea:lging and Channel Modilications) El Drainage Improvemeaa (Including Culvert Work) [] Road, Street or Bridge Construction El Subdivision (New or F__xpa~sion) [] Individual Water or Sewer System [] Other (Please Specify) After completing SECTION 2, APPLICANT should submit form to Local Administrator for review. ~;ECTIQN 3: FLOODPLAIN DETERMINATION {'Fo be completed bv LOCAL ADMINISTRATOR) The proposed development is located on ~ Panel No. , Dated Thc Proposed Dcvelopmeat: F1 la NOT located in a Special Flood H~?ard Axea (Notify the applicant that the application renew i~ complete and HO FLOODPLAIN DEVELOPMENT PERMIT IS REQUIRED). [3 1~ located in a Spodal Flood Hazard Area. FIRM zone de.xignation i~ 100-Yeax flood elevation at the site i~: Ft. NGVD (MSL) [] Unavailable [] The proposed development is Ioc~led in a floodway. FBFM Panel No. Dated [] Sec Section 4 for additional instructions. SIGNED DATE APPLICATION ~' -- PAGE 3 OF 4 SECTION 4: ADDiTIQNALjNFORJx4ATION [LE_Q~_I RED ~_To hccqmpleted bv LOCAL ADMINISTRATOR] Thc appi~C~m must submil the documents checked below b¢lore thc appliCaOon can be processed: [] A site plan showing the location of all c:6~tmg slructures, water bodies, adjacent roads, dimensions and proposed development. [] Development plans, drawn to scale, and specifications, including where applicable: details for anchoring structures, proposed elevation of lowest floor (h~duding basement), types of water resistant materials used below the f-u'st floor, deta~ of floodproo£mg of uCOJties located below the first floor and details of enclosnses below the l'u-sl floor. A~o, [] Subdivision or other development pla~z (If the subdivision or other development exceeds 50 lots or 5 acre~, whichever is the I~sser, the applicant must provide tOO-year flood elevations if they are not othc~sc available). I'-I Plans showing the extemt of watercourse relocation and/or land.form alterations. [] Top of new ftll elevation. Ft. NGVD (MSL). [] Floodproofing protection level (non-residential only) FCNGVD (MSL). For floodproofed structures, applicant must attach certification from registered engineer or architect. [] Certification [rom a registered engineer that the proposed activity in a regulatory floodway will not result in ~ increase ha the height of the tOO*year flood. A copy of all data and calculations supporting this £mding must also be submitted. [] Othc~ ~ECTION 5: PERMIT DETERMINATION (To be comvleted by LOCAL ADMINIb~TRATQR} I have determined tha( the proposed activity. A. l'q Is B. 13 Is not in conformance with provisions of Local Law ~ , 19__. The permit is issued subject to thc conditions attached to and made pa~t of thi~ permit. SIGNED , DATE [[BQX Ai$ checked, the Local Administrator may iasue a Development permit upoa payment of designated fee. _If BOX B is checked, the Local Administrator will provide a written summary o( deficiencies. Applicant may revise and resubmit an application to the Local Administrator or may request a bearing from the Boa.rd of Appeals. AFPF~d~: Appealed to Board of Appeals? [] Yes [] No Heazmg date: Aepeats Board Decksion --- Approved'~ [] Yes Coac[itioas C] No APPLICATION PAGE 4 OF 4 ~;E(y'I'ION 6: A...q-BUILT ELEVATIONS (To be submitted by APPLICAaNT before Certificate of Comoliancc is issued'} The following informa6on must be provided for project structures. This section must be completed bY a registered professional engineer or a licensed land surveyor (or attach a certification to this application). Complete 1 or 2 below. 1. Actual (A~-Built) Elevation of the top of ~he lowest floor, including basement (in Coastal Hieh Hazard Areas. bottom of lowe_q structural member of the lowest floor, exduding piling and columns) i~: Fr. NGVD 0aSL). 2. Actual (As-Built) Elevation of floodproofmg protection is FT. NGVD (MSL). NOTE: Any work performed prior to submittal of the above information is at the risk of the Applicant. SECTION 7: COMPLIANCE ACTION (To be completed l~v LOCAL ADMINISTRATOR'~ The LOCAL ADMINISTRATOR will complete thi~ section as applicable based on iuspectiou of the project to ensure compliance with the community's local law for flood damage prevention. INSPECTIONS: DATE BY DEFIC[ElxI'CIES? [~ YES i'-I NO DATE BY DEFICIENCIES? [] YES [] NO DATE BY DEFICIENCIES? [] YES [] NO SECTION 8: CERTIFICATE OF COMPLIANCE(To be comoleted by LOCAL ADMINISTRATOR) Certificate of Compliance issued: DATE:. BY:. Attachment B SAMPLE CERTIFICATE OF COMPLIANCE for Development in a Special Flood Hazard Area TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE FOR DEVELOPMENT IN A SPECIAL FLOOD ~ AREA (OV~rNER MUST RETAJN THIS CERTIFICATE) PREMISES LOCATED AT: PERMIT NO. PERMIT DATE OWNERS NAME AND ADDRESS: CHECK ONE: [] NEW BUILDING [] EXISTING BUILDING [] VACANT LAND THE LOCAL ADMINISTRATOR IS TO COMPLETE 3,. OR B. BELOW: COMPLIANCE IS HEREBY LOCAL LAW # ,19 SIGNED: CERTIFIED WITH THE REQUIREMENTS DATED: OF COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # ., 19__, AS MODIFIED BY VARIANCE # , DATED SIGNED: DATED: C/C(93) Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTI-IOLD Fax (631) 765-9502 Telephone (631) 765-1802 April30,2003 Judith Woodard 2005 Village La Orient NY 11957 RE: 1945 Village La TO WHOM THIS MAY CONCERN: We are unable to complete your Certificate of Occupancy because of the following reasons: X An Application for Certificate of Occupancy is not on file. (Enclosed) X No Underwriters Certificate on file. X The check is (not in file)S25.00 __ No Health Department Approval on file __ No final inspection has been completed. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 28522-Z Please contact our office on this matter. Thank you for your cooperation. SOUTHOLD TOWN BUILDING DEPT. Town Hall. 53095 Main Road P.O. Box 1179 Southold. New York 11971-0959 Fax (631 } 765-9502 Telephone (631 ) 765-1802 BUILDING DEPARTMENT TOWN OF SOUTHOLD October 5th, 2006 Judith Woodard P.O. Box 402 Orient, N.Y. 11957 RE: Alterations Barn TO WHOM IT MAY CONCERN: We? unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not one file. (Enclosed No Electrical Underwriters Certificate on file. The check is (not on file) $25.00 Returned outdated No Health Department approval on file. No final inspection has been completed. No Plumber Solder Certificate on file. (All permits involving plumbing ~ssued after 4/1/84 ) Final Town Trustee Approval BUILDING PERMIT: # 28522-Z Thank you for your cooperation. SOUTHOLD TOWN BUILDING DEPT. Please note if permit is expired, a renewal fee may be required. Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York I 1971-0959 Telephone (631 ) 765-1802 Fax (631) 765-9502 3rd request December 10, 2008 BUILDING DEPARTMENT TOWN OF SOUTHOLD Occupancy or use is unlawful without a Certificate of Occupancy Judith Woodard P.O. Box 402 Orient N.Y. 11957 To Whom It May Concern: It has come to the attention of the Southold Town Building Department that a Certificate of Occupancy has never been issued for Building Permit # 28522 issued on July 2, 2001 for repairs. In order to rectify this situation please submit the following to this office so that a C.O. may be issued. 6--""~application for Certificate of Occupancy is not on file.(Enclosed) c-/~No Electrical Certificate on file. ~The Check is not on file - $ 25.00 No Final Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued at~er April 1, 1984) Certificate of Compliance fi.om Southold Town Trustees. Approval of the Zoning Board of Appeals* Final Planning Board Approval. Town Hall Annex 54375 Main Road P.O. Box 1179 Southold. NY 11971 0959 Telephone (631) 765-1802 Fax (63 l) 765-9502 BUILDING DEPARTMENT TOWN OF SOUTHOLD December 19, 2011 Judith Woodard PO Box 402 Orient, NY 11957 Re: 1945 Village Lane, Orient TO WHOM IT MAY CONCERN: The Following Item(s) Are Needed To Complete Your Certificate of Occupancy: _ Application for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. // A fee of $25.00. __ Final Health Department Approval. __ Plumbers Solder Certificate. (All permits involving plumbing after 4/1/84) __ Trustees Certificate of Compliance. (Town Trustees #765-1892) __ Final Planning Board Approval. __ Final Fire Inspection from Fire Marshall. - Bob Fisher __ Final Landmark Preservation approval. BUILDING PERMIT: 28522 - Alterations to Storage Barn Regarding: 2005 Village Lane Property of Judith Woodard and Myma Burks March 9, 2012 Sirs: I have emptied and inspected the 4 Cesspools at the above address today. They are structurally sound and in good working order. They can handle the needs of the house and the requirements of the barn/storage area. Morris Cesspool Service 2760 Yennecott Dr Southold, NY 11971 631-765-3300 regi weile architect post office box 5!3 *~Cw york, ", 1939 Town of Southold Department of Buildings Town Hall Southold, New York 11971 9 March 2012 Re: Permit #28522Z 2005 Village Lane, Orient, New York Barn Renovation and Repairs Amendment to Certification of Work of 4/22/03 This is to confirm that in addition to the Certification of Completed Work Letter of 22 April 2003, I hereby submit that all work completed under this Permit complied with the New York State Building Codes and all other Codes applicable at the time of Completion. Work under this Permit for the Renovation and Repair of the Barn complied with Building Depadment Approved Drawings as submitted by this office on 13 December 2002. If you have further questions please feel free to contact me. Than. k you, _ regi weile architect 905 aquawew, east marion, new york, 11939 post office box 223 ~ e-mail vregwe e(~aol corn Town of Southold Department of Buildings Town Hall Southold, New York 11971 26 March 2012 Re: Permit #28522Z 2005 Village Lane, Orient New York Barn Renovation and Repairs Amendment #2 to Certification of Work Competed 4/22/03 Dear Mike Verity, As per your request I am submitting the prior submission of February 2003, for work completed for the above Barn as related to 1] installation of four sections of electric baseboard heating units along with 2] the Energy Code Compliance Review Worksheet for your Information and Use. Attached please find one copy of Worksheet, Part 6, from the New York State Energy Conservation Code: Thermal Rating Method One-and Two Family Buildings. As the Conservation Code did not offer a sub-section on requirements or analysis for BARNS, Studios or Storage buildings I chose to review the structure under the more stringent requirements for One and Two Family Buildings. I have also attached information related to the four baseboard units installed by the Owners Electrician. The total heat load supplied was minimal and for the purpose of keeping equipment and storage items at a reasonable temperature on the first level: 23,017 BTU with an electric draw of 28.12 amps. I am hoping this satisfies your request for information. If you have further questions please feel free to call me. Thank you, r~gi we~e NEW YORK STATE ENERGY CONSERVATION CONSTRUCTION CODE PART 6 WORKSHEET BUILDING ADDRESS THERMAL RATING METHOD ONE- AND TWO-FAMILY BUILDINGS CONTRACIOR,,ARCHITECT OR ENGINEER TELEPHONE GROSS FLOOR AREA NUMBER OF STORIES DEGREE DAYS If the building does not meet the following pre-qualifying conditions, Part 6 of the Energy Code may not be used. YES NO Building is one- or two-family residen;~al.<~ Building is detached. Building is less than 5,000 gross square feet. Building is three stories or less in height. Entrance doors have a storm door or certified U value of .40 or less. v// Glazing area/gross wall area is equal to or less than: 24% if 5,000 degree days .. 23% if 6,000 degree days 20% if 7,000 degree days 18% if 8,000 degree days 16% if 9,000 degree days If all of the above conditions are not met, either PART 3, PART 4 or PART 5 of the Energy Code must be used. 41 DIRECTIONS: For each component of the proposed building design enter the design information requested such as Areas, "U" or "R" Values. Additional lines are provided for designs with more than one c6mponent construction type. Obtain thermal ratings for each item by co~,sulting the appropriate ,,Tables. A. ROOF/CEILING Obtain Thermal Ratings from Table 6-1, 6-2, 6-1E or 6-2E depending upon degree~ days and heating type. Area: ~ U-Value: '~)~1' l~ ~quare Ft. Thermal Rating Squ~re F~t. Thermal Rating B. NET WALLS Square Ft. Area: U-Value: Square 'Ft. Obtain Thermal Ratings from Table 6-1 o'r 6-1E depending upon heating type. U-Value: ,0~0 0 Thermal Rating ~hermal Rating Note: Net Wall Area = Gross Wall Area minus Basement/Cellar Walls, Glazing Areas and Door Areas. C. GLAZING Obtain Thermal Ratings from Table 6-3 or 6-3E depending upon heating type. WINDOWS · i Area of Glazing: ~)0~ Area of Glazing: SKYLIGHTS Square Ft. ~quare Ft. U-Value: ,~'~ 0 Thermal Rating U-Value: Thermal Rating Area of Glazing: U-Value: Thermal Ratinj 42 D1. FLOORS Floor Area: Obtain Thermal Ratings from Table 6-i, 6-1E or 6-4E depending upon degree days and heating type. t U-Value: ,0~0 0 Thermal Rating D2. BASEMENT/CELLAR WALLS Wall Perimeter: Linear Feet Feet Inches Obtain Thermal Ratings from Table 6-4, 6-5, 6-6 or 6-5E depending upon degree days and heating type. Exposure Above Grade: U-Value of Wall: Depth of Wall U-Value Below Grade: Thermal Rating Note: Use the above grade U-Value of the wall. The Thermal Rating Tables have been designed to take into account the insulating effect of the earth. D3. SLAB INSULATION Slab Perimeter: Insulation R-Value: Obtain Thermal Ratings from Table 6-7 or 6-6E depending upon heating type. Linear Feet Thermal Rating 43 INFILTRATION CONTROL Obtain Thermal Ratings from Table 6-8 or 6-?E depending upon heating type. If the building does not meet the following conditions, enter NA (Not Applicable) for Thermal Rating. YES / NO All windows have an air leakage rate of 0.35cfm or less per linear foot of operable sash crack; All net wall areas have an infiltration barrier; and Conditioned Floor Area: (Shall not include basement/cellar floor area) A heat recovery ventilator, which transfers heat between the outgoing airstream and the airstream entering from the outside, is installed. ~ Square Ft. Thermal Rating F. SOUTH FACING GLAZING Obtain Thermal Ratings from Table 6-9 or 6-8E depending upon heating [ype. If the building does not meet the following conditions, enter NA (Not Applicable) for Thermal Rating. YES NO The building is no less than 1,250 square feet in conditioned floor area; At least 45 percent of all glazing faces within 30 degrees of true south; All glazed areas in buildings are no more than U(glazing) ~ 0.58; South facing glazed areas are free of any site obstructions during the heating season; and An area of four-inch thick concrete or masonry is exposed to direct sunlight from south facing glazing. The area of this concrete or masonry shall be no less than three times the area of south facing glazing. ~. South Glass/Total Glass: Glass Area/Gross Wall Area: __ Conditioned ~ % Floor Area: ~Q Squar~ Ft. (See Above) WA, Thermal Rating 44 ~ SUMMARY OF TOTAL THERMAL RATING If the Total Thermal Ratiqg is zero (0) or greater, the proposed design for the building envelope complies with the Energy Code. D1. D2. D3. Em THERMAL TABLE AREA U-VALUE RATING USED ROOF/CEILING ~(~) ,03~ lq ~'1 N~ET WALLS ~ 0 ~'/ GLAZING Window Window Skylights F'LOORS BASEMENT/CELLAR WALLS Wall Perimeter Exposure Above Grade Wall U-Value Depth of Wall u-Value Below Grade SLAB INSULATION Slab Perimeter Ip~ulation R-Value Feet Feet Inches Feet INFILTRATION CONTROL C6nditioned Floor Area ~.~'~_ Sq. Ft. SOUTH FACING GLAZING South Glass/Total Glass ~O~a Percent Gl. Area/Gross Wall Area ~ Percent Conditioned Floor Area . Sq. Ft. 45 regi weile architect Site Review Date: 14 March 2003 Loc~J0a: 2005 Village Lane, Orient, New Yod( Block/Lot #~5-3-1 P{i~mnit: Southold #28R3"~7 22 east 22nd streetL, new york 10010 212-982-4884 box 223. east marion, new york 11939 631-477-9735 Owner: Woorlard 2005 Village Lane, Odent, New York Coov: Woodard, M, Verity, Health Oeflertment of NY, Mattituck Plumbing, Bill Gorman ITEM DESCRIPTION bl,~--'ting 3/12/03 Mike Verity, Southold Building Department Work folder and documentation for the above repair and renovation was reviewed, with the following requests made by the Building Department and as noted on the attached Architectural Drawings: 1] Structural changes and repaim to be confirmed and documented as related to roofs 2] Change In stair location and construction to be documented. Installation completed in workmanlike fashion and coordinated with structural modifications and repaim. 3] All insulation to be installed shall be in compliance with the New Yod( State Building Code and Energy Conservation Standards. Submission of Energy Conservation Construction Code Analysis for Insulation Requirements am submitted as attached for future heating system amendment to these plans. 4] Plumbing: Addition of Water closet and Lavatory shall be filed and approved by Department of Health as per Code requirements. Delete references to Tub installatio~.k. 5] Proposed heating system: Heating system to be installed under separate contract and at future stage of construction. No heating system proposed for this submission. 6] Revised Architectural Drawings of all proposed work to be submitted to Building Department es Amendment to Current open Building Peri,nit by Architect and per Amendment to Peri'nit #285227 of 2/10/03. 7] Use of Structure to remain unchanged as Barn for storaae only, with wodcspane as existing in rear portion of structure. Roof Structure As per attached drawings repair and replace roof rafter-struts [support] as indicated. As per attached framing plan repair existing framing system for Storage loft. As per attached drawings add edditional structural supports as required by above plans. Insulation Energy Code Installation of insulation shall be as follows: Ceiline/Roof: R 30 or equivalent. Fur out existing framing members as required. Provide thru ventilation above insulation es required by code. Extedor Wall: R 19 or equivalent Fur out exi~ng framing as required. ,. Interior Walls: R14 or equivalent for sound absorption pu~. Attached please find submission of Form Part 6 Worksheet and backup Drawings. Page I of 2 Plumbing A~chitect is in process of filing Plumbing work with Health Department. Plumbing work to include installation of Water Closet and Lavatory, and all work needed to complete system as per code. Storage Since the Owner is in need of temporary Storage of items currently occupying space near Ground Zero which must be vacated by April 2, 03, the following proposal is offered for consideration by Owner and Building Department: 1] Press equipment and art supplies to be stored on existing concr~e floor at west section of Barn. Installation of Individual strut supports at roof, installation of insulation and sheet rock to be completed pdor to storage of this material. Permission to Store this matedal requested. Architect to certify completion of this work in accordance with code and structural requirements prior to storage. 2] Central section of Barn [two story structure] not to be used for storage until all roof and floor supports are con'ected and insulation and sheetrock installed as per attached drawings and Architects Certification. 3] East section of Barn [curre~ studio space] to be used for additional and temporary storage space for items of~rt.wedc.~rrently being relocation from New York until such ti,me as central two~__~-t~o~ B~R~ has been completed. ! 4] Storage spac/e W~ll not be heated u~l second and future stage of construction. Architect to r~ appropriate d~ngs~ installation of all equipment. Stair Now wood stair stringers, as installed, shall be reinforced as per attached. Now Location and existing [former location of] stair access indicated on attached plans. Opening has been increased in order to allow large fiat panel material access to upper space. List Of Attached Drawings: DWG 1 Existing Barn Plan as submitted 2/10/03 as Amendment #1 DWG 2 Existing Framing Plan and Now Work DWG 3 Plans; First Floor and Storage Loft DWG 4 Sections '. Environmental Worksheets: Part 6 Thermal Rating If you have further questions regarding this Site Review please call me at the above telephone number. Respectfully Submitted, r~li weile,amhitect Page 2 of 2 41'-6" ' X~New Concrete Slab~ )te: 2Story this sectipn only _Exisitn9 ladder access above / I-~--] New Uti l . ::~::. __ _ --7 , ~_.___, _ '~' Sink ~,~ New ~himney/ '~ /Exising Concrete Slabj ~EPLACE EXISITING MATERIALS THESE WALLS' /~ --- ~ ~---~---F - TC-~- -T----.z- ..... :/ ~- EXISTING NO CmANG~ EXISiTNG BARN :mcrete Fnoting a? ntir'e perimeter ;)f T~[. Snrvice as , de reqmtq. ,R , e windows as neD,~sary ,Ni w' Sheefrock (a walls ,,J ceilinqs SITE INFORMAl!ON Block/Lot # 25-3-11 2005 Village Lane Orient, New Yoe~'~ ' ~_-~-Provide thru venPi ationfabove insulation ~'~... / Insulation: Ceiling La R30 '~'"~..~.. Int. Wal s La R!9 existi~( I:~ Termite Shield 4"conc slab w/wm#4 --~_.____~Top of Footing La3'O" Below Grade SECTION@New Concrete Foundation Wall Scale: ~"=1'0" AMENDNENT TO BUILDING PERHIT ~ 28522Z February 10, 2003 E,XISTING FRAHING PLAN J~'!TH NE'I~' '~'ORK !scale: 1/8" = 1'0" X EXISTING FRAMING AT LOFT RAFTERS WITH NEW WORK scale !/8"=1'0" A~END~ENT TO 8U!LD'~HG PERMIT # 28522Z WEST STORAGE remove ex~g EAST STORAGE PLAN: FIRST FLOOR ENTRY west roof. east roof: ri dqe ~RO~F PL_AN: NO ~HANGES _14 Ma~h 2003 6~t~ collar beam 2x6@~4!!oc extg-- R-30 Insul ~xtisting dormer R-19 EAST STORAGE STORAGE LOFT new stai-- new x6@74"oc w/struts Insulation ?xisting tie bea~ WEST STORAGE -R-19 T~nsul ation scale: 1/'8"=1'0" R-30 Insulation Insure vent space above insulation R19 Insulation~ ~repai (re-secure at both locations) rafter at tie-rod collar extq. Insulation extq install ~x~ strut~ repai 2New Girders new stair WEST STORAGE Insulation: -- SECZIO-N_BB scale 1/8"=1'0" M~T~P ~ -4, OCCUPANCY OR USE IS UNLAWFUL I'~¢ITHOUT CERTIFICATE OF OCCUPANCY AP~PROV.~D AS ~OTED NOTI~U~G DEP~ ~ l, '.~ 765-1802 9 AM TO ~ PM ~OR THE,' 2, ROUGH -FRAMING & PLUMBING ' ~. IN SUCTION t '