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Home My WebLink About36787-ZTown of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 7/26/2012 CERTIFICATE OF OCCUPANCY No: 35845 Date: 7/26/2012 THIS CERTIFIES that the building Location of Property: SCTM #: 473889 Subdivision: AS BUILT ALTERATION 5855 New Suffolk Avenue, Mattituck, Sec/Block/Lot: 115.-5-18 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 10/26/2011 pursuant to which Building Permit No. 36787 dated 11/1/2011 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: "as built" interior alterations to kitchen, bedroom, baths, walk-in closets and utililty room and existin~ deck addition replaced in kind as applied for. The certificate is issued to Vergari, Joseph & Julie (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIHCATE NO. PLUMBERS CERTIFICATION DATED 7/23/12 36787 6/13/12 Mattituck Plumbing & Heating 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 #: 36787 Permission is hereby granted to: Vergari, Joseph & Julie 3 Wilder Ln Huntington, NY 11743 Date: 11/1/2011 To: 'As Built' Alterations (Interior) to a Single Family Dwelling; Kitchen, Bedroom, Baths, Walk-in Closets, Utility Room, as applied for. ' At premises located at: 5855 New Suffolk Avenue, Mattituck, NY SCTM # 473889 Sec/Block/Lot # 115.-5.18 Pursuant to application dated To expire on 5/2/2013. Fees: 10126/2011 and approved by the Building Inspector. CO - ALTERATION TO DWELLING SINGLE FAMILY DWELLING - ADDITION OR ALTERATION Total: $50.00 $1,097.60 $1,147.60 Building Inspector 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 #: 36730 Date: 10/312011 Permission is hereby granted to: Vergari, Joseph & Vergari, Julie 3 Wilder Ln Huntington, NY 11743 To: electric for "as built" renovation (plans to come & trustees) At premises located at: 5855 New Suffolk Ave. Mattituck SCTM # 473889 Sec/Block/Lot # 115.-5-18 Pursuant to application dated To expire on 4/3/2013. Fees: 10/3/2011 and approved by the Building Inspector. ELECTRIC $125.00 Total: $125.00 Building Inspector ~orm N~. 6 TOWN OF $OU~HOLD 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: For new building or new use: 1. Final $ur~ey °f pr°pcrty with accurate'location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health D~pt. of water supply and sewerage-disposal (8-9 form). 3-. Approval of electrical installation from Board 0fFire underwritem. 4. '8w. om 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 amhitecl or engineer responsible for the building~ .6. Submit planning Board Approval of completed site ptan requirements. B. For existing buildings (prior to April 9, 1957) fion-conforming us~, or buildings and "pre-existing" land uses~ 1. Accurate survey of property showing all properly lines, streets, building and. unusual natural or topographic features. ' 2. A properly c?.mpleted 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 $50.06. 2. Ceytifieate 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 o£ Occupancy - Residential $15.00. Commercial $15.00 New Construction: / Date. Old or Pre-existing Building: Location of Property: ,5-,~D"~6~ House No. Street O irorOw ofProporty:. , J U ' , / e ? Suffolk County Tax Map No 1000, Section. //~ Block 8ulxlivisi0n Date of Permit. Permit No. /5t- // _ (check one) Hamlet Filed Map. Lot: Applicant:,. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Foe Submitted: $ ~L9~ ~ Underwritem Approval: Final Certificate: ~ (check one) Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971 0959 Telephone (631 ) 765-1802 Fax (631 ) 765-9502 ro.qe r. richert~,,town.southold, ny. us BUILDING DEPARTMENT TOWN OF SOUTItOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Julie & Joe Vergari Address: 5855 New Suffolk Ave City: Mattituck St: NY Zip: 11952 Building Permit #: 36787 Section: 115 Block: 5 Lot: 18 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: REP Electric LicenseNo: 46288-me SITE DETAILS Office Use Only Residential ~ Indoor ~ Basement ~ Service Only ~ Commerical Outdoor 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Servicelph ~ Heat ~ DuplecRecpt ~ 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: 3- Ceiling Fixtures [~[~ HID Fixtures Wall Fixtures 131 Smoke Detectors Recessed Fixtures CO Detectors Fluorescent Fixtur~ ~ Pumps Emergency Fixture Time Clocks Exit Fixtures TVSS combination smoke/co detector, 2-exhaust fans, 15-ft wire mold, 2-40a ovens 1-30a cook top, 10 landscape lights Notes: Inspector Signature: Date: June 13 2012 81-Cert Electrical Compliance Form.xls BUILDING'DEPARTMENT TOWN OF 80UTHOLD JUL 2 4 2012 Eax CERTIFICATION a ,a d' (Please ,print) ?iumber: (Please pr'/nt) J I cenif7 thai the solder used in the water supply system contains less than 2/1 0 of 1% S,,,om to before me this <~(O o ~ ? o f...._.] 6,. c ?/ , 20/2 'xol,wy Public~¢..~ County DENISE KING Notary Public, State of New York Registration #01 KI6041757 Qualified in Suffolk County My Commission Expires May 15 2o1'.~ 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING / STRAPPING ] FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL [ ] FIRE SAFETY INSPEGTION [ ] RRE RESISTANT CONSTRUCTION [ ] RRE RESISTANT PENETRATION ~ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPEC/TION [ ] FOUNDATION 1ST [~] ROUGH PLBG. [ ]/~)UNDATION 2ND [ L~FRAMING / STRAPPING [ ] INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS:[ ] ELECTRICAL (RO~G_~/ ~[ ] ELECTRICAL/~ ~(FINAL) DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ]RO~HPLBG. [ ] FOUNDATION 2ND [~/]~INSULATION [ ] FRAMING/STRAPPING [ ] FINA~ [ ] FIREPLACE & CHIMNEY [ ] FI~SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [~FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: /~/~/~ ~ DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ~,~ELECTRICAL (FINAL) REMARKS: DATE INSPECTOR~ ........ TOWN OF SOUTHOLD BUILDING DEPT, 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] INSULATION C FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: DATE TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork.net Expiration PERMIT NO. 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. Trustees C.O. Application Flood Permit Single & Separate Storm-Water Assessment Form Contact: Mail to: Building Inspector APPLICATION FOR BUILDING PERMIT Date /O - 3 ,20 /1 INSTRUCTIONS a. This application MUST be completely filled in by typewritel' or iii 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 oflot 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 connnenced befbre 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 fol' inspection throughout tile work. e. No building shall be occupied or osed 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 issnance or has not been completed within I 8 months fi'otn such date. If no zoning amendments or other regulations affecting the property have been enacted in tile interim, the Boilding Inspector may attthorize, 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 ora 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 alteralions or for removal or demolition as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code authorized inspectors on premises and in building for necessary inspections./ knsing code, and regulations, and to admit / iSignature of applicant or name, ifa corporation) (Mailing address of applicant) I! '7 ~ State whether applicant is owner, lessee, agent, architect, engineen general contractor, electrician, plumber or builder Name of owner of premises 0(./O/8 g OO~q~9/'~ d6~4¢}4~1' · (As on the tax roll or latest deed) If applicant is a corporation, signature of duly attthorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. Location of land on which proposed work xvill be done: Ifouse Number Street Hamlet County Tax Map No. 1000 Section / / ~ Block ~ Lot / ~ Subdivision Filed Nlap No. Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy V,R¢4-t,dT b. Intended use and occupancy. 3. Nature of work (check which applicable): New Building_ 4. 5. /' Repair )~ Removal Demolition Estimated Cost q~ / gO/ Og/O. If dwelling, number of dwelling units If garage, number of cars --- Fee Addition Alteration Other Work (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specif,v nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Rear Height 7, ~ ' Number of Stories ~ (,wwo) _Depth Dimensions of same structure with alterations or additions: Front ~' Depth Height_ Number of Stories Rear ~'~ 8. Dimensions of entire ne~v construction: Front '" Rear -'"' _Depth Height ,- Number of Stories 9. Size oflot: Front '?.~9.¥{ Rear ~O.oo Depth ~'OO. oo 10. Date of Purchase '7 - I ' I ~ Name of Former Owner L. 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO ~ I3. Will lot be re-graded? YES )~ NO__Will excess fill be removed fi'om premises? YES NO 14. NamesofOwnerofpremises d ~-.J qEff4rAl?,~ Address '~l, qlcOfi:e- kh PhoneNo.~lto~lO~SZl~ Name of Architect Address Phone No Name ofContractor ,3 .~o__~e'oc.e,[l~ t'~,-~se~. Address ioo 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 ~vithin 300 feet of a tidal wetland? * YES NO · IF YES, D.E.C. PERMITS MAY BE REQUIRED. 1 6. 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, mnst provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? * YES · IF YES, PROVIDE A COPY. NO t,/ STATE OF NEW YORK) SS: COUNTY 3 I~{ i I' 6t V~:> ~'~Cr~ Ir {' being duly sworn, deposes and says that (s)he is the applicaat (N~me of individual signi~ 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. Sworn to before me this ] L/f~dayof tOF_,P0Z)~gp_~~ 20 ~/ ' BEDELL ,, ~otary Pu~ [ ~ No. ~'~6~ 7 ii S,gnature o~ Ap~ ~ Qua feam~uno~ Commission Exp res 8ep · % Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FOR~" PROPERTY LOCATION: S.C.T.M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A ~ ~ '~'~ /ODD I t~ '5-- i~ STO~-WATE~ 6UDING, D~INAGE AND EROSION CONTROL P~N ~!~$ ~istdct Section -Bilk Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YOR~ SCOPE OFWOI~ - PROPOSED CONS~U~ON 1'1'~ ~ / WO~S~S~ ~ Yes No a. What Js ihe Total Area of the Pmje~ Par~ls? (InduOc [ okd Area o~ all Parcels lo.ted iheS~peofWo&forPmposedConstn~dion) ~ ~ ~r~5 ~ ~lltNsProjectRetain~lSto~-WaterRun-Off · Generated by a Two (2') inch Rainfall on Site? b. What is gm Total Area of Land Cleating (s.v.t~s) (Yh~s item ~ll ~nclude ali mn4ff created by sRe [ cleating and/or constmcUon acfivi~es as well as all and/or Ground Dish]~an~ for the proposed ~ ) ~ Site Improvemenls and the ~anent ~ea~on of construction activin? (S.F. IA~) imperious su~aces.) PRO~DE BRIEF PROJE~ D~C~[ON (~ldeMdi~.lp~sa~N~ ' 2 Does the Site Plan and/or Su~ey Show~l Pro~sed . Drainage St~ctures ,ndicating Size & Location? This I~I Item shall include all Pro~sed Grade Changes and ~{~r~r~ C~,5 +,'~ ,~ ~C~ I- Slopes ~ntrolling Sugace Water Flow. ,.'u~ t~ ~+CU~[. U~ ~ '~ a.~ 3 D°es the Site Plan and/°r Su~ey descdbe ~e er°si°n ' . and sedimenl ~ntrol prac~ces that will be used Jo consol site erosion and sto~ water discha~es. ~is -- ~ ~ ~" ~ ~ [ ~ ~ r, ~ ~ ~ ~ item must be maintained throughout ~e Enlire Construction PeH~. ~(r,~,,~ ~r~ . ~cm~ o~ 4 Will this Project Require any Land Fil~ng. Gradingor ' Excavation where there is a change to the Natural ~ ~ ~ ~ 0 . '~ ~ ~ ~ ~ ~ ~fo~ ~ ~ ~ Existing Grade Involving more than 200 Cubic Yards / ~O~ ~ o[ Matedal within any Parcel? 5 Will this Application R~uire Land Disturbing Activi~es Encompassing an Area in Excess of Five Thousand (5,000 S.F.) Square Feet of Ground Sudace? 6i, there a Natural Water Coume Running ~hrough the Site? Is this Project within ~e Trustees jurisdiction General DEC SWPPP Requiremen~: Or within One Hundred (100') feet of a Wetland or Submission o~ a SWPPP is required for all Const~c/ion aclivltles involving soil Beach? d~sturbances o[ one (1) or ~re acres; including d~s/urbances al less than one acm {hal7 Wit there be Site preparalion on Existing Grade S opes Su~aces be Sloped to Direct Sto~-Waler Run-Orr required, post~ns~mction s~o~ ~er m~nage~n/practi~ ~at ~1 ~ used andlor Removal of Vegelation and/or the Cons ~c~on of any const~ct~ to ~u~ the pollutan~ ia s~ ~ter discha~es and to as~m Item Within the Town Right.f-Way or Road Shoulder STATE OF NEW YORK~ ~ COU~17 OF ........ ~.~ ................ SS O~NIE D. BUSH Not~ P*I~, ~ d ~ Yo~ T' ' ~OU~A ~ ..... t NO. 018U~l~ And d~a[ he/she is ~hc ................................ '('~';;~ ~;: ~: ~;~; ~ ~; '~[~ ................................................................ Owner zmVo~ rcpr~scmadvc al ~c O~cr or Om]ers, ~zd is duly auto,zed to peffom~ or have p~om~cd ~e s~(i work m~e ~d file d~Js application; that ~1 statements con~ncd ~n ~is application ~e ~e to d~c best or ~Js knowlcdg~ ~d ~al thc work will bc pe~ormed [n ~e m~mcr set ro~ m d~c application ~[ed heralds. ~WOH~ [O [)cfc)re ii~e IJtJs; .............. ................... o& / FORM - 06/~0 Towa Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Telephone (631) 765-1802 ax (631) 16 5 BY: Company Name: BUILDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION Date: I0 Name: License No.: Address: Phone No.: JOBSITE INFORMATION: *Name: *Address: *Cross Street: *Phone No.: Permit No.: Tax Map District: (*Indicates required information) / ~" 1000 Section: ~ ~ 5 Block: $ Lot: *BRIEF DESCRIPTION, OF WORK (Please Pdnt Cleady) IZ~/v~o,~ I 04 ~c~ · (Please Circle All That Apply) *Is job ready for inspection: *Do you need a Temp Certificate: Temp Information (If needed] *Service Size: 1 Phase *New Service: Re-connect Additional Information: YES / ~ Roughln Final 3Phase 100 150 200 300 350 400 Other Underground Number of Meters Change of Service Overhead PAYMENT DUE WITH APPLICATION 82-Request for Inspection Form Town Hall Annex 54375 Main Road P.O. Box I 179 Southold~ NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTI-IOLD TO WHOM IT MAY CONCERN: The Following Items Are Needed To Complete Your Certificate of Occupancy: Application for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. (contact your electrician) Telephone (631 ) 765 - 1802 Fax (631) 765-9502 A fee of $$0.00. Health Department Approval. I~s~t ~ee~Sc~O~ ~ ra t~e;i ficCoatme~ i i~11 ~r. ~ i~i v~i~i~i~e~l ~ii~ig~i r 4/1/84) Final Planning Board Approval. (Planning # 765-1938) Final Fire Inspection from Fire Marshall. Final Landmark Preservation approval. BUILDING PERMIT: 36787 - "As Built" Alterations Applicant: ~ V~ Architect/~ ~ ~~ SCTM# 1000 -- lt~~'- .5' - / ~ Subdivision: Property Address: -~',~-----q- /'//.~-n~-/~~ *Date Submitted: [ O-,g ~-~ t Date Reviewed: Estimated Cost: Zone: Conforming? _--- City: /'?{~ Pre COs? -- Building Permits (Open/Expired): BP__-Z / CI0 Z-__, Info: BP__ -Z / C/0 Z- ., Info: BP__-Z / C/0 Z~ , Info: Single & Separate Search Required? Y or~) Determination: ' BP -Z / CIO Z~ , Info: BP__-Z / CIO Z- j Info: $ To g t~.¥#tlrc-tL REQ. Lot Size: ACT. Lot Size: REQ. Lot Cov. ,to% ACT: Lot Cov. REQ. Front ACT. Front REQ Side ACT. Side REQ. Rear PROP. Rear -- REQ. Height .5,,q'/ ACT, Height R ff. at, ~o'rH $1b~5 A CT If yes, water body: Panel// (/ Flood Zone: Bfilghead/Bluff D~tance: ADDITIONAL APPROVALS REQUIRED pkt}s/$(or) $16'~t~'~, $~,~L~b SuRVa¥ OR $11'6 PLAN Suffolk County Health: Y or~_.J If yes, *Bed#: *Date: / / *Permit.' Town Septic: Y- N - If no, certification required: Y or N Received: Y or N By: NYS DEC: PR~-DECgaC~5 Y or~_)- Date: Southold Trustees: Y or~- Date: Southold ZBA: Y or ¢ Date: __/ Southold Planning: Y or~- Date: Town Landmark C of A: Y o{~DTE: CO~ITRtI~T~R Lie ~-/v_q ~E Notes: Permit #: / Permit #: Permit #: Permit #: L I,l~BILI TY,, or NJ Letter - Notes: or NJ Letter - Notes: - Notes: - Notes: *NYS CODE ~_ompliance (page 2): Y or N %4/o1~1~ /¥ ~ N ~ C o ~,l PE /V S ,~ T I O A/ .Fee Structure: Foundation: I g' I SF First Floor: .~3~ SF Second Floor: o%1,5' SF Other: SF Total: g73- SF Calculation: C BUILT + Initial Fee: $ Additional Fee ( ): $. SF X $, + Initial Fee: $ Additional Fee ( ): $ ,5'~t ~ ~ ~0 2~.~-~7t ~, ~'0 TOTAL: $ NEW YORK STATE CODE COMPLIANCE CHECKLIST CLIMATIC/GEOGRAPHIC DESIGN CRITERIA: Grounlt Snow Load: Weathering: Severe__ Frost Depth: 36"__ Design Temp: 11 __ Ice Shield Underlay: YE8 . USE/OCCUPANCY CLASSIFICATION: HEIGI~IT/FIRE AREA: TYPE OF CONSTRUCTION: DESIGN CRITERIA: ENGINEERED/pREscRIPTIVE FULL FRAMING DESIGN ELEMENTS: Y/lq HEADERS: YfN WALL STUDS: Y/N CEILING JOISTS: Y/IN FLOOR JOISTS: LU1MBER SPECIES AND GRADE: YfN Wind Speed; 120MPH__ SelsmicDesign Category: B , Termite: M-H Decay: S-M Flood Hazards: GLRDERS: YfN ROOF IC&IFTERS: Y/N WINDOW AND DOOR SCHEDULE: ,MISSLE TEST REQUIREMENTS: Y/N EGRESS 5.7 S.F.: Y/N LIGHT 8%: Y/N VENT 4%: YIN NAILING/CONSTRUCTION SCHEDULE: Y/N MEANS OF EGI~ESS: Y/N PLUMBING R1SER DIAGRAM: Y/N LOCATION OF F[R.E PROTECTION EQUIPMENT: Y/N TRUSS DESIGN: YfN CERTIFICATION: Y/N ENERGY CALCS: Y/N (~e$¢1t1~C~ TOTAL COMPLIENCE? Y/N (RETURN TO PAGE ONE J =0 /Ex/ST /_/T/LIT'[ /~PI 7L G" ± u' 4~ Four o~J~p 1 up (~ ~BGTIOFt ~'" 3/4" =' I: 0" E,x~ ST, -/¢ ~33 4"x/¢~ BT, SOU, G¼ 5F. ¢ o~. u~ ~AUUDR¥ COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED 80UTHOLD~BO~D ~z/~ W¢/~ To CoMpI. y W/?~¢ rye PLUMBER OERTIF~OA,TION ON LEAD COUNT BEFORE OERTIFICATE OF OCCUPANCY SOLDER USED IN WA TER ELECTRICAL INSPECTION REQUIRED PLUMBING W,~,~ER LIt/ES:NEED, TESTING'BEFORE COV'ERI~G SURPL Y SYSTEM CANNOT EXOEED2/IO OF I% LEAD ' ":': ROVED AS NOTEp r ~r Y BUILDING DEPARTMENT AT , 1302 8 AM TO 4 PM FOR THE ~ OLLOWING ~NSPECTiONS' 1 FOUNDATION -TWO REQUIRED FOR POURED CONCRETE 2 ROUGH ~ FRAMING, PLUMBING, STRAPPING, ELECTRICAL & CAULKING 3 INSU~TION 4 FINAL-CONSTRUCTION&ELECTRICAL MUST BE COMPLETE FOR CO ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS O FI65T R, ooR PI, AH I/" ' O" ) 11 Now L ~b~FFo%K AV~, H LJ F. * "J i Ira Haspel Arch/tect, P.C. S~)45,Moi- R. old Southold, N.Y. 11971 631-76~.2075 -phone 631-76~-5715-fox 516-398-8753-eeB ilt~pel~b-eb~pel teat- emali " C FDUA/O,4 Fl ON F/nOT ?~c~Z¢ SECT/OH5-- N°. IoO0 -11.5- $-I~ I/ l~- L l H oE~x,c ~ vA TED .) I I l t I