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HomeMy WebLinkAbout36033-ZTown of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 10/17/2012 CERTIFICATE OF OCCUPANCY No: 36010 Date: 10/17/2012 THIS CERTIFIES that the building Location of Property: SCTM #: 473889 Subdivision: ALTERATION 500 DEEP HOLE DR MATTITUCK, Sec/Block/Lot: 115.-12-6 Filed Map No. conforms substantially to the Application for Building Permit heretofore 11/8/2010 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: alterations to an existing one family dwelling as applied for. Lot No. filed in this officed dated 36033 dated 11/18/2010 The certificate is issued to LAWRENCE P & SHERRI KELLY (OWNER) ofthe aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 10/2/12 36033 8/17/11 /~tchogue East Plumbing FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PEI~4IT NO. 36033 Z Date NOVEMBER 18, 2010 Permission is hereby granted to: LAWRENCE & SHERRI KR¥.T.y 1200 BEEBE DRIVE COTCHOGUE,NY 11935 for : ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING PER TRUSTEES APPROVAL AS APPLIED FOR at premises located at County Tax Map No. ~73889 Section 115 pursna_~t to application dated NOVEMBER Building Inspector to expire on MAY 500 DEEP HOLE DR MATTITUCK Block 0012 Lot No. 006 8, 2010 and approved by the 18, 2012. Fee $ 746.00 Authorized Signature Rev. 5/8/02 ORIGINAL Form No. 6 TOW~N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 76S-1502 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, pyoperty lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewarage-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 PI.arming 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 o£Occupancy - Residential $15.00, Commercial $15.00 New Construction: Location of Property: Date. I /- I ~ -/0 Old or Pre-existing Building: (check one) House No. Street Hamlet Owner or Ownem of Property: ~ ~. t~ Suffolk County Tax Map No 1000, Section Subdivision Permit No.. 3 ~.o O ~ 3 Date of Permit. Health Dept. Approval: Block Filed Map._ ]] ° /~ - / {~ Applicant: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: Fee Submitted: $ 50 , Lot Lot: O ve (check one) Applicant Signature / Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631 ) 765-1802 Fax (631) 765-9502 roqer, richert~town.southold.n¥.us BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Sheeri Kelly Address: 500 Deep Hole Rd City: Mattituck St: NY Zip: 11952 3uilding Permit #: 36033 Section: Block: Lot: WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE ;ontractor: DBA: License No: SITE DETAILS Office Use Only Residential ~ Indoor ~ Basement ~ Service Only Commefical Outdoor 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage Service 1 ph Service 3 ph Main Panel Sub Panel Transformer Disconnect Other Equipment: INVENTORY Heat ~ DuplecRecpt ~ CeiringFixtures E~ HlDFixtures Hot Water GFCl Recpt Wall Fixtures ~.~ Smoke Detectors NC Condenser Single Recpt Recessed Fixtures ~ CO Detectors NC Blower Range Recpt Fluorescent Fixture ~ Pumps Appliances Dryer Recpt Emergency Fixtures[.~ Time Clocks Switches Twist Lock Exit Fixtures [~ TVSS combination "smoke/co detectors"-2, cook top-l, exhaust fan-2 widpool bath with elec heater Notes: Inspector Signature: Date: Aug 17 2011 81-Cert Electrical Compliance Form Town Hall Annex 54375 Main Road P.O. Box ! 179 Southold, New York 11971-0959 B I. HLDIlqG DEPARTMENT TOWN OF SOUTHOLD Telephone (~3 ! ).765- I $02 Fax (63 I) ?~$-9502 .CERTIFICATION Building Permit No. Owner: Plumber: Date: (Please (Please print) t / ?_/4 le~d. Sworn to before me this ~ dayof ~_f/--- , 20 ( ~ I certify that the solder used in the water supply system contain~ less than 2/10 of 1% VICKI TOTh Notary Public.State of New ¥or~ No. 01T06190696 O.ualified in Soffoik COunty bommtssim~ Fxoires I.tv 9~ ?~ I~.~-__ TOWN OF SOUTHOLD BUILDING DEPTi 765-t 802 INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING / STRAPPING FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION [ ]Fll~li~l~l'.i~rCO#S~6CTlO# [ ]Fll~ll~lSr.itl~ll~l~t~lO# REMARKS: ' DATE INSPECTOR ~~/~ 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 CONS~UCTION [ ] FIRE RESISTANT PENETRATION ~]~..LECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: DATE ~ INSPECTOR~-~~~~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST ~ ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [~' ]~/STRAPPING [ ]FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SA~"' 1l' INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT FENETRATION REMARKS:. INSPECTOR DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ]FIRE SA,-,., 'f INSPECTION [ ] FIRE RESISTANT COflSTRUCTIOfl '~ FIRE RESISTANT PF. NETRMIOfl / REMARKS:\ DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING / STRAPPING [ ] FIREPLACE & CHIMNEY [ ] F~RF.,mT~'rc0.smuc'n0. [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL REMARKS: DATE INSPE~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTIO N [ ] FOUNDATION 1ST [ ] RO~B'H PLBG. [ ] FOUNDATION 2ND [/.~'INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SA,-,-; ~ INSPECTION [ ] F;RE RESST~r C0f~UCn0. [ I F~RE RESIn'Am' pr:.cm~'no. REMARKS· ~]9~~'"'-~-~ DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING / STRAPPING [ ] FIREPLACE & CHIMNEY FIRE RESISTANT CONSTRUCTION [ ELECTRICAL (ROUGH) [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION [~ ELECTRICAL (FINAL) REMARKS: DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUG~,LBG. [ ] FOUNDATION 2ND [ ] I~JL-'ATION [ ] FRAMING/STRAPPING [y,],"FINAL [ ] FIREPLACE & CHIMNEY ( ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION ( ) FIRE RESISTANT PENETRATION ( ) ELECTRIC~OUGH) [ ) E. LECTRICAL(FINAL) REMARKS.~~~ :~//~,~ /~,~ ~ ~/--~, -/ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] II~J~LATION []F--lNG/STRAPPING [~'~N~' [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CO#STRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: · / DATE INSPECTOR~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUG~LBG. [ ] FOUNDATION 2ND [ ] I~'ULATI~ [ ] FRAMING/STRAPPING [~'~F,N&L(~( [ ] ~lR~l.~¢~ & CHIM#~¥ [ ] FIR£ [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRI.CAL (ROUGH) REMARKS../~ DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-t 802 iNSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] i/~4~__ TION FRAMING / STRAPPING [~j* FINAL ] RRE RESISTAHT CONSTRUCTION [ ~ ~ ELECTRICAL (ROUGH) . ~ [ ] ELECTRICAL (FINAL) TOWN OF SOUTHOLD BUILDiblG DEPARTMEN TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.: NOV 8 BLDG. DEPT. Examined u/Iy20/0 Approved I ~t~/20 t° Disapproved a/c Expiration q! ~, 20 [ ~ 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_ V'N.Y.S.D.E.C. Trustees Flood Permit , Storm-Water Assessment Form Contact: Mail (, B-t ilding Inspector APPLICATION FOR BUILDING PERMIT Date ¢"A,E0 ,20} INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose what se ever until the Building Inspector issues a Certificate of Occupancy. £ 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 l?om such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an addition six months. Thereafter, a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant or na/m4, ifa corporation) / (Matili~g address o f applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ' (As on the tax roll or latest deed) If applicant is a corpqration, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. '~'~kl. Electricians License No. t../ Other Trade's License No. Location of land on which proposed work will be done: 5"oo fao rg r/'/'To ok: House Number Street i - Hamlet County Tax Map No. 1000 Section /Iff'" Block /2 Lot ~fff,, Subdivision ~ Filed Map No. -- Lot -- State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy r--~,~,,/ ~ 5. b. Intended use and occupancy Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost /~/oOO 5. If dwelling, number of dwelling uni{s.../' ~,)~,~ if garage, number of cars Fee Addition Alteration Other Work o~$~}..~, ~/~,~o~.-~/,,o~,,,o,, (Description) (To be paid on filing~this application) Number of dwelling units on each floorOtk/ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. to/,,~ 7. Dimensions of existing structures, if any: Front ~/] Rear 5(o .Depth Height /~" Number of Stories ! Dimensions of same structure with alterations or additions: Front Depth 5vX¥,~__. Height ~ Number of Stories Dimensions of entire new construction: Front '~'/t'4' Rear ~',/,'~'-- Height 4-///~' Number of Stories 4/,///'t. Size of lot: Front Rear Depth Depth/_-' ,,q;2 5". 17 ' g'-- Rear 10. Date of Purchase Name of Former Owner Q 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 ~ Will excess fill be removed from premises? YES 'NO,-~ 14. Names o f Owner of premises.,5 I,P_.~I I IO¢'f Address ¢~'c ¥~.z~/~'/ Phone No. Name of Architect Name of Contract0r g~,15a. Is this property within l 00 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 of a tidal wetland? * YES X NO__ * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. ~lr. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. ~o~- ~ 18. Are there any covenants and restrictions with respect to this property? * YES__ NO ~ · IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ~--6,&~xxt_ ) ~~ ~ being duly sworn, deposes and says that (s)he is the applicant /(Name of individ{ml signin/antract) 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 tree to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this day of ~-,.,-- 20'.~ AUCIA WALKER ~ PuNic, State of New Yor~ N~t-~' Public Qualified in Soffo I~ Count'/ Comrmss~on Expires Sept. 25 ~ Signature. of Appli~p( 0~ M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall Annex 54375 Main Road P,O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TI~USTEES TOWN OF SOUTHOLD Permit No.: 7415A Date of Receipt of Application: October 4, 2010 Applicant: Sherri Kelly SCTM#: 115-12-6 Project Location: 500 Deep Hole Drive, Mattituck Date of Resolution/Issuance: October 20, 2010 Date of Expiration: October 20, 2012 Reviewed by: Trustee Jill Doherty, President Project Description: To change all windows and location of windows; replace extedor doors and install new slider in new location; replace siding and roof; construct roof layovers on front and dght side of dwelling. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the site plan prepared by Donald Salvitti, received on October 4, 2010, and stamped approved on October 25, 2010. Special Conditions: None. Inspections: Final inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. Jill M Doherty, Presidd~t Board of Trustees JMD:eac Jamt s F. King, Presidsnt Rob Gh, ~io, Jr., Vige-Prooident Dave J ~hn Bredemeyor Michael J. Domino #QB: 3C Dated October reqnir~ ee repla~ Town Hall A~ 54375 Mai~/~ P.O. Box 11 Southold, New York Telephon~ (631) q Fax (631) 765- BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE Date: October 15 THIS CERTIFIES that the llhanging of all windows and location of wind ;cment of exterior doors and existing slider; installation of new slider in new loc ~placement Of sidinl~ and roof; core,ruction of gable roof layovers At 500 Deep Hole Drive, Matfitu~k, N~v york Suffolk County Tax Map # 115-12-6 ~nforms to the application for a Trustees Permit heretofore fried in this ofli ~ctober 4, 2010 pursuant to which Trustees Administrative Permit 07415A 20, 2010, was issued and Amended on November 17, 2010 and conforms to neats and conditions of the applicable provisions of law. The project for w iflcate is being issued Is for the chan aing of ali windows and location of wind~ emcat of exterior doors and existin~ slider; installation of new slider in new 10c r~lacement of sidin~ and roof: construction ofi~able roof layovers. : The certificate is issued to SHERRI KELLy owner of the aforesaid property. ,ad 9 1971-0959 5-1892 641 2012 lion; ated I of the ich this tion: . TOwn of So.uthold ErQsion, !~edlmentatiOn & Sltorm.Water Run.Off ASSESSMENT FOR::: PROPr:~,y LOC~]~N: S.C. TAL~ ~Mat~al ~n a~ ~ ~a~? Date /~ ' Z~, -- / I File # TOWN OF SOUTHOLD COMPLAINT REFERRAL FORM Location of Complaint: --~'OC) ~.~o ~¥/~ /'~J~z~ SCTM ~ //~, -/~- ~ Pro~ O~er: ~ ~1' ~ ~ ~.//~ Phone NATURE OF COMP~INT: ACTION TAKEN: Optional: Complainant: Address Report Taken By:. Date Referred to Code Enforcement: .By Phone Phone: Date Mail In Pemon ~ CODE ENFORCEMENT REPORT SITE INSPECTION REPORT/DATE: ACTION/DATE: Date File # TOWN OF SOUTHOLD COMPLAINT REFERRAL FORM Location of Complaint: ~'©O .I~.o ~ D~Z- ~I~t-SCTM # 1lS--J~-- [~ Property Owner: ~L~O/d~r'~ C~_ .~ ~ NATURE OF COMPLAINT: ACTION TAKEN: Address Phone..' CODE ENFORCEMENT REPORT SITE INSPECTION REPORT/DATE: ACTION/DATE: Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Telephone (631 ) 765-1802 Fax (631) 765-9502 October 1, 2012 BUILDING DEPARTMENT TOWN OF SOUTHOLD Sherri Kelly PO Box 743 Cutchogue, NY 11935 Re: 500 Deep Hole Rd, Mattituck 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) A fee of $50.00. Final Health Department Approval. t// Plumbers Solder Certificate. (All permits involving plumbing after 4/'1/84) __ Trustees Certificate of Compliance. (Town Trustees # 765-1892) Final Planning Board Approval. (Planning # 765-1938) Final Fire Inspection from Fire Marshall. Final Landmark Preservation approval. BUILDING PERMIT: 36033 - Alterations FROM : CJG Cont~a¢~ln9 Inc FAX NO. : 6317228221 Nov. 04 2010 07:30PM P2 FROM : CJG Cont~actln9 Inc FAX NO. : 6317228221 Nov. 04 2010 07:29PM Pi CERTIFICATE OF L~BILI~ INEU~NCE O.~ ~ ~UILDING PERMIT EXAMINER: CHECKI,I,~T *DateSubmitted: /{-~'-tO DateReviewed: //- /0-~0 ~ EstimatedCost:~/O0~. ICTM# 1000- I f-~- / ~ ~' Subdivision: ~ropertynddress: L~--O0 ~ ~ luildlng Permits (Open/Expired): B?__-Z / C/0 Z-__, Info: IP __-Z / C/0 Z- , Info: BP __-Z / C/0 Z- , Info: lingle & Separate Search Required? Y or N Determination: ~Q. Lot Size: ACT. Lot Size: [BQ. Front ACT. Front REQ Side ACT. Side ~BQ. Height. ACT. Height. ~roj ect Description: Zone: Conforming? .. BP__-Z / C/0' Z- , Info: BP -Z/C/0 Z- ,Info:_ REQ. Lot Coy.__ REQ. Rear__ ACT; Lot Cov. PROP: R~ar Bulkhead/Bluff Distance: ~aterfront? Y or N? f yes, water body: Ct ~.~ . Panel# ?~/'~.-~,ood Zone: LDDITIONAL APPROVALS REQUIRED ;nffolk County Health: Y or N - If yes, *Bed#: *Date: / / *Permit#} - If no, certification required: Y or N Received: Y or N By: ~YS DEC: rn~-oEc~!!f~_~ Y or N - Date: / / ~outhold Trustees/fY)or N- Date: /0 / Town Septic: Y or N Permit #: or NJ Letter - Notes: Permit #: ~/~'-/~ or NJ Letter - Notes: louthold ZBA: Y or N - Date: / / Permit #: - Notes: ~outhold Planning: Y Or N- Date: :1__1__ Permit #: - Notes: ['own Landmark C of A: Y or N DTE: qotes: / /__ *NYS CODE Compliance (page 2): Y or N ?ce Structure: Calculation: *oundation: SF SF X $ =$ *irst Floor: SF + Initial Fee: $ lecond Floor: SF + Addition,al Fee ( ): $. )ther: SF SF X $ =$ ['otal: SF + Initial Fee: $ + Additional Fee ( ): $. TO~EAL: $ NEW YORK STATE CODE COMPLIANCE cHECKLIST CLIMATIC/GEOGRAPHIC D~SIGN CRITERIA: .Grolmll Snow Load: ~0. Wind Speed; I20MIH.. Seismic Design Categoryi B . Weathering: Severe __ . .Frost Depth: 36" _ Termite: M-H' Decay: D~lgn Temp: 11 -., · Ice Shield Underlay: ~ . lqo~d Hazai-ds: USPJOCCUPANCY CLASSIFICATION: · Ht~IGI:rr/FIP~ AI~A: .. TYPE OF CoNsTRucTION: DESIGN CRITERIA: ENGINEI]RED/pRESCRIPTiVE FULL FRAMING DESIGN ELEMENTS: y/N ItEADERS: y/N WALL sTUDs: CEILING JOISTS: YfN FLOOR JOISTS: YfN LUIVIBER SPECIES A_ND GRADE: Y/N GI-PJO ERS ~ Y/N ROOF RAFTERS: Y/N WEN-DOW AND DOOR SCHEDULE! .MISSLE TEST REQUIREMENTS: Y/N EGRESS 5.7 S.F.: Y/N LIGHT 8% :y/N VENT 4 %: Y/~ NAILING/CONSTRUCTION scHEDuLE: Y/N MEANS OF EGRESS: PLUMBING PGSER DIAGRAM: Y/N LOCATION OF FII~ PROTECTION EQUIPMENT: Y/N 'TRUSS DESIGN: CERTIFICATION: Y/N ENERGY CALCS: Y/N TOTAL COMPLIENCE? Y/N (RETURN TO PAGE ONE) NE W e ~-~ ,~Jl,¢ A VENUE SURVEY OF PR OPER T Y A T MA TTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, N Y. 1000 I1,5 ~ 12 - 06 Scale 1" = 30' J,Jly 5, 1~90 APPROVED AS NOTED t FOUNDATION - TWO REQUIRED FOR poURED CONCRETE 2 ROUGH. FRAMING, PLU blBING' STRAPPING, ELECTRICAL &CAULKtNG 3 iNSULATION 4 FiNAL_CONSTRUCTiON&ELECTRICAL MUST 6E CoMpLETE FOR C 0 ALL CONSTRUCTION SMALL MEET THE REOU{REMENTS OF THE CODES OF NEW YORK STATE- NOT RESPONSIBLE FOR BEStGN OB CONSTRUCTION ERRORS orr ,-~8r,,¢,-,,,, OR USE iS UNLAWFUL VV!TH,' !i !T CERTIFiCAq OF ,():/,";i PLUMBING ALL PLUMBING WASTE & WATER LINES NEED ~ESTING BEFORE COVERING PLUMBER CERTIFICA ON LEAD CONTEN CERTIFICATE 0~ OCCL ,COL. DER US~: D/7 SUPPLY S~ TEA4 C. ti. EXCEED 2/10 C? 1 o L, UNDERWRITERS REQUIRED R ETNN STORM WATER R PURSUANT TO CHAPTER ~6 oFt JOW O . % I C'4ASI C. F. '\ AG T i~/~''~ = F L EV,,%T t 0 N ',% SOUTH - Il4* F--.,L.~ V AT ~ 0 N NO~TH ELEVATt ON 60 P S? ,Iae L~*,~ I=-' I::. 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