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Town of Southold Auuex 8/19/2013 ~ P.O. Box 1179 54375 Main Road Southold, New York 11971 l ~ CERTIFICATE OF OCCUPANCY No: 36451 Date: 8/19/2013 THIS CERTIFIES that the building RESIDENTIAL ADDITION Location of Property: 5690 Indian Neck Ln, Peconic, SCTM 473889 Sec/Block/Lot: 98.-5-14.2 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 9/28/2012 pursuant to which Building Permit No. 37558 dated 10/4/2012 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 and alterations. including sunroom with landine and covered entry to an existine one family dwelline as applied for. The Certificate is issued to Santarsieri, Vito &Santarsieri, Carla (OWNER) of [he aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 37558 6/6/13 PLUMBERS CERTIFICATION DATED 6/10/13 Cu ogue East Plum ' tg & Heating i ut rued ignaf re TOWN OF SOUTHOLD y^~y)FFO(~ z r~ BUILDING DEPARTMENT ~ TOWN CLERK'S OFFICE :s ~'a f;' SOUTHOLD, NY qy r~ „,r`' 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 37558 Date: 1 01412 0 1 2 Permission is hereby granted to: Santarsieri, Vito & Santarsieri, Carla 22 Old Homestead Rd Albertson, NY 115071535 To: construct additions & alterations to an existing single family dwelling as applied for At premises located at: 5690 Indian Neck Ln, Peconic SCTM # 473889 Sec/BlocklLot # 98.-5-14.2 Pursuant to application dated 9/28/2012 and approved by the Building Inspector. To expire on 4/5/2014. Fees: SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $597.20 CO -ADDITION TO DWELLING $50.00 Total: $647.20 Building Inspector Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT "TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPeINCY ' This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For aew buildipg or nesruse: 1. Final survey of property with acctirate'location ofall buildings, property lines, streets, and unusual natural or . topographic features. 2_ Final Approval from Health Dept. of watef supply andsewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. 'Sworn statemcet from plumber certifying that the solder used.in system contains less than ?I10 of ! % lead. . 5. Commeroial building, utdttstrial building, multiple residences and similar buildings and installations, a certificate of Code Compliatrce'from architect or engincer responsible for the building, .6: Submit Planrting Board Approval of completed site plan requirements. B. For existing bnUdtngs (prior to April 9, 1957) non-canfotwing uses, or buildings acrd "pre-existing" land uses: Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly cpmpfeted application and cgnsent to inspect signed by the applicant- If a Certificate of Occupancy is denied, [he 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 X50.00, Accessory building $50.00, Additions to accessory building $50.00, Businesses $50.00: 2. Certificate of Occupancy on Pre-existing 9uitding - $100.00 3. -Copy a€Certificate of Occupancy - $25 . 4. Updated Certificate ofOccupancy - $50.00 5. Temporary Certificate o€Occupancy -Residential $15.00, Commercial $15.00 Date. /a y - 1 Z• Vevv Construction: ~ Ojl~d or Pre-existing BuildinQg. (check oneJ - ration of property: J~/o ~ U V MC~/rbrn ~G~~' L rcriwe~Q tTI2.K- House N~~o~~. Street Hamlet owner or ©wners of Property: ____[,~'D N- ~/.t~.QG. J~/h~1~..2 5 ~ e 2) - luffolk Courtly Tax Map No 1000, Section 9 ~ Block . S Lot ) ~ • a iabdivision Piled Map. Lot• . 'eamit No. _ ~ 558 Date of Permit. 1 d ' l,,Z Applic;anC iealth Dept. gpproval: Underwriters Approval: - 'lamring Board Approval: / ;equt~t for: Temporary Certificate Final Certificate: 1/ (check one) ee SubmiRed: g D r ~ ~=~J~ ~ APPIi SlPnffiUre 'pS11FfOlK Town Hall Annex ~~p+ c~Gy Telephone (631) 765-1802 54375 Main Road ~ ? Fax (631) 765-9502 T P.O. Box 1179 G ~ ~ Southold, NY 11971-0959 'y~yp1 ~.~at ro~er.richertng town.southold.ny.us BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: V & C Santarsieri Address: 5690 Indian Neck Ln City: Peconic St: NY Zip: 11958 Building Permit 37558 Section: 9$ Block: 5 Lol: 14.2 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: SBA: C-Cat ElectrlC License No: 953-me SITE DETAILS Office Use Only Residential x Indoor x Basement Service Only Commerical Outdoor x 1st Floor x Pod New Renovation 2nd Floor x Hd Tub Addition Survey Attic Garage INVENTORY Service 1 ph 200a Heat Duplec Recpt 11 Ceiling Fixtures 3 HID Fixtures Service 3 ph Hd W ater GFCI Recpt 3 Wall Fixures 4 Smoke Detectors Main Pand 200a A/C Condenser Single Recpt Recessed Fixtures 7 CO Detectors Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks Disconnect 200a Switches 7 Twist Lock Exit Fixtures TVSS other Equipment: 200a overhead service, 1-paddle fan Niles: Inspector Signature: Date: June 6 2013 ElecMcal Cert'rFicate.xls ho~~,QF su~ryola Town [{all Annex Telephone (63l)J65-1802 54375 Main Road ~ ~ Paz (631) 765-9502 P.O. Boz 1179 G Southold, New York t 1971-0959 '~~~/y~~'~~ar~yr a~ _VUpI~~ BUILBING bEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Date: ~ / Building Permit No. S owner: S~~~ar S ~ e r--~ t (rfelease prinfft) ,Q (.f. Plumber: JaL~ l~1Sn'I.O~dI ~U~G(ito~(/~° C I "I i"~G p (Please print) - T 2 g ~ 7- Icertify that the solder used in the water supply system contains less than 2/10 of 1 lead. (Plumbers Signature) Sworn to before me this l~~' \ day of ~V~.!~ 20~ ~ ~ CONNIE D. BUNCH Li~TI ~ Notary Public, State of New Yolk ' No. 018U6185050 t~uaiified in Suffolk County ,,....,,~1 Commission Expires April 14, 2y:1 b Notary Public,~~~County ~ saiir } TOWN OF SOUTNOLD BUILDING DEPT. 765-1802 SPECTION [ FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING /STRAPPING [ ]FINAL [ ]FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION [ ]ELECTRICAL (ROUGH? [ ]ELECTRICAL ( INAL) REMARKS: ~ DATE ~ fNSPECTOR 3 ~ ~O,OF SO(lT,y_ o "°!p f TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ]FOUNDATION i ST [ OUGN PLBG. [ ] FO ATION 2ND [ }INSULATION [ FRAMING /STRAPPING [ ]FINAL [ ] FIREPLACE A CHIMNEY [ ]FIRE SAFETY INSPECTION [ ] FlRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ]ELECTRICAL (ROUGH) [ CTRICAL (FINAL) REMARKS: v ~ ~ (d ~ ~ o a~ ~ ~ 7 -3 INSPECTOR DATE ~S~ o~~,OF 80(/ly ~ TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 1 NSPECTI ON [ ]FOUNDATION 1ST [ ] R GH PLBG. [ ]FOUNDATION 2ND [ INSULATION [ ]FRAMING /STRAPPING ( ]FINAL [ ]FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION [ ]ELECTRICAL (ROUGN~ [ ] EL~EpC~TRICAL (FINAL) REMARKS: ~ ~'`'Q-°Qa- J""'te'e ~ DATE O3 a'O ~ INSPECTOR ~o~~o~ soup TOWN OF SOUTNOLD BUILDING DEPT. 765.1802 INSPECTION [ ]FOUNDATION 1ST [ J ROUGH PLBG. [ J FOUNDATION 2ND [ J INSULATION [ ]FRAMING /STRAPPING [ J FINAL [ ] FIREPLACE A CHIMNEY [ J FIRE SAFETY INSPECTION [ J FIRE RESISTANT CONSTRUCTION [ J FlRE RESISTANT PENETRATION ELECTRICAL (ROUGH) [ J ELECTRICAL (FINAL) REMARKS: 4ei ems. - DATE 3 Z`' t ~ INSPECTORS` o~O,OF EO(17y,,. TOWN OF SOUTFIOLD BUILDING DEPT. 765-1802 ECTION INSP [ ]FOUNDATION iST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ] FRAMING ~ STRAPPING [ ]FINAL [ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION [ ]ELECTRICAL (ROUGH)ELECTRICAL (FINAL) REMARKS: ~t ~rr~'L- ~bC- DATE ~ l INSPECTOR ~ ~g ~lv`OF SOpry~ r TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 1 NSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ] IN CATION [ ]FRAMING /STRAPPING [ FINAL [ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION [ ]ELECTRICAL (ROUGH) [ ] ELECTRI~ INAL) REMARKS: DATE /3 INSPECTOR - ~,~,Of 8a/l ,moo TOWN OF SOUTNOLD BUILDING DEPT. 765.1802 1 NSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ] I CATION [ ]FRAMING /STRAPPING [ FINAL [ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION [ ]ELECTRICAL (ROUGH) [ ]ELECTRICAL (FINAL) REMARKS: / DATE ~~O ~z ~3 INSPECTOR • TOWN OF SOUTNOLD BUILDING DEPT. 765.1802 IN PECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION ( ]FRAMING /STRAPPING [ ]FINAL [ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION [ ]ELECTRICAL (ROUGH) [ ]ELECTRICAL (FINAL) REMARKS: ~r'~5.~ - 1 1 i ...v--.t. s DATE ~ INSPECTOR 3 7 ~o~~oF~,~ TOWN OF SOUTNOLD BUILDING DEPT. 765.1802 1 NSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ] I ON [ ]FRAMING /STRAPPING [ FINAL [ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION [ ]ELECT ~(rROUGH) ~ [ j ELECTRICAL (FINAL) REMARK ! lP-r~ C.~-C,~ JiJ (~.,~}Sj'~ ~ DATE K~ ~ ~ INSPECTOR ~ / ' _ FIELD NAEPOAT DATE COMMENT3 ~ ro FOUNDATION (1ST) C~ oC' ae FOUNDATION (2ND) r ~ c a/ n ROUGH FRAMING & d PLUMBING n O / to r INSULATION PER N. Y. D ~ Z, STATE ENERGY CODE ~ D 3 ~ R~ ~ , O J 2, n. ~ n FINAL .~-%S ~ 3«~ - Vim. ADDTT NAL COMMENTS ~ t- ti - \ ~ o ~ 25 "3 wc~ C-cr-~ m(< - z 0 3 /3 ~ C3 i r'~S q~~--~~-,~ ~ , S . ' ~ ~ ~ b ty~7 H TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following, before applying? TOWN HALL Board of Health SOUTHOLD, NY 11971 4 sets of Building Plans TEL: (631) 765-1842 Planning Board approval FAX: (631) 765-9502 Survey SoutholdTown.NorthFork.net PERMIT NO. cJ~ .5'S ~ Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Examined r - ~~f , 2Q~ Storm-Water Assessment Form__ Confect: Approved ~~/5~, 20~ Mail to: DAK /j.5S0~. Lee. Disapproved a/c F (ia~ !(.7S r zv_ p?THoW~ NY, tl9>~ Phone: 6 3(- Y33-9o 9 Y Expiration S 201 ' Building Inspector D ~ C ~ M TION FOR BUILDING PERMIT SEP 2 5 2012 Date C>Q 2H , 20 12. INSTRUCTIONS a. Thi applicatid~,,~P~Rgmpletely tiled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, a e. ee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 1 S mo;iths from such date. If no zoning amendments or other regulations affecting ine 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. D~ (Si a of applicant or name, if a corporation) P.o. ~Jnr 1(~7s So,r'Ha-o, NY 11971 (Mailing address of applicant} State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder A~ F ntT Name of owner of premises V i i o f Ca e~A S A ti~ AR.S ~ F_2 ~ (As on the tax roll or latest deed) If pli~c/yn/~)iS$/,/$$y/~prporation, sign true of duly authorized officer (N and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. D 1. Loc~~of land on which proposed work will be done: ~J LNDiRH NF~IL LANFz eC.On~i~- House Number Street Hamlet County Tax Map No. 1000 Section 98 Block S Lot Z Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~ESr DE-Jr ~ne~ b. Intended use and occupancy ~s I e EST I R L 3. Nature of work (check which applicable): New Building Addition X Alteration X _ Repair Removal Demolition Other Work (Description) 4. Estimated Cost ~ f)i) Fee (To be paid on filing this application) 5. If dwelling, number of dwellutg units ~ Number of dwelling units on each floor N/1 ]f garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. /VA 7. Dimensions of exis ' structures, if any: Front S~~-O Rear 5$ ~ o'' Depth 'f2 fD" Height Zs'-7`2 ' Number of Stories 2 Dimensions of same structure with alterationts or.. a~dditions: Front 38~ o`. Rear S8-o" Depth `1~gr-s" Height ZS-7%z Number of Stories 2 8. Dimensions of entire new construction: Front 2z-I! Z Rear 2Z ~n'~2 Depth ;!~-0" Height /y' 9" Number of Stories / 9. Size of lot:Front_ //R,92~ Reaz (3f,Sl~~ Depth Rvy 3y(o,/8~ 10. Date of Purchase Oq ~ Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES,_ NO X 13. Will lot be re-graded? YES NO X Will excess fill be removed from premises? YES_ NO X v Ilb ` craaw i 4. Names of Owner of }.remises SA.~rays le~~ f+ddress Phone No. Name of Architect ppx Ascot. Address P.o 8ox udls, Sou ,Horn phone No G 3t -Y33-9a 8 v Name of Contractor NA nr pals'riM~ Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAYBE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO X' * IF YES, D.E.C. PERMITS MAYBE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? * YES NO~_ * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF S~FFo~t~) ~j Rf~-'fr fS. 14gN~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, CONNIE D. BUNCH pp Notary Public, State of New Vork (S)He is the R~~ i No. Of BU61850b0 ^ualified in SufE91k r~rtty~ (Contractor, Agent, Corporate Officer, etc.) Commission Expires Aprlt t4, 2a 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. Swom to~efore me this /2~~daPy o~ ~Fz , ~ 20 Notary Public ' Si afore of Applicant ~ Town of Southold -Chapter 236 - Stormwater Management ~ xp SWPPP -Storm Water Pollution Prevention Plan Assessment Form GF1VIItAL INFORMATION: (All Requested Information is Required for a Complete Ap lication) APPLIeaNT NaNE: Ownv dbM-eonaaelorvgav ~On~) Peq,ntrawttEkPwrnstss.N~nxe~q ~a~~-. SbOC_ lrL V,1b CA2~A (b`7S ~a,TolotJ~ Nit, I l5'"f 1 Tw.gwn. _ 33- o ~ F° ! -y~0-335 4 .rauon.tk fa:Re E-MW. SS CJ t0.1`'t ON~.INri ,NFi"r E MN: °iopraAd°°°`3`(ss //`II~,A.~ Nl<« t_k~e 8r;dnexiipuaaafeomoamoaA~,PmpasedsaoataolBlrPs,Srn7 s.crs.k taro qQ suholm4oa13MPe,Pm~tSeope sad/or 3egammoft:oaehurfioa Acavity .w~ ~ ~ waw,mwrP.~..ta.me u...ercar.m...a~c~r.ar..mtsyw.a.fo.~r..mo~dafwrF: ~RKI?IWC__A&L~L ADD ,Q¢~(~- W~'~ © RD~__C°Aa~D__F_aTQ,4N~---tom----!i~~-- E-M~ tr~wsafh>oM lYyaw6MtvYwbar4aY~YtlrraefEmMmeaeYd Rw:aoe ----Jb~- Wrt)tiw~ ~z~i13't~/ ~ (1a1S~ Qolr~u_ - - - _o~__~r_x._?- TaMphwrth Fr, tk _~pjr'-~jS tt ~ ~ E.~aM: W_'~'.+y10._Irh1R.f+1°y2___O .J ICRFN~a~_`~ T~ y3 Ss'S~rlb 7.wa ~'crwb~Dw~ ~'foo Y.!IF _AL~-_ Qv,JOFF_- __Gv,t~ Co_~~N~A_ as.,~w Uni S iT ~~z^+ _q J -3 ~F7~R~ P~QOwaltaK End _ _L_____:J__-'_-- _ _.i__'"-'_-__ (MtldpMOd) Dnb: pY~WddWarM1/t WIN thk Ptofw~t DbturM Ova (5) or Man Aass at _ _ _ _ _ AtryOrrsTYnaOurtrrptMPtopaaadOsvsbpnrsnt? Yw ~ I/YEtk FNS~AawvlM Faaowiiyl a. Does the Applkart have a quewed tsepecmr on ~ Q Staff To Conduct the Regnted hmperLare 7 Ya No b. Does tlfe SWPPP Indirala How Freprently tra Silo O O LhtW aatlF.a vOearpMn area PewiltlpMgreW Wtla,hgdin rraorMhaWc Inspections svi9 Otxar and for Wtmt P'alod of 7ene 7 Yss No MOW F c• DoeatltsSWPPPA~Qu~Y~h'HTetr~Pv+rrY ~ ~ arM/or Petttutttettt Sai ~allmYan Maamrsa? Yes No d. Does the SWPPP Adequately IdeNify a Corrpl~a Proied P>~ Plan 1 Yas No ettu~ « (p.7ao1. tom. „m,,, e. Does the SYVPPP tttlicate Ad~tlarat 31fe Spacer Q Q Pwgkx:s 9tat WN be Utleced b Protect Water qusRy 7 Y~ No f. Has the Appacant SuWNtled a Corrpkl~ DEC Nonce 7:P~ « t yyEy~ ~yy Crwk ea. po.a. auw,d F,.rn.rvwwv,d_> Of 1nteM and SWPPP Aaepfanee Farm for Review by the Town of Southold ? Yas No /~(J Nom- . C S1'ATF.OFNFWYORK, S~Ffb~lL.......... - COUN170F _ $S Notary Public, State of New York No.01BU8185050 ~l(~ That I, 1~.J..~.-.F~.!T.._:Qa. ~ f~ being duly sworn, deposes and s~gyy,~jp~t~fp~k Co for Pd7rtit, (N.ms o/ YWlridrl Mpiiig Op.~eivd) Cammisslon xplres ~ And that he/she is the .......7.~^_!! (Ovix, ~laractor. Anent, CwpaaMOSnr,ala) Owner ancj/or representative of the Owtrer or Owners, and is duly authorized w perform a have performed the said work and to make and file this appliration; that all statements contained in this application are hue to the best of his knowledge and belief, and that the work wiIl be performed in the manner set forth io the application filed herewith. Sworn to before me this; ~iy~ .......c~S~.......-------..... day of ~_."~~.C-------- , 20.~~ D Notary Publu:......S..Td~f..ll. ~..~..f~?.(cL ~ c aA~a) SWPPP Assessment FORM: 03-12 ,Py"""`"'~ T.O.S. "SWPPP" Preparation -Chapter 236 ForDaparlmsMUaeOny: rT &o.T.M.s: PropenyAddma: 3`/SSTa./DiA~.I Storm Water Pollution Prevention Plan u- ~'ke ReWew Checklist Checklist # 1 ~ REQUIRED PLAN INFORMATION AND IMPLEMENTATION DETAILS: r i + , Ian S sat Dop f!w SWPPP Ad Provide for aeW/of MdleaN She Followin . YES r NO r N.A. , Eapbnstlon for NO or N_A. Location . f8 ro a one n a n - - r r ~ 2 ~ OonstrucUori Phaemp Plan IridMatlrtQ 8egusnce of P~oyoeedCorielrudlon ActlWtles. _ _ , i Q i Q i ®i- STQ.... ~''oyT~ `'"T b>J ' -3._Generel,Looetlon Mop _ .___9®~0~0~ ~~-_-$JR-J E`C 4 Dialenge Sde Plan Dravm t0 Scab at 86dy.(80'j feet to the Inch or larger Indlating the Following, . r0, ®+Q, S TZK- ~~R~2~. . . * .4pgaponendDescrtpUongfprgperly@cy+ndadga _.i®iOiOir _ _ e + r ~ _ c A I Etdsling, Natural endbr Man Made Features on antl wllhin SO of the Property Boundary _.1 ~ ~Q i0 i- - _ ~ ~ ~ d Teat Hob Data Inditrebrtg Soil Charocterlstlcs 8 Depth to, Seeeorml High Water Table- rOrO'®' t' ~~L SPR+cr ~ - e Contoure lndicaUnp Property Elevations SMln _2),,.._____ ~~-'DiDi©~ ~ _ -iL~~O~®r _ f Spot brarN J1 Finlah Floor EleveBons for Exlstl and Proposed StrucWree ~ ~ ~ ~ ~ " g '-i ooat7ori ~ WooderlAiees 8 IaolatadTrees a K1Tnimum 1NmensCori of 18'' Dlametsr;" { 0 ~ i r . _ _ h"SdHC'onseriatlonDTebfclSoifBurvey--__._ iQr®r _ - . ..._,O,O,m, _ _ 5. Background bformaUon about the Scope of the Project, Location 6 Daeaiptbn of the SUe O i O i S ~ Pt_.R as Proposed Chanpe6 tD the She and All Exiatlng Development on the sere Indudlnp fhe Fdlowrng. ~ , , ~ _@,,.AU.tm?mverlalN#InC11191DD7Ma1F~f9R.?IL§RdRIM414anFed+TRtW8Lt9N90,.. __.._.,......~~iQiQi i'___. b. All Excavetlon, Felling, Stripping 8 Grading Propkxied and IdantMed as to depth, Vdume ' ¢_NaWre of Mabrlalls VlvRIY§9; 'Q"Ql®~ c .All Areas R ulri Clperln and/or Gru _ ~ ; ~ _ . _.._e_9. pD.. _ _ k4!itiat._._ ®0,~,_ s___SyR~~y_ . . _ _ r d. All Arses Where Topsdl is to be Removed , SWCkplled end where Topsail well u1tlmMNy , , , , be Qleoed ~Q,.~,Q, e ~ All Temporer~ 8 Permanent Vegeudon b be Plaoed on 3Ue Q r0 r®' . . f~~ All TemeororyBPermanent Storm Water kurntt`9MP Curibd Measures Proposed i®iDiOi,~-Q ~uo,p 1~RAcT+c~S The Antra ted~ f'ettem of Surface bra Dud Periods of Peak iiwwff **ro (c2T Y ~ _ p. Pa ~9! _ _ iDi~iQi Y P . 1 ..fit-Fx! h' 75re LaceBon ofall Flosds ~bdvea+eys 3ldeweTks, Padoi. 9tru~res, GUUUee d bfher - ' ' r _ _ -,__,,.--I"m'provemenis.fndudfog7emponryAcodeeBCOns6nidio`nSfeplnpAiear _..,.._.........il~rQ;Qr..5P~32..SvR~z~.._ ".T 7fiiFxlstGpB'FiiisTConjouFaandaSpotETevalfoir"sofi)iselle--_ ....................._.i~i®~O f3 ~ ..A Seheduk~of iFie Sequsrice for the Inatallalion of AA Pbnned Sall Erosloe, Sedimentetfon , , , , - . 8 Stormwater Runoff Control Mstwrea. ' 0' 7...DeaaipUon of Pollutlon Prevention Mr;}swes tl+et will be Implemented _ _ . a 0, 0, ~M ~ - _ - ~ _ . 8. A Deecriptlon of the Minimum Floelon 8 Sediment Control PrecUOa b be Installed and/or r r ' + ~ ~ ~ _ ~ ~ ~ ~ ~ ~ Im lemerited for Each Constructlon Atli tl+etwW reauN In Soll Disdxbance. i)~ i ~ i 0 9. Descri 'on of ConaWcUonBWestematedale to be3torodOnSfle. 10. Temporery 8 PermenaM Soil Stab~tiatlon Plan MM meet the Currant Verolon of the ~ - ~i-1i..i: 4 (7ItS~ New York State 8btm Water DeslQn Manuel Technbel StendaM. i ~ iQ i0 ~ 11. GenerolSltePlenandConatructlonDrawlrglsforlhePro~ect____ r®iO+O~~'~_._Pu!-+~ 12. DlmenabnsiMabtial 8eetlMsUcns 8lnetalbtlon DSlalb for EroabnBSedimerd Cwrtrol Pradbes. ;Qr~r®+ ._m.________ r r 13. Temeorary Practices Mrat will De Converted b PamwneM control Meawros. ~ O,Q,®u _ _ _ _ 14. Implsmentetlon Schedule Por Staging Tamgrnary F_roalon Control Pradlce orBMP. ----_---aQ~O~®F__________.._.........__---_-_....___......-......__....._.---_.__.....__... 15. Maintenance Schedule to Enauro CoriUriuoue 8 Eftaclive Opeiatlori M Eroabn 8 r r , , Sedimem Contrd Prodlae. i 0 i 0 i 18. Names of Polentlal Surface Waters of the State of New York eM/or M341hat may be , , , , Im acted D DevebpmMt 'Q'Q'®' NO Nrz ----_e___y .._..._______.__a ~ 17. DelineeUOnof3tormWaterConlrolPlanlmQlementaUon_ResrioralDlllUesiorEechpartofthe,__~Q~Q~®'._L`!5?~L._ P eel COneWctlon tilt. + r r r 18. All other Erdsting Data that Describes Storm Water Rurrolf a_nd/or NaWrol Drainage bWales; 3Q r0'i® ~ 19. Iderrtifleatlon of All Contrector(s) / SubContracbr(e) Reaponalble for Installing, Conetrucdng. , , , , s . - _ . _ _ _ Re n R aein Ins and Malnlain' the FJOSlon BSedlmem Control Practlcea. 'QrOr®, NOT ~T THE T+M~ Storm Water Management Control Plan Cheeldist # i : Q9-72 ~j~ ti~ Town H~1 Aorcx ~ # Telephone (63q 7fis1804 s>37s n,o0a roger richert~~miso~u ld rrv us P.O• Baac 1179 Sau~hold, NY 11971-0959 BUIIDING DEPA1tTMEN1' TOWN OF SO[PPHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: , pQ, ~ ; Date: Z 1 ~ 3 Company Name: ~~r; c_ Name: - - License No.: - C Addl+~s: ~ .8 1~. ~ ~,g ~~Z Phone No.: 3 ~-1'~-F 3 JOBSITE INFORMATION: (*Indicates n3quired information) *Name: ;t ~o ~ ~nr ~0. ~a,~~ c» S~ e.r p "AddneSS: ~'\p 9 0 T n!~_ G' n ~ ~i ~ t,...+~_ 1 `~C'~~ L ~ l~ y 'Cross Street: "Phone No.: -1 p ~ nrv.- - o~ o„L - Permit No.: Tax Map D~brict 1000 Section: Block: Lot: l 'BRIEF DESCRIPTION OF WORK (Please Print Geary) Z,~ ~n ~ (Plaasa-Girds All That Apply) *Is job ready for inspection: S NO Rough in Final *Do you need a Ter?lP Certifirrate: YES Tamp 1 J 'Service Size: 1 Phase 3Phase 100 150 200 300 '100 Other 'New Senrice: nett Underground Numtler of Meters a of Service Overhead Additional Information: PAYMENT DUE WITH APPLInnC,,ATION G ZOO p,,,,~C? ICQ,G o C~ 5 ) ~ t a4S_ - _ a -rs-~~ ~~r _ ~ D • A • K ASSOCIATES, LLc reslden•lal a commercial design • englnee+Ing • consulting March 15'", 2012 To: Town of Southold Building Department Reference: Insulation Inspection Project Location: Santarsieri Residence 3455 Indian Neck Road Peconic, NY 11958 Building Permit # BP37558 The following Insulation inspection was performed at the above address on March 14, 2013 in accordance with New York State Code. Approval has been granted with the exception of Insulation needs to be installed in the crawl space prior to the final inspection. Up N~ 4?r Sincerely g~ 9 QEFHy^p'?'f; ~i~. +~y ~s r o re.l T .r James DetM~~ E ~ '~O€ U~t ~„?,q~F ~ l~ i L~ ~~~~~I APR-32013 I'lJ U 2L0 APT. i0 .'I + 'JT116LD Deerkoski • Arm • Kehl Associates, LLC PO. Box 1675 , Southold New York 1 1 9 7 1 Phone: (631)433-9084 Email: ssbn654@optonline.net Fax: (631)466-3354 ~ D • A • K ASSOCIATES, LLC reslderrial & commercial desgn • englnee~ing • consulting March 15"', 2013 To: Town of Southold Building Department Reference: Insulation Inspection Project Location: Santarsieri Residence 3455 Indian Neck Road Peconic, NY 11958 Building Permit # BP37558 The following Insulation inspection was performed at the above address on March 14, 2013 in accordance with New York State Code. Approval has been granted with the exception of Insulation needs to be installed in the crawl space prior to the final inspection. Sincerely ` , ~ ~Eh,Y `,I~P DEEH~~ir' G ~ James oski PE. I' w ~~Cq ~ ~ 1 ~ ~F c h~ ~1 ~ J1 D i JUN 1 1 2013 e~~c DEFT. T04'1': nr ~OpTUOID Deerkoski • Arm • Kehl Associates, LLC PO. Box 1675 , Southold New York 1 1 9 7 1 Phone: (631) 433-9084 Email: ssbn654@optonline.net Fax: (631)466-3354 TOWN OF SOUTHOLD PROPERTY RGCORD CARD a ; d~-o - - - / , Z _ OWNER STREET r'` VILLAGE DIST. SUB. LOT ~ Carla- ; , ~OR ER OWNER N E~ ~ ACR. .?o/..~, ,.~/~.f ~R. ~ I~` d°N , tar ~ Qe-a ZL~-#' i P.t~l ~ $ S W TYPE OF BUILDING e ~ ~ / p .f W F V .,i. •,l rf'e:u C'.e ~ UJ ft RES. 2-~o SEAS. VL..~- FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS ~ ~ ~ ~ ~J?o P Sa6. ~,t ~ ~~~n g~' 7 S' /,.oc - ^ ' P- ~ ip.2TRelf vrrE•Pe- G/.~.Zv.aL~ hr l' z ~Q _ _ , ~o O-U ~ , ~ / S/Lo FL ~/~a/~~ /3. Co nsfr. r w a'v,a.~ t/r 9S, o-•w ~ i o o©- 85 - I ~flc~- Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD 0 Meadowland DEPTH ? 1 ? P -r House Plot BULKHEAD Totol COLOR ¢ //xw TRIM G~~l ~ t~ - i 1 ~ - ~ _ ~ - o I - - - - ~R M: Bldgfj4 .~r.; x'3!-. 9-3~ y~J x{2/2 J L 1 Extenej~n ~ a. ~ ~ / Z u ~ ~ } .3 90 / Extension Extension ~ y ~ L S / o S/ ~ Foundation C . Bath y Dinette _ Porch Basement '~j~ Floors Q~ K. Porch Ext. Walls Y/» ~ ~ Interior Finish S /2 LR. Breezeway Fire Place ~ Heat 1/!~j DR. Garage / 7X ~ a ~ / ~O G yZ Type Roof Rooms lst Flaor BR. 3 Patio Recreation Room Rooms 2nd Floor FIN. B O. B. Dormer Driveway Total j~~/~: fV1AL FUJI Af2EA iS,_~SLS ~b S.F. i ~ r~ ~ V A ~ 4~J ~ ~C CK ~ D 2. .Nnz6'oo'E ,i9e a. ff - W zaa oa I ~'I I~ d ~ ~ ~ ~ ~ ~ ~ ~ s. li ~ 'A 4 1 s a t ~ it ~ ~ 1 _ I m ~ ~ - O' i I " M ~ • I J ~I~iN b ~ 8 I O 3 , ~ ~ ~ ~ a u 1 _ j _ ~x ~I 3 ~ ~ o 1 SFVS I ~ } ~ O ~ f QJPJS~+a WEW O ~ I F W - ' AoelT,ou ~ ° w o ~ "l7 ~ ~ ~ w p o ~ ~ ~ o ~ o o ~=1~ ' _ 3 i wo O 3 i ~ o~ Z I l y I D Igo Q u ~ P a l ~x µ I ~ w~a I ~ ~ I ,c w Y vws ~Ya. ~~i I II', II a ~I~, I 4' g o I~I~, WI a s ~ ~ ~i s TAx LOT i42 !I ~ ~ n N o III 3 II I II `o ~ 1I I ~ I, m 1 w ~I o b ~ ~I I z 1311.56' x S6T 48'40'~W ~ i ~ I Tnx toT 3a a it LANG NnW OR FORMtRLY OF PILZAHEL LI _ Ala ? ~ On: tA'_NL'vIS Ol RI l11F Il, II AN b01 ~r~03JN Arci NII, unKnM ¢FI 1n. 'h la~N~~. U H 1111 Exl Ilti 1018 111 IFFlCIICI IOk I_,1NIl ';uRVh 1'IIkS Al]OP ILD IIti' THE NlW YOFF ?TAIE , II aNl ~ n, i71.S. -L li I i i I. bIOLAIi iN Ir cC IOn ':'D"~ III I II NLW YII k ,It'll I 1 A171JN ,Ab ~Llr'll < it aRVC* ~l ~ vl i ~ L H IIF. Cvf ~~~f C `l N HALL N01 b[ l I7N',III[ I L D 10 731 f .AL ID 1 RUL LUNY NU V u lAL 111 i n w^ Oh II I.'i~t 1 FEIN. illAeiEU WIIII 111E INF I1Iti LMI IVI OF lAV Oh'I]INANti` ?h Rl UL. 4f ON1 alA'. VV :1~ _b ..-AiION ~ u?'. n NOI 51rM1 I1~ CC F'1 Ill ~IILINI INII I~iJ LII IILRh I1N IIAL L. KUP IIM_Y 10 14' I'i AEON Aril.. 1~p LIN I1IL AIF ICI lllf II1 LL IIMI'FlN Y, tdNr FNwLNfAL. m,I. NIY ANIJ 11 NI]ING IH)TiIUIIJP: I; fU HEREl7h I rt. ~ li`1S 111U111iN IFFIII ICFlIIIIIVS AF?c Nfll InHNSiIh:A InL 10 nIIUIIIONM IM;TIIUi]LNC fIR SUBGL UU~N1 OWNE!" ,.r-iJ l_r~ COUNTY IiAX MAP DIS tOOD SECT: 915 HLK: 5 LOT: 14.2 mnP ~u~L_ DATt. ~6J1~~~'!lC@' ~ IQ'U~V1G7771i 1 of NEW L ~ ~ 'L¢~¢ras¢~' 1G~ ~wtvw ~ e r. ~ BRy~O h Fr ~ lSJR1FitU PROF LRIY MAINTAINING THE RECORDS Of BURTON, BEHRENDT K SMITH 1 ~~:A II~L fJ: IN(iIAN NLCK (I'ECONIC) F SUFFOLK STATL OF NEW YORK fCW1v 9]U THOLD, COUNTA' O ~~s~v~~r ly~,v )Y~»~s 1 il7~D~ oeoo~3 ,~r:~E -r.~: n~~zlL 3, zoo9 ~et ~~lF_~ T.,- IANOMARh 1nNU SERV1cts, 1NC. TITLE No. ~~s-offal-oe-s (~32')4Tl'-l'77~ SANDS W ASlu4GTON T,TLE INSURANCE COMPANY VILO SAN TARSIERI 3c CARLA SAN TA RSICRI Q~~-.~~7~ ~~-_ALL 1'~-40~ FILE NO: 09-~ b3 _ _ _ REScheck Software Version 4,4.3 Compliance Certificate Project Title: Santarsieri Res. Sunroom Energy Code: 2010 New York Energy Conservation Construction Code Location: Suffolk County, New York Construction Type: Single Family Project Type: AtldltioNAlteration Heating Degree Days: 5750 Climate Zone: 4 Construction Site: Owner/Agent: Designer/Contractor: 3455 Indian Neck Lane Cada Santarsieri Brett Kehl Peconic, NY 11958 34551ndian Nedc Lane DAK. Assoc. LLC, Peconic, NY 11958 Southold, NY 11971 Compliance; 13.8% Better Than Code Maximum UA: 116 Your UA: 100 The %eohaa Wax Than Catle intlea,egech how tlose to canplianee gie house is beaetl an mtle tratleoR riles. It DOES NOT prwiCe an esEma[e of energy use a msl relative b a minimartmEe bane. , • • Ceiling 1: Cathedral Ceiling 384 30.0 0.0 • 13 Wall 1: Wood Frame, 16" o.c. 440 19.0 0.0 15 Window 1: Wood Frame:Double Pane with Low-E 107 D.310 33 Door 1: Glass 83 0.320 27 Floor 1: All-Wood Joistfrruss:Over Unconditioned Space 388 30.0 0.0 12 Compliance Statement: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit applicetion. The pro building has been designed to meet the 2010 New York Energy Conservation Construction Code requirements in REScheck Version 4.4.3 d mpty with the mandatory requirements listed in the REScheck Inspection Checklist. ~.R V~~~ ~U ~t5'1k° S~-~' 1 ~ ~ Z Name -Title Signatu D e ,~~OF "tW r ~ ~S~.DEFR~,~q~~ °m~ a. t t~~ OA9 7 ~ w ~~LSSt(7 Project Title: Santarsieri Res. Sunroom Report date: 09114/12 Data filename: C:\Program Files\My Documents\REScheck\Myers\Myers\Santarsiedrek Page 1 of 4