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HomeMy WebLinkAbout37446-Z ~Fgl,~ Town of Southold Annex 10/22/2013 wy~ P.O. Box 1179 54375 Main Road '8! Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 36577 Date: 10/22/2013 THIS CERTIFIES that the building SINGLE FAMILY DWELLING Location of Property: 330 Wesland Rd, Southold, SCTM 473889 Sec/Block/Lot: 59.-2-24.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this otficed dated 7/30/2012 pursuant to which Building Permit No. 37446 dated 8/16/2012 was issued, and conforms to all of the requvements of the applicable provisions of the law. The occupancy for which this certificate is issued is: one family dwellin¢ with partially finished basement and covered porches as apylied for. Corrected 10/22/13 for partially finished basement. The certificate is issued to McCarty, Glenn & McCarty, Theresa (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-12-0037 9/3/13 ELECTRICAL CERTIFICATE NO. 37446 7/24/13 PLUMBERS CERTIFICATION DATED 9/18/13 S h ubbard ho ' ed S7gnature Towu of Southold Annex 9/26/2013 P.O. Box 1179 54375 Main Road Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 36531 Date: 9/26/2013 THIS CERTIFIES that the building SINGLE FAMILY DWELLING Location of Property: 330 Wesland Rd, Southold, SCTM 473889 Sec/Block/Lot: 59.-2-24.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed iu this officed dated 7/30/2012 pursuant to which Buildiug Peruut No. 37446 dated 8/16/2012 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which [his certificate is issued is: one family dwelling with unfinished basement and covered porches as applied for. The certifcate is issued to McCarty, Glenn & McCarty, Theresa (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-12-0037 9/3/13 ELECTRICAL CERTIFICATE NO. 37446 7/24/13 PLUMBERS CERTIFICATION DATED 9/18/13 Stephen Hubbard A rued ignat TOWN OF SOUTHOLD BUILDING DEPARTMENT ~ ~ TOWN CLERK'S OFFICE '8®~o SOUTHOLD, NY ~1 ' 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 37446 Date: 8116/2012 Permission is hereby granted to: McCarty, Glenn & McCart~Theresa 24 First Ave East Rockaway, NY 11518 To: demolish 8~ construct a new single family dwelling with porches as applied for At premises located at: 330 Wesland Rd SCTM # 473889 Sec/Block/Lot # 59.-2-24.1 Pursuant to application dated 7/30/2012_ and approved by the Building Inspector. To expire on 2/15/2014. Fees: SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $1,916.80 CO -NEW DWELLING $50.00 Total: $1,966.80 -~--t/., - _ _ _ Building Inspector Form No_ 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1 % lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. 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 I. Certificate of Occupancy -New dwelling $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00, Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building-$100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy -Residential $15.00, Commercial $15.00 Date. ~ /o? l New Construction: ~ Old or Pre-existing Building: (check one) . Location of Property: ~j~~ I~cl>°~ ~~,~~--f ~ '~~~~n 1 d House No. Street Hamlet Owner or Owners of Property: ~ ~n~~C%~j~ ~ ~p (C~ ,n M L+ 1~~ Suffolk County Tax Map No 1000, Section S ~ Block p Z Lot ~ , Subdivision Filed Map. Lot: Permit No. ~ ~ ~'t~~ Date of Petmit. -iE~' Applicant: I Y~.P r~CC, ~ ~ ~ ~ Health Dept. Approvat• Undetwriters Approval: ~ Planning Board Approval: / Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ J ~ ~j~ Annlirant Cion aturo y,1FFQ(,~ Town Hall Annex ~p~ CD Telephone (631) 765-1802 54375 Main Road ~ '~y~ Fax (631) 765-9502 P.O. Box 1179 0 • ~ Southold, NY 11971-0959 'y~yo! * Sao! roger.richert(a~town.southold.nv.us BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: McCarty Address: 330 Welland Rd City: Southold St: NY Zip: 11971 Building PermN 37446 Section: 59 Block: 2 Lot: 24.1 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE contractor: oBA: Pimti Electric Inc License No: 33025-me SITE DETAILS Office Use Only Residential X Indoor X Basement X Service Only Commedcal Outdoor X 1st Floor X Pod New X Renovation 2nd Floor X Hd Tub Addition Survey Attic Garage INVENTORY Service 1 ph 300a Heat dl Duplec Recpt 63 Ceiling Fixures 24 HID Fixtures Service 3 ph Hd W ater GFCI Recpt 13 Wall Fixtures 12 Smoke Defectors 3 Main Pand 2-1 A/C Condenser 3 Single Recpt Recessed FiMUres 48 CO Detectors Sub Pand A/C Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances dw Dryer Recpt 1-20 Emergency FiMUres Time Clocks Disconnect 2-15 Switches 74 Twist Lock Exit Fixtures TVSS other Equipment: 300a underground service, 2-combination smoke/CO detectors, 5-exhaust fans 2-paddle fans, 4-ARC fauk circuit breakers, 1-17KW stand by generator wRh auto transfer switch and 100a sub panel Niles: Inspector Signature: Date: July 24 2013 ElecMcal Cenrficale.xls ~o~Of SO~I~o~ Town Hall Annex y ~ 'I'tlephone (G3I}765-1802 54375 Main Road 7` Fax (631) 789-9502 P.O. Box 1179 G C Sowhold, New Yoiic 11971-0959 a~ ~M....a ~t`P ~ BUILDING bEP~ ~ =1I ~ TOWN OF $OUTHOLD I~.~i~l ~ SEP ~ 5 2013 ~~,J ~ i CERTIFICATIQN Date: ~ 2 C Building Permit No. ~ ~ l Owner: ~ rC' `~C~ ~ ~i~~P_y1.'1 M /y ~r~ r 1 ~ (Please print) Plumber. ,5~~, ,~c~ _,S'. 1~6~a,y_/ (Please print) I certify that the solder used in the water supply system contains less thaw 2/10 of 1%ti lead. i (Plumbers Signature) Sworn to before me this ` c~ dayOf, 20 ~3 LYNNE A. HUBBARD Notary Public, S+ate of New York _ No.01HU5054648 qualified in Suffolk County -7-~`~~Q`j Commission Expires February 20, 20 ~l ` I,(.LID A A Notary Public, _ ~~(~t~/e ~Q i~County ho~v,Of $M/T~ 37~~~ TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 1 NSPECTION 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 (FINAL) REMARKS: (3Z. D DATE a-7~ INSPECTOR ~o~r,Of Sol~tyo6 ~7~~ TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 1 NSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION [ ]FRAMING /STRAPPING [ ]FINAL [ ]FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION ( ]FIRE RESISTANT CONS1RllCT10N [ ]FIRE RESISTANT PENETRATION [ ]ELECTRICAL (ROUGH) [ ] ELECTRN;AL (FINAL) REMARKS: ~ ~ r L DATE _ / ~ INSPECTOR -_I~.' - ~ f®~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING /STRAPPING [ ]FINAL [ ]FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ] FlRE RESISTANT PENETRATION [ ]ELECTRIC [ ]ELECTRICAL (FINAL) REMARK DATE ~ ~ INSPECTOR * ~OF 80l/T TOWN OF SOUTHOLD BUILDING DEPT. II 765.1802 1 NSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING /STRAPPING [ ]FINAL [ ]FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION I [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION [ ]ELECTRICAL (ROUGH) [ ]ELECTRICAL (FINAL) REMARKS: S ~ c-~- DATE ~ INSPECTOR L ~7~ aI~UF 3W/Ty f ~pf ~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECT [ ]FOUNDATION 1ST [ OUGN PLBG. [ ] F NDATION 2ND [ ]INSULATION [ ]FRAMING /STRAPPING [ ]FINAL [ ] FIREPLACE A CHIMNEY [ ]FIRE SAFETY INSPECTION [ ] FlRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION [ ] ELECTRIC~ROUGH) [ ]ELECTRICAL (FINAL) REMAR S: ~ l , , QLc~~- V ~ DATE ~ INSPECTOR ~o~~,oF:ouryo6 * ; n'j~ / TOWN OF SOUTNOLD BUILDING DEPT. G 7sS.,ao2 INSPECTION [ ]FOUNDATION i ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING /STRAPPING [ ]FINAL [ ]FIREPLACE 8 CHIMNEY [ ]FIRE SAFETY INSPECTION [ ] FlRE RESISTANT CONS1'RUC'TION ( ]FIRE RESISTANT PENETRATION ] ELECTRICAL (ROUGH) [ ]ELECTRICAL (FINAL) REMARKS: ~ tic _ o ~ DATE I Z- INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECT N [ ]FOUNDATION i ST OUGH PLBG. [ ] F NDATION 2ND [ ]INSULATION [ FRAMING /STRAPPING [ ]FINAL [ ]FIREPLACE 8~ CNIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION [ ]ELECTRICAL (ROUGH) [ ] ELECTR FINAL( REMARKS~: / Div DATE ~ ~ ~ INSPECTOR ~J o~~,OFSOI/T~ / ~1 ~ ibUNft;~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 1 NSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND ! INSULATION [ ]FRAMING /STRAPPING [ ]FINAL [ ]FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION [ ]ELECTRICAL (RO GH) ~ CTRICAL (FINAL( ARK . r ~n1~- ' DATE ~°2 ^ ~ 9 ~ INSPECTOR L l ~ ~ * "v(p* TOWN OF SOUTNOLD BUILDING DEPT. 765-1802 1 NSPECTI N [ ]FOUNDATION iST [ - OUGN PLBG. [ ] F DATION 2ND [ ]INSULATION FRAMING /STRAPPING [ ]FINAL [ ]FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION [ ]ELECTRICAL (ROUGH) [ ]rEL~ECTRN:AL (FINAL) REMARKS: ~~P "C~- DATE Z' y~ INSPECTOR J(,y~ Q ~o~~,OF SOIjT,y~6 ` ` # ®f TOWN OF SOUTNOLD BUILDING DEPT. 765.1802 INSPECTION [ ]FOUNDATION 1ST [ ] RO GN PLBG. [ ]FOUNDATION 2ND [ NSULATION [ ]FRAMING/STRAPPING [ ]FINAL [ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION [ ]ELECTRICAL (ROUGH) [ ]ELECTRICAL (FINAL) REMARKS: ...(i~~a..~~~~ C~~ ~-~`°i~~ DATE ~j INSPECTOR r \ ~o~~,OF SOI/lyo<o '1 ~ "`m~''',~' TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 1 NSPECTION [ ]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: DATE 2 ~ 3 INSPECTOR`S ~~of80(/Tyo TOWN OF SOUTNOLD BUILDING DEPT. 765.1802 1 NSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ] IN ATION [ ]FRAMING /STRAPPING [ ' FINAL [ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION ( ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION [ ] ELECTRICAL (9ROU(GH) / [ ] ELE(C~TRICAL (FINAL) REMARKS:r 1~1J L4A-i~ ~J~~f~,~ \ ~ ` f~ J~~,~~ P~,~~ ~S C~~. ~ - ~ w DATE ~ INSPECTOR \ ~ ~ ~ ~ ~o~~~ soa,,yo6 TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ] I [ ]FRAMING /STRAPPING FI [ ]FIREPLACE & CHIMNEY [ ]FIR ETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION [ ]ELECTRICAL (ROUGH) [ ]ELECTRICAL (FINAL) REMARKS: DATE L INSPECTOR j . FIELD ~ N itEPOAT DATE CONIIVIENT3 ~ ro r ~oUrina~ION (isx~ t ` FOUNDATION (2ND) ~ ~ G C~1 z _ c to a6 ROUC;H FRAMING & ~ ~ 2- ~E ~ ~ 1 PLUMBIlVG _ ~ ~.j' INSULATION PER N. Y. ~ "j STATE EHiERGY CODE _ a-'f ~ e0~ ~ ~ ~ G [lu_ ~ v~ $ ~ O / Y y~ ~ ~ ~13~~ /~3 .r~~...G-7 3 0~ ~ - ' G/` _ 3 ADDTTIONAL COMMENTS 1 le . G ~ / - ~ C,f" / G °T I° z G I z ~ ~ - 4CC b7~:=- m 20- t 1 - - ~ ~ ~ . ' ~°x ~ - o~ V.~ TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following, before applying`? TOWN HALL nBoard of Health SOUTHOLD, NY 11971 •4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 tL -1.Survey SoutholdTown.NorthFork.net PERMIT NO. ~ ~ 7 'tCheck ~lSeptic Foon N.Y.S.D.E.C. Tws[ees_ ~ GO. Application Flood Permit _ Examined _ ~ 1 . 20'''t_ Single & Separate q Storm-Water Assessment Form_.___. Contact: Approved 2~~ Mail to: Disapproved a/c Phone: Expiration ~ , 20 Building Inspector APPLICATION FOR BUILDING PERMIT Date (p , 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 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 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building htspector 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. ~ Q l (Signature o app~ant or name, if rporation) a~ ~-,5~ Aye (Mailing address of applicant) N State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or binder Q(il E2 ~~~T /J 1 Name of owner of premises ~ l o%r~n ~l' ~ C/ Y 7~L (As on the tax roll or 1 est deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be do e: 3 3o W ~ ~ ca c~ ~~c_,~~nO~~ _ House Number Street Hamlet County Tax Map No. 1000 Section Cj~ Block ©~Lot ` a~. Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and inten ed use and occupancy of proposed constntction: a. Existing use and occupancy c, ~ ~ ~ P ~0.,r,.~ ~ ~ r,, ~~r~ ,,,c P b. Intended use and occupancy Si\--to~~ ,,,-~'^~~{~~S;e{2„~CC~ 3. Nature of work (check which applicable): New Building ? Addition Alteration Repair Removal Demolition_ ? Other Work (Description) 4. Estimated Cost ~ y' ejO~ pn Fee ~~~1 r ~ (To be paid on filing this application) 5. If dwelling, number of dwelling units - ~ umber of dwelling units on each floor~~ If garage, number of cars Exts-r i 2 GAt2 ~~t~T~~~ 1 ~aa2 w,-r-~ q+zTlsi- ~SiUC~,c.~ A~-,cE 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. ~~N 2 GA'= C~AizACoE 2Z' ~ ZZ~ I 2Zr tG~,s'w/a~zr~~ t5.3 ts',3 7. Dimensions of existing structures, tf any: Front Rear Depth ~ I.3 Height 'Z, ~ Number of Stories l 2 No Al-t~~o-Aio~ foctlq~L s}ruc~urcS Dimensions of same structure with alterations or additions: Front ~-r.•.e ~s ~„~Rear ~1~+ Depth r.1~~ Height N/q Number of Stories t.S/g ~ ~ ~ 8. Dimensions of entire new construction: Front 51 Rear S1 Depth '}'L Height 2Co Ems" ± Number of Stories 2 ~ I 9. Size of lot: Front_ 1So Rear 2oy, ci Depth 23~} , S8 SNo.¢oi.l A- GoLOSrn, T'H 10. Date of Purchase t 13 2,o IZ Name of Former Owner ~e,r~«, .err d. ch.-,s~'oPvyer qnn M~ Gcv,.,~. -rr~s.}. 11. Zone or use district in which premises are situated ~2 - ~b 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO_~/ 13. Will lot be re-graded? YES NO S/ Will excess fill be removed from premises? YES NO 14. Names of Owner of premises Address 8 `f rs~~YE . E~. Phone No. 6ko '?off 1- o I o X Name of Architect ~efeso~ Car Address a'-I ; r<,{ AvF E. 2Phone No 51 to '7~I i o g' Name of Contractor rho n r Address 32 Ell-inn Ale Phone No. ~.i~, 75~ - Z9K~ Corerr~lc~~r-~ t~~tlgcfp 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 within 300 feet of a tidal wetland? *YES NO~~ * IF YES, D.E.C. PERMITS MAY BE 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: COUNTYOF,v/) ~/eI'P~SGL / /C: (rQ being duly sworn, deposes and says that (s)he is the applicant (Name of indi~/vidual signing contract) above named, (S)He is the /T e?l ~ j Q~,~{_-~ ~~r~l.7CC~ (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 thi day of 20LZ Eileen DeName Notary Publk•State of Naw Yor A E6722638 Ci Notary Public QualifietlinNassauCounty Signature of Applicant Commission Expires February 22, 20 Town of Southold -Chapter 236 - Stormwater Management SWPPP -Storm Water Pollution Prevention Plan Assessment Form GF.NF,RAi. INFORMATION: (All Requested Information is Required for a Complete Application) APP NAME or«ner. - aOela teirde Qa) Roperry DwnE1t 0/0i1h1eM tlan Appatanp r/ I Faxk Tekgtonek iaxk !I! e _ e-wk I 1~DnmpOoa of ComtroeNa®AeOVilf, Aopoem StruwnalBMPa„So0 s.RT k tOp Shba6>,EOa B11~a.PrgeetSrnpe aolVor $a~otComhucGOn Ac~riy oGl3 t~~wr,aswww~aryla~aued.il Nairle el andldrt?oMael Itsdporo®la lorlnlWeln.msonerswPPV: ~!"12 ~_4__! v 1 f :s E- ~ n / Ii I Id.nl. wPanella rtupena MtrmWbtlzadlltbletnnu a/r7wloneonsa Praeep: =~~--~~~`Y`=`E----- 1 ~ ' II _ r~r,~------------ a w II e pMr,e t. Faxk I - - i...i E ~ f r/, ;roar aaa aAd TolalNeaoflaMGear'ze~ -l -ProleU Parcels: and/or Gro,uM DisaWance: ~ yO~ (SF,I.bul Project D,xation: ^ Sbtl EM plnlfopaletl) -/~O .Date: / Dale: ~ / 0 1 VI Will this Project Disturbs five (5l or More Acres at - , Any One Time During the Proposed Development? Yes No "i ~ ! 11 YES: Pbaze Answer 1M Fopowh,gl a. Does Ule Applicant have a Qualified Inspector On Stall To Conduct Ne ltgquired Irspectbns ? Yes No b. Dces the SWPPP Indicate How Frequently the Site List ma NAMES w desaipuon or au PaenWil hn ~ ~ O O y patted Wahrbodka andlw Weaamis: Inspections will Occur and kr What Pedod or Trine ? Yes No 1 i c. Doesltle SWPPP AdagrrateH Identify Ap Temporary Q Q , arldlor Permanent Sal Stabatiration Measures? Yes No I j d. Does Ufe SWPPP Adequately Men6fya Complete ~ I Project PhasNg Plan? - Y~ ~ - i e. Does 1110 $WPPP IIIdICe18 Additional $ita Spedflc SbNa e/ Mnpschd WalxtwdY+IM: TYDr. 705th UsK Practices tllat wr be tjh'Rzed to PrdeU water Chralily 7 Y~ ~ ~ j , f. Has tale Applcant Submitted a Completed DEC Nolke Of Intent arld SWPPP Acceptance Form for Review ~ Q ryp° w Mwaea Wi1areoir les. LaMa, cre.Q, say, Pone, sound, FroMnM Welbnd_q by the Town of SoutlloM 7 Yes No - ~ I 1 S7 A7'F. OF NF,W YORK, COUNI'YOF......._v?...... SS 'M./ i That I,~c~.-.C...1.~..~ r.~......... being duly sworn, deposes and says thaz he/she is the a hcant for Perini I (q?irle oi4airpual stgtg Uoaanmt) PP S And that he/she is the .....-_....~..~,~„L2C,.(Y ..,EIY~: ..sue ! I Ion+iv. Cn»•acbr,Aymf. C«Vora» OICar.et)«...._......._._._......_..._...._....._.__._.. Ownv and/or represenhtive of the Owner or Owner, and is duly authorized to perform ar have pafotmed the said work and to I ~ make and file this appliation; that aV sta[emmts contained in this appliation arc true to the best of his knowledge and belief; and I ( I that the work. wiU be pis formed in the manner set forth in the applioUOn fded herewith. Sworn to before me this; ~ .......~...>.C~ .day of.... 2012_ ~ ; Notary Pubh._~.1 . j 11+yuazedAppford) SWPPP Assessment FORM: 031? LYNDA M NOTARY PUBLIC, State of New York N0. 07606020932, Suffolk Cou Term Expires March 8, 20 01-23-12;13:35 4214652 # 1/ 2 ho~~OF SU~/,ry~ Town aiallMnex ~ ~ Telephone (68U 765-180E sa37sa~ainasma er.richertC~t'"~ml ~ r.o.tae~aa79 rog ~0~. ,s souilwld AtY a asra-0959 SUII.DING DEPARTMT~'1V1' TOWN OF BOUTHOLD APPLICATION ~OI~ ELECTRICAL INSPECTION REQUESTED BY: ~ a//i3 /a- pate: !d r7 !a Company Name: 1 ti-+ TS ~Z2can4 c ~1~ Name: T ~ M ,-y License No.: 3 3 ~7~- . Address: ~ yc7 ~cw yan-/ti ~u ~ 1 nK roN //may Phone No.: ~$I6 - r7 ~ d - cr3 S JOBStTE INFORMAT{ON; ('"Indicates required information) `Name: G-I$Ntie d- T-~,~a.~esa m~~~~ _ "Address: 7~ (;1J-f~$ i~`~19~t p ~ owha ~.D M /~y'~f~ `Cross Street: Ji/~„~ ~ S /!,d ~p Permit No.: 3 7 N~1(~r Tax Map District: 1000 Section: ~ BbCk: !_ot: di~• / 'BRIEF DESCRIPTION OF WORK (Please Print Clearly) _ ~9h ~y o ~ S r~ 3 uo Psrr~ p ~t C~ ~Pwace arcie an That apply) `is lobs ~Y for ia>specdon: ~ NO ugh In Final `Do you need a Temp Certifleate: S NO Temp Informatiorr(tfneaded) `Service Size: 1 Phase 3Phaee 100 1'50 200 300 360 440 Other `New Service: Re-connect Underground Number of Meters Change of Service Overhead Additional Information: PAYMENT DUE WITH APPLICATION 82-Request for lnepectlon Fortn ~ ~ ~ ~ - m ~ ~ " TOWN OF SOUTHOLD PPPP~OPERTY RECORD CARD ER STREET ~ VILLAGE DISTRICT SUB. LOT ;I,nst~ kQ~.~~q-hrtLM~(~gnal>r~ ~~s' ~A-~r~ .5~ FORMER OWNER~hr~s+flfhnrMcKtnaa E / k - ACREAGE g r y~/ ~ _ ` TYPE OF BUILDING RES. ~D SEAS. VL. FARM C~SM;M. INS: CB. ~ MISC. LAND IMP. TOTAL DATE REMARKSS Z ~iN e a' e 0 c.r~ i ~d iP Cc/io~?~ d - 330 dN~o~ ~Z /iNTh+.ln~ ~eTz~P~~nFi L x fws~' L- /'9~ ~J 40 02 A D ~O l4 S'ao _ 2a ,MrT c/ F• ~.~T. .<_.-p.,._ 3 / U O gl ? v I~L~-`~70 ~ / 7~~ct/~/c~.?.Nr'~~~60 7~ .~/N~AS.t+_1Jr~~... ~~c- ~foari~ FC'. - p ~ Sa D S5~ ~ 0 ~2-b ' 4 a/R~ - Jo~rr~d ~ ~rc~, s - LS t9a n5~o X06 4 e oc `1~U ING CO ~ 9 ~ ~ ~ z AL ELO - L~ ABOVE_ / r ~ ~ /,S~a~aN Cl1Cte~`oya~ T /~S~ ~ Farm Acre Value Per Acre Value Y 2 p' Tillable 1 _ Q 0 e - ~?C ~ !~./r _ Tillable 2 _ ~ ~ - Tillable, 3 _~~a3 4 J~NlG( ~ `~~~~`,i - w~adla„a l z 6-L 2 3_?~~`{9~ ~c~Pvr~ta 7~U /Uc ~ 7us~ ti/~ Swompland y ~Yl Z ~ M~~Pn~a (L~I/) S ~1~f Brushland ~ ' / l3 - Z Z Z-' (YUJf T71 ~ r ~3ys' - - House Plot Tcta I , I I I - - x, - - il ~ - I f3 3. i - ov ~ ,~l1 t v1. Bldg. 1 ,2 ~ ?-~-w Foundation ~ ~ Bath xtension (jX ~0 r^ Basement ~ J-'Ur~f Floors ~~r l3 k ' _ / ~l Ext. Walls- a R, Interior Finish ~ - :xtension ! _ xtension C~ 3 3.'~? " ~ sire Place _ Head - , ~rrr~.G X p a $ G D Porch Attic -F ;Z~-- ~ j ~ O - Porc'n Rooms 1st Floor Bre ~ 8 Patio _ Rooms 2nd Floor Z.zX 2 11 L- Gar ye 1. ~ e~ $ S° ~ DrivewaY-- C;^ ~J t~ - - ~'d~Nad /U b ~6~ _ j~~p/~/ - - ' _ ~ROPEKTT KC~.VRV ~.r+nv ~7_.3T ~ S Z ~2 ~ VILLAGE DIST. SUB. LOT OWNER STREET / ,r t'~C d t`LF' E ACR. ~O FORMER~~O NER N~ ~"iSeL W TYPE OF BUILDING ' ~ ~.r SEAS. FARM COMM. CB. MICS. Mkt. Value :ES. VL..3/ IMP. TOTAL DATE REMARKS LAND z Ree t Q' E,iT. S~ ~Np a ~y G 16 y $ s ~ e . soo . sz /~e7,TC'ir'o%iPF.7 i u -9' ~!~-G - 3 C)--a 3 z-o 7 I ~ - AGE BUILDING CONDITION NORMAL BELOW ABOVE NEW Acre Value Per Value FARM Acre i FRONTAGE ON WATER Tillable FRONTAGE ON ROAD ~ Goo 30-0 Woodland DEPTH Meadowland BULKHEAD • House Plot - DOCK I Total o~~pf SO(/ryo Town Hall Annex y~ ~ Telephone (631) 765-1802 54375 Main Road T ~ Fax (631)765-9502 P.O. Box 1179 Southold, NY 11971-0959 ~ ~~~OOUNi'1,~` n BUILDING DEPARTMENT Ca`~ C~ TOWN OF SOUTHOLD September 19, 2013 ~y'~~~ a,~ ~ D Glenn & Theresa McCarty ~ 51~ 24 First Street ~ ~p5 ~ East Rockaway, New York 11518 ~ ~ ~ $~~{~V ~ TO WHOM IT MAY CONCERN: L,`1 The Following hems (if Checked) Are Needed To Complete Your Certificate of Occupancy: , Application for Certificate of Occupancy. (Enclosed) t ,,,,,,nom ~ Electrical Underwriters Certificate. (contact your electrician) 1N~ ~ ~I~j "'~`"L ~3 A fee of $50.00. e ~ G , L'~ y~ Final Health Department Approval 1/" Plumbers Solder Certificate. (All permits involving plumbing after 4!1184) Trustees Certificate of Compliance. (town Trustees # TBStssz) Final Planning Board Approval. (Planning # 765-~s3&) Final Fire Inspection from Fire Marshall. Final Landmark Preservation approval. Final inspection by Building Dept. BUILDING PERMIT : 37446-Z New Dwelling Generated by REScheck-Web Software Compliance Certificate Energy Code: 2010 New York Energy Conservation Construdbn Code Location: Suffolk County, New York Conshutfiion Type: Single Family Glazing Area Percentage: 11% Healing Degree Days: 5750 Climate Zone: 4 Construction Site: Owner/Agent: Designer/Contractor: 330 Wesland Road Southold, New York 11971 Compliance: 9.9X Better Than Coda Maximum UA: 507 Your UA: 457 The % Better orworsa Then Cotle imiu raflesta how close m mmpRmm the house ie Weatl on cetle eatlsalr rubs. h GOES NOT prwiEe en saGmab M energy uce or cost nlaG~e m e minimumcvtle home. Ceiling: Flat or Srdssor Truss 1156 30.0 0.0 40 Ceiling: Cathedral 256 25.0 0.0 10 Wall: Wood Frame, thin. o.c. 3275 15.0 0.0 225 Window: Wood Fmme, 2 Pane w/ Low-E 297 0.280 83 Door: Glass 43 0.320 14 Door: Slid 19 0.650 12 Basement: Slid Concrete or Masonry 912 15.0 0.0 54 Wall height: 8.2' Depth trelow grade: 5.8' Insulation depth: B.2' Window: Wood Frame, 2 Pane w/ Low-E 16 0.280 4 Door: Solid 19 0.200 4 Floor: AIFWOOtl JoisVTruss Over Uncond. Space 344 30.0 0.0 11 Compliance Statement: The proposed building design described here is consistent with the twikling plans, specifications, and other calculations submitted whh the permit applicafion. The proposed buikfing has been designed to meet the 2010 New York Energy Conservation ConsWcfiar Code requirements in REScheck-Web and to compy with the mandatory requirements listed in the RESGreck Inspec8on Cheddist. ~ /7 Name - Trtle ~ J Signature t 5 0 / Q~ ~F NE`N y0 _ Project Trtle: Data filename: Repot date: 07/27/12 Page 1 of 5 Generated by REScheck-Web Software Inspection Checklist Energy Code: 2010 New York Energy Conservation Construction Code Locafion: Suffolk Courdy, New York ConsWcgon Type: Singks Family Glazing Area Percentage: 11 Heating Degree Days: 5750 Climate Zone: 4 Ceilings: ? Ceiling: Flat or Scissor Truss, R-30.0 cavtty insulation Comments: ? Ceiling: Cathedrel, R-25.0 cavity insulation Comments: Above-Grade Walls: ? Wall: Wood Frame, 16in. o.c., R-15.0 ravky insulation Comments: Basement Walls: ? Basement: Solid Concrete or Masonry, B.T M / 5.8' b9 / 8.2' insul, R-15.0 ravity insulafion Comments: Windows: ? Window: Wood Frame, 2 Pane w/ Low-E, U-factor: 0.280 For windows without labeled U-factors, describe features: #Panes -Frame Type Thermal Break? _ Yes - No Comments: ? WirMow: Wood Frame, 2 Pane w/ Low-E, U-factor: 0.280 For windows witlwut labeled U-factors, describe features: #Panes _ Frame Type Thermal Break? _ Yes No Comments: Doors: ? Door: Glass, U-factor: 0.320 Comments: ? Door: Sdid, U-factor: 0.650 Comments: This door is exempt from the U-factor requirement. ? Door: Solid, U-factor: 0.200 Comments: Floors: ? Floor: All-Wood Joist/Truss Over Uncond. Space, R-30.0 cavity Insulafion Comments: Floor insulation is installed in permanent contact with the underside of the subfloor decking. Air Leakage: ~ Jofnts (incuding dm jdst junctions), attic access openirgs, penetrations, and all otlrer such openings in the building envebpe that are sources of air leakage are sealed with caulk, gaskeled, weatherstripped or otherwise sealed with an air bartier material, suitable film or solid material. Project Title: Data filename: Report date: 07/27/12 Page 2 of 5 ' ~ Air barter and sealing exists on common walls between dwelling units, on exterior walls behind tubslshowers, and in openings between windowldoorJambsend framing. ~ Recessed lights in Me building Mermal envelope are 1) type IC rated and ASTM E283 labeled and 2) sealed with a gasket or caulk between the housing and the interior wall or ceiling covering. ~ Access doors separating conditioned from unconditioned space are weather-stripped and insulated (without insulation compression or damage) to al leas) the Ievei of insulation on Me surrounding surfaces. Where loose fill insulation exists, a baffle or retainer is installed to maintain insulation applicetbn. ~ Wood-burning fireplaces have gasketed doors and outdoor combustion air. ~ Automatic a gravity dampers are installed on all outdoor air intakes and exhausts. Air Sealing and Insulation: ~ Buiding enveope air tightness and insulation installation complies by eaher 1) a post rough-in blower door test result of less Man 7 ACH at 50 pascals OR 2) the following items have been satisfied: (a) Air barriers and Mertnal bartier: Installed on outside of air-pemreable insulation and breaks or joints in the air barrier are filled or repaired. (b) Ceiling/attic: Air harder in any dropped ceilirglsofflt Is substantially aligned wiM insuWtan and any gaps are sealed. (c) Above-grade walls: Insulation is installed in substantial tooted and continuous alignment with the buikling envekrpe air barrier. (d) Fbors: Air barrier is installed at any exposed edge of insulation. (e) plumbing and wiring: Insulation is placed lxttween outside and pipes. Batt insulation is cut W fit around wrong and plumbing, or spreyedlbbwn ireutation extends behind piping and wiring. (t) Comers, headers, narrow framing cevtlies, and rim joists are insulated. (g) Shovredlub on exterior wall: Insulation exists between showersttubs and exterior wall. Sunrooms: 0 Sunrooms that are thermaly isolated from the building envekpe have a maximum fenestration U-fador of 0.50 and Me maximum skylight U-fador of 0.75. New windows and doors separating Me sunroom from conditioned space meet the buiding thermal enveope requirements. Materials Identification and Installatbn: ~ Materials and equipment are installed in accordance wiM the manufadurers installation instrudions. ~ Materials and equipment are identlfled so that compliance ran be determined. ~ Manufachirer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. ~ Insulation R-values and glazing U-tadors are Beady marked on Me building plans or spedfications. Duct Insulation: ~ Supply duds in attice are insuated to a minimum d R-8. All other ducts in unconditioned spaces or outside Me building envelope are insulated to at least R-8. Duct Construcflon and Testing: ~ Building naming cavities are not used as supply duds. ~ Ail joints and seams of air duds, air handlers, fitter boxes, and build'mg cevRies used as return duds are substantially airtight by means of tapes, mastics, liquid sealants, gasketlng or oher approved dosure systems. Tapes, mastics, ant fasteners are rated UL 181A or UL 181 B and are labeled according to tire dud consimdion. Metal dud oonnedions wflh equipmem ardlor fittings are mechanicelty fastened. Crimp jonts for round metal duds have a tooted lap d at least 1 12 inches and are fastened with a minimum of Mree equalty spaced sheet-metal screws. Exceptions: Joint and seams covered with spray polyurethane foam. Where a partialry inaccessible dud connedion exists, mechanical fasteners can be equaly spaced on Me exposed portion of Me joint so as to prevent a hinge acted. Continuously welded and kxicing-type kxgttudinai jdnta and seams on ducts operating at less than 2 in. w.g. (500 Pa). ~ Dud tightness test has been performed and meets one of the following test crfleda: (1) PostconsWdion leakage to outdoors test Less Manor equal to 8 dm per 100 ft2 of conditioned fbor area. (2) Postconshodion total leakage test (indudirg air handler endosure): Less than or equal to 12 dm per 100 tt2. (3) Rough-in total leakage test wiM air handler installed: Less Man or equal to 6 dm per 100 a2 of cond8ionad floor area. (4) Rough-in total leakage test without air handler installed: Less Man or equal to 4 dm per 100 fl2 of odrditioned floor area. Temperature Controls: ~ Where Me primary heating system is a forced air-furnace, at least one programmable Memxrstat is installed to conlyd Me prmary heating system and has set-prints initialized at 70 degree F for ttre hating cycle and 78 degree F for the coding cycle. Projed Title: Report date: 0727/12 Data filename: Page 3 of 5 ' ~ Heat pumps having supplementary eleddo-resistance heat have controls Mat prevent supplemental heat operation when the compressor ran meet the heating bad. ^ Heating and Cooling Equipment Sizing: ~ Additional requirements for equipment sizing are included by an inspection for compliance with Me International Residerrtial Code. ~ For systems serving multiple dwelling units documentation has been submflted demonslreting compliance with 2009 IECC Commerdal Building Medranical andlor Service Water Heating (Sections 503 and 504). Ciroulating Service Hot Water Systems: ~ Circulating service hot water pipes are insulated to R-2. ~ Circulating service hot water systems indude an automatic or accessible manual switch to turn oR Me dreulating pump when the system is not in use. Heating and Cooling Piping Insulation: ~ HVAC piping conveying fluids above 105 degrees F or chilled fluids bebw 55 degrees F are insulated to R-3. Swimming Pools: ~ Heated swimming pods have an onlofl heater swttch. ~ Pool heaters opereting on natural gas or LPG have an electronic pibt light. ~ Timer swttches on pool heaters antl pumps are presets. Exceptions: Where public health standaMs require continuous pump operation. Where pumps operate within solar- arMlor waste-heat-recovery systems. ~ Healed swimming pools have a cover on ar at Me water surface. For pods healed over 90 degrees F (32 degrees C) the cover has a minimum insulation value of R-12. Exceptions: Covers are not required when 60% o/ the heating energy is from site-recovered energy or solar energy source. Lighting Requirements: ~ A minimum o/ 50 percent of the lamps in pennanentiy installed lighting fixtures can be categodzed as one of the following: (a) Compad fluorescent (b) T-8 or smeller diameter linear fluorescent (c) 40 lumens per watt fa lamp wattage 15 (d) 50 lumens per watt for lamp wattage > 15 end 40 (e) 60 lumens per watt for lamp wattage > 40 Other Requirements: ~ Snow- and Ice-matting systems with energy supplied from Me service to a building shall include automatic controls cepeDle of shutting off the system when a) Me pavement temperature is above 50 degrees F, b) ra predpilation is falling, and c) the outdoor tempereture is above 40 degrees F (a manual shutoR confrol is also permitted to satisy requiremem'c'). Certificate: ~ A pemnanent certificate is provided on or in the elechical distribution panel listing Me predominant insulation R-values; window U-fedora; type and eflicienq of space-conditbning and water heating equipment. The cer5licate does not cover or abstrud Me visibility ~ of the dreutt diredory label, service disoonrned label or oMer required labels. NOTES TO FlELD: (Building Department Use Ony) Pnojed Title: Report date: 07/27/12 Data fibname: Page 4 of 5 ~ 2010 New York Energy ,Conservation Construction Code Certificate Gelling I Root 30.00 Wall 15.00 Floor / Foundffilon 15.00 Ductwork (uneondRionad spaces): Window 0.28 0.34 Door 0.32 0.24 Hearing System: Cooling System: Water Heater: Name: Date: COmmeMS: