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HomeMy WebLinkAbout37817-Z N'~~~ Town of Southold Annex 9/26/2013 ~ P.O. Box 1179 54375 Main Road ~~q Southold, New York 11971 ~ ~r CERTIFICATE OF OCCUPANCY No: 36537 Date: 9/26/2013 THIS CERTIFIES that the building ALTERATION Location of Property: 250 Center St, Mattituck, SCTM 473889 Sec/Block/Lot: 123.-2-21.3 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this otEced dated 2/5/2013 pursuant to which Building Permit No. 37817 dated 2/15/2013 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 and deck addition to an existing one family dwelline as applied for. The certificate is issued to North Fork Investors LLC (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 37817 9/25/13 PLUMBERS CERTIFICATION DATED 9/24/13 ttituck Plumbing & Heating - - - A o ' ed Si ature TOWN OF SOUTHOLD ~ BUILDING DEPARTMENT ~ G. TOWN CLERK'S OFFICE 'n®~ti~ SOUTHOLD, NY a.1 f 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 37817 Date: 2/1512013 Permission is hereby granted to: McGunnigle, Judith County Rd Peconic, NY 11958 To: construct alterations 8~ a deck addition to an existing single family dwelling as applied for At premises located at: 250 Center St, Mattituck SCTM # 473889 SeclBlocklLot # 123.-2-21.3 Pursuant to application dated 2/5/2013 and approved by the Building Inspector. To expire on 8/17/2014. Fees: SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $654.40 CO -ADDITION TO DWELLING $50.00 Total: $704.40 f~,ri r C,' 1 !~6^ 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 [he Building Department with the following: A. For new building or new use: I. 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). 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 I % lead. 5. Commercial building, industrial building, multiple residences and similaz buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: I . Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. A properly completed application and consent to inspect signed by the applicant. I f a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to [he applicant. C. tees I . Certificate ofOccupancy -New dwelling $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00, Swiinining pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, Businesses $50.00. Z 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 ofOccupancy -Residential $15.00, Commercial $15.00 Date/. ~ _ ~ ~ ~ ~ New Construction: Old or PrLe-existingLBuilding: ? (check one) ~n J,~. 1 Location of Property: L S ~ CC n l e ~ ,7 ~ • IA 4 { t T t~ 1~ House No. Street Hamlet Owner or Owners of Property: ~1 p 2T>7 {~,t-tc i 'V"€~'tj!f.J LLB- 2 Suffolk County Tax Map No 1000, Section ~J Block Lot t~~~3 Subdivision q Filed Map. Lot: Permit No. 3 ~ 0 ~ ~ Date of Permit. 02 S /.~J Applicant: Health Dept. Approval: Underwriters Approval: Planning 6oazd Approval: Request for: Temporary Certificate Final Certificate: (check one) C~ Fee Submitted: $ ~-fl - lf~f _ ~ v _ Applicant Signature ~o~~pf SOUryolo Town Hall Annex yy Telephone (631) 765-1802 54375 Main Road T ~ Pax (631) 765-9502 P.o. eox t 179 c Q roger.richert(p~town.southold.ny.us Southold, NY 1 197 1-0959 '.lam ~ ~~'~OOUNTI ,N~ BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: North Fork Investors LLC Address: 250 Center St City: Mattituck St: NY Zip: 11952 Building Permit#: 37817 Section: 123 Block: 2 Lot: 21~ WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: homeowner DBA: License No: SITE DETAILS Office Use Only Residential X Indoor X Basement X Service Only Commerical Outdoor X 1st Floor X Pool New Renovation X 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph 150a Heat gas Duplec Recpt 26 Ceiling Fixtures 8 HID Fixtures Service 3 ph Hot Water GFCI Recpt 7 Wall Fixtures 8 Smoke Detectors 3 Main Panel 150a A/C Condenser Single Recpt Recessed Futures 5 CO Detectors 1 Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances dw Dryer Recpt 1-30 Emergency Fixture Time Clocks Disconnect 150a Switches 22 Twist Lock Exit Fixtures TVSS other Equipment: 150a overhead service, 1-exhaust fan, 7-ARC fault circuit breakers Notes: Inspector Signature: ~ 1 Date: Sept 25 2013 81-Cert Electrical Compliance Form.xls ~~o. . ~ ~ ,~~~Fp ~ 201~~ ; H:II. 37093 Mein Rood O ~ :x t ~ P O Box 1179 yif~o~ •~QQI' I ~ Telepf\o r (6] 7 i;-"•.= ~tw York 11971.0939 J~( L~_-__-.~ I C BUII.DINd'DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Dale: Building Permit No. ~ ~ ~ ( 1 0+iner: Nol~n Co~l.c Z~a/tS~ocs LLL Plumber: -//~.t~-.~ac,l~ ~1 • %hlrl ;mac •r /7~„~ (Please prinQ l cenify shat the solder used in the water supply system contains less than 2/ 10 of I °r~ lead. um ers Signature) S++orn to before me this ~y' ~a~•oi . kvr~', 20'.,GZ, ~ CHELSEA L. CHALONE /~~t ~ Notary Public, State of New York Registration •O1CH8287108 l]ualified In Suffolk County Commission Expires August 5, 2017 ~oiary Public; S`;~~~- County 3 ~ g~ 7 ~o~MUe sou,,y~ TOWN OF SOUTNOLD BUILDING DEPT. 765.1802 INSPECTION [ ]FOUNDATION 1ST [v~OUGH PLBG. [~UNDATION 2ND [ ]INSULATION FRAMING /STRAPPING [ j FINAL [ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION ( FIRE RESISTANT PENETRATION [ ]ELECTRICAL (ROUGH) [ ]ELECTRICAL (FINAL) REMARKS: ~.s"'r-~`'S- ~ ' ~.~c Ur~ ~ ---~--~~r~-~-~= cam. DATE D7 ° ~ ~3 INSPECTOR -v ~o~~,OF 30llT,y~6 f ~ / ~b ~ TOWN OF SOUTNOLD BOIL ING DE 765 1802 'L~ 1 l 1~ INSPECT ON ~ ' [ ]FOUNDATION 1ST [ ] ROUG LBG. [ ]FOUNDATION 2ND [ ] INSULATIO [ ]FRAMING /STRAPPING [ ]FINAL [ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION ~ [~]~ELECTRICAL (ROUGH) [ ]ELECTRICAL (FINAL) REMARKS: DATE ~ l INSPECTOR ~,~,OF SOf/l~ ~ '~IbIMI'1 TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 1 NSPECTION [ ]FOUNDATION 1ST [ ] R GH PLBG. [ ]FOUNDATION 2ND [ INSULATION [ ]FRAMING /STRAPPING [ ]FINAL [ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION [ ]ELECTRICAL (ROUGH) [ ] ELECTRICAL F AL) REMARKS: DATE ~ l © ~ INSPECTOR ~ ~ TOWN OF SOUTNOLD BUILDING DEPT. 765.1802 INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. FOUNDATION 2ND INSULATION [l [ ]FRAMING /STRAPPING [ ]FINAL [ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION [ ]ELECTRICAL (ROUGH) [ ]ELECTRICAL (FINAL) C REMARKS: ~ ~~S\~S (.c J~.Jr~9-~C' DATE ~ 3 INSPECTOR \ 3 ~ 3NUF 801/ly_ f®# l TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 IN PE T10 S C [ ]FOUNDATION 1ST [ ] ROU PLBG. [ ]FOUNDATION 2ND [ ] 1 ULATION [ ]FRAMING /STRAPPING [ FINAL [ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION [ ]ELECTRICAL ,ROUGH) [ ]ELECTRICAL (FINAL) REMARKS:V~ )GJ~ r . - , DATE '°3 INSPECTOR I " O~~,Of SOIJTy~ 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 CONSTRUCTION [ ]FIRE RESISTANT PENETRATION [ ]ELECTRICAL (ROUGH) ELECTRICAL (FINAL) REMARKS: L--G~-- G(.~ DATE INSPECTO - - co~~~ ~ N ~D~ DA's' UQ ~pp~Ort (1sTa ~ x ~ ~ fly ` 'J ~ ~G& i goV ~~p,XNG ~ 1 a r ~~,~zoN ~y c D~ szw'~B~ _ ~ cox~~TS ~ o ~DTTiar~AL ~ m ~ _ ~ ~ ~ 1G i S i r~ T0~~1tN OF SOUTHOLD BUILDING; PERMIT APPLICA"PION CHECKLIST' BUILDING DEPARTMENT Do you have or need the following, before applyirig'I- TOWN HALL Board of Health SOUTHOLD, NY 11971 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey SoutholdTown.NorthFork.net PERMIT NO. 3 Check ~ Septic Form N.Y.S. D. E.C. Trustees C.O. Application Flood Permit Examined ~ ~20~ Single & Separate Storm-Water Assessment Form Contact: i Approved 1~' ~_~20 Mail to: Disapproved a/c Phone: (.P S - y 3 Expiration ~ ~ 20 ~ [3uilding Inspector rr II C I PLICATION FOR BUILDING PERMIT FE8 - 5 2013 Date 13 , zo INSTRUCTIONS 1 r~ ~tl~p -a-`Yfiis application MUST be completely filled in by typewriter or in inl: 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 loe 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 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 Depaivnent fbr the issuance of a Building Permit pursuant to the Building "Lone 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 fa' necessary inspections. 6 ~F (Signatw'e of applicant or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Dw~~-2 _ Name of owner of premises Jed ~ 1 f y~ii l< l.N tf'f ~PNi`~, (.1- (As on the tax roll or latest deed) [f ap licant is a co ra on, signature of duly authorized off cer ! (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 will be done: House Number Street 1a~ ~ ~ inlet iht:'f ure'~ `c ~'.:.h R `.a`-i ~uHe~bl County Tax Map No. 1000 Section_~~ _~„8~~~~I' "~'FO ~`1 Lot a~ 3 ...,...--~Od '~ul. ,>ya ttc.:a~r~t=a:e,;a ' Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing usf; and occupancy 5 t U l.% ~ n t ~`fi ~ 9C/~ C~ b. Intended use and. occupancy 5 < <-~-L-'z- - ~,~1T"t I `-"1 ,/LL-~ ~ D z" 3. Nature of work (check which applicable): New Building Addition Alteration _ Repair _~_Removal Demolition Other Work (Description) 4. Estimated Cost ~o,~ Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units ~ Number of dwelling units on each floor If garage, number of cars ~ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. _ 7. Dimensions of existing structures. if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front_ Rear Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated y~ 12. Does proposed construction violate any zoning law, ordinance or regulation? YES_ NO 13. Will lot be re-graded? YES` NOX Will excess fill be removed from premises? YES_ NO~ p orrlt S CA'"c'" /roc<.~t1.tE c:-•c_ ,~,t ~ ~ i 14. Names of Owner of remises r' f°n« IN~'~Address I18 F11`19a?~- (Cy Phho ~~~~N~~~~o.t o,~~~ Y7•~- %~~9 Name ofArchitec;t ~o84Ar ~?r~G-r- Address~~~XfrttSSw~~`"11)r-S~1'hone'~No j~~r~9 Name of Contractor muJsvGr~- 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 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 l 0 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 Ol~~~ C~^~`-1 G t-~'P ~1~'~ being duly swarn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the ~N/kCrlNG-` A't4J~ 6 (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 fife 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. Sw rn to before me e~}s day of t ' O~E~5Y A. PERKINS INI,,, ~ h'rvi r'o ><tc , dv s T+~ ^s', c~ ~ Notary Publb, State of NewlfroSt`~ hx, ~B iPE819083@ - otary ublic Q~1Hed 10 SuHOik Signature of Applicant 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) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey _ SoutholdTown.NorthFork.net PERMIT NO. ~ 7g~~ Check _ Septic Form N.Y.S. D. E.C. Trustees C.O. Application Flood Permit Examined ~ ~30_~ Single&Separate___ Storm-Water Assessment Form Contact: Approved_ ~20 ~3 Mail to: ~ Disapproved a/c _ _ - - Phone: ~.P ~ - y ~J Espuation ~ ~0 \ . ~~I'i ' ' ~ ~r'll; Building Inspector I ~ PLICAT[ON FOR BUILDING PERMIT I,,I I_'; FEB -5 2014-~ ~ ~ Date ~ 3 , 20 " - INSTRUCTIONS 1 o ~ ~ _ . ~a'`flfis 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 he occupied or used in whole or in part for any purpose what so ever until the Buildin_ 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 ar has not heen 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 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. (Signanire of applicant or name, if a corporation) (iS An~Do?~ ~ o c ~Lv[.LE t t (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ~ 1 ~vti 1< /Ntl~ ~'Nz~J l._. (As on the tax roll or latest deed) [f ap licant i^s a cor ra on, signature of duly authorized officer (Name and title of corporate officer) Bui Iders License No. Plumbers License No. Electricians License No. Other Trade's License No. L Location of land on which proposed work will he done: ,3 sU cc nlrL~- ~ R ~ t ~ , vc }{ouseNumber Street 8!+~"~t3'~`I~~ti~-~~' mlet_ 7ht!'lMre~l 4c, H': ~it:::a'~i ~(w3cV! CowrtyTaxMapNo. 1000 Section /~3 B~ Lot ca~~ 3 .,,,~~8t t~uLtx:y.J tk::u,tur~c~ Subdivisiat 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 g t r~ (T t.c n t ~ S ~ ~<N c~ b. Intended use and occupancy S ~ ~'~-Y, ~M7h I W i~C ~ ~ D z- 3. Nature of work (check. which applicable): New Building Addition Alteration _ Repair ~F:emoval Demolition Other Work (Description) 4. Estimated Cost~;,~ O~J Fee (To be paid on filing this application) 5. [f dwelling, number of dwelling units ~ Number of dwelling units on each floor ~ If garage, number of cars N ~ 6. if business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front_ Rear Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated v 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will loi be re-graded? YES_ NOX Will excess fill be removed from premises? YES NO~ 14. Names of Owner of premises Noon ~ Fani< l~diAddress I I g ~ r1Do ?p~ (t~ ~pho~t~N,~o. ~ ~ Y7'~- ~ D Name of Architect R-o g4>' t` C~!~~~~'r`- Address47fr EXfr~SSwa`'I D~.f~ P'h~tone' N"o~,~ ~~i~~~~.~ , =,gv y Name of Contractor oWN~- Address Phone No. l 5 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOI.D 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. [f 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 O15~~~) (~/c.A'l G- ~-~•/~f h~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the M~}r~+'~rFlNlr h~(4J'~ 6'rit..- (Contractor, Agent, Corporate Ofticer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and Fle this application; [hat 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. Sw rn ro before me thjs JJD !'-~it'o ~l< ~ tn/?C d'~» nS, day of L3 ~~y'0~ry~ ~~.`ry~~y-~~Py~~ ^ t PE8130~0 otary ublic Q~lry~ ~ SUHOIk Signature of Applicant Comrrttcrlon F.tq~lrw JuyCa ho~~,oF so~ly~~ Town Hall Mnez ~ ~ Telephone (6317 765-1802 54375 Main Road H (631) 765- 50 P.O. Box l l79 ~ • roger.richertCr~~ownsout~io~d.nv.us Southold, NY 11971-0959 _O Y~ BUILDING DEPARTMENT TOWN OF SOUTIiOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: (~t V -E~~~`~ .Date: ~t ?A ( 3 Company Name: n ,c-t'7i( -f o 2 ~ t U rL~ (c~ I.LG Name: G'fLPru- A-4 License No.: Address: Phone No.: t 7 ~ Y 3 1 JOBSITE INFORMATION: (`Indicates required information) 'Address: yY~ Cam'`- i ~ -rf~~/UC~ *Cross Street: r~~}..n-ate o r..p~ *Phone No.: ~ 2 ' Permit No.: '3 Tax Map District: 1000 Section: Z?i Block: `Z Lot: Z ~ *BRIEF DESCRIPTION OF WORK (Please Print Clearly) (Please Circle All That Apply) *Is job ready for inspection: YE NO o gh In ~ Final *Do you need a Temp Certificate: YES / NO ,9~ b~ ~M Temp Information (If needed) ~/y',Y'~' `Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other *New Service: Re-connect Underground Number of Meters Change of Service Overhea Additional Information: PAYMENT DUE WITH APPLICATION ~ ~4 v 82-Request for Inspection Form 1~ i T WN OF SOUTHOLD~ PROPERTY RECORD CARD L 0 0 0 - ~ ~ 3 _ ~ Z(. I ..Z OWNER STREET 5 VILLAGE DIST. SUB. LOT~ ~ ~ q FORMER OWNER 1d E ~ ACR~ (L't~it Ct,~r f Givl o • TYPE OF BUILDING !ar S r; RES. ~ SEAS. VL. FARM COMM. CB. MICS. Mkt. Value LAND IMF. TOTAL DATE REMARKS C; ~ D O O v. GG f ~v v~ ~;vo /'do iv ~ .~'/'/v2~'9~ sga.;h, ~>/.u %'~J~'77 <!rG .~-5 ~ pOtl ~ ~~~'•~''y Fi c~AC ~s ,o ja /'c~wni~LVYrah -~f 'a ~/y. ~e ~r ~n T~~~, 1~L~gG - L t Q 194 n 3 45 -6i L~YYLFN -}o ~c G t N,,,~~~~~5 ('r+-k ~V'- L_r03~Zw3g4 - 1~/IcG~ua~~~( -_r ~~~+Ldr~~-~i~ ~F - I i "i'5 Ic~f- ~ ~o c ~ - c' flYYGIN -}i~ -'C©YY. G~~~a 6 ~ ~ ,t ~ ~/~~A i 5 D`L 11 ~Prl~i'C,uIY'rCtM'~lmo ~ .~L~r.nn~'.N --~3ofooo AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE i FARM I Acre Value Per Vclue Acre Tillable ~ FRONTAGE ON WATER Woodland i FRONTAGE ON ROAD 6'~ ~ ~ ~ u ~ _ U Meodowland DEPTH -2, f J House Plot BULKHEAD Total ' i DOCK r COLOR. Gd7-~ %i'.r.- TRIM W N ~ ""L I ,il I . - - ~ ~.:w ~ I ~ ~'i I 1 ~ r' , r e I M. Bldg. I x D e2.7s .25 SlI ~ , Extension ~ ~ i Extension I Extension Foundation ~ Both - ~ Dinette Porch. ' Basement ~ Floors. - f/ . K. Porch I Ext. Walls 5 ~ Interio~`Finish L ~ ~ LR. Breezeway (Fire Place ~ Heat y DR. Garage Type Roof Rooms lst Floor BR. pnr;~ Recreation Room Rooms 2nd Floor FIN. B ii Dormer Driveway Total i , ~ ff S 02/12/2013 23:31 16316542101 ROBERT GRUBER ARCH PAGE 01/08 Fax Caver Sheep ROBERT J. GRUBER, ARCHITECT ~ L~, FEB 1 4 2013 476 EXPRESSWAY DRIVE SOUTH I L-- 11~EDFORD, NY 11'763 ~ _ r, ~ ~ ~ PHONE: 631-654-4949 FAX; 631-654-2101 Name: ~ Organiization: y',~„• Fay: 7~s 9 ~ ' Phone: - From: Date: 3 Job 13 -o o ~i p ~ ~ Pages: Comments: `Eo-~P.o.,,,~+~j-moo, ~ ~-s Original will be miailed will not be mailed ~i N i SURVEY OF PROPERTY AT MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. 1000-123-02 21.3 SCALE.• 1'=30' .DECEMBER 12, 2012 STREET CENTER EDGE OF PAVEMENT ~ U11UTT POLE _ OVERHEAD W1RE5 - " " NS6'5T0 "E 100.00' ~ ~ ° a 2ae.za' >Cm u Y ~ J ~ y~.~ N p \ y ' ~ 45.e' x 329' 2D. ~ a~3 ~ 4 rn Z ~ ~ ~ o Q 20.3' 45.4' ~ 54.3' ~ C.E. Z7 '~/r~" Z 'Y` D ~ ~ ~ U1 O ~ C ~ N D ~ Z ~ ~ m rt m 2sw wAU. ~ o~ ~ R. POLE m'j ~ i ~S I N ~ J wAU za'w a.Yw p I W W ~ O , O it it ~ ~ ~ 0.6'5 0.5'5 ~s~ 0.5'E ~ ~N 586'SY00 ~ CHAIN LINK FENOF.100.~' ' N/0/F ANC~REW & DENISE PLASTtRAS i North Fork Investors, LLC ~~~F NElyyQ^ ~~cr Fidelity National Title Insurance Services LLC ~"~~~e*S !'._T2~ a~~,,5 r`''te ~ ~ / t ~y ~,,a iT e S S°d ~ 3 S ~ ~ 2. ~ F fat ~ ! .6 4~ to F e ~ ~ r ti 1 i AREA°23,300 SQ. FT. ~ ~ ! ~ ~ .~'~~`u 0. 49618 ANY AL7ERA770N OR ADDl710N 70 THIS SURVEY lS A VIOLATION CONIC YOBS, P. C. OF SECT70N 72090F 7H£ NFW YORK STATE' fDUCAflON LAW. (631) 765-5020 FAX (631) 765-7797 EXCEPT AS P£R SECDON 7209-SUBDINSION 2 ALL CERTffICATiONS P.O. BOX 909 HEREON ARE VALID fOR THIS MAP AND COP/£S THEREOF ONLY if SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR 1230 TRAVELER STREET 12-300 WHOSE S1GNA7URE APPEARS HEREON. ¦=MONUMENT SOUTHOLD, N. Y. 11971 02/>2/2@13 23:31 16316542101 ROBERT GRUBER AP.CH PAGE 02/08 fiEScheck Softvvara Version 4,4.4 Compliance Certificafie i _ I ~ - - ~ ~ Project Tltle: wells Residence -Proposed Interior and- Exterior Alterations `u L!, FEB 1 4 2013 ~i Energy Code: 2010 New York Energy Conservation f` L,____` Location: Suffolk County, New York ~ „I I I Conswctivn Type: Single Family _r. ' ~ { Projrxd Type: New Conatructlon CondiOoned FloorA7ea: 1,692 }t2 Glazing Aron Peroentage_ 14Ys Heating Degroe Deyv: 5750 Climate Zone; 4 Permit Date: Construction Site: owner/Agent: DesignerlCOntrector: 250 Center Street Robert Gruber Mettituck, NY Robert J. GnitN:r Architect 476 F~Ipressway DrNe So. MedfoM, NY 11763 631-654.4949 r Compliance: O.D% Belter'rhen Codo Maximum UA: 200 Your UA: 200 TTe x anMr or Wdee Th n Cade IM,u mdn,in ~ cMb In cdmplinnm thn hmun le nMad anmdn tmAn-on Nb6. k 110E$ NOT ivp.i4p M nedm-dn of ennrpy uon m nnrt min11M b n minr,vm•mdn Mmn. Envelope Assemblies Floor t: N4Wood Joist7rmss:Over UncondlNoned Space g40 19.0 0.0 44 GcMirg t: Flat Cer'Onp a Sdsaw 7rws 940 30.b D.0 33 Wa0 t: Wood Fmmc, 16' o.c. 1,072 t5.0 0.0 68 Window 1: Wood Frame:Douhle Pane with Ww-E 147 0,200 41 SHGC: 0.32 I~e(Ir 7: Solid 20 0,340 7 Door 2: So9d 20 0.340 7 Compliance Statement: the prepesed builQing doeign deeonbed hero Is ednsietent with tho building plans, specifications, and other cabula0als submitted with the permit appNcation. The proposed building hoe been dosigned to meet the 2010 New York Energy Conxrwatlen CoruWCBon Code roquirements In RESCherk. Version 4.4.4 and to campy wiM Ne mandatory requirements listed in Ufa REScheck InspeUlon CheckNst. Name- SignaNre Date ,g~kp[D ,~~G 0~S d. g,~ rFO~ 6 _'7i - Pigott Title: W¢Ils Resldenee -Proposed Interior and EMerior Alterations ~j L9B71 Report date: 09J13/13 Data fil¢name: FaOLD FSIIRES COM CHECI<lREScheckWoh #13-007.rck R~' ~ ~ Paae 1 of E 02/i2/2013 23:31 16315542101 ROBERT GRUBER ARCH PAGE 03/08 REScheck Software Version 4.4.4 Inspection Checklist Requirements: 0.0% were addressed directly in the REScheck software Text in the'CornmentstAssumptions" column is provided by the user in fhe REScheck Requfrernents screen. For each requirement, the user certifies that a code requirement will be met and how that is doWmented, or that an exception is being claimed. Where compliance ~ Is itemized In a separate table, a reference to that table is provided. 201 ~ PlansVCriflstl FeldVkxlfted ~ ~ • York PralnspeetionlPtim'RavfpSJ, Value Walue Chihplios'7 CommemsfAssum~l0'ons En ~ " 103.2 . Cortstruulon drawings a,d ql i , ; n ' + Cpmphas , [PR1}' documontatlrn sutficlensy +II IL1 n i!,i[]poes Not Comply! t~ ~,demanshates energy code {i~rl>'+~ "~`!+i~`C[[NOl Observable ' clxnpuarxs tar the huildMg emebPo. fll [qu ~ , QNdt Applicable 103.2, lConsVUUbn drewings and MI ' ~ ~[,iCOmphes , 403.7 jdocumontati°n suffidentty I+; 1~pfir± ~ +'h;,ODoes Not Comply! (PR3p ~ demonstratss energy mde j ,PP' it a: " rj +r .QNOt Observable ' compllane° for ligFrting ead S t +i ~ ! .~„QNdt Apptiratxa mech,snic»I systems. Systems ssrving i'+In! tii ~ + , ; n;+r+mt multiple dwelling unAs must ;u,rilvy~ , (,,~~til ~'dem°»strate compliance with the + it ' + , eemmer°i»l Cede, 141 '+'~:,+r~,j ~ii ' d03,6 ~ ' Hsat(ng and eoWing squipmerd i» ~ Hcating~ .Healing' I CompFes ' }PIt2~, ~ r,, ~ 52ed per ACCA Manual S based en ~ 6Nmr` ~ Bto/hr_ 'I~Does Not Comply kreds p»r ACCA Manual J er other ;Cooling Cooling: ,[]NW Observable -d»pproved mettrods. I Blu/hr` Stu/hr_ 'QNet Applicable , Additional Comments/Assumptions: 1 High Impact (Tier t) 2 Medium Impacl (Ter 2} 3 Low Imp»ct (Tx:r 3) Project Title: Wells Residence -Proposed Interior and Exterior Alterations Report date; 02!13/13 Data filename: F:\OLD F51\RES COM CHECICtRESchecklJOb #13-D07.rck Page 2 of s 82/12/2013 23:31 16316542101 P.~BERT GP.UBER ARCH PAGE 04/09 x010 New Yorlc.: Foundadon Jnspectiom Complies ~ CordmegtslAssuHlptbris~ EnergL ~ 303.2.1 ; Expo4aed foundation Insulation it?Complies [FOttJa :protection. ?Daes Nat Comply ;4y ~?Nol Observable ~~~Not Applicable 403iE ' ; Snow metr contrds. ?Complles ~ (F0121r , . i ~?Ooes Noi Comply'. `I iii:.. '.?Not Observable ?NOt Applicable Additional Commerrts/Assumptlons: 1 High ImpaU (Tier 1 } ' 2. Medium Impact (Ter 2) 3 Low Impact (Tier 3) i Project Title: Wells Residence -Proposed Interior and Exterior Alterations Report date: 02!13/13 Data filename: F:10LD FS1tRES COM CHEC)CIRESCheckUob#13-007.rck Pace 3of fi 02/12/2013 23:31 16316542101 RLIBERT GP.UBER ARCH PAGE 05/08 2010New ~ ~ Plans Vahified Freltl Yarifred Yohk Framing 1 Rough=ln Inspsciion Value Value Carnphes? CommanislAgstmlptions Ere 402.4.4 ' Fenestration that g not site built Is ';!(~Gomplles [FR20J' ' listed and labeled as mceNng ?~9oss Nat Comply'' rZ, ~MMAANDMAlCSA r01A.5.7.lA440 or i ~ ,p:~pNOt Observable has InNIUaNen rates per NFRC 400 ~ QNot Applicable that do not exceed code limits. , 402.4:5. :IC-rated recessed fighting fixtures 1 , i ~'iC7COmpgea [FR16JF ~ sealed at housinghnterior finish and ` I•[]Doas Not Compy: ~,,yJ ; labeled ro indicate 8fC= 2.0 chrt Ir l ~ ~ y~i[]Nal ObsanvaDle ; taakage at 75 Pa. ~ !,„y Not Applicabb ' 403.$.1 • ~ Supply ducb in adiCa are insulated to ' R-_ _ R-_ nGomplias [FRt2J' IR-B. All other ducts in unconditioned R- ~ R- ~ODods Nat Comply; spaces yr outside the buiMing ~.[jNw Observable lerwelope ere insulated i0 R-8. Nel []Not Appllcable applicable N all s stems am ductless. 403.7..7. '~A0 joihly and xams of air duct^, air ' ! ~ ~;j~Complies ~i [FRt 3[' ;handlers, fitter boxes, and hullding i ~ h ' ~ 'p ~ ~ Does Not Compy :3Y Wvili96 used as return ducts are 1 ,I ~ rt ~ i ~ li:d~Not Observable ;sealed. , ° ~ h, I~; ~i Not Applicabb 403.2.3 :8ulldin. crrvities are rat used as duets i' ~ ~ q `-~Compges [FR18)3 or plenums. ~ ~';;I~i' ,;I~Does Not Comply, NY. ~ n ' ~ 3~ , ~C,[']NOt Observable I, ~ "rJ; p,,,I~Not Applicable 403.3 : tDlP.C piping cvttveying fluids above I R-~' R- ,C1COmp0es [FR171° ' ' 705 °F or chilled fluids below 55 °F I[aboes Nol Comply j ~ j are insulated to R-3. ~ :[]Not Observable ' ~ ~'pNot APDllceble 403.4 ~ : GirculaNng service hot water pipes ue R-,_ R-i I Camp6es [FR18J= ~ .insulated to R-2. I~Does Not Comply rt~i ~Nvt Observable ' ~ _ ~ ~,[JNOI Applicable 403 5 ~ ~ AummeNc ar gravAy dampers are i , ~ ` , r'', r Complies ~ _ [FRTg]4 { Inslaped on all outdoor ak intakes and , ~ i 4iS[]bces Not Comply, ; exhausts. ~ ~ I ` ~t11 ,j[JNot Observable n : ~ ~ ~ i'j ~Nbt Applicable ' Additional CommentslAssamptions: t High Impact (Tier 7) 2 Metlium Impact (Tier 2) 3 Low Impact (flat 3) ~ ~ Project Title; Wells Residence -Proposed Interior and Exterior Alterations Report date: 02N3l13 Data 111ename~ F10LD FS11RE5 COM CHECK1RESchecklJoh #13-007.rck Page 4 of 6 ROBERT GRUSER ARCH PAGE 06/08 0/12/2013 23:31 16316542101 2tl10~New ~ CnlnPlics~ Cnntmr'ntslAssumptilsn§ York InsulaUcn Inspcdtion ana 303.1. All ktstaltod Insulation labeled or !C7CompGes (IN13)z ~insGzllod R-vaWes provided- '~ODoos Not Comply' - i[]Nnt Observable Noi Appacabk Additional CommentB/AsSUmAtions: 1 Hlgb Impact (Tier 1) ~'l Medium Impact (Tlor 2) 3 Low Impact (Tier 3) Project Title: Wells Residenco -Proposed Imerior and Exterior Alterations Report date: 02/13/13 Data filename: F:10LD FS11RE5 COM CHECMREScheckUob #13.OOT.rCk v°^° F ° 92/12/2013 23:31 16315542101 P.OBERT GRUBER ARCH PAGE 07/08 2070New plansVcrlflad Field Veri6pd York. Final Inspection prwlslons~ ~ Complfes7 CbmmenWASSUmptlons Eher' ~Valua Value 402.4.7., IBullding envelope tighhrcvs vented ACN 50 I ACH 50 .?Complles 402.4.2.7 by blower door test resua d 6x;7 ACH ~ !?Does Not Comply [PITT[' ; at 50 Pa. This requirement may I[]NOt Observabo Mstead be met via visual inspection, ,[]Not Applicable I In which case venficsfion may need to occur during Insutgtion Inspe_c_tion. 402.a,3 ' Wood-burning fireplaces have _ i { ' + ~Camplies [FI8[?'..: : gasketed doors and vutdgor , 9"^ ' ~ r 4 I y i ~._-2?DOea Not Comply - ~ combustion air. 1 y , , ~ ~ ~?Not Observable ~ i_I{ I ~!?NotAppliwbla 403.2.2. ; Duet fighmesa via post-construction _ dm rirn ?Compties [F74)r Iwllh maximum leakage aF8 cirn to ~ ?Does Not Ctxnply:, 'outdoors, or 12 dtn across systems. ~ !?NOt Observable : For rough-in tests, v0rl8ralbn may j?NOt Applirable need to WryJr during Fromkl9 Inspection, with mazlmum leakage of ~ 8 crm across systems and 4 cfm lwllhout air hgndkr. a14; 7 , i I: 403.7:1 '.Programmable themiosuts installed ~ , t, 1 L ~ I xi.?COmpkes [FI9): ' 1 an toned air tumeces. I ~ , ' , ~'?DOes Not Comply II i"' - ~ [I ~~.I?Not Observable " ' + ii t , 1 h ~ i+~?NOt Applicable .,,4u..,y., 493.1:2 ';Heat p+nnp thermostat instilled on 41 'S Il ~jl?Compties LFY10)? :'she»t pumps. { ,i ,~'1,, , , + at l!)~?Does Not Comply yi, ~ j~ I 1 ci?Not Observablb x ' , • , ` ,~;3 `~"a^,?Not Applicable - 403.4'' ;Cirqulaling service hot wafer system I ' '?CompAes (Flitft ~ ihave ar>Tomatic or accessible manual ' g r'' +)li?DOes Not comply d3 j controls. , ~ , I 1 II w 'r, I,'I'{1?NOt Observable ' i-w. : rj: -.p~ N. IC,>;?NOt Applicable 403:9,7 ;Readily aecessibb swlich en heaters + i ' I i , ~ {s~?Compties (F172r~ for swimming pools. ; ~ I f.,ODOes Not Comply ' ~ , 7 ' i i";?Nel Observable :~i. h e, „ 403:9:2 ;Timer swltchos on pod healers and ~ , { , ),h ?Compties [F7t9N i, pumps are present. `i`,li!' "~,i ,;:?Does NOl Compy~, it i°i ''',i1 + 1a,'?N01 Observable ' !t+ u + y '~e) ..W?NOt Applk:gble 403:9.3 ',Heated swlmming pools have a cover ' ,,,1 , i7"?Compties (FI20[P Covers on pools healed over 90 °F + r , t, ~ ~,,{]boes Nol Comply ;are Insulated to R•12. + , I F~'• I ~ , ;y 1 ~i[4?NOt Observsble d07.3 ; Com Bence certificate steel _ { PI ' H + v ,lw 'r`?Compties (Fl~ ; :.2 P p° { lu A, , , , ^~i~?Does Not ComWY'. raj ~If ICI I{i 1`, b'~?NOt Observable I+, .t, ~ e•[]Not Applicable 303.3~~ ~~Manutaeturor manuals for mechanical illl kj i ' ~~hpl `~)~?COmPlles [FIi8j7 and water heating equipmem have ~ I, + y;l +d ! -?Doas Nat Canply'~ ;been provided. , lwl ~ ' , f rf I ,~I)?Nd Observable + Additional CommerrWAssumpt7ons: 1 Hlgh Iml>acl ier ~2 Medium Impact (ilor 2 3 Low Impact (Tier 3) Project Title: Wells Residence -Proposed interior and Exterior Alterations Report date: 02/13113 Data filename: F:10LD F511RES COM CHECMRESchetdtUob At13-OOZrck page 6 of 6 02/22!2013 23:31 16316542101 RQBERT GRUBER AP,CH PAGE 08!08 2010 ~le~v 'Yerl~ Energy ~onseruafiicn ~c~nsfirucfii®n bode Energy Efficiency Cerfiificafi~e wall 15.00 Floor 19.00 Ceiling !Roof 30.00 Ductwork (unconditioned spaces): Window 0.28 0.32 Doer 0.34 Heating System: Cooling System: Water Heater: Name: Dato: Commants~