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Afr�Fpp� }tom Town of Southold P.O. Box 1179 53095 Main Rd �y,Southold, New York 11971 y 631-765-1981 CERTIFICATE OF OCCUPANCY No: 37440 Date: THIS CERTIFIES that the building ALTERATION Location of Property: SCTM #: 473889 Subdivision: 1240 Glenn Rd, Southold, Sec/Block/Lot: 78.-2-30 Filed Map No. 2/18/2015 2/18/2015 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 1/8/2015 pursuant to which Building Permit No. 39500 dated 1/22/2015 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: "AS BUILT" ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to of the aforesaid building. Bissell, George & Burkhardt, Patricia (OWNER) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 39500 02-18-2015 10-15-2014 Peter Victoria Au t ed ignat re yzpz»" Ov�w i Permit #: 39500 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD,NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: Bissell, George & Burkhardt, Patricia 3901 SE St. Lucie Blvd Unit 54 Stuart, FL 34997 Date: 1/22/2015 To: "As built" alterations (finish second story to habitable space) as applied for per SCHD approvals. At premises located at: 1240 Glenn Rd, Southold SCTM # 473889 Sec/Block/Lot # 78.-2-30 Pursuant to application dated 1/8/2015 To expire on 7/23/2016. Fees: and approved by the Building Inspector. AS BUILT - SINGLE FAMILY ADDITION/ALTERATION $1,120.00 CO - ALTERATION TO DWELLING $50.00 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 I% 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. B. For existing buildings (prior to April 9, 1957) non -conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00, Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. 4�7/ Y d7 New Construction: Old or Pre-existing Building: V (check one) Location of Property: 12 0 LEN N O,,*!> '::;t_Y0ZT) House No. Street Hamlet Owner or Owners of Property: 45�e eoo' SCLC .0" /0A 7- OG U2kWP 2 Qi7 Suffolk County Tax Map No 1000, Section -;7B Block Lot �30 Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: 'l2A,t„(C LOLL Ccs l �1 �� Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ '5000 Final Certificate: V (check one) 1 Applicant Signature Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Telephone (631) 765-1802 Fax (631) 765-9502 roger. riche rt(a-town.southold.ny.us CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: George Bissell & Patricia Burkhardt Address: 1240 Glenn Road City: Southold St: New York Zip: 11971 Building Permit #: 39500 Section: 78 Block: 2 Lot: 30 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: AS BUILT DBA: License No: SITE DETAILS Office Use Only Residential X Indoor X Basement X Service Only Commerical Outdoor 1st Floor Pool New Renovation 2nd Floor X Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt 41 Ceiling Fixtures 1 HID Fixtures Service 3 ph Hot Water GFCI Recpt 4 Wall Fixtures 3 Smoke Detectors 4 Main Panel A/C Condenser Single Recpt Recessed Fixtures 5 CO Detectors Sub Panel A/C Blower Range Recpt Fluorescent Fixture 2 Pumps Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks Disconnect F1 Switches R32 Twist Lock Exit Fixtures TVSS Other Equipment: 4 -Exhaust Fans; 3- Paddle Fans Notes: Partially finished basement and finished attic (2nd floor) with 2 bedrooms. Inspector Signature: Date: February 18, 2015 14 Electrical Compliance Form.xls Building Permit No. CERTIFICATION Date: Owner: 97 -f -;C> 2 G-�, I S C L. L -- (Please print) Plumber: io Tj�2 V l (Please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this kc7 day of 20-(-q- Notary Public, IIC--County (Plumbers Signature) VICKI TOTH NoryNo 0 `&6640696 ttYyyork C9f��issiondExpiressJJu vc28 2 l� 'DF SOUIy� • �o TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ] FOUNDATION 1 ST ] FOUNDATION 2ND ] FRAMING/ STRAPPING ] FIREPLACE A CHIMNEY ] FIRE RESISTANT CONSTRUCTION ] ELECTRICAL (ROUGH) ] CODE VIOLATION [ ] ROU PLUMBING [ ] ULATION [ FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (FINAL) [ ] CAULKING DATE INSPECTOR OF SOpj�°!o TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLUMBING [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING/ STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) <;;"LECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: DATE � �� INSPECTOR���'�'�'�- " Ffts INVX N I�.Ei'OI�'T RATE CONIlVACNT3 FOUNDATION (1ST) C4 FOUNDATION (71ND) r ROUGH FliA11WQ & PLUMING INSULATION PER N. Y. y STATE ENERGY CODE 17 FINAL , wpm ulcii TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 p www. northfork.net/Southold/ PERMIT NO. 3 l �a Examined , 20 Approved, 20 Disapproved a/c Expiration7/, 20" '-2 1 BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans_ Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to:A(tK �f�lf{'���/ APPLICATION FOR BUILDING INSTRUCTIONS Date I-,)/ - O'7 - , 20� 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 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 p p i l\' t building for necessary inspections. authorized itis ectors on remrsesand (Signature of applicant or name, if a corporation) (Mailing address of applicant) I , State tVheiher applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises (As on the tax 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. or latest deed) 1. Location of land on which proposed work will be done: 124-0 L c,utir 4en4a Ly House Number Street Hamlet :J County Tax Map No. 1000 Section �� ''�'{,�tlo r 2 Lot Subdivision c:x F+lsd lap (Name) . 340 Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy II'j,� b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work /&7' (Description) 4. Estimated Cost 5 If dwelling, number of dwelling units If garage, number of cars Fee l� yc,Q m (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front 4_6 Rear ¢7 Depth 4 7, Height 7--' Number of Stories 2— Dimensions Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Height Number of Stories 9. Size of lot: Front /C_71,4-_7 Rear 9. ( Depth 2�1• Depth 10. Date of Purchase Name of Former Owner Z�C-h�y 11. Zone or use district in which premises are situated 12- 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO V 13. Will lot be re -graded? YES NO V Will excess fill be removed from premises? YES NO 14. Names of Owner of premises 64y5 'dW-9-:54W Qi./v�C t�ddress /Z nLl Phone No. G'�/ - Name of Architect L2�ilL aelyzz'rC 44 Address 'f OS Phone No l03/4 • 71 Name of Contractor 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 BEREQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO V * 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. STATE OF NEW YORK) SS. COUNTY :i�ekG/`C GLEE (�l�{�L �l l being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the7`�<� (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 thigl _ day of "�d l tj 4 1-11 20C Notary Public NoWMPubNc, Vag o1 N" yo* OwNsed i � CMmft W EVW APA 14, (, Signatur f Applicant Scott A. Russell (Sill SupSOR SOUTHOLD TOWN HALL - P. O. Box 11791 53095 Main Road - SOUTHOLD, NEW YORK 11971 S5'7C'0]KMWA\TlE)K MANAGEMENT Town of Southold CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT) DOES TRIS PROJECT INVOLVE ANY OF THE FOLLOWING: (CHECK ALL THAT APPLY) A. Clearing, grubbing, grading or stripping of land which affects more tt than 5,000 square feet of ground surface. 13. Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. '�. Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. "E. Site preparation within the one -hundred -year f loodplain as depicted on FIRM Map of any watercourse. Installation of new or resurfaced impervious surfaces of 1,000 square feet or more, unless prior approval of a Stormwater Management Control Plan was received by the Town and the proposal includes in-kind replacement of impervious surfaces. If you answered NO to all of the questions above, STOP! Complete the Applicant section below with your Name, Signature, Contact Information, Date & County Tax Map Number! Chapter 236 does not apply to your project. If you answered YES to one or more of the above, please submit Two copies of a Stormwater Management Control Plan and a comoleted Check List Form to the Building Department witG your Building Permit Application. APPLICANT: (Property NAME: Professional. Agent. Contractor, Other) Contact Information: _, flame[ —.a+— / J _ _ Property Address // Location of Construction Work: S.C.T.M. '`: 1000 Date, District Section Btock Lot **** FOR BUILDING DEPARTMENT USE ONLY **** Reviewed By: e r -n /� &t all - Date: /_ � _.15 Approved for processing Building Permit. 1R--,l Stormwater Management Control Plan Not Required. Stormwater Management Control Plan is Required. (Forward to Engineering Department for Review.) Town Had Annex 54375 Main Road P.O. Box 1179 SoftK NY 11971.0959 BUH DING DEPA,RTSEEW TOWN OF SOU MOLD ESTED BY: ` /,) k (�l�(���l.J %x} Date: my Name: -F Gr 1/.( A P1L- h-�?" - No.. No.: X31 -- Telephone (631) 765-1804 JOBSITE INFORMATION: (*Indicates required information) *Name: *Address: %2¢G� CJ�CJ lam. , Gam;>TGt� *Cross Street: Off= Al 714.-IA� *Phone No.: / - `%��✓ — �f30 Permit No.: Tax -Map District: 1000 Section: '�_ Block: --157Z—'Lot: ; *BRIEF DESCRIPTION OF WORK (Please Print Clearly)2'l y GUMS AVZI (Please Circle AN That Apply) *Is job ready for inspection: *Do- you need a Temp Certificate: Temp Information Qf. needed) *Service Size: 1 Phase 3Phase 0YE1 NO. Rough In YES 100 150 200 300 350 *New Service: Re-c"ecf Underground Number of Meters Change of Service Overbead Additional Information: PAYMENT DUE WITH APPUCATION pp Frank Wolfgang Uellendahl Architect 123 Central Ave POB 316 Greenport, NY 11944 t: 631.477.8624 e: frank@frankuellendahl.com January 7, 2015 --- ----- ._ _. Submitted to: Building Inspector's Office J FEB - 6 2015 Town of Southold I � Owners: George Bissell and Patricia Burkhardt 1240 Glenn Road Southold, NY 11971 Project: As -Built Permit for a finished basement and a finished attic at 1240 Glenn Road in Southold The above referenced single family home was constructed in 2001. Mr. John Deveau, the previous owner, received a CO for the finished on October 5, 2001. He subsequently continued construction to finish the attic to include 2 additional bedrooms and a portion of the basement with a recreation room, an adjoining home office / guest room and 2 bathrooms. The owner failed to obtain a CO for the completed project. The S.C.Department of Health Services approved a septic system on April 30, 1999 for a 4 - bedroom single family residence. The permit plans indicate as well that the owner's intend was to construct a 4 -bedroom house. The attic was insulated accordingly, and so was the portion of the basement that has direct access to the yard at grade level. At the request of the current owners I reviewed all pertinent documents and created the As - built floor plans. The REScheck Compliance Certificate passed better than code. I herewith certify to the best of my knowledge that all work - including plumbing work - was performed as per NYS code. r TOWN OF SOUTHOLD PROPERTY RECORD CARD_ OWNER STREET C VILLAGE DIST SUB. LOT .�1v1 e44 FORMER OWNER S v N E ACR. S W TYPE OF BUILDIN ' RES. .21 SEAS. VL. ,ea�5r FARM COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKS 4,01e#1.-/ 1 6 'r' , �+► ieJ A l a� 2 o,�r_ �t a r! ry tozx- AGE BUILDING CONDITION vow 615sell eeff76 `09 ,000 NEW NORMAL BELOW ABOVE FARM Acre Value Per Acre Value Tillable 1 Tillable 2 Tillable 3 Woodland Swampland FRONTAGE ON WATER _ Brushland FRONTAGE ON ROAD House Plot DEPTH BULKHEAD Total DOCK F ,!5tJf:Z1/EY OF LOT # 14 MAP OF "PilE5T CREEK E5TATE5u SITUATE- BAYVIEPi -A TOM OF SOUTHOLD SUFFOLK COUNTY, NY 5VRVEYED 11IN AMENDED 02-04-qq SUFFOLK oot.NnY TAX 1000-R6-2-50 [I CERTIFIED TO, I JOHN F. DEVEAU TesL Hbl 4.01 le"Ro'ad -i Wf— pro" �R MMIX COUMDEPARTNWCOF Mant I Ml PEW= FOR APPROVAL OF COMMUM m bmmLz rmmy RnMENCE ONLY APP40VED FOR IWAXWUM OF EXPIRES THREE YEARS FRoMDA7Eop NOTES. qND --VA MONUMENT FOUND `N WM 0 PIPE FOUND HEDGE AREA = lqbql 5F OR 0..46 \ �5- 1-- AG 9 ELEVATION5 REFER To "V' '24 k SRAPHIr- 5CALE I 3O 4 - geek NE 7 7" EN, v, '7 LAIN40 WV.—E�LERS, LAN N. y s IC. NO 50202 A_ MAIN STREET FFIHEAD,N.Y. 11901 4,43?138 rax --69-8287 HI'F[Rf:NCE a 9E 277C ..... - ------- ------ I ° eORVEY OF LOT # 14 Tom or- 5oun4oLp JOHN C. EHLERS LAND SURVEYOR SUMOLK COUNTY, Nr SURVEYED 11-16-qD 09-15-01 I SUFFOLK COUNTY TAX 0 Roild CERTIFIED TO: JOHN F. PEVEAV ` NEC a MONUMENT FOUND coo AREA IqOql 5F OR 0.46 ACRES APQ . \��' JOHN C. EHLERS LAND SURVEYOR Generated by REScheck-Web Software Compliance Certificate Project THE BISSELL BURKHARDT RESIDENCE Energy Code: 2010 New York Energy Conservation Location: Suffolk County, New York Construction Type: Single-family Project Type: New Construction Conditioned Floor Area: 0 ft2 Glazing Area 10% Climate Zone: 4 (5750 HDD) Permit Date: Permit Number: 3 Construction Site: Owner/Agent: 1240 GLENN ROAD George Bissell SOUTHOLD, New York 11971 Owner Designer/Contractor: Frank Uellendahl Architect Compliance: Passes using UA trade-off Compliance: 3.4% Better Than Code Maximum UA: 596 Your UA: 576 The % Better or Worse Than Code Index reflects how close to compliance the house is based on code trade-off rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum -code home. Envelope Assemblies Ceiling: Flat or Scissor Truss 987 19.0 0.0 0.051 50 Ceiling: Flat or Scissor Truss 228 19.0 0.0 0.051 11 Skylight: Metal, Thermal Break, 2 Pane w/ Low -E 8 0.420 3 Wall: Wood Frame, 16in. o.c. 2,470 13.0 0.0 0.082 203 Wall: Wood Frame, 16in. o.c. 1,235 19.0 0.0 0.060 52 Window: Wood Frame, 2 Pane w/ Low -E 251 0.310 78 Door: Glass 117 0.300 35 Floor: All -Wood Joist/Truss Over Uncond. Space 290 19.0 0.0 0.047 14 Floor: Unheated Slab -On -Grade 125 0.0 1.042 130 Insulation depth: 2.0' �p Compliance Statement: The proposed building design described calculations submitted with the permit application. The proposed Conservation Construction Code regylirernentsin REScheck Versil the REScheck Inspection Check Name - Mile ila �T?rw4•i3 W'8 , „tS Project Title: THE BISSELL B ,v'i'i NCE with the building plans, specifications, and other signed to meet the 2010 New York Energy ly with the mandatory requirements listed in o I - 06 -to— Date Report date: 01/06/15 REScheck Software Version 5.5.0 Inspection Checklist Energy Code: 2010 New York Energy Conservation Construction Code Requirements: 0.0% were addressed directly in the REScheck software Text in the "Comments/Assumptions" column is provided by the user in the REScheck Requirements screen. For each requirement, the user certifies that a code requirement will be met and how that is documented, or that an exception is being claimed. Where compliance is itemized in a separate table, a reference to that table is provided. Section # Pre-Inspection/Plan Review Plans Verified Value Field Verified Value complies? Comments/Assumptions & Req.ID 103.2 Construction drawings and ❑Complies [PR1]1 documentation sufficiently ❑Does Not d demonstrates energy code []Not Observable compliance for the building ❑Not Applicable envelope. 103.21 Construction drawings and ❑Complies 403.7 documentation sufficiently ❑Does Not [PR3]1 demonstrates energy code []Not Observable y, compliance for lighting and ❑Not Applicable mechanical systems. Systems serving multiple dwelling units must demonstrate compliance with the commercial code. 403.6 Heating and cooling equipment is Heating: Heating: ❑Complies [PR2]2 sized per ACCA Manual S based Btu/hr Btu/hr ❑Does Not on loads per ACCA Manual J or Cooling: Cooling: ❑Not Observable other approved methods. Btu/hr Btu/hr ❑Not Applicable Additional Comments/Assumptions: 111 High Impact (Tier 1) 12 1 Medium Impact (Ter 2) 13 1 Low Impact (Tier 3) Project Title: THE BISSELL BURKHARDT RESIDENCE Report date: 01/06/15 2910 New York Energy Foundation Inspection Complies? Comments/Assumptions 303.2.1 _ Exposed foundation insulation ❑Complies [FO1112 protection. ❑Does Not 14, ❑Not Observable ❑Not Applicable _ 403.8 Snow melt controls. ❑Complies [FO12]2 ❑Does Not ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 111 High Impact (Tier 1) 12 1 Medium Impact (Tier 2) 3 1 Low Impact frier 3) Project Title: THE BISSELL BURKHARDT RESIDENCE Report date: 01/06/15 Section # Framing / Rough -In Inspection Plans Verified Value Field Verified Value Complies? Comments/Assumptions & Req.ID 402.4.4 Fenestration that is not site built ❑Complies [FR20]1 is listed and labeled as meeting ❑Does Not AAMA/WDMA/CSA 101/I.S.2/A440 ❑Not Observable or has infiltration rates per NFRC ❑Not Applicable 400 that do not exceed code limits. 402.4.5 IC -rated recessed lighting fixtures _ ❑Complies [FR16]2 sealed at housing/interior finish ❑Does Not V and labeled to indicate &It;= 2.0 []Not Observable cfm leakage at 75 Pa. ❑Not Applicable 403.2.2 All joints and seams of air duds, ❑Complies [FR13]1 air handlers, filter boxes, and ❑Does Not building cavities used as return ❑Not Observable — ducts are sealed. ❑Not Applicable 403.2.3 Building cavities are not used as [Complies [FR15]3 duds or plenums. []Does Not ❑Not Observable ❑Not Applicable 403.3 HVAC piping conveying fluids R- R- ❑Complies [FR17]2 above 105 OF or chilled fluids []Does Not below 55 OF are insulated to R-3. ❑Not Observable ❑Not Applicable 403.4 Circulating service hot water R- R- ❑Complies [FR18]2 pipes are insulated to R-2. ❑Does Not ❑Not Observable ❑Not Applicable 403.5 Automatic or gravity dampers are ❑Complies [FR19]2 installed on all outdoor air ❑Does Not M, intakes and exhausts. []Not Observable ❑Not Applicable Additional Comments/Assumptions: 1 High Impact (Tier 1) 2 Medium Impact (Tier 2) 3 Low Impact (Tier 3) Project Title: THE BISSELL BURKHARDT RESIDENCE Report date: 01/06/15 2010 New York Insulation Inspection Complies? Comments/Assumptions Energy 303.1 All installed insulation labeled or ❑Complies [IN13]' installed R -values provided. ❑Does Not []Not Observable ❑Not Applicable Additional Comments/Assumptions: 111 High Impact (Tier 1) 12 1 Medium Impact (Tier 2) 3 1 Low Impact (Tier 3) Project Title: THE BISSELL BURKHARDT RESIDENCE Report date: 01/06/15 Section' # Final Inspection Provisions Plans Verified Field Verified Complies? Comments/Assumptions & Req.iD Value Value 402.4.2, Building envelope tightness ACH 50 = ACH 50 = ❑Complies 402.4.2.1 verified by blower door test result ❑Does Not [FI17]1 of &It;7 ACH at 50 Pa. This []Not Observable requirement may instead be met ❑Not Applicable via visual inspection, in which case verification may need to occur during Insulation Inspection. 403.2.2 Duct tightness via post- cfm cfm ❑Complies [F14]1 construction with maximum []Does Not leakage of 8 cfm to outdoors, or ❑Not Observable 12 cfm across systems. For ❑Not Applicable rough -in tests, verification may need to occur during Framing Inspection, with maximum leakage of 6 cfm across systems and 4 cfm without air handler. _ 403.1.1 Programmable thermostats ❑Complies [FI9]2 installed on forced air furnaces. ❑Does Not (]Not Observable ❑Not Applicable 403.1.2 Heat pump thermostat installed ❑Complies [FI10]2 on heat pumps. ❑Does Not ❑Not Observable ❑Not Applicable 403.4 Circulating service hot water ❑Complies [1`111]2 systems have automatic or ❑Does Not accessible manual controls. ❑Not Observable ❑Not Applicable 401.3 Compliance certificate posted. ❑Complies [FI7]2 ❑Does Not ❑Not Observable ❑Not Applicable 303.3 Manufacturer manuals for ❑Complies [FI18]3 mechanical and water heating ❑Does Not V equipment have been provided. []Not Observable ❑Not Applicable Additional Comments/Assumptions: 1 I High Impact (Ter 1) 12 1 Medium Impact (Tier 2) 13 1 Low Impact (Tier 3) Project Title: THE BISSELL BURKHARDT RESIDENCE Report date: 01/06/15 2010 New York Energy Conservation Construction Code Energy Efficiency Certificate Above -Grade Wall 13.00 Below -Grade Wall 0.00 Floor 19.00 Ceiling / Roof 19.00 Ductwork (unconditioned spaces): Window 0.31 Door 0.30 Skylight 0.42 Heating System: Cooling System: Water Heater: Name: Date: Comments . A CN CIO i 28310 ih 28310 28310 28310 2668 AS -BUILT � CUPANCY OR m FINISHED HEATED FLOOR AREA = 857 SF 2ND FLOOR &BASEMENT U o OWNERS PLUMBER CERTIFICAT*N CLG, HGT: 8'-0" GEORGE BISSELL ON LEAD CONTENT BEFORE PATRICIA BURKHARDT 1240 GLENN ROAD o CERTIFICATE OF OCCUPANCY S D --- coS D CO SOLDER USED IN WATER U SU F'PLYSXSTEM CANNOT LATE: Z m cD O _ _ M N EX ED 2l1� OF 1 % LEM, - FEE- � � " O 0 'F OTIFY _ RU's , u ? I 1 IvT AT --- 7.55-1802 3 A .. _ 4 PM', Ft, R THE =BISSELL DWG. NAME C14 FOLLOWING i vr!P;_:C'T!ONls- S A-1 ©¢ 1. FOUNDATION - TWO REQUIRED y RESIDENCE Ac FOR. eOURF.D CONCRETE DN "' 2. ROU- - e !$7IING Pi R RIljT t- ,. �= ' 3. INSUL> ION SOUTHOLD, NY ` 4. FINALco i RUCTION °,BUST J 1240 GLENN ROAD CLG. HGT: 8'-0" BE C PLETE 1FCFi C.O. 24310-2 vS 0 ALL CO TRUCTiON SHALL MEET THE m ARCHITECT REQUIRE. 1ENTS OF THE CODES OF NEW o YORK STATE. NOT RESPONSIBFOR FRANK UELLEND AHL 316LE P.O.BOX 316 2668 n;:R rn1 c R CONSTRUCTION ERRORS GREENPORT NY 11944 28310 ih 28310 28310 28310 2668 ----_L0"x20"1 IGHT HALLWAY CUPANCY OR S C7 BATH 2 N U o OWNERS E IS UNLAWFUL CLG, HGT: 8'-0" GEORGE BISSELL fHOUT CERTIFICATE= PATRICIA BURKHARDT 1240 GLENN ROAD o S D --- coS D CO 6:5SOUTHOLD, o TEL:631-765-5480 o DATE: 01/08/2015 cD O _ _ M SCALE: 3/16" = 1'-0" M 00 N O 0 2ND FLOOR PLAN c! DWG. NAME C14 S A-1 ©¢ 00 FsTDJ to `/3 BEDROOM 3 DN "' LOUNGE AREA A ,. �= ' CLG. HGT: 8'-0'4 CLG. HGT: 8'-0" CLG. HGT: 8'-0" co m----- N S D STORAGE 2668 .1-001 sKY�1cH�� 30 x30 CLOSET L — ' CLOSET 28310 ih 28310 28310 28310 �N STORN91r,;;T ER, : L„ ti' „ IF: F UANT TO CHAP T EP 236 E TOWN CODE. PLUMBING ALL PLUMBING WASTE & MATER LINES NEED TESTING BEFORE COVERING 2ND Fiooe PLAN ASmBUILT PERMIT APPLICATION, TEL: 631-477 8624 CUPANCY OR S C7 W a C7 2 U o OWNERS E IS UNLAWFUL o GEORGE BISSELL fHOUT CERTIFICATE= PATRICIA BURKHARDT 1240 GLENN ROAD o NY 11971 OCCUPANCY 6:5SOUTHOLD, o TEL:631-765-5480 �N STORN91r,;;T ER, : L„ ti' „ IF: F UANT TO CHAP T EP 236 E TOWN CODE. PLUMBING ALL PLUMBING WASTE & MATER LINES NEED TESTING BEFORE COVERING 2ND Fiooe PLAN ASmBUILT PERMIT APPLICATION, a � S C7 W a C7 2 U D Cn o o o o DATE: 01/08/2015 w SCALE: 3/16" = 1'-0" 3 AS -BUILT 0 2ND FLOOR PLAN c! DWG. NAME �cr_ S A-1 ©¢ DWG. NO .. C f ELECTRICAL LEGEND 4) DUPLEX RECEPTACLE OUTLET s 0 SMOKE DETECTOR FI GROUND FAULT INTERRUPTOR OUTLET c0 CO DETECTOR SURFACE MOUNTED CEILING FIXTURE EM TELEVISION, CABLE F SURFACE MOUNTED WALL FIXTURE CEILING FAN W/ LIGHTS $ SWITCH EXHAUST FAN WITH LIGHT Q HIGH HAT FIXTURE EXTERIOR LIGHT 45'-0" COVERED PATIO ON GRADE 00 4� J AS -BUILT 2ND FLOOR & BASEMENT i 1 I � m BISSELL RESIDENCE SOUTHOLD, NY fl 1240 GLENN ROAD ARCHITECT FRANK UELLENDAHL P,O.BOX 316 GREENPORT, NY 11944 TEL: 631-477 8624 5 OWNERS i GEORGE BISSELL ' PATRICIA BURKHARDT 1240 GLENN ROAD SOUTHOLD, NY 11971 _ 31-765-5480 �ktg2 A 1 Q V J 6 H w 0 � BASEMENT BASEMENT - o J V O BASEMENT c m O \ D D D � U FINISHED O BASEMENT 4 DATE: 01/08/2015 W SCALE: 3/16" = 1'-0" Y AS -BUILT g o BASEMENT PLAN O N DWG. NAME FINISHED HEATED FLOOR AREA = 769 SF A-2 BASEMENT PLAN ®s DWG. NO