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Town of Southold 3/24/2015 P.O. Box 1179 Z 53095 Main Rd D �� ,1 Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 37478 THIS CERTIFIES that the building RESIDENTIAL ALTERATION Location of Property: 3445 Wickham Ave, Mattituck, SCTM #: 473889 Sec/Block/Lot: 107.-9-10 Date: 3/20/2015 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 4/18/2014 pursuant to which Building Permit No. 38871 dated 5/8/2014 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to Kelvin Kubo Trust (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 38871 01-12-2015 02-27-2015 1,2 Mattituck Plumbing oriz d Sign ure r TOWN OF SOUTHOLD �N? BUILDING DEPARTMENT TOWN CLERK'S OFFICE "a 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) Permit #: 38871 Date: 5/8/2014 Permission is hereby granted to: Safir, Howard & Safir, Carol 131 Charles St Annaaolis. MD 21401 To: Alterations to an existing single family dwelling as applied for. Additional certifications may be required from architect prior to issuance of CO. At premises located at: 3445 Wickham Ave, Mattituck SCTM # 473889 Sec/Block/Lot # 107.-9-10 Pursuant to application dated To expire on 11/7/2015. Fees: 4/18/2014 and approved by the Building Inspector. SINGLE FAMILY DWELLING - ADDITION OR ALTERATION $200.00 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 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. 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. New Construction: Old or Pre-existing Building: (check one) Location of Property: 321vs- W, C KN4 rpt AVE. House No. Street Hamlet Owner or Owners of Property: e�c L V i Suffolk County Tax Map No 1000, Section Subdivision Permit No. Health Dept. Approval: Planning Board Approval: Date of Permit. Request for: Temporary Certificate Fee Submitted: $ Block Filed Map. _ Applicant:_ Underwriters Approval: Lot Lot: Final Certificate: (check one) 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(aD-town.southoId. ny.us CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: KUBO Address: 3445 Wickham Ave City: Mattituck St: NY Zip: 11952 Building Permit #: 38871 Section: 107 Block: 9 Lot: 10 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: G&S Electric License No: 578-e Residential Commerical New Addition X Indoor Outdoor Renovation Survey Heat gas Duplec Recpt 51TE DETAILS Office Use Only X Basement X 1 st Floor X 2nd Floor Attic INVENTORY Service Only X Pool X Hot Tub Garage Service 1 ph 200a Heat gas Duplec Recpt 38 Ceiling Fixtures 8 HID Fixtures Service 3 ph Hot Water gas GFCI Recpt 5 Wall Fixtures 7 Smoke Detectors 4 Main Panel 200a A/C Condenser Single Recpt Recessed Fixtures 19 CO Detectors Sub Panel A/C Blower Range Recpt gas Fluorescent Fixture Pumps Transformer Appliances 1-dw Dryer Recpt Emergency Fixture Time Clocks Disconnect 200a Switches 29 Twist Lock Exit Fixtures 1dTVSSLl Other Equipment: 2 -combination smoke/co detectors, 2 -exhaust fans, 1 -paddle fan, 3 -ARC fault CB': Notes: Inspector Signature: Date: Jan 12 2015 81 -Cert Electrical Compliance Form.xls ti to P.O. Box 1179 ` Smthold, NY 11971-0959 vv�ll l j� BUMDING DEPAUMENT TOWN OF SOUTHOLD CERTIFICATION Building Permit No. Owner: �ly1 �i Kiko " 1 ►� L15� 1 Please print) Plumber: C vRuillt%q (Please print) lead. Telephone (631) 763-1802 Tax M l ) 766.0.409 i D /-----�� .I� f E8 z 7.7i Date: a 1 7 hf� I certify that the solder used in the water supply system contains less than 2/10 of 1% Sworn to before me this -2"77� day of "'u a R-1 , 20 /5 - DENISE KING Notary Public, State of New York Registration P011<16041757 Qualified in Suffolk County My Commission Ex - ire -1 - Notary Publi �ounty a 71e - pf SO(/jyo TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ /-FOUNDATION 1ST [ • j "DATION 2ND [VfFRAMING/STRAPPING [ ]FIREPLACE & CHIMNEY I ] FIRE RESISTANT corisrnucnooi I ELECTRICAL (ROUGH) [ ]CODE VIOLATION REMARKS: ] ROUGH PLUMBING ] INSULATION ] FINAL ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION ] ELECTRICAL (FINAL) ] CAULKING DATE ��� INSPECTOR J fjf so Ile, Ulm, TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION FOUNDATION IST FOUNDATION 2ND FRAMING / STRAPPING FIREPLACE & CHIMNEY FIRE RESISTANT CONSTRUCTION ELECTRICAL (ROUGH) CODE VIOLATION REMARKS: ROUGH PLUMBING INSULATION FINAL FIRE SAFETY INSPECTION FIRE RESISTANT PENETRATION ELECTRICAL (FINAL) CAULKING DATE Lo2 (4 — IIPSPECTON? tfs cou Nmv TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPE FOUNDATION I ST 6UNDATION 2ND FRAMING/ STRAPPING FIREPLACE& CHIMNEY FIRE RESISTANT CONSTRUCTION ELECTRICAL (ROUGH) ]CODE VIOLATION REMARKSA CilgA400 12-i 0 N f r:7ROUG!H PLUMBING r I INSULATION r I FINAL r ] FIRE SAFETY INSPECTION r I FIRE RESISTANT PENETRATION r I ELECTRICAL (FINAL) r I CAULKING r 17 _... DATEIHO/C�L -INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION FOUNDATION I ST FOUNDATION 2ND FRAMING / STRAPPING FIREPLACE & CHIMNEY FIRE RESISTANT CONSTRUCTION ELECTRICAL (ROUGH) CODE VIOLATION ROUGH PLUMBING INSULATION FINAL FIRE SAFETY INSPECTION FIRE RES ANT PENETRATION E� ICAL (FINAL) CAULKING DATE -INSPECTOR Ilt 7 TOWN OF SOUTHOLD BUILDING DEPT. 7654 802 INSPECTION ] FOUNDATION 1 ST ] FOUNDATION 2ND ] FRAMING/ STRAPPING ] FIREPLACE A CHIMNEY ] FIRE RESISTANT CONSTRUCTION ] ELECTRICAL (ROUGH) ] CODE VIOLAMN R"ARKS: [ ] R UGH PLUMBING [ INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (FINAL) [ ] CAULKING .-71-n 10 DATE /�"�// INSPECTOR �� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ] FOUNDATION IST ] FOUNDATION 2ND ] FRAMING/ STRAPPING ] FIREPLACE A CHIMNEY ] FIRE RESISTANT CONSTRUCTION ] ELECTRICAL (ROUGH) ] CODE VIOLATION REMARKS: [ ] ROUGH PLUMBING [ ] INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION ELECTRICAL (FINAL) [ ] CAULKING DATE � �v �� INSPECTORS 36- tF SO�ryolo • TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ] FOUNDATION IST ] FOUNDATION 2ND ] FRAMING/ STRAPPING ] FIREPLACE A CHIMNEY ] FIRE RESISTANT CONSTRUCTION ] ELECTRICAL (ROUGH) ] CODE VIOLATION REMARKS: [ ] RO H PLUMBING [ ]1 SOLATION [ FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (FINAL) [ } CAULKING ;i DATE INSPECTOR 1/� / f i TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ] FOUNDATION 1 ST ] FOUNDATION 2ND ] FRAMING/ STRAPPING ] FIREPLACE & CHIMNEY ] FIRE RESISTANT CONSTRUCTION ] ELECTRICAL (ROUGH) ] CODE VWk.ATION REMARK [ ] ROU PLUMBING [ ] I UL [ FIN 6 [ ] FIRE NSPECTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (FINAL) [ ] CAULKING DATE S ` INSPECTOR a, --r oe 3 69 71--t TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ] FOUNDATION IST ] FOUNDATION 2ND ] FRAMING/ STRAPPING ] FIREPLACE A CHIMNEY ] FIRE RESISTANT CONSTRUCTION ] ELECTRICAL (ROUGH) ] CODE VIOLATION 0VMAn rc. [ ] ROUGH PLUMBING [ ] IN [ INL [ 11 FIRE S INSPECTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (FINAL) [ ] CAULKING DATE � �f INSPECTOR --xxHITE C T C MARK SCHWARTZ & ASSOCIATES 28495 Mai„ Road • PO Box 933 • Cutchogue NY 11935 631.734.4185 1 uaca%:ill kssarchitcct.cum March 09, 2015 Southold Town Building Department P.O. Box 1179 Main Road Southold, New York 11971 Re: Additions and Alterations to: Kubo House 3445 Wickham Avenue Mattituck, New York To Whom This May Concern: � MAR ' ? 2015 �= I have been to the site and reviewed the insulation installation. I hereby certify, to the best of my knowledge, the insulation work has been completed as per Compliance Certificate dated 03/09/15 and meets or exceeds NYS code requirements. Please call this office if you have any questions or require additional information. AIA TOWN OF SOUTHOLD BUILDING DEPARTMENT . TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown:Noi thFork.net - Examined 20 . Approved , 20 Disapproved a/c Expiration � i - 20� BUILDING PERMIT APPLICATION CHECKLIST Do yoti have or'need the following,, before applying? BoarddoflIealth : . 4 sets of Building Plans Planning Board approval Survey PERMIT NO. C>teck Septic Term N.Y.S.DX.C. Trustees Flood Peraut Storm -Water Assessment Form k r + Coif8C�i APR 1' ,- �__ _. _ Mail to: MM- M- a sash A APPLICATION FOR MOLDING PERMIT Iite 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 applicatid 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 througlidV ti'ie 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' witlun 18 montbs from_su�r. �If up zQpittg tmeA ujten or lith r tegd�latioiis affecting the property have been enacted in the inWim, the Building Inspecbprt ay authorizp,_in_ writing, the extension oPtheipermit for an addition six months. Thereafter, a new permit shall be 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 - .t ,.Ig jv�Yand-otherag81;c, - vys, Ordinances or • able, Regulations, for the constructim-pf buildia, ons, pra� ons grfor removul;or :dgmo## A as herein. desctibed. The applicant agrees to comply with all applic ib a oTditiances�, li�ulding code, housing code,, and regulations, and to admit authorized inspectors on premises and in building for necessary' inspections., ; (Mailing address o appli t) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, ek6ffidan;'plumber or builder Name of owner of premises I/ 1 I ✓ 1 i 1 0 P, VY (As on the tax roll orllatest If applicant is a corporation, signature of duly k6orize — aber (Name and title of corporate officer) Builders License No. Plumbers License No. , - Electricians -License -Ne. Other Trade's License No. 1. Location of land on which proposed work will House -Number Street Hamlet County Tax Map No. 1000 Section - U Block q - Lot Subdivision Filed Map No. Lot . State existing use and. occupancy, of a. Existing use and occupancy, uses and 1inten ed use and occupancy of proposed construction: � 1 A oM.�-, `Gl b. Intended use -and occupancy, y &61A.QM41D,0 3. Nature of work (check which-applicable)L.New Builduig A' tion Alteration epW Remq Demolition Other Work kcL- COdp,� YA 0-i> � cod -c �Calo► , �m V �- uw�l ✓oma, tion 1. Estunatedost ' ►w `b�- m Fee (To be paid on filing this application S. If dwelling, number of dwelling units { Number of dwelling units on each floor If garage, number of cars S. If business, commercial or mixed occupancy, specify nature and extent of each type of use. i � 1 7. Dimensions of existing structures, if any: Front d • �� Rear Depth Height Number of Stories Dimensions of same structure with alterabonslor gdd#iorls: Front Rear Depth Height Number of Stories 3. Dimensions of entire new construction: Front Rear Depth Height -, Number of Stories a. Size of lot: Front % Rear iD (� J Depth 10. Date of Purchas0 �a'� i Name of Former. Omer' ` = Ymd yCL 11. Zone or use district in which premises are situated _ ..1 7., 7;s 12. Does proposed construction violate any zoning Iaw, or,, 'dunce or regulapo ? i19S _ NO 13. Will lot be re -graded? YES NO Will excess fill be removed from premises? YES NO)—( 14. Names of Owner of premises 0,�1t►,� r; i s . Address ? �Al, i 3 :,�1,�� hone No,� 017213_1-5t9 Name of Architect - . � ; 1 A Address • . i f, _: - 4 •Phone No Name of Contracto60 �o Y i. A --AAA .S ul j�LLQ Address 7W (i ;IRTY VT Phone No.; &31-`7 22-513-0 15 a. Is this property withui-100 feet of a tidal wetland'or-a fiesliwatl� er wetiiandT? *YES.NO * IF YES, SOUTil0f, TOW�I TRUSTEES'& D E:C p T S MAY -BEE . UIRED.' Q b. Is this property withirij00 feet of tidal wetland? * YE t`NO •; * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale,;w# pccuraxe 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_L_ * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ) beiiig'duly sworn, deposes and say_ s that (s)he is the applicant (Name of individual signing contract) above named, - (S)He is the (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this- application; that all statements contained in this application are true to the best of his knowledge and belied and that the work will, be performed in the manner set forth in the application filed therewith. me this V -6f 20 VIUN lu,n f_��Notary Public Sta of9NGew York No. Oblit Qualified in unty Signa o k Coof Applicant Commission Expires July 28, 2U 1f Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Telephone (631) 765-1802 "aou��roaer.richertt,wnsoo75 ny us BUILDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Date: i�4, Company Name: v, 6-- Name: =Name: A 17 License No.: Address: Phone No.: l / JOBSITE INFORMATION: (*Indicates required information) *Name:_l� *Address: , : ( C t44,�2, ! C Cross Street: ��-��;-� � �>� . *Phone No.: Permit No.: 3 1 Tax Map District: 1000 Section—:LBlock: Q *BRIEF DESCRIPTION OF WORK (Please Print Clearly) A�� -,-,)/a1J -�; "r 2 X21 >., (Please Circle All That Apply) *Is job ready for inspection: YES fg) Rough In Final *Do -you need a Temp Certificate: NO qS) Temp Information (If needed) *Service Size: 1 Phase 3Phase 10 *New Service: =�nnectUnderground Additional Information: .82=Request fol Inspection Foan 0 150 00 300 350 .400 lOther Number of Meters / Change of Service Overhe PAYMENT DUE WITH APPLICATION /d a© -/,J7 -9-/o j�. TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET" r' I VILLAGEDIST , Tillable SUB. LOT ir Q' Woodland FRONTAGE ON ROAD FORMER OWNER N ayc�/ C.- E Q IZ • -RQr-.l: aI A �s11'+/ yttffY ACR. , � � �3 20 Ale, ti_ _ S wtl W AIL � 3�✓ TYPE OF BUILDING SEAS. i VL. FARM COMM. CB. MICS. Mkt. Volue LAND IMP. TOTAL DATE REMARKS r.,;; S / �b /I3 ,7 `r-Rmr S. AS's, 4'r is S. "'As's:5 'f �+'ryo• P J1 • b Fcf.tp,% -- _ • z� 46 ��I"Tf T'���j t'3 �J•._ i 1 ` 1 - AGE i I BUILDING CONDITION NEW NORMAL s BELOW ABOVE FARM s Acre Value Per i Acre Value , Tillable FRONTAGE ON WATER Q' Woodland FRONTAGE ON ROAD Meadowland DEPTH House Plot BULKHEAD Total I DOCKe5 cowl COTO CERTIFIED TO: s KELVIN KUBO KELVIN KUBO TRUST.\ FIDELITY NATIONAL TITLE INSURANCE COMPANY AREA 14,150 sq. ft. (to be line) ■ =MONUMENT m ANY AL n AATM CR_ADDiTM TO TMS SLRVEY IS A VICLATM ,. OF SECTMY 7M OF TME WV Yj3W $TATE EDLiCATM LAW �. EXCEPT AS PER SECTzav 72rVSU2BP4SXN E ALL CERnFICATraw FEfEQM ARE VALID FUR TMSMIP AMD COPIES DEBT QALY IF SAID MIP m CrIES WAR TRE LM'IESSED SEAL. OF TRE SLRVEYOR uwsF SIGNITLA'E APPEARS HEIIEDM fly \"e SURVEY OF PROPERTY AT MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK 1000-107-09-10 SCALE:' 1'=30' MARCH 26, 2014 J4� � ALY.S LIC NQ 49618. (516) 765 - 5820 P. Q BOX 999 1230 SOUTF�D, W. GREET [14-029 it APPLICATION a PAGE ► of 4 TOWN! OF SOUTHOLD FLOODPi_,AIN DEVELOPMENT PERMIT APPLICATION -- ELss- ncnom -------niis form is to be filled out in duplicate.>✓ N I: E PR VISION APPLiC c read acUN —2 ?_014is J11. No work may start untila pewit is issued. 2 The pc,mit may be revoked if any false statemcau are made herein_3. II revoked, all nock meat cc=until pCrmit is re -issued. w dCil — of Com fiance i 4. Development shall not be used or occupied not a p --- 5. The permit will expire if no work is commenced within six montbs of issuance. 6. Applicant is hereby informed that other permits may be required to fuLO local, state and federal regulatory requirements. 7. Applicant hereby gives consent to the Local Administrator or his/her representadve to make reasonable inspections required to verify compliance. 8. I, THE APPLICANT. CERTifY THAT ALL STATEMENT S HEREIN AND iN AITACHMEN TS TO . THIS APPLICATION ARE, TO THE BEST OF MY KNOwLEDG>E:, TRUE AND ACCURATE. (APPLICANI"S SIU*ATURE) ' �� • i DATE 2. PROPOSED DgfjWpMMM ab be eorreriicted by APPLICAMl NAME AD[ZR_FS$ TELEPHQNE r c. p►PPI.IcArrTi, k , � ��:, '. � -� y �,I-, r : <;'=, � � • t�.r`•1: �,., r ; ;�,�?,i� ►1 _� i1 � � -� r � BUILDER /1 ,5 , . , , - —51"d3• To avoid dehy in processing the application, please 4rm^de enooth informuion to cosuat y identify the project location- Provide the street address, Int emmbes or legal d=cdpoon (attach) and, outside urban ares, the d'isUner to the nearest lute rsecting road or wed -known landmark, A sketch attached to this application showing the project locadoo would be hetpfuL •1��F�_ rl. APPLICATION PAGE 2 Of: d DESCRIPTION OF WORK (Check all applicable boxes): A. STRUCTURAL DEVELOPMENT ACTIVITY STRUC.'t'UR[ TYPE O NeW Structure Residential (1-4 Family) O Addition Residential (More than 4 Family) Amteration O Non-residentiai (Floodprooftng? O Yes) O Relocation ❑ Combined Use (Residential & Commeraal) 0 Dcmdlition F Q Manufactured (Mobile) Home (10 Manu - [3 Repiarrment factured Home Park? O Yes) ESTIMATED COST OF PROJECTS 13. OTHER DEVELOPMENT ACTTVMES: O Fill O Mining 0 Drilling O Grading O Excavation (Except for Stmemral Development Cbecked Above) Q Watercotuse Alteration (including Dredging and Channel Modifications) O Drainage Impro eats .(fadudin Calvert Work) O Road. Street ore Construction O Subdivision (New or Expansion) O Individual water or Ser System 0 Other (Please SpeaTy) Atter completing SECTION 2. APPLICAAW- should submit form to L.oeal Administrator for review. SE ON 3 FLObDPi� DETERMINATION fi c comnlct by C[1t'at ADM)NiSC �' & The proposed development is located on FIRM Pard Dated 'Clic Proposed Deveiopmemt: O Is +f J located in a Spcdal Flood Hawrd Arca (Notify the appiicamt that the agPlsatiOn review a complete and NO FLOODPLAIN DEVF_ 0pjgFNi PERMIT IS RMUDLUD)- O Is located is a Special Hood Hued Arca. FIRM zone designation is.Ft. NGVD (MSL) loo -Year flood elevation at the ste is: O Unavailable O The proposed development is located in a floodway. FBFM Panel No. Dated— (:I See Section 4 for additional instrucuoas. SIGNED JPYY t '7-� • ter— � � l _ r jc Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 March 5, 2015 ��� V SOUTy� O S COUNTY, BUILDING DEPARTMENT TOWN OF SOUTHOLD Kubo Kelvin Trust 238 W 1391h Street New York, New York 10030 Telephone (631) 765-1802 Fax (631) 765-9502 RE: 3445 Wickham Avenue, Mattituck NOTE: Certification from an architect or engineer is required stating the insulation was installed per New York State Code. Your surveyor must provide a final construction elevation certificate dated after construction was completed. TO WHOM IT MAY CONCERN: The Following Items (if Checked) Are Needed To Complete Your Certificate of Occupancy: Application for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. A fee of $50.00. Final Survey with Health Department Approval. Plumbers Solder Certificate. (All permits involving plumbing after 4/1/84) Trustees Certificate of Compliance. (Town Trustees # 765-1892) Final Planning Board Approval. (Planning # 765-1938) Final Fire Inspection from Fire Marshall. Final Landmark Preservation approval. Final inspection by Building Dept. Final Storm Water Runoff Approval from Town Engineer BUILDING PERMIT: 38871-Z alterations U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENCY OMB No. 1660-0008 National Flood Insurance Program Important: Read the instructions on pages 1-9. Expiration Date: July 31, 2015 SECTION A - PROPERTY INFORMATION '.. Al. Building Owner's Name KELVIN KUBO w, A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 3445 WICKHAM AVENUE City MATTITUCK State NY ZIP Code 11952 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) _..- -- -- -- ---- --- 1000-107-09-10 t A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIALi A5. Latitude/Longitude: Lat. 41 DEG OOMIN 59SEC Long. 72DEG 32MIN 13ASEC H o r i z Vital �FV1 NAD 1927 E NA 19A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. iI AR 19 2015 � A7. Building Diagram Number 7 --� A8. For a building with a crawlspace or enclosure(s): A9. For a building ith arlattached garage: a) Square footage of crawlspace or enclosure(s) 1410 sq ft a) Square fo tage of attache�_ara'ge, - s ft b) Number of permanent flood openings in the crawlspace b) Number o permanent J9,od,gpegings in the attached arage or enclosure(s) within 1.0 foot above adjacent grade 6 within 1.0 - c) Total net area of flood openings in A8.b 1200 sq in c) Total net area of flood openings in A9.b sq in d) Engineered flood openings? E Yes ❑ No d) Engineered flood openings? ❑ Yes ❑ No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name B3. State SOUTHOLD, TOWN OF 360813 SUFFOLK NEW YORK B4. Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone 36103CO481 H Effective/Revised Date Zone(s) AO, use base flood depth) 09/25/2009 X & AE EL 8 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile E FIRM ❑ Community Determined ❑ Other/Source: Bl 1. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 E NAVD 1988 ❑ Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes E No Designation Date: ❑ CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* E Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations - Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, ARAE, AR/A1-A30, AR/AH, AR/AO. Complete Items C2.a-h below according to the building diagram specified in Item AT In Puerto Rico only, enter meters. Benchmark Utilized: Vertical Datum: NAVD 88 Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 E NAVD 1988 ❑ Other/Source: Datum used for building elevations must be the same as that used for the BFE. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) b) Top of the next higher floor c) Bottom of the lowest horizontal structural member (V Zones only) d) Attached garage (top of slab) e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) g) Highest adjacent (finished) grade next to building (HAG) h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. / certify that the information on this Certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. ❑ Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a ❑ Check here if attachments. licensed land surveyor? E Yes ❑ No Certifier's Name JOHN T METZGER License Number 49618 Title OWNER/PRESIDENT Company Name PECONIC SURVEYORS Address 1230 TRAVELER STREET City SOUTHOLD State NY ZIP Code 11971 Signature ���Date 03/16/2015 Telephone 631765-5020 FEMA Form 086-0-33 (7/12) See reverse side for continuation. Replaces all previous editions. Check the measurement used. 8.4 E feet ❑ meters 10.4 E feet ❑ meters ❑ feet ❑ meters ❑ feet ❑ meters 12.3 E feet ❑ meters 5.5 E feet ❑ meters 9.5 E feet ❑ meters ❑ feet ❑ meters SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. / certify that the information on this Certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. ❑ Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a ❑ Check here if attachments. licensed land surveyor? E Yes ❑ No Certifier's Name JOHN T METZGER License Number 49618 Title OWNER/PRESIDENT Company Name PECONIC SURVEYORS Address 1230 TRAVELER STREET City SOUTHOLD State NY ZIP Code 11971 Signature ���Date 03/16/2015 Telephone 631765-5020 FEMA Form 086-0-33 (7/12) See reverse side for continuation. Replaces all previous editions. ELEVATION CERTIFICATE, page 2 IMPORTANT: In theses aces, co the corresponding Information from Section A. P PY P 9 F _ �` Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Wow 3445 WICKHAM AVENUE io City MATTITUCK State NY ZIP Code 11952 SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Comments Signature Date 03/16/2015 SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items E1—E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B, and C. For Items E1—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F — PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ Check here if attachments. SECTION G — COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8—G10. In Puerto Rico only, enter meters. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or Zone AO. G3. ❑ The following information (Items G4—G10) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building: ❑ feet ❑ meters Datum G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum G10. Community's design flood elevation: ❑ feet ❑ meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments ❑ Check here if attachments. FEMA Form 086-0-33 (7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 4 Building Photographs Continuation Page IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 3445 WICKHAM AVENUE City MATTITUCK State NY ZIP Code 11952 Company NAIC Number: If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. FLMA Form 086-0-33 (7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 3 Building Photographs See Instructions for Item A6. IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 3445 WICKHAM AVENUE City MATTITUCK State NY ZIP Code 11952 Company NAIC Number: If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. es all previous editions. ELEVATION CERTIFICATE, page 3 Building Photographs See Instructions for Item A6. IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 3445 WICKHAM AVENUE City MATTITUCK State NY ZIP Code 11952 Company NAIC Number: If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. ELEVATION CERTIFICATE, page 3 Building Photographs See Instructions for Item A6. IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE �Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: ICKHAM AVENUE City MATTITUCK State NY ZIP Code 11952 Company NAIC Number: If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken; "Front View' and "Rear View"; and, if required, "Right Side View' and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. rtMA corm Ubb-U-33 (7/12) Replaces all previous editions. U_s.MEPARTMENTOFHONFlANDSECUMW ELEVATION CERTIFICATE F>`DS%C 8AlWGlWCY11ANAGM9NT A69NCY OMB No. 1660-0008 Nonmoral Flood Ina wKr P►osronr Important: Read the instructions on pages 1-9, Expiration Date: July 31,2015 SECTION A -PROPERTY INFORMATION Al _ Building Owner's Name KELVIN KUBO A2_ Budding Street Address (including Apt, Unit, Suite, and/or Bidg. No.) or P.O. Route and Bar No. 3445 WICKHAM AVENUE City MATTTTUCK State NY ZIP Code 11952 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Desaiption, etc.) 10CD-107-09-10 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc,) Q�S:c_KNrLsi A5. Latitude/ ongkude: LaL 41DEG OOMIN 59SEC Long, 77DW 32MIN 13.48EC HorizoMi Datum: ❑ NAD 1927 ® NAD 1963 A6. Attach at least 2 photographs of the building if the Ceffcate is being used to obtain flood insurance. A7. Budding Diagram Number 9 A8. For a building with a crawlspaee or enclosune(s): A9. For a building whit an adadied garage: a) Square footage of crawlspaoe or enclosure(s) 1_410 sq ft a) Square footage of attached garage _ sq ft b) Number of permanent flood openings in the crawlspaee b) Number of permanent flood openings in the attached garage or enclosure(s) within 1.0 foot above adacent grade 0 within 1.0 foot above adjacent grade C) TOW net area of flood openings in AS.b _ sq in c) Total net area of flood openings in A9.b sq in d) Engineered food openigs? ❑ Yes a No d) Engineered flood openings? ❑ Yes ❑ No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 81. NFIP Community Name & Community Number B2. County Nwme 83. State SOUTMA TOWN OF 360813 SUFFOLK NEW YORK B4.MNumber B5. Suffix 1%. FIRM Index Date 87. FIRM Panel 138. Flood B9. Base Flood Eievation(s) (Zone 10300481 H ,c) Bottom of the lowest horizontal structural member (V Zones only) Effectivell1evised Date Z s) 1 AO, use base Rood depth) d) Attached garage (top of slab) _ ❑ feet 09120" Ane 4.5 810. Mdicate the source of the Base Flood Elevation WE) data or base flood depth entered in Item B9. ❑ FIS Pro% 0 FIRM ❑ Community Determined ❑ Other Source: 811. indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 is NAVD 1988 ❑ other/Source: B12. lathe tuiidirg located in a Coastal Barrier Resources SystemCBRS) area or -Otherwise Protecsed Area (OPA)? ❑ Yes ® No Designation Date: [I CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Co Obvc tion Drawings' ❑ Building Under Construction" ® FinlohW Construction A new Elevation Certificate vA be required when Construction of the balding is complete. C2. Elevations - Zones Al -A30, AE, AH, A (with BFE), VE. V1 V30. V (with BFE). AR, ARIA, ARIAE, APJA1-A30, ARIAH, ARIAO. Complete items C2.a-h below according to the building diagram speti6ed in Item A7. In Puerto Rion only, enter meters. Benchmark Utilized: Vertical Datum: NAND 88 Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 ®NAVD 1988 ❑ OthedSouroe: - Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. a) Top of bottom floor (including basement, uawlspace, or enclosure floor) 3.5 ® feet ❑ meters b) Top of the next higher door 10.1 ®feet ❑ meters ,c) Bottom of the lowest horizontal structural member (V Zones only) 13 Let ❑ meters d) Attached garage (top of slab) _ ❑ feet ❑ meters e) Lowest elevation of machinery or equipment seminars the buildiN 4.5 ® feet ❑ meters (Descrihe type of equipment and location in Comments) f) Lowest adjacent (fmished) grade nerd to building (LAG) 5.9 ® feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 9.5 ®feet ❑ meters h) Loarest adjaoent grade at lowest elevation of deck or stairs, including structural support _ _ ❑ feet ❑ meters SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This cetti6ration is to be signed and sealed by a land surveyor, engineer, or arty auftr¢ed by Naw to certify elevation udarmatim. I caddy that fire iftmation an this QerWwal a represents my best efforts to interpret the dab ava+lable_ I urxhin /arid that any false sfatenmW may he punisha by tine orimpri sorxneW under 18 U.& Code, Section 1001. ❑ Check here if comments are provided on back of form. Were IsoWe and longitude in Section A provided by a ❑ Check here rT attachmer>;ts. licensed land scxvaW JR Yes ❑ No CedWees Name JOHN T METZGER License Number 49618 Title OWNS-RIPRESIDENT Company Name PECONIC SURVEYORS Address 1230 TRAVELER STREET City SOU17HOLD State NY ZIP Code 11971 Signature., -')lQ Date 04!2812014 Telephone 631-7&5--420 FEMA Form 0864.33 (7112) See reverse side for ocintinuation. Replaces all previous editions. KREScheck Software Version 4.6.0 tyll' Compliance Certificate Project Energy Code: 2010 New York Energy Conservation Location: Suffolk County, New York Construction Type: Single-family Project Type: New Construction Conditioned Floor Area: 0 M Glazing Area 12% Climate Zone: 4 (5750 HDD) Permit Date: S� Permit Number: 44 Construction Site: Owner/Agent: �D171-- �� MAR 10 2015 Designer/Contractor: Mark Schwartz, Architect P.O. Box 933 Cutchogue, NY 11935 631-734-4185 mksarchitect@optonline.net Compliance: Passes using UA trade-off Compliance: 10.0% Better Than Code Maximum UA: 311 Your UA: 280 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 Floor 1: All -Wood joistfrruss:Over Unconditioned Space 1,086 19.0 0.0 0.047 51 Ceiling 1: Cathedral Ceiling Ceiling 2: Flat Ceiling or Scissor Truss Wall 1: Wood Frame, 16" D.C. Window 1: Wood Frame:Double Pane with Low -E Door 1: Solid Door 2: Glass Wall 2: Wood Frame, 16" D.C. Window 2: Wood Frame:Double Pane with Low -E Compliance Statement: The proposed building clesigoffeR calculations submitted with the permit application. Th of Conservation Construction Code requirements in RESchec th Inspesti he kli . Name Titl 10 16.0 0.0 0.066 44 '37 0.290 11 e building plans, specifications, and other ed to meet the 2010 New York Energy Rl h the mandatory requirements listed in r re Date Project Title: Report date: 03/09/15 Data filename: C:\Users\Drafting Station\Documents\REScheck\KUBO.rck Pagel of 2 475 24.0 0.0 0.042 20 611 24.0 0.0 0.042 26 "" Aqs'" 1x191 16.0 0.0 0.066 64 S� 44 0.300 43 J„ 32 0.280 9 ! 4 0.290 12 10 16.0 0.0 0.066 44 '37 0.290 11 e building plans, specifications, and other ed to meet the 2010 New York Energy Rl h the mandatory requirements listed in r re Date Project Title: Report date: 03/09/15 Data filename: C:\Users\Drafting Station\Documents\REScheck\KUBO.rck Pagel of 2 .r� REScheck Software Version 4.5.0 Compliance Certificate Project APR 2 9 %1014 Energy Code: 2010 New York Energy Conservation L ------- ---- Location: Suffolk County, New York Construction Type: Single-family T__ ,_._-__..-.._...-- Project Type: New Construction Conditioned Floor Area: 0 ft2 Glazing Area 15% Climate Zone: 4 Permit Date: Permit Number: Construction Site: Owner/Agent: Designer/Contractor: KULBO-SHIGETOMI Mark Schwartz, Architect WICKHAM AVE P.O. Box 933 MATTITUCK, NY Cutchogue, NY 11935 631-734-4185 mksarchitect@optonline.net .trade-off Compliance: 4.7% Better Than Code Maximum UA: 278 Your UA: 265 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 Floor 1: All -Wood joist/Truss:Over Unconditioned Space 1,080 21.0 0.0 0.044 48 Wall 1: Wood Frame, 16" D.C. 1,687 15.0 0.0 0.077 111 Window 1: Wood Frame:Double Pane with low -E 39 0.290 11 Window 2: Wood Frame:Double Pane with Low -E 167 0.300 50 Door 1: Glass 41 0.290 12 Ceiling 1: Cathedral Ceiling 510 22.0 0.0 0.046 23 Ceiling 2: Flat Ceiling or Scissor Truss 292 30.0 0.0 0.035 10 Compliance Statement., The proposed building design described here is consistent with the buil . g plans, specifications, and other calculations submitted with the permit application. The proposed building a been d n d meet the 2010 New York Energy Conservation Construction Code requirements in REScheck Version 4.5 a atory requirements listed in the RESch vTZ s SC W,4 r O Name - Title Signature Date 4cr, .rs Y _ Project Title: G ' ` Report date: 04/24/14 Data filename: C:\Users\Drafting Station\Documents\REScheck\KULBO-SHIGETOMI.rck Page 1 of 1 rias VFUL IS UNLNI HOUT CERTIFICATE Lk C,04 OCCUPANCY "T p AV1,46 6a(kmy, voVNLh LS ay\d Sx1y'lklum-6 ( 0- 6) w�43w6 wt, AyJjx6e^ [3wk4M-> LYAN o,,4� -7:s j DATE: '5 FE Ol Fe )l F-,U'ATIM� 4. FINAL I'll,"'! I QT c 0 1 r - AC 0., LL R EQ H PA! Yo-�,K S-FlTl-, %M, �N'SIPILL FOR DESIGN OR CO,"STRUCTION - V� : u �, '4 C: ERROR& !;MVERNEAD BUILDING SUPPLY Bili Snarler. Mid Setter: Sold To: GABRIELSEN BLDRS LLC PO BOX 317 JAMESPORT NY 11947 - ROBERT Received items Bekriv in Good Condition PRICES EXP 4rFV14 Ship To: Authorized Signature Sv'NROC�M * QUOTE * * QUOTE * * QUOTE * * QUOTE * * QUOTE * * QUOTE Customer No. Order Date Omer No. Customer P.O. No. Job Name Page No. 702529500 4/11/1492244/00 3455 WICKRAM AVE SUNROOM 1 Driver Ship Date Invoice Date Invoice No. RBS P.O. Sales Rep Order Type Warehouse No. 00118 Chris W. QUOTE 01 HM Ord Qty Shp Qty U/M Item No. Description Unit Price Amount ANDERSEN 400 SERIES WINDOW p0-6943.19 6,943.19 REF IQ QUOTE 93816 1 1 EA 95 5/4X4 VERSATEX SURROUND PKG 2025.00 2,025.00 28 28 EA 121X04X16FJ 1X4X16 WINDSORONE PLUS 17.03 476.84 PRIME ALL CUTS 3 3 EA 1254X04X16FJ 5/4X4X16 WINDSORONE PLUS 23.29 69.87 PRIME ALL CUTS 1 1 EA 95 HARDWARE ALLOW 250.00 250.00 100 100 LFT 0254X04T 5/4X4 TG CM CL FIR - FLOOR 1.55 155.00 1 1 EA 95 DOOR ALLOWANCE 500.00 500.00 Sub Total Sates Tax PAY THIS AMOUNT 10,419.90 898.72 11,318.62 TERMS and CONDITIONS of SALE GENERAL INFORMATION Material distributed by Riverhead Building Supply Corporation (RBSC) is of good quality and workmanship, free from defects which render it unserviceable for the use for which it was manufactured. The high quality of our products is safeguarded while in our possession. Our products must be given the same careful treatment by others. They must be property handled and protected at all times. We will not be responsible for defects resulting from neglect of these precautions. RETURNED MATERIAL STOCK MERCHANDISE - Return of stock merchandise will be accepted with appropriate invoice number provided merhandise is in original cartons, in good condition, and includes all packing instruction/material, if any. RESTOCKING AND HANDLING CHARGE - All returns are subject to a 15% restocking and handling charge based upon full order price. SPECIAL ITEMS - Returns of special items must have prior approval by RBSC and subject to conditions of the repective vendors. Any costs incurred will therein be the responsibility of the customer. CLAIMS No claims for shortages, damage or error in shipment will be allowed unless reported within 5 days after receipt of goods. No claims for service work performed by others will be allowed unless specifically authorized by us in advance. DAMAGED MATERIAL it is the responsibility of the customer to inspect all merchandise for possible damage at time of delivery and/or pickup. RBSC will not assume responsibility for damage unless properly noted on delivery receipt. TERMS OF SALE Invoice amount due must be received by Riverhead Building Supply Corp no later than the 25th day of the month following the purchase. Credit cards will not be accepted as payment towards account balances. LATE CHARGE A one and one-half percent (1-1/2%) monthly late charge on all past due account balances PRICES ON QUOTES WILL EXPIRE 14 DAYS FROM ORDER DATE URIVERNEAD BUILDING SUPPLY Bili Soadw. Bails attar. Solo To: GABRIELSEN BLDRS LLC PO BOX 317 JAMESPORT NY 11947 - ROB Received Items Below in Good Condition PRICES EXP 4/25114 Ship To: Authorized Signature * QUOTE * * QUOTE * * QUOTE * * QUOTE * * QUOTE * * QUOTE Customer No. Order Date Order No. Customer P.O. No. Job Name Page No. 702529500 4/11/1491783/00 3455 WICKHAM AVE 5 Driver Ship Date Invoice Date Invoice No. RBS P.O. Sales Rep Order Type Warehouse No. 00118 Chris W. QUOTE 01 HM Ord Qty Shp Qty U/M Item No. Description Unit Price Amount 1 1 EA 95 ANDERSEN 400 SERIES 6626.92 6,626.9T NEW WINDOW PACKAGE IQ # 93812 ------------------------------ ADDITION ITEMS PER ROB G: 20 20 EA 012X04X08 2X4X8 S4S DOUG FIR CONST 3.57 71.40 10 10 EA 012X04X16 2X4X16 S4S DOUG FIR PREMIUM 7.68 76.80 10 10 EA 012X08X16 2X8X16 S4S DOUG FIR PREMIUM 14.66 146.60 10 10 EA 012X10X16 2X10X16 S4S DOUG FIR PREMIUM 21.32 213.20 2 2 EA 2111ML24 1-3/4 X 11-7/8 X 24 LVL 111.05 222.10 Copy of TJM design specifiers 24 24 822076 PL PREMIUM 3X ADHESIVE 10 OZ 4.49 107.76 2 2 75GRS10D GRIPRITE 3" 10D STK BRT 2M 29.99 59.98 Sub Total Sales Tax PAY THIS AMOUNT ** CONTINUED ** TERMS and CONDITIONS of SALE GENERAL INFORMATION Material distributed by Riverhead Building Supply Corporation (RBSC) is of good quality and workmanship, free from defects which render it unserviceable for the use for which it was manufactured. The high quality of our products is safeguarded while in our possession. Our products must be given the same careful treatment by others. They must be properly handled and protected at all times. We will not be responsible for defects resulting from neglect of these precautions. RETURNED MATERIAL STOCK MERCHANDISE - Return of stock merchandise will be accepted with appropriate invoice number provided merhandise is in original cartons, in good condition, and includes all packing instruction/material, if any. RESTOCKING AND HANDLING CHARGE - All returns are subject to a 15% restocking and handling charge based upon full order price. SPECIAL ITEMS - Returns of special items must have prior approval by RBSC and subject to conditions of the repective vendors. Any costs incurred will therein be the responsibility of the customer. CLAIMS No claims for shortages, damage or error in shipment will be allowed unless reported within 5 days after receipt of goods. No claims for service work performed by others will be allowed unless specifically authorized by us in advance. DAMAGED MATERIAL It is the responsibility of the customer to inspect all merchandise for possible damage at time of delivery and/or pickup. RBSC will not assume responsibility for damage unless properly noted on delivery receipt. TERMS OF SALE Invoice amount due must be received by Riverhead Building Supply Corp no later than the 25th day of the month following the purchase. Credit cards will not be accepted as payment towards account balances. LATE CHARGE A one and one-half percent (1-U7%) monthly late charge on all past due account balances PRICES ON QUOTES WILL EXPIRE 14 DAYS FROM ORDER DATE ■ 1 101-710 LO zLU =� 1 z Ipe 1 % in / EX- FJ -o (0 TOTAL AREA: 1315 SQ. FT. PROVIDE MIN. (7) g x I I FLOOD VENTS (VERIFY LOCATIONS IN FIELD) '^ BASMENT TO BE FILLED WITH IN 1' OFin NATURAL GRADE PER NYS CODE I 1 I 1 1 LALLY COLUMN ON ■ LOI 12"dia. CONC. PIER 2'X2'X8" CONC. FTG. (TYPICAL) ' - - 1 . 1 ce Low I 1 • W �iu W ■Q z r O lit � I u XX� I� IX z IJJ W W W 1 1 1 1 I 1 7� • 1 I • 1 1 • / • EY- ■ FJ ■ p I I I I IcD I 1 1 I 1 1 1 1 1 1 1 4,_117 411 4'-5i/2" 4'-31/2" 0 in ■ ce ■ oe . oe gLULULu u lit lit • r I ■r Ix �� ■ W ■W ■W 1 1 EXISTING OPENING 1540-510 SMART VENT 1540-510 SMART 1540-510 SMART VENT FOUNDATION PLAN, SCALE: iia^ = r III SUMMARY A- This Section fraludes unit • ason assemblies consoling or the r011001191 1. Flood vonte 1.2 421ALITY ASSURANCE A. Conform to applicable DOCA, 411x=, I050, and ICC eodl• for autOnallc flood venting rdMpirsaents, PART 2 - PRODUCTS 2,1 FLOOD VENTS A. Csenerd, Provide automatic opening twd-A" single heISM and double height vent activated by flood! waters to relleve, unbalanced lateral forces on foundation malls. 5. Minimum Opening: Ability to paw objects up to 3 inch" ME, mal In dfaneter. C. Size, Designed to ?It openings In modular masonry oonstruction. I. Single Height, 16 x S Inches (400 x 200 mm). 2. Double Height. 16 x 16 Inches (400 x 400 mm). D. Frame, Vent., and Louver Material, Stainless steel, Type 316, formed and welded contnuction, F- vent: Pivoting, scud Irioulateal race, perforated face for vamUlatton, removable. 1. Free Area (Vont lal.loN: 1/4 Inch (6 Me) aquae prforattom single: 50 sq, In. (0.032 sq. m.), double: 100 sw, In. (0.064 sq. m.). 2. Free Ana (Flood Relief): single 200 sq. In. (OAA sq, m.), double: 400 aq, In (0,2M sq. m,). 3. Leuven, Automatic ventilation louvers with bimetal operator. 4. Vent Operation, "ale/ float releases vent on ruing and felling water. F. Installation Anchors, StalnWas, steel straps, four for each verrL No Installation tools required. G. Maintenance Tools. Requires thin blade to release float pins. H. Products, Subject to coq•Ilaloe with roqulrements, provide en of the following. 1. Smart VENT Manufactured by Mart VENT, Inc. PART 3 - EXECUTION 3.1 FLOOD VENT A. General: Install flood vents in scoprelanee with manufacturer's NrVuctiore, spaced evenly round foundation perimeter, mlerfmmwn 12 Inches above grade to bottom or vent. 5. Install one single height flood vent for every 200 wl, ft. Of ormiosed space below flood plain. C. Install one double height flood vent for every 400 oq. ft, of enclosed spew below flood plain. D. Adjust flood vents for proper operation. 1540-510 SMART VENT FLOOD ZONE CONSTRUCTION AS PER N.Y,S, RES, CODE 8321 FLOOD VENT BLOCK OR POURED INSTALLATION INSTRUCTIONS 14-1/4- ROUGH OPENING EXTERIOR INTERIOR ALTERNATE STR DOOR •� • •• UPPER STRAPS L ATIONS ON SI S REMOVED • • BEHIND WALL •s ALTERNATE 15-1/4. OPE • e SIDE STRAPS e • BEHIND WALL 2 Do 2-x 15-1/4' OPEN PEN 9-1/4' ROUGH - ■-1/4' HI H X OPENING L 1s-1/4' WIDE ROUGH OPEING 3-01 OPEN OFA -x 15-1/4. OPEN 'RAME DOOR OPEN FRAME- R SHOWN OPE ►s •• BOTTOM STRAPS IN FRAME • s BEHIND WALL STRAPS W BEIND WALL 12' AND CAN BE BROKEN OFF MAX AT SLOTS TO AVOID L• e OBSTRUCTIONS �• EXTERIOR VIEW FINAL GRADE • • ' SIDE SECTION VIEW 1. Prepare • CLEAN 16-1/4' wide by 1-1/4' high rough opening for •.ch wit (1 biwk wide x 1 black high) with the bottom of the halt no mon then 12- above Rnished gid•. 2. Measure well thickness and MM (mon then 90' ) 4 straps at nearest slot to the measurement frem Pointed and. 3. Rem•w doer from frame. (tum upside down, ratoht bottom of door outward and slide out of slots) 4. Insert two strops Into two topeats of .foto in frameea from rear. After pushing tooth through rear t slots, ONLY PUSH STRAPS ONE CLICK INTO FRONT SLOTS Straps should haw bent logs Minting up. 5. Caulk may be applied Behind fent frame fiongo. Tilt frame se top gess into well opening first with strap logo going behind wall abow opening. Push trams, into opening w front flange is tight to face of wall. ■. Reach through from• opening and install two bent straps through two bottom eats of slots in frame, trapping well between front flange and bent strap. Squeeze all strap tl ht. Frame should be flush to vel face end occurs. 7. Chock that frame Is square and slots aro clear f debrIs, mortar end caulk. S. Install doer Into frame, by grasping bottom of Ioor (with pI.:t1 pins) and front (with smaller squares) facing up. Slide door into frame such that metal pins an each side slide into slots on sides of tram•. Lot the door slide down following the path of the sots, until they ora at the bottom of the slots in the dimples. B. Let the bottom of the door go se that the door rotates down into the frame. Check that door Is latched on both sues. N o_ F /� . 3 2z - )53f (LEY TINN V-MW-('OPON&Ii mamma eawv� _ +•moue- our— I wswwu TVICAL WINDOW OMINC- (LES TW W 4 -40W -W OPIIM0 1ST. FLOOR P SCALE: 1/4" = 1' asmes Killeen• to mrosy snr� 21 aaa���■laaaa��l■■■aaaam mfo0 nr�inn Emu=nmmi be ol■laama� nM1 on 2L0 as ! aaliz w,.rl�r.IBEL•.Gz�tC. ISI ■� I i� II � • A NGir[LIlaifgr■B_e�rmiict'irlt r�tiaa.E' M MNn I lkgN 43 11BBr2 SBii OF 1P BE 020 11 oil i:�1N11R. �C"Bt� ill! I wswwu TVICAL WINDOW OMINC- (LES TW W 4 -40W -W OPIIM0 1ST. FLOOR P SCALE: 1/4" = 1' asmes Killeen• to mrosy snr� �� l i L� \ � � ole ",� ■ EL'I, l L� \ � �� 1 J \ �l 1•i '�, 7 L 7- e• • 7 '• • • • I • I i WI DSORf1E DEBRIS PROTSCr1ON FASTENIING SCHEDULE FOR WOOD SnIUCTU IAL PANELS WOOD STRUCTURAL PANES WITH A NINIMl1M THIONLSS OF 711V AND MAX" PANEL SPAN OF • RET SHALL BE PIMMIr BD FOR OPNING PBDTECr1ON IN ONE! AND TWO-STORY BUI1.011I . PANELS SHALL ELT PRKUT TO CNN GLAZED OFINKi WITH ATTAOIMNT HARDWARE PROYDBD. (RIIR TO 3BLTION 160!.1.4, 160!,6,5 AND TALE 160.1.4 OF IN RESIDENTIAL GMTRWM COW. THIS IS NOT A SUMMUTION FOR DESIGN -PRESSURE. ALL OPINIONS PNW HAVE DISIGN IREYIA(E UPGRADES WHOM APPLICABLE, ALL PANES MUiT BE CIT TO SIZE AND READY TO USE ON ANY NEW WODOWS AND DOORS. NIITTRS MILT BE M1RKED FOR WHAT OPENING IT IS TO COVER. HARDWARE MUiT ACO"ANY 3HUrrOtS FDR INSTALLATION. Im.11lf xtNawwaealS t-asarnsnastrmaTa stane.omnsrmmama elMlema at.-wwea wexmor+e.c (MORE THA 4' -MW -V OPENING) L -PLTwm. -aamnae mamm assns wwWt• wwosseas- wmowatz'wc Compliance Ce &On-stob, �€iy�ilit IiBN�Q■Illt 7r�BMBai�B6iE�aELEL�IGrWla�1`4aB �>� BiaaatiawBlia6BBB�iELiB onawwt w olmwapm ale NOMPARM us CbmwBar3■I1r 4 1omw**Aw �low f ■frtclrirlrnlc,�m111llrt It�'llrr� BBmIBYBI■11lm 7Q f11sWk =0 vvh"MMBYY■arer"gnse=MRtPSgwrlYrsSim�,tfmlmBrim CX145 1 1 1 1 CX145 1 O 1 1 1 I I I 1 1 1 1 REPLACE EXISTING WINDOWS AS NOTED WITH SAME SIZE AS OPENINGS. VERIFY EXISTING WINDOW HEADERS - MIN. (2) 2X6 UNLESS OTHERWISE NOTED 2ND. FLOOR PLAN SCALE: 1/4" = 1' t.�as=>` B>VB�alil•�aim� 21 aaa���■laaaa��l■■■aaaam mfo0 nr�inn Emu=nmmi R R IWfim�■lYmaas ol■laama� nM1 on 2L0 as ! aaliz w,.rl�r.IBEL•.Gz�tC. ISI ■� I i� II � • A NGir[LIlaifgr■B_e�rmiict'irlt r�tiaa.E' 116E I lkgN 43 11BBr2 SBii 32 020 11 i:�1N11R. �C"Bt� ill! REMO U7111i ! II I ■ I III �� l i L� \ � � ole ",� ■ EL'I, l L� \ � �� 1 J \ �l 1•i '�, 7 L 7- e• • 7 '• • • • I • I i WI DSORf1E DEBRIS PROTSCr1ON FASTENIING SCHEDULE FOR WOOD SnIUCTU IAL PANELS WOOD STRUCTURAL PANES WITH A NINIMl1M THIONLSS OF 711V AND MAX" PANEL SPAN OF • RET SHALL BE PIMMIr BD FOR OPNING PBDTECr1ON IN ONE! AND TWO-STORY BUI1.011I . PANELS SHALL ELT PRKUT TO CNN GLAZED OFINKi WITH ATTAOIMNT HARDWARE PROYDBD. (RIIR TO 3BLTION 160!.1.4, 160!,6,5 AND TALE 160.1.4 OF IN RESIDENTIAL GMTRWM COW. THIS IS NOT A SUMMUTION FOR DESIGN -PRESSURE. ALL OPINIONS PNW HAVE DISIGN IREYIA(E UPGRADES WHOM APPLICABLE, ALL PANES MUiT BE CIT TO SIZE AND READY TO USE ON ANY NEW WODOWS AND DOORS. NIITTRS MILT BE M1RKED FOR WHAT OPENING IT IS TO COVER. HARDWARE MUiT ACO"ANY 3HUrrOtS FDR INSTALLATION. Im.11lf xtNawwaealS t-asarnsnastrmaTa stane.omnsrmmama elMlema at.-wwea wexmor+e.c (MORE THA 4' -MW -V OPENING) L -PLTwm. -aamnae mamm assns wwWt• wwosseas- wmowatz'wc Compliance Ce &On-stob, �€iy�ilit IiBN�Q■Illt 7r�BMBai�B6iE�aELEL�IGrWla�1`4aB �>� BiaaatiawBlia6BBB�iELiB onawwt w olmwapm ale NOMPARM us CbmwBar3■I1r 4 1omw**Aw �low f ■frtclrirlrnlc,�m111llrt It�'llrr� BBmIBYBI■11lm 7Q f11sWk =0 vvh"MMBYY■arer"gnse=MRtPSgwrlYrsSim�,tfmlmBrim CX145 1 1 1 1 CX145 1 O 1 1 1 I I I 1 1 1 1 REPLACE EXISTING WINDOWS AS NOTED WITH SAME SIZE AS OPENINGS. VERIFY EXISTING WINDOW HEADERS - MIN. (2) 2X6 UNLESS OTHERWISE NOTED 2ND. FLOOR PLAN SCALE: 1/4" = 1' t.�as=>` B>VB�alil•�aim� 1#s, tMI SAM a Omanilf■liia iNgLlgm4mrTmom sn 2L0 as SAW l!1 aaliz w,.rl�r.IBEL•.Gz�tC. �Xii:. i� '� �,�IT� IBJ NGir[LIlaifgr■B_e�rmiict'irlt r�tiaa.E' 116E lkgN 43 11BBr2 SBii 32 020 11 i:�1N11R. �C"Bt� ill! U7111i .1111,illilir AaIIIBial�nBcL`111BaBI�Ba1Bfi1B�BEBi[irM�1i2 C "'A". PLUMBING SCHEMATIC N.T.S. 0 AMIAWM TIC mYFM PAINTER TO PRIME AND PAINT ALL DOOR EDGES TO MAINTAINCONTRACTOR SHALL NOTIFY ARCHITECT OF ANY DISCREPANCIES BETWEEN THE DRAWINGS, THE SPECIFICATIONS, AND THE FIELD CONDITIONS, AND SHALL REQUEST CLARIFICATION BEFORE COMMENCING WORK. CONTRACTOR SHALL VERIFY ALL GENERAL CONTRACTOR TO COORDINATE MEETING WITH OWNERS FOR APPROVAL OF ALL GENERAL CONTRACTOR SHALL BE RESPONSIBLE FOR ALL BUILDING DEPARTMENT INSPECTIONS MANUFACTURER'S WARRANTY AND SHALL BE INSPECTED TO VERIFY ALL WORK I DIMENSIONS AND CONDITIONS AT JOB SITE• INCLUDING BUILDING AND SITE CLEARANCES FOR DELIVERY OF EQUIPMENT AND MATERIALS, AND REMEDY ALL DISCREPANCIES WITH ARCHITECT PRIOR TO THE COMMENCEMENT OR CONTINUATION OF WORK. I ROUGH ELECTRIC. PLUMBING, AND HVAC PRIOR TO INSULATING AND SHEETROCKING I AND SHALL SECURE THE C of 0 PRIOR TO RECEIVING FINAL PAYMENT FROM OWNERS. REVISIONS: U ^O a pa-+ U OOO Z 0 waw Feel �pqZ AW W a�� a H Za� �OU Q N a a O ►-t U 0 Ntl W M CIJ v C C; xc o \, u ENO, UU O �V w DRAWN: MH / MS SCALE: 1/4"=1'-O" JOB #: June 23, 2014 SHEET NUMBER: A-1