HomeMy WebLinkAbout41264-Z �Q�p Cal Town of Southold 1/16/2018
,..'� P.O.Box 1179
'. 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39452 Date: 1/16/2018
THIS CERTIFIES that the building AS BUILT ALTERATION
Location of Property: 60125 North Rd Unit 2A. Greenport
SCTM#: 473889 Sec/Block/Lot: 44.1-1-8
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
12/28/2016 pursuant to which Building Permit No. 41264 dated 1/3/2017
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"FMSHED BASEMENT WITH BATHROOM IN AN EXISTING ONE FAMILY DWELLING, AS
APPLIED FOR
The certificate is issued to Tiedemann,Edmund&Susan
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 41264 09-20-2017
PLUMBERS CERTIFICATION DATED 03-29-2017 and J. 'edemann
th rized Signature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
V 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#: 41264 Date: 1/3/2017
Permission is hereby granted to:
Tiedemann, Edmund
PO BOX 179
Greenport, NY 11944
To: legalize "as built" finished basement in existing condominium as applied for with flood
permit. Additional certification may be required.
At premises located at:
60125 North Rd Unit 2A. Greenport
SCTM #473889
Sec/Block/Lot# 44.1-1-8
Pursuant to application dated 12/28/2016 and approved by the Building Inspector.
To expire on 7/5/2018.
Fees:
AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $980.00
Flood Permit $100.00
CO -ALTERATION TO DWELLING $50.00
Total: $1,130.00
Bui sp .ctor
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 i,,
denied,the Building inspector shall state the reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy-New dwelling$25.00,Additions to dwelling$25.00,Alterations to dwelling$25.00,
Swimming pool$25.00,Accessory building$25.00,Additions to accessory building$25.00,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. Dec. 18th 2016
New Construction: Old or Pre-existing Building: V (check one)_
Location of Property:60126 Unit 2A Route 48 Southold
House No. Street Hamlet
Owner or Owners of Property: Edmund and Susan Tiedmann
Suffolk County Tax Map No 1000, Section 44.01 Block 1 Lot 08
Subdivision Seabreeze Village Condominiums Filed Map. Lot: 2A
Permit No. a Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ 5®
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Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G _roger.richerta-town.Southold.ny.us
Southold,NY 11971-0959 c®U
9
BLULDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Tiedemann
Address: 60125 North Road (Unit 2A) city;Greenport st: New York zip: 11944
Building Permit#: 41264 Section: 44.1 Block 1 Lot: 8
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 Hot Tub
Addition Survey X Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt CeilingFixtures
1 HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures 2 CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks
Disconnect Switches Twist Lock Exit Fixtures TVSS
Other Equipment: "AS BUILT" - "ELECTRICAL SURVEY"- "NO VISUAL DEFECTS"
Notes: 8 ft. Lighting Track, 2- Paddle Fans, 1- Exhaust Fan.
Inspector Signature: Date: September 20, 2017
0-Cert Electrical Compliance FormAs
soTja
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
T V
1
BUILDING DEPARTNMNT
TOWN OF SOUTHOLD
JAN 1 2 2018
TOWN OTS SOUMOLD
CERTIFICATION
Date:
Building Permit No.
Owner:-f-L-V-76WO
(Please print)
Plumber:. lf—,OA7z��IJ0
(Please print)
I certify that the solder used in the water supply system contains less than 2/10 of I%
lead.
Jumbers Signature)
Sworn to before me this
day of 20LI-1
A�-
0 Tublic, ounty
My Comm.Exp1me 12-26-M
�o� olo
Comm,Nct�
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] SULATION
[ ] FRAMING / STRAPPING [ FINAL(Al &v v-rmjvowf)
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS: I rt �"j %S.
',;Ml Af\, ` 0 QAlAVk9-A'
erw `A 40 L,5r k/(40 u
DATE INSPECTOR
SO�Tyo
cou
— 1
TOWN OF SOUTHOLD BUILDING DEPT.
765-18®2
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLRG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ] ELECTRICAL (FINAL)
REMARKS:
DATE `� INSPECTOR -
JAMES DEERKOSKI P.E.
260 Deer Dr.
Mattituck, NY 11952
631 7747355
Date: 12/14/17
To:
Southold Town Building Dept. JAN 1 2 2018
Re: �tJt ; ,n
Insulation Inspection TOWN OF 5OUTHOLD
Tiedmann
60126 Rt. 48
Unit 2a
Southold, NY
To Whom It May Concern
An Insulation Inspection was performed on the above mentioned residence, and all
insulation was installed as per plan and meets all State and Local Codes. Please feel
free to call me with any questions
Sinc rel o NEw yo
P� ) EE
James D er ski P.E. * ��� 0s�
�2`SC�Op o. 07Z�'��.
ROFESS��
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FIELD INSPECTION REPORT 'DATE COMMENTS
FOUNDATION(IST)
--------------------------------------
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----------------------------------- -
'FOUNDATION(2ND) a
ROUGH FRAMING&
PLUMBING
INSULATION PER N.Y. y
STATE ENERGY CODE
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msvl c�wllti
FINAL
ADDITIONAL COMMENTS
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20- I P 5.00 IZ • �7 cWR
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALb Board of Health
SOUTHOLD,NY 11971 4 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502Survey.
SoutholdTown.NorthFork.net PERMIT NO. Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
Flood Permit
Examined 20 Single&Separate
Storm-Water Assessment Form
Contact:
Approved is ,20 Mail to: Joan Chambers
Disapproved a/c PO Box 49 Southold NY 11971
Phone: (631)294-4241
Expiration J .2
o
20
D MC R O �%J( Bui n ector
[[�2 �`/0 X155 DDPPLICATION FOR BUILDING PERMIT
DEC 282016
Date December 1 st 520 16
BUILDING DEPT. INSTRUCTIONS
a. Re 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
authorized inspectors on premises and in building for necessary inspections.
(Signature of applicant or name,if a corporation)
PO Box 49 Southold NY 11971
(Mailing address of applicant)
State whether applicant is owner, lessee,agent, architect, engineer, general contractor, electrician,plumber or builder
Agent
Name of owner of premises Edmund and Susan Tiedmann
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
60125 Unit 2A Route 48 Southold
House Number Street Hamlet
County Tax Map No. 1000 Section 44.1 Block 1 Lot 08
Subdivision Seabreeze Village Condominiums Filed Map No. Lot 2A
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy Single family residence
'b. Intended use and occupancy Single family residence with firiished'basement
3. Nature of work(check which applicable):New Building Addition Alteration
Repair Removal- , Demolition Other Work
(Description)
4. Estimated Cost Fee
(To be paid on filing this application)
5. If dwelling,number of dwelling units 1 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 23'-8" Rear 17'-8" Depth 42'-2"
Height 26' Number of Stories 2
Dimensions of same structure with alterations or additions: Front Same Rear Same
Depth Same Height Same Number of Stories 2
8. Dimensions of entire new construction: Front 22'-3' Rear 161-4" Depth 40'10"
Height 8' Number of Stories Finished basement
9. Size of lot: Front 366.68' Rear 398.89' Depth 435.00'
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated RR High Density Residential
12. Does proposed construction violate any zoning law, ordinance or regulation?YES NO__NL_
13. Will lot be re-graded?YES NO__V Will excess fill be removed from premises?YES NOS_
14.Names of Owner of premises Edmund and Susan TiedmanAddreSS 60125 CR 48 Southold Phone No. (516)810-8023
Name of Architect Address Phone No
Name of Contractor Address Phone No. a
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO
* IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? *YES NO-,/
* IF YES,D.E.C. PERMITS MAY BE REQUIRED.
16. Provide survey,to scale,with accurate foundation plan and distances to property lines.
17. If elevation at any point on property is at 10 feet or below,must provide topographical data on survey.
18.Are there any covenants and restrictions with respect to this property? *YES V NO
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF Suffolk
Joan Chambers being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named, CONNIE D.BUNCH
' Notary Public,State of NOW York
(S)He is the Agent No.01 BU61 SW50
(Contractor, Agent, Corporate Officer, etc.) Qualified in SWIM
Commission Expires April 14,2-2
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 tq!before me this _ ��o,,
aT�day of�Qi� 20
Notary Public igiiature of Applicant
®�Of S
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TOW°Hall Annex 41 Telephone(631)765.1802
54375 Main Road QQ
P.O.Box 1179 G roy_ er riChert OWfl�o7a g o[g ny us
Southold,NY 11971-0959 �`+�• �y0
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: ,loan Chambers Date: Dec 19th 2016
Company Name: PressSTART Permits
Name:
License No.:
Address: PO Box 49 Southold NY 11971
Phone No.: (631)294-4241
JOBSITE INFORMATION: (*Indicates required information)
*Name: Edmund and Susan Tiedmann
*Address: 60125 Unit 2A Route 48 Greenport NY
*Cross Street: Chapel Lane
`Phone No.: (631)294-4241
Permit No.: �(a
Tax Map District: 1000 SL'Ctiorl: 44� # BIoCk: 1 Lot: Og
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
As built finished basement
(Please Circle Ali That Apply)
*Is job ready for inspection: YES NO Rough In na
*Do-you need a Temp Certificate:
. YES / NO -
Temp Information(If needed)
*Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other
`'New Service: Re-connect Underground Number of Meters Change of Service Overhead �®
Additional Information: PAYMENT DUE WITH APPLICATION ��
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'fOV✓N CLERK �' � � Southold Ncv,- Ytirk 1 1
ItISrnA.R OF MAJ.STA'ns"cS ?�� I 1- Fax (S I(i)
t.G71St-I R.
MARRIAGE OFFICER _ bO Tcicnconc (5I(1) ](1� 1
RECORDS M/VNAGEMENTOFFICEIt r�01
F REEDOM OF INFORMA'nON OFFICER
OFFICE OF THE TOWN CLERIC
TOWN OF SOUTHOLD
THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION WAS ADOPTED BY THE
SOUTHOLD TOWN BOARD AT A REGULAR MEETING HELD ON AUGUST 24, 1993:
RESOLVED that the Town Board of the Town of Southold hereby adopts
two (2) new forms to be used under tfie Flood Damage Prevent regulations
Of, the Code of the Town of Southold: "Floodplain Development. Permit
!(pplication" (FDP(93) ) , and ;'Certificate of Compliance frj'r Develc-pment in
Special Flood Hazard Area (C/C(93)) .
IF
- -� -
TOW''OF SOUPIOLD
/�h T. Terr
Y
Southold Town Clerk
August 25, 1993
t
APPLICATION
r PAGE 1 of 4
TOWN OF SOUTHOLD
FLOODPLAIN DEVELOPMENT PERMIT APPLICATION
This Corm is to be filled out in duplicate.
SECTION 1 GENERAL PROVISIONS (APPLICANT to read and sin)-
1. No work may start unW a permit is issued.
2 The permit may be revoked if any false statements are made herein.
3. If revoked, all work must cease until permit is re=issued.
4. Development shall not be used or occupied until a Certificate of Compliance is issued.
S. The permit will expire if no work is commenced within six months of issuance.
6. Applicant is hereby informed that other permits may be required to fulfill local,state and federal regulatory
requirements.
7. Applicant hereby gives consent to the Local Administrator or his/her representative to make reasonable
inspections required to verify compliance.
8. I,THE APPLICANT,CERTIFY THAT ALL STATEMENTS HEREIN AND IN ATTACHMENTS TO
_ THIS APPLICATION ARE,TO THE BEST OF MY KNOWLEDGE,TRUE AND ACCURATE.
(APPLICANT'S SIGNATURE)—..,— DATE
V �
/SECTION 2: PROPOSED DEVEL0PI.r4ENT (Ta�c completed by APPLICANTI r_ 3( Z 4
NAME ADDRESS 39 g6?X 41 TELEPHONE
AP P LI CANT
BUILDER
ENGINEER
PROJECT I-.0CAT70N:
To avoid delay in processing the application, please provide enough information to easily r- ufy the project
location. Provide the street address, lot number or legal desorption (attach) amd, outside urban areas, the
distance to the nearest intcrsccting road or well-known Landmark A sketch attached to this application showing
the project location would be helpful.
"'Q'_I a I.1
FDP(93)
• 1 1
• 4 f
APPLICATION
PAGE 2OFa
DESCRIPTION OF WORK (Check all appbcable boxes)
A CTRUCTURAL DEVELOPMENT
ACTIVITY STRUCTURE TYPE
❑ New Structure WResidtindal (1-4 Family)
❑ Addition ❑ Residential (More than 4 Family)
154-Alteration ❑ Non-residential (FloodprooFmg? ❑ Yes)
❑ Relocation ❑ Combined Usc (Residential & CommerdaJ)
❑ Demolition ' P ❑ Manufactured (Mobile) Home (In Manu-
0 Replacement factured Home Park? ❑ Yes)
ESTIMATED COST OF PROJECT S
B. OTHER DEVELOPMENT ACTIVITIES:
❑ Fill ❑ Mining ❑ Drilling ❑ Grading
❑ Excavation (Except for Structural Development Checked Above)
❑ Watercourse Alteration (Including Dredging and Channel Modifications)
O Drainage Improvements (Including Culvert Work)
j ❑ Road, Street or Bridge Construction �}
❑ SuF//;division (New or Expansion) /
/ ❑ Water or Sewcr Systcm 1
❑ Other (Please Specify)
After completing SECTION 2, APPLICANT should submit form to Local Admiautrator for review.
SECTION 3 FLOODPLAIN DETERMINATION (To be completed by LOCAL ADMINISTRATOR)
The proposcd development is located on FIRM Pancl No. . Dated
The Proposed Development:
❑ Is NOT located in a Special Flood Hazard Arca (Notify the appUcant that the application
review is complete and NO FLOODPLAIN DEVEI".OPMENT PERMIT IS REQUIRED).
❑ Is located is a Special Flood Hazard Arca.
FIRM zone designation is
100-Year flood elevation at the site is: Fl. NGVD (MSL)
❑ Uoavailablc
❑ Tbc proposed development is located to a (loodway
FBFM Pa.oel No Dated
❑ See Sccnon 4 (or additional iostruclions
SIGNED DATE
APPLICATION -4
PAGE 7 OF 4
SECTION 4• AQQfTI NAL INFORMATION REQUIRED To he completed by L CALADMINIST•RATQR
The applicant must submit the documents checked below before the application can be processed:
❑ A site plan showing the location of all costing structures, water bodies, adjacent roads, lot
dimensions and proposed development.
❑ Development plans,drawn to scale, and specificatipns,including where applicable: details for
anchoring structures, proposed elevation of lowest floor(including basement), types of water
resistant materials used below the first floor, details of floodproofmg of utilities located below
the first floor and details of enclosures below the fust floor.
Also
❑Subdivision or other development plans (If the subdivision or other development axceeds 50
lots or 5 acres,whichever is the lesser, the applicant must provide 100-year flood elevations
if they are not otherwise available).
O Plans showing the extent of watercourse relocation and/or landform alterations_
❑ Top of new fill elevation Ft. NGVD (MSL).
❑ Floodproofing protection level (non-residential only) Ft:NGVD (MSL). For
floodproofed sauctures,�ipplicant must attach certification from registered engineer or
architect. /
❑ Certification from a registered engineer that the proposed activity in a regulatory data an y
will not result in an increase in the height of the 100-year flood. A copy of all data and
calculations supporting this finding must also be submitted.
❑ Other.
SECTIQN 5: PERMIT DETERMINATI N e completed by L AL ADMINI RAT R
I have determined that the proposed activity. A. ❑ Is
B. ❑ Is not
in conformance with provisions of Local Law IF 19_. The permit u issued subject to the conditions
attached to and made part of this permit.
SIGNED DATE
if BOX A is checked, the Local Administrator may issue a Development Permit upon payment of desiglaled
fcc.
If BOX B 15 checked, the Local Admirustrator wdl provide a written summary of dcficicnacs. Applicant may
revise and resubmit an application to the Local Adrninistrnlor or may request a bearing from the Board of
Appeals
i
APPLICATION d'
PAGE 4OF4
APPEALS. Appealed to Board of Appeals? ❑ Yes ❑ No
Hearing date:
PPea S—B-U� --- roved; rte, '-cs9NO
Conditions
SECTION 6 AS BUILT ELEVATIONS (To be submitted by APPLICANT before Certificate of Compliance
is issued
The following information must be provided for project structures. This section must be completed by a
registered professional eo&ecr or a licensed land surveyor (or attach a certification to this application).
Complete 1 or 2 below.
1. Actual (As-Built) Elevation of the top of the lowest floor, including basement(in Coastal Hieh Hazard
Areasbottom of lowest structural member of the lowest floor, excluding piling and columns) is:
FT. NGVD (MSL).
1
Z y Actual (As-Built) Elevation of floodproofmg protection is FT. NGVD (MSL).
NOT'/ Any work performed prior to submittal of the above information is at the risk 6f the Appl'canL.
SECTION 7 COMPLIANCE ACTION (To be completed by LOCAL ADMINISTRATORI
Tbc LOCAL ADMINISTRATOR will complete this section as applicable based oo inspection of the project to
ensure compliance with the community's local law for flood damage prevention.
INSPECTIONS: DATE BY DEFICfEtgCIES? ❑ YES ❑ NO
DATE BY DEFICIENCIES? ❑ YES ❑ NO
DATE BY DEFICIENCIES? ❑ YES ❑ NO
SECTION 8 CERTIFICATE OF COMPLIANCE(To be completed by LOCAL ADMINISTRATOR)
Certiftcatc of Compliance issued: DATE: BY:
• � I I 1
✓ l
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r r r
Attachment B
/• BAMPLE
/ CERTIFICATE /JF COMPLIANCE
for Development in a Special Flood Hazard Area
i
• r• a !f I
',- TOWN OF SOUTHOLD
CERTIFICATE OF COMPLIANCE
FOR DEVELOPMENT IN A SPECIAL FLOOD HAZARD AREA
-- (n xwrl E-F MUST RE AIN THIS CERTIFICATE) --
PREMISES LOCATED AT: PERMIT NO.
PERMIT DATE
OWNERS NAME AND ADDRESS: CHECK ONE:
0 NEW BUILDING
O EXISTING BUILDING
Cl VACANT LAND s
f 1
THE LOCAL ADMINISTRATOR IS TO COMPLETE A.. OR B. BELOW:
A. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIR.EMENTS OF
LO CAL LAW # , 19
SIGNED: DATED:
B. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF
LOCAL LAW # , 19_, AS MODIFIED BY VARIANCE #
DATED
SIGNED: DATED:
CIC ( 93 )
Er
PLUMBER CERTIFICATION
-OIV LEAD CONTENT BEFORE
CERTIFICATE OF OCCUPANCY
AR R Q VED AS NOTED SOLDER USED IN IIIA TER
SUPPLY SYSTEM CANNOT
DATMBUIL�DFIN�G_
B.P.# ,EXCEED 2/10 OF 1% LOAD.
FEE:
3Y:NOT! BE°ARTMEi� T
765-1802 8 AM 10 4 PM FOR THE PLUMBING
FOLLOWING INSI'E;;TIONS: ALL PLUMBING WASTE
1. FOUNDATION - TWO REQUIRED ,A i&WATER LINES NEED
FOR POURED CC'�CRETE -LISTING BEFORE COVERING
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. F114AL - CONOTRUCTION MUST
BE COMPLETE FO", C.O. ELECTRICAL
ALL CONSTRUCTION SHALL MEET THE INSPECTION REQUIRED
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS. RETAIN STORM WATER RUNOFF
PURSUANT TO CHAPTER 236
COMPLY WITH ALL CODES OF OF THE TOWN CODE.
NEW YORK STATE & TOWN CODES 'I
AS REQUIRED AND CONDITIONS OF FL00 zoo
TOWN ZBA CAI�PI.�r! 'I,�d 94�
FLOOD DAMAGE PREVENTION
D SOUTHOLD TC''NNI CODE
TOWN TRUSTEES7—
Lv c nFr
Ii'ana
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
General Notes Scope of Work 1) UV�Ly
Interior Renovation.
'L All work shall be peftirried In strict accordance with the
rules and regulations of the Southold Building Code and the Additional Construction Notes
Li
New York state codes having jurisdiction over any portion of
work.
LINEN
2 The general contractor and all subcontractors shall visit 10(wic- C
the site and verify all dimensions and the existing conditions 1.All portions of the proposed structure shall comply With
covering or affecting the work prior to construction Any the Building Code of the State of Now York and the
discrepancies or omissions which would interfere withthe W
satisfactory completion of the work described herein shag be Residential Code of the State of New York.
reported to the architect or property owner.
2.All portions of the proposed structure are designed to
3 Before starting work,the contractor shall make a STORAGE AREA
th rough examination of those portions of the st=ture In which comply with local geographic and climactic criteria as
the work Is to be performed,checking all the
stated in the adjoining table.
the
or underlying locations Report to the architect or
property owner any and all conditions which may Interfere with 3.All structural elements are designed to be adequate for
or Do not start otherwise affect or prevent the proper execution and J 3:eed of 120 0
Core a ground snow load of 45 psi,and wind speed C?
completion of the rt the work until such to SITTING ROOM
a work 0
conditions have been examined and a course erection mutually mph. LAV.
Z
agreed upon.
4.Footings shall be at a minimum of 36"below finished
4 Failure to notly the architect or the owner of unsatisactory J
❑
conditions will be construed as an acceptance of the conditions grade. 6 of
U)
to properly perform therequIred work, 5.Poured concrete shall have a compressive strength of 22 W
0
5.The execution of the work constitutes acceptance of the 4 0 0
conditions Later claims will not constitute relief from the 2500 psi at 28 days. 0
s
requirements of the work,nor will extra compensation be paid
by the owner. 6.Sill plates shall be preservative treated wood and be Z
installed above 160 oz copper termite shield.
a All work is to conform with drawings and specifications of the
architect and engineer consultants. 7.Shingle siding shall conform to ASTM D 3679 SH ER
T The general contractor is to maintain a complete and up requirements and be installed in accordance with the AS BUILT FINISHED BASEMENT
to date set of drawings on the job site at all limes, requirements of the Building Code of the State of New
Including contract documents and specifications York and manufacturers specifications.
It
S The contract documents and drawings are not to be 8.An ice shield of self adhering polymer modified
scaled under any circumstances Field approvals by the
architect or owner are required are required for final locations of bitumen sheet shall extend from the eave's edge to a min. i STORAGE CLOSET
oftrior and interior partition walls,wag openings,electrical of 24"inside the exterior wall perimeter.
artists and devices Including light fixtures,mechanical devices 2x4 @ 16 O.C.STUD WALL TYP.
and equipment plumbing fbibures,and decorative Wif 1/2"GYP.BD.
surfaces and materials. Energy Conservation Notes R-13 BATT INSUIL.
WATER INTAKE
g.Fumish and supply all materials,labor,and equipment as
required to perform and COMPIffte the work Indicated in ft 0
a act documents and drawings
Dribre 1.All building envelope components shall comply with
Chapter 6 of the Energy Conservation Code of the State kr
0 FURNACE
10,
It shall be the contractors responsibility to ascertain of New York. co 0
all prevailing procedures including,storage and toilet L
facilities,protection of existing work to remain,access to work RIS.d—)8"
area hours of permitted work,availability of water and 2.All glazing shall have a max.U Factor of,40.
d 1c power,and all other conditions and restrictions, 00
..
for this particular location.
3.Ceilings shall be provided with a min.R-19 fiberglass
t INTAKE
11.The general contractor shall take every precaution to batt insulation.
protect the existing work to remain.g'work to remain becomes
4.Exterior walls shall be provided with min.R-13 PLAN
damaged during the course of operations,ftwill be repairad toHWT
the owner's satisfaction,at no additional cost, fiberglass batt insulation. Iw D
:A1 1 1/4"=11
V-The general contractor shall obtain any and all permits • —1)
required for the performance of the work,and also file the V I l4f—
necessary documents with the Department of Buildings in
preparation for permitting
13.The general contractor shall make the necessary +
arrangements to utilities and services temporarily disconnected
while Performing the work as required,and maintained for
temporary use.
14 The general contractor shall do all cutting and Geographic and Climate Design Criteria
chopping for ad[subcontractors and trades. Subject to Damage From SEAL. T I E D M A N N RESIDENCE
115 The general contractor shag provide proper shoring Ground Wind Sin Winter Ice Shoild
Spas Design Undedaymeni Flood
smir
and bracing for all remaining structure prior to removal of Snow d Design
Weathering Frost Termite Decay
Lead s g Ina 6 012 6 ROUTE 48.
existing structure MPH Category L Tamp Required Hazard
Depth
16 The general contractor shall be responsible for necessary Moderate,to S 11-03 yes NA
patching and refinishing of the adjacent properties as required 45 psi 120 B Severe 36' Heavy M= SOUTHOLD N.Y.
the to contract work within the project age. -------
17.The general contractor will be responsible for scheduling all UNIT 2A '
Inspections as required,Including,
(a)foundation
(b)rough framing SCTM# 1000-44.01-1-08
(c)rough electrical Building Department Information Nev
(it)rough plumbing yZONE RR
(a)fined electrical PRESCRIPTIVE OR ENGINEERED. PRESCRIPTIVE C. D 0
(I)finish SQUARE FOOTAGE ADDED EXISTING PROPOSED
18.Surplus material of every character resulting from the work. BASEMENT: 725 sq ft. 725 sq.ft.renovated J,-
FIRST FLOOR. AS BUILT f -;F-
which may be left over during the work and after the work is PLAN
SECOND FLOOR
completed,shall be hauled away and the site left entirely clean Arric
and unobstructed on a regular basiswrn SCALE 1/4" 1' NOV 30TH 2016
19.Execute the work in a careful anti orderly manner with DESIGN LOADS: ROOF-DEAD LOAD 20 psf SNOW LOAD 45psf
the least possible disturbance to the public. SECOND FLOOR NON SLEEPING AREA-DEAD 20psf LIVE 40psf
ATTICS WITHOUT STORAGE-DEAD 10psf LIVE 10 psfW[TH STORAGE,DEAD 10psfLIVE 20psf i Q 0 PO BOX 49
20.The general contractor Is solely responsible for construction STAIRS DEAD 10 list LIVE 4Dpsf GUARDRAILS HANDRAILS DEAD 5psfUVE200psf SOUTHOLD NY 11971
safety and shag hold the owner,architect,and ROBERT WILSON
assigns harmless from litigation arising out of the F 1�\v631-294-4241
contractors failure to provide necessary construction safety EXPOSURE CATEGORY C
means and methods. SEISMIC CATEGORY B
WIND ZONE 120 m -WITHIN I MILE FROM COAST E D TEST APPLICABLE
PPP�AYAI E4;,M
21.
Perform the work in accordance with the highest standards TTMTff17T= - -- LYWLJ.rAN=Lb rUK rKu I r ;anb i VVINU DUKN= APPROPKIA I t: oress
and established pracbees of the trade,and conform to all village, ATTACHMENT HARDWARE SHALL BE INCLUDED PANELS SHALL COVER ENTIRE GLAZED OPENING
state,and federal authorities having jurisdiction over this work. =L MBER SPECIES&GRADE 1JuuULA5 FIR-LARCH SELECT SI'RUCTURAL GRADE Fb=1459 psi
ENGINEERED LUMBER LVL 1.9E Fb 2600psi&11.7/8'TJI 560 SERIES MAX.VERTICAL SHEAR 205016s
22 Work specified shall be performed by subcontractors FLOURS- I vvL) & i LAYER 1/2 PTS FIN.SURFACE
WALLS-11 LAYER 5/8'Cox APA RATED,NAILED WITH BID @4-O.C.@ EDGES,6.O C.@ INTERIORS TARTO A 101
regularly engaged in the supply and installation of work IF PNEUMATIC GUM IS USED NAILS SHALL BE 097-099 1-3/43"0 C.EDGES,6-D.C.INTERIOR 1 OF 1
required by these speaficabons. ROOF-I LAYER 314"CDX APA RATED NAILED WITH BID @ 4-D.C.@ EDGES,6-0 C INTERIORS IF oermits I drci
23 It Is the Intent that the contract documents and bid PNEUMATIC GUNS ARE USED-NAILS SHALL BE.097..099"L.1-7/8'.3-0 C.EDGES,6-O.0 INTERIOR -
specifications Include all labor and material to accomplish a
complete Installabon
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