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HomeMy WebLinkAbout34532-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34141 Date: 12/16/09 THIS CERTIFIES that the building IN-GROUND SWIMMING POOL Location of Property: 1745 ALDRICH LA LAUREL (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 125 Block 2 Lot 1.19 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 25, 2009 pursuant to which Building Permit No. 34532-Z dated MARCH 25, 2009 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 ACCESSORY IN GROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR. The certificate is issued to WILLIAM T & SUSAN C BAIRD (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1174183 10/31/03 PLUMBERS CERTIFICATION DATED N/A u on ed Signature Rev. 1/81 mo\, I Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALT, 765-1802 APPLICATION'FOR CERTIFICATE OF OCCUPANCY o d zcc � � . This application must be filled in by typewriter or ink and submitted to the Building Department with the mg: C)= 00 -A. For new building or new use: 1. Final survey of property with accurate location of all buildings,property lines,streets,and unusu Ana 1 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 o o ea 5. Commercial building,industrial building,multiple residences and similar buildings and installations,a certificate of Code Compliance-from architect of engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For.existing buildings(prior to April 9, 1957) non-conforming uses,or buildings and"pre-existing"land uses: i. Accurate survey of property showing"all property lines, streets,building and unusual natural or topographic -features. .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$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$50.60. 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 X pate._ New Construction Old or Pre-existing Building: (check one) 4ocation of Property:. `,q-1 ILf� J, L,4 House No.�. Street Hamlet v6wner.or Owners of Property: U 'Suffolk County Tax Map No 1000, Section Block Lot , Subdivision -Filed Map. Lot: ;Xermit No. �� �-- Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: / Request for: Temporary Certificate Final Certificate: C/ (check one) Fee Submitted: $ S 0 aG�� ( Applicant Signature` FORM NO. 3 TOWN OF SOUTHOLD ' BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 34532 Z Date MARCH 25, 2009 Permission is hereby granted to: - WILLIAM T & SUSAN C BAIRD 1745 ALDRICH LANE LAUREL,NY 11948 for CONSTRUCTION OF AN IN-GROUND SWIMMING POOL IN THE REQUIRED REAR YARD W/ FENCE TO CODE. REPLACES EXPIRED BP # 29372 at premises located at 1745 ALDRICH LA LAUREL County Tax Map No. 473889 Secti.on. 125 Block 0002 Lot No. 001 . 019 pursuant to application dated MARCH 25, 2009 and approved by the Building Inspector to expire on SEPTEMBER 25,. 2010 . Fee $ 150 . 00 Authorized Signature ORIGINAL Rev. 5/8/02 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) �) q --�3�- PERMIT NO. 29372 Z Date MAY 12 , 2003 Permission is hereby granted to : WILLIAM T & SUSAN C BAIRD 1745 ALDRICH LANE LAUREL,NY 11948 for CONSTRUCTION OF AN IN-GROUND SWIMMING POOL IN THE REQUIRED REAR YARD WITH FENCE TO CODE AS APPLIED FOR at premises located at 1745 ALDRICH LA LAUREL County Tax Map No. 473889 Section 125 Block 0002 Lot No. 001 . 019 pursuant to application dated MAY 12 , 2003 and approved by the Building Inspector to expire on NOVEMBER 1 Fee $ 150 . 00 A h&' ed Signature i ORIGINAL Rev. 5/8/02 0 rJ�rJ�rJ�rJ�r�r�rJ�rJ�rJ�r�r�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�r..PcPrJ�cP�PrJ�r.PrJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�r.PrJ�rJ�rJ�r�r�rJ�r�rJ�rJ�r�i��PrnrJ��PrJ�i�rJ�rJ�r�rJ�rJ� e0 5 BY THIS CERTIFICATE OF COMPLIANCE THE s 5 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 5 SBUREAU OF ELECTRICITY 5 5 40 FULTON STREET - NEW YORK, NY 10038 M 5 CERTIFIES THAT 5 5 5 5 Upon the application of upon premises owned by 5 5 5 5 SWEET HOLLOW ENT. SUE BAIRE 5 5 100 SWEET HOLLOW RD. 1745 ALDRICH LN 5 HUNTINGTON, NY 11743, LAUREL, NY 11948 5 5 Located at 1745 ALDRICH LN LAUREL, NY 11948 5 5 5 5 Application Number: 1174183 Certificate Number: 1174183 5 5 5 5 Section: Block: Lot: Building Permit: BDC: NS11 5 5 5 Described as a Residential occupancy,wherein the premises electrical system consisting of 5 electrical devices and wiring, described below, located in/on the premises at: [5 5 Basement,Pool/Spa, 5 C5 r55 was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below,was 5 j found to be in compliance therewith on the 31st Day of October,2003. 5 5 5 Name QTY Rate Rating Circuit Type Appliances and Accessories 5 Time Clock/Switch 1 0 C rj Furnace 1 0 Gas Cj 5 Pool/Spa Bonding 1 0 5 5 Panels 5 5 1 80 6 5 5 Wiring and Devices 5 Switch 5 0 General Purpose 5 5 Fixture 3 0 Pool/Spa 5 5 Receptacle 5 0 20 amp Pool/Spa 5 CCJ, Receptacle 2 0 GFCI C5, l� (Swimming Pool):This certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable to have Lj 5 frequent test and/or repairs made by a qualified person. 5 5 5 5 - seal 5 5 5 5 1 of 1 5 5 5 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 5 A0 OF SO�lyo�o e COU ou TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: -��"�—'Z— ®� f &70— DATE INSPECTOR pE SOUryOlo 3 Id- Z, TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLOG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENET .TI REMARKS: T a r - •/ I W � flVQ/O o i t DATE � J INSPECTOR Of SO(/T�OI coum,Ncc� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] IN LATION [ ] FRAMING / STRAPPING [ FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CANSTRUCTION [ ] FIRE RESISTANT PENETRATION r �- REMARKS: 050 � - DATE tr-9 INSPECTOR pP SO(/j�o rOUHTY, TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLO [ ] FOUNDATION 2ND [ ] INS ION [ ] FRAMING / STRAPPING [ FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: CW DATE �` �o INSPECTOR "� FIELD-INSFECTION REPORT , DATE .com a ,.. Cif FOUNDATION(1ST) ell FOUNDATION(ZND) t O 'ROUGH FRANIING& PLUMBING r . INSULATION PER N.Y. �o H STATE ENERGY CODE , o oe ., FINAL Xle- Y ADDITIONAL COMMENTS M U sty ." � TOWN OF SOUTI3,OLD' BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARi?MENT • I 3? - Do you have or need the following,before applying? TOWN HALL I Z 2003 :..:.J -`` Board of Health SOUTHOLD,NY 1�971 -- _�.._._.__..__ _t 1 3 sets of Building Plans TEL: 631 765-1802 :;� ( ) , ,��•., �,:.'� ���;- , Planning Board approval FAX: (631) 765-9502---___— z.._� c� Survey www. northfork.net/Southold/ PERMIT NO.�9 37L:Z,� Check. Septic Form N.Y.S.D.E.C. Trustees Examined ,20 Contact: Approved 3 ,20 � Mail to: 2 Disapproved a/ Phone: Expiration ,20 �— ui i InSpec APPLICATION FOR BUILDING PERMIT Date , 20 INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 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) 1 �CtK%Gh t� eve (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder (0u)n &r Name of owner of premises �_ Get f , (As on the tax roll or la est deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: -7 4 S A-id v;c h Lk:) l as LAv e House Number Street Hamlet County Tax Map No. 1000 Section I a � Block— .Lot; Subdivision Filed Map'No:' - Lot'`' (Name) 2. State existing use and occupancy of premises and intended use and occupancy:of,proposed construction: a. Existing use and occupancy p r d a 4-'re (R b. Intended use and occupanc 16-AC C_S i cte n.c .c 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work k6tO ; rn m I • (Descri 'on) 4. Estimated Cost i � o o o c Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front 1 —7 5 Rear I r7 0 Depth V 10. Date of Purchase 19 3 Name of Former Owner M U✓ h1.4 j --A 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO t/ 13. Will lot be re-graded? YES NO Will excess fill be removed from premises? YES NO Z 14.Names of Owner of premises SU SQ,n 13►1/ 02 Address S4 me A g"LM- Phone No. a�9�'-/a a a Name of.Architect Address Phone No Name of Contractor NA- Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below,must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF%u4 V being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)) above named, (S)He is thel (Contractor,Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief, and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this Z- day of MAq 20 0! of Public Applicant Lorraine LaRosa NOTARY PUBLIC,State of New York No.01 LA6059257 Qualified In Suffolk County Commission Expires Mayy9,200QM TOWN. OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET VILLAGE DIST. SUB. LOT i�Yt 1 - n a - �U 4 , `�. C FORMER OWNER N E • ` LA n' i S W TYPE OF BUILDING LO RES. y SEAS. VL. FARM COMM. CB. MILS. Mkt. Value ` LAND IMP. TOTAL DATE REMARKS f _ Oct) 6- '� r, �"`= � '+' ��' O tM-{J ���e� t' ' � 1\f� �1 C 6� t� '�`��'ifi..V`�'C'``. l.)l n �`,'1. �t�- 6,.:•�?�:"� '���4'g / �. y� _ / 7'7 ao 01 r-se-. I E 4 '?�-/ 'PP c"? a � - ar_aYi c&gym A 4 ,{an Tillable �� FRONTAGE ON WATER t Woodland FRONTAGE ON ROAD ` Meadowland DEPTH House Plot -=r BULKHEAD Total J 4 z.C'C'°'ti/ ``t ip y :gig• T MINE Wilma ■■■■E■ ii■■■■■■■■■■■■ ■■■■■■ ■■■■■■■■■■■■■ .. Foundation Interior Finish Ext Rooms 1st Floor MGM: r y, COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AW ROVED AS NOTED AS REQr ED AND CONDITIONS OF P. DATE• B. l SOUTHOLD TOWN ZBA I Pro � B SOUTHOLD TOWN PLANNING BOARD NOT FFY BUILDING DEPARTMENT AT P SOUTHOLD TOWN TRUSTEES .7 S AM TO 4 PM FOR THE ME t 1 FOUNDATION - TWO FIEWRO FOR,POURED CONCR CERTIFIED To: $rLn 2. ROUGH - FRAMING DING TICOR TITLE GUARANTEE COMPANY �j�5' SURVEY OF INSULATION SUFFOLK COUNTY NATIONAL BANK FiNdAI. - CONSTRUCT .MUST sus NM T. -AR D �` LOT 6 8E COMPLETE FOR 0. o D ' d MAP OF CONSTRUCTIONS MEET THE T05 5• >E� o, `� LAND OF RICHARD J. CRON il OUIREMENTS OFTH IJFNEW To*D 1 ^ FILE No. 7975 FILED SEPTEMBER 30, 1985 ALL CONSTRUCTION SHALL L ` ` STATE. NOT R FOR ? �" SITUATED A T OR CONSTRUCT ERRORS. MEET THE REQUIREMENTS OF THE �� `;u '�' CODES OF NEW YORK STATE. �� LAUREL TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK Cow- wO S.C. TAX No. 1000-125-02-1.19 0 SCALE 1"=�'(o- FLO ZOxkE A ao'� 0` OCTOBER 19, 1993 .000 COMP Y WIT -CHAPTER"46" ' ,em s° � R� r ,��''' .��"` '0 NOVEMBER 10, 1994 (UPDATE SURVEY) FLO01 DAMA L P PREVENTION SOLITi LD T�� - CODE. �' E TS •. Z o �. � 1 � .- OOIG AHbI - �� AREA = 102,590.90 sq. ff. O N O , — s 1,0 \ 2.355 ac. 1.s Poo Iwo N/0/FNNFTT CSOF r c+' Z �eC�!i~�'�/ // •v���o�D, N.Y.S. Uc. No. 40666 Joseph A. Ingegno N/D/,rE PA5 } Land Surveyor NYmSo a4�" VA-C THECoWnV s UR IJMY =NIT PEW" Oft i WA FOR W..f9MOW�THE "Tlt�D TM�vea riw�croKs naZ ra aR > �"'.-:' •'' C 1'V er r.E uus ro AfTiKtio Mo e;•7P1Fn BOOM=10L:au NOT t a tiff= We Arta. -&A&Adom - SR.Pran - C...& (on L.),A i 7 MR lJON USE IT THE WN ym mv,'AY-2 701 t A UILA THE C?►. j TlU`E 'SDQAA ouwtwltm�mcx+m Nf)C01>wu./M PHONE (516)727-2090 Fax (516)722-5093 a1Pt••Y'.18 11E'It AND IV:1 IY1gY TE f"R�f�' !'lE7MRf8.AID.ON N6�T)fUF 10 M THE D=TAM"..F. OF RWNT K MAYV mrt us'.iwrc.wMi►ap(9L 13K A ATYI - 01R LOCATED AT "ALM ADDRESS AND,•DA EASOIDM OF MOM, r• Ll1D[RVG�IRRIIR�oM F IM DVM ''� Gw lkim P.O. am 1931 TDB T1E Al9vEF3 ar M lD.T1910�TM �1Of` .. •.-.. - .—_ _ —___ A.W. NOT LgN'll ARE NOT.017ARk-'TELD. Tv.04t wAvvxT FS w NOT T4.Yr8 viaLL _—— — A.F,.boqu., N..Yak 110.11 RiraMwd, Nw YaA 119r'1 I USE IS UNLAWFUL ---- --- -7-9 3... 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Alacni-ze4.P"E AIET 3 3 b.R? r R, f ONT QaJD tiTfCL W17`14 A Y41NINVM LtiP of 30 bLA OI4J•41Tc45. 014ALbL_ 0100L +•+ATZdL- 4Ajro4,Y 67 r+rt.CQS 4hltiJEN bAa%E POOL ToAc tihlNSvC.TIor+ I Alm AP-D,,NO pvS� aI KfV-T'FULL.Ov04W4.1a4[Lt+I. -1Eo.TNCd Puw+► C►DAC&TYTo w1� ~yu2c.''(A lc_ TIcL `.2 QL F1.+ISN 1 YALaI C FAN►) - " • g� SVFrILIEwr To cr•FTY POOL IN I.A P104Jl5 CC` - Cr ALL'PlPP&U Lxowtl IS Dl�t.ar++a+kTIC UI+LC% OT'AZ&W"7 CHGtI AY EL_ - '1iPt[PSIM�LL,SE P0LET)A[LEw[- I 3cb �® I :� ,UL1(-L' TOZE NON Syr:A\ND TO SA.oPE /►mar I`a0►.t POOL tnD 'NODIy1-46.O ,• AD D SMALL OC %W'A#,U_C U"CSS tout. It ILkDIVS +w v rat*..it S o '- : bsw;v Couroa , To t-+.t.c*JT MI►+ SIhMDAQO y c b`To 'AuCt .h znhLa o p: Iw+7 ��• o!' oV ."Zl1E i / � �'' `, • 1-4CAT.Ior+ al;pven.IewD -IIEjTp NtfT f.f4�+11E*tE�aTS uALK (ooTiop&,L) .-0f•.Ooa.gD K f RC .vweC1;`+l►IT'C 1S• - 7Y , •"IVADII-N-INb tDll STµCTUAPJL oaaLr J►L� S- c I O N ()V4iAlv A6-- "fkK rjtkkL cartloLjA To TUC ` ' l•ATE'4T STAuaAn7S CF.M! fl((r O•�ALSJIMM1ub _pLAV �0at:`ktyriTUTL Py,tDL_pC/•.>,CpDE,S � 1.A.✓Ow1.L G1�4 4Ps�, io .ti.�c 5 �►1FZ G� - - - ��SL.L SI�CT C"AiRGAlP — Lit •y��L cELT1or+ — "1 PSCiCAS- ;oo�No i Ttrk L1Nit •_ l rILE - _• .•.. - - � � 'jSTC T ►NOD£L �St-Ir.MtR IµLtT _ __ _____- _ _ _ __ _ _ _Y AST F tLTEfL i ( �-i` U wDE lv kT t IL ll QUNV (CI TIOUN.) VAIK R p% LINT UM1>4 v ATf Rt�V S1CINM VA _ } l:rM I + _ GWAT+L Ll" Toy 0+ L' r�AlLflUMJ re St CT I O N E- D SCHEMATIC PIPING ARRA ;•!'�� Fy I��T : -•: • GUNITI SWIMMING POOL :Y Tom' ,J+ .,�� �3 L�t�L /Ll►1FORCCD {r'E rTH L S c 7 O• NOlk% It:* o L 1 Z' OC V E RT 1 2` o cgm OIL If XY r FLo 04 ' - M[yT1) laVIYAIL tfT BUILDING PERMIT EXAMINER CHECK LIST , ^ DATE REVIEWED: c.�1/2JDa APPLICANTS DATE SUBMITTED:/ /03 SCTM# N DISTRICT: 1,000, SECTION: , BLO K: , LOT: SUBDIVISION: p ADDRESS: 174 CITY: ZONING DISTRICT: CONFORMING? BUILDING PERMITS OPEN/EXPIRED: BP 14 -z/c/o o FVT /Btu -z/c/o 4,00 ,RINFO BP /C/0ok ( -Z/C/o Z- , INFO PRE CO: Y R N BP -Z/ C/o Z. , SINGLE & SEPARATE CERTIFICATION-REQUIRED NOTES: LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30, 1983),UNDERSIZED TS FROM JAN.1997 100-25.Merger.(A nonconforming at any time after 7/1/E REQ. LOT SIZE: ACT. LOT SIZE: S p REQ. LOT COV. ACT. LOT COV. REQ. FRONT �` PROP. FRONTTQ E '� ACT. SIDE REQ. REAR 200/ PROP. REAR REQ. IlEIGHT PROP. HEIGHT PROJECT DESCRIPTIO _ W ESTIMATED PROJECT COS CHITECT/EN ER: 1,J FAST TRACK WATER FRONT? DESCRIPTION: PANEL #: FLOOD ZONE: -, COMPLIANCE: APPROVALS REQUIRED SUFFOLK COUNTY HEALTH D • YES O ED #): DTE: / / PERMIT#: TOWN SEPTIC RECEIPT: Y or&' NEW YORK STATE DEC: PRE-DEC 9/1/75 YES r SOUTHOLD TOWN TRUSTEES: YES TOWN ZONING BOARD APPROVAL: YE TOWN PLAN. BOARD APPROVAL: YES o TOWN HISTORICAL PRE (SPLIA): YES NEW YORK STATE CODE COMPLIA E (SEE PAGE 2)0g$-of NO NOTES:V.Q,t' & 9 FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR: SF SECOND FLOOR: SF OTHER: SF INIT OTHER TOTAL TOTAL: SF FEE FEE FEE 1. ( SF)- (NSF)= SF X $ _$ +$ +$ _ $ 2. ( SF)- ( SF)= SF X $ _$ +$ +$ _ $ 3. ( SF)- ( SF)— SF X $ _$ +$ +$ —$ FINAL TOTAL. NEW YORK STATE CODE COMPLIANCE CHECKLIST USE/OCCUPANCY CLASSIFICATION: s. HEIGHT/FIRE AREA: TYPE OF CONSTRUCTION: DESIGN CRITERIA: ENGINEERFD/PRESCRIPTIVE FULL FRAMING DESIGN ELEMENTS: HEADERS: Y/N WALL STUDS: Y/N GIRDERS: Y/N CEILING JOISTS: Y/N FLOOR JOISTS: Y/N ROOF RAFTERS: Y/N LUMBER SPECIES AND GRADE: Y/N DESIGN LOAD CALCULATIONS: Y/N SHOULD INCLUDE LIVE,DEAD,SNOW,SEISMIC AND WIND(INCLUDING UPLIFT AND EXPOSURE) WINDOW AND DOOR SCHEDULE: MISSLE TEST REQUIREMENTS: Y/N EGRESS, LIGHT, VENT: Y/N LOAD PATHS: Y/N ROOF TO FOUNDATION NAILING/CONSTRUCTION SCHEDULE: Y/N MEANS OF EGRESS: Y/N PLUMBING RISER DIAGRAM: Y/N LOCATION OF FIRE PROTECTION EQUIPMENT: Y/N TRUSS DESIGN: Y/N CERTIFICATION: Y/N ENERGY CALCS: Y/N TOTAL COMPLIANCE? Y/N(RETURN TO PAGE ONE)