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HomeMy WebLinkAbout37523-Z , U�Fa Town of Southold Annex 11/21/2012 cry P.O.Box 1179 54375 Main Road oy � ` Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 36051 Date: 11/21/2012 THIS CERTIFIES that the building ALTERATION Location of Property: 500 Center St, Mattituck, SCTM#: 473889 Sec/Block/Lot: 123.-2-19 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 9/17/2012 pursuant to which Building Permit No. 37523 dated 9/18/2012 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: bathroom alteration in an existing one family dwelling as applied for. The certificate is issued to Smith,David&Smith,Victoria (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 37523 11/20/12 PLUMBERS CERTIFICATION DATED 11/1/12 Long Island An. Labs 19 'Authox9ed Signature �guF t � TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE "oy • o� } 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 #: 37523 Date: 9/18/2012 Permission is hereby granted to: Smith, David & Smith, Victoria 1981 Duncan Dr Scotch Plains, NJ 07076 To: Alteration to a Single Family Dwelling; Bathroom, as applied for. At premises located at: 500 Center St. SCTM # 473889 Sec/Block/Lot# 123.-2-19 Pursuant to application dated 9/17/2012 and approved by the Building Inspector. To expire on 3/20/2014. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $236.40 CO -ALTERATION TO DWELLING $50.00 Total: $286.40 Bui ing Inspector Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: L. 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$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. d9 New Construction: Old or Pre-existing Building: (check one) Location of Property: .5 o o C ENn'eY�2 S'C�. M �C�t['fiJC,K 4_ House No. Street Hamlet Owner or Owners of Property: S ref t7jj t Suffolk County Tax Map No 1000, Section l,T 3 Block o z Lot Subdivision Filed Map. Lot: Pen-nit No. Date of Permit. Applicant:'P Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate:_ (check one) Fee Submitted: $ Applicant Signature o��oF so�ryol Town Hall Annex ~ Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Q roper.riche rt(a)town.southo Id.ny.us Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: David Smith Address: 500 Center St City: Mattituck St: NY Zip: 11952 Building Permit#: 37523 Section: Block: Lot: 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 Service Only Commerical Outdoor 1st Floor X Pool New Renovation 2nd Floor Hot Tub Addition Survey X Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt Ceiling Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt 2 Wall Fixtures 1 Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks Disconnect Switches 2 Twist Lock Exit Fixtures TVSS Other Equipment: bathroom alteration, 1-exhaust fan Notes: Inspector Signature: Date: Nov 20 2012 81-Cert Electrical Compliance Form.xls FAX—SJC-102—TDM 11/5/2012 9: 20 : 48 AM PAGE 5/007 Fax Server LO 14G NYSDOH FLAP#11693 ISLAND Laboratory Report USEPA#NY01273 ANALYTICAL CTOOH#PH-0284 LABORTOWR INC. PADEP#68r2943 5010ONS WAY" - LIAL#2102909 November 01,2012 Page 1 of 2 Smith,David Smith,David 500 Center Street Mattituck NY, 11952 500 beriterstreet Mattituck,`NY11952 Dear Smith, David, Enclosed please find Long Island Analytical Laboratories'analysis report(s)for sample(s)received on October 29,2012.The report was issued on November 01,2012 for the following: CLIENT 1D ANALYSIS 2nd Bathroom Plumbing Lead If you have any questions or require further information, please call at your convenience, Long Island Analytical Laboratories Inc. is a NELAP accredited laboratory.All reported results meet the requirements of the NELAP standards unless noted. Report shall not be reproduced except in full without the written approval of the laboratory.Results related only to items tested. Long Island Analytical Laboratories would like to thank you for the opportunity to be of service to you. //II Best Regards, .- Long Island Analytical Laboratories, Inc. Michael Veraldi-Laboratory Director 110 Colin Drive • Holbrook, New York 11741 Phone (631) 472-3400 - Fax (631) 472-8505 a Email: LIAL@Iialinc.com FAX—SJC-102—TDM 11/5/2012 9: 20 : 48 AM PAGE 6/007 Fax Server Page 2 of 2 3 Client:Smith David Client ID:500 Center Street Mattiluck,NY 11952 Date Time Collected: 1012612012 20:00 Sample ID:2nd Bathroom Plumbing Date Time Received: 1D1291201213:22 Laboratory ID:2102909-01 Matrix:Solder ELAP;411693 Total Metals Analysis Parameter Date Analyzed Method MRL Result Units Flag Lead 10/31/2012 EPA6010 C 0.01 <0.01 % Date Prepared: 10/31/2012 Preparation Method:EPA 3050E Date Analyzed: 10/31/2012 Analytical Method: EPA6010 C Data Qualifiers Key Reference: MRL Minimum Reporting Limit LONG ISLMD ALYTI4,,,"AL LAWRATORIES INC. 110 Colin Drive • Holbrook, New York 11741 'TORO-OWWa-AN,etrncAlsatrrtotsTMYI Phone (631) 472-3400 • Fax (631) 472-6505 • Email: LIALQIialinc.com 6 ANALYTICAL X LQNG '� Pg_-/_DI LADORATORIES vic. 110 Colin Drive•Holbrook, New York 11741 •Phone (631)472-3400•Fax(631) 472-8505•Email: LIAL@Iialinc.Com 4 CHAIN OF CUSTODY / REQUEST FOR ANALYSIS DOCUMENT (I CLIENT NAMEIAD jESS CONTACT. �n'N/r r}s�'f SAMPLER ISMIfATUREt DATE TIME SAMPLEIS)SEALED ib �Ll�i/� PHONE: 3��� l� �IK� j Z8'a� YESINO� 2102909 1 l i PLERNAME(PR E TIME CORK CTCONTAINERIS) y FA MI ZOI�'{� d PROJECT LOG TION: 712 YES r NOFJ 3 4k �''- M't� I`'tR I�.�G � g SAMPI S R£CEIVfiD AT � TERMS 6 CONDITIONS:Aeeaunts Rre payable in tuff vithln Ih)rty days.outslanoing balances accrue service 1 charges of 1.5%per month. Tendering nl samptas to UAL iar analyUeal testing constllutas agmamanl by I Oc �o bw rlsarnpler Io LIAL's Standard larms !!�� r LABORATORY �`` ID# ° c~ LOCATIONeAl < c!t wt rea.t.rr u..orar Al. .of N Ai-o QN 127 1 1 ro 24 I I 1" �k4coa1., o 2. co 1 3. 4. O 0) s. a 7. ' 3 8. 'D a 9. Iz1 1a. 12. I Oo Q 13. 14. .� MATRIX:S-SOIL;SLaSLUDGE; DW=DRINKING WATER:A-AIR;W=WIPE; FTURtIAROUND REQUIRED: COMMENTS!tNSTR(UCTiD 5 x TYPE: CHIPS;BMa BULK MATERIAL W1V=WASTEY�A7ER ORMAL �STAT 7C.&Sawf is � •l/CQ�C01'r(Tr L0 TYPE: G=GRAB;C.COMPOSITE;SS-SPLIT SPOON (D PREB:(1)ICE;12)HCL;(3)H2SOd;(4)NAOH;15)NA2S303:(9)HNO3:(7)OTHER RELINQ S O B I T R DATE/0 RINTED NAME RECEIVED 13Y(St ' TUR TE PRINTED NAME rOg TIME g tw/b I. p.l L TIME RELINQUISHED BY(SIGNATURE) DATE PRINTED NAME RECE BY U ODIAN DATE/13--;-' ' I 'PRINTED NAME TIME 14 TIME 1 t sAl IEy3 L >�I WHITE-OFFICE I CANARY-LAB I PINK-SAMPLE CUSTODIAN/GOLDENRO -CLIENT YSDOH ELAP11 11693 USEPAlf NY01273 CTOOHII PH-0284 Of SOUT,yolo cour�v,N�' TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION. [ ] FRAMING/STRAPPING KFINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION '[ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: C2�fJ .y DATE INSPECTOR /;` , OP SOpr�,olo V Id�OUMy,�c (n,$p TOWN OF SOUTHOLD BUILDING �b D 765-1802 v 1 INSPECTIO N u( �w [ ] FOUNDATION 1ST { [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING/STRAPPING [ ] FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ELECTRICAL (FINAL) REMARKS: DATE Eft�� INSPECTOR FIELD 1NSP$GQNiEPORT DATE COMMMNTS FOUNDATION(1ST) � � C� • FOUNDATION(2ND) � O U ROUGH FRAMYNQ& y PLUMBINGf Cq INSUL•ATION PER N.Y. H STATE ENERGY COME • J Y FINAL ADDITIONAL COMMENTS Dja �s Vm . r� z TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD,NY 11971 4 sets of Building Plans TEL:(631)765-1802 Planning Board approval FAX:(631)765-9502 �� 2 Survey SoutholdTown.NorthFork.net PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Examined IIII P / 20 Storm-Water Assessment Form qQ Contact: Approved 1 V .20 I Mail to: .Jsappreved-alc Phone: Expiration� .0 >20 Building Inspector APPLICATION FOR BUILDING PERMIT Date G s O. ,20_,p_� 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 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 Ith ices and in building for necessary inspections. . D LS V 15 sayNav�>�w EiLY"3sel-- i is G - (Signature of applicant or name,of a corporation) SEP —4 2012 ��VE•� A13t� 1t_t�►t�l-`t. I170 1 (Mailing address of applicant) er app scant is weer,lessee,agent;architect,engineer,general contractor,electrician,plumber or builder TOWN OF SOUTHOLD Name of owner of premises 1n S M�-�"�► (As on the tax roll or latest deed) pplicant' orpora n,si f irly authorized officer (Name and title of corpo 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: tiS"o a G E.►.t-tl=.tz, �T'• M!b't:�'►-r�t c,K House Number Street Hamlet County Tax Map No. 1000 Section 1 ?3 Block o Z Lot Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy `;_1-j w %-A...1fj d b. Intended use and occupancy "b W E LL 10.1 G 1, N 1 G 3. Nature of work(check which applicable):New Building Addition Alteration_ Repair Removal Demolition Other Work ' (Description) 4. Estimated Cost ;k a. O 00 . ace 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 t•• '` Rear rJ t^1 O" Depth $7 n ,- t Height ) Number of Stories Dimensions of same structure with alterations or additions: Front N /G Rear fJ/ C Depth hL/ (:A Height f c C. Number of Stories ©N X CAN/G 8. Dimensions of entire new construction:Front Rear K /A Depth N'J A Height IJ/N, Number.of Stories t1t/A - 9. Size of lot:Front .CLRear "I. O Depth 1 10.Date of Purchase c!1 z6 1 e 9 Name of Former Owner e!Z erMD&O 61 AA 11.Zone or use district in which premises are situated 12.Does proposed construction violate any zoning law,ordinance or regulation?YES NO� 13.Will lot be re-graded?YES NO ✓Will excess fill be removed from premises?YES NO 14.Names of Owner of premises Address Phone No. Name of Architect M V f t'F, •' _Address44 a wi MM 11704ne No 1 s - '7;S 7 Name of Contractor Address Phone No. 15 a.Is this property within 100 feet of a tidal wetland or a freshwater wetland?*YES NO *IF YES,SOUTHOLD TOWN TRUSTEES&D.E.C.PERMITS MAY BE REQUIRED. b.Is this property within 300 feet of a tidal wetland?*YES N04e—..*" *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 restriction *IF YES,PROVIDE A COPY. Tmoma J LEZ Notuy Public'-Stnto of Nam►York STATE OF NEW YORK) N0:01ZE6251477 SS: Qwlifled In Strtbik CCU �ilT COniINTY OFJ^Cl- A fly CominitaIon Empires fY��d� PEAP P^ I being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the us N Ca 1"lE C M (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. Swom to before me this _ ayaf �iLl�(✓Q 20 Notary -SignatureofApplieWr �3�sa3 CONSENT TO INSPECTION R the undersigned, do(es)hereby state: Owner(s)Name(s) That the undersigned(is)(are)the owner(s)of the premises in the Town of Southold, located at 6-0 0 Ge k f e y- Ot-e-e-f— , which is shown,and designated_on_the_Suffolk_County Tax Map as District_1000, Section /Z3 ,Block G Z ,Lot 11 That the undersigned(has) (have)filed,or cause to be filed, an application in the Southold T wn Buildin Inspector's Office for t e ollowmg: �r � - That the undersigned do(es)hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, including any and all buildings located thereon,to conduct such inspections as they may deem necessary with respect to the aforesaid application,including inspections to determine that said premises comply with all of the laws,ordinances,rules and regulations of the Town of Southold. The undersigned, in consenting to such inspections, do(es) so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used in subsequent prosecutions for violations of the laws,ordinances,rules or regulations of the Town of Southold. Dated: a ) ' (Print Name) (Signature) (Print Name) pF SO!/ryol Town Hall Annex ~ Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 yIrou BUILDING DEPARTMENT TOWN OF SOUTHOLD October 9, 2012 David Smith 1981 Duncan Dr Scotch Plains, NJ 07076 Re: 500 Center St., Mattituck TO WHOM IT MAY CONCERN: The Following Items Are Needed To Complete Your Certificate of Occupancy: Application for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. (contact your electrician) A fee of$50.00. - Fi al 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. BUILDING PERMIT: 37523 — Bathroom Alteration FAX-SJC-102-TDM 11/5/2012 9 : 20 : 48 AM PAGE 2/007 Fax Server FAX COVER SHEET Date: November 5, 2012 From : David J . Smith 500 Center Street Mattituck, NY 11952 908-723-6062 (mobile) To: Building Department 54375 Main Road P.O. Box 1171 Southold, NY 11971 Phone: 631-765-1802 Fax: 631-765-9502 Pages: Six (6) including cover FAX-SJC-102-TDM 11/5/2012 9: 20 : 48 AM PAGE 3/007 Fax Server November 5,2012 David J.Smith 500 Center Street Mattituck, NY 11952 908-723-6062(mobile) Building Department 54375 Main Road P.O. Box 1171 Southold, NY 11971 Phone:631-765-1802 Fax:631-765-9502 Re: Permit#37523 Plumber/Solder Certificate Dear Sir or Madam: Please find attached Long Island Analytical Laboratories'analysis report for lead content associated with the solder used in the water supply system of the new bathroom alteration.The test results show that the solder contains less than 0.01% lead(the minimum reporting limit)which,therefore, complies with applicable building codes. 1 can provide the original laboratory report if needed. Please let me know. Otherwise, I kindly request that a certificate of occupancy be forwarded to me at the address above. Thank you for your assistance with this matter. If there are any questions, please don't hesitate to contact me. Best Regards, David J.Smith o��oE so�ryol Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 ep Southold,NY 11971-0959 y�4UNTY,�� BUILDING DEPARTMENT TOWN OF SOUTHOLD November 7, 2012 David Smith 1981 Duncan Dr Scotch Plains, NJ 07076 TO WHOM IT MAY CONCERN: The Following Items Are Needed To Complete Your Certificate of Occupancy:. Application for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. (contact your electrician) A fee of$50.00. Final 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. BUILDING PERMIT: 37523 — Bathroom Alteration pf SNIIy0, 0 Town Hall Annex Telephone(631)765-1802 54375 Main Road (631)765- 50r P.O.Box 1179 G� Q _roger.richertifown.soutM d.nv.us Southold,NY 11971-0959 'Q • a� �y�0UN11,� BUILDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Date: Company Name: Name: License No.: Address: Phone No.: JOBSITE INFORMATION: (*Indicates required.information) *Name: C,u t v' &I-A *Address: o6 Cfi v'e *Cross Street: U V Al&C-L �J "Z *Phone No.: (O 2-� ��---�-5�. Permit No.: 2 Tax Map District: 1000 Section: 1 a"3 Block:_ Lot: 1 *BRIEF DESCRIPTION OF WORK (Please Print Clearly) (Please Circle All That Apply) *Is job ready for inspection: YES / NO Rough In Final *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 P� - ,0 �- 82-Request for Inspection Form , T ` N OF SOUTHOLD PROPERTY RECORD CARD /� - �7 � OWNER - '-' STREET CC) VILLAGE DIST. SUB. LOT, :... FORAn`�'.E�R-OV1 NER G,,ff a iS E ACR. �.:�U� ��e< • &)ltnn "_, ` � W. ScIN.a 535 f 20 S W TYPE OF BUILDING U S,C floLL RES. ',-7- SEAS. VL. FARM COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKS 0 D 70 0 , j ol4bi5/ 2Zz z S'cz A ' /o aoo W. 13,gR !C't JR, f 1bupgz -0 r p 3?�3G �G C� C,..�. d o / a c� ! �•�1 79 -/�/ �F o /a/ ! / 1,o �A /y,- 4-, J7 uP r c P O y t? if J J a �/��'�'� /�''1? Z /f 4/a6 Z jId. I// 0Y1& 14a "i4 .0" .,�� C(I 492'�00 S '7v-a/ Iae � � . 3��/7c �c/de c/ ru; a.,e �eaj .ZOO $�00Cb �a �eaiOC7r1 Sfara�CrrP� e': C' y,7i"oo V NEW NORMAL BELOW ABOVE /�i fj�? Sao/y a �� Q� ey����i Sf6raye $-i�e/ t alE �j 7,1-a FARM Acre Value Per Value ill / 9J o / Acre �y �r�z i o -,,a ���re� � l�U Tillable' 130 & L I190Lp 0 93a- U,nn I W 4v 4aas - NO, Coo Tillable 2 Qs �v 6mi-41l 4Gny.- Tillable 3 A 5 � e_ e Woodland. Swampland FRONTAGE ON WATER Brushland FRONTAGE ON ROAD 0j' �Q U jHouse Plot DEPTH BULKHEAD ,10 ;Total DOCK i. F' T _ ■e■■e ® Q�tot NN ■■■E■■■■■■■■■■■ ■■■■ ■ �,■■"■.■M■■■eMIS■■■e■ MIN JIMMINESA E■ENE®■ IY■■I,EME■E■■■■E■NEON EMEMIN IN ^Y,,yv;^- MEMINE a 'k* •..., :dt '�"rry'cl?c�4C�"�.-'` y --/-•� -�~i> rA F,}�F �� t,,,y,."'-6N3�- Y��yS.� �y -' 441 ��-"f �:�rt may- `^ � e! SEEN MENNIMEMEMOMMEMEN Foundation Basement Ext. Walls Fire Place Dormer Driveway • / f • ea- r ®� B. P. # .3 7S P,3 BUILDING PERMIT EXAMINER CHECKLIST Date Submitted. / l-^� ate Reviewed. Applicant: �V� L Owner: r �_*� v 0�Are KrWEugineer: Estimated Cost. SCTM# 1000 - Subdivision: Zone: Conforming? Property Address: ®� City: 144 Q Pre COs? Building Permits (Open/Expired): BP -� -Z/C/O Z- --- ,info: BP -Z/C/o Z- , Info: BP -Z/C/o Z- , Info: BP -Z/C/o Z-__,Info: BP -Z/C/o Z- ,Info: Single& Separate Search Required? Y o Determination: STOP,MWA:.r�,_:R_ttN,QJF.F: �-- REQ. Lot Size: ACT. Lot Size: REQ. Lot Cov. 07 ACT: Lot'Cov. REQ. Front ACT. Front REQ Side ACT. Side REQ. Rear PROP. Rear REQ. Height. 35" ACT. Height Re dt.�W- H $I DES A C T Project Description: ��,�-� `� a► ��� � Waterf tnor�Y-o� If yes, water body: Panel# Flood Zone: Bulkhead/Bluff Distance: ADDITIONAL APPROVALS REQUIRED PLA N S(4f) SIGNED, S�rILED uPVtY SITE PI-AN Ofi Suffolk County Health: Y of N/- If yes, *Bed#: *Date: /_/ *Permit#: Town Septic: -N� �/ - If no, certification required: Y or N Received: Y or N By: NYS DEC: PRE-DEC 9/1/75 Y o IN Date: / /_ Permit#: or NJ Letter- Notes: Date: _/ / Permit#: or NJ Letter-Notes: Southold Trustees: Y o� Southold ZBA: Y o(9- Date: / / Permit#: -Notes: Southold Planning: Y or(o Date: _/ / Permit#: -Notes: Town Landmark C of A: Y oiDTE: _/ /_ *NYS CODE Compliance(page 2): Y or N CoNTRA-CToR �1cENSt AIS/IBILIrY L.I/4BiLIT/ 1A/okk/'JENS CoMPF/1(,S�TIB�/ Notes a Fee Structure: Calculation: a lei G- Foundation: S.F X $ =$ 36, First Floor: SF + Initial Fee: $ c-0 D, OQ Second Floor: SF + Additional Fee Lam: $ Other: SF SF X$ . =$ Total: SF + Initial Fee: $ r� + Additional Fee( ): $ C of o FEE) `X 0, C? 0 AS BUILT FEE -e— TOTAL: $ �L'3 61 NEW YORK STATE CODE COMPLIANCE CHECKLIST CLIMATIC/GEOGRAPHIG-DESIGN CRITERIA: Ground Snow-Load;ZO Wind Speed: 120MPH Seismic Design Category:B Weathering: Severe Frost Depth: 36" Termite: M-H' Decay: S-M . Design Temp: 11 -lee Shield Underlay: YES Flood Hazards: USE/OCCUPANCY CLASSIFICATION: HEICT f IT/FIRE AREA: TYPE OF CONSTRUCTION: DESIGN CRITERIA: ENGINEERED/PRESCRIPTIVE ` FULL FRAMING DESIGN ELEMENTS: YIN .READERS: Y/N WALL STUDS: Y/N GIRDERS; YIN CEILING JOISTS: YIN FLOOR JOISTS:YIN ROOF RAFTERS: YIN LUMBER SPECIES AND GRADE: YIN WINDOW AND DOOR SCHEDULE: MISSLE TEST REQUIRE) ENTS: Y/N EGRESS 5.7 S.F.: Y/N i LIGHT 8%: Y/N «NT 4%: Y/N NAILING/CONSTRUCTION SCHEDULE: YIN MEANS OF EGRESS: YIN P LUMB ING RIS ER D IAGRAM LOCATION OF FIRE PROTECTION EQUIPMENT: Y/N TRUSS DESIGN: YIN CERTIFICATION: YIN .ENERGY CALCS: Y/N (RESCHECK) TOTAL COMP>GIENCE? Y/N (RETURN TO PAGE ONE) 09/30/2009 09:03 FAX 6314772164 GREENPORTUFSD 1@002 . • • CENTER STREET , E. 100.OQ' N. B5.41'50' ; a z _ , Ali � . m T" ao�.Q cn • '� per �t yyn.�. En ry _ m 1 W y o 85"41'5O� 001 W F R. NlOIF D.•P.& r M RNUOSEN SCROLL .AREA =23,300 sq.ft SURVEY FOR GORDON HAAS AT MATT/TUCK TO•INN OF SOUTHOLD SUFFOLK COUNTY,N.Y 1000-128-02-19 Scale: 1"=40' Oct, 4, 1996 CER77FIED TO, GORDON•NAA•S THE LONG ISLAND SAVINGS BANK SF o4 NEIy - 0 xxrurrx�ncwaaamn+armnrsar=.41AXAM OF 7AyV,710D:c�'•Y>�r�Me6SfA7 �ncc�nWur, N'R LIC..NO. 496rB cw.r•,Av W mum ra sUMMM z ALL ca mr&r �, ya M W AW.V"Faa:MM MP AM OW'Try atr F s o urr aarrnvtt eEup.Tr� v VA cw RE SUPEM CO 'Ric. • xr�•smwn�'�xs a�trt - r5161 7, . r I m prrr mm-sw tAw 71 f gmu.rmm BY' P. 0.BQX 9 . 9EUSm.BYANY00-0[ (InU2WACWT 1230 TRAVELER STREET . . srN� n� sOtl7ilOLD, i tl _ a!-Eix. X CL — S. Q. Ir r 13DR,M 1 �QYEI� LI�/1 ice.G �i...,�11 -1 o DEN_ m - I 5 -_G IZX11- STUDS I ci-11074/z GI-rp-nue-eL, LAI _ - riJ f .Q C.O. DETECT'UR I II GFGI, 1 G1. rT t 4 Z +_. �_ t0 S.D. I C-sF-CI. _ to X I GL. RIDF..- GF'CI _J f -.1��.✓ f �•;`i4 �> I N i O O APPROVED AS i=1D 1 ED S.D. 16s U i TE: —1 -Q-8 p # 3 7SS Ft q-0. Z18XG- ' NOTIFY BUILDING DEPARTMENT AT 765-1802 8 AM TO 4 PM FOR THE -�X - -F3 FOLLOWING INSPECTIONS: 1. FOUNDATION - T1ti`O REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING 9: PLUMBING CL. I ! a 3. INSULATION 4 4. FINAL - CONSTRUCTION MUST 4- S-CI xc G - ^z-�8x �_ ' -� BE COMPLETE FOR C.O. _ Lx - ALL CONSTRUCTION SHALE_ MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONS15LE FOR COMPLY WITH ALL CODES OF DESIGN OR CONSTRUCTION ERRORS. ELECTR'1"Ak NEW YORK STATE & TOWN CODES !l AS REQUIRE ,,^ OLDTOVA' �, YQ SOUTH ,Y N FANNING BOARD ,vm - S T SOU' D TOW! : STEES ^ S.DEO — — PLUMBER CERTIFICATION ON LEI D CONTENT BEFORE � C iE Co CERTIE!^.ATF OF OCCUPANCY SOLDER USED IN WATER SUPPLYSYSTEM CANNOT 5 F ILI EEL t-- I—T-ER ST, t''�b�c�l—TITUCK,N',''�( EXCEED 211 J OF 1% LEAD. S.C.T. 1`-1. : 1700 — 12-B — Cl Z I� SCALE:SH[3\^/N APPROVED BY: DRAWN BYP, R. SOUNDVIEW ENGINEERING P.C. PLUMBINGDATE:;5._eo—jz REVISED TEL:516-633-6489 44 UNION AVENUE ALL,FLU:WATER LINES NEED DING WASTE ��--��'��I 0N AMITYVIILLE,NEW YORK 11�01-3024 -&W �xl SST '� ;TESTING BEFORE COVERING DRAWING NUMBER r i I 1 v cu.raw G TYP, I- 44,II PVC WAS=71 - I I A-" PVC i 1 = E-L < F-E) Z F-L.. 5P, C.�DN W.AL-L • . - _._ ° d ° —t -- a ate----cr —�-----•--as r „ —=- � .. -_ a o �, 01 e I ° A' P. C. St4l� Q � q-Z— 1111 'Ell 4 o a 4 4 j1111 -� a n to I e . + I -f [3] Z�X Eli\ — a` 1 Q m ell l7 - — - - - - - — -�— - — 1_ ® — - _ _�- - - - t\l a 7 7 I ° ------ 7`- CI T 0--- - --- -p I -7 I a.I I c' _ a i-'1 a II +/ - A. a Lj v 4 h 4 i II 4 J, I =,o 57/8 7--rP!1-7--><1 � I— — — _.. — _ a• -__ - _ b Z?_G V H��TItaIG r i C. — — I G"11 L 1-1. [ °�Ez �s 1 try I I C.0,=-F. S_ p I U ® 0•S_ Tro l`�lK CZ 7 5 CaAI.GP. i Ito C MCA i CAFT � Z G x 11-41 LJ p D o co .8 •• ., Q ° I I '4 a trb A -0: 1R [9 Q ° �u •C� .!'� s d'1 s$ S c, - CI �-D a NDA ! 1-` N SOUNDVIEW ENGINEERING P.C. SCALE: APPROVED BY: DRAWN BY DATE: B—ZS—I Z REVISED 44 UNION AVENUE I AMITYVILLE,NEW YORK 11701-3024 - R �,,�-F,u uI�`Q DRAWING NUMBER