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37462-Z
o�sUFF01, , Town of Southold Annex 5/28/2013 Gym P.O.Box 1179 � 54375 Main Road oy Southold,New York 11971 � Sao CERTIFICATE OF OCCUPANCY No: 36458 Date: 5/28/2013 THIS CERTIFIES that the building RESIDENTIAL ADDITION Location of Property: 2625 Stars Rd, East Marion, SCTM#: 473889 See/Block/Lot: 22.4-3 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 8/13/2012 pursuant to which Building Permit No. 37462 dated 8/21/2012 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: Additions &Alterations to a Single Family Dwelling Bedrooms, Bath,Walk-in Closet, Laundry, 2 Car Garage, as applied for. The certificate is issued to Bombardiere,Lucille (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 37462 4/16/13 PLUMBERS CERTIFICATION DATED 4/25/13 Mattitu,9k Plumbing&Heating Corp Aur Sigrxture -ram TOWN OF SOUTHOLD BUILDING DEPARTMENT ' TOWN CLERK'S OFFICE SOUTHOLD, NY 9 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#: 37462 Date: 8/21/2012 Permission is hereby granted to: Bombardiere, Lucille 19 Wilson St Massapequa Park, NY 11762 To: Additions &Alterations to a Single Family Dwelling; Bedrooms, Bath, Walk-in Closet, Laundry, 2 Car Garage, as applied for. At premises located at: 2625 Stars Rd SCTM # 473889 Sec/Block/Lot# 22.4-3 Pursuant to application dated 8/13/2012 and approved by the Building Inspector. To expire on 2/20/2014. Fees: CO -ADDITION TO DWELLING $50.00 SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $665.60 Total: $715.60 Building 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 snew-use. 1. Final survey of property with aceumte-location of all buildings,property lines,streets,and unusual natural or topographic features. 2. Final Approval from Health DepL 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.2110 of 1% lead. 5- Commercial building*industrial building,multiple residences and similar buildings and installations,a.certificate of Code Compliaiice'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"nand uses: 1- Accurate survey of property showing all property lines,streets,building,and•unusual natural or topographic at feures. _ 2_ A properly cpmpleted application and consent to inspect signed-by the applicant_ If a Certificate of Occupancy is denied, the Bdilding Inspector shall state the reasons therefor in writing to the applicant. C_ F,-es I- Certificate of Occupancy-New dwelling$50.00,Additions to dwelling$50.OQ,Alterations to dwelling S-50.00;- Swimming pool$S0.00,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 Certifcafe of Occupancy- $50.00 • 5_ Temporary Certificate of Occupancy-Residential$1.5_0%Commercial$15.00 / Date_ J. Vew Construction: V 01d or Pre=existing Building: (check one) !Amtion of Property: 2 1p e2 5— House No. Street Hamlet )wnir or Owners of Property: u e I LPL A O m 8A Pno I E_ laffolk County Tax Map No'1000,Section oZ Biock y Lot 3 ►a"vision filed Map. '' (( Lot: Permit No.,� �T(D o� Date of Permit.' f Z . Applicant: health Dept.Approval: Underwriters Approval: Planning Board Approval: request for: Temporary Certificate Final Certificate: (check one) ee Submitted: $ 5 C is at Sienature Town Hall Annex a�q cQ�� Telephone(631) 765-1802 54375 Main Road ® :� Fax (631) 765-9502 P.O. Box 1179 ` Southold, NY 11971-0959 y?t�l roger.richertCaD-town.southold.ny.us BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Bombardiere Address: 2625 Stars Rd City: East Marion St: NY Zip: 11939 Building Permit#: 37462 Section: 22 Block: 4 Lot: 3 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Roslak Electric Inc License No: 3677-me SITE DETAILS Office Use Only Residential x Indoor x Basement Service Only Commerical Outdoor x 1st Floor x Pool New Renovation x 2nd Floor Hot Tub Addition Survey Attic Garage X INVENTORY Service 1 ph 200a Heat Duplec Recpt 16 Ceiling Fixtures 3 HID Fixtures Service 3 ph Hot Water GFCI Recpt 3 Wall Fixtures 4 Smoke Detectors 1 Main Panel 200a A/C Condenser Single Recpt 1 Recessed Fixtures CO Detectors 1 Sub Panel A/C Blower Range Recpt Fluorescent Fixture 4 Pumps Transformer Appliances Dryer Recpt 1-30 Emergency Fixtures Time Clocks Disconnect 200a Switches 13 Twist Lock Exit Fixtures TVSS Other Equipment: 200a overhead service, 1-paddle fan, 1-exhaust fan Notes: Inspector Signature: Date: April 16 2013 Electrical Certificate.xls So&ro Town Hall Annex Telephone(631).765-1902 54375 Main Road P.O.Box 1179 Fax(63 I).76 -9502 G . Southold,New York 1.1971-0959 �Q Own BUILDING DEPARTMENT TOWN OF SOUTHOLD .CERTIFICATION Date: Building Permit No. Owner: 501' AID I ME (Please print) Plumber: 941JL COT- (Please print) I certify that the solder used in the water supply system contains less.than 2/10 of 1%. lead. (Plumbers.Signature) Sworn to before me this day o 20/_5 DENISE KING Notary Public,State of New York . Registration #01 K16041757 Public Qualified in Suffolk County 15, Not : County My Commission Expires May j i ho��OP SOUTyo� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 NSPECTION . . . [ OUNDATION 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: c .DATE INSPECTOR - oE SO(/Ty�� N � o�yco ,� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION . . [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FO DATION 2ND [ ] INSULATION FRAM ING/STRAPPING [ ] FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) TRICAL (FINAL) REMARKS: c DATE / / '( INSPECTOR L �o��OF SOpT�o� Lo cOUHI`1,� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ROUGH PLBG. [ ] FOUNDATION 2ND [ . ] INSULATION [ ] FRAMING/STRAPPING [ ] FINAL [ 'FIREPLACE CHIMNEY [ ] FIREJSAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ IRE RESISTANT PENETRATION . [ ] ELECTRICAL (R GH) [ ] ELECTRICAL (FINAL) RE ARKS: 0 DATE ®� �" �3JNSPECTO!12� rjF SO(/l�ol . cOUNi`I, ` TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING/STRAPPING [ ] FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL ( UGH) [ ] ELECTRICAL (FINAL) REMARKS: ° �- DATE ©3 ° �� INSPECTOR pF SO(/l�o� V TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ] ELECTRICAL (FINAL) REMARKS: DATE �� �� INSPECTOR '--^=- s OF SO(/T�o cOUM`I,� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTIO [ ] FOUNDATION 1ST [ ] ROUG BG. [ ] FOUNDATION 2ND [ ] IN LATION [ ] FRAMING/STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROU .H) [ ] ELECTRICAL (FINAL) REMARKS-- DATE //-'3-INSPECTOR 3 ,2 ( � oFso�r um, TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]i FRAMING /STRAPPING [ R�FIREPLACE & CHIMNEY [ ] INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: DATE INSPECTOR Robert G. Bassolino. R. A. Architect 28-55 210 Place, Bayside, NY 11360 (718) 225-9161 May 15,2013 vdV 3Z� tp�� Gary J Fish . Building Inspector Town of Southold Re: 2625 Stars Rd Dear Mr Fish. This is response to your recent inspection. I certify to the following: The garage is completely separated from the occupied portion of the house with a%hour envelope. The wall above the garage loft is covered with 5/8"gypsum wall board. T The vent into the crawl space is closed with concrete block. [There is a vent to the front of the building.] The access to the crawl space is through a framed removable panel covered with 5/8"gypsum wall board. There is no need for drywells for the roof leaders. The grade is level, there is no runoff and the Soil Is medium compact sand with good percolation. y R ert Bassolino RA 1� i' I 0 • � • 1 1. r Try, %%! ' j = _ - = -�•,� PLUMING POM 1 • Y STATE ENERGY • f AA ADDITION • MEN 1 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 Survey www. iiorthfork.net/Southold/ PERMIT NO. l ( Check Septic Form N.Y.S.D.E.C. lo Trustees Examined ,20 I Contact: Approved ,20 D v E Mail to: f2o6E�'r �5A.55oLi NO 26-55 014 Pi-AajF Bisappr&ve4,a/c $a.YsIV F;/ raY I t 1�o J U L 3 1 2012 I Phone:Ile- 2 25-r f&t Expiration O ,20 BLDG.DEPT. joiAi�i -----Building Inspector APPLICATION FOR BUILDING PERMIT Date .J U L-r 2 q , 20 ( Z 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 writin_g,the extension of the permit for an addition six months:Thereafter, a new permit shall be required. �M ___. APPLICATION IS HEREBY MADE to the Building Department forihe.isguance of atBuilding Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County,New oth t applicabl%Laws, Ordinances or e � . , Regulations,for.the construction of buildings, additions, or alterations or f¢ r6moval ai,4;6nolition �herein described.The applicant agrees to comply with all applicable laws, ordinances,building c' 'd�;housing:gdaee,an+�t� 'I t' s, and to admit authorized inspectors on premises and in building for necessary inspection'; '`(Si~s tore of applicant or name,if a corporation) 2 g-2S 2 C -rH p-�rG� � -rsinfor,, hLY t k3&d (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder Name of owner of premises LUG l LL J.� eOM15kq_D l 1✓pa E=- (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: 2 4�,25 s T, fzS 12�A.4:;) e=_A�T N`< House Number Street Hamlet County Tax Map No. 1000 Section 2-2- Block € ;',ti ,Lot 3 Subdivision Filed Map N6',"," Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy &>WE. b. Intended use and occupancy o ft kjx A vL:-f' L L.L 3. Nature of work(check which applicable): New Building Addition >G Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost � 6Z5S ocb ,—' " 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 / If 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front 4-� o�� Rear 4-6 o" Depth 23 Height 1.5 0''/ Number of Stories I Dimensions of same structure with alterations or additions: Front 77�&' Rear Depth Height 16 L-e> 11 Number of Stories Llz> t� c it 8. Dimensions of entire new construction: Front76,r e>+-fir -o)Rear�46-1 o�1!q� Depth Z3 8tg Fo'o" Height 15 0" Number of Stories I f I�-� J 9. Size of lot: Front I I 'o t' Rear I f z -d c Depth 18(_-73 $ ! en .3 9 10. Date of Purchase 06 I R, GR`L22 Name of Former Owner --M A44 C)e-t ,LL_LCE 11. Zone or use district in which premises are situated 4_7 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 X NO 14.Names of Owner of premises Address0 -A5Ar i a_uA, F"Arz(e.Phorie No. �G6�7 q- z►2 Name of Architect Address 2g-55 z i4TI+ FL Phone Nol5AX- ✓�- 7($-2zs- Name of Contractor r Address Phone No. a 16] f _ .15 a..Is this property within-100 feet of a tidal wetland or a freshwater wetland? *YES NO X * 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 aVee ) being duly sworn;deposes and says that*)he is the applicant (Name of individual signing contract) above named, OHe 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 belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me thisT 17 ay of lJ y �e-, 20 2, Notary Public ignature of Applicant EMMUELCARAVANOS Notary Public,State of Now York No.OICA4866400 Qualified in Queens Coup lbrm Expires J 28,20 L �* boar o � Town of Southold - Chapter 236 - Stormwater Management z rl � SWPPP - Storm Water Pollution Prevention Plan Assessment Form GENERAL INFORMATION: (All Requested Information is Required for a Complete Application) APPLICANT NAME: owner-Agent-Consultant-Contractor or Other Cirdeone I ( ) Property OWNER:(lf Different than Applicant) I ddre= i y L 5l t7dress- ttG b 9 W IIL-4DM ST K, Y l l Z T eplwne Fax# Lelepttone# _ Z f Fax# E a k tt7 E-Mal: E Pro rH Address: ws. $�V ©` Brief Desmpbon of Combuction Activity,Proposed SMWUU,l BbfPs,Soil ! s C.T .#: 1000 2 2 3 D Stabalization BN P4 Project Scope and/or Sequence of Constnution Activity Emma Section Ld (Provide A&Wonal Pages as Needed) lume of Contractor and/or C tact person Responsible for hn IementaUon of SWPPP; T > A 5 _G a ---------------- - ddress: 51 -- i!'--pv-Vb(n_aD1lL_C Telephone# Fax# ----- -------------------------------- i E-Mal: ---------------------------------------^ E ( • Nam Persons Responsible for Insta allon 3 Malnte�of lsoston Contro Praettce; ------ I ; fD(ds� Address: ------------- ------------ --------------------- Telephone#: Fax# t --------------- --- ------- E-Mail: " ---------------- ;...t Total Area of Ail -__----- -------------------- Total Area of LandCleari ------------- Project Parcels: Z� Z/ �-l 5 and/or Ground Disturbance: /' IsF-/floes-) -- ......-_.•___ I Project Duration: Start End -------------------- (Anticipated) G .Date:f O r l` l� Date: to y I- '. (Number of Cal Days) ------- Will this Project Disturbe five(5)or More Acres at -- -- ------- `"" ------------------- Any One Time During the Proposed Development? Yes No ---------------------------------- If YES:Please Answer the Followin 1 ...---------------.-._...---------.-.--------'-------- 1 a. Does the Applicant have a Qualified Inspector On i Staff To Conduct the Required Inspections? Yes No b. Does the SWPPP•Indicate How Frequently the Site List the.NAMES or description of all Potentially Impacted Waterbodies and/or Wetlands: j Inspections will Occur and for What Period of Time? Yes No - � ---------------------- ------- tl c. Does-the SWPPP Adequately Identify All Temporary = -------- , and/or Permanent Soil Stabalization Measures? - Yes No ----------------------------- j d. Does the SWPPP Adequately Identify a Complete -----------------------.-._._ _ _________ __ i Project Phasing Plan? Yes No Status of Impacted Waterbod e. Does the SWPPP Indicate Additional Site Specific Status Y•leg.I MDt,393(d)Listed,Impaired_) Practices that Will be Utilized to Protect Water Quality? Yes s �No f. Has the Applicant Submitted a Completed DEC Notice Type or Impacted Waterbo _ - -- - Of Intent and SWPPP Acceptance Form for Review �, P ay.(eq.Lake,creek,Bay,Pond,Sound,Freshwater Wetland_) by the Town of Southold? Yes No ; STATE OF NEW YORK, C --------------- OUNTY OF....... 41 �' "- tat I, 44.&�.._being duly sworn,deposes and says that be/she is the applicant for Permit, (Name of indrvt"signing Docvmentj And that be/Ar4s the (Owfier,Contractor. I.Corporate officer,etc)•••• •• ••...••...••• •• f Owner and/or representative of the Owner or Owners,and is duly authorized to perform or have performed the said work and to I , 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 herewith. Sworn to before me this; .......�-/� .day of-----...'.a.�l u ..... .20./...Z Notary Public. ... .... .. ...' . . .............. ............. ... .... .. ............... r� •1 5i alone of Apprcant) SWPPP Assessment FORM: 03-12 ; j wg mum -P.O.not 1 M Soud�ld,MC i l!rf109.y9 511I1.DING DEPARTMENT TOYM OF'8OU Ti'COM AppLICATION FOR 94 C�. TR CAL 1NS2991I0N MRF-OMSTED SY: �- r License No.: b7 rasa: RO Pf drte too.: (6:�Y-)9 3: - "`2 70 JOSMTEINFORMAT",: ('`Indicates required.(nf(i *Addrross:.:: s ,� *cross Stt"t ;Phone No.: la ff*No.: 7 2- Tax WWP okww t: 10M Section: Skm*:_ Lot:-..'B� *BRIEF DESCRIPTION OF WORK (Please Print Clearly) (Pkaw CIroN AN That Apply) nit yob M*toy kapecion: G4lf-., YES ! N4 ROU0 in F1na1 •fin you need a Twv CW~e: ES NO Timp 11dormew t1t nee" _ '$e1Vke Slate: 1 Phase 3Phase 100 150 2 300 3a0 400 "G1tFi.or 'New Service:. Rs-corms Underground Number of Meters. .Change of Service Qverheed Acfdl�liomah Inlorrnaelian: PAYMM M MI ,. A y M V -Aeq�esrt Rar MepscYore Farm Robert G. Bassolino R. A. Architect 28-55,214u'Place, Bayside, NY 11360 (718)225-9161 ACT. 17, za 12 w I r✓C>l Pd&5 BoX+C}�3p�ol �� 1=1 Nl0 TREE 05/11/2013 08:36 6317346270 BAY CREEK BUILDERS PAGE 01/01 Robert G. Bassolino R. A. Architect 28-55 21e Place, Bayside,NX 11360 (718)225-916 1 (March 7,2013 Mr Michael verity Building DepaMnent Town of Southold Re:2625 Stars Road Lucille Bombarderie Dear Mt Verity, This is to advise you that the a fiberglass insulation[R1.9]which was installed in the wall cavity and the floor are ace"ble to me and moets the N'YS code. If you require any further information,please contact me. Sincerely, $assolino RA B. P. # 3 7 BUILDING PERMIT EXAMINER CHECKLIST Date Submitted: 7-3 f_'`Date Reviewed. Applicant: -- Owner: Architec �� Estimated Cost: / S `t/£ inz" �— ry SCTM# 1000 - Subdivision:"' �la� � Zone: �`�� Conforming? IVO Property Address: City: C.Os. 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 N�Deterinination: STORM Nt}rt' :R�tt4-a .F REQ. Lot Size: °j�� ACT. Lot Size: ;�O) 9,71 REQ. Lot Cov: a0`jo ACT: Lot Cov. REQ. Front ACT. Front gi REQ Side ACT. Side_REQ. Rear L�-D PROP. Rear REQ. Heigffit. 3 57 ACT. Height K. RE 0. SeTH SI DES 3 A C T Pro'ect D scription: q /" � r �d� . . Walk Waterfront? Y or If yes, water body: Panel# Flood Zone: Rulkhead/Bluff Distance: ADDITIONAL APPROVALS REQUIRED QLAN S +f) SIGNED, SFrILED f±SuRVtY Suffolk County Health: Y 06 If yes, *Bed#: *Date: / / *Permit#: Town Septic: Y-N - If no, certification required: Y or N Received: Y or N By: NYS DEC: PRE-DEC 911/75 Y or �t Date: / /_ Permit#: or NJ Letter- Notes: Southold Trustees: Y or N�- Date: _/_/ Permit#: or NJ Letter-Notes: Southold ZBA: Y orUNDate: _/ / Permit#: -Notes: Southold Planning: Y ci f Date: _/ /_ Permit#: -Notes: Town Landmark C of A: Y oa14TE: / / *NYS CODE compliance(page 2): Y or N CoNTRA<TV L.10ENSCABIL11- t.1l4BILITY ..1A/olel�It1ENr�go CoMPE/V.S'4T-10W ,� r Notes. �t , � c� t_19 Fee Structure: Calculation: Foundation: S.F X 6© First Floor: _SF +Initial Fee: $ r, a00 Second Floor: SF +Additional Fee ( ): $ Other: SF S F X$ , =$ Total: +� SF +Initial Fee: $ µ +Additional Fee $C F f OF o EE) �t .50, 00, � � � � b 0 AS BUILT FEE - --&- TOTAL: $ I NEW'PORK STATE CODE COMPLIANCE CHECKLIST CLIMATIC/GEOGRAPHIC IDESIGN CRITERIA: ..Ground Snow Load:20 Wind Speed; 12OMPH Seismic Design Category:B Weathering: Severe Trost Depth: 36" Termite: M-H Decay: S-M Design Temp: 11 -Ice Shield Underlay: YES Flood Hazards: USE/OCCUPANCY CLASSIFICATION: HEIGHT/FIRE AREA: TYPE OF CONSTRUCTION: DESIGN CRITERIA: ENGINEERED/PRESCRIPTIVE FULL FRAMING DESIGN ELEMENTS: Y/N HEADERS: Y/N WALL STODS: Y/N GLRDERS: YIN CEILING JOISTS: YIN FLOOR JOISTS:Y/N ROOF RAFTERS: Y/N LUMBER SPECIES.AND GRADE: Y/N ViWINDOW AND DOOR SCHEDULE: •MISSLE TEST REQUIREMENTS: Y/N EGRESS 5.7 S.F.: Y/N i LIGHT 8%: Y/N VENT 4%: Y/N NAILING/CONSTRUCTION SCHEDULE: Y/N MEANS OF EGRESS: Y/N PLUMBING RISER DIAGRAM: YIN - LOCATION OF FIRE PROTECTION EQUIPMENT: Y/N TRUSS DESIGN: YIN CERTIFICATION: YIN .ENERGY CALCS: C ESCHECK,) �o/0 TOTAL COMPLIENCE? Y/N (RETURN TO PAGE ONE) LE ', 49a* 8TJ?>"C?i.':U CAL^?i! ITOPITEALTH 87 C :. nY2 '...,: A 4L The,euage tocztl r f:mr.Geer: 6 inspected aad!o,ca-5r.:3 +:"�,,`:>^a.;t ^"r cnd focnd to top ae— he satisi,cta.FG^r�Ati f;i it v.;e;: ;i;•,^?"OOi+:S. 3i�rl1v '•a:'E.i'.6"chi-J Oft-ice uVArater arl WrateHa.a;MLIagement I r 3': CZ.3013 rj IV ✓ � fRA,Y/E/I�DE'� � /D-Xd�aG4.9U6G ',ice t l LOB J 1 GC'4?'R�[- 9 .�ts�v�Y�"oe-�i'9Y�,LGir'/�G��DrY�8,9,�0��,2E' �,y�Q�.e�•t'�'svrr�' LoT% y9. /Y�i9��F.�Tis'RS/12,yii/AC po,�c ydB LCi4�T/�iq,GJG31/ �l t/it/O,+J✓'o�JTiS/4G.0 /�/• ?� //�7/ �rlJi9iPAN,7E1r�r!T. Y i�OE�cvr�P�g o�Eee.y/a+��is�o a^xs H1or��v rc_.5 bra Avy - e /c,-I w FGYJ.�/,rJ.9TiovLoC.J.9.u�J/D.ey/��aao �%c��ve✓Ey�lsrry'eP,laa� ; rs.c: ..1�#/G�da-Zz�D•s/a � o�/,eac��i�E-Fa�uy� NO LE Q ... LAiqb EC-.col/ Z 58r6o' /�Td,�r � S•Qoni•Y.Ca9.�.y1.sw0 ro 17Ile,01 GG`f✓'jR�L ��j�/ .�u�✓E'y�oe• �iAYs�,L�'%LC��D�i'J�/�,20/�,eE �,t,T�vR�.e A�a'x�x�. • .1aaTjta�mot/ �"/ ��"✓7"/�i9.e>aJN a/�/N O��oUTiS��GO il/. _Crdl9rP�f"NTE��T•�P.9Y4�•GGfG�LGc�"�o�F7�.9 />/�,eE.�14��wn ,c-�/�C7/JUGi2rc f/ �cs✓/.t/C. icy 7"7. /� ejg e� a . f%�,aa�eve✓Ej%rYr�HB�ta� ��:• i f REScheck Software Version 4.4.3 Compliance Certificate Project Title: BOMBARDIERE Energy Code: 2010 New York Energy Conservation Construction Code Location: Suffolk County,New York Construction Type: Single Family Project Type: Addition/Alteration Heating Degree Days: 5750 Climate Zone: 4 Construction Site: Owner/Agent: Designer/Contractor: 2625 STARS Rd • • ;fir._. � ,t„ Compliance:10.6%Better Than Code Maximum UA:104 Your UA:93 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. AssemblyGross Cavity Cont. Glazing UA or or fi•• Perimeter LI-Factor Ceiling 1:Flat Ceiling or Scissor Truss 118 30.0 0.0 4 Ceiling 2:Flat Ceiling or Scissor Truss 294 30.0 0.0 10 Wall 1:Wood Frame, 16"D.C. 416 21.0 0.0 24 Wall 2:Wood Frame,16"D.C. 272 21.0 0.0 13 Window 1:Vinyl Frame:Double Pane 30 0.480 14 Window 2:Vinyl Frame:Double Pane 13 0.480 6 Window 3:Vinyl Frame:Double Pane 8 0.480 4 Floor 1:All-Wood Joist/Truss:Over Unconditioned Space 118 21.0 0.0 5 Floor 2:All-Wood Joist/Truss:Over Unconditioned Space 294 21.0 0.0 13 Compliance Statement: The proposed building design described here is consistent with the building plans,specifications,and other calculations submitted with the permit application.The proposed building has been designed to meet the 2010 New York Energy Conservation Construction Code requirements in REScheck Version 4.4.3 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. f•Gc7 Z_ Name-Title Sig re Date r Project Title: BOMBARDIERE Report date:08/17/12 Data filename:C:\Users\Joan\Desktop\Ray 2010.rck Page 1 of 4 REScheck Software Version 4.4.3 NOInspection Checklist Energy Code: 2010 New York Energy Conservation Construction Code Location: Suffolk County, New York Construction Type: Single Family Project Type: Addition/Alteration Heating Degree Days: 5750 Climate Zone: 4 Ceilings: ❑ Ceiling 1:Flat Ceiling or Scissor Truss,R-30.0 cavity insulation Comments: ❑ Ceiling 2:Flat Ceiling or Scissor Truss,R-30.0 cavity insulation Comments: Above-Grade Walls: ❑ Wall 1:Wood Frame, 16"o.c.,R-21.0 cavity insulation Comments: ❑ Wall 2:Wood Frame,16"o.c.,R-21.0 cavity insulation Comments: Windows: ❑ Window 1:Vinyl Frame:Double Pane,U-factor:0.480 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 2:Vinyl Frame:Double Pane,U-factor:0.480 For windows without labeled U-factors,describe features: Wanes Frame Type Thermal Break? Yes No Comments: ❑ Window 3:Vinyl Frame:Double Pane,U-factor:0.480 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: Floors: ❑ Floor 1:All-Wood Joist/Truss:Over Unconditioned Space,R-21.0 cavity insulation Comments: Floor insulation is installed in permanent contact with the underside of the subfloor decking. ❑ Floor 2:All-Wood Joist/Truss:Over Unconditioned Space,R-21.0 cavity insulation Comments: Floor insulation is installed in permanent contact with the underside of the subfloor decking. Air Leakage: ❑ Joints(including rim joist junctions),attic access openings,penetrations,and all other such openings in the building envelope that are sources of air leakage are sealed with caulk,gasketed,weatherstripped or otherwise sealed with an air barrier material,suitable film or solid material. ❑ Air barrier and sealing exists on common walls between dwelling units,on exterior walls behind tubs/showers,and in openings between window/doorjambs and framing. ❑ Recessed lights in the building thermal envelope are 1)type IC rated and ASTM E283 labeled and 2)sealed with a gasket or caulk between the housing and the interior wall or ceiling covering. Project Title: BOMBARDIERE Report date: 08/17/12 Data filename: C:\Users\Joan\Desktop\Ray 2010.rck Page 2 of 4 Access doors separating conditioned from unconditioned space are weather-stripped and insulated(without insulation compression or damage)to at least the level of insulation on the surrounding surfaces.Where loose fill insulation exists,a baffle or retainer is installed to maintain insulation application. Wood-burning fireplaces have gasketed doors and outdoor combustion air. Automatic or gravity dampers are installed on all outdoor air intakes and exhausts. Air Sealing and Insulation: ❑ Building envelope airtightness and insulation installation complies by either 1)a post rough-in blower door test result of less than 7 ACH at 50 pascals OR 2)the following items have been satisfied: (a)Air barriers and thermal barrier:Installed on outside of air-permeable insulation and breaks or joints in the air barrier are filled or repaired. (b)Ceiling/attic:Air barrier in any dropped ceiling/soffit is substantially aligned with insulation and any gaps are sealed. (c)Above-grade walls:Insulation is installed in substantial contact and continuous alignment with the building envelope air barrier. (d)Floors:Air barrier is installed at any exposed edge of insulation. (a)Plumbing and wiring:Insulation is placed between outside and pipes.Batt insulation is cut to fit around wiring and plumbing,or sprayed/blown insulation extends behind piping and wiring. M Corners,headers,narrow framing cavities,and rim joists are insulated. (9)Shower/tub on exterior wall:Insulation exists between showers/tubs and exterior wall. Sunrooms: ❑ Sunrooms that are thermally isolated from the building envelope have a maximum fenestration U-factor of 0.50 and the maximum skylight U-factor of 0.75.New windows and doors separating the sunroom from conditioned space meet the building thermal envelope requirements. Materials Identification and Installation: ❑ Materials and equipment are installed in accordance with the manufacturer's installation instructions. ❑ Materials and equipment are identified so that compliance can be determined. ❑ Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. ❑ Insulation R-values and glazing U-factors are clearly marked on the building plans or specifications. Duct Insulation: ❑ Supply ducts in attics are insulated to a minimum of R-8.All other ducts in unconditioned spaces or outside the building envelope are insulated to at least R-6. Duct Construction and Testing: Building framing cavities are not used as supply ducts. All joints and seams of air ducts,air handlers,filter boxes,and building cavities used as return ducts are substantially airtight by means of tapes,mastics,liquid sealants,gasketing or other approved closure systems.Tapes,mastics,and fasteners are rated UL 181A or UL 181 B and are labeled according to the duct construction.Metal duct connections with equipment and/or fittings are mechanically fastened.Crimp joints for round metal ducts have a contact lap of at least 1 1/2 inches and are fastened with a minimum of three equally spaced sheet-metal screws. Exceptions: Joint and seams covered with spray polyurethane foam. Where a partially inaccessible duct connection exists,mechanical fasteners can be equally spaced on the exposed portion of the joint so as to prevent a hinge effect. Continuously welded and locking-type longitudinal joints and seams on ducts operating at less than 2 in.w.g.(500 Pa). l] Duct tightness test has been performed and meets one of the following test criteria: (1)Postconstruction leakage to outdoors test:Less than or equal to 8 cfm per 100 ft2 of conditioned floor area. (2)Postconstruction total leakage test(including air handler enclosure):Less than or equal to 12 cfm per 100 ft2. (3)Rough-in total leakage test with air handler installed:Less than or equal to 6 cfm per 100 ft2 of conditioned floor area. (4)Rough-in total leakage test without air handler installed:Less than or equal to 4 cfm per 100 ft2 of conditioned floor area. Temperature Controls: ❑ Where the primary heating system is a forced air-furnace,at least one programmable thermostat is installed to control the primary heating system and has set-points initialized at 70 degree F for the heating cycle and 78 degree F for the cooling cycle. ❑ Heat pumps having supplementary electric-resistance heat have controls that prevent supplemental heat operation when the compressor can meet the heating load. Heating and Cooling Equipment Sizing: Project Title: BOMBARDIERE Report date: 08/17/12 Data filename:C:\Users\Joan\Desktop\Ray 2010.rck Page 3 of 4 ❑ • Additional requirements for equipment sizing are included by an inspection for compliance with the International Residential Code. ` ❑ For systems serving multiple dwelling units documentation has been submitted demonstrating compliance with 2009 IECC Commercial Building Mechanical and/or Service Water Heating(Sections 503 and 504). Circulating Service Hot Water Systems: Lj Circulating service hot water pipes are insulated to R-2. ❑ Circulating service hot water systems include an automatic or accessible manual switch to turn off the circulating pump when the system is not in use. Heating and Cooling Piping Insulation: ❑ HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to R-3. Swimming Pools: Lj Heated swimming pools have an on/off heater switch. ❑ Pool heaters operating on natural gas or LPG have an electronic pilot light. ❑ Timer switches on pool heaters and pumps are present. Exceptions: Where public health standards require continuous pump operation. Where pumps operate within solar-and/or waste-heat-recovery systems. Lj Heated swimming pools have a cover on or at the water surface.For pools heated over 90 degrees F(32 degrees C)the cover has a minimum insulation value of R-12. Exceptions: Covers are not required when 60%of the heating energy is from site-recovered energy or solar energy source. Lighting Requirements: ❑ A minimum of 50 percent of the lamps in permanently installed lighting fixtures can be categorized as one of the following: (a)Compact fluorescent (b)T-8 or smaller diameter linear fluorescent (c)40 lumens per watt for lamp wattage<=15 (d)50 lumens per watt for lamp wattage>15 and<=40 (e)60 lumens per watt for lamp wattage>40 Other Requirements: ❑ Snow-and ice-melting systems with energy supplied from the service to a building shall include automatic controls capable of shutting off the system when a)the pavement temperature is above 50 degrees F,b)no precipitation is falling,and c)the outdoor temperature is above 40 degrees F(a manual shutoff control is also permitted to satisfy requirement V). Certificate: ❑ A permanent certificate is provided on or in the electrical distribution panel listing the predominant insulation R-values;window U-factors;type and efficiency of space-conditioning and water heating equipment.The certificate does not cover or obstruct the visibility of the circuit directory label,service disconnect label or other required labels. NOTES TO FIELD:(Building Department Use Only) Project Title: BOMBARDIERE Report date:08/17/12 Data filename: C:\Users\Joan\Desktop\Ray 2010.rck Page 4 of 4 Nt=Vy -dN 5'TCzuG'TlQ►•t C / � ?�Ir✓-TIIJG� t33utt_C�tNLT 4�'-o'f fit ! 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( - �T4�n_x 33:=_4�1__. --.� •Nt=`�''�_t��v-'T'f�ZLJGTtz..3F•i - -- 4--8. 2 -X i _Jt - .•2S; ,� - Q,d F PLUMBER CERTIFICATION :Li. -- _ - ._. -- - - _._ - - a a--...] OM LEAD CONTEAIT BEFORE -?- �- '_-. • - - ' 7 I S CERTIFICATE.&OCCUPAINCY SOLDER USED 1N WA"TER:. Q . l�u�+r>h-rlol•� �'3 -� g ri - .. . . - Sul_�'i t�G� :4�;. 2 � � :� �` SUPPLY SYSTEM_°CANNQ!T - - ' • . 4 i - EXCEED 2/10 OF 1%"LEAD. r Z�-�Fo , 1=X f5T 1 N C o N ✓T_ i S N1~W r. D�. - _ - r /t � ( ���-rrX 1+.'Tf� v�tt t-+t�vi �c tsr"U. s���K - •r `iii. . ' IY(I1.!_ tZ��:,,r2 Y.t�t2� - ��"-''�/, - t.l �E mpLKItJ� 17D (AJ a N4OWr7+ t z an vrJtT. _ AST- r 4z 1 4; zo 'L'`irr t f 'f r �/ I rl - KkylC� O - �� 2-q 5 vv I IL OCCUPANCY OR - --.__-___� _ _ Fill - .: N , utY e tam- ti p ( --- I�10`T' S USE IS UNLAWFUL _ S �. . . 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IG .aN �"r-off- J ors't'S a_ -S.6a t . `� ° a 1;1 I — ._ - St M t�a�P-� L-&-rtN6, P�Y�oar� pile : BY: 0 NOTIFY BUILDING DE ARTMENT AT = 9 ,N _ 5 (Z,I 2"n_Q," k (�� Ek 5Tla `lam I�' O!. I \J' rt Y - - I. PRc'��tD t= ,dt.-L, tJ�w UTTt'=R-5 L.�At'. 125 f'�'r AI--t_ �� P 765-1802 8 AM TO 4 PPS FOR THE 13! . ? _ - _ L --N I i t' i • E3tzGi .p�•IQT �VILc�t H c� .co;zhd�Z 5. `x C}' / h Goj i�„jT_•J l`GT PaR- ¢ O S`ttNG pt2 exI0-TG K1T �-� '' - n� w/oe,To l I r QN� = jt4OrA-t_1- v�rr-r CN1sNtlt= r Ns u o p7 FOLLOWING INSPECTIONS: t . $ .. y�„l� a► T tz ci-1 H P r r OL �' T t • 9 7 1. FOUNDATION - TWO REQUIRED d 3 is t :1°�K¢,Mfk� W FOR POURED CONCRETE \./ ktZ Qtl g� C'✓� { ( 4., µ, ,, •GL \ 6G �F, 2. ROUGH - FRAMING & PLUMBING Jr *x ��.. .>.. �.. -- --- - tl �►r--14N. vYL:C: y - _rrt�"`r. F3--- �,�, ��L,;.t, WAtK-/N 3. INSULATION �I,� >< 54o 2 •c.�Nt�►�'f *; C 4. FINAL • CONSTRUCTION MUST L4 BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE �� �t -- 0 - If •� Q J. .. � T - -- REQUIREMENTS OF THE CODES OF NIEW - / J �4- YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. 5 OL N ' I �,r �i 2 II -� I ,� t l I r . s,.�.r�,. �- c•�1 F, t (0 4--tD `� �c ,� fry �_ �► i' C y K ELECTRICAL INSPECTION REQUIRES ►trz r W — _o t r o M , ►4 ,I 1 QF ZE 51 D EE f 4 C E —PCB� • !T" 61�.5 =��_�2 -7 _• tQ---1 Z RETAIN STORM WATER RUNOFF q!,o - � y� !q q' •�� G�IT EG"T '7-tt - 62 PURSUANT TO CHAPTER 236 - AL-TER�"t'ldN To �1CP�"fIN6t F, I,LxL -o(t-4er_ 1 . r- 2s. tZ to Z 6t26 Ro�� Si'/S,!'.z� M AtJc>rZ �L8-r✓-5 2 14 T fx- G I t� N 4. OF THE TOWN CODE. 2�-� • - � •- .y • Sot.�-t74-c5t o I•t... v `!'Z�t�t� _ •'7 Ds, 113 I _ t t~ � Ga N5`C• - t�x15-rU GONST_ stew 16-15-pt--t":r sN t+4AL-1 - N EW._ G C> _-5Ta vcr t ca tJ ' --GN �Z PLYVuOc�i7 - ' ! 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