HomeMy WebLinkAbout36756-Z J�'SU pt Town of Southold Annex 10/30/2013
P.O.Box 1179
�N 54375 Main Road
$
o - Southold,New York 11971
y�01 '1a04!'
CERTIFICATE OF OCCUPANCY
No: 36589 Date: 10/30/2013
THIS CERTIFIES that the building RESIDENTIAL ALTERATION
Location of Property: 11365 Sound Ave, Mattituck,
SCTM#: 473889 Sec/Block/Lot: 141.-3-6.2
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
9/30/2011 pursuant to which Building Permit No. 36756 dated 10/14/2011
was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for
which this certificate is issued is:
alterations to an existing one family dwelling as applied for.
The certificate is issued to Elliott,Kyle&Kathy
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 36756 8/20/12
PLUMBERS CERTIFICATION DATED 10/24/13 George Almyroudis
71hed S' nature
fF0 , TOWN OF SOUTHOLD
gUFFU(�cOA
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
Ca
SOUTHOLD, NY
r 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#: 36756 Date: 10/14/2011
Permission is hereby granted to:
Elliott, Kyle & Kathy
11621 Ayres Ave
Los Angeles, CA 90064
To: Alterations to a Single Family Dwelling;
Kitchen, Bath, Powder Room, Staircase, as applied for.
At premises located at:
11365 Sound Ave, Mattituck
SCTM # 473889
Sec/Block/Lot# 141.-3-6.2
Pursuant to application dated 9/30/2011 and approved by the Building Inspector.
To expire on 4/14/2013.
Fees:
CO -ALTERATION TO DWELLING $50.00
SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $324.80
Total: $374.80
Buildi g 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:
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 sQmpleted application and consent to inspect signed-by the applicant. If a Certificate of Occupancy is
denied, the Building Inspector shall state the reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy-New dwelling$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00,
Swimming pool$50.00, Accessory building$50.00,Additions to accessory building$50.00,Businesses$50.00!
2. Certificate of Occupancy on Pre-.existing Building- $100.00
3. Copy of Certificate,of.Occupancy-$_25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy -Residential$15.00,Commercial$15.00
Date.
New Construction: Old or Pre-existing Building: (check one)
Location of Property: /3�s D /Q 5XV,70/ 4yc- Z44011,_/U60k_
House No- Street C Hamlet
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section Block Lot p�
Subdivision Filed Map- Lot:
Permit No. lD Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $
plicant Signatu
pF SO!/T�OIo
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 • �Q roger.richerta-town.southo Id.ny.us
COUNT`I,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Elliott
Address: 11365 Old Sound Ave City: Mattituck St: NY Zip: 11952
Building Permit#: 36756 Section: Block: Lot:
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor- DBA: North Eastern Electric License No: 41853-me
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X Service Only
Commerical Outdoor X 1st Floor X Pool
New Renovation X 2nd Floor X Hot Tub
Addition Survey Attic X Garage
INVENTORY
Service 1 ph Heat gas Duplec Recpt 39 Ceiling Fixtures 15 HID Fixtures
Service 3 ph Hot Water elec GFCI Recpt 5 Wall Fixtures 5 Smoke Detectors 4Main Panel A/C Condenser 2 Single Recpt Recessed Fixtures 15 CO Detectors
Sub Panel 1-60 A/C Blower 2 Range Recpt 1 Fluorescent Fixture Pumps
Transformer Appliances dw Dryer Recpt 1-30 Emergency Fixture Time Clocks
Disconnect Switches 36 Twist Lock Exit Fixtures TVSS
Other Equipment: 3-combination smoke/co detectors, 1-paddle fan, 2-exhaust fans,
12 ARC fault circuit breakers
Notes:
Inspector Signature: Date: Aug 20 2012
81-Cert Electrical Compliance Form.xls
CERTIFICATION
Date: 10 2�I 113
Building Permit No. �j �j 7 (2
Owner: OA 113Co 5 O\CL S:0\AA- K\J( S 2.
(Please print)
Plumber: ( e-gprge-
(Please print)
I certify that the solder used in the water supply system contains less than 2/10 of 1%
lead.
(Plumbers Signature)
Nefore
Sworn me this
day of 20 /S
�rff�J � Lill �V L ;f � ,!
Notary Public, —County OCT 2 9 2013 Ln
DOROTHYA.HELLBERG' TOW BLDG. DEPT.
OLD
Notary Public State of New York N OF SOVTH
commission No.01 HE6167738
Qua2W in Suffolk County
commission Expires June 4, 15
TOWN OF SOUTHOLD BUILDING DEPT.'
765-1802 .
1 NSPECT-0- LIGH
I
[ ] FOUNDATION 1ST [:7 PLBG.
[ ] FO DATION 2ND [ ] INSULATION
FRAM
ING [ ] FINAL
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL R UGH) [ ] ELECTRICAL (FINAL)
REMARKS:
�J 1
r
v �G
T v V
i
t
DATE INSPECTOR
1
�j� <✓ Of SO(/r�o
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOU DATION 1 ST [ k]'ROUGH PLBG.
[ IF UNDATION 2ND [ ] INSULATION
['- FRAMING/STRAPPING ( ] FINAL
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRI L (ROUGH) [ ] ELECTRICAL (FINAL)
REMARK ( �
DATE �� �' INSPECTOR
AOF SOUlyolo -
cow
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING/STRAPPING [ ] FINAL
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ , LECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS:
DATE �� �� INSPECTOR '`
3 67S-6- OF S0(/j�olo
cOUNi`I,
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTI-0-N
[ ] FOUNDATION 1 ST [ 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 r �` � -IN
SPECTOR
J
o�yCOU ,N
TOWN OF SOUTHOLD BUILDING DEPT.
7C5-1 SO2
INSPECTION
[ ] FOUNDATION 1 ST [ ] IOU PLBG.
[ ] FOUNDATION 2ND [ NSULATION
[ ] FRAMING/STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS:
/c-10
r
DATE INSPECTOR
I
so
UN1Y,
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION .
[ ] FOUNDATION 1ST [ ] ROUGH G.
[ ] FOUNDATION 2ND [ ] IN ATION
[ ] FRAMING/STRAPPING [ INAL
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRI (ROUGH) [ ] ELECTRICAL (FINAL)
- � . `
REMARK :r
xf
A _ r�
� r
41
DATE INSPECTOR
'cv- d-
�/
�Of SOpT _
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION . .-.
[ ] FOUNDATION 1 ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] IN
[ ] FRAMING/STRAPPING [ 1 L
[ ] FIREPLACE A CHIMNEY [ ] FIRES INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRIC _ ROUGH) [ ] ELECTRICAL ((FINAL)
REMARKS: Cam_
DATE INSPECTOR `
�o�apf SOAp
(/j�,o`o
coum,�'
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION ' '.'.. .
[ ] FOUNDATION i ST [ ] ROUGH PLOG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING/STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [, ELECTRICAL (FINAL)
REMARKS:
DATE �� INSPECTOR �—
OF SOUI�olo
V
o��Y�DUHi`l,�c�
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION '
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] LN"SUL
[ ] FRAMING/STRAPPING [ FIN L �.
[ ] FIREPLACE A CHIMNEY [ ] FIRE INSPECTION
[ ] FIRE-RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS:
DATE A /( )**" INSPECTOR
i
A' 1 1 0 • �_ • 1 1'
UAW
i
Mom
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1: 1 _ /ter/- .�' � •/_.,.� f.._ ..�1_.� �- � 1�1� "1�
—- 02WA -
1 • •
STATE ENERGY CODE..
�(: 1 • fit .t/J
ADDITIONAL COM
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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
SoutholdTown.NorthFork.net PERMIT NO. Check
Septic Form
N.Y.S.D.E.C.
V�
R
((� Trustees
Flood Permit,
Examined 1 (/ 120 l Single&Separate
SEP 3 0 2011 Storm-Water Assessment Form
Contact: �
Approved � _ � 120 I I BLDG.DEPT. �� �
Mail to:
TOWN OF SOUTHOLD
l 'eved�c �P
JJ Phone:
Expiration /` 120 f�
Building.Inspector
APPLICCATION 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 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 perinit.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 rom such date. If no'zoning ameridinents 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.
Mel ,.Lh[ u lg f 1{S 4: -
(Signature of applicant or name, if a corporation)
? aa ;,4
(Mailing address of ap icant)` t Q r '4,
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
�i - �-,<4
Name of owner of premises fc
remisesc fey 16 —
(As on the tax roll or latest deed)
If appl' ant i a co ation, signature of duly au hor►iz7eedd officer
G w- l
(Name a ti of corporate o ficer)
B ' ders License No.
�8���`
Plumbers License No. 8!9 !�P
Electricians License No. ea — N1 or
Other Trade's License No.
1. Location of land on which proposed w rk will be done:
(13 (Os- 0'a9
House Number Street Hamlet
Count Tax Ma No. I000 Section ` ° 1 Lot
Y P of Btock, ,,, b
Subdivision y.. Tiled jMhVNo0 =i 3.; Lot
2. State existing use and occupancy of premises and inte ded use and occupancy of proposed construction:
a. Existing use and occupancy ��N7�i� L
b. Intended use and occupancy A"-'es!cg� .7`,
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost tloo" 000"
, Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units '_-� `Number of dwelling units on each floor 3 en, Qv,,
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_ a f Rear /J Depth
Height 'Q y Number of Stories
Dimensions of same structure with alterations or additions: Front Rear /S .3
Depth Height 1? 5/ Number of Stories a
8. Dimensions of entire new construction: Front .�"`tG��o r dP b Depth �—
Height Number of Stories —
9. Size of lot: Front //0 . b Rear 113 A7 Depth 196 • �,/
10. Date of Purchase Name of Former Owner
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 remises? YES NO
g �Qo�Alrj.
` !o14. Names of Owner of premises e io Address /S37 �Ci r1<e .t /A ,3•t S 7��ac�
Name of Architect Ali e Mt kl e ✓►'�^ _ Address l? va S Phone No 63/ 78 6 asC 7
Name of Contractor HfLf-t juS'7-e ies (,7-0 Address-2 7 HBPhone 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 RE UIRED.
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 NO Y
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF )
J 0 K eV-5'44a K- being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing cont ct) above named,
(S)He is the
Contractor, gent, 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
X YRL
day of 20IL \
Notary Public �E ti(ALHORN Signature of A
S' Notary:Public,State of New York o p
Registration#01 KA6205483
Qualified In Suffolk County
Commission Expires May 11,201
I
Town Hall Annex relephone(631)765-1802
54375 Main Road ,,aarxc(631)765-g5QQ2
P.O.Box 1179 / town )6766'61d.n .us
i
Southold,NY 11971-0959
APPLICATIOI
REQUESTED BY: I
Company Name:
Name: off^ so
License No.: 1711,9-G3 /44&�
Address: 3 ? L le
Phone No.:
JOBSITE INFORMATION; (*Indicates required information)
*Name:
*Address: 1136 plr'
*Cross Street:
*Phone No.:
Permit No.:
Tax Map District: 1000 Section: Block:. Lot:
*BRIEF DESCRIPTION OF WORRK� (Please Print Clearly)
—Omj-z0 e
(Please Circle All That Apply)
*Is job ready for inspection: YE NO R gh In JFinal
*Do you need a Temp Certificate: YES / NO
Temp Information (If ede )
*Service Size: 1 Pha 3Phase 100 150. 200 300 0 400 Other
*New Service: Re-connect Underground Number of Meters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
82-Request for Inspection Form
ho��pF SO!/Tyolo
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
�C4UNTY,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
August 27, 2012
Kyle Elliott
1537 Redding Rd
Fairfield CT 06824
Re: 11365 Sound Ave, Mattituck
TO WHOM IT MAY CONCERN:
The Following Items Are Needed To Complete Your Certificate of ccupancy: n
"Before a Certificate of Occupancy can be issued,we.still need a payment of$150 for h Electrical
Underwriters Certificate
Application for Certificate of Occupancy. (Enclosed) / 1�
Electrical Underwriters Certificate. (contact your electrician)
A fee of$50.00.
Final Health Department Approval.
Zplumbers 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: 36756 - Alterations
B. P # 367,S-k q
BUILDING PERMIT EXAMINER CHECKLIST "Date Submitted: ! Dale Reviewed:2 -13 -11
Applicant. n Owner:
Architects c C� Estimated Cost: /
SCTM# 1000 - 3 Subdivision: Zone: Conforming? "
r
Property Address: ow_ City: /56 r �Pre COs?
Building Permits (Open/Expired): BP -Z/GO 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:
—T
Single& Separa a Search Re uired? Y o Determination: .R_uN-a,F-F '—"
REQ. Lot Size: ACT. Lot Size: REQ. Lot Cov. oZo�jo ACT: Lot:(;ov.
REQ. Front ACT. Front RLQ Side ACT. Side REQ. Rear PROP. Rear
REQ. Height . 3,57" ACT. Height R E ct. BOTH SIDES A C T
4�1&
._
Project Descri tion:
Waterfront? Y or .
If yes, water body: Panel# Flood Zone: B:Ul�khead/Bluff Distance:
ADDITIONAL APPROVALS REQUIRED PLq N S(If) SIGNED, SuRVeY
Suffolk County Health: Y-oro- If yes, *Bed#: *Date: _/_/ *Permit#: Town Septic: YO
- If no, certification required: Y or N Received: Y or N By:
NYS DEC: PRE-DEC9/1/75 Y or0- Date: / /_ Permit#: or NJ Letter— Notes:
Southold Trustees: Y Oro- Date: /_/ Permit#: or NJ Letter—Notes:
Southold ZBA: Y org - Date: / / Permit#: —Notes:
Southold Planning: Y or IQ- Date: '/ /_ Permit th —Notes:
Town Landmark C of A: Y oGDTE: _/_/_ *NYS CODE-Compliance(page 2): Y or N
CONTRA-CTOR t,ICE-NSt AIS,4B1LIrY LlltBrLIT- U/okklMEnis CoMp�ivS4TIOn/
Notes:
Fee Structure: Calculation:
Foundation: SF X $ , 0=$ 0--T, $CJ
First Floor: SF + Initial Fee: $ 00-0 0 , 00
Second Floor: SF +Additional Fee ( : $
Other: SF SF X$ , =$
Total 3 SF +Initial Fee: $
+ Additional Fee $
C of o FES) lJ 00
A5 BUILT FEE — '— TOTAL: $ , to
NEW YORK STATE CODE COMPLIANCE CHECKLIST
CLIMATIC/GEOGRAPHIC DESIGN CRITERIA:
Ground Snow Load:20 Wind Speed: 120MPH Seismic Design Category:B
Weathering: Severe Frost 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: YIN WALL STUDS: Y/N GIRDERS: Y/N
CEILING JOISTS: YIN FL6OR JOISTS:YIN ROOF RAF TERS: Y/N
_LUMBER SPECIES AND GRADE: YIN
wiNDOW AND DOOR SCHEDULE:
'MISSLE TEST REQUIREMENTS: Y/N
EGRESS 5.7 S.F.: Y/N 4
LIGHT 8%: Y/N
VENT 4%: Y/N
NAILING/CONSTRUCTION SCHEDULE: Y/N
MEANS OF EGRES S: Y/N'
PLUMBING RISER DIAGRAM: Y/N
LOCATION OF FIRE PROTECTION EQUIPMENT: Y/N
TRUSS DESIGN: Y/N
CERTIFICATION: YIN
ENERGY CALLS: Y/N (RESCRECK)
TOTAL COMPLIENCE? Y/N (RETURN TO PAGE ONE)
S
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�- AS REQUIRED ANIONS OE_
SO �OLD TOWN R
. UT N PLANNING BOARD
— SOU�T D TOWN TRUE El,
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"`'...'.'ED AS NOTED
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gyg �� ��,I •� f<� I> .p J I I ri c TO, 4 PM FOR THE
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�Z" !'� ' , . PJ -TWO REQUIRED
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ELECTRICAL &CAULKING
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ST BE COMPLETE FOR C.O.EC
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;; ---- � �F�I I:.: �I ._CONSTRUCTION SHALL MEET THE
1.l f; OUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
s -' ) DESIGN OR CONSTRUCTION ERRORS. .
in Q
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-SO,'_ . R USED IN WA TER
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A WATEA UNE&KSED
^ z ' � !f'L�t'� t r T ("' , TESTING�CEFORE COVERING
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