EX #03-24 Ex - Newman, Brian

4
Post Office Box 549
101 Veterans Memorial Drive
Kitty Hawk, NC 27949
1/18/2024
Brian K Newman
PO Box 1450
Kitty Hawk INC 27949
RECEIVED
Phone [phone] FEB 2 7 2024
Fax [phone]
ww w. townofki h vhawk.ory
®CM -EC
Exemption Number -03-24 Ex
RE: EXEMPTED PROJECT (Statutory Exclusion) - MAINTENANCE AND REPAIR OF EXISTING
STRUCTURES - [G.S.113.103(5)(B)(5) and [15A NCAC 7K.0103(a)]
PROJECT ADDRESS - 4509 N Virginia Dare Trl
AREA OF ENVIRONMENTAL CONCERN - Ocean
Dear Mr. Newman:
I have reviewed the information submitted to this office in your inquiry concerning the necessary filing of an
application for a minor development permit under the Coastal Area Management Act. After making a site inspection
on 1/17/24, 1 have determined that the activity you propose is exempt from needing a minor development permit as
long as it remains consistent with your site drawing and materials list submitted on 1/18/24. and meets the conditions
specified below. If your plans should change and your project will no longer meet these conditions, please contact
me before proceeding,
MAINTENANCE AND REPAIR - [G.S.113.103(5)(B)(5) and 15A NCAC 7K.0103(a)] - Maintenance and repairs
(excluding replacement) necessary to repair damage to structures caused by the elements are specifically excluded
from the definition of development under the conditions and in the circumstances set out in G.S. 113A-103(5)(b)(5).
Individuals required to take such measures within an AEC shall contact the local CAMA representative for
consultation and advice before beginning work.
Structures may be repaired in a similar manner, size and location as the original structure. No expansions or
additions are permissible. The repairs are limited to 50% of the market value of the existing structure and the
following specific conditions,
1. The project consists of the replacement of girders, ancillary fioorjoists, and sistering of pilings as
determined by contractor, as shown on the attached drawing and materials list.
2. The proposed repairs shall be consistent with all other applicable local ordinances and North Carolina
Building Code standards.
3. Value of house $186,200; 50%cost of house $93,100; Cost of work $4,800; Value work left in
12 months $88,300
This exemption to CAMA permit requirements does not alleviate the necessity of your obtaining any other State,
Federal or Local authorization and N.C. Building Permits. This exemption expires 90 days from the date of the letter.
Rob Testennan, LPO �i — Issued: 1/18/24
P.O. Box 549
Kitty Hawk, NC 27949 Expires: 4/17/24
CC: Lisa Doepker, NC DEQ

Property Address
Town of Kitty Hawk
Planning & Inspections Department
101 Veterans Memorial Drive, PO Box 549
Kitty Hawk, NC 27949
Phone: [phone] Fax: [phone]
Revised April 2022
RECE!\>0==r.
FEB 2 7 2024
RESIDENTIAL BUILDING PERMIT APPLICATION®CM-E
`/50`% NVc�L�re Tr1 N# 9671010qS49(059
Property Owner Name: ,-- Q n K • 2W IYIO Y 1
MailingAddress: f d bo `j��0 _ _ KL}�'t/_1�Q�k /VC
(Zip)
� ®� (City)
Phone: (41j (off-3gi Fax: (_) Cell:
Email: �ti i�in�WM4n °�/hSh.CO/»
D Owners 0 Builder 13Contractor - License # / 7
Name:
Mailing Address:
(zip)
Phone: O;Zti —3gi�iFax: (__}
Email: 6ui/AC10rhah(9MV).C4'1?
(City)
Cell: (252�)�( Zfe
(State)
(State)
&h:QIl1MG1Qr Information An affidavit will need to be signed by each subcontractor prior to beginning work.
Contractor
Electric
Plumbing
HVAC
Fuel Piping
Irrigation
NC License No.
Phone #
No work shall be covered or concealed until approved by the Kitty Hawk Building inspector
Page 2

General Description of Work:
Cla of Work:
;'Single Family ❑ Two Family ❑ Accessory Bldg.
❑ Pool ❑ Other
Type of Occupation:
G�I` Rental/Spec ❑ Permanent/ 2^d Home
Type of Action:
❑ New 0 Addition ❑ Remodel Repair/Replace
❑ Moving ❑ Demo ❑ Other
Estimated Cost of Construction
(includes value of all labor and all materials):
Building -
Electrical - $
Plumbing - $ Mechanical - $
Gas - $ Other - S
Total Cost of Construction - $ AZ- d
Proper B jilding Details
No. Stories: Bldg
Height:-----___
No. of Bedrooms: Existing__ Proposed_
No. of Baths: Full Half
Foundation Type:
Roofing Material:
Exterior Finish:
Fireplace: 0 Y 0 N
If yes: ❑ Wood O Gas O Other
Staff to Complete FIRM Da a•
Map Panel #:
Effective Date:
any; I(ar•
-F{oo�-
' piss
and
RECEIVIF
FEB 2 ) 2024
Utilities (p gAW circ►e ong
Water: Dare Co. / Well
Electric: Underground / Overhead
Amperage
Phase
voltage
Flood Zone:
Base Flood Elevation
So pare F a e F ilfino Pro
Heated Living Space:
Unheated Space: e
Porch: w
a
Deck: SO
TOTAL: sqft
l_ _
Base Flood Elevation (BFE):
Regulatory Flood Protection Elevation:
Date a CoinPtete Applk gbh: MY ON Workap Comp Form; . .
RecNved BY. _.. Date of COMP ..e Appiketi6e: pM A Info Submitted -
9 -- _

Town of Kitty Hawk
Planning & Inspections Department
101 Veterans Memorial Drive, PO Box 549, Kitty Hawk, NC 27949
Phone [phone] Fax [phone]
GENERAL CONTRACTOR SIGN OFF FORM
RECEIVED
FEB 2 7 2024
GENERAL CONTRACTOR INFORMATION DCM-EC
Qualifier's Name: riQ K • {v 2W n 10 n
Business Name: ��WMar� W(�1Cttl C7'�lom�es C'ons� i
Business Address: ��.[�oX r�/50f i�f�
Business Phone (Includes Area Code): 5._—� �. _ 2}
NC General Contractor License #:
General Contractor License Limit: Vnl i mi �ed
General Contractor's Email Address:
Surety Bond (Project Over $30,000):
PROJECT INFORMATION
Property Owner: '?)r Ia_n_ _ A,Lo rylczn -1
Property Address of Job:
I the undersigned have read and understand the General Statutes pertaining to General
Contracting in North Carolina. I hereby affirm or swear I am licensed and qualified to
assume all responsibility and liability of a General Contractor upon this project. If I
resign or am no longer affiliated with this project, I will notify the local authority (Town of
Kitty Hawk Building Inspections) immediately by phone or in person and in writing within
thr a (3) working(lays.
X_ _
Signature Da e
Revised April 2022

RECi=ivr:D
Town of Kitty Hawk
Planning & Inspections Department
FEB 2 7 2024
101 Veterans Memorial Drive, PO Box 549, Kitty Hawk, NC 27949 k.J��yn/� C
Phone [phone] Fax [phone] I. M—GC
AFFIDAVIT OF WORKERS' COMPENSATION COVERAGE
N.C.G.S. § 87-14
Thehe un`ed applicant for Building Permit being the:
Contractor
Owner
m Officer/Agent of the Contractor
do hereby aver under penalties of perjury that the person(s), firm(s) or corporation(s)
performing the work set forth in the permit:
_ has/have three (3) or more employees and have obtained workers'
compensation insurance to cover them,
has/have one or more subcontractor(s) and have obtained workers'
compensation covering them,
has/have one or more subcontractor(s) who has/have their own policy of
workmen's compensation covering themselves,
has/have not more than two (2) employees and no subcontractors,
while working on the project for which this permit is sought. it is understood that the
Inspection Department issuing the permit may require certificates of coverage of worker's
compensation insurance prior to issuance of the permit and at any time during the
permitted work from any person, firm, or corporation carrying out the work.
Firm Name:
Signature:
Title: OW At'r
Date:
Revised April 2022

Town of Kitty Hawk
Planning & Inspections Department
101 Veterans Memorial Drive, PO Box 549, Kitty Hawk, NC 27949
Phone (2S2) 261-3552 Fax [phone]
RECEIVED
HOMEOWNER AUTHORIZATION FORM FEB 2 7 2024
Property Owner(s): Pick %AkWm�
Property Owner(s) Mailing Address:
1 hereby give authorization to:
D!—j_CAAJ� - (VfWMO-h
(Contractors Name)
Box NO
to apply and obtain all permits on my behalf.
-
n............ Sig .. _ -_
( roperty Owners nature}
(Property Owners Signature)
(Date)
Physical address of property where work is to be conducted:
`)50R N
DCM-EC
Revised April 2022