EX #09-24 - KH4220 LLC

Post Office Box 549
101 Veterans Memorial Drive
Kitty Hawk, NC 27949
3/11/24
KH4220 LLC
69 Van Cortlandt Ave
Ossining NY 10562
Phone [phone]
Fax [phone]
www.town<)fkittvhaWk.org
Exemption Number — 09-24 Ex
RE: EXEMPTED PROJECT (Statutory Exclusion) - MAINTENANCE AND REPAIR OF EXISTING
STRUCTURES - [G.5.113.103(5)(B)(5) and 115A NCAC 7K.0103(a)]
PROJECT ADDRESS — 4220 N Virginia Dare Trl
AREA OF ENVIRONMENTAL CONCERN - Ocean
Dear Sir or Ma'am:
RECO -- .;
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 3/11/24,1 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 3/9/24, 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 doors, windows, siding, 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.
This exemption to CAMA permit requirements does not alleviate the necessity of your obtaining any other State,
Feder"al I authorization and N.C. Building Permits. This exemption expires 90 days from the date of the letter
Testerman, LPO Issued: 3/11124
P.O. Box 549
Kitty Hawk, NC 27949 Expires: 6/9/24
CC: Lisa Doepker, NC DEQ
MAR 1 1 2024

Town of Kitty Hawk
Planning & Inspections Department
101 Veterans Memorial Drive, PC Box S49
Kitty Hawk, NC 27949
Phone: [phone] Fax: [phone]
'v bVED
MAR 1 1 2024
RESIDENTIAL BUILDING PERMIT APPLICATIDNID CM -EC
Property Address gaOV; Al, V1Y1 I1Ii:d;7 k.w 1PIN It
Property Owner
Mailing Address.
(zip) /Dsb
Phone: (A);4)
Email:
Lien Agent Details Submitted:
Authorized Ageni,(C-ontractor
O owner O Builder
Name: C -1; t R✓a �cL'
Mailing Address:
Fax: (___-_)
"ntractor - License #
M
ate)
(Zip) 35a- (City) (sta
/_
Phone: ( ) b) -�� 6,,5 Fax: (_) Cell: (al3
Email: (!�� L�'%/e%L 1�/:)
Sub -contractor information: An affidavit will need to be signed by each subcontractor prior to beginning work.
Contractor NC License No.
Electric
Plumbing
HVAC
Fuel Piping
Irrigation
Phone #
No work shall be covered or concealed until approved by the Kitty Hawk Building inspector

General Description of Work:
IC
Cla f Work:
Single Family ❑ Two Family ❑ Accessory Bldg.
❑ Pool ❑ Other -
Type of occupation:
❑ Rental/Spec ❑ Permanent/ 2nd Home
Type of Action:
❑ New ❑ Addition O Remodel 0-Repair/Replace
❑ Moving ❑ Demo ❑ Other
Estimated Cost of Construction
(includes value of all labor and all materials):
Building- $ AW2�1 Electrical - $
Plumbing-$- Mechanical - $
Gas - $
Other - $
Total Cost of Construction - $ J %�( , �
Proposed Building Details:
No. Stories: Bldg
Height:
No. of Bedrooms: Existing Proposed_
No. of Baths: Full Half
Foundation Type:
Roofing Material:
Exterior Finish:
Fireplace: ❑ Y ON
If yes: ❑ Wood O Gas ❑ Other
tl
Water: Dare Co. / Well
Electric: Underground / Overhead
Amperage
Phase
Voltage
Base Flood Elevation
MAR 1 1 2024
DCM-E
.g, u:me,+Fee -
Square Footage: UiStfng Pr000sed
Heated Living Space: sq h
Unheated Space: sgfl
Porch: sq
e
Deck: sq n
TOTAL: aq e
Staff to Complete FIRM Data:
Map Panel #: Base Flood Elevation (BFE):
Effective Date: Regulatory Flood Protection Elevation:
..... ,..,
Date'.Complete Applicetioh: E] Y.M.N. Workers Comp:Form
Received'B Dete n(Cbmplete Appli atioa. T r, __ Clen Agent Info:Subinitted

Town of Kitty Hawk RECEIVED
Planning & Inspections Department
MAR 1 1 2024
101 Veterans Memorial Drive, PO Box 549, Kitty Hawk, NC 27949
Phone [phone] Fax [phone] CM
y y�� AA —EC
(.
GENERAL CONTRACTOR SIGN OFF FORM
GENERAL CONTRACTOR INFORMATION
Qualifier's Name:
Business Name:
Business AddresE
Business Phone (includes Area Code):
NC General Contractor License #:
General Contractor License Limit:�jd�
General Contractor's Email Address: L) ,,
Surety Bond (Project Over $30,000):
PROJECT INFORMATION
Property Owner: ) 3 i) I-L (,
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
three (3) w in days.
Sig dture Date
RevisedApril 2022