HomeMy WebLinkAbout26471-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-27069 Date: 05/09/00
THIS CERTIFIES that the building ADDITION
Location of Property: 1130 SALTAIRE WAY MATTITUCK
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 100 Block 1 Lot 30
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 61 2000 pursuant to which
Building Permit No. 26471-Z dated APRIL 26, 2000
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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR
"AS BUILT".
The certificate is issued to ELEANOR C HUNEKE
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
S
-",Z /
u crized Signature
Rev. 1/81
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 26471 Z Date APRIL 26, 2000
Permission is hereby granted to:
ELEANOR C HUNEKE
1130 SALTAIRE WAY
MATTITUCK,NY 11952
for
CONSTRUCTION OF AN "AS BUILT" DECK ADDITION TO AN EXISTING ONE
FAMILY DWELLING AS APPLIED FOR.
at premises located at 1130 SALTAIRE WAY MATTITUCK
County Tax Map No. 473889 Section 100 Block 0001 Lot No. 030
pursuant to application dated MARCH 6 , 2000 and approved by the
Building Inspector.
Fee $ 75 . 00
Auth ed Signature
ORIGINAL
Rev. 2/19/98
Form No. 6
;`
MAY R TOWN OF SOUTHOLD
BUILDING DEPARTMENT
"''
c0T. TOWN HALL
CG d" �OF SGUTHOLD 765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. This application must be filled in by typewriter OF, ink and submitted to the building
inspector with the following: 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 completed application and a 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 Buildine - $100'.00
3. Copy of Certificate of Occupancy - v .251.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date . . . . :s��/.... . . . . . . . . . . . . . . . . . . . . . . . . .
New Construction. . . . . . . . . . . Old Or Pre-existing Building. . . . . . . . . . . . . . . . .
Location of Property. . . . . .0 viol . .j :.ct'.7n. . . . . . . .
House Noo./� / )StreEt Hamlet
Onwer or Owners of Property. L.- i.4 �F i. . . ` .'. . / �U!7 . ;e�. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
oop�
County Tax Map No 1000, Section. . f.��. .BIock. . . . . . . . . .Lot. . . . . .... O
Subdivision. . .. . . . . . . . . . . . . . . . . . . . . . . . . .��.//. . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . .
Permit NAR &Y .?. . .Date Of Permit.7.AbA6 . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . .
HealthDept. Approval . . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval . . . . . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . .
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . .
Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4.dc. 5 7$ 3 J (� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
C0 ?10"O6 t jtb'0' T;4 P�✓AN�2�hLt
FIELD INSPECTION REPORT DATE COMMENTS
II it _ [roC
II II H
FOUNDATION
II p
p
II_ II_ _______- __ [
FOUNDATION (2ND) n ii m S.
----------_—
II
II
II
ROUGH FRAME 5 --
fi II
PLUMBING
It
II 11
INSULATION PER N. Y. — —1t y
STATE ENERGY ii
— It
CODE
II I
N II H
tl�
I1�
FINAL --11 It ,q
lit
ADDITIONAL COMMENTS.
ra
H
H
H
O
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ALTIPLATIOP,02 ADDITION
TO MIS 1,01-4 IS A VIOLATION YORK
OF it
SFC110TI 7701 W- FNF NEW TOkF STAT!
TDUCACOPIES ICN SAW. i
v�'r ;MFNIA:.9`^TM'i.roW'sttr .D SMAP EAL O anAi
• ��G� ppNTYFNlCS:FD S:A: S4A1t M^T St CChSIDFElO
LLOO ffll�r�. r, C, SO t:A TA40 l3Vl CGfT.
`O 2 � F;• n• �''' ! l GVA•ANMS INgICA1:C NtRlf'l SNALL RUN
Wl
N 70 iM 01:.0-4 10E vrLOM iN[SVIYIT,
�O� TE H 4 15 �t:At1D.AND ON NI^ tfNASF TO THE
.�80n ill
COMF4M.GOWk A.MAL AGENCY AND
'�' •l r�':I A (!I IY.STIAUCN L.:4J H-110M AND
5,� .: - 1 F SSIONFFS Of THE ,ENDING OKII•
0 y . /Qy)�� U GLLA7AMR!Fl5 ANOT TFANSFEfAFI
AIMoONAL INSTITWIOW 0117
SWSIO(KIR
'.0}' `pPC'"�Ty OwNIRS.
30
/'8S
Cr 1
O? •
N 27
O+ Lp t ZOO OO N
W O
OL
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o 1 OO 3O
e 01
N.73 0
�i1 t ' • 1A.�n t Za
01
C).00
`OO
O, 00 �O,W.
29 . ..
�05 NEW Yo
Sri 1�j W.
TAE LOCATION OF CVELLS AAD CESSPOOLS
SROW11 RF.RLIU ARE FROM FIELD OBSERVATIONS
ANDIOR FF.Oi:1 DATA OBTAINED FROM OTHERS
z
SURVEY FOR
107,9gx 1)72--1 BEN NENDOIZZA 1, pfLT,
n• .I ,�;o'°oma
1190 —� _ D LOT NO. 28 SALTAIRE ESTATES . °A41 1.,G.„<E°
MATTITUCK
,TOWN OF SOUTHOLD
K)TE: SUFF. CO.,N.Y. GUARANTEED TO:
r N MONUMENT SOdrRGLD SAW/AV4BAWK d
suss stON FILED IN THE OFFICE 'OP THEu e40 t gm4RANrEw r?LEO/v, 15V#OF
CLERK OF SUI>FOLK COUNTY ON AUG.3,1966 SCALE• { AWRICAN/r/rtC lA CI NCE Q7.
AS MAP NO.4682 . SEPT. 3011975 YOUNG & OUNGq
N O V. 2 0,19 75 �JEg �� 1�+�
JAN, I , 1976 PROFESSION NEER
LANG SURV£fOR,N.Y.8.L1C.NO M945 '
ERNEAO' N:Y:__0000_•_'•____..._0000_.•.
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION i ST [ ] ROUG LBG.
[ ] FOUNDATION 2ND [ ] IN LATION
[ ] FRAMING [ FINAL
( ] FIREPL CHIMNEY
REIARKSWde/' ✓<' a2
g ? iv04' i
JG? 7
L�
DATE j INSPECTOR
-67 ) 1
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ✓]/FINAL
( ] FIREPLACE A CHIMNEY
REMARKS:
b
DATE INSPECTOR AGj-,A r7,.A�,
t' t}; ���p ��ryyh BOARD OF HEALTH . . . . . . . . . . . . . . .
PRY\
— 6 LIJIAI FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . .
TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . .
(� ,:....._. .. .
BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . .
TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . .
SOUTHOLD, N.Y. 11971
TEL: 765-1802 NOTIFY: I�
CALL . . . . . . . .
Examined.... ............ 20.... MAIL TO- . . . . . . . . . . . . . . . . . . . .
Approved...` l Zr.......`. .... Permit No. �............. ..................................
Disapproveda/c .................................. ..................................
..................................... ... ..........
_ C.11 a.
(Building instor)
APPLICATION 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
3 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 giving a detailed description of layout of property mist be drawn on the diagram which is part of
this application.
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
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 whatever until a Certificate of
Occupancy shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Znre 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.
a
.....................................................
(Signature of applicant, or name, if a corporation)
...................................................
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buil
?? ...:...�4� � Gam?? ti . ..................................................
Nacre of owner of�premises ....... .!.Cr?-... Uj?: .��.Q-.:......................................................
(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. ....................
Location of land on which proposed work will be dome.............................................................
...... � .lJ�� ...� :...?...... ..(...........................................
House Naber Street Hamlet
Cutty Tax Map No. 1000 Section /�2C.......... Block .��............ Lot`s/C) .........
Subdivision ...................................... Filed Map No. ............... Lot ...............
(Name)
itate existing use and occupancy of premises and intended use and occupancy of proposed construction:
m. Existing use and occupancy .......... :e...................................
. Intended use and occupancy ...........:�.1.�i>f .��!....,(!� �1..........
W08.M Ar1WYYJ
SWIMshh ha 51n!2.*t.!!?119 YNATON
SEGO:G'0i1i0.0"
gokmo Alol1.,2 ni bsAilsuo
,, 02.8dWbU aahx.;ax nnsT
I. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... w
Repair ............ Removal ............. Demolition ............ Other Work ..................................
(Description)
l
Estimated Cost ..... . � ............ fee ..............................................
(to be paid on filing this application)
If dwelling, nuhber of dwelling units ............ Number of dwelling units on each floor
.... ............
Ifgarage, number of cars ......................................
If business, commercial or mixed occupancy, specify nature and extent of each type of use................
Dimensions of existing structures, if any: Front................ Rear ... Depth
............ ...... ... ........
Height ......................... Number of Stories ......................
Dimensions of same structure with alterations or additions: Front ............... Rear ...............
Depth .................... Height .................... Number of Stories ...............
Dimensions of entire new construction: Front ................. Rear ............... Depth ..............
Height ......................... Number of Stories .....................
Size of lot: Front .................... Rear .................... Depth ....................
0. Date of Purchase ..................... Name of Former Owner ........................................
1. Zone or use district in which premises are situated ..............................................................
2. Does proposed construction violate any zoning law, ordinance or regulation: ........................
3. Will lot be regraded .................... Will excess fill be removed from premises: YES NO
4. Names of Owner of premises ........................... Address .............................. Rhone No. ...........
Name of Architect .................................... Address .............................. Rhone No. ...........
Nameof Contractor ................................... Address ...............................Rhone No.
5. Is tlhis property within 300 feet of a tidal wetland? * YRS .......... ND ..........
*IF YES, SOLMM TOM TMSIEE.S PE141T MAY BE ISQDIRED.
PLOT DIAGRAM
locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions "
ran property lines. Give street and block number or description according to deed, and show street nares and indicate
hether interior or corner lot.
r�c�cPo/ CG"�GL'-LLrC�/I
CAIE of My] YO W,
SS
ol1CIlY of ....
t✓�.�t.�� —...••„ ..................being duly sworn, deposes and says that he is the applicant
.. ..........................
Nave of individual signing contract)
love named,
e is Lhe ........ Q'c nc
................................................................................
(Contractor, agent, corporate officer, etc.)
f said owner or owrxtrs, and is duly authorized to perform or have performed Che said work MY] to make arxl file this
ppl ication; that all statements contained in this application are true to the best of his knowledge and belief; and
hat the work will be performed in the manner set forth in die application filed therewith.
worn to *ore me is
Notary Put lic `- '. L-
6Y'Ni M.HOHDt — ..................
110TARV'P�UBLIIC ki�iai1M%4 (signature of Applicant)
Ckmi fled In Suffolk Com
Term Expkn March B,20.W
BUILDING PERMIT REVTEW CHECK LIST
Applicant/ // //'' Date
Owners Name: 1 4v1PKP l ,& Reviewed:
Architect/ _ Date .
Engineer: Submitted:
SCTM #:
District: 1.000 Section: 1-0-0 Block: Lot: 39
Project Subdivision
Location: 1 jy S ( F-2 Name:
Single&separate Required
certification: (Yes/No) J
Rey Req.
Zoning District: [Lot size: Actual: ] [Lot coverage Proposed:_]
Req. RW Req.
[Front Yard Proposed: ) (Side Yard Proposed: 1 (Rear Yard Proposed: ]
Project Description: As D&A
AGENCY PERMITS Permit
REQUIRED FOR REVIEW N.A. NO YES Number
Suffolk County Health Dept.
New York State D. E. C.
Town Trustees
Town Zoning Board approval:
Town Planning Board approval:
Flood Plane Elevation???
Flood Zone:
Notes:
i
i
f
r
f
AS NOTED
'I DATE: B.P.
+ FEE: BY:
NOTIFY BUILDING D ARTM T AT
+ pQ 765-1802 9 AM T 4 PM THE
!� FOLLOWING INSPECTIONS: t
i 1 FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING dt PLUMBING
I i
I + + 3. INSULATION J
FINAL - CONSTRUCTION MUST
`
BE COMPLETE FOR C.O.
3Z'
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY - ---
F CODES. NOT RESPONSIBLE FOR `_
12a 41�
DESIGN OR CONSTRUCTION ERRORS
- 4y4 pA 2
�op90 F ESSVO
f X1 0 J tr�Q 3 T -------------
Ai.rorl
Ai.rn e Iw-
' '. inti 'y!, '�'.*' .it"t,.';L' �.i:�-d' -T1'•''.�'�'s'�` � _.. _.