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Home My WebLink About29360-ZFORM NO. 4 TOWi~ OF SOUTHOLD BUILDING DEPD~qTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29915 Date: 12/15/03 THIS CERTIFIES that the building ADDITION Location of Property: 1065 SALTAIRE WAY MATTITUCK (HOUSE NO.) (STREET) (HAMLET) Co~nty T~ ~ap No. 473889 Section 100 Block 1 Lot 23 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 5, 2003 pursuant to which Building Permit No. 29360-Z dated MAY 5, 2003 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 AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to RORY & JENNIE L FORRESTAL (OWNER) of the aforesaid building. SUFFOLK COLS~I"f DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICA~ NO. PLU~RERS CERTIFICATION DA'£~ Rev. 1/81 N/A N/A N/A ~U/r '~ e/d~ignat ute FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 29360 Z Date MAY 5, 2003 Permission is hereby granted to: RORY & JENNIE L FORRESTAL 1065 SALTAIRE WAY MATTITUCK,NY 11952 for : CONSTRUCT A DECK ADDITION TO AN EXISTING ONE FANILY DWELLING AS APPLIED FOR. THIS PERMIT REPLACES BP#23560. at premises located at County Tax Map No. 473889 Section 100 pursuant to application dated MAY Building Inspector to expire on NOVEMBER 1065 SALTAIRE WAY MATTITUCK Block 0001 Lot No. 023 5, 2003 and approved by the 5, 2004. Fee $ 150.00 / Authorized Signature COPY Rev. 5/8/02 IPOR. I~ NO. J 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) N.° 23560 Z ~t. ..................~ ~ .......... , ,~.~/ ...... ../..~.....~f..~..~./..~ /~ ............ ......... .~.~ ....................................................... o,g~,m,~, ,~o,.d o, ........... /.~...~..~......~....~..~...~ ................................. ~u.uo~, ,o o,,,,,o,,o~ do,~ ............... ~...~.~. ....... . ,~..~.~.d o~,~ ,~ ~, Building Insp~t~~' ~ Fee $....~~ ~ii~i~~ ...... Rev. 6/30/80 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 fo~l~g: 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 o f electrical installation from Board o f Fire Underwriters. 4. Sworn statement from plmnber 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 Plamfing 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 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 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 / New Construction: it/ Old or Pre-existing Building: Location of Property:House! O ~No.X~ r.~a,/~ T"~'t o"~ Str~ee( Owner or Owners of Property: Suffolk County Tax Map No 1000, Section]t~ Subdivision Permit No. ~. ~ ,5 ~' O Date of Permit. Health Dept. Approval: ~.af,~ Planning Board Approval: t~'/',~ Request for: Temporary Certificate Fee Submitted: $ Date. (check one) Han~let Final Certificate: Applicant Signature (check one) BlocktSgY)'[O O Lot ~ ~ ~ Filed Map. Lot: Applicant: '"~a n~/ ~'o' ('O'a,~;~',,-,~ Underwriters Approval: _) 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION I ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] ROUGH PLBG. [ ] IN.ON [ ] FIREPLACE & CHIMNEY DATE ~/~~ INSPECTOR INSULATION PER N. Y. STATE ENERGY CODE FODNDATION (2ND) II pa ROUGH FRANE & PI.DI~B lNG ~I '~ r~"~. ._ --n ' ' ' BOARD OF HEALTH ......... ~ 1~,1~ ~ ~ ~ I~2~~o~o., ~07~ o~ ~,,~,~ ......... ~{"~ I ~ ~/t~i~ TOWN OF SOUTHOLD /~URVEY ..... f-. -: ........ ii~,ll J[]~ ~ ~t]~ BUILD NG DEPARTMENT /ClIECK ....... .~ ......... ~ '~ -- '~ IL)I TOWN HALL SEPTIC FORH '.7_.. ~ ......... Approved . ~ ~ermit N~ · ,~ / / - . ' .. ............ , .... ~isapprov~d i ................................... : . ................................ Date ................... 19... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 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 pubUc sti-eets or areas, and giving a detailed descriptioo of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building hrspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shail 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 Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or P, egulations, for the construction Of buildings, additions or alterations, or for removal or demolition, as herein described. Fhe applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to ]dmit authorized inspectors on premises and in building fornecessary inspections. ~ ' - . %~jJ~ign~Tre of applic me, if a corporation) (Mailing addresg of applicant) -- State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........... ~ .~.~4 cat ................................................. ........................... ',lame of o,vner of premises ..... .NO ,: ~...~',.. ? ,,--'/~..c,~ .......................... (as on the tax roll or latest deed) f applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Plu nber s License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done· ..... 10 O.~ .... 6~..,?&C....~..,rte_... w..,~4. ...... , ..... ............. ~:/.,~':,.-n..,.,.'?c/.(...,w..~ ......... Ilouse Number Street Hamlet County Tax Map No. 1000 Section . . . ./.~..~. ........ Block . . .O/ ' Lot .... d).2~ ...... ' .... Subdivision .................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. F~!sting use and occupancy ....... ~. ~x,r~.~_,,.t..~.~..'[~-...r~. ~.. ,.~O'k~,.r:.-~./~. .......................... / b. Intended use and occupancy ......... .~,'~ .................................................. 3. Nature of work (check which applicable): New Building .......... Addition i".-'.s~.... Alteration .'~ ........ Repair .............. Removal .............. Demolition .... : ......... Other Work..~2.e'~/(' ....... 4. Estimated Cost ......... Fee ..... (to be paid on filing tbls application) 5. If dwelling, number of dwelling units ........ / ...... Number of dwelling units on each floor ..... /. .......... · If garage, number of cars ........................................................................ 6. If busisess, commercial or mixed occupancy, specify n.ature and extent of each type of use .... .t'?"/./~. ........... 7. Dimensions of existing structures, if any: Front .... /,,;,. ( ....... Rear ...... ~, / ..... Depth .. ,.~. ',.7. ......... Height ............... ~umber of Stories ..... ' .'.~. ............ .................................... Dimensions of same structur,, with alterations or additions: Front . . . ~/ ........... Rear ...(¢/. ......... 8. Dimensions of entire new constrnction: Front .... ~..~. ....... Rear .... t.~,¢-~ ....... Depth . .~ .......... Hei=l~t .... ~'~ ......... Number of Stories .... :~ ................................................ 10. Date of Purchase ....... ~.Y'//J~.? ................ Name of Former Owner .. I,;t~'-~Z:~e'ac4/G ............ 11. Zone or use district in which premises are situated..{¥~. -.e~.~; .~.~..-~'-~.. ,~._J~ ......................... i ....... 12. Does proposed constroction violate any zoning law, ordinance or regulation: ................................ 13. Will 10t be regraded ....... ,ilO. ~ ................ Will excess flu be removed from premises: Name of Architect .......................... Address ................... Phone No ............ : .... Nmne of Contractor ..... ~ ............... Address ................... Phone No ................ 15. I~ this property within 300 feet of a tidal wetJand? *Yes ........ No.~( ..... *If yes, Southold Towu Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street nmnes and indicate whether interior or corner lot. OCCUPANCY OR USE IS UNLAWFUL W)THOUT CERTIFICATE OF OCCUPANCY APPJ OV D AS NOTED FINAL TleE RFOUIREMFNI'S OF STATE OF NEW YORK, S,S COUN'FY OF ................. ........................................ · ......... being duly sworn, deposes and says that he is the applicant (Name of individual siguing contract) above nan]ed. He is tile ...................... · ....................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly autl~orized to perform or have performed the said work and to make and file this q~plication; that all statements contained hi this application are true to the best of his knowledge anti belief; and that the ,york will be performed in the manner set forth in tile application filed therewith. ' Cworn to before me this ~ ........... day of.. ~l'r..~ ........... 19 . ........................ u ~otary Pubhc County ' _/~ ~/ / / WALTER C. CO~STEI-LO .~-' : . . .~:::~-~,..~~ , . . Notary PubliCUo. 46,90900State r°.fr. NoW York .'' ~. '__~' · '.-'"" ........ k~§tnre ................... of applicant) . 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