HomeMy WebLinkAbout31355-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-31355 Date: 09/12/05
THIS CERTIFIES that the building ADDITION
Location of Property: 800 SALTAIRE WAY MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 100 Block 1 Lot 33
Subdivision
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 8, 2005 pursuant to which
Building Permit No. 31355-Z dated AUGUST 12, 2005
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 "AS BUILT" DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED
FOR.
The certificate is issued to JAMES B & KIMBERLY J BOOMER
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Authorized Signature
Rev. 1/81
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF
1
AUG 2 9 2Z r;;i; {
L-
I
-J
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 P tanning Board Approval of completed site plan recluirements.
B. For existing buildings (prior to April 9, 1957) non -conforming uses, or buildings and "pre-existing" land uses:
1. Accurate surve) of property showing all property lines, streets, building and unusual natural or topographic
features.
A properl}, 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 $2500, 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:
Location of Property:
No.
Old or Pre-existing Building:
Date. fje15 ,� 1� QS
11
(check one)
Hamlet
Owner or Owners of Property:2___�xbadl�
Suffolk County Tax Map No 1000, Section /DO Block 0,*01
Subdivision
Filed Nlap.
P6rmitNo. ,3 L��---Date9fPemtit._— _--...---._--- ---Applicant:
Health Dept. Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $
>
Underwriters Approval:
Lot:
Final Certificate: _�� _ (check one)
_ -:9.1 b,
Applicant Signature
O@Pr Pdd3 L3cPcP cPr Mfflffl0 0M 0 I Ir� rJ�rn r�r� �rJ rJ rJ cJ 0O
5 BY THIS CERTIFICATE OF COMPLIANCE THE��
5 NEW YORK BOARD OF FIRE UNDERWRITERS 5
5 5 BUREAU OF ELECTRICITY C5
40 FULTON STREET — NEW YORK, NY 10038 5
5 CERTIFIES THAT
CSU Upon the application of upon premises owned by
5 JAMES BOOMER JAMES BOOMER 5
5 800 SALT AIR WAY 800 SALT AIR WAY 5
S MATTITUCK, NY 11952 MATTITUCK, NY 11952 5
Located at 800 SALT AIR WAY MATTITUCK, NY 11952 c7
5 Application Number: 2066529 Certificate Number: 2066529
�] Section: Block: Lot: Building Permit: BDC: ns11 CSSU
5 Described as a Residential 0-599 square ft. occupancy, wherein the premises electrical system consisting of
5 electrical devices and wiring, described below, located in/on the premises at: 5
5 First Floor, Second Floor, garage only, Detached Garage, Outside,
SA visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 5
5 herein, was conducted in accordance with the requirements of the applicable code and/or standard 5
5 promulgated by the State of New York, Department of State Code Enforcement and Administration, or other 5
5 authority having jurisdiction, and found to be in compliance therewith on the Day of 5
16th August, 2005. 5
5 5 NameT(TYY Rate RAkUg Circui[ Type
Panels
5 1 100 18 5
5 Cj Wiring and Devices 5
Outlet 16 0 Fixture
Cj Fixture 2 0 Incandescent
Fixture 14 0 Flourescent 5
5 5 Outlet 12 0 General Purpose C5
Receptacle 10 0 General Purpose lj
Switch 6 0 General Purpose
Receptacle 1 0 20 amp Appliance
CSS GFCI Circuit Breaker 1 0 20 amp 5
,C] Receptacle 1 0 GFCI 5
5 5
seal
CSS, I of 1 111
�c This certificate may not be altered in anyway and is validated only by the presence of a raised seal at the location indicated. 5Cj
5 5
O cP r� m
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. 31355 Z Date AUGUST 12, 2005
Permission is hereby granted to:
JAMES B BOOMER
800 SALTAIRE WAY
MATTITUCK,NY 11952
for :
"AS BUILT" DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING
AS APPLIED FOR
at premises located at
800
SALTAIRE
WAY
MATTITUCK
County Tax Map No. 473889
Section
100
Block 0001
Lot No. 033
pursuant to application dated AUGUST 8, 2005 and approved by the
Building Inspector to expire on FEBRUARY 12, 2007.
Fee $ 300.00
Authori�ignature
ORIGINAL
Rev. 5/8/02
TOWN OF SOUTHOLD
1 BUILDING DEPARTMENT
.`TOWN HULL
aSOUTHOLD, NY 11971
TEL: (631) 765-1812
FAX: (631) 765-9502
www. northfork.oeUSouthold/ PERMIT NO.
Examined 1"0�
Approved i i 20 S
Expiration ;Z L 20-21
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying? .�
Board of Hea1M
4 sets of Building Pham
Planning Board approval
Survey
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Contact•.
Mail to
aft .Sa�T�fE t✓/fY �f4rt
Phone.
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date && / 20p, -
INSTRUCTIONS
it 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 public sueeta or
arem, 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 pan for my purpose what so ever until the Building Inspector
issues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not been completed within Ig months Eon such date. If no zoning amendments or other regulations affecting the
property have been enacted in the interim, the Budding Inspector may atdhorize, 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
ILa
thorized inspectors on premises and in budding for necessary inspections.Ifs(Signature ofapphcant or Dame, ifacorpouuon)
AUS s99rg f��, rrrr�f
g 2k'w
(Mailing address ofapphc,Suftwhetherappner, lessee, agent, architect, engincer, general contractor, electrician, plumber or builder
Name of owner orWernises S foil— f
(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.
of land on which proposed work will be done:
County Tax Map No. 1000 Section /,ft O D Block 0/
Subdivision SgGr4" F.5r4-rrrc Filed Map
�.. 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
1 i a. Existing use and occupancy. % % f'//�f'� /(011 V4
b. Intended use and occupancy .' T/S b
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work,/
(( escnption)
4. Estimated Cost Fee _3pady
(To be paid on filing this application)
5. If dwelling, number of dwelling units Number of dwelling units on each floor
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 RearDepth
Height Number of Stories
Dimensions of same structure with alterations or additions: Front
r q '�O/,1.�
8. Dimensions of entire new construction: Front Rear Depth d.0
Height Number of Stories
9. Size of lot: Front ��f%_Rear JQQ t Depth�®4/
10. Date of Purchase _Name of Formp Fortner Owner �gy L - fAf—p ✓
11. Zone or use district in which premises are situated
12. Does proposed concoction violate any zoning law, ordinance or regulation? YES_ NO—Z
13. Will lot be ro-graded? YES_ NO-ZWilllexcess
fill be removed from premises? / YES_ NO �i
t4. Names of Owner of premisesT �,. Y�f�dress OV Yone No. e2? J fi 7z!D
Name of Architect Address Phone No
Name of Contractor Address Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? •YESNO�
• IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED.
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.
STATE OF NEW YORK)
SS'
COUNTY OFSJW )Q
f,q%L/: 5 A • OR being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the Mj IV\y.�,
(Contractor, Agent. Corporate Officer, etc.)
of said owner or ownera, 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 roamer set forth in the application filed therewith.
Sworn tgUtore me this
_ day of �0 200�
Notary Pugic Signature of Applicant
Nowib I '4 5�
fissisn EKNms June�30,
Camm200 7
/c
Appl-icant/
Owners
ArchitecU •
Cagi(1eer:. ne.� e .
SCTM #:
Dis(rict: 1.000 Sec(ioit: 00 13 lock: Lot: _53
Project (,C%
Location: �OD � ��
T
Siqic &, separate Required
ccm1focation: (yes I No)
Dale. .
Qpe-
Submitted:/—�
/
S
Subdivision
Name:
Rte. �
Lading Oiwict: 1 1 (I of size: _V Aqual: V J (Lot cuvc�agc I' -rip ,cd
' Side
i� I ;
(1�'roat Yard �_ t'ropo§ed: J(Side Yard 'JLL(Q�ar Ya _ Protwscd� �
Project Desoription: .T
.. A.GEI�C'Sd...iQ"E��IiTS e if.
R_ FO.U1RJtD FOR RICWEW NO YES member
Suffolk County Hoalth• Dept.
Naw York State. D. E: C.
Town Tnwto;,,,,s
Town Zoning Board approval-.
Town Planning Board approval:
Flood .Plaae Elevation 72?
Flood Zone -
0
TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER
STREET a)
VILLAGE
DIST.
SUB. LOT.-
rt).
0 -3-
FORMER OWNER
N
E
ACR.
S
S
W
r
TYPE O BUILDING
WW f1Ne r i wr'ZZ
RES. D
SEAS,
VL.
FARM
COMM. CB. MICS. Mkt. Value
LAND
IMP.
TOTAL
DATE
REMARKS
i/00
00
'� 6
/2Z 73 Se?Soo, /,I,�/„Q�ry�CN� Iy�
,
S r' ry WF
?/3LD9 P� �az,.4 ."� sd
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//
G3o
a J
i 7s
E—=y-.rv'
a--
p9
630
/7'
AGE
BUILDING CONDITION
NEW
NORMAL
—Ac
BELOW ABOVE
FARM
re
Value Per
Value
Acre
Tillable
FRONTAGE ON WATER
Woodland
FRONTAGE ON ROAD
Meadowland
DEPTH
Plot
BULKHEAD
yOouse
Protol I
v °
�,,
i
,�
s..
DOCK
FIELD INSPECTION REPORT
DATE
COMMENTS
FOUNDATION (1ST)
------------------------------------
03
'v
u1 m
3
FOUNDATION (2ND)
�m
7
z
ROUGH FRAMING &
PLUMBING
0
o�
N
y
INSULATION PER N. Y.
STATE ENERGY CODE
r
FINAL
-a
ADDITIONAL COMMENTS
O
O
3
0
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`-� A
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x
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v
....n"OREW ALTFRA" M OR ADDMON TO THIS _
SURWY a A VIOLATION Or SECMM 72M OF THE � •
FEW ■ON[ STATE UNrATION UF. COPIES OF TNS
SURVEY NAP NOT DFSEAL THE SIIRYEroILS HIKED
SEAL OR ET) A ED SIR SHALL NOT BE
�qED H A VAuo TRUE DOPY Y TO THE
MOIGTED HEREON 9NE RLM OILY ro A E
PD150N FOR RIION THE S~ COMPANY. T$ RIEPAi9. AND �,
00 IRS eNAL ro THEAGENCY.
TRLE N
CuAnAKT TITAL Ar.ENCY. OR LEMWFERAME M ANDA Q
INSTI�IU,0NS OR SUIRSEOUENT T OWNERS
ADOrIIONAL
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/ X,,A'N PARCEL AREA = 20.000 Sq.Ft.
6
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GUARANTEED TO: JAMES B. do KIMBERLY J. BOOMER
FRANCIS X. KARL L.S.
27 ARTHUR AVENUE
BLUE POINT. N.Y.
11715
(931) 353 -ml MK
(LN) 393-7152 FAX
SCALE 1P= 20'
A 1 9/20/04 1
UTLINE SURVEY
REV. DATE
Oc6CwIETION
arcm It cMwff TAX YAP
LOT *31
DtS WT 1000
ON THE MAP OF
SEcnoN-1 moo
MSALTAIREESTATES"
a_=_01.00
FLE /4992 - FLED ALIQ 3, 19"
LOT 033.000
SATO AT
MATTITUCK,
9 m BOWYSc
TOWN OF SOUTHHOLD,
F<F e
SUFFOLK COUNTY, N.Y.
or.�GN .xltvl�.s
(6!4 298-2250
draw4u@optonline.net
CERTIFICATION OF V
REAR ELEVATION NAILING & CONNECTIONS Uz
REQUIRED.
SCALE: 1/4" = 1'-0" Uj A
� yah
L CONSTRUCTION SHALL
�AEL�THE REQUIREMENTS OF TH W
CODES OF NEW YORK STATE.
OF NEW Y W O
CZ gP J.DEEgfo's'.; C. 0
APPROVED AS NOTED
B.P.OQ��LLL�L��= y�OA9O.p
LEFT ELEVATION FEE: 5a._ BY: -�..,- 6,— OFES DRAWN BY: MH
NOTIFY BUILDING DEPARTMENT AT
SCALE: 1/4" = 1'-0" 765-1802 SAM TO 4 Id FOR THE July 06, 2005
FOLLOWING INSPE-TIONS:
1 FOUNDATION -
D CC`NORETEUIRED SCALEOCCUPANCY OR
1/4"= 1'-0"
2. ROUGH - FRAMING & PLUMBING USE IS UNLAWFUL SHEET NO:
3. INSULATION _
4. FINAL - CONSTRUCTION MUST WITL40U CERT IFICAT
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET THE OF OCCUPANCY
I r t REQUIREMENTS OF THE CODES OF NEW
YORK IBU 1 L ( PRIOR ?,OO '3 DESIGN ORE CONSTRUCTION (ERRORS.
12" DIA. CONC PIER
HOUSE
T i 2 - 2X10 PT GIRDER
I I
I � I
I I
W I I
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I I
I I
4-------T—�- 2-2X10 PT GIRDER---�---------�
Ib•L 9 0' L 91-V L 9'-01
I I
NOTE: I
GIRDER ANCHORED TO I
12" DIA CONC. PIER aw- PIERS W/ S.S.
3'-V BELOW GRADE ANCHORS CM.)
' 2 - 2x10 PT GIRDER
p--- ---,------------fl---------a
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ J
i
m
SECTION A -A
2.2X10 PT GIRDER
SECTION A -A
SCALE: 1/4" = V-0"
BUILT PRIOR 2003
SCALE: 1/4" = V-0"
M -,4N xRvv-b
(6M 298-2250
DRAWN BY: MH
my 06, 2005
SCALE: 1/4" = 1'-0"
SWEET NO:
HOUSE (REAR)
m--,4N-tMvccs
/ (6!4 298-2250
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to' -to• e'-+• to -10• q� °�� DRAWN BY: MH
zs'-o•My 06, 2005
1ST. FLOOR PLAN sN SCALE: 1,4" =1'_°"
Fpm°. 07
SCALE: 1/4" = 1'-0' AO�Ess� SWEET No:
5UIL.T PRIOR 2003 0