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31153-Z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31160 Date: 09/14/05 THIS CERTIFIES that the building ADDITION Location of Property: 205 SUMMIT LA EAST MARION (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 38 Block 7 Lot 10.3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 13, 2005 pursuant to which Building Permit No. 31153-Z dated MAY 20, 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 DECK ADDITION TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to RICHARD & JUDITH GOLDSMITH (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A uL7 riA d Signature Rev. 1/81 FormNo.6 --- -- TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL D 22095 J 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANC�=r_ o 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 10/'o 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 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 i y Date. New Construction: Old or Pre-existing Building: _ _(check one) Location of Property: �0� JUVY)M /I- C4 Ate EX7sr Ma r- ( ori House No. Street Hamlet Owner or Owners of Property: C&LIF4D QW,j, N /O /T)4 O L-D S M 1 T4 Suffolk County Tax Map No 1000, Section Block Lot Subdivision aM U7sT 14 T Filed Map. Lot: 17 Permit No. Date of Permit. Applicant: / 4 n/,yr'R _J�A Health Dept. Approval: Underwriters Approval: Planning Board .Approval: Request for: Tempporaan,Certificate Final Certificate: _ (check one) Fee Submitted: $ -�[S X`n A Applicant Signature Co ( 0 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. 31153 Z Date MAY 20, 2005 Permission is hereby granted to: ALEXANDRA JONES 36 BLACKSMITH CT HUNTINGTON,NY 11746 for CONSTRUCTION OF A DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 205 SUMMIT LA EAST MARION County Tax Map No. 473889 Section 038 Block 0007 Lot No. 010 . 003 pursuant to application dated MAY 13 , 2005 and approved by the Building Inspector to expire on NOVEMBER 20 , 2006 .2ze Fee $ 150 . 00 QAz'u'thorid Signature ORIGINAL Rev. 5/8/02 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN LATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY [ J FIRE SAFETY INSPECTION REMARKS: co No DATE INSPECTOR 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1 ST [ ) ROUGH PLRQ. [ ) FOUNDATION 2ND [ ] IN TION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REM KS: gng l�-e� DATE INSPECTOR 765.1802 BUILDING DEPT. INSPECTION [4/FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] F UNDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ j FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE l INSPECTOR r 4� Ob0 - 39 , 7- TOWN OF SOUTHOLD PROPERTY RECORD CARD E OWNER STREET Z O S VILLAGE DIST. SUB. LOT C ho i 5 Lin, s f MQ_�iUr1 0� mm�� �st��ks�P c o t ACR REMARKS app✓ �l/S o Z TYPE OF BLD. GU SmQ f \�Lt r C PROP. CLASS - 13 16-5 LAND IMP. kOTAL DATE a�25 .-,-5 az - FRONTAGE ON WATER TILLABLE FRONTAGE ON ROAD WOODLAND DEPTH MEADOWLAND BULKHEAD HOUSE/LOT TOTAL FIELD INCTION REPORT DATE COMMENTS _W FOUNDATION(IST) U1 ------------------------------------ C FOUNDATION(2ND) m 2 O O ROUGH FRAMING& m3 PLUMBING LA 3, l r INSULATION PER N.Y. STATE ENERGY CODE 'I n^ /t/O FINAL ADDITIONAL COMMENTS Z m m }N O 2 - z z 0 TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying'' TOWN HALL Board of Health SOUTHOLD, NY 11971 4 sets of Building Plan TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 r Survey wnvv. northfork.net/Southold/ PERMIT NO. �J J 3 Checkd R Septic Form N.Y.S.D.E.C. / Trustees Examined 20 9 ) Contact: Approved '�I}b,20 !7S Mail to: Disapproved a Phone: Y?2—9?80 P'L Expiration It ,20�,(� 673- 8?av Building Inspector is Ilc��s i�r i5 Lid I 'M 13 2005 L, APPLICATION FOR BUILDING PERMIT oLD,- DEPT. Date 12_ 200 7wr�QF J INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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, anti 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 part for any 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 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, 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, housingode, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signa of applicant me,if a corporation) f6 (Mat ing address of applicant) en1490w //qw el State whether applicant is owner, lessee, agent, architect, engineer, general contractor, ctnpcian, lumb r or builder DWWy- Name of owner of premises 4J U6,&/ R F-T;N es (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. 1. Location_9f land on which proposed work will be done.- S1 one: /�� v�0 S i m m rwt� �a.n7 P ��- f► lat^t&J House Number Street Hamlet County Tax MaNo. 1000 Section 3� Block O7 l.-v..,14 ;, .;0%13 Subdivision �t,,.rimt f rS�f� ret Filed Map No. L3ol.• (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work_ (Description) 4. Estimated Cost '3&6• Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each 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 Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO-1X- 13. OQ13. Will lot be re-graded? YES NOAI Will excess fill be removed from premises? YES NOX 14. Names of Owner of pwnises At LAEA4Dr"V6Address t4l, 10 Li hone No. &S L-1613--914W Name of Architect 1 Address ne No Name of Contractor ddress 6 one No. 63, 1-613 07 a 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * 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_.I(^_ * 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 survev. STATE OF NEW YORK) SS: COUNTY OF ) ` / Q'+ AL,c-vA'1�1.V, V O� g duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the 0 r/ 1 nLP'C (Contractor, Agent, Corporate Offic etc.) of said owner or owners, 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 manner set forth in the application filed therewith. Sworn to before me this _ /3 day of `-104.5 . -__ 2.0 49S Notary Public ignat e of Appltc LINDA J COOPER NOTARY PUBLIC•Stab of Now York NO.01C048t583 S�8•C Term Explree Decembs seCnl-9 LI�I4- kxz-- SURVEY- OF LOT 17 MAP OF '=;,2�JDQ �fos SUMMIT ESTATES Cxt05 8 SECTION No. 2 FILE No. 10768 FILED MAY 21, 2002 60; �o° \�� ��o S8'�. �� SITUATED AT EAST MARION , TOWN OF SOUTHOLD Z 8.9 "' :c?��.• ` SUFFOLK COUNTY, NEW YORK -1 a LOT 0 so'�'•. S.C. TAX No. 1000-38-07- 10.3 O r N F SCALE 1 "=30' OCTOBER 26, 2004 � 553;• _ _ - - 13.4' bL � ti CONCRETE O ams Y FOUNDATION ' �1 � AREA = 31 ,995.09 sq. ft. v 0.735 ac. 21.1' 5.0' 13.4• 01 0 5.4 s, CD 91 R=40.00' C'4e�.��t�' L=59.94' J � PREPARED IN ACCORDANCE WITH THE MINIMUM� N 76*2224" ~pry� TITLE SURYM AS ESTABLISHED STANDARDS FOR AND APPROVED AND ADOPTED WBY THE 1•�� 1a�o�+ TITLE USE THE NEW YORK STATE AND iA RECNARC f i 8. ®� NE gAslt' 03' F�.o'(MIT°g�rvrsroy llilne ESTA N n TGS Afgp"O°PO "OSOF %s �E�;+ ��n C '�o © N.Y.S. Lic. No. 49668 UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VKKAT)ON OF SECTION 72OF THE NEW YORK STATE EDUCATION LAW. Jo eph A. Ingegno ECTIONU COPIES OF V SURVEY MAF NOT '° Land Surveyor THE LAND SURVEYOR'S SL INKED SEAL DR EMBOSSED SEAL SHALL. NOT BE CONSIDERED TO BE A VAIJD TRUE COPY. CERTIFICATIONSNLTO HINDICATED HEREON T14ESHALLS RUN ONLY TO THE PERSON FOR Y/TIOM THE SURVEY 3 IS PREPARED, AND ON HIS BEHALF TO THE Title Surveys — Subdivisions — Site Plans — Construction Layout TITLE COMPANY. GOVERNMENTAL AGENCY MID i LTO ENDING ASSIGNEIES OF THE LENDING IN H • AND PHONE (631)727-2090 Fox (631)727-1727 TUTKON. CERTIFICATIONS ARE NOT TRANSFERABLE. A P 7r V1 7F tii DECKING Teco each N� g - p�- aRiN='.T AT . � TYPICAL Joist to girder FLOOR SYSTEM 4x4 or 6x6 POST O� p ` ;C:r T Ez Simpson Galvanized -''Ac F..-_a � RE LIJ post to Concrete FE - 'G PLUMB 1 r connector ABU44 N Strap back of or equal, anchored ? IcnoN MUST post to Header ,� = -OR - Galv 2X10 DECK JOISTS- p " Into 12 concrete pier O wkh Typ_86 ails " , 1C'i ION SHALL ME 2 x 10 Treated Nailer Board 'F�Ou6,,'n-NITS OFiHFCOOESO N Strap 3-8d Nails ° YONI; STATE. NOT RESPONSIB FbW �- Lag Bolted to framing with in each End „ OESIGN OR CONSTRUCTION ERI 1/2" diameter galvanized 36 high railing DOWN bolts at 24" on center to code TO O sta5agered. 13�-0" 6'-0 " GRADE taco at each Jofst. 25'-0" AS REQUIRED TYPICAL STRAPPING FOR DECK PLAN SCALE: 1/8 = 1'-0II DECK CONSTRICTION Typical Nailer --- i ALL LUMBER: SOUTHERN TELLOW PINE: FB 950, EA4, BASED ON TABLE 4B FORM THE 1 w .. . .. .. . . . . ALL FASENTERS SHALL BE GALVANIZED -� _ 995 HIGH EDITION OF THE WFCM MANUAL G pp lU = W _ Q C o [1 z Q Q0 tit' 36" HIGH RAILING 2x10 treated F Q Joists Q u "{ "'« ' - - ' I61n oc O `� `9 a 2-2x8 treated i m 2x10 rim board deck girder ,- w mttm TYPCIAL DECK ELEVATION TYPICAL PORCH/DECK FOOTING 6 -O 13�-0 12" poured pier footing to II � II virgin Boll. 4" cca poet 25 -0 LL Q N 3 0 SCALE: I/S = I -O DECK FRAMING PL N See details on this drawing for strapping and uplift connections. a u + SCALE: I/8 = 1 -O OCCUPANCY OR 1 0_r F 4 1 IPI' 41 , ,r_ UiI r rICATE CERTIFICATION OF UNDEAWRITEASCEATIFICATE NAILING & CONNI-:,TIONS REQUIRED REQUIRED. Applicant/ r Date. �,c� rcA-rl,����1 � Reviewed: 5 Owners Naai�e:... _ -- Architect/ n Qate: Submitted: SCTM District: 1,000 Sec(iott: o Block: Lot: Project Q Subdivisiotl Location: ��_X�t;�v�;=�� �- "'=— Natne: Sin&le 8,- separate Required cetliftcatiat: (Yes f No) e< Req. Rcy. Xwint District: It of size: Acluaf: I (Loc cuvcra Prupus�d Rte" Req, Rcq. (I rant Pard Proposed: i' (Side Yard Proposed: J (Rea and _ Proposed, Project Description: ACENCS ERI�',ii`>t`S c if QUIB D FOR REVIEW Y.A. NO YES Number Suffolk County Health-Dept. N6w York State. D. E.C. Town Trssstees . Town Zotung Boatel approval: Town Planning Board approval; — Flood..Plaae Elovadon??� Flood Zone: r -