HomeMy WebLinkAbout34071-ZFORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPD=RTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33289
Rte: 09/24/08
THIS CERTIFIES th=at the building ADDITION
Location of Property: 795 SALTAIRE WAY MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 100 Block 1 Lot 20
subdivision Filed Map No. __ LOt No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 10, 2008 pursuant to which
Building ~nnit No. 34071-Z dated JULY 21, 2008
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 ADDITION TO EXISTING DECK ON AN EXISTING ONE FAMILY DWELLING AS APPLIED
FOR.
The certificate is issued to WILLIAM J MEYRAN
(OWNER)
of the aforesaid building.
SUFFOLK COUN~f DEPART~4ENT OF HEALTH APPRO~rAL
ELK~-£KICAL CERTIFICATE NO.
PLIERS CERTIFICATION DA'£~D
N/A
N/A
N/A
A~horized Signature
Rev. 1/81
I11111 '; "--:~t., :',, ): TOWN OF SOUTHOLD ~
l / / ,?'. :
~_Ot~PLICATION FOR CERTIFICATE OF OCCUP~CY
This application must be filled in by t~ewriter or it~ and subufitted to the Building Department with the following:
A. For new building or new use: 1. Final survey of propelly with accurate location of all buildings, prope~y lines, streets, and unusual natural or
topographic features.
2. Final Approval from ttealth 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 iii system contains less than 2/10 of 1% lead
5. Conmier¢ial building, industrial building, multiple residences and similar buildings and installations, a certificate
of Code Compliance from architect or engineer responsible for the builcli~g
6 Submit Planning Board Approval of completed site plan requirements.
For existing buildings (prior to April 9, 1957) non-conlbrming nses, or buildings and "pre-existing" land uses:
1 Accm ate survey of propm~y showing all propelly lines, streets, bnilding and unusual natural or topographic
features
2. A properly completed application and consent to inspect signed by the applicant. Ifa Certificate ofOccupanc5 is
denied, thc Bnilding Inspector shall state the reasnns therefo~ in writing to the applicanl.
Fees
I Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $2500, Alterations to dwelling $25.00,
Swi~mning pool $25.00, Accessory buitding $25.00, Additions ~o acccsso~ y buihting $25.00, Businesses $50.00.
2 Certificate of Occupancy on Pm-existing Bnilding $100.00
3. Copy of Certificate of Occupancy - $.25
d Updated Certificate of Occupancy - $50.00
5. Temporaly Certificate of Occupancy- Residential $1500, Connnelcial $15.0(!
New Constmgttoa:
Location of Propmly:
Old or Pre-existing Building: ~ (check one)
Hamhci
House No.
SuffBlk C6unty Tax Map No 1000, Section
Subdivision Filed Map. Lot:
Health Dept. Al)proval: Undem'riters Approval:
Pla/ming Board Approval:
Request fbr: Temporary Certificate
Fee Submitted: $ '~. ,.~--7' a r)
Final Certificate:
(check oue)
- AppJ'~'f~ signatur~ ----
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. 34071 Z Date JULY 21, 2008
Permission is hereby granted to:
for :
WILLIAM J MEYRAN
795 SALTAIRE WAY
MATTITUCK,NY 11952
EXTENSION OF AN EXISTING DECK TO AN EXISTING SINGLE FAMILY
DWELLING AS APPLIED FOR
at premises located at
County Tax Map No. 473889 Section 100
pursuant to application dated JULY
Building Inspector to ex~ire on JANUARY
795 SALTAIRE WAY MATTITUCK
Block 0001 Lot No. 020
10, 2008 and approved by the
21, 2010.
Fee $ 200.00
Authorized Signature
COPY
Rev. 5/8/02
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] INSULATION
[ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS: '~ ~,~ ~t_
DATE
Town of Southold
Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM
PROPERTY LOCATION: S.C,T.M. #:
District Section BI k Lot
THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OFA
STORM-WATER, GRADING, DRAINAGE AND EROSION CONTROL pLAN
CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW yORK.
Item Number: (NOTE: A Check Mark (,~) for each Question is Required for a Complete Application)
Yes No
I Will this Project Retain All Storm-Water Run-Off Generated by a Two (2") Inch Rainfall on Site?
(This item will include all run-off created by site clearing and/or construction activities as well as all Site
Improvements and the permanent creation of impervious surfaces.)
2 Does the Site Plan and/or Survey Show A Proposed Dra nage Structures Indicating Size & Location?
This Item shall include all Proposed Grade Changes and Slopes Controlling Surface WaterFIow!
3 Will this Project Require any Land Filling, Grading or Excavation where there is a change to the Natural
Existing Grade Involving more than 200 Cubic Yards of Material within any Parcel?
4 wfi~ this Application Require Land Disturbing Activities Encompassing an Area in Excess of r~
Five Thousand (5,000) Square Feet of Ground Surface?
5 Is there a Natural Water Course Running through the Site?
ts this Project within the Trustees jurisdiction or within One Hundred (100) feet of a Wetland or Beach.
6 Will there be Site preparation on Existing Grade Slopes which Exceed Fifteen (15) feet of Vedical Rise to
One Hundred (100') of Horizontal Distance?
7 Will Driveways, Parking Areas or other Impervious Surfaces be Sloped to Direct Storm-Water Run-Off
into and/or in the direction of a Town right-of-way?
8 Will this Project Require the Placement of Material, Removal of Vegetation and/er the Construction of
any Item Within the Town Right-of-Way or Road Shoulder Area?
(This item will NOT include the Installation of Driveway Aprons.)
9 Will this Project Require Site Preparation within the One Hundred (100) Yea F oodpla n of any Watercourse? r~
NOTE: If Any Answer to Questions One through Nine is Answered with a Check Mark in the Box, a Storm-Water, Grading,
Drainage & Erosion Control Plan is Required and Must be Submitted for Review Prior to Issuance of Any Building Permit!
EXEMPTION: Yes No
Does this project meet the minimum standards for classification as an Agricultural Project?
Note: If You Answered Yes to this Question, a Storm-Water, Grading, Orainage & Erosion Control Plan is NOT Required! -- --
STATE OF NEW YORK,
COUNTT OF ........................................... SS
&.
That I, . ............ lining duly sworn, deposes m~d says that he/she is dm applicant [bt Pemtit,
~ of md vldual srg~ Doournen0 ~NNIE O.
And that be/she is fl~e _ ~.01~61~
...................................................................................................... ~.~..; ......................
o~.~c co,e~loc A9~.t Cowo,ot~ Om~, ~t~m~i~ E~ ~ 14. ~/~
O~er and/or representative of die Owner of ();~mr's, and is duly aufl~orized to perform or bare performed die s;dd work ~d to
make ;md file this apl)licafion; that ;dl statements contained in fids applicadon are true to the best o~ his knowledge and belief; ~d
~at dae work will be performed in the manner set fordi in flie application filed bere*~4flt.
Sworn to before me flus;
............................................... , ..................................
o, ,bfic: ..... .....................
FORM - 06/07
TOWN OF SOUTHOLD ~
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown. NorthFork.net
PERMIT NO. ,ff¢~)'~/'~'
Examined 7 /~l , 20 O}/
Approved 7 /,20~ [
Disapproved a/c
,20
Expiration
,JUL I 0
[ Building Inspector
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
4 sets of Building Plans
Planning Board approval
Surve~
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Flood Permit
Storm-Water Assessment Form
Contact:
Mail to:
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
Date o ~7//~/O 35~ ,20
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, 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 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, Suflblk 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.
,
-- '/Si~g~re of appl~t or name, if a corporation)
(Mailing address cC/applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Nameofownerofpremises gC~//~;,~a,- ~-~, /'L/~z~ ,~,~
(As on ~e 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 done:
House Number Street
Hamlet
County Tax Map No. 1000 Section [00 Block [ Lot '-
Subdivision Filed Map No. Lot
2. State existing use and occupancy of premises ,and intended use and occupancy of proposed cbnstmction:
a. Existing use and occupancy ~ --~ ~ t ~t~,,,-~ ~
b. Intended use and occupancy
Nature of work (check which applicable): New Building
Repair Removal Demolition
4. Estimated Cost
5. If dwelling, number of d~velling units
If garage, number of cars
Fee
Addition
Other Work
Alteration
(Description)
(To be paid on filing this application)
Number of dwelling units on each floor
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front
10. Date of Purchase
Rear Depth
Height Number of Stories
/.
Dimensions of same structure with alterations or additions: Front ZT/r-'> Rear
Depth Height Number of Stories
Dimensions of entire new construction: Front zT'O Rear Depth t~
Height Number of Stories
Size of lot: Front r/ $~-'> Rear ~__ F~ (_~ _Depth
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__
13. Will lot be re-graded? YES NO ~¢'~1 excess fill be removed from premises? YES__
14. Names of Owner of premises r.~,,~-, fl'/'~z~,~ o,--- Address~pI~'a-~/-'~"~e
Name of Architect ~t,,/. ~./-/. t' Address ,/~*---t',z/~: ~/~-
Name of Contractor Address
Phone No.
Phone No
Phone No.
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 ~
* 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.
18. Are there any covenants and restrictions with respect to this property? * YES__ NO ~
· IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF )
~ ?//r'~ ~ ~,, IB"/,P-z~I~ o, ~ being duly sworn, deposes and says
that
(s)h~
is
the
applicant
(Name of individual signing'contract) above named, CONNIE D. BUNC8
Nole~y Public, Stale of New York
(S)He is the No. 01BU6185050
(Contractor, Agent, Corporate Officer, etc.) Commission Ex, res April 14, '~0..~__
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 tme 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
I O'q~x day of
Notary Public
20 O~
~ Signature4~Applicant
TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER STREET -7 C~ VILLAGE DIST SUB.
FORMEP,,OWNER-T'.-~-, ..-~_~v,/~_.~.~ N ~' Lo'ir '~---"~ ~' ACR. J
'W
, .. (? ! ~. .'~ buP
RES. c~/,~)/ SEAS. (VL~_. ~--"~/ FARM COMM. CB. MISC. Mkt. Value
LAND IMP. TOTAL DATE REMARKS
AGE BUILDING CONDITION ~ ~
FA~ -~cre ~l~r j ~ U u
Tillable 1/~E~ ~0 ~/~ ~//o//~/0~'--~'~
Tillable 2/~ ~/~O~v ~0 / Ig//
Tillable 3
W~land
Swampland FRONTAGE ON WATER
Brushland FR~TAGE~
House Plot DEPTH
~ ~ ~ ~ BULKH~D
Total DOCK
100.-1-20 10/07
~ /,4//I(..~., ~-~ 2~ ..~ ~-~ /~ ~- Foundation ~ C,, Both / ~ Dinette
:, ~5 ~Gt [Basement Full Floors ~ A K.
~tensio~ ~ ~ /0 ~ ~0 ~ J~ ~%~ ~ ~t' Walls ~ff. C~ Interior Finish ~ ~ ER'
Heat
~tenslon ~ ~ / ~' ~ ~7 ~ ~ Fire Place
Type Roof Rooms 1st Floor
Porch~ ~ V .~ ¢'/'~ ~ ~ ~ Recreation Roo~ looms 2nd Floor ~ FiN. B.
'~f ~ ~ ~P ~ .A 5~ Dormer
Porch -~ l~ ; ' ~ ~
., ~ x__~. 3~
Br~zeway Driveway
P~tio
O.B.,Ho2 :~30 = ~0~ i.~ ~00
Total to Jo? ~
1[[[[[ [I if ( ~
II
COLOR
TRIM
,Foundation ~ ~ ! Bath
Basement ~ ~. j / Floors
Ext. Wails
Fire Place
Interior Finish
Heat
FRONT ELEVATION
LEFT ELEVATION
SCALE: 1/4" = 1'-0"
RIGHT ELEVATION
SCALE: 1/4" = 1'-0"
~ n H
Design Services
www, mchdesionservices.com
phone;
(63'1) 298-2250
e-mail:
michael@mchdeslgn se~ices.com
DRAWN BY: MH
July 09, 2008
SCALE: 1/4" = 1'-0"
SHEET NO:
EXISTING
POST
POST
SECTION A-A
SCALE: 1/4"= 1'-0"
NOTE:
EX4 ACQ POST
ANCHORED TO
EXLST~B
BOULDER
FOUNDATION "--~" "--~"
PLAN T~EIN NEW G~RDER S'-3"
EXISTING
POSTS
(EX. STA[RSI
{3) 2X10 DF#2 HD
FLOOR PLAN
SCALE: 1/4" = 1'-0'
¢ NUT5 (TYpiCAL)
(631) 298-2250
e-mail:
mlchael~mchdeslgflservices.com
Z
DP, A, WN BY: MH
July 09, 2008
SCALE: 1/4" = 1'-0"
SHEET NO:
WIND LOAD PATH CONNECTION AND CONSTRUCTION DETAIL DRAWINGS
SPLICED JOISTS OVER HEADER/GiRDER mSr~LL~S ,~ ~U~mL~S ,~COM~T~O~S DECK POST FTG. CONNECTION
CLIMATIC & GEOGRAPHIC DESIGN CRITERIA
DECK AND COVERED PORCH NOTES:
NAILING SCHEDULE
ROOF SHEATHING:
ROOF FRAMING:
WALL FRAMING:
DECK FRAMING:
DesiGn Services
www. mchdesiRnservic_.es. _c9_ m
phone:
(631) 298-2250
e-mail:
mlchael@mchdedg nservices.com
Z
DRAWN BY: MH
]uly 09, 2008
SCALE: 1/4" = 1'-0"
SHEET NO: