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Home My WebLink About33718-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Date: 03/13/08 No: Z-32924 THIS CERTIFIES that the building DECK ADDITION Location of Property: 1380 (HOUSE NO.) County Tax Map No. 473889 Section 106 JACKSONS LANDING (STREET) Block 9 MATTITUCK (HAMLET) Lot 17 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 28, 2008 pursuant to wbich Building Permit 110. 33718-Z dated FEBRUARY 29, 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 "AS BUILT" DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JAMES A & LISA A HINSCH (OWNER) of the aforesaid building. N/A SUFroLK COUlITY DEPAR'l'MKNT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE 1110. N/A PLUMBERS CERTIFICATICIIII DATED ~:#,=. Rev. 1/81 . :1) .1 t'"' I I, II I. MAR I, " Iud; ! L I . I ~-("~~,-..:-~l Q ..~\ , .J I APPLICATION FOR CERTIFICATE OF OCCUPANCY Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 Yf\-ev1 - 13'60 ~~ ?-rwfr ( "y) 0/ . )/ q )7- Tlus applicatIon must be filled in by typewriter or ink and subnlitted to the Building Department with the following A. For new building or new use: I. Final survey of properly 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 fonn). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Swam statement from plumber certifying that the solder used in system contains less than 2/10 of I % lead. 5. COlmnercial building, industrial building, multiple residences and sinlilar 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 I. CertifIcate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swinuning 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 Celtiflcate of Occupancy - $50.00 5. Telllporory Ce.1ificate of Occupancy - Residential $15.00, Commercial $15.00 Date. 3-1 I-ag New Constl11ction: / , Old or Pre-existing Building: (check one) J0 Y1 -rr l T-Ctc Location of Property: {?;;F;o <JlAn 5.,... 4/\.:'1"...r _ Street Hamlet House No. Owner or Owners of Property: ____~ ~, 0'\0C- J _L-t.~ I-/-. Nk ~ ----------------.-.------ Suffolk County Tax Map No 1000, Section 47 ~ 8"h 1 Block__-.!..~__ Lal __ boo ~ 017 SlIbcllvislon_______.~_____u___~___~__ Filed Map. ~__,,_ Lot:__ Permll No ~3 71 ~__ Date ofPen11it: . '2-/'l"lkr_ Appllcant:_ S~J._lj'^:~ __ Heallh Dept: Approval _________ Undenvriters Approval __ Planning Board Approval Request for Temporary Celilficate __~ Fee SubmJlted: $ 2- s ,ou Final Certificate: --L_ __ (check one) ~re ~. 731'3.L CC Z. 3J.P'f 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. 33718 Z Date FEBRUARY 29, 2008 permission is hereby granted to: JAMES A & LISA A HINSCH 1380 JACKSON LANDING MATTITUCK,NY 11952 for : AS BUILT DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 1380 JACKSONS LANDING MATTI TUCK County Tax Map No. 473889 Section 106 Block 0009 Lot No. 017 pursuant to application dated FEBRUARY 28, 2008 and approved by the Building Inspector to expire on AUGUST 29, 2009. Fee $ 400.00 ~ C2LL , Authorized Signature ORIGINAL Rev. 5/8/02 33//r-t-- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] FOUNDATION 2ND [ ] FRAMING I STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRucnoN REMARKS: [ ] ROUGH PLBG. [ ] I~ATION [0INAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRAnON Co --'-- DATE /3///1 De' t l ..,. ~ FIELD INSPECTION REPORT DATE I . FOUNDATION (1ST) ------------------------------------ FOUNDATION (2ND) ROUGH FRAMING & PLUMBING --- -- LNSULATION PER N. Y. I------~- STATE ENERGY CODE FLNAL . -. g.1J/ lOR / ' o-r./L.. ( /) II r//J f'../. II f/ . ADDITIONAL COMMENTS COMMENTS . - (Ji ~ \)Ji"l ~~ -..., 0\)"" -\1~c:: ~~~ ~~ - uJ :z ~ 9 I ~' ~ ". [;i i"l ;;, ..., f 0 c ",. II: ~ ~~ t"l ~..., ~ r;" <' \' rxl'y./ 7/ r - ;:> ~ :I:: - <----0 ~ :E Ct' ~ -t ::0 r: (f' ;:> . 01>, i"l ~. ~ -~ ~ ..., - 0 z . 1\ ~ ~ -3 iI: I:l i"l ~ ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD. NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net "?:? 7(% "b' BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health -4 sets of Building Plans Planning Board approval -Survey Check '-\C\O.. 00 Septic F onti N.Y.S.D.E.C. Trustees Flood Permit Storm-Water Assessment FOffil_ PERMIT NO. Examined 20-N Approved Disapproved alc ,20d Contact: Mail to: r/J-t ,20~ Phone: Expiration f~ _.--;<-::-\ , , '\ II. \.... ' Building Inspector "....-..... \ APPLICATION FOR BUILDING PERMIT r \ \ .. 1. ~ 'Ml'OusrJ' \ Date, 20_ \ ~$ INSTRUCTIONS \, a. This application M be completely filled in by typewriter or in mk and submitted to the Building Inspector with 4 sets of plans, agcurate plot plan to scale. Fee according to schedule. fY.P1ot 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 South old, 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. ~ ignature of applicant or name, if a corporation) /::'1;0 34d:So^, L..tlf-b/u- ;..(l/rUTlU'" Y (Mailing address of applicant) 1/'1 ~z. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises 3",vWS I-\wsL.4 L-IS"'- I-I''''~L " (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 ofland on which proposed work will be done: l3\S'o ~An$O"'" LIIMJIMfi- MAlT.ruel- House Number Street Hamlet County Tax Map No. 1000 Section Subdivision '173'3.5') Block /0'-',-'1-/7 Filed Map No. Lot Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy S~ ~ v"5;.~ ' ". b. Intended use and occupancy "'/t1i-Ul ..{;..."'1 I'"!'S' k c... 3. Nature of work (check which applicable): New Building Repair Removal Demolition Addition .~ Other Work Alteration .l.u " (Description) 4. Estimated Cost 15,000 Fee 5. If dwelling, number of dwelling units tv/A If garage, number of cars (To be paid on filing this application) Number of dwelling units on each floor 6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use. f./! It 7. Dimensions of existing structures, if any: Front Height Number of Stories Rear Depth Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Height Number of Stories Rear Depth 9. Size ofIot: Front Rear Depth 10. Date of Purchase 5 I'll Name of Former Owner DfI.vt~. 11. Zone or use district in which premises are situated ~s.clw+.:J 12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO ~ 13. Will lot be re-graded? YES_NO ~ Will excess fill be removed from premises? YES_NO_ i-l..-nm<:t Address \"lio.:r~<So<- Ww~ Phone No. Address Phone No Address Phone No. 14. Names of Owner of premises SI\w.s. 1-l'M.~L Name of Architect MAv k SdMA. k Name of Contractor 5,,,, i\ulx 2'j'i-L{,(P, 73'1 - '11~5 L{7~ -I'g 7'( 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES _NO -L- * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 30.0. feet of a tidal wetland? * YES_NO---2.- * 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_ N01- * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF 5::-f.N/.C ) ::r.; <> A. U,~ being duly sworn, deposes and says that (s)he is the applicant individual signing contract) above named, (S)He is the AG-el/l' (Contractor, Agent, Corporate Officer, 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. Swo9,1 to*-fore me thi~ o{~ - day of hm..a. 'Y 20Q~ ~_,~dl~ _''''''IT ~ Notary Public iOTAJ.YPUBLlc'Stllt,)l New Signature of Applicant NQ. 52..,(t<\33485 CIuIII1Ii In Sullor. ~ :,; ['J1,*,~NcI'l30.~/O SURVEY OF LOT 12 . MAP OF JACKSON'S LANDING .EO WAR. 28, 1969 FILE No. 5280 SITUATATEO AT MATTITUCK TOWN OF SOUTHOLO ~FFOLK COUNTY, NEW YORK I S.C. TAX No. 1000-106-09-17 I SCALE 1. = 30' APR. II, 1991 \ 'lED TO: BRIDGEHAIlPTON 'NA TIONAL BANK TlCOR TITLE GUARANTEE Co. JAWES A. HINSCH USA A. BROCKHOFF :. 20,800.20 .q ft 0.~775 acr.. A. Ingegno Surveyor ft Main Street ~ew Ytlrk 11901 727-2090 16) 369.2009 nll:: 0..... xt'"' zt'"' PI ~~ :DO ~> &.t::l 1'8.21" , , :; LOT 13 ~ 0 !Ii ~ ~ l\) 0 I N 88"34'40. E 160.00' , , i, , , Z 'N 'N Ul ,. ,,, ,'" . U1k/IY 0 0 ". <-, - I , P<U - > . r , 1.4"E.' /'.i () N Ul Ul ..... :;0:::- N N C/) q III QI q 0 ~ 0..... Z " ,., ~ ....,. i ------- '.0- LOT 12 C/) """"DICK .. S1D'S 5: """"s.- f z IIOOF t::l - ..... Z -.r CCIfC. Q -. .... ....... - ..... " - - ---Jljj' ;< '" '" , , I 0 I , 0 - III III 0 0 ," '" 0 0 I I , , , , ... USE .. ... S 88"34'40. W' 160.00' PNponld In _ _11le_ -- far ... ......,... ........ bJ ... L. L A. L. a. """ _......1lIII1dapIod 1or__bJn._Vodl_LMoI . 11IIe &. .... N.Y.S. Lie. ~o. 49668 LOT 11 ~ o ~ . 91-154 SURVEY OF LOT 12 .MAP Of. JACKSON'S LANDING FILED WAR. 28. 1961 FILE No. 5280 SITUATATEO AT MA TT1TUCK TOWN Of SOUTHOLO SUffOLK COUNTY, NEW YORK s.c. TAX No. 1000-106-09-17 SCJ.lE ,. -= 30. APR. If. 1991 - cannED TO: BRIDGEHAWPTON 'NAnOHAL BANK TICOR TITLE GUARANTEE Co. JAWES A. HINSCH USA A.. BROCKHOFf AREA = 20,800.20 .. ft 0..4n5 Gc.... Joseph A. Ingegno Land Surveyor -- ---- 1186 East Main St'eet Rive,head. New YtJ,k 11901 (516) 727-2090 FAX _ (516) 369-2009 -----.--., -- ,n::: 0_ xt'"' xt'"' ~ 11:<l "0 ~> .etl "-"" z > 0 N (') (II :>;:- N C/) q 0 :<; ~ C/) s: Z tl - Z l;) '" !" 0 ~ N.Y.S. Uc. ~o. <4.9668 . , LOr '3 ~ " I l\l ~ c: N 88"34' 40' E 160.00' , , , VI :~ '. :- """'" . 0 , m" ~ I I N , , (II ..... N - .. q . ..... ~.... . j ,., LOT '2 -- . """ I -.- ""'- - .... - ""'- "'.M< '" I 0 0 ~ -... . ... 160.00' LOT It ;:0 0 ~ - S 88"34'40' W. -..-.....- ......... .... .. ....,. .. ......... .., ..l.. LA. L...................... ....... _ br n......,...... LIIlf . 'J-.. . .. . 91-151 Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C.T.M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A STORM-WATER, GRADING, DRAINAGE AND EROSION CONTROL PLAN CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. 1iiSiriCt ~ BiOCk ~ ---------------------------------------------------- Item Number: (NOTE: A Check Mark (~) for each Question Is Required for a Complete Application) Yes ~ ---------------------------------------------------- ~ [d ":L [d [d ':i- [d Y. [d * [J X- [J ~ [J 'ci [J 'i 1 Will this Project Retain All Storm~Waler Run-Off Generated by a Two (2") Inch Rainfall on Site? (This item will include all run-off created by site olearing and/or construction activities as well as aU Site Improvements and the pennanent creation of Impervious surfaces.) Does the Site Plan and/or Survey Show All Proposed Drainage Structures Indicating Size & Location? ~ This Item shall Include all Proposed Grade Changes and Slopes Controlling Surtace Waterflowl 2 3 Will this. Project Require any Land FUling, Grading or Excavation where there Is a change to the Natural Existing Grade Invo'lvlng more than 200 Cublc Yards of Material withIn any Parcel? Will this Application RequIre Land Disturbing Activities Encompassing an Area In Excess of Five Thousand (5,000) Square Feet of Ground Surtace? 4 5 Is there a Natural Water Course Running through the SUe? Is 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 ofVerticat 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 Malerial, Removal of Vegetation and/or ttle Construction of any Item Within the Town Right-of-Way or Road Shoulder Area? (This item wlll NOT include the Installation of Driveway Aprons.) 9 Will this Project Require Site Preparation wilhin the One Hundred (100) Year Floodplain of any Watercourse? 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 lhis project meet the minimum standards for c1assjfication as an Agricultural Project? Note: If You Answered Yes to this Question, a Storm-Water, Grading, Drainage & Erosion Control Plan is NOT Required! -------~-------------------------------------------- STATE OF NEW YORK, COUNTY OF .:Syrro':t That I, uu:::fi:\~6.k/~'!\I.~~4 . ......'is . ... . beUl~; duly SWOlIl, depost:'.s and sav.'> tInt he/she is tJ1f' applicant for Pcnnil, (~jaf11e of imjividual signing Document) ~,.,.oL And tJLll he/she JS lhe (Owner, Contractor. Agent. COlj)orate Officer, e(c.) Ol'mer and/or represcnlative of the Owner of OWIlcr's, and is duJ)' aulhorlzed Lo perform 01 have performed the said work and to make and file tJ-us application; that all statements contained in th.is application are true to the besl of h.is knowledge and belief; and that the work will be performed in the manner set forth in the application filed herewilh. Sworn to before me th is; -,1... ....~'? ~.......... .. day orE0tYc4..0j .~...~a.aI::::. ....... JAm''J: S1n.UT .... , 2o<?2?' ........~~;';,;;;.,;;.;~;)......"..".........".... Notary Public: ." . .. ~.52..{i6JJ~S " a ~~~21/() FORM - 06/07