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Home My WebLink About33777-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Date: 04/01/08 No: Z-32955 THIS CERTIFIES that the building DECK ADDITION Location of Property: 750 (HOUSE NO.) County Tax Map No. 473889 Section 113 HOLBROOK LA (STREET) Block ~ MATTI TUCK (HAMLET) Lot 9 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 24, 2008 pursuant to which Building Permit No. 33777-Z dated MARCH 31, 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 EVELYN M JAHN (OWNER) of the aforesaid building. SUFFOLK COllIIITY DEPAR'1'MEIIT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ~hor~ Rev. 1/81 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 following: A. For new building or new use: 1. Final survey of propel1y 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 2/1 0 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 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, 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 ofCertilicate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. t7.R.! : New Construction: Old or Pre-existing Imi18i~ Location of Property: 7>0 H ",If, 0/'6>6 k L ~ '< e House NO;.: S;5\et Owner or Owners of Property ~<;" e;. ~ e 011 C... -6 ( Suffolk County Tax Map No 1000, Section / r s: D 0 Block (check one) Act. 'y 'I- ,'~/.J"C J:... Hamlet k<{.'{k= (;tJQ Lot 90~6 Subdivision Filed Map. Lot: Permit No. :"). '?J) 'J '7 ~ Health Oept. Approval: Date of Pennit. ~) 3, I 0 <t Applicant: Underwriters Approval: Planning Board Approval: . Request for: Temporary Certificate Final Certificate: -- Fee Submitted: $ J. S, UV Applicant ~. 7'10 \of (p co?:: 3)..~5<S 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. 33777 Z Date MARCH 31, 2008 permission is hereby granted to: EVELYN M JAHN PO BOX 466 MATTITUCK,NY 11952 for "AS BUILT" DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 750 HOLBROOK LA MATTI TUCK County Tax Map No. 473889 Section 113 pursuant to application dated MARCH Block 0006 Lot No. 009 24, 2008 and approved by the Building Inspector to expire on SEPTEMBER 31, 2009. Fee $ 400.00 'l Ji1~ rIA-,ll. , Authorized Signature I ORIGINAL Rev. 5/8/02 3/J-1/0 g It/vi if ,rf- ~-o -r- l'f y It! <.~ NolL Jb~ ~~ ~ M~~6kA /JU-~C+D<h~ ~/I1) &00& r....__ ~e....cl [~~Wa--3- FIELD INSPECTION REPORT DATE I I. . COMMENTS \)J ~"d ~t'l ~~ ~>-l ['\J'lt FOUNDATION (1ST) FOUNDATION (2ND) ~ r~ -----------------------------------~- . -..lz \110 o. ROUGH FRAt'\1ING & PLUMBING ~~ ~ ---f-- INSUL.-\T!ON PERN. Y. ST.-HE ENERGY CODE -- --- :r: . ?; ~,E ;...3 ~ 3-)..7- y I-if- l.xlll I .. n J .. ". c.. d. 1) u l.v''''~b J.. ~ l,;t.. 0*- ~'/A . ~ FINAL . ADDITIONAL COMMENTS 1 .... (<\0 l ::E r'Z ~ ~ --- -- .....,t'l -~ ~~ ~ >-l ~- 0 z :r: \ t'l -- >- ,... :., ... - 0 t'l "d , :-3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 119(1 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdT own.N orthFork.net PERMIT NO. H 7 7 1-? BUILDING PERMIT APPLlCA nON CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.SD.E.C. Trustees Flood Permit Storm-Water Assessment Form ~-Et-. 20~ ?;J}ll-,20~ Examined Approved Disapproved ale Contact: Mail to: Expiration 1 ~,20~ Phone: I ~-I-t , Building Inspector '! OK APPLICATION FOR BUILDING PERMIT Date 3/2~ I . ,20~ i INSTRUCTIONS a. This application MUST b~ 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 oflot 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 e tions, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant or name, if a corporation) ;'J.e, Q~,.. .fZ.s'~ ~"?(" ~A7""" Ae-",t). ? /h-Itlc. ,...,. V. (Mailing a,olliress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ~JoJ k<>-{'k~ (--,:<;:'1-) (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. /;/,4- 1. Location of land on whiChyroposed work will be done: 7 SO No b.ro=k Lr.",-?, House Number Street }{ &. 't-'t-)Y.lUC J Hamlet Lot Lot 9066 County Tax Map No. 1000 Section Subdivision /1'$0(: Block C co Filed Map No. 2. State existing use and occupancy of premises and intended use and occupancy ofproPQsed construction: a. Existing use and occupancy A ;:.;-",,1 /L,"".AL b. Intended use and occupancy A /lS'~,,> j7"1't. 3. Nature of work (check which applicable): New Building Repair Removal Demolition Addition Other Work .AS .1'v/L-r A~ration 4r,f (Description) 4. Estimated Cost Fee 5. If dwelling, number of dwelling units If garage, number of cars (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 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 oflot: Front Rear Depth 10. Date of Purchase Name of F Offiler Owner II. 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_Will excess fill be removed from premises? YES_NO ~ 14. Names of Owner of ~remises I Addre5..,?'1" ,/1;,(.,~ ,4 c'I,/Phone No. Name of ffr~*~ /lo/l;>..<-r 0 ,6'4 (.PA/ Address / ,A->-.LJ ~ 'l' Phone No ~:.?/ -...?"76" - 5"2.5'"2- Name of Contractor Address 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.e. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES /'" NO * IF YES, D.E.e. 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 OUil(>Y1<: ) ~Q.(QlVlQ t:1 ~, mar + In () being duly sworn, deposes and says that (s)he is the applicant (Name of i ividual signing contract) above named, (S)He is the f;yecceJo( (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. Sworn to before me thksll ,A I qJt... day of IV(~QI\ ~~ JOiJwdw Notary Public 20fl- AISHA NASRU NOTARY PUBUC, No.01NA81 CluaIIfted In CcxnmIs8Ion Expl . . 1 RlJSTEES John M. Br.demeyer. III. Presidenl Henry P. Smilh. Vice President Albert J Krupski. Jr. John L. Rednoski. Jr. John B. Tuthill Telephone (516) 765-1892 SCOTT L. HARRIS Supervisor BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.o. Box 1179 Southold, New York 1197! Fax (516) 765-1823 Telephone (516) 765-1800 August 27, 1990 Edgar A. Jahn P.O. Box 466 Mattituck, NY 11952 RE: SCTM *1000-113-6-9 Dear Mr. Jahn: The following action was taken by the Southold Town Board of Trustees on Thursday, August 23, 1990: RESOLVED that the Southold Town Board of ~rustees grant a waiver to build a one family dwelling as shown on survey dated June 11, 1990 subject to no activity to take place seaward of the boat house and a $35.00 waiver fee..- If you have any questions, please do not hesitate to. contact this office. ptr:y~:ec John M. Bredemeyer, III President; Board of Trustees JMB:jmt cc: Rodick Canst., Co. Inc. Building Dept. C.A.C. \ \ , Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION, S.CT.M." . THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OFA /"':?P 115<'>0 Goo 900 STORM.WATER, GRADING, DRAINAGE AND EROSION CONTROL PLAN Oistelol S"lioo ~ t:;;t 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 ---------------------------------------------------- J:!Q ---------------------------------------------------- 1 Will tllis 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 81te Plan and/or Survey Show At( Proposed Drainage Structures Indicating Size & location? This Item shall include all Proposed Grade Changes and Slopes Controlling Surface WaterFlowl ,A../Or ,+/'/C.fC~..84 As b'''/'Cf .tJ,rc.k 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? [J [d [d [d [d [J [d 3 4 Will thIs Application Require Land DisturbIng Activities Encompassing an Area in Excess of Five Thousand (5,000) Square Feet of Ground Surface? 5 Is there a Natural Water Course Running through the Slle? 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 of Vertical 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, Remova! of VefJetation andtor the Construction of any Item Within th8 Town Right-or-Way or Road Shoulder Area? (This item witl NOT include the Installation of Driveway Aprons_) 9 Will this F'roject Require Site Preparation within the One Hundred (100) Year Floodplain of any Watercourse? NOTE: If AllY 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 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, Orainaga & Erosion Control Plan Is NOT Required! / [J IT ./' / ./ c/' c/ ./ v .!'l!! STATE OF NEW YORK. ---------------------------------------------------- /JuO(!Y' '3 Tb~l( I, ( '( J\ 'NTY () F . ...R~~/1I1~~....(Y']lldIVIO. II'J:,ll,('"I Ir"j,""l<J<l1SI(j()II\\.I[l()(.urn.-",l.,' E;Y-ec.ubc ... SS hem/'," duly .';\\'01 [1, ckpo\e,\ ;llHl says that hehdle, i.\ tlw ;q.lpIIGlIlt fur Pelmit l\lld 11.;(( lit ,:IH' )" L1i" (OWller, CQlllraclor. ,n.\)cnt, COII'Urille Uff,cel, etc,) O\\'IICI awl,:uI 11:lilCSC)ILll1\'(' ()fthc (hocr of 0\\'1 In's, and IS dull' ;J1Ithorw'd (1.1 ]wdorlll or have performed the s;lld wurk Jnd t(J make and file till.') application; that all statements contained in this applicatioll ale true to tllC best or hi:; knowledge and belief; and that tJlC wOlk willlw pnfomH'd ill Lhr Ill;llllln set forth ill the applicatloll riled herewith. S\\'(J111 tf, liC!"')IC Ill'" liil'; 10-U ..... .. da, ulrVIQfc0qqq ,2UOg FORM - 06/07 Notal)' Public ~'AqJt:)j)iAA.~ (Sfgnaluf A.pplicanl) Hydrographic Map Prepared for: Carol Kafka Su~eyed:August7,2007 SCT # 1000-113-6-9 Situate' Mattituck Creek Town. 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(7" .~ I .- . ,,'-..--- --. 5-2" .....~+- , /' " s-z ~~4t--&- ~O'C - .. f .----.-. it 'I \;, ~ ~ ,YJ . \a , " ..\ ~\ - ~l "\ , "j \-.1}' ~. \, .~: .;': ... ; ~ -., ~'( i " # //..i'OC1 -';:"'0 -7<%><:< - J /" /f "0 DATE J.'.R (j S? lE',Ar,k/l /'<,eSI€)E"-^/CIIF ,-\J,~:~\ '...~ .~\"-'; ;J I ' ~ Ii 'j I '\ , ,)1 , ,. H . -.--. ,j'--r~ II HI' , I! , " 1 ~-l ". .C~ ~~ l ' '.~ ~ 1 " .\ , ... ."l ~ 1 . I~~ ;~:~ ,,". -----, \., I ' , ' I I \: I::~ .~ "i A,~ _ ('C!\ J MEeT -,.c- r, CL n1FICATION OF NAILING & CONNECTIONS REQUIRED. OCCUPANCY OR IJSE IS UNLAWFUL THn T r.r' : -!r:~- ~\.r " !~ S ,) L'-( IJ Ar~?tOV[J !\"'~.: .:-~CTtD C -:0. -::>1'1./( , ,\ L...._~...,.. _J (), F E' -.liLtc.._ r;C" __.;s e' } J///? 7, !t:. 7 _ '~';2 S ,',} -'"c-: , ,;C h ,,-0',":','::' ::,:~" 1. ,_,.~Ti()N - 'T,.'-/C' 'or'" -l) ~': i.-; i'CU~lEO CC'lC;':', 2. !"iOUGh - FFA:'.~:.'~ & 3. li~SULATION 4. FINAL - COiF;",' 'TiC" BE COMPLETe "'; e.c. ALL CONSTRUCTiOi: SHALL . 'ET THE REC;UiREMENTS OF THE coe. 11' NEW YORi( STATE. NOT RESFONS<E FOR DESIGN OR CONSTRUCTION "':RORS. II.;: Ra'SERT O'BRIEN P.e. . 1M CC?NSUL TINa ENGINEERING SERVICES . Main Road. Laurel. N.Y. 11948 APPROVED BY SCALE )S.' /1-= '/ # DRAWN BY,,(c. I REVISED /-fS.tf'v/?r zJFc!t 7.5".. #-' .eA'~ .c~$ /I4~~rv.::oE:: .tV DRAWING NUM8ER ..2008" -2