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,,�o�OSUEFot�-eV Town of Southold 2/18/2016 0 0 la`: P.O.Box 1179 i x 53095 Main Rd oyAli 1 7� �o� Southold,New York 11971 1. CERTIFICATE OF OCCUPANCY No: 38103 Date: 2/18/2016 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 14825 Route 25. Mattituck SCTM#: 473889 Sec/Block/Lot: 114.-8-4 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 1/29/2015 pursuant to which Building Permit No. 39522 dated 2/3/2015 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: MINOR ALTERATIONS WITH SECOND FLOOR STAIRCASE TO AN EXISTING OFFICE/RESIDENCE AS APPLIED FOR The certificate is issued to Hinsch,James of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 39522 02-03-2016 PLUMBERS CERTIFICATION DATED AuLre r - TOWN OF SOUTHOLD (j.. .' Su�FntK BUILDING DEPARTMENT a 0€ a �` TOWN CLERK'S OFFICE Q ,4. SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 39522 Date: 2/3/2015 Permission is hereby granted to: Hinsch, James 7290 Peconic Bay Blvd Laurel, NY 11948 To: Additions and alterations to an existing office/residence as applied for. At premises located at: 14825 Route 25. Mattituck SCTM # 473889 Sec/Block/Lot# 114.-8-4 Pursuant to application dated 1/29/2015 and approved by the Building Inspector. To expire on 8/4/2016. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $200.00 CO -ADDITION TO DWELLING $50.00 Total: $250.00 MIL v ----- Buildin• Inspector 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 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 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$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00, Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,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 Date. ©/ (—L9//, New Construction: Old or Pre-existing Building: (check one) Location of Property: 1 ¢'O z f "14lir/ 'I Al/977l f 7 e x... House No. Street Hamlet Owner or Owners of Property: J 7 J 7/ r/ Jr CH Suffolk County Tax Map No 1000, Section Ni Block Lot 1-/-- Subdivision Subdivision Filed Map. Lot: Permit No. 3 q.5 ,P . Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: 1' Request for: Temporary Certificate Final Certificate: (check on ) Fee Submitted: $ SQ Prov / Applican ignature I,,,, ow,.,.���_ •011 A a S007,54 Town Hall Annex �I . Telephone(631)765-1802 54375 Main Road i ; Fax(631)765-9502 P.O.Box 1179 G , ,�� Southold,NY 11971-0959 �®l� �O'or� roger.richert(a�town.southold.ny.us = OOUNT'1,1,,•." .i. ," BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Hinsch Address: 14825 Route 25 City: Mattituck St: New York Zip: 11952 Building Permit#: 39522 Section. 114 Block: 8 Lot: 4 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: G & S Electric License No. 578-E SITE DETAILS Office Use Only Residential X Indoor X Basement Service Only Commerical Outdoor X 1st Floor Pool New X Renovation 2nd Floor X Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt Ceiling Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt Wall Fixtures 1 Smoke Detectors Main Panel NC Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel NC Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances - Dryer Recpt Emergency Fixtures Time Clocks Disconnect Switches 1 Twist Lock Exit Fixtures TVSS Other Equipment: "Second Floor Entry Way Light" Notes: Inspector Signature: Date: February 3, 2016 Electrical 81 Compliance Form.xls _zecoutirin.". TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ J FOUNDATION 1ST [ ] ROU PLUMBING [ ] F> DATION 2ND [ NSULATION [, RAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: ?------172pi.442,,tk DATE .3 5- INSPECTOR / 3/ q li - - 11��,ho��OF SOUjyolo,; 4., i,t.; , =`'Y,OUHiV,� ' TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION- _ [ ] FOUNDATION 1ST [ ] ROUGH PLUMBING [ ] FOUNDATION 2ND [ ] IN CATION [ ] FRAMING /STRAPPING [ INAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: 1 CZ #fir % , Cek...)2.<_. ; ' - - y DATE 3 / 3 / S INSPECTOR . - /1-4.- , FIELD INSPECilIoN REPORT DATgCOI 1 ENTS ' FOUNDATION(1ST) -. 4 . UVJ FOUNDATION(2ND) . , ' • ' . . . . . . . — ; • . /4e:iti4LL/C--.11.'...-0.'-'1.;";(;fr.1) -4 • . . ' . ' ' ' - 5) • ROUGH FRAV'G& • ' . . -..1,1 PLUMBING , . . •.___. .t • . 1—_,,,,r, / . . Ck( 6;,-1!'ee•-,,,,,, 621 • INSULATION PER N.Y. y STATE ENERGY CODE ' Ca .. • . Al 6,gr°°. Ut "---2-e9. , , , . ,7,1, FINAL , 5�.. ADDITION . 6mtv)2NTS^tr.�.;. . �w .. Q .. o . • �� t' 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 Plans TEL: (631) 765-1802Planning Board approval FAX: (631) 765-9502Survey SoutholdTown.NorthFork.net PERMIT NO. S9 5- .7____-- --- Check Septic Form N.Y.S.D.E.C. , . . , - Trustees C.O.Application Flood Permit Examined ,20 Single&Separate I / Storm-Water Assessment Form •2) 1 , Contact: Approved 20 Mail to: / R/2,K �/ GNGC/ rZ- Disapproved a/c � Phone: 7,.7.1-- . 1 f(�/ Expiration ,20 k )11° �I j : ns•e for if fl I 1 JAN 292015 Li I APPLICATION FOR BUILDING PERMIT _____________1 Date • ®/ 2- � /57- = ;', 20 BIDE DEPT—_ __ INSTRUCTIONS TOWN OF SOUTHOLD 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 expiredf.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,housing code,and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant or name,if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agen • architect. - gineer, general contractor, electrician, plumber or builder Name of owner of premises JkMEJ .Pc<71:-/ . • (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. Locatiog,of and on which proposed work'will be done: 1 f,a-0 r A�i� go -!,,, s - kf77-frc/1,( House Number Street - " r,: a„`' ''Hamle County Tax Map No. 1000 Section l l• s/__ ' ' Block` ' ' h°' "tD Lot ik 60,23,L zto 5�1 Q j� ;,Y STORMWATER Scott A. Russell ,, :1 ( �T SUPERVISOR k,,,,„,„,) MAN A\Gt]E�]t]El�T SOUTHOLD TOWN HALL-P.O.Box 1179 „_ T �753095 Main Road-SOUTHOLD,NEWYORK 11971 fd --' . Town of Southold .� iso'" CHAPTER 236 - STORMVVATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) DOES THIS PROJECT INVOLVE ANY OF THE FOLLOWING: CS (CHECK ALL THAT APPLY) D dif§ A. Clearing, grubbing, grading or stripping of land which affects more t than 5,000 square feet of ground surface. . O 24 B. Excavation or filling involving more than 200 cubic yards of material t within anyparcel or anycontiguous area.r - preparation g , �.. 1 Site pre aaratio orLstopes which. exceed ID feel vertical rise to 100 feet of horizontal distance. O d. D. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. t • t E. Site preparation within the one-hundred-year floodplain as depicted on FIRM Map of any watercourse. D re F. Installation of new or resurfaced impervious surfaces of 1,000 square feet or more, unless prior approval of a Stormwater Management Control Plan was received by the Town and the proposal includes in-kind replacement of impervious surfaces. If you answered NO to all of the questions above, STOP! Complete the Applicant section below with your Name, Signature, Contact Information, Date & County Tax Map Number! Chapter 236 does not apply to your project. * If you answered YES to one or more of the above, please submit Two copies of a Stormwater Management Control PIan and a completed Check List Form to the Building Department with your Building Permit Application. — S.C.T.M. : 1000 tate: APPLICANT: (Property Owner,Design Prof t nal,Agent,Contractor,Other) Dr;trrzt p NAME. /O�// ( j >:r4g/ °IL 9.113:110- Sect Ion ock Lot s s,�rurir �' '••r'.•= !? -t ) N L' )n 'T t N 1�C)t� 1 iL_?I. '.� �s_I :,Pz'�', I[:I��"1- L:.� :i f�'r' Contact Information- 7:2, ...Y Yiefr 61-4.AdA....)Revlc, ed By- (�U / 1 hA Date- Frzl /{6 PropertyfZ.T Address / Location of Construction Work. - -- - . �/ �° — r�ppl:t(. _— ' °'7 G!' /.`� '$ Storrnwater:LLLagernen; Conttvl 'lar:Nu; lac�:.�trrrl /i14-7-771/- li�- n StortiiwLaier av)ar.,:gemcnt Cct;trol Plan t<ect.f:ce .fp'A,ur:l to Fogfi;?'er'E!y Deprl,fr}ct;t fo:Rcv e i 1(1r<t'✓( ' S ,1 F' --.70r; .'$A" 20 'I , + d ri o . Town Hall Annex :711:51:q_ Telephone(631)765-1802 54375 Main Road , ' (631)76595P.O.Box 1179 Q �� roger.richertt 'o`wn.soutll0ltl.ny.us • Southold NY 11971-0959 �� �� . ,gyp , , • • BUILDING DEPARTMENT I TOWN OF SOUTHOLD I • APPLICATION FOR ELECTRICAL INSPECTION I - • REQUESTED BY: .. Date: �/////j-- Company Name: 6 A S F (Fc-q---r-Li . • Name: /2: £ U !21'4/ cli'L-_-u.., • . License No.: _s--767 - E.- Address: fl 8, 00g- c?,.1 �' j . Phone No.: s-76, f,6 - • JOBSITE INFORMATION: (*Indicates required information) • *Name: 'rp M's fl-/AJ C-I-II .— CX ,%i c�- *Address: /ycrc,1 ' AI All ,ia b ; MATT/TUC-4 *Cross Street: ,Va/�/TdG/L Lz-/6 N •fc..4 co _ . *Phone No.: • �qi •S3 3 Permit No.: -5 / ). )-- Tax-Map District: - 1000 • Section: /17 Block: 6= Lot____K . *BRIEF DESCRIPTION OF WORK(Please Print Clearly) . . /116 S£LLAlP /600.1_- iF_.4v,-meg 647_ *• sal . (Please Circle All That Apply) . *Is job ready for inspection: • a NO. Rough In *Do-you need a Temp Certificate: YES Temp Information(If needed) *Service Size: 1-,P-has- _ '--; e 100 150 200 300 350 400 Other *New Servic� E R r-s.m- r nd Number of Meters Change of Service Overhead • Additional In` ation: MAA 16 7015 PAYMENT DUE WITH APPLICATION RI nr, UPI TONIN OF SOUTHOLD r • .82-Request for Inspection Form - I q 1 i .-__�__.-_._.__-.__.._.,—.___________ ________ ____-_____r.____�.__._-r__.._ ___._..._.-_._..__...-.-.-�___.___._�____ _.___.._-. _..--_____.--_--_.__ _.....__I�-_�r� . . - \ \ . . } .' • ‘10-1- . - . \ 1 PO/ r N.( M DATriZICI A N. ' tq, 11% . fr,, Nil,, 0.h.,- . i �p of t,14�E N� .4 k�E{Fp �_ :i' _ \IAT LN,E LGYG}'C)Isl \_Tr-INI-61-'-' t 0 AT - _G?;R. �:sp } ' V , , MATT S UCK - z �,_ -tF 1 H-OLD,N,r. IC \ rn \\ t , _, t J \\/" SV # • ri \ / , D Z,eVb FLOOR ��CrO \ s -L? *\-- t/ // _ - 5 iN / . ::IL Z 0 0- --c- \b' i ", r,J i.. ,-16- 7 •I v. tjl J rc it ' �?�g "I yi • t ' C - VC ' f/% /• . - - ji____________ , r � 44 - P •,,.c `-gip`=. t ` - .,. "rc4 A 4.` t! ±ed eitsratlon or acklitiott px ! ' ` y-".- this survey is o vio'atian of ' ��y. ecwona1l3afthe itevirYork St GUARANTEED TQ D-iE SECURSFY TnTLE CUA N7Y CO. ' r-ducation Law. - - - ___ - d "" + • 01F pp Copies of this survey atm not bearing • AI`s e>' r `" F= "'OUT ri 0 L_i.,_SAV I N`5 SAN K I- r�I `. ,c( C K ��, O the Rend surveyor's inked sea;cc r4� `7 �.' "[} _ _i j �i� '�,/ p �� ��� ?'41/1/ ---1> embossed seal shalt not 6e wns'isiered ----! APQ _28,. i 6 i 1.-'�',° 'i "�', 1�' OO D `'P G 40 be a valid true copy. °"f,^j i^;r-- r ; " \ ;f: --r-P 1,ST-f C_•,r_ ! _ /1 ; ,�x---� ',J-'' X - - r- Guarantees Indicated hereon shall run J tiJ�' �'f_�_� \V 1'i\i } `f. t 'r�� r j.';rt rl,,' ;,. " o= Cnly to the person for whom the suntoy� .ms s w- 'S (0 �O is prepared,and on his behalf to the / p { n�i�y{ ,fy q 4,� tidocompsn%govcmrr.antalagency and �^' ��C,/ZLr •- eie.r '� i ±�Qi .7�7•- r . !r ,P,5,,,. L S 2 56 \2, fending institution hated horeon end - ._^__ ---- _________1,____, ------ ! Iv ..a-r ¢C o.. •- �,,,.q a Cij ej.J�..� to the assignees of the landing _..Ic E Ns 1:<-, Lal ,L)st JEV`(��.QS 1C�1 �I� ;�. +V.�P. ' ,-.. taboo.Gsuarantees are not transferable----•-----•--------_ _ to sdditianai institutions or subsequent - .