HomeMy WebLinkAbout29992-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-29955 Date: 01/12/04
THIS CERTIFIES that the building ACCESSORY
Location of Property: 2165 GABRIELLA CT MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 108 Block 4 Lot 7.52
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JANUARY 5, 2004 pursuant to which
Building Permit No. 29992-Z dated JANUARY 6, 2004
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 ACCESSORY 9' X 16' HORSE SHED IN REQUIRED REAR YARD AS APPLIED FOR.
The certificate is issued to ROBERT D & SUSAN A TOMAN
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
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//"t' orizetfSignature
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-29956 Date: 01/12/04
THIS CERTIFIES that the building . ACCESSORY
Location of Property: 2165 GABRIELLA CT MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 108 Block 4 Lot 7.52
Subdivision Filed Map No. Lot No_
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JANUARY 5, 2004 pursuant to which
Building Permit No. 29992-Z dated JANUARY 6, 2004
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 ACCESSORY POLE BARN IN REQUIRED REAR YARD WITH A 10 ' X 23 ' ADDITION
AS APPLIED FOR.
The certificate is issued to ROBERT D & SUSAN A TOMAN
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO_ 48365-A 11/14/00
PLUMBERS CERTIFICATION DATED N/A
uthor'zed Signature
Rev. 1/81
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. 29992 Z Date JANUARY 6, 2004
Permission is hereby granted to :
ROBERT D & SUSAN A TOMAN
PO BOX 1605
MATTITUCK,NY 11952
for
CONSTRUCTION OF AN ACCESSORY POLE BARN IN REAR YARD AS APPLIED
FOR. (REPLACES BP #252452) AMENDED TO INCLUDE 101X231ADD & A 9 'X16 ' ACCY SHED
( NOTE : 2 CO ' S REQUIRED)
at premises located at 2165 GABRIELLA CT MATTITUCK
County Tax Map No. 473889 Section 108 Block 0004 Lot No. 007 . 052
pursuant to application dated JANUARY 5, 2004 and approved by the
Building Inspector to expire on JULY 6, 2005 .
Fee $ 405 . 30
1
f
Auth rvZed e
ORIGINAL
Rev. 5/8/02
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. 25245 Z Date OCTOBER 19, 1998
Permission is hereby granted to:
ACMT EQUITIES INC.
1138 WILLIAM FLOYD PKWY
SHIRLEY,NY 11967
for
CONSTRUCTION OF AN ACCESSORY POLE BARN GARAGE IN THE REAR YARD OF
A SINGLE FAMILY DWELLING.
at premises located at 2165 GABRIELLA CT MATTITUCK
County Tax Map No. 473889 Section 108 Block 0004 Lot No. 007 . 052
pursuant to application dated AUGUST 26 98 and approved by the
Building Inspector.
Fee $ 124 . 00
Application Fee + 35.00
159.00
Building OITrspectctor
COPY
Rev. 2/19/98
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. 27754 Z Date OCTOBER 5, 2001
Permission is hereby granted to:
ROBERT D & SUSAN A TOMAN
PO BOX 1605
MATTITUCK,NY 11952
for
CONSTRUCTION OF AN ACCESSORY POLE BARN GARAGE IN REAR YARE AS
APPLIED FOR. (REPLACES BP425245Z)ALSO AMENDED TO INCLUDE 3 10X10 HORSE STALLS .
at premises located at 2165 GABRIELLA CT MATTITUCK
County Tax Map No. 473889 Section 108 Block 0004 Lot No. 007 . 052
pursuant to application dated OCTOBER 1, 2001 and approved by the
Building Inspector.
6
J
Fee $ 351 . 00
Authorized Signature
ORIGINAL "
Rev. 2/19/98
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 I%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
Date.
New Construction: / Old or Pre-existing
/Building: ((check one)
Location of Property:R 16 C �416A-- 4121 ( ` k
House No. Street ) r Hamlet
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section �t/� Block Lot Y�
Subdivision ( Filed Map. Lot:
Permit No. `T Date of Permit. 0!' Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ "2S,0r
App ' t Signature
�s 319
co55
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$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-existinFi3uilding- $100.00
3. Copy of Certificate of Occupancy-$.25
4. Updated Certificate of Occupancy- $'50.00
5. Temporary Certificate of Occupancy-Residential $15.00, Commercial$15.00
Date.
New Construction: Old or Pre-existing Building:
�'�'` �(check one
)
Location of Property: <_ `QI/J((k C- ` & fJ -
House No. Street Hamlet
Owner or Owners of Property: � i 1&j
`
Suffolk County Tax Map No 1000, Section 1 C/ Block Lot + l
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ 05
gAlpplignature
6�. c. �5 31
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t` �T€�:e4y� t C: � 1� � Y.. � tyiy,?�� n fs t:._a a °%i� '�,t lt��L i'�t31'�, ,�•z, � '�... '
` Electricallnspecticn Certlfltrate
Electrical Inspection Service, Inc. '
375 Dunton Avenue
East Patchogue, New York 11772
(831)26641612 ,
Date: 41/14/2000 Application No. 48365A
Issued to; Robert& Susan Toman
Street: 2185 Gabriella Court
Village:Mettituck Zip:11952 Town;Southold H
Section: Block: Lot:
Introduced by: Vogel Electric Lic.# 3943-E
Lias exmWmd and fooid to be io coLnp%,mv with tlu Alai' gal Cada
/l 1
'j ❑Attic fst Floor O/S Residential
(W--Pool 54 t>8t Garage, n f
)1 --Basement 2nd Floor ❑ O/S Commercial __ NV Detects Cl
Switches Receptacles Fixtures GFI Heaters A/C Fans
� 1 1
Dishwasher WasherlAmp Dryer/Amp Oven RangelAmp Garbage Disposal
, F.
r
Furnace Oil Gas Circulator Smoke Detector Bell Transformer
1
~ I l
Meter Amps Phase Motors Telephone Television Carbon Monoxide
1 '
Other Equipment: v� H
/ A901 3 �.
` Hugo S. Surd!
President
r Building Permit NO. Thts certifirace must not be altered in any manner
Inspa ors may be identif ed w tW,credentials
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/ ...' y�'✓`1I ^I,'7 , Ili±�, r', w�, , �.�4 , I��. 'I' r '�„ •� ''�: r V,/'� J +•' +,�_../
77
-1 b TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER - - —
__ _ _ - STREETD-IST SUB.
OT
tAi � cit� r
(-MT 77A 4�- nc ]T�-lr, c)
ACR. REMARKS
TYPE OF BLD.
16(, -L i'perfijz) N6MT -7o %cc),,:,
PROP. CLASS
LAND IMP t TOTAL DATE
64
A�"
000
FRONTAGE ON WATER TILLABLE
FRONTAGE ON ROAD WOODLAND
DEPTH MEADOWLAND
BULKHEAD HOUSE/LOT
TOTAL
UABRIELLA
ixmaf¢
Ft555.
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rAW rNTm
M-1802
BUILDING DEPT®
INSPECTION
[ ] FOUNDATION IST [ ) ROUGH PLDG®
[ ]
FOUNDATION 2ND [ ] IJUSULATION
[ ] F !MING [ FINAL,
[ ] FIREPLACE A CHIIMNEY
REMARKS
�-� ILI
T
ATE 1, �v ,1`0 INSPECT®
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION .2ND [ ] IN TION
[ ] FRAMING [ FINAL
[ ] FIREPLACE S CHIMNEY
REMARKS:
DATE INSPECTOR
n .0g
H
OUNDATION
?OUNDATION (2nd )
ROUGH FRAME & �
-PLUMBING
y
3 y
• - x
m
m
ZHSULATION PER N . Y.
STATE ENERGY
CODE
x
a
4 .
FINAL -
l s O
11
ADDITIONAL CO S•
dV
V-Q
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H
- O
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m
- r�J
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BOARD Ov BSALTFI I..... ...; .....
.11=1 HO. 1 3 SETS OF FLANS......... . .......
TOWN OP SOUTNOLD SUPIM IV.,.: .... ..,.,.;.. ....... .
BUILDING DRPARTMUT MUCK ......... ... . . . . . . 7 ... . . .
TOWN IIALL arenc 110M ... . ... .. . . . . . .... .
SOUTHOLD, N.Y. 11971
TCI.r 765-1802 NOTIM
1,ramnined. �/ " S�j�y 19.... CALL ...... ... . . . . . . .. .
. ,
9 -z7--
........................
TOr.
nl>lrw
........ .............
Disapproved a/c ......... .........
_.
(lkiildirrg lnsiiector)
AUG 2 6 I'LICATTON 1109 UUILDING PURNIT � I
$IDG,DEPT
Date .... . . . . . 19. . . .
F UTH I INSTRUCTIONS
a. T)is application must be coccpletely filled in by typewriter or in ink and mbai.tted to the Building inspector wi
3 sets of plana,.accurate plot plan to scale. Pee accordiugto acherh}le.
h. Plot plan shooing location of lot and of bolldings on preadses, relatioaahip to adjoining ptemisea or public
streets or areas, and Riving a detailed description of layout of property neat be draaxh on the diagram cinch In Part of
this application.
C. '1114 Wrk covered by rills application may not lie coamnced before Ivv=hce of Wilding Permit.
d. Upon approval of this application, the Iicillding Inspector tall: issue a Bailding Permit to the applicant. Such
permit shall, be.kept on the Premises available for inspection ti,rwglwot the work.
e. No'buildicg shall be occupied or used in dale or in part for any purpose Whatever until a Certificate of
Occupaocy shall have been granted by rile Wilding Inspector.
APMIC1i1TCN IS jX= tWX to the Uuildina Department. for rlis iasuanee of a I3uildiag Permit puretwat to the
Wilding Zone Ordinance of the Tvwn of Southold, Suffolk County, New York,-ard other applicable Taws, Ordinances or
Regulations, for the construction of Ixiildiogs, additions or alterations, or fol reawal or demolition, as herein
described. 114e applicant agrees to Comply with ail applicable laws, ordinances, building code, housing code, and
re8t1lation4,v41'd to admit authorized inspectors on premises and in but I g for(�nec�ssary insuacti
•'(SignaCure of applicant, or thama', if a ratiar)
10-,1��..1 icEV........
(Mailing address of applicant)
Statt�e %4hedler applicant Is owix4r, lessee, agent, architect, engineer, general contractor, electrician, plucker or builcU
..................aM.n.....i. .............✓.rp.................... ......:......................
...................
Nare of weer of premises
(as or the tax roll or latest deed)
If applicant is a corporation, signature of duly auUulrized officer.
CNune and title of corporate officer)
Builders License No,
Pluvbers License No. ....I....I...............
Lrlectriciarts License No.
OC11er Trade'a License No.
I. "ation of land on chick proposed uvrk will be done..................................................
....lhuse.llzber ,icQr,� ......... .$treet..Gcb'(i'411 'i.....................o.......................................
palet
County Tax Yzp tb. 1000 Section ...... ,� .... Mock ......
�•f�
•\..... ...... \nt......611490z'
..y ..hi.
Sut�divisioa .............................\........ Piled Flap No. ........:,..... Tat
(Nacre) ...............
2. State existing use and occupancy of premises and intended use aryl ,paiicy
a. Existing-use and Occupancy ..... .. flE t E 372 lT�E00Aposed corhsensetion:
..... . ......�':�`3i:ktfi`"1+�'..� .i�il.yrt�t�,...............
�l__ �� . Nnrra9 rtra3ih 8 rs t t i'suD
b. InteoY l use Sod occupancy r
tittura of work (dm*sAiidt agftitableh ti w 1ltildteg ..Y....... Addition .......... Alteration .....,..,.
MixiIr ............ Reamal .•.......u.• 13mlition .........•.. Atter Pork ..... ...0.. .... .......
(Description)
ItatIrmted CoatJ:....•.... fen. ...:.........................A................
(to be Paid.on filing this application)
It dmll Ing, anger of dwelling tmits ..,.�.t............ 11"ber of rhrelliing tmita on each floor
IE garage, gainer of earn ..............:WID.................
If lxialtreas, Wntereiat or muss ocntpency, specify nature and extent of each type of use......................
Wtsensioins of existing structures, If arty: lhont......."........ hear ...... ........ Depth ....:
Wight ......................... t#nber of Stories . ... ..........
.... . . .
Dimesnalonn of Sara etrt" with alterations or'ildditionst Pront .......;....... Rear ......... ......
Depth .................I.. lkight ......;..,7... .... tAaimr of Stories ...............
Dinensiona of entire Dela moatructiont Proot X%............ near ............... Depth .......... ....
Ikl it
...................... tAnber of Stories ..............4...... !
Size of Mots [hat[ Beat ....... ..... ,... llepCh .... r .� % �
.......
dote of Hrrdrsae ...... HAM Donner Q.mer i< > � '�
11. laor use district In shirt premieea are situated ... ��r.�.-.�r�l-!i'..1�..� X :.
ta S i
12. Does proposed construction violate any znning las, ordinance or regulations .. N�� -
T
13. Hill. lot be regretted. .................... hill excess fill be ramved frau premiaeasImo:Y�^r NO'-
14. Naanea of owner of preniaes ................:......:... Mdrass ... .. ... ......,.......... Plxxne No. ;...........
Ham of Architect ......................i............. Address .........I.................... mom Iia. ............
S
Hans of Contractor ...........y:.:.................... Address .................,.............lbooe No. ............
15. is this property within 300 feet.of a tidal tietlendR * YRS .......... NCi ..........
el+ YM, SOIli117D Mai 11EJS1t+I18 PLtiZE rr MAY dill RC(ilil M.
PLOT DIAGRAM -
Locate clearly and distinctly all buildings, sAtetber exiating or proposed, and indicate all aet-beck dimnsions
hon property linea. Give atimt end block nunber or description according tesdeed, and adxxt street 'sans and indicate
%Asetluer Interior or corner lot.
c
';mil: ar till ytxg1,
WINIY u' �tJk- .........
............
f �[e....................................Luing duty sworn, detx>ses slur says draC be is the ajipliumc
(Nme of initvi(hxil signing contract)
ntxwe suited,
He is the .......... ....................I.......... ...................................................
(Cartractor, naent,-corporate officer, etc.)
of said oA,er or owners, mxl is duly authorized to perform or have iurrtimned the said sxnrk aoxl to make ant file this
nip>Iicntims; that nit atata=ta contatned in this application are true to the hest of his kistvIedge mid 1x;liefi mnl
that the work wi ?4JON0.
the saner set forth in the application flied tberewtth.
�?aom to before
Z� .Notary l'cilnlic 1.SCOTT.State of Ybrk
NIk
. 1C472
firm May 31, -
LOT AREA = 40,009 i S.F.
FIRST FLOOR AREA = 'I s.r.
'J III IIIN 11 X11111it[1'ARIMI 111111 IN At IN'J I'll I':
SF,LOIIU I-LOOR ARLA
p Init M'I VIVAI IA IDII•:INIIf NON nlll Y
GARAGE FLOOR AREA = 1. S.F.
OAR.: __-___--_115 NEL NOT.
APPROVED:
THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR
FIRS RESIDENCE WILL CONFORM 10 111E SIMPARDS OF Q
TIE SUFFOLK COUNTY DEPARTMENT OF HEALTH SERMCES. Q
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3
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W
LOi 2 LOT 1
Wml VACANT R = 25.00'
L = 39.69'
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GABRIELLA COURT r ROM NNYEP coNSVVX7m n
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L=56.27' 246.30'
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SHARE
N/T ACMS UIµMWSKI 1A' TOPSOIL
VACARI
1.0' LRAM
ELEVATIONS SHOWN HEREON REFER TO U.S.C. k G.S. DAVM.
b 5.0' CLAY
THE EASTENCE OF RICHT OF WAYS AND/GT EASEMENTS OF RECORD,IF ANY.NOT SHOWN ARE NOT GUARANTEED.
THIS PRAY WAS PREPARED M ACCORDANCE WIN ME EXISBNC CODE OF PRACTICE FGR LAND SURVEYORS ADOPTED BY THE NEW YORK STATE
ASSOCIATION OF PROFESSIONAL LAND SURWYONS, TD.D' SAND A GRAVEL
ANY ALTERATION OR AUDI TO NITS SURWY IS A MOLARON OF SECRON 7209 OF TIE NEW YORK SIAM EDUCATION LAW. COPIES OF THIS SURVEY
MAP NOT DEARHO VIE LAND SURVEYOR'S MKLV SEAL at EMBOSSED SEAL SHALL NOF DE CONSIDERED TU UC A DICT, TRUE COPY,NO U"NOAL or
THIS STATE.UP OF ANY BTY, COUNTY, TOWN OR "LAKE HIRER,G ATOZO WIN111E ENRffiCEMFNI OF LAWS.OAVWANCES OR"FOULAIRMS SHALL NO WATER
ACCEPT OR APPROVE ANT PUNS OR SPECIFICATIONS THAI ME NOT SIAMPUI. O.RIRICAPONS INDICAILD HEREON MALL RUN ONLY 10 1111: PERSON
FOR WHOM VIE SURVEY IS PREPARED,AND ON 1115 9EHALF TO THF. NNE COMPANY. GOVERNMENTAL AGENCY AM LENDING MSIIUTION LISTED HEREON
AND TO THE ASSIGNEES OF ME LENDING INSIBURpT. CORRUGATIONS ARE NOt TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SURSEMENT OWNERS
SUFFOLK COUNTY TAX MAP DIST.11000 SECT.108 BLK.04 P/O LOT 7.1 BURTON
MAP NOv 9913 DATES OCTOBER H, 1996
LOT 6BEHRENDT i�,of NEIVY
,�"��
MAP OF ELIJ4IR'5 LANE ESTATES, SECTIONS SMITH 5 G.o,PO
LOCATIONS MATTITUCK PI+A I
ENGINEERS
TOWN OF SOUTHOLD. SUFFOLK COUNTY, NEW YORK ARCHITECTS
511RVEYORS
SURVEYED: MARCH 21 , 1987 PREPARED: NOVEMBER, 1996 �'
CERTIFIED TO: BUOVODANTONA ALIPERTI 244 EAST MAIN ST.
PATCHOGUE. N.Y. 11772
(516) 470-0349 .._
SCALE: I- = 50.00' FILE NO: 87-359-6 FAX 473-0361
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