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HomeMy WebLinkAboutZ-32956FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 32956 Date: 04/01/08 THIS CERTIFIES that the building ACCESSORY Location of Property 750 HOLBROOK LA MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Nap No. 473889 Section 113 Block 0006 Lot 009 Subdivision Filed Nap No. Lot No. conforms substantially to the Requirements for a ACCESSORY STRUCTURE built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 32956 dated APRIL 1, 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 ACCESSORY BOAT SHED* The certificate is issued to EVELYN M JAHN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. Au horized Signature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 750 HOLBROOK LA MATTITUCK SUBDIVISION• MAP NO. IAT (S) NAME OF OWNER (S): EVELYN M JAHN OCCUPANCY: EVELYN M JAHN ADMITTED BY: AfXX*G?ANIND BY: KEY AVAILABLE: BUFF. OD. TAX MAP HO.: 113.-6-9 SOURCE OF REQUEST: ROSEMARY MARTIN - 3/24/08 DATE: 04/01/0 DWELLING: TYPE OF COISTRUMCK• FOONIATICK: TOTAL ROCKS: IST FLR.• 0 BATBROON(S): 0.0 PORCH TYPE: BREEZEMAY: DOMESTIC BOTMATER: # STORIES: 0.0 # EXITS: 0 CELLAR; CRAWL SPACE: 2ND FLR_• 0 3RD FLR.• 0 TOILET ROCK(S): 0.0 UTILITY ROOM(S): DECK TYPE: PATIO TYPE: FIREPLACE: TYPE HBATER: AIRCONDITICKING: TYPE BEAT: NARK AIR: BO'IWATER: OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: SKIING POOL: OTHER: STORAGE, TYPE OOKSY.: BOAT SHED VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE REMARKS: BP#19464Z-COZ19837(NEW DWELLING)-BP#33377Z-COZ32955 (DECK ADDITION) H •'•H' � 1 1' }:II 2a Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT 110NN'N BALL 765-1802 C�C_u 51(t 33 t", yF5 ? AP LICATION 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. Q 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. �' J Z. New Construction: Old or Pre-existing/ Building: � // (check one) —7 Location of Property: / SO N41 I b ,re, o IC L. a k R - 'I-. r Y k C House No. Street Hamlet Owner or Owners of Property: C— S't�Y E! e tf Ca G� [� Suffolk County Tax Map No 1000, Section �) 3 © Block 600 Lot O Subdivision Filed Map. Lot: Permit No. Date ofPenuit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) ,- Fee Submitted: $ /00,00 A Signature 3_Rc-74Oti7 �kcot 3A5G CONSENT TO INSPECTION the undersigned, do(es) hereby state: Owner(s) Name(s) That the undersigned (is) (are) the owner(s) of the premises in the Town of L Southold, located at '7 S 0 k") Ivan � Lau.e.t�(Q Fy ."* which is shown and designated on the Suffolk County Tax Map as District 1000, Section // 3 ry Block (o o 0, Lot i 06 0 That the undersigned (has) (have) filed, or cause to be filed, an application in the Southold Town Puilding Inspector's Office for the following: Ge _W ©cc uP�z c l ✓ „_� l_ That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, including any and all buildings located thereon, to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that said premises comply with all of the laws, ordinances, rules and regulations of the Town of Southold. The undersigned, in consenting to such inspections, do(es) so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used in subsequent prosecutions for violations of the laws, ordinances, rules or regulations of the Town of Southold. Z /Z Dated: Z/©a (Signature) (Print Name) JIM OL Ell IF � W2k Fir OEM. i ios 6i "Imump 0 Hydrographic Map Prepared for: Carol Kafka Surveyed: August 7, 2007 SCT# 1000-113-6-9 Situate: Mattituck Creek Town: Southold Suffolk County, NY Datum: Low Water Tide: 5' +/- r' = 40' SEA LEVEL MAPPING 631-722-3390 P.O. Box # 366 Aquebogue, NY 11931 House u Lan Holbrook Lane Wetlond Boundary 'O HW h nary. --- 3 -------'- 02 -0 6 -ok -14 -1.3 -0q-----------------------------__.._ _ _ -1.5 _____-______________.___. —2 -2.4 -2.7 _ .__.._._ 2.3. -2.3 3,1 - -4 ------------------ .--------- --------------- 51 5.5 Dock 6h 61 ----------------- H 0 Ward's __.___.____.__ Howard's Branch of Mattit; uck Creek Flood Dook Mgrsh book N W*E S ------------------- Dock ROBERT 'LS NYS PLS# 50197 '112001 8.50.1 AM S. S.M\kaFkcr.pro m s O S L O O nT - O m i u O J O � O« OF N # -6 J N 6 J Wetlond Boundary 'O HW h nary. --- 3 -------'- 02 -0 6 -ok -14 -1.3 -0q-----------------------------__.._ _ _ -1.5 _____-______________.___. —2 -2.4 -2.7 _ .__.._._ 2.3. -2.3 3,1 - -4 ------------------ .--------- --------------- 51 5.5 Dock 6h 61 ----------------- H 0 Ward's __.___.____.__ Howard's Branch of Mattit; uck Creek Flood Dook Mgrsh book N W*E S ------------------- Dock ROBERT 'LS NYS PLS# 50197 '112001 8.50.1 AM S. S.M\kaFkcr.pro S�JFFOLK GO; HEALT H•DEfT APPROVAL Al_ lI STATEMENT OF INTENT I. THE WATER SUPPLY AND ScWAGE DISPOSAL Alf 7 rit"f� ...":' i`s.' .SYSTEMS FOR THIS RESIf`3ENCE WILL; . :� r / '- — - CONFORM TO THE -S7,k IWJC' S CF THE SUFFOLK CO.DEPT OF HEALTH SERVICES.. APPLICANT . r• SUFFOLK COUNFT V DEPT: . •OF' .HEALTH . fi-C _ 5 E R VI C)E�S — FOR APPROVAL FOP, � / r E4 3 ` o CONSTRUCTIONDNLY t 01 ,Y J`: ,\frCi�p ./ -mss ^✓- i C� �...CUI�'' �/'� \ `ct 3 _ DATE:. - / H 1 5 R EF.'NO eve:-, ,j "><• t�� _ --i 7 •'+� .'APPROVE D: SUFFOLK CO. YO.X MAP DESIGNATION: 615T. SECT. &LOCK WNERS ADDRESS; cb\�' - fir'5 fC l c ��r Fti -aE n Southold i X7 5 Board of Tru= r,, TEST .HOLE :.ST -AMP _. F•C'Yi%?:. 8Jl�Lfi'JV`' rrrj'.�.r c. +:.Cv. —� ..�. .�� - - 'f: :or -. .. ;�/ or4.:at AA�'r^• \ \ tiG Id A L. 1._ fi LSf � Y w+t�` atr nrg r• "21 1.7913 NOP$OUTHOLD n r lul b4 1 P rson W \\ - / 3 - 1 m sc S 1 u o7 Jlo landma anti insLluti4na or subaeaumt P1P "i TT? Cln�� ` -.1 l f 4 4N^`\fi\t 7 01.11-1 1 r.!EI. VANE TUYL. P C. '� 'v�LL-'"�`orAar6lJS ^'ffDGr_t�O $`•.cwtJ E'c LICENSED LA SURVEYOR$ ND .,_+�.�'.� _t._t 'ss ti .)!. .,;?- '1 (:_. GREENP�RT hif16[ YORK _ ArIW LOCATION: 1"50 Tt6" �-- (number & street) SUBDIVISION: MAP NO.: NAME OF OWNER(S): o- OCCUPANCY: (tylk) (municipality) LOT(S): (owner -tenant) ADMITTED BY: ACCOMPANIED BY: KEY AVAILABLE: SUFF. CO. TAX MAP NO. 1000- 3 — SOURCE OF REQUEST: DATE: DWELLING: TYPE OF CONSTRUCTION: FOUNDATION: TOTAL ROOMS: IST FLR: BATHROOM(S): PORCH TYPE: BREEZEWAY: DOMESTIC HOTWATER: _ TYPE HEAT: OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: SWIMMING POOL: OTHER: # STORIES: # EXITS: _ CELLAR: CRAWL SPACE: 2ND FLR: 3RD FLR: TOILET ROOM(S): UTILITY ROOM: DECK, TYPE: PATIO, TYPE: FIREPLACE: GARAGE: _ TYPE HEATER: AIRCONDITIONING: _ WARM AIR: HOTWATER: STORAGE, TYPE CONST.: GUEST, TYPE CONST: VIOLATIONS: CHAPTER 144 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE REMARKS: INSPECTED BY: DATE OF INSPECTION: �?— 9-'%a e, TIME START: END: