HomeMy WebLinkAboutZ-33001FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
NO: Z- 33001
THIS CERTIFIES that the building
DWELLING
Date: 04/28/08
Location of Property 3340 PARK AVE MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 123 Block 0008 Lot 021
Subdivision
Filed Map NO. Lot NO.
conforms substantially to the Requirements for a ONE FAMILY DWELLING
built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z- 33001 dated APRIL 28, 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 ONE FAMILY DWELLING*
The certificate is issued to DOUGLAS W. & MARCIA G. POLLOCK
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL
NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
Rev. 1/81
(OWNER)
N/A
N/A
N/A
Aut orized Signature
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 3340 PARK AVE MATTITUCK
SUBDIVISION: NAP NO.: IAT (S)
NAME OF OWNER (S): DOUGLAS W. & MARCIA G. POLLOCK
OCCUPANCY: SINGLE FAMILY DWELLING DOUGLAS W. & MARCIA G. POLLOCK
ADMITTED BY: OWNER ACCOMPANIED BY: SAME
HEY AVAILABLE: SUFF. CO. TAX MAP NO.: 123.-8-21
SOURCE OF RHQUEST: IRA L. ZANKEL, ATTY 4/17/08 DATE: 04/28/08
DWELLING:
TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 1.0 # EXITS: 2
FOUNDATION: POURED CONCRETE & CEMENT BLOCK CELLAR: PART CBAML SPACE: PART
TOTAL ROOKS: IST FLR.: 7 2ND FLR.: 0 3RD FLR.: 0
BATIBOOM(S): 2.0 TOILET ROOM (S): 0.0 UTILITY ROOM(S):
PORCH TYPE: WOOD FRAME DECK TYPE: WOOD PATIO TYPE:
BRH1923M11Y• FIREPLACE: GARAGE:
DOMESTIC BOTHATER: YES TYPE HEATER: AIRCQIDITIONING:
TYPE BEAT: GAS MARK AIR: YES HO TATER. YES
OTHER: ELECTRIC HOT WATER HEATER
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONEY.:
SNMRNG POOL:
.. ..y. �.
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
REMARKS: BP#1918ZCOZ1573 (ADD) BP#11989ZCOZ11726 (ADDS) BP#24211ZCOZ25700 (DECK ADD)
INSPECTED BY:
GEORGE
DATE ON INSPECTION: 04/25/08
TINE START: END:
HPR-iT-2e13E 10;40 EROM:WICkAM SREIM 531 295 5565 TC:51646660,12 P. 6021006
I
Irorm NorF
TOW,; OF SOVTROLD
BUILDING DEPARTMENT
Towle BALL
^65-1801
APPLICATION FOR CERTIFICATE OFOCCLiPANCY
This application trust L•c Cl1cd in by tA.)!!writer o iak and submittecl to the Building Department Wilh 1]',c following
A. For new building or new uce;
1. Final survry of property with ac:xtratt: loralion of all buildins, property lines, streets, and unnsUal t>iatural or
renographic features.
2. FjnaJ Approval from ?lcalth ,Du -t. of water ,upp,y and setve,ra.r c -disposal (S-9 form).
3. Approvalofelectrical installation frnmJ3oard of Fire Underwriters,
4. Swom statement from phjrnber ratifying that the soleer used in s}stem contalrts less than 2/lG of 1°io lead,
5. Commercial building, industri;tl building, mu1l:Jplc ruaid'gnces and sin lar buildings and installation=, a certificate
of Code Compliance from architect or engineer responsible for The building.
6. Submit .Platuting Board Approval of completed site plan requiremcnrs,
B. Icor existing buildings (prior to April 9, 195') non-epnforning uses, or buildings and "pre-existing" laud uses:
1, A,rcurat:e survey of property s nwint, all property lines, i; tceta, building and unusaai .rat Fal or topographic
feaf4lre$,
2. A properly completed application and cotascnt to inspect signed by thte applicant. If a Certificate at Occupancy is
denied, file 131ulding Inspeclor sllall state the reasons therelf'or in writing to the applic nt.
C. Fees
I. Cettificale of Oeeupurcy- Now dwelling, .$25.00, Additions to dwelling 525,00, .Altere.limts to dwelling $25,00,
Swimming pee] $25.00, Accessory building, 825.00, Additions to accessory building 525.00, Businesses
2. Certificate of Oeeupancy en Pre-existing Building - $100100
3. Copy of Certificate of Oecupaucy - $15
4. UpdatedCcrificalaofCiccttpaacy- $50.00
5, Temporary Octt�:ftcatc of4�ccupancy - ResidenliaL $15.G0,'Cotnmercia; 5J SAO
Date. April. 16, 2008
NcwConsuucti,onrOld or Pre-exishngBuilding:_ X {check on for a are story £ratne
dwelling.
l.acati.on of P.ropetty: 3344 Park Avenue Mattat„nk
Kousc No, Sweat
Owner ar Owners 6f propmy: Douglas William, Pollack and Marcia Glen Pal -lock
Sc1folk County Tax N!l p No 1000, Section 123 Block S Jot _ 21
Subdivision — -----.--Filed Map, _ T,01:
Pen' it NO Date of peraaiit,__ Applicant:
Health, Dept, Appr-oval: Underwriters Approval:
Planning Board Approval:
Request for; Temporary Certificate
I?= Submitted; $ 140.00
�� c� 33001
Final Ce tAcate; x (check one
Applicant Signa -mile
RPF -17-2008 10:41 FROM:WIiCK.P[I BP 631 2383.. __ T0:51E466504c P. OC,3, 007
CONSENT TO Pv5° CTTnI f
DOUGLAS WILLLAM POLLOCK AK'D MARCIA GLEN POLt_,OCK
_ tha undersiPed, do(c0 hereby state:
�ovmcz(s) Nat:uc(s)
That the undersigned (Is) (are) the owner(s) ofthe premises in lic Town of
Southold, boated at 3340 Park Avenue, Matrt ruck, New York 11932
which is shown and designated on 1.11c t uffnll Couniy fax1vla.n as Distr of 100p,
SectSon 1.23-__, Blo& 8 Lot 21 _
That the undorsigued (has) (nave) filed, or cause 10 he flied, at application in the
Southold Town 3u11dinP Inspeotar's Office f+lr the following: for a. Pre -Existing,
Ilse Certificate of Occupancy for acts story frame dwellin
S.
Tbat the undersigned do(es) l:,emby giye consent to the Building Inspectors of the
Town of Southold to enter upon flee above descnbcd property, including any and a.11
buildings located thereon, to conduct such inspections as theymay deem necessary vii
respec to tie aforesaid application, inclldinginspections to determine that Said premise's
ccAnply witu. all of the laws, ordinetnces, Ales turd regolat'.0ns.of'ihe Town of Southold.
The undersigned, in consenting lc+ such inspections, do(es) so with the k, 1W)
and unclerst4nding that any information obtained in the eanduc! of such iuispectiona may
be used it subsequent prosecutions for violations Of the Iaws, ordinances, rule; or
mgWations of the Town of Southold..
Dattd: �Anr t1. 2008
(Signature)
Pollock
(1?13111 ')
(Siginabur,c) _
Marcia. Glen poll.ock
(Print Na,,ae) ��
,li:....
TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER
STREET
VILLAGE
DIST. SUB. LOT
/ d
W �� Yt `✓ e ,
�i�!L .:,, '�"sT��
-/ �1zz:';i-`r `s- d-.a�'..... �.^f_
FORMER OWNER2�I
N
E
ACR.
O
S
W
PE OF BUILDING _
S
r;
:ES. C O
SEAS. t
VL.
FARM
COMM. CB. ISC. Mkt. Value
= 14C2- Mlc�oaNnclii= �a I�mi u Y
LAND
IMP.
TOTAL
DATE
REMARKSa I J
r F_:a
0
/C7
/&0O
�v � LG-rP'f
o c :- ,
r/i4Ike) %6 2 >�:,ia i,.�L ±J' %hnLliPf f,C
Ike)
300
A e
: %jam 1
�c c , Sa v
AGE
BUILDING CONDITION
.
NEW
NORMAL
BELOW
ABOVE
l
IfD Ci�-�IISP S D ' Q +ke— PpI fi)6� 4 W'tj' aS�fODZ
Pp
FARM
Acre
Value Per
Acre
Value�)j
-xt
(✓� 9f�"C'�' v �(�' 'r)';'!' �� ���
Fillable 1
Fillable 2
-illable 3
Woodland
;wamplond FRONTAGE ON WATER
3rushland FRONTAGE ON ROAD
louse Plot DEPTH
BULKHEAD
Fatal DOCK
M. Bldg/. J
Extension
-:7
s
Extension
J
Extension'
Basement Aiwf4yiWc�
r piers
Floors
Porch
ext. Walls
Porch'
0
/Fire
Place
G.
Garage
Patio
O. B.
Total
COLOR
TRIM
Dinette
K.
LR.
DR.
BR.
FIN. B.
Foundation
Both
Basement Aiwf4yiWc�
r piers
Floors
ext. Walls
Interior Finish
/Fire
Place
G.
Heat 3�g8
y6
Type Roof
Rooms 1st Floor
Recreation Room
Rooms 2nd Floor
Dormer
Dinette
K.
LR.
DR.
BR.
FIN. B.
SURYT---Y OF PROPERTY
51TUATE: MATTITUCK
TOWN: 5OUTHOLD
5UFFOLK COUNTY, NY
SURVEYED APRIL 8, 2008
APRIL 15, 2008
SUFFOLK GOUNTY TAX u
1000-123-8-21
c4/.
�0 0
'� \
NOTE5:
Area = q,761 5q. Ft.
Area = 0.2241 Acres
N
W e E
S
CMSTOPHER E. ROSS
MIICHELLE S. ]ROSS
HMSON CrrY SAVINGS BANK
,OMMONWEALTH LAM TIME
INSURANCE CONFANY
LIL IHEDGE GRASS
5EAGH
tie line alon
� 9 A.H.W.
N83 °33'0611N
51.72'\,
GREAT PiR ®XT717�AN
.1 1—d LI
JOHN C. EHLERS LAND SURVEYOR
6 EAST MAIN STREET
N.Y.S. LIC. NO. 50202
RIVERHEAD, N.Y. 11901
369-8288 Fax 369-8287 REF.\\Compagserver\pros\08\08-132.pro
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N O L/L
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W e E
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CMSTOPHER E. ROSS
MIICHELLE S. ]ROSS
HMSON CrrY SAVINGS BANK
,OMMONWEALTH LAM TIME
INSURANCE CONFANY
LIL IHEDGE GRASS
5EAGH
tie line alon
� 9 A.H.W.
N83 °33'0611N
51.72'\,
GREAT PiR ®XT717�AN
.1 1—d LI
JOHN C. EHLERS LAND SURVEYOR
6 EAST MAIN STREET
N.Y.S. LIC. NO. 50202
RIVERHEAD, N.Y. 11901
369-8288 Fax 369-8287 REF.\\Compagserver\pros\08\08-132.pro
LOCATION: 3 3 LI -0 ! 'NA
(number & street)
SUBDIVISION: '
NAME OF OWNER(S): .
OCCUPANCY: /
0-0-4-f
MAP NO.:
(municipality)
LOT(S):
(type) il. (owner -tenant)
ADMITTED BY: ACCOMPANIED BY: �---
KEY AVAILABLE: SUFF. CO. TAX MAP NO.1000- /A 3 — $ — � I
SOURCE OF REQUEST: DATE: q --1(o —o g
DWELLING:
TYPE OF CONST UCTION: W*-tk # STORIES: # EXITS: 1;LFOUNDATION: � Cav'c�1�7 _ d-- LLAR: ei¢ CRAWL SPACE:
TOTAL ROOMS: 1S FLR: 7 2ND FLR: — 3RD FIR:
BATHROOM(S): TOILET ROOM(S): UTILITY ROOM:
PORCH TYPE: _ ooh P�PqC DECK, TYPE: iNoo PATIO, TYPE: ---
BREEZEWAY: FIREPLACE: GARAGE:
DOMESTIC HOTWATERTYPE HEATER: AIRCONDITIONING: ---
TYPE HEAT: 40 (94S WARM AIR: M5 HOTWATER: >e
OTHER: W
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.:
SWIMMING POOL:
OTHER:
/ &vF
STORAGE, TYPE CONST.:
GUEST, TYPE CONST:
VIOLATIONS: CHAPTER 144 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
INSPECTED BY:
DATE OF INSPECTION:
Al, 2 -s -e �
TIME START: END: