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Home My WebLink AboutZ-24943FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-24943 Date MARCH 19, 1997 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 810 HOLBROOK LANE MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section Subdivision 113 Block 6 Lot 10 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-24943 dated MARCH 19, 1997 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 WITH ACCESSORY STORAGE WOOD SHED The certificate is issued to EDWARD & JUNE GIBSON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. B ding insp for Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCAT[ON: 810 HOLBROOK LANE MATTITUCK, N.Y. _ number & streets municipality SUBDIVISION MAP NO. LOT(s) NAME OF OWNER (s) EDWARD h JUNE GIBSON OCCUPANCY SINGLE FAMILY type (owner -tenant ADMITTED BY: MARGARET RUTKOWSKI ACCOMPANIED BY: SAME KEY AVAILABLE SUFF.CO. TAX MAP NO. 1000-113-6-10 SOURCE OF REQUEST: PATRICIA A. MOORE, ATTY DATE: FEB. 242 1997 _ DWELLING: TYPE OF CONSTRUCTION WOOD FRAME FOUNDATION BLOCK CEILLAR FULL T[TTAL. ROOMS: IST FI.R. 5 2ND FL.R. 3 3RD PLR. BATHROOM (s) 1 TOILET ROOM (s) 1 UTILITY ROOM PORCH 'TYPE BREEZEWAY DOMESTIC HOTWATER FURNACE TYPE NEAT OIL HOT WATER _# STORIES 1-1/2 # EXTTS__3_ CRAWL SPACE OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST SWIMMING POOL. OTHER: -------------------------------------------------------------------------- -------------------------------------------------------------------------- VIOLATIONS: CHAPTER 45 N.Y. S'L'ATE UNIFORM FIRE PREVENTION b BUILDING CODE FIREPLACE TYPE HEATER WARM AIR DECK, 'TYPE WOOD OIL PATIO GARAGE AIRCONDITIONING IIOTWATER FURNACE WOOD FRAME S'T'ORAGE, TYPE CONST. WOOD SHED , G[lES'T, TYPE CONST. LOCATION DESCRIPTION I ART. SEC. REMARKS: BP #4905-Z-COZ-4145 (add/alt) BP #13768-COZ-16574 (add), BP #23987-Z-COZ-24941 (Wood Stove) CO Z-24942 Ile - (Accy Garage) INSECTED INSPECTED BY DATE OF INSPECTION MARCH 5, 1997/MARCH_14, 1997 -- MICHAEL VERITY -- — -- TIME START 10:15 AM END 11:20 AM Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 FEB 2 41997 - BLDG. DEPT "1: OF SC APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: 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,Z 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 a 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 Buildine - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00•, Commercial $15.00 Date ............ F?b,.19,.1997................ New Construction........... Old Or Pre-existing Building .... X..... House & Garage Location of Property..,, 810 Holbrook Lane Mattituck House No. Street Hamlet Onwer or Owners of Property... Edward Gibson and June Gibson P Y................................................................. County Tax Map No 1000, Section.., 113 ........ Block ..... 6.......... Lot ... 10 ................. Subdivision....................................Fi.led MaP ............Lot...................... Permit No................Date Of Permit ................ Applicant. Edw�Lpd,¢,,June,Gibson Health Dept. Approval ...................... ..Underwriters Approval... .................... Planning Board Approval.. ....................... Request for: Temporary Certificate.......... Final Certicate.... $...... Fee Submitted: $.,,,,,,100.00 �/6 r Patricia .. ..Gibs. e�� or�Edwa I I tl3 /PLICANT Gibsbny arc�....,K.,-c•; CONSENT TO INSPECTION Edward Gibson and June Gibson the undersigned, Owner(s) Name(s) do(es) hereby state: That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at 810 Holbrook Lane, Mattituck, NY 11952 which is shown and designated on the Suffolk County tax map as District 1000, Section 113 , Block 6 , Lot 10 That the undersigned (has) (nave) filed, or caused to be filed, an applica- tion in the Southold Town Building Inspector's Office for the following: Certificate of Occupancy on Pre-existing Building for house and garage 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 as evidence in subsequent prosecutions for vio- lations of the laws, ordinances, rules or regulations of the Town of Southold. Dated: February 20, 1997 (signature) Patricia Moore, attorney for Edward & June Gibson (print name) (signature) (print name) HOLBROOK RD TIE= 194.73' N 83°11 '30"W I CM P 90' FD FD. Y O N O 4- (k: O Z SURVEY OF DESCRIBED PROPERTY SITUATE MA T TI TUCK, TOWN OF SOU THOL D SUFFOLK CO., N.Y. SURVEYED FOR THOMAS P. ROCHE DONNA M. ROCHE GUARANTEED TO: THOMAS P ROCHE DONNA M. ROCHE RIDGEWOOD SAVINGS BANK FIDELITY TITLE INS. CO. TOWN OF SOUTHOLD AREA = 24,265953 S. F or O. 5571 Acres IP FD. = IRON PIPE FOUND CM FD. = CONCRETE MONUMENT FOUND Guarantees indicated here on shall nun only to the person for whom the survey is prepared, and on his behalf to the title compeny, Covermental Agency, len.'.i :g insGtJ;cn, if listed hereon, and to the cssicnees of the lending irslitution. C ucrantees are not transicroble to additional institutions or s.bsequsnt owners. Unauthorized alteration or addition to this survey i; a violation of Section 7209 of 'lu t"ew Ycr! State Edcccticn Law. Ccpies of this survey mop not bearing the Lcnd Surveyors embussed seal shall not be considered to be a valid true pony. 0 O 0 O m 2� 31 64'N F pRPCE G . (Private) 751 1*10 'TILIT POLE m 2A �Ia N ?IVEWAY OVER 6.5'f CELLAR i £NT. 1 CHIMNEY O 11.3' B4 12.6 2 STORY W WOOD FRAME RES. 2.4 - 0 1 m X6.3 N d fA co bo R.0 I. P ON LINE —, l 15.0 FRAME f„ SHED O co APPROX. H. W. L. S8502e1211E S?� 39.21 38.9 HOWARDS BEACH of MATT/TUCK CREEK 41 N W v SURVEYED 4 JANUARY, 1997 SCAL E I " _ 40' SURVEYED BY : STANLEY ✓. ISAKSEN, ✓R PO BOX 294 NEW SUFFOLK, N.Y, 11956 (516) 734- 5835 97R617 LOCATION: g129 V. (number & street SUBDIVISION NAME OF OWNER (s) OCCUPANCY 14* � BUILDING DEPARTMENT TOWN OF SOUTHOLD ING CODE INSPECTION REPORT , '--o A ? g � e MAP N0. LOT(s) owner -tenant ty ADMITTED BY:ACCOMPANIED BY: KEY AVAILABLE SUFF . CO . TAX MAP NO. /p p o - / 3 - G - /0 SOURCE OF REQUEST: DATE:-- Z-/'Z'O/'r % DWELLING: TYPE OF CONSTRUCTION. FOUNDATION _116` — CELLAR 7 TOTAL ROOMS: IST FLR. ,� 2ND FLR. 3 3RD FLR. BATHROOM (s) TOILET ROOM (s) _ / UTILITY ROOM PORCH TYPE _ DECK, TYPE PATIO { # STORIES � �, # E%ITS CRAWL SPACE BREEZEWAY FIREPLACE -"'-'— DOMESTIC HOTWATER TYPE HEATER TYPE HEAT a4�— WARM AIR OTHER: GARAGE AIRCONDITIONI G HOTWATER ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. "2%�/a+Q" �•.e STORAGE, TYPE CONST. SWIMMING POOL , GUEST, TYPE CONST. OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE START /0,'/ �