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Home My WebLink AboutZ-24818FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-24818 Date DECEMBER 24. 1996 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 3625 GRAND BLVD. MATTITUCK, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 107 Block 1 Lot 5.1 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a One Family Dwelling built Prior to: APRIL 9, 1957 OCCUPANCY NUMBER Z-24818 pursuant to which CERTIFICATE OF dated DECEMBER 24, 1996 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 GARAGE * The certificate is issued to HENRY J. & FLORENCE A. PAVLAK (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECT Rev. 1/81 BUILDING DE PATU "I".NT TOWN OF SOU"I'1101,I) 11011SING CODE, T'N'spl."UTION REPORT LOCATION: 3625 GRAND BLVD. MATTITUCK, N.Y. - i —in I � —er -W—!; IT e -e -I mull I C I pa I Ly SlIBI) I v I S I ON MAP NO - NAME OF owNrit HENRY PAVLAK OCCUPANCY SINGLE FAMILY ype ADMITT13-11) BY* HENRY PAVLAK ACCOMPANUU) BY: SAME KEY AVAJf,ABI,E--- MAP No - ---LQ( SOURCE OF REQUEST: -l.-------HENRY-PAVLAK — -------- DATr:19 1996_ I STORIES 1-1/2 1 EXITS 2 T—yPr IF CONS'T'RUCTION --- WOOD FRAME FOUNI)ATI ON CEMENT BLOCKFULL CRAWL,SPACr ---------- - - TOTAL IZOOMS, IST 310) Fillt-- IIATIMOOM (s) ------ -- TOILE.T Room 11TILITY ROOMREARMUD ROOM PORCH TYPI-, FRONTPORCH � I.Ypr. PATIO SIDE BACK FIRF"PLACE DOMESTIC 1107'WATEll xx TYPE 11FATER OFF BOILER AIRCONDITI.ONtNG TYPf-'. IIFIAT OIL WARM Alit 110TWATER xx O'rlltiRt WOOD BURNING STOVE ON __1973_____ ACCUESSORY STRUCTURES: CARACE., TYPE Or CONST. 2-1/2 CAR WOOD STORAGE, TYPE CONST. SWIMMING Pool. cm,-.s,r, 'ryvr. (,,()Nc;,r. - --- - ------ OTIMIt, ------ ---- -- --------------------------------------------------------------------------------------------------- ------------------------------------------ ---------------------------------------------------- VI.OLATIONS: (',IIAP'I'rR 45 N.Y. S*wf'r, UNIFORM FIRE 111trVrXTI.ON & BUlI,DINC cot)r LOCATION DESCRIPTION ART.-- SEC. INS11FICTE.1) BY CO Z-7419 (ADD) BP 1112302 - Co Z-11971 (ACCY GARAGE) DATE Of,- INSPEICTION—DEC. 23, 1996 N M. I4S---- TIME START 9:45 AM END 10-10 AN FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 — 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted = Yrear to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal—(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and Installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non -conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1, Certificate of occupancy $25:00 -- BUSINESS $50.00 2. Certificate of occupancy on pre-existing dwelling $50.00 3. Copy of certificate of occupancy $ 5 .•0 0 , over 5 years $10.00 4.Vacant Land C.O. $•20.00 5.Uodated C.O. $••50.00 Date Nov...1 ...1 ... ............ • - r NewConstruction...... Old orPre-existing Building . X.......... Vacant Land ...... Location of Property ......... Grand Avenue,.Matti tuck:. New, York .. . . . . .. . . . . ...... . . House No. Street Hamlet Owner or Owners of Property .. Henry, J.. Pavl ak,,, Jr; ; and. Florence, A.. Pavl ak..•... . . . . .. . .. . County Tax Map No. 1000 Section. Q7 .......... Block ........... Lot.. 5 -1 .......... . Subdivision .................................Filed Map No. ..........Lot No. ............. Permit No........... Date of Permit ..........Applicant ................................. . Health Dept. Approval ......... ...............Labor. Dept. Approval ......................... Underwriters Approval . .......................Planning Board Approval ...................... Request for Temporary Certificate .....................Final Cer ' i ate .................... . Fee Submitted $ .. , , 100. Q0 .................. . Construction on above described building and permit meets all p bI c dqs and regulations. �r-- -- Applicant ..:.GARY F ESQ•.......................... . P.O. BOX 706 now. to-to•7e CUTCHOGUE, U., N.Y. 11935 CONSENT TO INSPECTION Hrnry J. Pavlak Jr, and Florence A.,Pavlak 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 Grand Avenue, Mattituck, NY which is shown and designated on the Suffolk- County uffolkCounty tax map as District 1000, Section 107 , Block 1 Lot 5.1 . 1 That the undersigned (has) (have) filed, 'or caused to be filed. an applica- tion in`tho.southold Town Building lnspeaw. •o OULea Zew ♦ha fnllewing: One and one half story frame house 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 ' w knowledge and understanding that any information obtained In the conduct of such inspections may be used as evidence in subseq lations of the laws, ordinances, rules or Date d:�i� 4-6 8 uen prosecutions for vio- the Town/of Southold. r lee signature) e G (print name) (signature) (print name) / Southold Town Planning Board Ln Sm SOUTHOLD, L. Lt N. Y. 11971 PLANNING BOARD MEMBERS John NVI,ckholm, iChairman Henry Molaa Alfred Grebe Herta Fr nk C le or March 12�-1970 Gary F. Olsen, Esq. Main Road Mattituck, L.I., New York 11952 4 r Re: Henry John Pavlak Dear Sir; At a regular meeting of the Southold Town Planning Board held on March 11, 1970, the revised map for division of property of Henry John Pavlak, Grand Avenue, Mattituck, New York, was presented to the Board. Please be advised that the Board approves of the division of the above described property as shown on amended survey by Van Tuyl & Son, dated March 51 1970. Yours truly)), q/& (,l./�� C� Joh" n ickham# Chairman Southold Town Planning Board JW/bn t , ;';, TOWN OF SOUTHOLD PROPERTY RECORD CARD/ OWNER STREET // < VILLAGE DIST. SUB. LOT ORMERR N E ACR. U, � r d��. ( W -te �- =' r TYPE 111111-111 r5Y � •� RES D SEAS. VL. FARM COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKS 9 0o Q 0 I �'- i✓ D a 1 s r� lbs -Y70 2 v U0 o 0 iy 2 j' j �� ./ l AC IO D -c1 J- 1 J Jo 5 U d a "D Q ! j C/ O j ~� r e / LL/Y7Gp�/ ;/M,' 4>19 1 d --o b L 66,9� ji. (' Z-u� %+3G v -5-.5 C) % br =rJe- / 4 e `� c2 '1, tea ��. ^� 2- iC.?d-y.�<<.� _ y �^ B CON JTI Na `� 02 f RL A F' 81 1p J3 1ip.^11-16f1 +' . NEW NORMAL BELOW ABOVE ��'�� / �3a z C�ny�S/. (zccrss �jaiag� �.P• FARM Acre Value Per Acre Value I /F�'� I _ 9F?,�� I+-3T..r - 512114 11 5F3 1- -) n 1y'x•11, , _ PSIy Tillable 1 Tillable 2 Tillable 3 Woodland Swampland FRONTAGE ON WATER f Brushland FRONTAGE ON ROAD' � r M 2_ House Plot DEPTH I BULKHEAD Totgl- ,,.t DOCK IV BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT T.00A'PTON:3� hS number & street municipality SUBDIVISION MAP NO. LOT(s) NAME OF OWNER (s) ze OCCUPANCY�j1'i l (type owner -tenant ADMITTED BY: ACCOMPANIED BY:— KEY AVAILABLE SUFE . CO . TAR MAP NO. SOURCE OF REQUEST: DATE: DWELLING: / TYPE OF CONSTRUCTION /�/�.Q �� //� # STORIES < EXITS FOUNDATION6^,-1�131aafl CELLAR k4le" _ CRAWL SPACE- — -- TOTAL ROOMS: IST FLR. 2ND FLR.*)_ 3RD FLR._ BATHROOM (s) 4- TOILET ROOM (s) _ UTILITY ROOM_ PORCH TYPE-�� 't�- BECK, TYPE PATIO BR17EZEWAY FIREPLACE GA/RAGE DOMESTIC HOTWATER TYPE HEATER a�l-�'�LAIRCONDITION G - TYPE HEAT-- f WARM AIR — HOTWATER — _ OTI1ER:—d- /0 p -------- ACCESSORY STRUCTURES: GARAGE, TYPE OF SWIMMING P00L OTHER: CONST. G(,04_ STORAGE, TYPE CONST. GUEST, TYPE CONST. VIOLATIONS: CHAPTER 45 N.Y. SPATE UNIFORM FIRE PREVENTION h BUILDING CODE REMARKS: I NSPECTIED 11 DA'Z'E OF INSPECTION —/ _71�0 TIME START� END / i%