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Home My WebLink AboutZ-19535 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE-EXISTING CERTIFICATE OF OCCUPANCY No Z-19535 Date NOVEMBER 27, 1990 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 940 PIKE STREET MATTITUCK, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 140 Block 3 Lot 10 Subdivision Filed Map No. Lot No. conforms substantially to the requirements for a Private One Family dwelling built prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF OCC. #Z-19535 . dated NOVEMBER 27, 1990 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 Q The certificate is issued to PEARL A. MAZGULSKI (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. Building Inspector Rev. 1/81 - - - - - i +, BUI LDI1•:G DEPART:•L:iT T0:•lN OF SOUTFiOLD, N. Y. HOUSIi:G CODE INSPECTION REPORT Location 940 PIKE STREET MATTITUCK, NEW YORK knumoer & street) kl,iunicipality) Subdivision Map No. Lot(;,) Name of Owner(s) PEARL A. MAZGULSKI Occupancy A-1 (type) owner-zenanz) Ad-Zitt ed by• JOHN BERKE ARnT Accompanied by: SAME Key available Suffolk Co. Tax No. 140-3-10 Source of request PEARL A. MAZGULSKI Date OCT. 23, 1990 D1,TELLING Type of Construction WOOD FRAME �StOr1eS 1 STORY Foundation CEMENT BLOCK Cellar FULL Crawl space Total rooms , lst. Fl 3 2nd. F1 - 3rd. Fl Bathroom(s) 1 FULL BATH Toilet room(s) Porch, type Deck, type Patio, type CEMENT Breezeway Garage Utility room (FRUNT-nRD) Type Heat OIL Warm Air FLOOR HEATER Hotwater Fireplace(s) NONE No. Faits 2 Airconditioni ng Domestic hotwater LILCO GAS Type heater Other ACCESSORY STRUCTURES: NONE Garage, type const. Storage, type const. Swi.:uning pool Guest, type const. Other VIOLATIONS:- CHAPTER 45—N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE - Lc,cation Description Art. 1 Sec. I I . I , • I Remarks Inspected by: Date of Insp, OCT. 23, 1990 G J FISH • Time start end,7. t vx ,,. --z 12,a,;-ri...,bd cy:`��."5.+.....r. :.i S. 5° J v 4 .r..h V' r � 4 • ' s a � ^zd `-. 3 _�.. ._.is�.c*.'s" •�^,�i.•�l .to-.tis t• + ..,.�'.c_ t r. 7- 07` 4 30 l/f q, • . Form No. 6 G LJ rp' �` TOWN OF SOUTHOLD / Td/�— ' BUILDING DEPARTMENT TOWN HALL 765-1802 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% 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 Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $/15.00, Commercial $15.00 Date . . . !.d.l.�!.� . . . . . . . . . . . . . . . . . . . . . . . . . . . Vew Construction. ��jjc(�!. . Old Or Pre-existing Building./. Location of Property'-, -$ . . . . P1 k� .. . . . . . . . .�1::�y.��V. .l . . .N . . . . . . . . . . . . House No. Street • . Hamlet )nwer or Owners of Property. . . . . . . :�:� Q:. . . „ . . . . . . . . . . . . . .. . . . . . . . . . �ounty Tax Map No 1000, Section. . . . . . . . .Block. . . . . . .. . . . . . . .Lot. . . . . .1.4. . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . ?ermit No. . . . . . . . . . . . . . . .Date Of Permit. . . . . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . iealth Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . ... . . . . . . . . . . . . . . . . . . . . Tanning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Zequest for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . . . . . . . �w� o$pp . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �� `f 7 r APPLICANT `Q•/ co 1 S 3 l CONC.s/DEWALK PIKE STREET DRILL HOLE/N \ x"IN CONC. DRILL HOLE/N /::6-'45'40'E 104.08' CONC.SIDEWALK S/DEWAL K 4,11,1 S708' ' 4,13 53.00 ' S.63°45'40"W. 175.67' I I U(A I Zt I m N63D45'40"El y I o I a /5.00' Ilk I c 1 q o O I VI I A I - / STORY n' FRAME V .•1 HOUSE PAT/O Ip UI � Q � I /4.9' a o I V STORY r FRANE O n HOUSE O � 2 y C� >s N N 90 NOTE ■=MONUMENT c li SUFF.CO.TAX MAP- DIST. SECT. EILK. LOT - I 1000 140 03 008 q II I 1000 140 03 009 II N 1000 140 03 010 b FRAME SHOPS GARAGE Oy I ✓EANA- OFrLOUS REVISIONS YOUNG 8c Y NFk y O.T SS 20 SHED SZ.97' t T /I KI 4.,3•—++ WOOD FENCE �I / 'n� S.67',T020"W� �� a O L/N 1 j 400 OSTRANDER AVENUE, RIV RHO �rrtV�y t /5.00 J 5 EN 402D"{f /O7/7, ALDEN W.YOUNG '� ARq. .Y UNG ENCRO —;� Ri ACHES O./1 PROFESSIONAL ENGINEER AND OR ENCROACHES 0.3• LAND SURVEYOR.N.Y.S.LIC.NO,12D45 IG.N 93 I SURVEY FOR: UNAUTHORIZED ALTERATION OR ADDITION TO Ak ✓.Q IHES THIS SURVEY IS A VIOLATION OF SECTION O.45893 J NQVNS T209 OF THE NEW YORK STATE EDUCATION PEARL A. MAZGULSKI STAN/SLAGY W/N/ARZ ESTATE LAWours I � COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED - TO BE A VALID TRUE COPY AT MATTITUCK GUARANTEED TO: GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE TOWN OF SURVEY IS PREPARED,AND ON HIS BEHALF sou THE �1 / TO THE TITLE COMPANY,GOVERNMENTAL HEREON,AND TO LENDING TIHE ASSIGNEES NOFI THE SUFFOLK CO., N.Y.STED eY LENDING INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE TO ADDITIONAL SCALE: 1�I_ =nI DATE:•11ttiF IC. IQQ7 NO ��'.;7n/) I CONSENT TO INSPECTION EA iZ Ii,4 MA-Zj6 v �'`r � I 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 ? I �`' f /l-7—/Tt/ck A/ which is shown and designated on the Suffolk County tax map as District 1000, Section , .Block Lot That the undersigned (has) (have) filed, 'or caused to be filed, an applica- tion in the Southold Town Building Inspector's Office for the following: 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: r (signatu e) (print name) (signature) (print name)