HomeMy WebLinkAbout23872-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
No. Z-24820 Date: DECEMBER 26, 1996
THIS CERTIFIES that the building ACCESSORY
Location of Property 715 DEEPHOLE DRIVE MATTITUCK, N.Y.
House No. Street Hamlet
County Tag Map No. Section 115 Block 13 Lot 7
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DEC. 23, 1996 pursuant to which
Building Permit No. 23872-Z Dated DEC. 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 ACCESSORY GARAGE "AS BUILT" BETWEEN 1958 S 1966 AS APPLIED FOR.
The certificate is issued to: EDWARD & VERONICA TABORSKY
OWNER
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH'APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED: N/A
Bu' dineInspector
Rev. 1/81
FORM NO. e
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N° 23872 Z ate ........................................ 19..q.6
'v
Permission is hereby granted to:
. ...... .............. .. ..........................
.. ... ....� ....................
to .. '..?.' .�. .... . .... .... .... . . ....�....... . ...... .... .....4°
ofpremises located at . . 1.. .'... .. . ... .. . ..... ... .................................................
.................................................... ... ...........................................................................
.................................................................................................................................................................
County Tax Map No. 1000 Section .....tl�............ Block .... ......... Lot No. ........ ..,/ .....
Ppursuant to application dated �� y. 19 �f and approved by the
PP ........ ................................ .. ,
Building Inspector.
c3..5
Fee $....... . ..........
......... ...... .,?. � 1. .J... .
i . ,�.�.: ..............
�g nspector
Rev. 6/30/80
-m
r
n TOSvi1 0; SOUTHOLD
aC iLDi�-rC OtP tiu2TMEv7
OSv�i ;'L47 T
A_pDL=CATION FOR CERTIFICATE OF OCCUP ANC
apD"Cation. !Rust be =filled __. by typeWriter OF, ink and submitted =o :he bu'ld'nc
inspector w:tn the -ollowing: for new building or new use:
Final Survey of property With accurata location oI all bui-ldings , proper:-- lines,
streets, and unusual natural or topographic features.
-. -final Approval Lrom Health Deft. of Water supply and sawerage-disposalrS form)
J. Approval of alectrical install from. Board Or lire URder'.Jriter5.
- Sworn Sworn statement from plumber certirving that the solder used in systam contains
^ less than 2/10 of la lead.
D. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certliicate of Code Compliance from architect Or engineer
responsible for the building.
b. Submit ?fanning Board', Approval of completed site plan reouirements.
IF
3. ^or existing buildings prior to April 9, 1957) non-conforming uses, or buildings and
rpre-existing" land uses:
Accurate survey of propert-J showing all property lines, strzets, bu ding and
unusual natural or topographic features.
A properly completed aup location and a consent to rspect si-.ied by the auu licant.
=- a Certificate of Occupancy is denied, the Buildinaj 1nSpeCtor Shall State the
reasons therefor in ;4-r iting to the applicant.
w o o S
OZrt1i4_Cate OEL Occupancy - New dwelling $2� .00; Additions CC dwelling 325.00,
Alterations to dwelling 525.00, Swimming pool $25.00, ACcessory building S25.00,
:additions to accessory building S25-00. Businesses 550.00.
_. Certificate of Occupancy on Pre-existing Buildi
ng - $100.00
r -
�• Copy o .ertificate or Occunanc - .25r,
Updated Cer=ificate of OcclIpaLlCy - S50.00
J. Temporary Cartificate of Occupancy - Residential 515.10, Commercial S15.00
Data .4.Z"J. f. . -5 . . . . . . . . . . . . . . . . . . . . .
iew Con i_s�ruct�on. . . . . . . . . . Old Or Pre-exist Buiiding. . . . . .
:�ocation of Property. �K �. . . . -�. ��e.��rc . . .Ne,-'6
House No i� Street ,Hamlet
�nwer or Owners of property..0 c7V.!7 v C�
.punt, Tax Map No 1000, Section. . �. . . . . .3-ack. . � . . . . . . . . .Lot. �d�. . . . . . . . . . . . . .
'ubdiJision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . =;Ie ' Man . . . . . . ' r
jot. . . . . . . . . . . . . .
NO. //� .Da^ta 0- Par,Ri:. . . . . �F . .AODIicanz �.8r.s . . �.�.�.�J`�
:ea_tz Dept. Approvai. . . . . . . . . —�.�� . . . . . . . ..Undervritar. ==pprovai . . . . . . . . . . . . . . . . . .
n oard A pD royal. . . . . . . . . . . . . ...
g Hest f o _amLtOCa ✓ -'-r i Kate. . . . . . . . . . . _ _nal CartiCa:a. . . . .
✓�Ce -OLv;J Oc SOU-HOLD
r
a j7D vG �P,h�___ —
TM HA I
-_S02
APPLICATION PO El Cc' =C� O.=I ,_L P CCCUP^1NC=
... T n_s application must be _riled in by tvpewL_..er O ink and Submitted _o the bun-
inspector with the following: for new building or aew use:
Final survey of property With accurate iocat'OP. OL all buildings, property iineS
Streets, and unusual natural or topographic features.
:. Pinai Approval t=om 'Heald: Dent. of '.Dater supply and sewerage-disposal(S forZI)
� . :iooroval oil elect_ical hnStallation from Board of Fi-- Under"Jri=ers.
u. Sworn Statement from plumper Certif-Jing that the solder used in system contains
less than 2/10 of le lead.
5. Commercial building, industrial building, multipie residences and si'liilar buildi:hgs
and installations, a cer_iEicate oil Code Compliance from architect or engineer
responsible for the building.
b. Submit Planning 3oard; ADproval of completed Sit= plan reauirements.
]. "or existing buildiihzs prior to April 9, 1951) non-conforming uses, or buiidinas and
pre-existing" land uses:
Accurate SllrV?V OL pLODert;J showing all property Lines , streets, building and
unusual natural Or topographic :eatures.
2- A properly completed app lica-ion and a Consent -0 inspeC= signed by the a7D''-icant.
if a C2rtifiCate of Occupancy is denied, the Building lnspectOr shall State the
reasons therefor in writing to the aDOI'-cant.
1 C?rtiLica-e of 'OCcupanc,; - New dweilin$ S23.00. Additicns cc dwelling S25 .00,
Aiterati0ns to dwelling 525.00, SwimmiP.g !pool S25.00, ACcessOrJ buildinz S25.00 ,
Additioris to accessory building 525.00. Businesses S50.00.
2. Carti_icate of Occupancy on Pre-existing 3uildin2 - $100.00
Copy Of Cartificate of Occupancy - .25c
� • Updated CertiS.iCate of OCCUDancy - S50.00
p. iemuorary Certificate of Occupancy - Residential J15.00, COC�mm/eL'CJdTi 510.00
Date .(• •��. L3 . . (. .1�. . . . . . . . . . . . . . . . . . . . .
-,
e.�w Cons t�sction. . . . . . . . . ... Old Or Pre-existing Building. . . . .
ocation of Property. � � .C.Q .1/y'� . . . .v C 1.� s( . .� ... . .(. �.r. S .2 .
House No. Street: Let
?nwer or Owners of Property.
oust Tax Map No 1000, Section.I. . . . . . . . . . . . .Blocc. .f
. . . . . . . . . . . .iot. .P (((
,ubdiJisior.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map . . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . .. . . . .
Rio. . ���✓. � Date 0 a
= e rm i a pp I
iea_th pep-. ypproval. . . . . . . . .!l/.r . . . . . . . . . . . .Underwriters Apt)roval . . �, !. . . . . . . . . . . . . .
��UeSt =0=. 'empOCar; Cc_ti5'_Cate. . . . . C2:"t=cite
..e,e . . . . . . . . '
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
S�L-f)3
Qv a a 0
AFFIDAVIT
Edward Taborsky and Veronica Taborsky, both residing at 2810
Norwood Lane, Venice, Florida 34292F being severally sworn depose
and say:
We are the owners of the premises situate at 715 Deep Hole
Drive, Mattituck, New York.
We purchased these premises as vacant land from Frank S.
Zieleski in 1958. We obtained a building permit to construct oursef
home somewhere in 1959, or thereabouts, and during
the the construction of the home discussed with the then building
inspector, Howard Terry, the fact that now we were interested in
constructing a garage. This conversation would have taken place
either 1960 or so since it did take us quite a while to build the
home.
Mr. Terry told us at that time that it was not necessary for
a building permit be obtained for an accessory building and
accordingly, we did construct the garage and it has been in its
current location on the premises since about 1960 or 1961.
As to the accessory structure the
December 10, 199 shown this nsthe
survey of Roderick Van Tuyl, dated
encloses a water pump and has been on the property, again, since
the early 1960s.
We respectfully request that the Building Department of the
Town of Southold waive any requirements for a Certificate of
Occupancy for these structures or in the event one is required that
this affidavit be accepted as proof of the pre-existing status of
these accessory structures.
Edw rd Ta orsky
ca'
Veronica Taborsky
Subscribed and sworn to before me
this 2--3- day of December, 1996.
Not P blic State of ��
�O
FRANCIS I YAKABOSKI
Notary Public,State of New York
No. 9762290
Qualified in Suffolk County
Commission Expires April 30, 19 4q
* BOARD OF IIBAI:I'll . . . . . . . . . . . . . . .
FORM NO. 1 3 SETS OF PLANS _
r TOWN OF SOUTHOLD SI111VLY
r1/ ISUILI)]:NG DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . .
'TOWN IIALL SEPTIC FORM . . . . . . . . . . . . . . . . . . .
SOU'THOLD, N-Y. 11971
TEL: 765- 1002 NOTIFY:
CALL . . . . . . . . . . . . . . . . . .
MAIL TO: . . . . . . . . . • . . . . . . . . . .
AI�►rovr'd.../.... .../..., 191�r! Permit No.�! '�. ................................ ...
Disapproved a/c ....... ........ ............. ...................................
(Ikcildinl,L�Cor)
t APPLICATION FOR BUILDING PEMMIT - 3 1 N
Date
. .V2
CJ Jb INSTRUCTT.ONS
a. lbi9 application mrst be canpletely filled in by tylxAmiter or in ink and submitted to the Wilding 'Inspector wi
3 setts of plans, accurate pl.6t plan to scale. Fee according to schedule.
b. PloL plan slowing location of lot and of: Imildings on premises, relationship to adjoining prenises or Ixabl is
streets or areas, and giving a detailed description of layout of properly mist lie drrmm on the diagran wl►i(Ji is Ivirt of
ibis appl•icLion. -
c. 'Ibe %x►rk covered by this application rrry riot lie caunenced before issck►nce of Ik►ilding Permit.
d. Upon approval of this application, ti►e Ikjilding Tnspector mill issue a Ikrilding Pennit to the applicant. Such
I►ermit shall be kept on the premises available for inspection througl►out the Ix►rk.
e. No Wilding; shall be occupied or used in wl►ole or in pert for any ixrrl►ose wl►alever until a Certificate of
(kculku►cy slral.l. have been P,ranLed by the Ikrilding Inspector.
APPIA(Wrim IS IT(3111i13Y I•IATJr to the Wilding Deparhnent for the issuance of a Wilding Pennit pursuant to Lhe
Ik►ilding Zone Ordinance of the 'I'mi of Scx►thold, Suffolk Ccxrnty, New York, aril other applicable Laws, Ordinances or
Regulations, for the construction of Imildings, addiEii)os or alterations, or for reirPoval or demolition, as herein
deescrilted. 'Ibe applicant agrees to conply with all. apIAicable laws, ordinances, building code, housing Cale, amxl
regulations, and to adnit authorized inspectors on premises and in Ix il.ding for r I h Lions.
......................................................
(Signature of a11pplicant, or naane, if a corporation)
(14ail.ing address of:jp0lAcanC)34-(
State w1►elher applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plunber or Ixmilde
........................................................................................................................
I ' f
Made of (mier of premises ..LAG' 1.�. ...G �QYS!5.. ....U'a f/.`to At.f•�.,�{. 1!�.. ....... .
(as on the tax roll or latest deed)
if allA icant is a corporation, signature of duly auL110rized officer.
................................................••.......
(N.mw and title of: corporate officer)
Ik►ilders License No. ....... ............_...
Philibers license No. ...-K A.... .........
Electricians License No. ...................
Oder 'Irade's License No. ... ^............ /
I- I ocat.ion of lard on which prolx►sed work will be done... ..............
`t%t `tt�'.t`'..��....:�:.`- ....... ......... z:................................................
Ikx►se Umber Street llammilet
r 2
Cotinty Tax Kip No. 1(XX) Sect.icx► _l.t/_ram......._ Block .(./..3.......... 1,ol'
SulxlivisiofI ...............1.................... Filed Kip No. .............. l..oL .............
(iJ�'rrme)
2. Stage existing; use and occul-kincy of premises and intended use ar' oc ocy of: proposed constnicLion:
a. GxistirmP, use and occulknxy. :.. �.�r�!- '�..�r l%�. .
1►. Ir►tteixkcl use and occupancy ......C...Y... -.4._.... . /! ..... .................................
ONO
rQ?'1eF:7.`.`• :�il_'i?�¢�!Si 1:eFr'%�;,ff� �y
oFW.....U i ADE is w'.jF:c!c? wlxD
' t
N•Uure of ;.kirk (c:Iwcic t.Aiicli a rlicahle 1`I(_°(j Ikiil(lin� '
ffl ): t, A(klition .. A erli n /�—
Iti!lufir ............ Heirnial ............. Denx)l1t•ioil ............ Other 14ork _ (.? �c.a�Jr.....`? y':t e
(ik'ctc:ripCicxi)�f ( �r,'�
Iistimated U)SL .Q.4?..�......... fee ....... .....................................
(to Ix1 paid on filing this appl.iratiolr)
f (local I ing, ixriller of A.?ell ing ialiLs ............ Umber of (h,rel I ing units oil each fIoor .... r.........
1 f gauge, ixnl)er of czars .......0�1- ........... ............... .
: If Ixlshle;in, connercial or inixed occopancy, specify nahire awl extent of each //type of uee.....................
Dimeonions of: existing itrtx_Luves, if fifty: 1?rcxll:.. ..1!Y..... ... hear ....... Depth ......... ........
lkigl(t ...1.................... Kriber of Stories
Dblie eions of slue stnxaure with alteraticxts or additions: Front ..... .. .... .... .Mar ...............
Dept11 ............... ..... Ileilgit ............... ..... N(rllier of Stories
I)itimnsioos of: enLire i".y constril(fticxl: F"kilt Itear . ...... ........ Depth ............ ..
Ileiglfl: ......................... Ulidwr of SLorie(r .......... ...........
'Size of lot. Pron'u f.d.v� ....... Mar ... ,�Q:�Ikplla /J
f). Iral:e of-, l't(rcllsse ... ...... T1:nxa of 1'Urltx;r (a.+lxa' ....�
I. Zone or use district in t.Alicli premises are situated .......... ...
2. lkws prolxmed coostrix:Licit violnte any zoidng law, ordinaoce or regulaticxl. . .. ... . .......... ,
1. Will lot be regrixlecl ..... ...... Will excess fall. he rei;med froxn preanises: YES 119.) r
5. T4rfes of 0woer of prevnises ... .C�id•��. 4-F'.Ch!JO cklress .............................. 111ax� iJo. .4S ....
tlirfle of ArcJ►i Cec:t' .................................... Address ........ ,.............. .... Illone No. ....... .. .....
Armin of (;cxll:raclor ................. .................. A(klress ...............................I1lown No. .. ..... .......
:i. Is this prolxarLy Within W) feet of a tidal weLlnfxl? * YES .........:
*1f YES, SQUIII(l(I) 'Ium 'I1111S11 E.9 11i1"fl' IIAY IIE 11E()lllturl).
PLOT DIAGRAM
Locale clearly awl distinctly all lxrildings, t,Alether existing or proposed; afxl itxlicate all. set back dimensions
`run proix-tTy (.ions. Give street' aril block rKst6er or description according to deed,,aixl sliow street nirnes and irxileate
Tether interior or•corner lot-.
0VED AS WIMP
_�l�._ BY:
I'�I(�'E';F S1, 1.MNG DEPAA&F1N AT
76 -1.902 9 AM TO 4 PSI FOR THE
FOl.l..OWMIIG Wd PECTIONS:
1, t°OU,NI ATIOWI -- TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH q FRAMII IS & PLIIUMING
3, INSULATION
4. FII�&A€ .. CONSTRUCTION MUST
BE COMPLETE FOR C.Q.
ALL CONSTRUCTION SHALL. MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
;VNIr. ( larw YOW, CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
1 Jl Itl I Y (A' .�..
ohs
.. .�. '. ..1. 1�..—�t...... .....lxainl, n ls
(lily swcrr , delxen afxl says: (lint he in the
... nppl is:nnl
(Kiln of iml'lvidual. signing coot.racL) ((
Axlve furled,
ka i a. Ilse ... ....... . y. µ' -. .............. -..._...
(Colitrfictor, ngeot, corimi-we of:firer,''elc.)
of snid (iwour or (yAx!rn, mxl is duly authorized to lxtrfonn or have lx'rfonned .Ihp said wont soil to nxilte aixl file Ibis
nlfpl icaLion; dint: fill. sLateilent(; coiiLahxid io this nppl icatioo fire Imle t•ci=the ties(: of hin ko wledge nix( Ixil.ief; nixl
:hnt the writ will be per.fovimA in the nknnx-r -net .I'or.11i in the nplAicntioo filed therewith.
'Icx)rn to Ixafore fir_ thin 't
Notary Milli; ....................... .
...
FRANCISJ.YAKA80SKI (Sit nature of A lrpl i<:ant.
) a
Notary Public,State of New York
No. 9762290
Qualified in Suffolk County
Commission Expires April 30. 19�
FA.
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r�rar}^"�� ALO
AT
-'�"dh'• ai, f"`r"'- : •r'1. � i 3''+` $�
^'° �.' .11 u��ej''1-r p .I�:•4. b}'• �1 l�I f
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w r SCALE-40�I I�_
l, , ►�rtusMrp.lRr+•.r ri+e+rvsi46.w G f`�I 1 t Y P F �t t�
f to this survey Ls-a vtolat[roi of _
S a y Section 7208 of the New Yrirk Rfat- p_
6 � x._-'�`' <,.I,,-IAP I �= E_k ✓ fidacatonta f t;7{y-.± �, t•..;I f. .. {.
rr Copies
r.
t �•_________ survey map not be
apes 0,this sury arin.7 !
the land surveyors inked seal orrIEC
embossed seal she[!not be conslderes! � „�r_..._.... ,,�,.p,..._ :t•-'•----- .. ''
to be a valid We co?
DC Guarantees indicated„oraon shelf^.,s }g^4 q 4; s , V. ,
orJy to the person for whom the surve• _ i-' 4 *•� .� — (��.'J,.(��. -4�
Is prepared,and on his beh.,Jf to the
- - fitio ccmaany,gcve rncnt I a,7orGY Y,tie )ell
tnstilutioP. �rl�'l , 34�
. to the essiInac;scrUso4,sd;ngimil. w� ---�_ ,{�' Ir
Wvcn.Gu^`.::crs::renaliran'`srahMe• `+'f1 LAN
(lj{�� {,¢'! j'"'e"'_ 4 �9'+,1 �J��y{'p rFy,T�.. l IfG n.
.. -, i..1 w`Mt wl.+y1 i/Z1mA Vril6y b.F1. 'A.'W-�-Y„w life
` • - - to addtional in6lUsfonss dr subs9R �' co O 6`-
.. .. gNSfQrg, ,, - - ....,,....,.;:. _ .� -e--o---.::.. _ rid-• _ Fp J
LANDS
-_:, -r .. .... ,_.. ...T.--.w.r.+r+.-�y..J.:.+--,+ae-.-.,.'N:..-r.....•w..•-•.r.+�,,.. w-. ..,.�,r.r- -,.-.;.:J'...,. -.-�.� .. ..-..L,. ...--s--.+..e.:..•L��m.;..ro..r�.i-,�•:w- .,.� -< - ..w-,r... w�.a...:.h......a.,..:..,:.,.1-.te.J:.-.r+:r,.:»�.;+A-» «..t....... ."..:.....v-«:.e.�."-