HomeMy WebLinkAboutZ-19074FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-19074 Date MAY 23, 1990
THIS CERTIFIES that the building COMMERCIAL
Location of Property 13175 ROUTE 25 (MAIN ROAD) MATTITUCK, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section
Subdivision
140 Block 3 Lot 38
Filed Map No. Lot No.
conforms substantially to the requirements for a commercial building
built prior to: APRIL 9, 1957
pursuant to which
CERTIFICATE OF OCC. Z-19074 dated MAY 23, 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 COMMERCIAL BUSINESS STRUCTURE *
The certificate is issued to ROBERT & CORNELIA WADDINGTON
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NO RECORD PRE EXISTING
UNDERWRITERS CERTIFICATE NO. NO RECORD PRE EXISTING
PLUMBERS CERTIFICATION DATED NO RECORD PRE EXISTING
*PLEASE SEE ATTACHED INSPECTION REPORT.
Building Inspector
Rev. 1/81
BUILDI;:G DEPART:IEPiT
T0J111 OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location 13175 ROUTE 25 (MAIN ROAD) MATTITUCK, N.Y.
�numoer do street) Nunicipaiity)
Subdivision Nap No. Lots)
Name of owner(s) ROBERT & CORNELIA WADDINGTON
Occupancy HAMLET BUSINESS OWNER
(type owner -tenant
Admitted by: REN SCHEUERMAN Accompanied by: SAME
Key available Suffolk Co. Tax No.140-3-38
Source of request
DTELLING:
ROBERT WADDINGTON
Date 4./23/90
Type of construction CEMENT BLOCK & BRICK #stories ONE
Foundation CEMENT Cellar SLAB Crawl space
Total rooms, lst. F1 TWO 2nd. F1 3rd. Fl
Bathroom(s) ONE Toilet room(s)
Porch, type Deck, type Patio, type_
Breeze:•iay Garage Utility room
Type Heat OIL Warm Air xx Hotwater
Fireplace(s) No. E:cits 2 Airconditioning
Domestic hotwater Type heater
Other
ACCESSORY STRUCTURES:
Garage, type const._
Swimming pool
Other
Storage, type const.
Guest, type const.
VIOLATIONS: CHAPTER 45--N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
Remarks • >iP #13451 CD Z17898, lF #15278 OD 217897 1W 15401Z OD 217899
Inspected by: Date of Insp. April 25, 1990
Gary Fish Time start 10:35 end 11:00
I
Form No. 6
.�.�...
TOWN OF SOUTHOLD�
IL52
BUILDING DEPARTMENT
TOWN HALL
2
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765-1802
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APPLICATION FOR CERTIFICATE OF OCCUP
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.
BOForexisting 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,
QAdditions to accessory building $25.00. Businesses $50.00.
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, Commmjerrcial $15.00
Date...... ./..`.�....................
New Construction........... Old Or Pre-existin Buildi ..5�.......
Location of Property .......................... Aa, .L"K[..L"4 ......... A .........
House No. Streets r / Hamlet
Onwer or Owners of Property....�0�21,��EL��/ Wc2�QG!,
County Tax Map No 1000, Section .... J.YG..... Block .... 3 .......... Lot..3.�...............
Subdivision....................................Filed Map ............ Lot ......................
Permit No................Date Of Permit ................ Applicant .............................
Health Dept. Approval..........................Underwriters Approval.........................
Planning Board Approval ........................
A, -'a"4
Request for: Temporary Certificate........... Final Cer a
Fee Submitted: $ IAT ...................
APPLICANT............
CONSENT
TO
INSPECTION
�+' (_-OI-a e /1,2- l i zc Ck lq
Owner(s) Name(s)
do(e.$) hereby state:
►� , rAR2AIMM
, the undersigned,
That the undersigned (4 -j4 --(are) the owner(s) of the premises
in the Town
of Southold located at /�I 1 7, /" 2 ek fl6,� N/2 Z7 i GbC
, which is shown and designated on the Suffolk-
County
uffolkCounty tax map as District 1000, Section 146 , Block 3 _, Lot 3
That the undersigned Gds) (have) filed, or caused to be filed, an applica-
tion in the Southold Town Building Inspector's Office for the following:
That the undersigned doh 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(*g so with the
knowledge and understanding that any information obtained in the conduct of
such inspections may be used as evidence in subs equentpxosecutions for vio-
lations of the laws, ordinances, rules or regulation jhe Town of Southold.
Dated:
signature
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(print name)
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