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Home My WebLink AboutZ-12415FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..Z12,415 ......... Date ......... bp.r.J:l...5 ............. i., 19.8.4 THIS CERTIFIES that the building ~7.-.(2.)~ ......................................... Location of Property 1645 Bunqalow Lane Mattituck County Tax Map No. 1000 Section . . .12 3 ...... Block . . .0.3. .......... Lot 0 2 0 Subdivision ..... X. ......................... Filed Map No...X. ..... Lot No. Requirements for a private one-family dwelling built prior to conforms substantially to the At~t-io~-f~r-B~iklin~-Permi-t-hm-etofrrre--Fd~d in-th~-off'rce-tllrced Certificate of Occupancy Apr i 1 2 3 19 5 7 pursuant to wh/ch B~q}di~l'g Pern~t No.. . g ~2.4 ~ 5... -dated ..... .Ap.r.i..1..5. .............. 19..8.4, was issued, and conforms to aL of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... · .a.. p.r.~.y.a.t.e..o..n.e.zf.a..m.~.l.y...d.w.e.i. 1..i.n.~..a..n.d..a.c..cg.s.s..o.r¥..o..n?.qa..r.F.a.r..a9F..' ....... The certificate is issued to ............ HAR.O.L..D. H. & .~OAN F. WHELAN ....... to~n'o'r, ¥~:4,," ~ ...................... of the aforesaid building· Suffolk County Department of Health Approval .... rio. l:.e. qQl:~ ............................ UNDERWRITERS CERTIFICATE NO .......... r~o. re.co~O ............................. SEE ATTACHED HOUSING CODE INSPECTION REPORT. Building Inspector Rev. 1/81 BU~DIi.,~ DmP:~ ~ -[~,hT TO'JN OF SOUTHOLD, N. Y. HOUSING CODE INS?ECTION REPORT Location Subdivision 1645 Bungalow Lane (numoer & street) Mattituck ........... (Punic i~ ) Me-l~ No. Lot(s) Flame of Owner(s) Harold H. & Joan F. Whelan Occupanc~f R-1 Admitted by: Mr. Whel, an owner "' (own~:~er.~n~) Accompanied by: .sam__e_ Key available ___ _Suffolk Co. Tax No,__i~ .... Source of reques't Harold H. Whelan ~ 3/23/84 _Dc ~ e~ D!'~JLLI~: Type of construction Fete:darien block Totol rooms, ]st. F1 Bathroom(s) 1 Porch, type Breezeway ..... Type Heat oil fired Fireplace(e) Domestic hotwater Other 5 wood #stories 1 Cellar .partSa~raw]_ sp?cc rest 2nd. Fl_, ,3rd, Fi.~ Toilet room(s) Deck, type Patio, type ...... Garage .... Utility room Warm Air central NO. Exiis 2 Ai~,conditionin~ __Type hearst__ gas ACCESSOPY STRUCTt~ES: Garage, type const, wood~ one-carStorage, type const. Swim,ming pool Guest, type const. Other wood fence~ w~st side ~rd ViOI,ATIONS: Housing Cod.r, Chapter 52 !.,~_~ at ion i Description storage blldg..___need ~om, e' repairs kitchen gas stove--no shut off 6rt. [ III 152-30-A .. 3 t Remarks :__ Curtis W. "Herren. Time start;. 3:0__lend 3,,:30 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall $outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate 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 peoperty 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 $5.00 2. Certificate of occupancy on pre-existing dwelling / land 3. Copy of certificate of occupancy $1.00 use--?re-Existing C.O. $15,00 Vacant land C.O. $ 5.00 Date .~. 23, 1984 New Building ........... . . Old or Pre-existing Building. .× Vacant Land Location of Property ..... Bungalow Lane, M..at.t. ituck House No. Street Ham/et OwnerorOwnersofProperty Harold H. Whelan and Joan F. Whelan C~u nty Tax Map No. 1000 Section ...12 3 Block ...... 3 2 0 ............ . . . Lot . ............................. Filed Map No ........... Lot No .............. Subdivision .... Permit No ........... Date of Permit .......... Applicant... ............................. . . Heakh Dept. Approval .......... Labor Dept Approval ..................... Planning Board Approval ...................... Underwriters Approval . .. Request for Temporary Certificate .................... Final Certificate . .X FeeSubm e oo -co ....... ons r "Q~' ''; ......................... ~-'' c~' ~('~'17 v/~(~'~'-'~ ~ ' App,,c,n, -' ' .............. Rev, 10-10-78 CONSENT TO INSPECTION HAROLD H. WHELAN & JOAN F. WHELAN , the undersigned, Owner(s) Name(s) do(es) hereby state: That the undersigned [i~k (are) the owner(s) of the premises in the Town of Southold located at Bungalow Lane, Mattituck, New York · which is shown and designated on the Suffolk County tax map as District 1000, Section 123 , Block 3 , Lot 20 That the undersigned [4~ (have) filed, or caused to be filed, an applica- tion in the Southold Town Building Inspector's Office for the following: __ Certificate of Pre-existing Use 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. Harold(s~gnature) H~. Whel (print name) (signature) (print name)