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Home My WebLink AboutZ-26003FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 26003 Date: 10/02/98 THIS CERTIFIES that the building DWELLING Location of Property 580 PRIVATE RD #17 (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 123 Block 0006 Subdivision Filed Map No. __ Lot No. __ MATTITUCK (HAMLET) Lot 020 conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 26003 dated OCTOBER 2, 1998 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 ONE CAR GARAGE* The certificate is issued to KEVIN & MARGARET WHITROCK (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTI~ Rev. 1/81 ~ N/A N/A N/A Building BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 5S0 PRIVATE RD ~17 MATTITUCK SUBDIVISION: MAP NO.: -- LOT (S) -- NA~ OF OWNER (S): KEVIN & MARGARET WHITROCK OCCUPANCY: SINGLE FAMILY SEVIN & 5f~RGARET WEITROCK ADMITTED BY: KEVIN WEITROCK ACCOMPANIED BY: SAME KEY AVAILABLE: BUFF. CO. TAX MAP NO.: 123.-6-20 SOURCE OF REQUEST: REVIN WSITROCK 9/23/98 DATE: 10/02/99 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 1.0 $ EXITS: ~ FOUNDATION: CEMENT BLOCK CELLAR: PART CRAWL SPACE: PART TOTAL ROOMS: 1ST FLR.: 4 2ND FLR.: O 3RD FLR.: O BATHROOM(S): ~.0 TOILET ROOM(S): 0.0 UTILITY ROOM(S): __ PORCH TYPE: DECK TYPE: REAR PATIO TYPE: REJiR BREEZEWAY: FIREPLACE: GAP, AGE: DOMESTIC HOTWATER: XX TYPE HEATER: OIL AIRCONDITIONING: CENTP~kL TYPE HEAT: OIL WAP34 AIR: XX HOTWATER: OTHER: GARAGE, TYPE OF CONST.: WOOD FRAME-1 CAR WIDE STORAGE, TYPE CONST.: SWIPING POOL: GUEST, TYPE OONST.: OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC, REMARKS: INSPECTED BY: EOUFi; DATE ON INSPECTION: 09/30/9S TIME START: 10:50 AM END: 11:10 AM Form No- 6 TOWN OF SOUTHOLD BUILDING DEPARTM]ENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the buildin: inspector with the following: for new building or new use: t. Final survey of property with accurate location of ail 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 ~% lead. 5. Commercial building, industrial bailding, multiple residences and similar buildir 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. For existing buildings (prior to April 9, 1957) non-conforming uses, o~ ~ailding$ an Ypre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual nataral 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 Buildin~ - $i00.00 3. Copy of Certificate of Occupancy - = 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. House No. Street H~ et Subdivision .................................... Filed ~p ............ Lot ........... ~'. ....... Pe~it No ................ Date Of Pe~it ................ Applicant ................... ~ ....... Health Dept. Approval..........-....----...-.--Underwriters Approval ....................... Planning Board Approval ..... Request for: Fee Submitted: Temporary Certificate ........... Final Certicate ........... APPLICANT CONSENT TO INSPECTION Owner(e) Name(s) do(es) hereby state: · the undersigned, That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at S'Bo · which is shown and designated on the Suffolk County tax map as District 1000, Section ~-3. , Block ~. , Lot_~d~_~~. 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 [n 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. /stgnaNre) - __ (print name) '