HomeMy WebLinkAboutZ-18634FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-18634 Date December 11, 1989
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 735 WICKHAM AVE. MATTITUCK, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 140 Block 2 Lot 28
Subdivision Filed Map No. Lot No.
conforms substantially to the requirements for a private one family
dwelling built prior to: APRIL 7, 1957 pursuant to which
CERTIFICATE OF OCC. #Z-18634 dated DECEMBER 11, 1989
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 PRIVATE ONE FAMILY DWELLING *
The certificate is issued to RICHARD & STUART WOODWARD
(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
*SEE ATTACHED INSPECTION REPORT.
Building Inspector
Rev. 1/81
BUILDIIIG DEPART:1EiT
TOWN OF SOUTHOLD, N. Y.
HOUSIidG CODE INSPECTION REPORT
Location 735 WICKHAM AVE. MA4TITUCK, N.Y.
�numoer do street) 1,1unicipaiity)
Subdivision Map No. Lot(s)
Name of Owner(s) RICHARD 5 STUART WOODWARD
Occupancy HB (HAMLET BUSINESS) OWNER
(type owner -tenant)
HAVE CREATo SAME
Admitted by: Accompanied by:
Key available Suffolk Co. Tax No. 140-2-28
Source of request RUDOLPH A. BRUER, ATTY Date 12/1/89
MMLING :
BAC
PLO
E
Type of construction WOOD FRAME. ##stories 2
Foundation BRICK Cellar 1/6 Crawl space
Total rooms, lst. F1 5 2nd. F1 3 3rd. F1
Bathroom(s) ONE FULL Toilet room(s)
Porch, type FRONT SCREENED Deck, type Patio, type_
Breeze,aay Garage Utility room
Type Heat PROPANE HEATERS, ;farm Air x Hotwater
Fireplace(s) No. Exits Airconditioning
Domestic hotwater LILCO GAS Type heater
Other
ACCESSORY STRUCTURES: NONE
Garage, type const. Storage, type const.
Swimming pool Guest, type const._
Other
VIOLATIONS: -CHAPTER 45—N.Y. STATE UNIFORM FIRE PREVENTION 6 BUILDING CODE
Lncation
Description 1Art.1
Sec.
EMENT AREA 6
Buildings S Structures shall be maintained free
CHAPT.1
F
OR
of insect vermin and rodent harborage and
SEC.
1243.9
infestation.
11242.4
IXTERIOR
Exterior surfaces shall be maintained in good
i
conditions. Surfaces not inherent by resistant
E.
to deterioration shall be treated with a
(protective
coating of paint or other suitable
preservative.
Remarks:
Inspected by:
�� . Date of Insp. 11/5/89612/8/89
Fish Time start9:30 end 9:50
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall BLDG. Dtpr,
Southold, N.Y. 11971 TOW^v 1�
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriterZ�R ink, and submitted +ftnw�� 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 property 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 $25.00 -` BUSINESS $50.00 ACCESSORY $10.00
2. Certificate of -occupancy on pre-existing dwelling $ 50.00
3. Copy of certificate of occupancy $ 5.00 , over 5 years $ 10.00
4.Vacant Land C.O. $ 20.00 /
5.Uodated C.O. $ 50.00 Date..... Gq
New Construction-,....OldorPre-existingBuildinggat/.-c
.� ....... Vacant Land
�.............
Location of Property .... 1/.0 . ...... ........ !!t'.c -......�/�(.
House No.. � WI /1 Stree � L � Ham/et
Owner or Owners of Property ...IV✓l (J UW�I W / �--
l7 t t d
County Tax Map No. 1000 Section ....�. i..b. , ... Block ......d ..... Lot ...... ........
Subdivision .................................Filed Map No. ... of No. .............
Permit No. .......... Date of Permit ..........Applicant ................................. .
Health Dept. Approval ........................Labor Dept. Approval
........................
Underwriters Approval ........ ................Planning Board Approval ..................... .
Request for Temporary Certificate .....................Final Certificate ...� .... I ............
Fee Submitted S .../P, .. `.. . . .............. .
Construction on above described building and rmit meets all applicable codes and regulations.
Applicant ...
.......................
Ra. 10 10-78
co is�3 y
CONSENT
TO
INSPECTION
do(es) hereby state:
the undersigned,
That the undersigned (is) (are) //the owner(s) of the premises in the Town
of Southold located at V ,tC fL�
�IC which is shown and designated on the Suffolk
County tax map as District 1000, Sections , Block �, Lot d 8
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:
/1 A A , - /ice, A-" I
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 Token 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 regulati of he Southold.
Dated:ho
�� /
( ignature)
(print name)
ature)
int name
SURVEY OF PROPERTY
AT MATTITUCK.
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N.Y.
1000 - 140 - 02 28
SCALE 1 30'
OCT. 7, 1989
CERTIFIED TO
CHICAGO TITLE INSURANCE CO.
SOUTHOLD SAVINGS BANK
THOMAS A. TAYLOR
PHILLIP L. SCHOLL
S. LIC. NO. 49668
*60P.C.
( 516)k-�
y�S10
P.O. BO
MAINROAD
SOUTHOLD, N.Y. 11971
F
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P
StJOJSE
(518)727 4vZS
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op`�0 QaP�4
PS
AREA = 11,647 sq. ft.
or 0.2680 acre
o�-o3s'3a
prepared In aeoordance with the minimum
standards for title surveys as established by
the L.1. A. L. S. and approved and adopted
for such use by The Now Yarb State Laved
Title Awdatien.
BUILD '
! DEP: PT::=IIT
T0d-N OF SCUT,' --:OLD, il. Y.
HOUSING CO`F Ii•iSPECTION RE -PORT
Loca tion
�r:ll"i1Der of s i.r eV c
Subdivision
Name of Oaner(s)
lklap No.
Occupancy kL1 .
c-LI1
Ad :ii1 ('zd by:
C;.cbmpanied
I'lu:iycipali may)
Lots)
o�;mer-zenan E)
by
Key available Suffolk .Co. T
Source of reques '
Tax
No
Date ,�01
DWELLING: -
Type of construction GG' L
7, -stories C"'�� Cellar
-4 -Crawl space --7--
Total rooms, 1st. Fl s 2nd. F1 ,3
3rd. F1
Bathrooms) Toilet room(s)
Porch, type ' It '� eck, type
Patio, type _
Breeze:•�ay Garage Type
Type Heat Utility room
Warm Air !� Ho twater
Fireplace (s No . axi is
Aircondi,,ioni r_o
Domestic ho Water--
Type heater
Other
ACCESSORY STRUCTURE'S. p/
Garage, type const. Stora., type const.
Sx•liuuili ng pool Guestm type ype const.
VIOLATIONS: CHAPTER 45--N.Y- STATE UNIFORM FIRE PREVENTION & TZTTTT nTuf-
.•,.,,,,
Re -marks:
Inspected by: 2Date of Insp:
Time start