HomeMy WebLinkAboutZ-26755FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 26755 Date: 10/27/99
THIS CERTIFIES that the building ACCESSORY
Location of Property 355 HOBSON DR LAUREL
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 122 Block 0006 Lot 025
Subdivision Filed Map No. -- Lot No. --
conforms substantially to the Requirements for a A(~S(~k~h'~'l~
built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z- 26755 dated OCTOBER 27, 1999
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 NON-HABITABLE GARAGE *
The certificate is issued to WILLIAM WYCRE
of the aforesaid building.
(OWNER)
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
N/A
N/A
N/A
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LAUREL
MAP NO.: -- LOT (S) --
WILLIAM WYCHE
ACCOMPANIED BY:
KEY AVAILABLE: SUFF, CO. TAX MAP NO,: 122.-6-25
SOURCE OF REQUEST: ABGAIL WICK~. ATT~ DATH: 10/27/99
TYPE OF CONSTRUCTION: WOOD FRAME
CEMENT CELLAR:
1.0 0,0
FOUNDATION:
TOTAL ROOMS
BATHROOM (S)
PORCH TYPE:
BREEZEWAY:
DOMESTIC EOTWATER:
TYPE HEAT:
2ND FLR.: O
TOILET ROOM(S): . ..
DECK TYPE:
FIRE Pf~CE:
TYPE HEATER: **
WARM AIR: HOTWATER:
OTHER: **~QT WATER HEATER IS NOT IN WORKING ORDER.
STORIES: I,Q # EXITS:
CRAWL SPACE:
3RD FLR.: O
UTILITY ROOM(S):
PATIO TYPE:
GARAGE:
AIRCONDITIONING:
GARAGE, TYPE OF CONST.:
SWI~4ING POOL:
OTHER:
STORAGE, TYPE CONST,:
GUEST, TYPE CONST.:
VIOLATIONS:
LOCATION
CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
DESCRIPTION
ART. ! sEC.
NOTE: THIS STRUCTURE IS AN ACCESSORY GARAGE
WITH FULL BATH AND KITCHEN SINK, REFRIGEMATOR
NO STOVE.
DATE ON INSPECTION: 10/12/99
TIME START: 10:30 END: 11:00
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
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.
B. For exksting buildings (prior to April 9, 1957) non-conforming uses, or buildings and
Upre-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.
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 Buildinm - $100.00
3. Copy of Certificate of Occupancy -
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
New Construction ........... Old Or Pre-existing Building.~..~.~.frame garage
355 Hobson Drive,
Location of Property ........................................................
House No. Street Hamlet
Onwer or Owners of Property..~.~:.~Y~? ................................................
County Tax Map No 1000, Section...~ ........ Block...~ ............ Lot..~ ..................
Subdivision ........ Filed Map Lot ..................
Permit No ................ Date Of Permit ............. . .. Applicant .............................
Health Dept. Approval .......................... Underwriters Approval ........................ .
Planning Board Approval ........................
Request for:
Fee Submitted:
Temporary Certificate ........... Final Certicate...x. .......
PPLI NT
Abig~l A. Wic~am, ~s~q., Agent
WILLIAM L. WYCHE
CONSENT
TO
INSPECTION
· the undersigned,
Owner(s) Name(s)
do(es) hereby state:
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at 355 Hobson Drive, Mattituck, New York 11952
· which is shown and designated on the Suffolk
County tax map as District 1000, Section 122 , Block 6 , Lot 25
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: Pre-
Existing Use Certificate of Occupancy for detached frame garage.
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
lations of the laws, ordinances, rules or regulations of the Town of Southold.
Dated:
(signature)
Abigail A. Wickham, Esq., agent
(print name)
seoJ shall n~t be considered to be a valid cony
~erson to, whom the su vey is p enar~ . ~-~.:,ru? on,y to the
SURVEY FOR REFERENCE
WlLLI~U L.8 F~NNY E. WYCHE
AT MATTITUCK
TOWN OF SOUTHOLD eUARANTEED TO,
SUFFOLK COUNTY~ ~N, ~ ' 5gcuR~TY TITL ~ ~ GUARANTY COMP~Ny
SOUTHOLD SA~ ~NGS BANK.
SCALE ~ I":~0'
MARCH 2, 1971 :
~ULY S, 1977
L 4ND ~URVEYOR