HomeMy WebLinkAboutZ-41128 Sl1ffFQ�,��o Town of Southold 3/11/2020
Gy 53095 Main Rd
r„f Southold,New York 11971
CPRE EXISTING
CERTIFICATE OF OCCUPANCY
No: 41128 Date: 10/22/2018
THIS CERTIFIES that the structure(s)located at: 5505 Mill Rd,Mattituck
SCTM#: 473889 Sec/Block/Lot: 106.-6-1
Subdivision: Filed,Map No. Lot No.
conforms substantially to the requirements for a built prior to
APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 41128
dated 10/22/2018 was issued and conforms to all the requriements of the applicable provisions of the law.
The occupancy for which this certificate is issued is:
cement block one family dwelling with enclosed porch, cement patio, outdoor shower and accessory wood frame shed.*
Notes:BP 44112 alterations COZ-41127. Propane gas disconnected and wall furnace disabled.
The certificate is issued to AWC Dockside LLC
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
A4fhoVize 'gnature
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 5505 Mill Rd,Mattituck
SUFF.CO.TAX MAP NO.: 106.-6-1 SUBDIVISION:
NAME OF OWNER(S): AWC Dockside LLC
OCCUPANCY:
ADMITTED BY:
SOURCE OF REQUEST: AWC Dockside LLC DATE: 10/22/2018
DWELLING:
#STORIES: 1 #EXITS: 2
FOUNDATION: slab CELLAR: CRAWL SPACE:
BATHROOM(S): 1 TOILET ROOM(S): UTILITY ROOM(S):
PORCH TYPE: enclosed DECK TYPE: PATIO TYPE: cement
BREEZEWAY: FIREPLACE: GARAGE:
DOMESTIC HOTWATER: x TYPE HEATER: electric AIR CONDITIONING:
TYPE HEAT: Propane Gas WARM AIR: HOT WATER:
#BEDROOMS: 2 #KITCHENS: 1 BASEMENT TYPE:
OTHER:
J
ACCESSORY STRUCTURES:
GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: wood frame shed
SWIMMING POOL: GUEST,TYPE OF CONST:
OTHER:
VIOLATIONS:
i
REMARKS:
INSPECTED BY: JOHNJ DATE OF INSPECTION: 10/2/2018
TIME START: 9:57am END: 11:05am
J
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. 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 existing 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 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$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00,
Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,Businesses$50.00.
2. Certificate of Occupancy on Pre-existing Building- $100.00
3. Copy of Certificate of Occupancy-$.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy-Residential$15.00,Commercial$15.00
Date. September 24, 2018
New Construction: Old or Pre-existing Building: V (check one)
Location of Property: 5505 Mill Road
House No. Street Hamlet
Owner or Owners of Property: AWC Dockside LLC
Suffolk County Tax Map No 1000,Section 106 Block 06 Lot 001
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted:$ 100.00
Applicant Signature
{
CONSENT TO INSPECTION
AWC Dockside LLC ,the undersigned, do(es)hereby state:
Owner(s)Name(s)
That the undersigned(is)(are)the owner(s)of the premises in the Town of
Southold, located at 5505 Mill Road
which is shown and designated on the Suffolk County Tax Map as District 1000,
Section 106 ,Block 06 ,Lot 001
That the undersigned(has) (have)filed,or cause to be filed, an application in the
Southold Town Building Inspector's Office for the following:
Certificate of Occupancy on Pre-existing Building
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 in subsequent prosecutions for violations of the laws,ordinances,rules or
regulations of the Town of Southold.
Dated: 9/24/18 ..Sig /ur
(Signature)
D—�
Daniel Cooke
(Print Name)
(Signature)
(Print Name)
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* # TOWN OF SOUTHOLD BUILDING DEPT.
coum" 765-1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
�j �.JV v\/w `Q� t -aiV ��iNllflV �• 1 1/v
DATE tO w-- INSPECTOR
nt
LOCATION, 0 it-
hos4�
(number & street) , , (municipality)
1 4 %
SUBDIVISION: MAP Wo LOT(S): ,
NAME OF OWNER(S)':
OCCUPANCY: 7 ilkamil lit
(type) (owner-
tenant)-ADMITTED BY: - ACCOMPANIED BY:
KEY AVAILABLE: SUS'. 'CO. TAX MAP.' 0. 1000- D � B
SOURCE OF REQUEST: DATE: %1"93
DWELLING
TYPE OF CONSTRUCTION: STORIES: #EXITS:
FOUNDATION: _. 5� .. )W9MENT: ,'CRAWL SPACE:
# OF BEDROOMS: IST FLR: 2ND FLR: 3RD.FLR
BATHRG°OM(S) TOILET Iti('1OM(S): UTILITY ROOM:
P0RCH.TYPE DECK, TYPE: .
"PATIO;TYPECA
BREEZEWAY: FIREPLACE: - r"ARAGE:
DOMESTIC HOTWAtFR:':z TYPt NEATER. ,""_�l ATRCONDITIONING:
TYPE HEAT: . 1 &OW RM AIR: NOTWATE
(�
J -
# OF KITCHENS: : wn
S r
FINISHED BASEMENT:- YES, 'NO
OTHER: Vf DVS v S�'i(1✓�/1 i
ACCESSORY STRUCTURES '
GARAGE; TYPE OF CONST.:
STORAGE, "
TYPE CONST.. QfOD J ArVO
SWIMMING P*O-OL: _� GUEST,'TYPE CONST.-"
OTHER:
VIOLATIONS: CHAPTER 144•&N.Y. STATE:UNIFORM irk PkEVENT.ION & 13UI,LDING CODE
LOCATION D' C I PTION t.. ART. SEC.
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REMARKS:
INSPECTED B : n
Y _JO's. J DATE OF INSPECTION,
TIME START: ., + END:
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