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Home My WebLink AboutZ-29638FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 29638 Date: 08/13/03 THIS CERTIFIES that the building DWELLING Location of Property 2815 SIGSBEE RD LAUREL (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 126 Block 0006 Lot 003.001 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 29638 dated AUGUST 13, 2003 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 TWO CAR GARAGE* The certificate is issued to ELEANOR PEDERSEN of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. Rev. 1/81 (OWNER) N/A N/A N/A th ized'Signature BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 2815 SIGSBEE RD LAUREL SUBDIVISION: MAP NO.: LOT (S) NAME OF OWNER (S): ELEANOR PEDERSEN OCCUPANCY: SINGLE FAMILY ELEANOR PEDERSEN ADMITTED BY: ELEANOR PEDERSEN ACCOMPANIED BY: SAME KEY AVAILABLE: SUFF. CO. TAY MAP NO.: 126.-6-3.1 SOURCE OF REQUEST: OLSEN & OLSEN ATTY - 8/7/03 DATE: 08113/03 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 1.0 # EXITS: 4 FOUNDATION: CEMENT CELLAR: CRAWL SPACE: TOTAL ROOMS: 1ST FLR.: 6 2ND PLR.: 0 3RD FLR.: 0 BATHROOM(S): 2.0 TOILET ROOM(S): 0.0 UTILITY ROOM(S): YES PORCH TYPE: DECK TYPE: WOOD PATIO TYPE: BREEZEWAY: FIREPLACE: ONE GARAGE: DOMESTIC HOTWATER: YES TYPE HEATER: GAS AIRCONDITIONING: TYPE HEAT: GAS WARM AIR: YX HOTWATER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. SWIMMING POOL: OTHER: 2 CAR WOOD FRAME STORAGE, TYPE CONST.: GUEST. TYPE CONST.: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE REMARKS: SP #17527-Z-COZ-17868 (ADD) INSPECTED BY: GARY J. DATE ON INSPECTION: 08/13/03 TIME START: 10:00 AM END: 10:25 AM 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 $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 Building - $100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporar?Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Old or Pre-existing Building: Date. August 5, 2003 (check one) Location of Property: 2815 Sigsbee Rd. Mattituck House No. Street Hamlet Owner or Owners of Property: Eleanor Pedersen Suffolk County Tax Map No 1000, Section Subdivision Permit No. Health Dept. Approval: Planning Board Approval: Date of Permit. Request for: Temporary Certificate Fee Submitted: $ 100 0o 0`0--C0-2--a9G38' Block r Lot Filed Map. Lot: Underwriters Approval: Final Certificate: / , (cVeck one) OLSEN & OLSEN LLP 32495�� App} ant Signature CUTCHOGUE. W 11035 nn i7, zons ie: [n leoz/5t PAGE 02 1 P1�ll \ o� c Dt 105 P 2a', L m / tp0' e• tJGG°f. m p �\G � s No 5 t 11-00 . bgD6°�O tt6 VOt 4 NOTE- °= MONUMENT SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY AS MAP NO, BOI. REYISIONs YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG VPOP6[[,ONAL ENDINE[q AND LAnD [VPV[YOq 'AnD SURVEY FOR: WILLIAM Sr-PEDERSEN Q ELEANOR PEDERSEN .... LOT 115 AND PART OF LOT IOTA OF °AMENDED MAP OF MATTITUCK PARK PROPERTIES, INC," AT GUARANTEED TO: LAUREL SOUTHOLD SAVINGS BANK TOWN OF INTER -COUNTY TITLE GUARANTY SOUTHOLD MORTGAGE Co. SUFFOLK CO., N.Y. ° SCALE, I �• • 30• DATE, DEC. 21, 1971 71-769 CONSENT TO INSPECTION F.laannr PoAoraan by Rary Flanner 01aQn as attnrna3, the undersigned, Owner(s) Names) do(es) hereby state: That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at 2815 Sigsbee Rd., Mattituck which is shown and designated on the Suffolk County tax map as District 1000, Section 126 , Block 6 Lot 3.1 That the undersigned (has) (have) filed, 'or caused to be filed, an applica- tion in'the Southold Town iluiioing inspect..., c r.cL�., r-- ♦h„ fnllowina: 1 Story Stucco house and detached 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 In the conduct of such inspections may be used as evidence in subs equent,rlNsecut ions for vio- lations of the laws, ordinances, rules or regulationsAf thi Town of Southold. Dated: August 5, 2003 1. Gary Flanner Olsen (print name) (signature) , TOWN OF SOUTHOLD PROPERTY RECORD CARD V V U ✓ u VILLAGE DIST. SUB .� LOT Z,67A151 OWNER STREET -Iyu-(� 1 ►'� p J' h'�f�vl. �J ! sS'- o� d u=f- l� do .`° at-/ p. P FORMER OWNER, N WIP E ACR.0) S W TYPE OF BUILDING RES. SEAS. VL. FARM COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKS— 3/ Routrlb�.�� .�Acr.�e'�``p"a:,, dkcJ T- o 3 F6 d �.2 �a QQQ L'7t9@ 35�. �� d ,1�y-; 7-6 ` !S- -7- Con5+Yr,, a- " 1 J -x- "I - i n a &(42Q q A 7 2e rs G ,A Ic /V AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Acre Value Tillable 1 Tillable 2 Tillable 3 Woodland Swampland FRONTAGE ON WATER Brushland FRONTAGE ON ROAD House Plot DEPTH BULKHEAD Total DOCK •� 9 Y � tW, ., ,• 'fit �� 'Rr ��. TOWN OF SOUTHOLD r PROPERTY RECORD CARD OWNER STREET VILLAGE DIST. SUB. L-- LOT -`/d 7,4 &1// t ///2.A r; !" eA �L 4 %-'► J l J- 4,e /T d Q. 4a v r f t''`r Aculel �4c,C"t '40a k./,( FORMER OWNER N E ACING S W TYPE OF BUILDING .ES. 3 Z SEAS. VL. FARM COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKS �fly� ,to J Q Q Q % �i+e r.� .?ci" e ebu ffl �UK61 &4/ 7b N6T+t I% 0 t%' . d z t c a.d 75- / %a fP 4r AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Acre Value ('illable 1 "illable 2 'illable 3 Voodland wampland FRONTAGE ON WATER fry ;rushlond FRONTAGE ON ROAD louse Plot DEPTH BULKHEAD 'otal DOCK �. �/��//��:�; \ 7&. /,4' 1� � ��w}� �? » � »� �/ � . x§� a\ �2 LOCATION: (number & street) (municipality) SUBDIVISION: MAP NO.: LOT(S): NAME OF OWNER(S): .Q 10 OCCUPANCY: (type) (owner -tenant) ADMITTED BY: �,,,, ACCOMPANIED BY: KEY AVAILABLE: SUFF. CO. TAX MAP NO. 1000 - SOURCE OF REQUEST: DWELLING: DATE: TYPE OF CONSTRUCTION: V, # STORIES: # EXITS: FOUNDATION: CELLAR: CRAWL SPACE TOTAL ROOMS: IST FLR: 2ND FLR: 3RD FLR: BATHROOM(S): ,z TOILET ROOM(S): UTILITY ROOM: y�5 PORCH TYPE: DECK, TYPE: f PATIO, TYPE: BREEZEWAY: FIREPLACE:p GARAGE: DOMESTIC HOTWATER: 5 TYPE HEATER:1_ �i�l�- AIRCONDITIONING: TYPE HEAT: �.!%�,q� WARM AIR: HOTWATER: OTHER: ACCESSORY STRUCTURES: 'Z�-� GARAGE, TYPE OF CONST.: `�/8- -i/ `�,O:ORAGE, TYPE CONST.: SWIMMING POOL: GUEST, TYPE CONST: OTHER: VIOLATIONS: CHAPTER 45 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION I DESCRIPTION I ART. I SEC. REMARKS: INSPECTED BY: DATE ON INSPECTION: d j TIME START: .4 END: