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Home My WebLink AboutZ-29885FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY NO: Z- 29885 Date: 12/05/03 THIS CERTIFIES that the building DWELLING Location of Property 18875 MAIN RD MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 108 Block 0004 Lot 002.001 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- 29885 dated DECEMBER 5, 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 ATTACHED ONE CAR GARAGE The certificate is issued to JOAN JACOBS,& ORS. (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. Rev. 1/81 N/A N/A A4Aorized Signature BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 18875 MAIN RD MATTITUCK SUBDIVISION: MAP NO.: LOT (S) HAMS OF OWNER (S): JOAN JACOBS,& ORS. OCCUPANCY: SINGLE FAMILY DWELLING JOAN JACOBS,& ORS. AD!(ITTRD BY: JOAN JACOBS ACCOMPANIED BY: SAME KEY AVAILABLE: BUFF. CO. TAY NAP NO.: 108.-4-2.1 SOURCE OF REQUEST: ABIAIL A. WICKHAM 9/29/03 DATE: 12/05/03 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME i STORIES: 1.0 • EXITS: 3 FOUNDATION: CEMENT BLOCK CELLAR: FULL CRAWL SPACE: TOTAL ROOKS: 1ST FLR.: 4 2111) FLR.: 0 3RD FLR.: 0 HATBROOK(S): 1.0 TOILET ROOK(S): 0.0 UTILITY RDOK(S): ** PORCH TYPE: SCREEN PORCH REAR DECY TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: GARAGE: ONE CAR DOMESTIC HOTMATER: YES TYPE HEATER: AIRCONDITIONING: TYPE BEAT: OIL NAM AIR: HOTNATER: XX OTHER: **OFF KITCHEN ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: SMDINRNG POOL: STORAGE, TYPE CAST.: GUEST, TYPE COAST.: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE INSPECTED BY: DATE ON INSPECTION: 10/06/03 GARYISN TIME START: 9:30 AM END: 10:00 AM Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 S"11 2 9 2003 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 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 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 Building - $100.00 3. Copy of Certificate of Occupancy - I .25V, 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ,September 26, 2003 . New Construction........... Old Or Pre-existing Building..,X for one story frame house with 4 at�ache3'gara'gge and covered rear porch. tuck Location of Property.. 18875 ............. Main Road............_._....................... House No. •Street Hamlet Onwer or Owners of Property... Joan Jacobs,. Peter. Grabowski and. Carol. Giacone................. ....... ........... ... . ..... ..... County Tax Map No 1000, Section... 108 ....... Block .... 4........... Lot ... 2.1 ................ Subdivision....................................Filed Map ............ Lot ...................... Permit No................Date Of Permit ................ Applicant ............................. Health Dept. Approval..........................Underwriters Approval......................... Planning Board Approval ........................ Request for: Temporary Certificate........... Final Certicate..X........ Fee Submitted: $............................. `-'G'�!' Abigail A. APPLICANT Wickham, Agent TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET VILLAGE DIST. SUB. LOT FORMER OWNER E ACR. ., . r ,� , S —� W f ,-, ef -:^, tom✓.- TYPE OF BUILDING ,/c� n �s,P--` (RES. �a SEAS. VL. FARM COMN(/ CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS -f, I — txx) �t ca 't- 6Ls—Nh Toa 3LOJ 3 70 AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Acre Vclue FRONTAGE ON WATER Tillable Woodland FRONTAGE ON ROAD / J Meadowland DEPTH House Plot BULKHEAD DOCK Total COLOR I 6 � e r � TRIM (,, - wlbww e, l cr t M. Bldg. Extension Extension Extension Foundation Crviu. iZ Bath Dinette! PorchA t/ Basement Floors K. Porch j Ext. Walls Interior Finish Breezeway Fire Place Heat DR. Garage Type Roof Rooms 1st Floor BR. Patio Recreation Room Rooms 2nd Floor FIN. 13 O. B. iDormer Driveway Total JAMES J. DEERKOSKI, P.E. 260 Deer Drive Mattituck, N.Y. 11952 (516) 298-5506 Re: 18875 Main Rd. Mattituck, NY 11952 To Southold town Building Dept; After an inspection of the Roof over the screened porch at the above-mentioned property, the porch roof is structurally sound with the installation of the new Microlam girder, and meets all criteria for roof snow loads. Sincerely James %koski v Ac -o 6.s / Fe 9S- ✓►14/iO M-4 77lu-c.[c- /� 768-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: A10 141,zlf DATE j0 L d INSPECTOR CONSENT TO INSPECTION ABIGAIL A. WICKHAM 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 18875 Main Road, Mattituck, New York 11952 which is shown and designated on the Suffolk County tax map as District 1000, Section 108 Block 4 Lot 2.1 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: a Pre -Existing Use Certificate of Occupancy for one story frame dwelling with attached garage and covered rear porch. 1 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 allof 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 subsequent prosecutions for vio- lations of the laws, ordinances, rules or regulations of the Town of Southold. Dated: September 4, 2003 i signature) Ab i ail A. Wickham, Agent print name (signature) (print name) MAP NO. %6 PARCEL NO.94 7-7-/77/CK-GQfENPOP ;fAK7S7E'3-5:A1&Z09 C UUN I T Uh Siifib/K SHEET 1 OFO SHEETS SURVEY NOTES ON FILE AT NEW YORK STATE DEPARTMENT OF TRANSPORTATION REGIONAL OFFICE LOCATED AT HAUPPAUGE, NEW YORK S.C. TAX /000 - /0e - ¢ -/ CC D L 3425 P444 TRN- None P.I.N. 00¢7.92 Ile GRA6oeKl 0 40 80FT SCALE 6) NYQ J� z w c',/J,C6 W',,�ed00'' o *5 Gf Area r.3� JZ1B * A 015 Tak � ��Folk w �� Colin y 0t'ne ) - � rReP A- 0 8 J o. i. o. /. <,`'i') - Ro.w � I• X4-2 , � tJSc,40/� 2-1 o q ` I Z f/vust y� � Q H l /hA % N727. a 03 E T/T(/_ G'Q,Lc-EN.�p7 ,oj-� (C Pj-3 CONTINUED ON SHEET 2 P. o. C LOl7e - 3o t `s'ye229 LOCATION: (number & street) (municipality) SUBDIVISION: NAME OF OWNER(S): OCCUPANCY: (type) MAP NO.: LOT(S): (owner -tenant) ADMITTED BY: MAO �T_Acwx3l ACCOMPANIED BY: KEY AVAILABLE: SUFF. CO. TAX MAP NO. 000 - SOURCE OF REQUEST: DWELLING: DATE: TYPE OF CONSTRUCTION: # STORIES: Ou_e_ # EXITS: —3 FOUNDATION: CELLAR: Aj CRAWL SPACE: -- TOTAL ROOMS: IST FLR: 2ND FLR ` - 3RD FLR: , BATHROOM(S): T ROOM(S): UTILITY ROOM: PORCH TYPE: /, DECK, TYPE: PATIO, TYPE: --- BREEZEWAY: FIREPLACE: GARAGE: 64--2 40-c_ DOMESTIC HOTW TER: TYPE HEATER: AIRCONDITIONING: TYPE HEAT: WARM AIR: HOTWATER: �/ OTHER: ACCESSORY STRUCTUR�,/� GARAGE, TYPE OF CO ST(.: SWIMMING POOL: OTHER: STORAGE, TYPE CONST.: GUEST, TYPE CONST: VIOLATIONS: CHAPTER 45 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION D SCRIPTION ART. SEC. 414 C REMARKS: INSPECTED BY: DATE ON INSPECTION: n TIME START: END: �f�