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Home My WebLink AboutZ-30408FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N -Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No= Z- 30408 Date: 09/08/04 THIS CERTIFIES that the building DWELLING & COTTAGE Location of Property 975 LEGION AVE MATTITUCK (HOUSE NO.) (STREET) (HAMLET) -County Tax Map No_ 473889 Section 141 Block 0004 Lot 017 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- 30408 dated SEPTEMBER a, 2004 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 COTTAGE, ACCESSORY WOOD FRAME The certificate is issued to BARBARA SAILOR (OWNER) of the aforesaid building_ SUFFOLK. COUNTY DEPARTMENT OF BEALTH APPROVAL N/A ELECTRICAL NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. Rev. 1/81 N/A N/A Authorized Signature BUILDIUG DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE II7SPECTIO)7 REPORT LOCATIOI7: 975 LECIO17 AVE MATTITUCK SUBDMSION: MAP NO_: LOT (S) NAME OF OWNER (S): BARBARA SAILOR OCCUPANCY: RESIDENTIAL BARBARA SAILOR ADMITTED BY: B.APBARA & WAYNE SAILOR ACCOMPANIED BY: SAME I(EY AVAILABLE: SUFF. CO- TAX MAP NO_: 141.-4-17 SOURCE OF REQUEST: 13ARDARA SAILOR - ?/30/04 DATE: 09/08/04 DWELLII7G: TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 1.5 # EXITS- 2 FOUNDATION: BLOCK CELLAR: PART CRAWL SPACE: PART TOTAL ROOKS: IST FLR.: 4 2ND FLR-: 2 3RD PLR.: 0 BATHROOM(S): 0.0 TOILET ROOM(S): 1.0 UTILITY ROOM(S): YES PORCH TYPE: DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: GARAGE: DOMESTIC HOTWATRR: YES TYPE HEATER: GAS AIRCONDITIONING: TYPE HEAT: CAS WARM AIR: YES HOTWATER: OTRHR: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: WOOD FRIIE STORAGE, TYPE COMET.: SWIMMIUG POOL: GUEST, TYPE CONST.: WOOD FR NIE* OTHER: *3 ROOMS, 1 BATH, OIL HEAT, & PUHLIC WATER VIOLATIONS: CB -n PTER 45 N.Y. STATE UVIFORM FIFE PREVENTION & BUILDING CODE REMARKS: EP#30620-COE-30407 (ENCLOSE CARPORT ON COTTAGE FOR STORAGE) INSPECTED BY: / L� �Y� !A, _ teLQ. CHRISTOPRER M. TALBOT _ DATE ON INSPECTION: 05/13/04 TIME START: 10:30 :.K END: 10:45 AI4 _. _ .. Form No. 6�-�� -.P-11 30M TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWNHALL 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. Aproperly 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 L 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 - $?5 4- Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date.-7/1,loc/ �l New Construction: Old o Pre-existing B ding: (check one) Location of Property: 7�cJ� )9rg61FjL - 7TY ('G[C- S 2 - House No. Street Hamlet Owner or Owners of Property: /f��iii'gi4ell 5/a 1Lv P Suffolk County Tai: Map No 1000, Section Block `r Lot 1 % X Subdivision Permit No. XHealth Dept. Approval: CPlanning Board Approval: Filed Map. Date of Permit. Applicant: Underwriters Approval: r Request for: Temporary Certificate Final Certificate: Fee Submitted: $ w j— C 0 130 tfb 3� Lot: (check one) Applicant Signature ,A _ 140 „ W OF OUTHOLD PtiOPERTY RECORD CARD OWNER STRfL-T 9 75 VILLAGE DISTRICT SUB. LOT FORMER OWNER ' N E `��"C REAG//E // Av S WY Y' -TYPE OF9UILDING _ RES. d, SEAS, VL. FARM COMM. IN'e I "ryl -�.g IaMISO �' „• Est. Mkt. Value LAND IMP, TOTAL DATE REMARKS a� E.. - --ZI r .50 I IJ�IJ - - . x Y� a.oZg �. F .,-•,-; �.i. ., Ems- CJ.'&/c- - 4 11 AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FRONTAGE ON WATER Farm Acre Value Per Acre Value FRONTAGE ON ROAD a.c r•{� �a+i. Tillable 1 BULKHEAD Tillable 2 DOCK- Tillable, 3 ° Woodland ' Swampland Brushland+' House Plot ;Totq l N r N. Bldg. ( k _ Foundation - Bath 5xtension �' i- j.. ti� / n (/c/ y Basement Floors Q -- Extension 11�l1l� yam. Ext. Walls // Q �W Interior Finish Extension Fire Place 0 Heat i - -- Porch f7 -r h/ j3 y 1C Roof Type --- -- Porch ) ;� a,. - Rooms 9st Floor''✓ti` 9 -f�ieezew y Garage 0. B. ��,,-,,,� ��pp _ ACL a' {4 �l- 7/3 �,t.f� _ �Fy - 7 -,Lod,vJ Patio _ Driveway ... - � . Rooms 2r9� ti laor- t,, Dormer .. CONSENT TO INSPECTION the undersigned, do(es) hereby state: Owner(s) Name(s) That the undersigne(is (are) the owner(s) of the premises in the Town of Southold, located at 30S 64016] E /b y -F j TACK. Al. which is shown and designated on the Suffolk County Tax Map as District 1000, Section /(// , Block z/ , Lot /% That the undersigned (has) (have) filed, or cause to be filed, an application in the Southold Town Building Inspector's Office for the following: That the undersigned do(es) hereby gi ve 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: 3v (Signature) (P (Pri t Na , e�) ((�� (Signatur� (Print Name) 2- I 'q6./jlr.. lmf �s�.d T hI^wdep, r 04..,AM OW&O'' ✓/ Q�Ab A'"a""X (r"aAW a P. E OIL. G"rAK ^^m") ESURVEYED: JJ4Y 9A.m.iv lam MM # Is -mw 141- 4-11 MAP OF PROPERTY SITUATE AT: AJATTITuuA, TOWN OF: xrTNa-o COUNTY OF: MAP OF: I76Sc - F&PF&J-ry FILED: Saw I dah.. .»Y "= al .aurorsAnarArATAAw wamaNrewui Ae11M e/fe" wwlr Nu .a. as �o ria mwi®m.r.wwnwa� aiOAi+i°o amar CERTIFIED ONLY TO. wt&T.le }AIL�m WALLACE T. BRYAN r abr fiq 7m a� rrri& 1..11`•-.-r to. eF u,T Uczswm LAND suRvEvbII SAPC M.AwAb"O. Tn10 "i cj/. Lfm- 3*rA11LANNAAV8ffiM 71718. PJM. 1W'LAD'IA4 IAYFOiR.NY 117M !JI WJILLer ` A4W roAak 0)1}19S'l"I Lepo'14 LOCATION: I0y � 4urm.ic, (number & street) SUBDIVISION: NAME OF OWNER(S): OCCUPANCY: MAP NO.: A (municipality) wml!r . LOT(S): (type) (owner -tenant) ADMITTED BY: g 5AI ACCOMPANIED BY: iA w/C KEY AVAILABLE: a SUFF. CO. TAX MAP NO. 1000- - -7 SOURCE OF REQUEST: DATE:-JV114 . '30f --100ja DWELLING: i f TYPE OF CONSTRUCTIO 80 # STORI S: # EXITS: Z FOUNDATION: I� CELLAR: Am` CRAWL SPACE: TOTAL ROOMS: 1ST FLR: 2ND FLR: 2 3RD FLR: BATHROOM(S): L TOILET ROOM(S): ® UTILITY ROOM: S PORCH TYPE: DECK, TYPE: PATIO, TYPE: BREEZEWAY: FIREPLACE: 09 GARAGE: DOMESTIC HOTWATE :_ TYPE HEATER: AIRCONDITIONING: �10 TYPE HEAT: WARM AIR:HOTWATER: OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: STORAGE, TYPE CONST.: SWIMMING POOL: #.l®'41E-i GUEST, TYPE CONST: W ma - OTHER: &K, -t Gil.vr Po6ll- vJ44&L VIOLATIONS: CHAPTER 45 & N.Y. STATE UNIFOF,M FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. REMARKS: INSPECTED BY: Q �� DATE OF INSPECTION: USS f 3 T TIME START: ib = 3® END: