HomeMy WebLinkAboutZ-30555FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 30555
Date: 11/15/04
THIS CERTIFIES that the building DWELLING AND ACCESSORY
Location of Property 820 OLD SALT RD MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 144 Block 0005 Lot 015
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- 30555 dated NOVEMBER 15, 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 ENCLOSED PORCH AND RAISED SLATE PATIO AND
ACCESSORY TWO CAR GARAGE.*
The certificate is issued to JOHN SCUDDER MORSE
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
.ice _ 1 ' Z.
izettf Signature
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 820 OLD SALT RD MATTITUCK
SUBDIVISION: MAP NO.: LOT (S)
NAME OF OWNER (S): JOHN SCUDDER MORSE
OCCUPANCY: SINGLE FAMILY RESIDENCE JOHN SCUDDER MORSE
ADMITTED BY: ACCOMPANIED BY:
KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 144.-5-15
SOURCE OF REQUEST: JACK MORSE DATE: 11/15/04
DWELLING:
TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 1.0 # EXITS: 3
FOUNDATION: CEMENT CELLAR: PIT CRAWL SPACE: X
TOTAL ROOMS: 1ST FLR.: 5 2ND FLR.: 0 3RD FLR.: 0
BATHROOM(S): 2.0 TOILET ROOM(S): 0.0 UTILITY ROOM(S):
PORCH TYPE: ENCLOSED & UNHEATED DECK TYPE: PATIO TYPE: SLATE RAISED PATIO
BREEZEWAY: FIREPLACE: GAS GARAGE:
DOMESTIC HOTWATER: YES TYPE HEATER: AIRCONDITIONING:
TYPE HEAT: OIL WARM AIR: HOTWATER: X
OTHER:
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.: TWO CAR
SWIMMING POOL:
OTHER:
STORAGE, TYPE CONST.:
GUEST, TYPE CONST.:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION I DESCRIPTION I ART. SEC.
REMARKS: RE -INSPECTED 11/9/04
INSPECTED BY:
GARY J
DATE ON INSPECTION: 10/12/04
TIME START: 10:10AM END: 10:40AM
i
Form No. 6
TOWN OF SOUTHOLD ° w : SEP 2 8
BUILDING DEPARTMENT
TOWN HALL
765-1802 rc'
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.S.Rr 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. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ,S
Date. Q • I L4 . 0 4
New Construction: Old or Pre-existing Building: _ (check one)
Location of Property: ;t p nth5.1� L -r e`ZO +M c4-cT� T �x.K N4
House No. Street Hamlet
tj
Owner or Owners of Property: %4N S O t45q,
Suffolk County Tax Map No 1000, Section tLA LA Block ' S Lot W
Subdivision X Filed Map. >c Lot:
Permit No. Date of Permit. Applicant: 6N14
Health Dept. Approval: k Underwriters Approval: k
Planning Board Approval:
Request for: Temporary Certificate k Final Certificate: (check one)
Fee Submitted: $ 10 0.'00
O0 -2 3o!5 5 S
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) b'l�n Applicant Si ture
" TOWN OF SOUTHOLD IOPERTY RECORD CARD
OWNER
STREET
VILLAGE
DISTRICT
SUB.
LOT
Sq 7
G�fj%1
jj• //` / / 1
FORMER OWNER
N
E
ACREAGE
S
W
TYPE OF BUILDING
ZES.4/a
SEAS.
VL.
FARM
comm.
� IND.
I
CB. ( MISC.
LAND
IMP.
TOTAL
DATE
REMARKS
170
lJ
1
o-6
5po a
AGE
BUILDING CONDITION
NEW
NORMAL
BELOW
ABOVE osE
D
Farm
Acre
Value Per Acre
Value
Tillable 1
Tillable 2
billable, 3
Noodland
>wampland
�.
3rush.land
I
=louse Plot
dotal
P27j-
M. Bldg.
KI 7 Ot 0 6"\
Foundation
Bath
Extension#Y
Y�� 3
n� //� 17 1/
Basement
"Ll,
PA
Floors
Extension
-
Ext. Walls
interior Finish
Extension
Fire Place
Al
Hecot
,00e
Attic
0 Vt-ot,
M 7
-3/7
Porch
Rooms 1st Floor
3 X I?
Patio
Rooms 2nd Floor
Garage
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7 (,
Driveway
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FILED MAY lo, 1H40 FILE No. i310 N
51TUATE: MATT1TUCK' °�,
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JOHN S. MORSE
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