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Home My WebLink AboutZ-30753 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 30753 Date: 02/08/05 THIS CERTIFIES that the building DWELLING Location of Property 465 FARMERS RD MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473689 Section 139 Block 0003 Lot 029 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- 30753 dated FEBRUARY 8, 2005 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 JAMES & BLANCHE DUGGAN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTM@TP OF HBALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO_ N/A i PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. - A thorized Signature Rev. 1/61 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 465 FARMERS RD MATTITUCK SUBDIVISION: NAP NO.: I.OT (S) NAMH OF OWNHR (S): JAMES & BLANCHE DUGGAN OCCUPANCY: SINGLE FAMILY DWELLING JAMES & BLANCHE DUGGAN ADMITTHD BY: JAMES DUGGAN ACCOMPANIBD BY: SAME RHY AVAILABLH: SUPP. CO. TAR MAP NO.: 139.-3-29 SOURCH OF RHOUHST: JAMES DUGGAN 01/09/05 DATH: 02/08/05 DWELLING: TYPH OP CONSTRUCTION: WOOD FRAME # STORIHS: 2.0 # BRITS: 2 POUNDATION: CONCRETE CHLLAR: PART. CRAWI. SPACH: PART. TOTAL ROOMS: 1ST PLR.: 5 2MD PLR.: 2 3RD PLR.: 0 BATHROOM(S): 2.0 TOILBT ROOM(S): 0.0 DTILITY ROOM(S): ONE PORCH TYPH: ROOFED DHCR TYPH: WOOD PATIO TYPH: BRBHZHWAY: PIRHPLACH: GARAGH: ONE CAR DOMHSTIC NOTWATHR: YES TYPH HHATHR: HOT WATER* AIRCONDITIONING: TYPH HHAT: OIL WARM AIR: HOTYU~TBR: OTffi2• *BASEBOARD ACCESSORY STRUCTURES: GARAGH, TYPH OP CONST.: STORAGH, TYPH CONST.: SWIMNING POOL: GUHST, TYPH CONST.: OTBBR: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. ~ SEC. xw~nxrs: BP#30922-Z-COZ-30751 (AGCY SHED)BPp30943Z-COZ-30752 (NEW BOILER) r INSPHCTHD BY: DATH ON INSPBCTION: O1 07 OS GHORGH GILLHN TIMH START: 9:45 AM HND: 10:15 AM Form No. 6 • TOWN OF SOUTHOLD • BUILDING DEPARTMENT TOWN HALL _ 765-1802 SAM [j 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 Apri19, 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 $15.0//0 Date. ~..//J-yt ,3 Yv 0 J'- New Construction: Old or Pre-existing Building. ~ (check one) Location of Property: ~ .f~ ~/Q K~ ~ i1.- /C ~jtF?7' iii e !L House No./ Street Hamlet Owner or Owners of Property: ~/Q ~/l.Ip a- ~'t^~ ~G g ~f Q K~ Suffolk County Tax Map No 1000, Section ~ ~ 1 Block ~ Lot 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: $ Applic~ Signature ~a,~c.b~(n7~-- C-~z c,~ ~ 3 0 753 CONSENT TO INSPECTION ~Gtn.+-tR{ a- N'ctic-~f ~ u~- ,the undersigned, do(es) hereby state: Owner(s) Name(s) That the undersi",g~/n~/ed (is) (are) the owner(s) ~f the premises in the Town of Southold, located at 7`~~ t-~Kr+rG.L 9 ~i1-Tn xrc tG , which is shown and designated on the Suffolk County Tax Map as District 1000, Section 13q ,Block Lot _ 2~~_. That the undersigned (l:as) (have) filed, or cause to be filed, an application in the So//uthold Town Building Inspector's Office for the following: Fo 2 EKrt~.n / R7ui~d/n ~--i~/~ 7~ ? 9 9 /1/0.? Oa.t7~o/~+.ii ~ L/Jt O ~~~`,.teyS sq ,(~at~ " LQ„s urC_c ~ 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 l respect to the aforgsaid application, including inspections to determine that said premises comply with al] 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. 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