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Home My WebLink AboutZ-30763FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 30763 THIS CERTIFIES that the building SEASONAL DWELLING Date: 02/11/05 Location of Property OFF ORIENTAL AVE FISHERS ISLAND (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 010 Block 0011 Lot 002 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- 30763 dated FEBRUARY 11, 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 SEASONAL DWELLING.* The certificate is issued to GEORGE C MATTHIESSEN (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. Aut orized Signature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: OFF ORIENTAL AVE FISHERS ISLAND SUBDIVISION: MAP NO.: LOT (S) NAME OF OWNER (S): GEORGE C MATTHIESSEN OCCUPANCY: SEASONAL DWELLING GEORGE C MATTHIESSEN ADMITTED BY: ACCOMPANIED BY: KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 10.-11-2 SOURCE OF REQUEST: STEPHEN L HAM, III ATTY DATE: 02/11/OS DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 1.0 # EXITS: 2 FOUNDATION: BLOCK CELLAR: NONE CRAWL SPACE: X TOTAL ROOMS: IST FLR.. 3 2ND FLR.: 0 3RD FLR.: 0 BATHROOM(S): 2.0 TOILET ROOM(S): 0.0 UTILITY ROON(S): YES PORCH TYPE: DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: NO GARAGE: NO DOMESTIC HOTWATER: YES TYPE BEATER: ELECTRIC AIRCONDIT TYPE BEAT: NO HEAT WARM AIR: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: SWIMMING POOL: BOTWATER: STORAGE, TYPE CONST.: GUEST, TYPE CONST.: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. REMARKS: BP 30953 ADD COZ- INSPECTED BY: GARY J : NONE DATE ON INSPECTION: 01/29/05 TIME START: END: i Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN 8 ALL DEC Z 9 �ilt�4 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. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. December 28, 2004 New Construction: Old or Pre-existing Building: X (check one) Location of Property: (no #) r/o/w off Peninsula Road Fishers Island House No. Street Hamlet Owner or Owners of Property: George Carey Matthiessen Suffolk County Tax Map No 1000, Section Subdivision 010.00 Block 11.00 Permit No. n/a Date of Permit. n/a Filed Map. Applicant: n/a Health Dept. Approval: n/a Underwriters Approval: Planning Board Approval: n/a Request for: Temporary Certificate Final Certificate: X Lot 002.000 Lot: n/a (check one) Fee Submitted: $ 100.00 c C k, C) Applicant Signature Stephen L. Ham, III CONSENT TO INSPECTION George Carey Matthiessen , te undersigned, do(es) hereby state: Owner(s) Name(s) y That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold, located at r/o/w off peninsula ]toad, Fishers Zslsnd , which is shown and designated on the Suffolk County Tax Map as District 1000, Section 10 , Block. 11 , Lot 2 That the undersigned (has) (have) filed, or cause to be filed, an applicatr.on in the Southold Town Building Inspector's Office for -the following: pro -existing Certificate of Occupancy for single-fam:Lly dkelli.ng That the undersigned do(os) 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 in subsequent prosecutions for violations -of the laws, ordinances, rules. or regulations of the Town of Southold. Bated: Aecember G,-> , 2004 � (Signa ) George Carey Matthiessen (Print Name) (Signature) (Print Name) 01/28/2005 10:27 FAX 631_-788 7798 FITELEPIiJNE LOCATION: (n:msber & shreet) (municipal3r) SUBDMSION; MAP Na. -_ NAME OF OWNER(S): _ s+I1 L LOT(S): OCCUPANCY; S .`. s i :- ACCESSORY STIMCTUpM: GARAG4 TYPE OF Co"ST.s STORAGE, TYPE CONST.: SV�'IlKM�IG POOL: OTHER: GUEST, TYPE CONtT: VIOLATIONS: CHAPM41 & N.Y. STATE UNIFOF.M FIFE PREVENTION ,,, Rz,, V= - DATE OF JXSPECTION: TIME START. SND: 2002 ... 11 l (type) - (owner�caaaot) ADMITTED BY: XXYSOU AVAILABLE: ACCOMPANIED BY: SOURCE OF REQUEST: SIIFF CO. TAX M,►P N0.1000-/� — i/ . 7i� - J/ DWELLjNG: TYPE OF CONSTRU O rr v: /'�� # STORIES: # tears: FOUNDATION: CELLAR: IYIi CRAWL SPACE -TOTAL ROOMS: 1S FLI : BATHROOIK(S): PORCH TYPE. 2ND FLR: R M'RD TO LET ROOM(S); .� _iUW ---,. TUA ROOM.• 7R. BREEZEWAY: - _ DECK, TYPE: ..._ PATIO, TYPE: --. Acv.. FiREPLACEo� /�✓ DOMESTIC HOTWATF.i` TYPE HEAT: Ij EGARAGE: �-``— AIRCONDMONjPTG: OTHER: WARM AIIt: $OTWATERs ACCESSORY STIMCTUpM: GARAG4 TYPE OF Co"ST.s STORAGE, TYPE CONST.: SV�'IlKM�IG POOL: OTHER: GUEST, TYPE CONtT: VIOLATIONS: CHAPM41 & N.Y. STATE UNIFOF.M FIFE PREVENTION ,,, Rz,, V= - DATE OF JXSPECTION: TIME START. SND: 2002 ... 11 l TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET VILLAGE DIST. SUB. LOT; C. 6Z4 FORM OWNER NGU � � �► ;+� E �MA-rT �✓1 fi R d' /9• " / g /1 PfJ Pte✓ S IX p W TYPE OF BUILDING ES. SEAS. .00 VL. FARM COMM. CB. MISC. Mkt., Value LAND IMP. TOTAL DATE REMARKS C/ D �aop � O 0 � t /lri �d�� aLc�t�^�`f<fi�%y �� ,!�>f.�`7`��•,te /1s6t5._ A11O'7�odd I M R Z�oOO lrjp l00 5" U '- L, -o AGE NEW NORMAL BUILDING CONDITION • BELOW ABOVE s FARM Acre Value Per Acre, Value 'illable 1 'illable 2 illable 3 ✓ood l and wampland FRONTAGE ON WATER rushland FRONTAGE ON ROAD louse Plot DEPTH BULKHEAD otal DOCK 4• ;'4i N/F ,ar LUCIA HENDERSON PARKING AREA GARBAGE ENCLOSURE v 3'±--, °Ncc y � ICA � SHED 5'± D GARDEN V� N/F ,ar LUCIA HENDERSON PARKING AREA GARBAGE ENCLOSURE v 3'±--, °Ncc y o voi (R `X HIGH WATER v APPROXIMATE UMITS FLOOD ZONE AE 10/ AE11 PANEL 19 OF 1026 FIRM MAP # 36103CO019G MAY 4, 1998 INNER BAY WET (GREAT) HARBOR DEED LINE EXISTING FLOATING DOCK RAMP PILE (TYP.) EXISTING FIXED DOCK �Z RAMP F ' MARSH . _ •r OVERHEAD UTILITIES --W EXISTING SHED 5'± GARDEN V� Off' Z IRON PIPE (FOUND) O o AREA SUBJECT TO As� RIGHTS FOR THE PURPOSE OF INGRESS J` u'R AND EGRESS AND FOR THE INSTALLATION AND MAINTENANCE OF PUBLIC ul\.00 6'- SERVICE UTILITIES F (LIBER 10251 /PAGE 551) IRON PIPE 3847± SQ. FT. Z (FOUND) N 928.72 N E 761.35 NS 0 ci X10 \00 V, ,, O -n ,1 o voi (R `X HIGH WATER v APPROXIMATE UMITS FLOOD ZONE AE 10/ AE11 PANEL 19 OF 1026 FIRM MAP # 36103CO019G MAY 4, 1998 INNER BAY WET (GREAT) HARBOR DEED LINE EXISTING FLOATING DOCK RAMP PILE (TYP.) EXISTING FIXED DOCK �Z RAMP F ' MARSH . _ •r OVERHEAD UTILITIES --W