HomeMy WebLinkAboutZ-30827FORM NO, 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPA/~CY
No: Z- 30827 Date: 03/21/05
THIS CE/~TIFIES that the building SEASONAL DWELLING
Location of Property 355 SOUND BEACH DR MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 099 Block 0001 Lot 019
Su]~dlvision 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
OCC~3P~/~CY ~d~4BER Z- 30827 dated M/%RCH 21, 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 F PAUL DIMARCO
of the aforesaid building.
( OWNER )
SUFFOLK COUlqTYDEpARTMENT OF H]~LTHAPPRO%rAL
HLE~-~'~IC3%L CERTIFICATE NO.
PLUMBERS CERTIFICATION DATm
*PLEASE SEE ATTACHED INSPECTION REPORT.
N/A
N/A
N/A
Rev. 1/81
BUILDING DEPARTMENT
TO~4 OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
Id)CATION: 355 SOUND BEACH DR
SUBDIVISION:
NAME OF OWNER (S): F PAUL DIMARCO
OCCUPANCY: SEASONAL ONE FAMILY
AD~i'I-r~Y: CHRIS RIVERA
MATTITUCK
MAP NO.: LOT (S)
F PAUL DIMARCO
1.0 # EXITS: __2
PATIO TYPE:
ACCESSORY STRUCTURES:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
~: BP205 ENC SCREENED PORCH COZ157
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by ~pewriter or ink and submitted to thc Building Department with the t\qlowing:
A, For new building or uew use:
l. 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 o f 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:
I. 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.
Co
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 $50.00.
2. Certificate of Occupancy on Pm-existing Building - _$ I00.00
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
New Construction:
Location of Property: ~ ~..~
House No.
/"7
Owner or Owners of Property: ~--~'
Suffolk County Tax Map No 1000, Section
Subdivisio~/'),Cf F /d,'dd
Permit No. Date of Permit.
Health Dept. Approval:
Planning Board Approval:
Request for: Temporary Certificate
Date.
Old or Pre-existing Building:
Stl~ect : /
B:o k Ye
(check one)
,/ Hamlet
Lot 1/~
Filed Map.
Lot:
Applicant:
Underwriters Approval:
_X.
Final Certificate: t-'/
(check one)
Fee Submitted: $
Aj~licant Signature
CONSENT TO INSPECTION
Owner(s) Name(g)
That the undersigned (is) (are) the owner(s) of the premises in the Town of
Southold, located at
which is shown and designated on the Suffolk County T~x Map as District 1000,
Section ]~ ,Block
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 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.
Dated:
( P fi~nt Name)
(Signature)
(Print Name)
LOCATION:
(number & street)
(municipality)
SUBDIVISION:
NAME OF OWNER(S):
OCCUPANCY:
MAP NO.:
LOT(S):
(type)
(owner-tenant)
ADMITTED BY:
KEY AVAILABLE:
SOURCE OF REQUEST:
ACCOMPANIED BY: .~
SUFF. CO. TAX MAP NO. 1000-
v~t.4 DATE: .,~.AO~O.f'~
! /
DWELLING:
TYPE OF CONSTRUCTIO, N: ~'/,~,,~f //Dyg.~ # STORIES:
FOUNDATION: (~.~x.c.q-~ t~ {.~- · CELLAR:
TOTAL ROOMS: 1ST FLR: ~?t 2ND FLR:
BATHROOM(S): t,q~._. TOILET ROOM(S):
PORCH TYPE: ~.J~z~_ DECK, TYPE: - -,
BREEZEWAY: FIREPLACE:
DOMESTIC HOTV,fATER: 3~.~YPE HEATER: -~
TYPE HEAT: /4/t;rA/,~? WARM AIR:
OTHER:
# EXITS:
CRAWL SPACE:
3RD FLR:
UTILITY ROOM: ~
PATIO, TYPE: ~
GARAGE: .~
AIRCONDITIONING:
HOTWATER:
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.:
SWIMMING POOL:
OTHER:
STORAGE, TYPE CONST.:
GUEST, TYPE CONST:
VIOLATIONS: CHAPTER 45 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
REMARKS:
INSPECTED BY:
DATE OF INSPECTION:
TIME START: 7; ~''~)
END:
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