HomeMy WebLinkAboutZ-30891 FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southol3, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 30891 Date: 04/29/05
THIS CERTIFIES that the building DWELLING
Location of Property 2730 GRAND AVE MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 107 Block 0002 Lot 006
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- 30891 dated APRIL 29, 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 GARAGE UNDER HOUSE*
The certificate is issued to ESTATE OF LINVILLE G.FARROW
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMBNT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
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uthorized Signature
Rev. 1/61
BUILDING GE FrATM E[IT
TJWII OF SGUTHO ~D
HOUS IIJG CODE IEJS FECTIO[d REPOP.T
IACATION: 2730 GRAND AVE MATTITUCK
SUBDIVISION: MAP NO.: IAT (S)
MAMH OF ONNSR (S): ESTATE OF LIIJ'?I LLE G.FARR047
OCCUPANCY: RESIDENTIAL ESSTATE OF LItJ'?ILLE G.FAAROW
ADMITTED BY: WAY[JE SAILOR ACCOMPANIED BY: SAME
RSY AVAILABLB: SUFP. CO. TAX MAP NO.: 10'.-2-6
SOURCH OF RHQUHST: MART ILI D. FIt7NEGAII ATTY 4/22SOS DATH: 04/29 OS
DWELL I[JG:
TYPH OP CONSTRUCTION: WOOD FRAME # STORIES: 1.0 # E1IIT5: 3
FOUNDATION: CEf4EtJT BLOCK [-ar•r na- FULL CRAWL SPACH'
TOTAL ROOMS: 1ST PLR.: 5 2ND PLR.: 0 3RD PLR.: 0
BATHROOM(S): 1.0 TOILHT ROOM(S): 0.0 UTILITY ROOM (S):
PORCH TYPE: DHCR TYPE: PATIO TYPH:
BRSEZHWAY: PIRHPLACH: GNE GARAGE: U[JD ER HOUSE
DOMHSTIC HOTWATHR: 'fES TYPH HEATHR: OIL BUP.IJER AIRCONDITIOMIIJG:
TYPE HEAT: OIL WARM AIR: HOT'WATett: YES
OTffi2: OIL HOT WATER HEATE P.
ACCESSOP.Y STRUCTURES:
GARAGE, TYPE OP CONST.: STORAGE, TYPH CONST,:
SWIlQIING POOL: G06ST, TYPE CONST.:
OTFIBA:
VIOLATIONS: CHAPTER 45 PL'f. STATE UNIFORM FIRE PREVEt7TION & BUILDING COLE
LOCATION DESCRIPTIOt7 ART. SEC.
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1NSPHCTRD BY: T6 ON INSPECTION: 04/27/05
GEORGE GI LEIJ TIME START: 10:30 AM END: 10:55 AM
~ A1f~~~----~' ~ ~1- t~l b'L~ Ca-'u`-~~ J
Form No. 6 ~ L '
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TOWN OF SOUTHOLD ~5 ~
BUILDING DEPARTMENT • ~ 2L ~ ~ ~ y ;111
TOWN HALL L
765.1802 L-~ 1
E 1'kFT
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, proper[} lines, streets, and unusual natural or
topogmphic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form).
3. Approval of electrical installation from Boazd of Fire Underwriters.
4. Swom statement from plumber certifying that the solder used in system contains less than 2/10 of 1°i° lead.
5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate
of Code Compliance from azchitect 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 a consent [o 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 onPre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $2.5.00
Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy -Residential $15.00, Commercial $15.00
Dale. April 21, 2005
New Constmction: Old orPre-existing Building: R (check one)
Location ofPropert}•: 273 Grand Avenue Mattituck
House No. Street Hatnlet
Estate of Linville G. Farrow
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section 107 Block 2.00 Lot 008.000
Subdivision n/a Filed Map. Lot:
Penni[No. Da[eofPermit. Apphcant Twomey, Latham, Shea & Kelly, LLP
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: R (chec ne)
FeeSubmitted:$ 100.00 Twom r' Latham, Shea & Kelley, LLP.
ay: ~
cant Signature
Martin D. Finnegan, Esq.
Attorney for the Estate of.
Linville G. Farrow
c~:,.~- ~ ~ ~
B~~o~3o891
CONSENT TO INSPECTION
_~`'7~ ..~~Llk ~ ~~TVT~/ ,the undersigned, do(es) hereby state:
O~ Her(s) Name(s)
That the undersigned (is) (are) the owner(s) of the premises in the Town of
Southold, located at Z~l~j~ ~Q„,~Q J~.
which is shown and designated on the Suffolk County Tax Map as District 1000,
Section (D`~ ,Block 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: _ C C7
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.
7- Y~o S
Dated:
(Signat )
/lilftf~iZnJD ~7~t~s~--~ r,~.o
(Signature)
(Print Name)
LOCATION: ~ / .3 ~ G~Iq-/1/ ~ l4 U~ . ~ /'7~TT~ T K C
(number & street) (municipality)
SUBDIVISION: MAP NO.: LOT(S):
NA1~lEOFOWNER(S): ~57~T~ D /--/NV/LC G. R,('o W
OCCUPANCY: e
77 (type) p (owner-tenant)
ADnIITTED BY: N~Y~~ S~ ~ L~ ^ ACCOMPANIED BY:
KEY AVAILABLE: ~ ~ SUFF. CO. TAX MAP NO. 1000- I ~ 7- 0"1 -
SOURCE OF REQUEST: MAIEY/N ~/~NEGAN APPLIc, DATE: ~ - o27-OS
DWELLING:
TYPE OF CONSTRUCTION: ° D ~R//M~ # STORIES: I'VE # EXITS: 3
FOUNDATION: CEMENT B to c!c CELLAR: F/s~c.. CRAWL SPACE:
TOTAL ROOMS: 1ST FLR: S' 2ND FLR: 3RD FLR: -
BATHROOM(S): / TOILET ROOM(S): UTILITY ROOM:
PORCH TYPE: DECK, TYPE: PATIO, TYPE:
BREEZEWAY: FIREPLACE: oNE GARAGE: ONC N CQ ou~~
DObIESTIC HOTWATER: yes TYPE HEATER: ol~ BNIt~~ AIRCONDITIONING:
TYPE HEAT: O ~ L. WARM AIR: HOTWATER: ~`~S
OTHER: 6/L, XU1' W~-[E~ f~~i
T
ACCESSORY STRUCTURES: ~n/?F
GARAGE, TYPE OF CONST.: STORAGE, TYPE CONST.:
SWID1bIING POOL: GUEST, TYPE CONST:
OTHER:
VIOLATIONS: CHAPTER 45 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRI TION ART. SEC.
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REMARKS:
INSPECTED BY: 6~0. G/LLt,n/ DATE OF INSPECTION: ~ ' ° ~
TIME START: ~ ~ 30 /9-H1 END: I ~ ' ss~`"'l
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SURVEYED: ~~B.al Zoos TAX MAP # /~o~-~o~.po-2-2~ SCALE ~~~=qo•
MAP OF PROPERTY SITUATE AT: DNADTHDRIGED nEFEN:IIGIJ Dn
MA T T l r~lc K _ ADDffICIN TO 'EHIi iUItvEY IS
VIOLATION OE iECI'ION T_ua JI' THE NEW
I~ II yIF^""^'aF],~ YOIU: STTTE CUVinfIJN LS\C
TO ~11/ I V ~J F • S~T/'I oL~ ~1:~ AL'.~~q~~ NI'IES OF THIS iUItYE! ALAI' NUI
+ V pEAWt+O TnC LAND SURVEVG6 INACD
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COUNTY OF: ~cJP~or~c 1 NE~ ]OQ{: ~ ~ ~tF: 'i N CunIUN"FEES Ok CEICiWG.TIOru
I ]M1 INDICnfED HHI:EGN SnALL I:UN ONL}'IJ
~ S,^ ~ THE PERSON FOIL WHOAI ME>VIO'E'f Ii
LOT
~~SeYr; I'fILrAREG. AIJD GN IUS pEMLF TO'fl1E
MAP OF: G~sc-2.iP~E-C~ P2oPG-RT~( '~+-4`'~~'?-_ "rA rlrLe ccnlr,,N.. ccvEnN~1LNI:,L ,
n ~,..\'v ACGNCY AND LENDINi, WiTI'Nl'ION
~\r\~o ~`tl~arj~'~ j' JFTED HE~DLENUIIJCO fHNSTITIU"I ION
_ ~"J f ~""'•C' ~ ~ CUAMNTEE~ OII CP.ICI IEIviflGNi .,RE
FILED: N01' TIUNSFEM6LF TO nCAI"IIGNAL
IHSI'ITUI'IONi Olt SUnSEQb EN'f OWNBU.
IJO hHl'9GL EASFUNT JIJ I'nOOEI(fY
CERTIFIED ONLY TO: JNLEis NJ"fLD, IUCJItDCG EaSEIACNTS
UR NClif OF ^nV~ IF .Ak! I+iiF SHOWN.
nltE lJO' CCR'fIFIEU
~n/4.y,vC 5.~,~0~ WALLACE T. BRYAN
=~~rE ~A¢i~e T,T~c ,'IGC.ac.)/ L-rt, LTCfvNSL'D LAND SURVEI'OR
' 39 PAULANNA AVENUE
IIAYPOR"T, NY 11705
~I - - (C31)-•{72-177(1
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