HomeMy WebLinkAboutZ-31079FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 31079
Date: 08/03/05
THIS CERTIFIES that the building DWELLING
Location of Property 10575 SOUND AVE MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 122 Block 0001 Lot 004
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
OCCUPANCY NUMBER Z- 31079 dated AUGUST 3, 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 *
The certificate is issued to MATTHEW MEYER
of the aforesaid building.
(OWNER)
SUFFOLK COUIFrYDEPARTMENTOFHEALTHAPPROVAL
ELEC'~RICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DA'r~u
*PLEASE SEE ATTACHED INSPECTION REPORT.
N/A
N/A
N/A
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTROLD
ROUSING CODE INSPECTION REPORT
LOCATION: 10575 SOl/ND AVE
SDBDIVISION:
N~ OF O~ (S): MATTHEW MEYER
OCCUPANCY: ONE FAMILY RESIDENCE
AD~4I'~-r~UBY: MATTHEW MEYER
MATTITUCK
MAP 90.: LOT (S)
MATTHEW MEYER
SOURCE OF P~ST: MATTHEW MEYER 7/26/05 DAf'E: 0e/03/05
# S~RIES: 2.0 ~ EXITS: ~3
(~I~: PART. ~ SPA~: PA/~T.
ACCESSORY STRUCTURES:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATIOn! DESCRIPTION ART. SEC.
IL~: BP #31287-Z (AS BUILT DECK)- COZ-31066
GEORGE GILLEN T/~ START: 10:15 AM [~ID: 10:40 AM
JUL Z Ii 2005
Form No. 6
TO'WN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application nmst be filled in by typewriter or ink and submitted to the Building I)epamnent with tile follow ng:
A. For new building or new use:
· 1. Final survey of property with accurate location of all buildings, property liues, streets, and unusnal natural or
topograplfic realm'es.
-~2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form).
' 3. Approval of electrical installation front Board of Fire Underwriters.
4. Sworn statement front plmnber certifying that the solder used in system contaius less than 2/10 of 19o lead.
5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate
of Code Compliance front architect or engineer responsible for the buikling.
6. Submit Plamfing Board Approval ofcoinpleted 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 ofprol)erty showing all property lines, streets, building and unnsual uatural or Iopographic
features.
2. A properly completed application and consent to inspect signed by tile apl)licam. Ifa Certificate ot Occupancy is
denied, the Building h~spector shall state the reasons therefor in writing to the applicant.
..--.2.
3.
4.
5.
C. Fees
1. Certificate of Occnpancy - New dwelling $25.00, Additions to dwelling $25.00, Alteratious to dwelling $25.00,
Swimofing pool $25.00, Accessory building $25.00, Additions to acccssor3' building $25.00, Businesses $50.00.
Certificate of Occupancy on Pre-existing Building - $100.00
Cop5, of Certificate of Occupancy - $.25
Updated Cetxificate of Occupancy - $50.00
TemporaD' Certificate of Occupancy - Residential $15.00, Cormnercial $ l 5.00
Old or Pre-existing Building:
New Construction:
Locatiou of Prupedy:
Date..___72/~¢.,4/O %'" (check one)
House No. Street
Suffolk County 1'ax Map No 1000. Section ~ _
Subdivision
Permit No.
Health Dept. Approval:
Plamting Board Approx al:
Request for:
Date of Permit.
Ten~poraW Certificate
Block
Filed Map.
Applicant:
Underwriters Approval:
Fioal Certificale:
ltanflet
Lot OO&
(check one}
CONSENT TO INSPECTION
Owner(s) Name(s)
, the undersigned, do(es) hereby state:
That the undersigned (is) (are) the owners) of the premises in the Town of
Southold, located at / O
which is shown and designated on the Suffolk County Tax Map as District 1000,
Section zl~_%gS'~ Block ~-2~- , Lot ooO~ -oogl~
That the undersigned (has) (have) filed, or cause to be filed, an application in the
Southold Town Building Inspector's Office tbr 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:
/~ t .( S ignfit u_ r.,511.---~__
(Print Name~
(Signature)
(Print Name)
~J~l. 1. 200~-H:39~M MARG[OTTA & ~IC]GL[ANG
N
ul. 1, 2005~tl:39AM ~AR$[OTTA & RI¢iGL[A#O
(number & street)
(municipality)
SUBDIVISION: '----- MAP NO.: -'"-'--- LOT(S):
NAME OF O~rNER(S):
OCCUPANCY:
(t~e) (owner~)
ADMITTED BY: ~A~,~/"2'~t~-~'0 /~r~-~/(~ ACCOMP~IED BY:
~Y AVAILABLE: ~ ~ SUFF. CO. T~ MAP NO. 1000-
SOURCE OF ~QUEST: ~TTff~ ~ ~ DATE:
DWELLING:
TYPE OF CONSTRUCTION: ~/,~tw
FOUNDATION: C~'-m ~-nt 7'-
TOTAL ROOMS: IST FLR:
BATHROOM(S):
PORCH TYPE: xa/~,~p /]/~'0~f~/b
BREEZEWAY:
DOMESTIC HOTWATER: ~/~".5 TYPE HEATER:
TYPE HEAT: ~q .5' WARM AIR:
OTHER:
~/-- o C--tk-'- CELLAR:
2ND FLR: 0-
TOILET ROOM(S): - ~
DEC~ TYPE: ~
FI~PLACE: ~o ~ ~
# STORIES: ~ # EXITS:
?,4R ~- 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:
TIMESTART: /1t9:-)5-/~F~1 END: