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Home My WebLink AboutZ-31689FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 31689 Date: 07/18/06 THIS CERTIFIES that the building Location of Property 15900 MAIN RD (HOUSE NO.) County Tax Map No. 473889 Section 115 subdivision DWELLING MATTITUCK (STREET) (HAMLET) Block 0003 Lot 001.003 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- 31689 dated J73Ly 18, 2006 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 SHELDON J & GEOFFREY CULLISON ( OWNER ) of the aforesaid building. SUFFOLK COUIFrYDEPARTMENT OF~EALTEAPPROVAL EI~C~IICAL CERTIFICATE NO. PLI~4BEi~S CERTIFICATION DA'r~U *PLEASE SEE ATTACHED INSPECTION REPORT. N/A N/A Authorized Signature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT SOURCE OF I~EQU~: SHELDON CULLISON 05/31/06 DATE: 07/18/06 ACCESSORY STRUCTURES: VIOL4~TIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. ~: BP #2918-ZCOZ-3049 (ACCY STUDIO APT./GARAGE) GEORGE GITJ.RN Ik~TE (~ INSpEC"rI(~: 06/06/06 TIME START: ~0:10 AM ~]D: 10:30 AM Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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. Fina~ survey ~f pr~perty with accurate ~~cati~n ~f a~~ bui~dings~ pr~perty ~i~es~ streets~ and unusua~ natura~ ~r 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. May 27 , 2006 New Construction: Old or Pre-existing Building: LocationofProperty: 15900 Main Road X (check one) Mattituck House No. Street Owner or Owners ofProperty: Sheldon J.W. Cullison & Geoffrey D. Cullison Suffolk County Tax Map No 1000, Section 115.00 Subdivision Permit No. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ 10 0.0 0 Date of Permit. Hamlet Block 0 3.0 0 Lot Filed Map. Lot: Applicant: Underwriters Approval: 001.003 Final Certificate: X (check one) i attire. CONSENT TO INSPECTION Sheldon J.W. Cullison the undersigned, do(es) hereby state: o e of That the undersigned (is) (m'eq~t~e owner(s) of the premises in the Town of Southold, locatedat 15900 Main Road, Mattituck, New York which is shown and designated on the Suffolk County Tax Map as District 1000, Section 115 , Block 3 , Lot 1.3 That the undersigned (has) 0mvc9 filed, or cause to be filed, an application in the Southold Town Building Inspector's Office for the following: Certificate of Occupancy on Pre-existing Building 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, roles 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, roles or regulations of the Town of Southold. Dated: May ~J , 2006 Sheldon J~W.I Cullison (Print'Name) (Signature) (Print Name) 84,8~ 'Ill .o AREA.- 80,069 Sq. Ft. = 1.838 Ac. CLEA?ING AREA: 32,8,7,9 S.F. = 41.0~ SURVEY OF DESCRIBED PROPERTY SITUATE AT MA F//TUCK TOWN OF 50UTHOLD SUFFOLK COUNTY, NEW YORK SCALE: 1" = JO' DATE: MAY 16, 2006 S.C.T.M. DIST. I000 SEC. 115 BLK. 3 LOT 1.3 CERTIFIED TO: FILE NO. 50612 [ ~ REVISIONS: PAT T. SECCAFICO PROFESSIONAL LAND SURVEY'OR, P.C. PHONE: (651) 728-5.530 FAX: (851) 728-6707 N.Y.S. LIC. PHONE: (631) 878-0120 F~: (6,71) 878-7190 NO. 049287 COPYi~IGHT - 2006 PAT 7~ SECCAFICO P.L.S.. P.C, S 88°50'00''F 79.37