HomeMy WebLinkAboutZ-31833FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 31833
THIS CERTIFIES that the building
DWELLING
Date: 09/22/06
Location of Property 1305 NEW SUFFOLK AVE MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 114 Block 0011 Lot 026
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- 31833 dated SEPTEMBER 22, 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 WITH ACCESSORY 2 CAR GARAGE*
The certificate is issued to DOROTHY WINIARZ
(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.
Authorized Signature
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 1305 NEW SUFFOLK AVE MATTITUCK
SUBDIVISION: MAP NO.: LOT (S)
BANE OF OWNER (S): DOROTHY WINIARZ
OCCUPANCY: SINGLE FAMILY DWELLING DOROTHY WINIARZ
ADMITTED BY: ACCOMPANIED BY:
KEY AVAILABLE: SUFF. CO. TAR NAP NO.: 114.-11-26
SOURCE OF REQUEST: GARY F. OLSEN, ATTY 9/1/06 DATE: 09/22/0
DWELLING:
TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 2.0 # EYITS: 4
FOUNDATION: CEMENT BLOCK CELLAR• FULL CRAWL SPACE:
TOTAL ROOMS: IST FLR.: 6 2ND FLR.: 1 3RD FLR.: 1
BATHROON(S): 1.0 TOILET ROOM(S): 1.0 UTILITY ROOK(S): ONE
PORCH TYPE: ENCLOSED DECK TYPE: PATIO TYPE:
BREEZEWAY: FIREPLACE: NONE GARAGE:
DOMESTIC HOTfATER: YES TYPE HEATER: BOILER AIRCOHDITIONING:
TYPE HEAT: OIL {ARM AIR: HOTSATER: YES
OTHER: OIL HOT WATER HEAT -RADIATORS, SEPARATE HOT WATER HEATER
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.: 2 CAR WOOD FRAME STORAGE, TYPE CONST.:
SWIMMING POOL: GUEST, TYPE CONST.:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
REMARKS: BP#4604-COZ-5700 (ADD)
INSPECTED BY: / DATE OR INSPECTION: 09/13/06
GEORGE GICLEN TIME START: END:
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. 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. Coimnercial 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. August 24, 2006
New Construction: Old or Pre-existing Building: % (check one)
Location of Property: 1305 New Suffolk Ave., Hattituck
House No. Street Hamlet
Owner or Owners of Property: Dorothy Winiarz
Suffolk County Tax Map No 1000, Section 114.00 Block 11.00 Lot 026.000
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept. Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $ 100.00
�nc.'i ►a a,s
Underwriters Approval:
Final Certific�
OLSEN & OU
32495 MAIN
PO BOCUTCHOGUEXNY 11935
TOWN OF SOUTHOLD PROPERTY RECORD CARD
/000 -2(L
OWNER
STREET " 5
VILLAGE
DIST
SUB. LOT
Z
e 5Uf o f
19-esQ
FORMER O ERj�
p�s2
E 1 -
ACR 3
3 J
S
/t•(..,
W
A >
TYPE OF BUILDING, �
2 �-f-Qr �u J Q G i Q0
Gyo�
SEAS.
VL.
66M
COMM. CB. MICS. Mkt. Value
LAND
IMP.
TOTAL
DATE
REMARKS
_4
S�J
31-6 d
Q 0 0
d
s .,
V { - 7 Vt�� r4d a
6 6a
so o
a0
d y 7v
icy 8- a s A �1��/9a` <1e�Y� •
AGE
BUILDING CONDITION
NEW
NORMAL
BELOW ABOVE
FARM
Acre
Value Per
Acre
Value
Tillable
Woodland
FRONTAGE ON WATER
FRONTAGE ON ROAD
�10 ue Q S"4 a
Meadowland
DEPTH
a50
House Plot
BULKHEAD
Total
i
DOCK
1x1-
� l ei�4, 'e
�4 IN
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08/22/2006 15:10 FISHER EGAN 8 GOLDEN LLP 4 97347712 NO.346 D03
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NEW S UFFOIX AVENUE
DESCRIBED PROPERTY
wwrc
MATTITUCK, TOWN OF S0UTH0LD
SUFFOLK COUNTY, N.Y.
QUARANYM SUR1gM FOR: XS0M GOWER WftYM. 1+ AALM 2M
M� CATHERINE GOLDER SCALE 1 •� �Q'
CAnIERe1C 4OLM
SAFE mu**R TIRE ANAENCY. LTM AREA r T5,18$ S.F.
1NSSW EDUCREW iLgERAL CRtRu UNION 0.77�ACRES
.�1�w1~mWai>aw�� 1N# lQW-114-11-72E
SUeVt:YED FJY
'°'` • +�o wr $TANLEY J. 1SAKSEN. JR-
.� P.O. BOX 224
NEW SUM M.Y. 11956
.wma®..sr��...smnr 831-734-
wR LICE L,4N0 SURVEYOR
°O" L;c. 2. 49273 '0687523
CONSENT
TO
INSPECTION
for Dorothy Winiarz
Owner(s) Name(s
do(es) hereby state:
the undersigned,
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at 1305 New Suffolk Ave., Mattituck
which is shown and designated on the Suffolk
114.0011.00 026.000
County tax map as District 1000, Section , Block Lot _ _
That the undersigned (has) (have) filed, or caused to be filed, an applica-
tion in -the Southold Town Building inspecw. arfi— fo.. +ha fnllowing:
Wood frame residence with covered porch and detached garage
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 as evidence in subs equentfpros¢cutions for vio-
lations of the laws, ordinances, rules or regulations/oj, thX Town of Southold.
Dated: August 24, 2006
Gary Flanner Olsen
(print name)
signature
(print name)
LOCATION: 13 OS Z44�
r
(number & street) (municipality)
SUBDIVISION: MAP NO.: LOT(S):
NAME OF OWNER(S):
OCCUPANCY: L. w
"t (fie) (owner -tenant)
ADMITTED BY: ACCOMPANIED :BY:
KEY AVAILABLE: SUFF. CO. TAX MAP NO. 1000-
SOURCE OF REQUEST: (j DATE: o 6
DWELLING:
TYPE OF CONSTRUCTION: WOOD F;eAh'1 E # STORIES: � # EXITS:
FOUNDATION: c,,��,,,-� f CELLAR: �;ZE�7 -CRAWL SPACE:
TOTAL ROOMS: 1ST FLR: 0 2ND FLR: 3 3RD FLR:
BATHROOM(S): TOILET ROOM(S): UTILITY ROOM:
PORCH TYPE: c DECK, TYPE: PATIO, TYPE:
BREEZEWAY: FIREPLACE: of WC GARAGE:
DOMESTIC HOTWATER: TYPE HEATER: D AIRCONDITIONING:
TYPE HEAT: L WARM AIR: HOTWATER:
OTHER: t� % #A r� - 11�y4sr ��,c� N c.�rf , 1 ,0 <
ACCESSORY STTWCTURES:
;.GARAGE, TYPE OF CONST.:
SWIMMING POOL:
OTHER:
,n1190P F "E -STORAGE, TYPE CONST.:
GUEST, TYPE CONST:
VIOLATIONS: CHAPTER 45 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION'-` ART. SEC.
REMARKS: Atl P,eeG (2--1 d
INSPECTED BY:
DATE OF INSPECTION:
TIME START:
END: