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Home My WebLink AboutZ-34888FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUP/LNCY No: Z- 34888 I~te: 04/07/11 THIS CERTIFIES that the building DWELLING Location of Property 18375 MAIN RD (HOUSE NO.) County Tax ~4ap NO. 473889 Section 115 subdivision MATTITUCK (STREET) (HAMLET) Block 0002 LOt 012 Filed Map NO. Lot NO. conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which C~u~TIFICATH OF ~C~3PANC~f~ER Z- 34888 (Lated APRIL 7, 2011 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 REAR COVERED PATIO AND ATTACHED ONE CAR GARAGE. * The certificate is issued to IRENE RUTKOSKI ESTATE (OWNER) of the aforesaid building. SuFfOLK COUNTY DEPART~TOFHEALTHAPPROVAL ~.Rt-£KICAL CERTIFICATE NO. ~5U~E~S CERTIFICATION ll~'l'~u *PLEASE SEE ATTACHED INSPECTION REPORT. N/A N/A N/A Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT I~TIG~: 18375 MAIN RD MATTITUCK SUBDI%-ISIOII: ~ NO.: II)T ~ OF (~ (S}: IRENE RUTKOSKI ESTATE OCUlArlY: ONE FAMILY DWELLING IRENE RNTKOSKI ESTATE PORCIt TYPE: 1.0 ~ EXITS: 3 3RD FLR.: ~0 PATIO ~"fPE: COVERED IN REAR ACCESSORY STRUCTURES: VIOLATIONS: C~LkPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. RE-INSPECTED 4/5/11 IIA~'E ~ Ii%ISI~(]~: 03/31/11 T~ START: ~D: 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 DeI[artment 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. 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 sit? plan requirements. Bo 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 i~nspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. 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, A~dditio~ns to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing BuildifigQ100.0~l.) 3. Copy of Certificate of Occupancy- $.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commemial $15.00 New Construction: Location of Property: Owner or Owners of Property: U~_~,~ -~ Suffolk County Tax Map No 1000, Section Subdivision Date. Old r~,Pfe-exist~ Building: J House No. Street (check one) Block c:~ Filed Map. Applicant: Underwriters Approval: Permit No. Date of Permit. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Hamlet Lot ~>~ Lot: Final Certificate: (check one) CONSENT TO INSPECTION Owner(s) Name(s) , the undersigned, do(es) hereby state: That the undersigned (i~s) (a, re) the owner(s) of the premises in the Town of Southold, located at ~CfxD1 )~{~ ~4P ~ x5 ~'~ c~ ~ ~, ~ ~(f , which is shown and designated On t'~ee Su~o'lk County Tflx Mhp ~ts'~]strict 1000, Section I\ ~ , Block <>.D~ , Lot ~ ~ . That the undersigned (has) !have) filed, or cause to be fi~jd, 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: (Print Name) TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STRE~ I ~&~7~ V,LU~GE D~ST.SUB. LOT , ~ W x TYP~ 6F BUILDING ~/~ S~S. V:. FARM CO~. ~B." MICS. Mkt. Value ~ND I. MP. TOTAL DATE RE~RKS AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per V~iue Acre Tillable FRONTAGE ON WATER Meadowlond DEPTH House Plot BULKHEAD Total ~ ~ DOCK COLOR M. Bldg. Extension Extension Extension Porch Porch Breezeway Garage ?0 Foundation Basement iExt. Walls Fire Place Type Roof Bath Floors Interior Finish Heat RoOms ]st Floor inette :LR. DR. BR. Patio Recreation Room Rooms 2nd Floor FIN. B O.B. Dormer Driveway Total N 1'O~t~ SURVEY OF PROPERTY A T MA TTITUCK TO,tN OF SOUTHOLD SUFFOLK COUNTY, N.Y. 1000-1!5-0R-I$ SCALP,: l'=RO' SEPTEMBER 21, '2010 AREA=Il;369 SO. FT. MAIN i~oAI) (5.1~. 25) ANY ALTERATION OR ADDITION TO THIS SURVEY IS A t4OLATION OF SECTION 7209OF THE NEW YORK STATE EDUCATION LAW, EXCEPT AS PER SECTION 7209-SUBDlI4SlON 2. ALL CERTIFICA770NS HE~XNV~ARE VAUD FOR THIS MAP AND COPIES THEREOF~3NLY iF -' SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR V~'HOSE SIGNATURE APPEARS HEREON. /15ECONIC (651) 765-5020 FAX (631) 765-1797 P.O. BOX,909 so~r~b¢ ~.~..~ 110.~04 LOCATION: (number & street) SUBDIVISION: NAME OF OWNER(S): OCCUPANCY: MAP NO.: (municipality) LOT(S): (type) (owner-tenant) ADMITTED BY: KEY AVAILABLE: SOURCE OF REQUEST: ACCOMPANIED BY: SUFF. CO. TAX MAP NO. 1000- DATE: DWELLING: TYPE OF CONSTRUCTION: FOUNDATION: ~ U TOTAL ROOMS: 1STFLR: ~j..0~'~~ it STORIES: ~ it EXITS: CELLAR: ~ CRAWL SPACE: ~ 2ND FLR: 3RD FLR: BATHROOM(S): .oZ TOILET ROOM(S): PORCH TYPE::~i~~ECK, TYPE: BREEZEWAY: :' --- FIREPLACE: ~ DOMESTIC HOTW. A~TER:4J~__ TYPE HEATER: TYPE HEAT: ~ ~' WARM AIR: OTHER: UTILITY ROOM: PATIO, TYPE :(~~ AIRCONDITIONING: HOTWATER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: SWIMMING POOL: OTHER: STORAGE, TYPE CONST.: GUEST, TYPE CONST: VIOLATIONS: CHAPTER 144 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRiI'TION ART. SEC. REMARKS: INSPECTED BY: DATE OF INSPECTION: TIME START: END: