HomeMy WebLinkAboutZ-35812Town of Southold Annex
54375 Main Road
Southold, New York 11971
7/11/2012
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: 35812 Date: 7/11/2012
THIS CERTIFIES that the structure(s) located at: 9395 Route 25, Mattituck
SCTM ti: 473889 Sec/Block/Lot: 122.-6-18
Subdivision: Filed Map No. Lot No.
conforms substantially to the requirements for a built prior to
APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 35812
dated 7/11/2012 was issued and conforms to all the requriements of the applicable provisions of the law.
The occupancy for which this certificate is issued is:
House labled "A" on survey is a wood flame one family dwelling with blue slate patio.*
House labled "B" on survey is a wood frame one family dwelling *
NOTE: BP 21084 fire repairs to dwelling COZ-22808.
The certificate is issued to
Collins, Leroy
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLIERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
A~l~r~ ed Signature
LOCATION:
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
9395 Route 25, Mattituck
SUFF. CO. TAX MAP NO.: 122.-6-18
NAME OF OWNER(S): Collins, Leroy
OCCUPANCY:
ADMITTED BY: Mariusz Jachimowicz - HOUSE "A"
SOURCE OF REQUEST: Collins, Leroy
SUBDIVISION:
DATE: 7/11/2012
DWELLING:
TYPE OF CONSTRUCTION:
FOUNDATION:
TOTAL ROOMS: IST FLR.:
BATHROOM(S): 1
PORCH TYPE:
BREEZEWAY:
DOMESTIC HOTWATER:
TYPE HEAT: oil
# BEDROOMS: 2
OTHER:
# STORIES:
cement block CELLAR:
2ND FLR.:
TOILET ROOM(S):
DECK TYPE:
FIREPLACE:
yes TYPE HEATER:
WARM AIR:
# KITCHENS: I
50%
3RD FLR.:
UTILITY ROOM(S):
PATIO TYPE:
GARAGE:
off boiler AIR CONDITIONING:
HOT WATER: yes
BASEMENT TYPE: unfinished
1 # EXITS: 2
CRAWL SPACE: 50%
blue slate
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST:
SWIMMING POOL:
OTHER:
STORAGE, TYPE OF CONST:
GUEST, TYPE OF CONST:
VIOLATIONS:
REMARKS:
INSPECTED BY:
GARYF
DATE OF INSPECTION:
TlME START: ~/O:16'~
7/10/2012
END: ///] ~
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 9395 Route 25, Mattituck
SUFF. CO. TAX MAP NO.: 122.-6-18
NAME OF OWNER(S): Collins, Leroy
OCCUPANCY:
ADMITTED BY: Mariusz Jachimowicz - HOUSE
SOURCE OF REQUEST: Collins, Leroy
DWELLING:
SUBDIVISION:
DATE: 7/11/2012
TYPE OF CONSTRUCTION:
FOUNDATION:
TOTAL ROOMS: 1ST FLR.:
BATHROOM(S): 1
PORCH TYPE:
BREEZEWAY:
DOMESTIC HOTWATER:
TYPE HEAT: oil
# BEDROOMS: 2
OTHER:
# STORIES:
cement block CELLAR:
2ND FLR.:
TOILET ROOM(S):
DECK TYPE:
FIREPLACE:
yes TYPE HEATER:
WARM AIR: yes
# KITCHENS: 1
1 # EXITS:
50% CRAWL SPACE:
3RD FLR.:
UTILITY ROOM(S):
PATIO TYPE:
GARAGE:
electric AIR CONDITIONING:
HOT WATER:
BASEMENT TYPE: unfinished
2
5O%
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST:
SWIMMING POOL:
OTHER:
STORAGE, TYPE OF CONST:
GUEST, TYPE OF CONST:
VIOLATIONS:
REMARKS:
INSPECTED BY:
GARYF
DATE OF INSPECTION: 7/10/2012
TIMESTART: E D:
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPAZCY
This application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: 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 site plan requirements.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
'!pre-existing" land uses:
1. Accurate survey of property showing ali property lines, streets, building and
unusual natural or topographic features.
2. A properly completed application and a consent to inspect s~icant.
If a Certificate of Occupancy is denied, the Build~-~t~f ~h~ll~t~t~\lthe
reasons therefor in writing to the applicant'
1.
Certificate
Occupancy- New dwelling $25.00, Ad~~ell~g-$2~.00,~
· Alterations to dwelling $25.00, Swimming pool $25.~P, ~cessory b~25.p0,
Additions to accessory building $25.00. Business~$5~~,
2. Certificate of Occupancy on Pre-existing Buildinm - $t00.00~0,~1~1~
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 July 5, 2012
New Construction ........... Old Or Pre-existing Building. ~. r..T~.P..(~). ~ story frame dwellings
Location of Property .... ~ .......... Route 25 Mattituck
House No. Street Hamlet
Onwer or Owners of Property.. PP~. ~A,.~ ~Y~. ~. ~3A~ .q~Ae~y..C~,.~q~ased
County Tax Map No 1000, Section...J~ ........ Block...~ ............ Lot..1.~ ..................
Sub.division .............................................. -..-.Filed Map .... -..~.~.~.--.-.~Lot .................. --'~'''i
Permit No ................ Date Of Permit ................ Applicant .............................
Health Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate...~ .......
Fee Submitted: $.l~..~q ...................... ~/ ~ ~ A /,~ ~ /]
CONSENT TO INSPECTION
Estate of LeRoy Collin, deceased
Doreen Sawicki, as Executrix of the ~ , the undersigned, do(es) hereby state:
Owner(s) Nmne(s)
That the undersigned (is) (are) the owner(s) of the premises in the Town of
Southold, locatedat 9395 Route 25, Mattituck, New York 11952
which is shown and designated on the Suffolk County Tax Map as District I000, '
Section 122 , Block 6 , Lot 18
That the undersigned (has) (have) filed, or cause to be filed, an application in the
Southold Town Building Inspector's Office for the following: Two (2) one story
frame dwellings.
· That the undersigned do(es) hereby give con~ent 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 regnlations.ofthe 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: July 5, 2012
(Print Name)
(Signature)
(Print Name)
N
W-+ E
S
OURVEY HAY IE,, 2012
OUF:FOLI< C, OUN'Dr' TAX #
I000 - 12';' - 6 - 15
MARIUSZ ~ACH]MOWICZ
]~OLISH & SLAV{C FEDERAL CRm~DF~ UN-ION
F~Dmu.rrY NATIONAL TFrLB ~NSURANCB CO.
NOTE~3:
0 PIPE FOUND
Ar'sa: -/2,425 ~L.
Area = 1.662-/
®P..APHIC, c"~C, ALE I"= 60'
JOHN C. EHLERS LAND SURVEYOR
6 EAST MAIN STI~I' N.Y.S. LtC. NO.
~, N.Y. 11901 369-8288 F~ 369 ~287
REF.C:\U~%lohn~'u~y Dropbox\12\12-130.pm
NNEP,
SEAS.
IMP.
.-AND
OF $OUTHOLD PROPERTY RECORD CARD
VL. FARM
TOTAL
VILLAGE SUB.
TYPE OFBU ILD!
0
COMM. B. /vttSC. Mkt. Velue
DATE REMARKS
~GE
RM
:hie 1
hie 3
dland
npland
~land
~e Plot'
NOEMAL
Acre
BUILDING CONDITION
· BELOW ABOVE
Value Per Value
Acre
I r
FRONTAGE ON W'A'tER
FRONTAGE ON ROAD
DEPTH
BULKHE.,4,D
DOCK
7,_3 ~
COLOR
Foundation
Fire Place
Both
FIS"dr~
Interio~ F[nis~
Rooms ist Floor
(D
DR.
I Drive,ray
ERIC J. BRESSI,ER
ABIGAIl. A. WICKHAM
LYNNE M. GORDON
JANET GEASA
I,AW OI'FICES
WICKHAM, BRESSLER, GORDON & GEASA. P.C.
13015 MAIN ROAD. P.(). BOX 1424
MAfTI I'UCK. LONG ISLAND
NEW YORK 11952
631-298-8353
I ELEFAX NO. 631-298-8565
~w~,bla~ a aol.com
July 6, 2012
~ II.I.IAM WICKII/XM (06-02)
275 BROAD IIOI,LOW ROAD
%UIIE I I I
MEIVII,EI:. NEW YORK 11747
631-249-9480
I l!EI }:AX NO. 631-249-9484
Attn: Ms. Connie Bunch
Town of Southold Building Department
P.O. Box 1179
Southold, New York 11971
Re: Propert3' owned by Doreen Sawicki, as Executrix of the
Estate of Leroy Collins, deceased
Pre-Existing Use C.O. Application - 9395 Route 25, Mattituck, NY
SCTM# 1000-122-6-18
Dear Connie:
We represent the owner of the above referenced property. The following items are
enclosed:
1. Application fi~r Pre-Existing Use Certificate of Occupancy for two one story
frame dwellings;
2. Consent to Inspect;
3. Print of Survey prepared by John C. Ehlers L.S. dated May 18. 2012:
4. Copy of Property Card; and
5. $100. applicalion fee.
Please contact the lenant. Mariusz Jachimowicz. at 631-871-9807. to arrange tbr the
inspec~
~[~~ Very trulY~Ab~a~il A~W. ick~~/~/yours.
30 shdbprecoapl~
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] ROUGH PLBG.
[ ] INSULATION
[ ] FINAL
[ ] FIRE SAFETY INSPECTION
] FOUNDATION 1ST
[ ] FOUNDATION 2ND
[ ] FRAMING / STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESISTANT CONSTRUCtiON [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (FINAL)
[ ] ELECTRICAL (ROUGH)
REMARKS:
DATE
:>?
LOCATION:
(number & street)
(municipality)
SUBDIVISION:
NAME OF OWNER(S):
OCCUPANCY:
MAP NO.: LOT(S):
(type)
ADMITTED BY: ~ ~ {,~ ,,~ ~_~
KEY AVAILABLE:
SOURCE OF REQUEST:
:t4. O I~ I'~---~ (owner-tenant)
ACCOMPANIED BY: (~112
SUFF. CO. TAX MAP NO. 1000-
DATE:
UTILITY ROOM.
PORCH TYPE: DECK, TYPE: ~ ' PATIO, TYPE~
BREEZEWAY: ~ ~.,. _ FIREPLACE: ~ ' ,GARAGE: -
- ~;~ ~ ~Rt NDITIO~G.
TYPE HEAT C~ , WA~ AIR: 5 ~/
~ OF KITCHENS: ~f
HOTWATER~.t~.~
FINISHED BASEMENT: YES NO~~¢.~ ~
OTHER:
GARAGE, TYPE OF CONST.: STORAGE, TYPE CONST.:
SWIMMING POOL: GUEST, TYPE CONST:
OTHER:
VIOLATIO~R 144 & N.Y, STATE UNIFORM FIRE PREVEN'EION & BUILDING CODE
LOCATION "~' ~)-'~"~ DESCRIPTIOaN ' ~ ART. SEC.
INSPECTED BY:
DATE OF INSPECTION: