HomeMy WebLinkAboutZ-35825Town of Southold Annex
54375 Main Road
Southold, New York 11971
PRE EXISTING
CERTIFICATE OF OCCUPANCY
7/23/2012
No: 35825 Date:
7/18/2012
THIS CERTIFIES that the structure(s) located at: 4830 Deep Hole Dr., Mattituck
SCTM #: 473889 Sec/Block/Lot: 115.-17-1
Subdivision: Filed Map No.
conforms substantially to the requirements for a
APRIL 9, 1957
Lot No.
built prior to
pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-
35825
dated 7/18/2012 was issued and conforms to all the requriements of the applicable provisions of the law.
The occupancy for which this certificate is issued is:
wood frame one family dwelling and accessory 1 1/2 car garage.*
The certificate is issued to
Frefichs, Helen
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
LOCATION:
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
4830 Deep Hole Dr., Mattituck
SUFF. CO. TAX MAP NO.: 115.-17~1
NAME OF OWNER(S): Frerichs, Helen
SUBDIVISION:
OCCUPANCY:
ADMITTED BY.7
SOURCE OF REQUEST: Frerichs, Helen
DATE: 7/18/2012
DWELLING:
TYPE OF CONSTRUCTION:
FOUNDATION:
TOTAL ROOMS: 1ST FLR.:
BATHROOM(S): 2
PORCH TYPE:
BREEZEWAY:
DOMESTIC HOTWATER:
TYPE HEAT: oil
# BEDROOMS: 3
OTHER:
# STORIES: 1.5 # EXITS: 3
CELLAR: fi~l] CRAWL SPACE:
cement block
2ND FLR.: 3RD FLR.:
TOILET ROOM(S): I UTILITY ROOM(S):
DECK TYPE: ' - PATIO TYPE:
FIREPLACE: GARAGE: 1.5 car
AIR CONDITIONING:
HOT WATER: x
BASEMENT TYPE: unfinished
yes TYPE HEATER: off boiler
WARM AIR:
# KITCHENS: I
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST:
SWIMMING POOL:
OTHER:
STORAGE, TYPE OF CONST:
GUEST, TYPE OF CONST:
VIOLATIONS:
REMARKS:
INSPECTED BY:
DATE OF INSPECTION: _6/~/~'"~
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 Depamnent with the following:
A. For new building or uew 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-dispusal (S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement fi.om 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 fi.om 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, Alteratinns 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
Old or Pre-existing Building: t~ (check one)
House No. Street
New Construction:
Location of Property:
0wneror0wnersofProperty: .////~Le~/*/ ~ fi~-'"/~/C,~q- ~-~.fT'/qZ-~'
Suffolk County Tax Map No 1000, Section //~'- Block / -7
Subdivision Filed Map.
Hamlet
Lot
Lot:
Permit No.
Health Dept. Approval:
Date of Permit.
Applicant:
Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $ / t~9, Ov
Final Certificate:
(check one)
CONSENT TO INSPECTION
Owner(s) Name(s)
the undersigned, do(es) hereby state:
That the undersigned (is) (are) the owner(s) of the premises in the Town of
Southold, loeatedat z/z oc'- '~ O ./-) ~'r~s fY /'~ ~. e-- l.)~q tv~ d: ff// tl '['Fl '~'tt C~
which is shown and designated on the Suffolk County Tax Map as District 1000,
Section ![~5'-,Block /7 ,Lot /
That the undersigned (has) (have) filed, or came to be filed, an aoplicationjn the
Southold Town Building Inspector's Office for the following: /2tq £ ff~/~'7-~(~'~/O4 ?~
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:
(Print Name)
RICHARD F. LARK
MARY LOU FOLTS
LARK & FOLTS
Attorneys at Law
28785 MAIN ROAD
PO BOX 973
CUTCHOGUE, NEW YORK 11935
Tele. No. (631) 734-6807
Fax No. (631) 734-5651
E-mail: LarkandFolts~aol.com
June 20, 2012
Southold Town Building
PO Box 1179
Southold, NY 11971
RE:
Department
Helen J. Frerichs Estate
4830 Deep Hole Drive, Mattituck,
Section 115, Block 17, Lot 1
Gentlemen:
NY
On behalf of my client, Julia L. Cooper,
Helen J.
Please call Julia L.
for your inspection.
MLF/m
Enclosures
Executor of the Estate of
Frerichs, I am enclosing the following:
Application for Pre-Existing Certificate of Occupancy signed
by Julia L. Cooper, Executor, with copy of survey attached.
Consent to Inspection signed by Julia L. Cooper, Executor.
Our check payable to the Town of Southold in the amount of
$100.00 representing the fee for a Pre-Existing Certificate
of Occupancy.
Cooper at 722-2248 to schedule an appointment
Very truly yours,
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
] FOUNDATION 1ST
[ ] FOUNDATION 2ND
[ ] FRAMING/STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] ROUGH PLBG.
[ ] INSULATION
[ ]FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRIC~L,.(ROUGH) [ ]ELECTRICAL
(F. INAL)
~r.I~ARKS~"~/~' ~.. ~/~-~ ' ~ ~
~ r
DATE ~' ~
~INSPECTOR ~
LOCATION:
(number & street)
SUBDIVISION:
NAME OF OWNER(S):
OCCUPANCY:
MAP NO.:
(municipality)
LOT(S):
(type)
ADMITTED BY:
KEY AVAILABLE:
SOURCE OF REQUEST:
(owner-tenant)
ACCOMPANIED BY:
SUFF. CO. TAX MAP NO. 1000-
DATE:
DWELLING
TYPE OF CONSTRUCTION: STOmES:
FOUNDATION: ~--.,,~ .--~ 7"~ ~ t~5-BA S EMENT: ~(/~
# OF BEDROOMS: 1ST FLR: / 2ND FLR: ~
BATHROOM(S)?~~:2 TOILET ROOM(S):
./~/~'"' # EXITS:
CRAWL SPACE: ~
3RD FLR: ...
~UTILITY ROOM:
PORCH TYPE:
DECK, TYPE:
PATIO, TYPE:
BREEZEWAY: -- ~ -'------ '
FIREPLACE: GARAGE: /~..~
DOMESTIC HOTWATER:/~/- TYPE HEATER: Cj~~RCONDiTiONiNG:'
HOTWATER: /
TYPE HEAT: ~ WARM AIR:
X.
# OF KITCHENS: ~ ~/f
FINISHED BASEMENT: YES NO
OTHER:
ACCESSORYSTRUCTUR~g
GARAGE, TYPE OFCONST.:..
SWIMMING POOL:
OTHER:
STORAGE, TYPE CONST.:
GUEST, TYPE CONST:
VIOLATIONS: CHAPTER 144 & N.Y. STATE UNIFORM FIRE PREVEN'i~ION & BUILDING CODE
LOCATION ~ DESCRIPTION / '-'~' ART. SEC.
/
INSPECTED BY:
DATE OF INSPECTION:
TIME START: ?)CF END:
t
MAP OF'
MATTiT'UCK, N.Y',
.l
:)WNER
TOWN OF SOUTHOLD PROPERTY RECORD
STREET
CARD
LOT ~.~ ~,
,~
FORMER OWNER
ES. ~/,/~ SEAS. VL
FARM
LAND iMP. TOTAL
DATE REMARKS
'iitobie FRONTAGE ON WATER
Voadtaml
le~se Plot
'oral
FRONTAGE' ON ROAD
DEPTH
BULKHEAD
COLOR
Po~h C~_~ ~
Breezeway
Patio
Wo~s
Place
Raof
Floors
nterior FintsK
1st Floor
2nd Floor
Driveway