HomeMy WebLinkAboutZ-28052FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 28052
Date: 11/05/01
THIS u~KTIFIES that the building
DWELLING AND ACCESSORIES
Location of Property 505 HOLBROOK LA
(HOUSE NO.) (STREET)
County Tax Map No. 473889 Section 113 Block 0006
Filed Map No. -- Lot No. --
subdivision
MATTITUCK
(HAMLET)
Lot 006
conforms substantially to the Requirements for a ONE FAMILY DWELLING
built prior to APRIL 9, 1957 pursuant to which c~KTIFICATH OF
OCCUPANCY NU~4BER Z- 28052 dated NOVEMBER 5, 2001
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 CONCRETE PATIO AND ACCESSORY SHED AND BOAT
HOUSE.*
The certificate is issued to ANNE ARGENTIERI & ORS.
( OWNER )
of the aforesaid building.
SUFFOLK COUNTYDEPARTMENT OF HEALTHA~PROVAL
ELBt-rKICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATmU
*PLEASE SEE ATTACHED INSPECTION REPORT.
Rev. 1/81
N/A
N/A
N/A
~Signature
BUILDING DEPARTMBNT
TOWN OF SOUTNOLD
BOUSING CODE INSPECTION REPORT
LOCATION: 505 HOLBROOK LA MATTITUCK
SUBDIVISION: MAP NO.: ~ (S)
~ OF (3~ (S): ANNE ARGENTIERI & ORS.
OCCUPANCY: SINGLE FAMILY DWELLING A~E ARGENTIERI & ORS.
WOOD FRAME # STONI~:
CEMENT BLOCK C~.T,~:
OTHER: BATHROOM IN BASEMENT
1.0 ~ EXITS: __2
FULL CRAW~ SPACE:
ACCESSORY STRUCTURES:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FINE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
P~: REINSPECTED 11/2/01
07/24/200]
15:45
G317347702
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. Tills appl~cation must be filled tn by typewriter OR 1ok and submitted to the buildin8
inspector with the followgn8: for new buildt~g or new use:
1. Final survey of property with accurate locaCion of all buildings' property lines,
streets; and unusual natural or topographic features.
2. Final Approval from Health Deft. of water supply and sewerage-disp0'sa1($_9 form).
3. Approval of electrical installatlon from Board of Fire Underwrtter~.
Sworn statement from plumber cer~lfying that :he solder used in system contains
/ess than 2/~0 of IX lead.
5. Commercial build~ng, industrial butldi~g, multiple residences and s~milar bu~ldings
and tnstallatioua, a certificate of Code Compliance from architect or engineer
responsible for the build,ag.
6. Submit Planning Board Approval of completed site plan requirements.
For exlsting buildings (pr~gr to April 9, 1957) non-conforming uses~ or buildings and
"Pre-existing" land uses:
1. Accurate survey of property ehow~ng all proper~y lines, e~reets, bu~ldia8 and
unusual I%s:ural or toposrephtc features,
2. A properly Completed ap~licatton and e consent ko inspecc siSned by the
If a Certificate 6f Occupancy is denied, the Build,n8 Inspector shall state Che
reasons ~herefor in wr~:~n8 ~o the applica~c.
C. Fees 1, CertifiCate of Occupancy - New dwellin§ $25.00, Additions to dwellin& $25,00.
AiLeraCions to dwelling $25.00, Swlll~mtn8 pool $25.00, Accessory buildin~
Additions to accessory building $25.00, Businesses $50,O0.
2. Ce~ttficate of Occupancy ~n Pre-exis~in§ guildi~g - $100.O0
3. Copy of Certificate of Occupancy - $5.00 aver 5 years - $~0.O0
4. Updated Certificate of Occupancy - $50.00
Temporary C-rtificate of Occupancy - Residential $~5.00, Commercial
.~%uf5 OF ~Fe_exjet~na aulld~-o ~ ............
H-- - ' ......... '~''.~ ......... Ill~,.~
llamle~
bd~v~s~on. ~ ' ' .-
. FJZed ~ap ............ Lo~ ...... ~...~ .......
cm~C No ................ Date Of
................ Ai)PlJcan~
ilCh Dept. Approval.,. -
....................... Underwriters Approval. '
Ink'n8 ~oard Approval .............. ' ......................
ueeL fo:~ Temporary Certificate ........... F/nal Cer~Jca~e. ~
5ubm~ed: .........................
do(ca) hereby
That the IIIIder~l~lled (is) (are) the OWllel-(s) o[ tile premises in U,e Town '
Cou,~ty tax map as Dlstrlc~ I000, S~ctiol~
'l'ha~ Iha undersianed (hae] {have) fl]ed, o~ caused to be tiled, an applica-
tion tn the Southo d Totm 9ulldi,g I~spector,s Office Ior the followb]g~
Tha~ the undersi/fned do(es) Ilereb:t give col]sent to the 13uilding Inspeetoz's
of the Town orSouthold to ell[er upon the above desel'lbed property, iuclufllng
deem ne6essary wi~h respec~to the aforesaid application, lnclud~]g inspeetlo~s
aod reRulatton~ of the Tow~ ol Southold.
knowledge aod understat~din/l tho[ any h~fornlatlon ob~Mned In the eo.duct o[
lotions o~ the law~, ordina.ces, rule~ of re~,ulailons ol the Town oiSou[hold.
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JOHN C. EHLERS LAND SURVEYOR