HomeMy WebLinkAboutZ-9376]FORM NO. 4
TOWN OF SOUTHOLD
BUH.BING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No.. Z.9~76 ..... Date . .Ma.neb..~A, ............... , 19.79.
THIS CERTIFIES that the building located at E/S. Bay. kvenua ........... Street
Matt±tuck, N. Y.
Map No...XX ........ Block No.. XX ...... Lot No..XX ..............................
REQUIR~4ENTS FOR ACCESSORY BUILDINC~ BUILT PRIOR TO
conforms substantially to th~
.C~TIFICA~. OF OCCUPANCY
dated ...Aoril. 2.~., ......... , 195.7.. pursuant to which ~ No. Z9.~7.6..
dated .. Mar.ah. qb., .......... , 19.7.9, was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is ...~..t.l.d.i.n.g.s..g.!..&..#6.,..S.e.~.onal .Co.t.tag~s.,..Building .#~,..Storage.
The certificate is issued to . .. Harold. G,..Baldwin. & .w.f. ..........................
(owner, ~)
of the aforesaid building.
Suffolk County Department of Health Approval ...... N/R ..........................
UNDERWRITERS CERTIFICATE No ............... N/JR ..........................
2~05 - 2Z~15
HOUSE NUMBER . .&. 2.425. i... Street ...... Ray .A.v. enue,...l~a.tti~k,.
lq...
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..............................................~. ~.~~.~. ~.'..~..z..~..I~' ......... ~ ','~ ................ ~
B~d~g I~peetor
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
Z~s--/ HOUSING CODE INSPECTION REPORT
z~ /
Location Z~/~/ ~/~ d/ ~/~ /c/~7-//~-67 C ~ -
(number ~ street) (Municipality)
Subdivision Map No. Lot(s)
Name of Owner(s) /-//~/f~)/-O ~-
Occupancy ~/type) ~7~'~2~%0X~/3~'- Jr~-5~ ~O'ZT'd~Z( own er-ten,bt )
Admitted by:~iT Z~O~ Accompanied by:
Key available Suffolk Co. Tax
Source of request~-~. ~r/~TAz~ ~q~-/C/ Date
DWELLING:
Type of construction ~/~oz2 ~/~3/~/~ #stories _~
Foundat~on/~y~D ~ ~/~ ~-- Cellar/~P~/~rZ Crawl space
Total rooms, let. FlJ:~ 2nd. Fi -- ~rd. FI --
Bathroom(~' Oz~ ~m~. Toilet room(s)
Porch, type~/~C~. Deck, type
Breezeway Garage -
Type Heat /~/~/~ Warm Air
Fireplace(s) No. Exits
Domestic hotwater/7/Z/~/~-~/~=~ Type heater
Other
Patio,
Utility room
Hotwater ~
Airconditioning
ACCESSORY STRUCTURES:
Garage, type const.
Swimming pool
Other
Storage, type const.
Guest, type const.
VIOLATIONS: Housing Code, Chapter 52
Location Description Art. Sec.
Remarks:
Inspected by: Date of Insp.
Time startY:~ ~. A{end~: ~ ~. ;7'.
BUILDING DEPARTMENT
TOYfN OF SOUTHOLD, N. Y.
~ ~ZF~TBOUSING CODE INSPECTION REPORT
~Vo Sl .~ .
(~umber & street) (Mo_nicipality)
Subdivis ion Map No. Lot ( s ) '~
Name of Owner(s)
Admitted by:
Key available Suffolk Co. Tax No./O~O-/~$z-~po%/
Source of request-~ ~.,."/h~' .~,~5,,~/5'~aS~'i Date ~.~/'~,.~/~' '~
Type of construction
Foundation
Total rooms, 1st. Fi ~--~<~
Bathroom( s )
Porch, typ e~z~ -
Breezeway.
Type Heat /y~o ,'~
Fireplace(s)
Domestic hotwater
Other
~JO 0 ~ Y-~/~/'~ #stories
Cellar ~ Crawl space
2nd. F1 ~ 5rd. F1
Toilet room(s) ~
Deck, t~e '" Patio, t~e
Garagq Utility room
Warm Air ~ Hotwater ~
Airconditionin~
No. Exits O,u~=
z4x~zg Type heater
ACCESSORY STRUCTURES:
Garage, type const.
Swimming pool
Other
Storage, type const.
Guest, type const.
VIOLATIONS: Housing Code, Chapter 52
Location Description Art. Sec.
Remarks:
Inspected by:
~7/~M~Dat e
of Insp.
Time start~.end~
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
g~Z~/ HOUSING CODE INSPECTION REPORT
~numbe~ & street) (Municipality)-
Subdivision ,- Map No. Lot(s)
Name of Owner(s)
Occupancy H- /
(type)
Admitted by:~/a7
' Cowner-te~ant)
Accompanied by:
Key available
Source of request/~/-
Suffolk Co. Tax No./~fPO
, ~5'~Y,~/ Date
DWELLING:
Type of construction
Foundation ~o~~ Cellar
rooms, 1st. FI~/~. 2nd. F1
Total
Bathroom(~
Porch, type
Breezeway.
Type Heat
Fireplace(s)
Domestic hotwater
//YrJn~ /z/~/../~t~ #stories
~ Crawl space
--' 5rd. F1
Toilet room(s) ~"
Deck, type ~ Patio,
Garag% Utility room
Warm Air Hotwater
Other
type
No. Exits ~ Airconditioning
.Type heater
ACCESSORY STRUCTURES:
Garage, type const.
Swimming pool
Other
Storage, type const.
Guest, type const.
VIOLATIONS: Housing Code, Chapter 52
...Location Description Art. Sec.
/'
Inspected by: g~--~iLmte of Insp.
Time start~5$ ~end ~.'~ ~-~'
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec-
tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa-
tions, a certificate of Code compliance from the Architect or Engineer responsible for the building.
5. Submit Planning Board approval of completed site plan requirements where applicable.
For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or
topographic featu res.
2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling or land use
3. Copy of certificate of occupancy $1.00
$5.00
New Building ............. Old or Pre-existing Building ...X. ........ Vacant Land .............
Location of Property ................ .~.a:.~...A.v.e.~ .u.e ..................... ~ .a.t.t;.J:.t..u.c.~. .......
House No. Street Ham/et
Owner or Owners of Property VIRGINIA ELSIE BALDWIN
County Tax Map No. 1000 Section .1.4..4... p.q ....... Block . .0.4...0..0 ........ Lot...0.0..4...0.0..0 .....
Subdivision ................................. Map No ............... Lot No ...............
Permit No ........... Date of Permit .......... Applicant ..................................
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $ .............................
Construction on above described building and permit meets all applicable codes and regulations.
Rev. 10-10-78
Applicant..' . .V.I,~..VI IA .... ELSIEE..L.S.I.E,. B.B~,.L~..N/./L N ....................
STATE OF NEW YORK )
) ss.:
COUNTY OF SUFFOLK )
PIERRE G. LUNDBERG, being duly sworn, deposes and says:
I am one of the attorneys for VIRGINIA ELSIE BALDWIN, who
is about to convey premises in the Town of Southold, located at
Bay Avenue, Mattituck, New York, to WILLIAM C. MERCURIO and
LINDA E. MERCURIO, his wife, and PHILIP T. RODILOSSO and NANCY J.
RODILOSSO, his wife. Mrs. Baldwin is now a resident of 10126
Campana Drive, Sun City, Arizona. The closing is scheduled for
March 19, 1979 at Garden City, New York, and it is impossible to
get an affidavit from Mrs. Baldwin prior to that time.
Attached hereto as Exhibit "A" is a copy of a Certificate
of Occupancy issued in 1970, being No. Z4095. As Exhibit "B",
I annex a copy of a survey of the premises, last dated February 14,
1979. The Certificate of Occupancy is for the premises designated
as a one-story frame house and patio, nearest James Creek. This
affidavit is submitted in support of an application for a Pre-
existing Building Certificate as to the two frame cabins and the
one-story frame house shown to the west of the house for which
the Certificate of Occupancy was issued.
Upon information and belief, all three of these structures
were erected prior to April of 1957. The source of my information
and belief is the seller, Mrs. Baldwin, and also Burt Lewis who
is the broker in the transaction and who has been a resident of
the Town of Southold and active in the sale of real properties
since prior to 1957, to my own personal knowledge. It is,
therefore, respectfully requested that a Certificate that these
are pre-existing buildings be issued by the Building Department
of the Town of Southold.
Sworn to before me this
13th day of March, 1979
' ~ / Notary Public
MAR$ORIE E. EDWARD~
NOTARY PUBLIC, State of New York
No. 52-1080430
TOWN ~'i: SOUTtlOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southohl, N. Y.
Certificate Of Occupancy
lk'o. Z~qQg~'....... Date .......... bf.c...~2 ....... , 19.~.Q
THIS CERTIFIES that the building located at E/S.~gy ~y~ ............. Street
~v~ap No..~ ......... Block No...~ ...... Lot No.. Z~ i,~attituc~..E.-~.~ .....
conforms substantially to the Application for Building Permit heretofore filed in this office
dated ........... Z~e...~9. , 19 70. pursuant to which Building Permit No. ~Sq2Z..
dated ....... J~¢...q.9.. , 19.70 , was issued, and conforms to all of the require-
merits of the applicable provisions of the law. The occupancy for which this certificate is
issued is ~F~ete one famzl5 awellzng
The certificate is issued to Harola G. salawzn Owner
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval .Q2¢...Iq .,..1.970...by. k. Villa ....
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Exhibit "A"
Exhibit "B"
Exhibit "B"
l'
Unauthorized ahero~ion or addillon to Ihis survey is o vlolalion of
sect~. 7209 of the New York State Education law.
Copies of this sur~ey map not bearing Ihe land surveyor's inked
seal or embo¢-sed seal shatl not be considered to be a valid copy.
Guarantees o, co ,, co o indicated hereon shal~ run only to ~he
person for v, hom Ihe survey is prepared, and o0 his behalf to the
tille company, governmental agency and lending institulion listed
hereon, and to Ihe assignees of Ihe landing inst;~ution, Guarantees
SURVEY FOR
WILLI/IM C. E~ LIND,~I E. MEF?CURIO ~
pHILIP 7~ ~ N/~NCY,.J. RaDII'OSSa
A'T MATTITUCK
TOWN OF SOUTHOLD
SUFFOLK COUNTY~ N.Y.
SCALE: 1"=40, Q ~
GUARANTEED TOz
SECURITY TITLE ~' GUARANTY COMPANY.
SUBURBIA FEDERAL'SAvINGS 15 LOAN
ASSOCIATION.
WILLIAM C.~ LINOA E. MERCURIO 8, PHILIP
N.Y.S, LIC. NO. 287Z~
RIVERHEAD~N.Y.