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Home My WebLink AboutZ-27823FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 27823 Date: 07/20/01 THIS CERTIFIES that the building DWELLING Location of Property 560 SUNSET AVE MATTITUCK (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 115 Block 0003 Subd/vision Filed Map No. __ Lot No. __ conforms substantially to the Requlre~_nts for a ONE FAMILY DWELLING built prior to APRIL 9~ 1957 purser to which CERTIFICATE OF OCuu~ANCY N73MBER Z- 27823 dated JULY 20~ 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 ONE CAR GAEAGE AND BRICK PATIO.* (HAMLET) Lot 002.001 The certificate is issued to SHELDON CULLISON ( OWNER ) of the aforesaid building. SUFFOLK COUlqTYDEPAII~T~qT OF~ALTHAPPRO%rAL ELRC~rKIC~J~ C~KTIFICATH NO. PLDMBERS C~KTIFICATION DA'£~43 *PLEASE SEE ATTACHED INSPECTION REPORT. N/A N/A -//hor/z ed Signature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 560 SUNSET AVE SUBDIVISION: NAME OF OWNER (S): SHELDON CULLISON MATTITUCK NAP l~O.: LOT (S) SHELDON CULLISON KI~Y AVia_II~ABI~: SI]FF. CO. TAX P. AP NO.: 115.-3-2.1 SOURCE OF P.~: MARY LOU POLTS, ATTY DATE: 07/20/01 ACCESSORY STRUCTURES: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. DA~'E ON INSPECTI(~: 07/16/01 GARY J FISH TI~l~ START: 10:05AM ~]13: 10:35AM Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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. 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 a 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, Alterations 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 Buildine - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary ~ertificate of Occupancy - Residential $15.00, Comercial $15.00 ~ Zo oI Date .............................. New Construction ........... Old Or Pre-existing Building .... ~ ............ Location of Prop rty 560 Sunset Avenue e .......... ....... Mattituck House No. Street Hamlet 0nwer or Owners of Property Sheldon Cullison County Tax Map No 1000, Sec~4-- 115.00 ..Block. 03.00 ................. Lot. 002:001 Subdivision ' .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval.' ......................... Underwriters Approval ......................... Planning Board Approval ' Request for: Temporary Certificate ........... Final Certicate..~ ....... Fee Submitted; ,.~.,..~. ' ....... CONSENT TO INSPECTION Sheldon Cullison , , the undersigned, Owner(s) Name(~ do(es) hereby state: That the undersigned (is) (~) the owner(~s~ of the premises in the Town of Southold located at 560 Sunset Avenue, Mattituck, New York · which is shown and designated on the Suffolk County tax map as District 1000, Section 115.00 Block 03.00, Lot 002.00L That the undersigned (has) (~ filed, or caused ~o be filed, an applica- tion in the Southold Town Building Inspector's Office for the following: __ Pre-existing Certificate o,f 0ccu~ancy That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, inciuding 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 as evidence in subsequent prosecutions for vio- lations of the laws, ordinances, rules or regulations of the Town of Southold. (s ~Ln~tur e) Sheldon Cullison (print name) (signature) (print name)