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Home My WebLink AboutZ-27869FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 27869 Date: 08/14/01 THIS C~KTIFIES that the building DWELLING/LND ACCESSORIES Location of Property 400 BARTLEY RD (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 144 Block 0003 Filed Map NO. __ Lot No. __ Subdivision MATTITUCK (HAMLET) Lot 028 conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9~ 1957 pursuant to which c~('£IFICATH OF OCC~3P~C"~I~JMB~ Z- 27869 dated AUGUST 14, 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 ENCLOSED FRONT PORCH, ACCESSORY ONE CAR GARAGE~ AND NON-HABITABLE 8 ROOM STORAGE BUILDING.* The certificate is issued to EDWARD M & MARY ROBERTA DANA (OWNER) of the aforesaid building. SUFFOLK COUNTYDHPARTMENT OF~R~LTHAPPROVAL EL~-£KICA~ c~KTIFICATHNO. PLUMBERS CERTIFICATION DA'l'~u *PLEASE SEE ATTACHED INSPECTION REPORT. N/A N/A N/A Rev. 1/81 BUILDING DEPARTMENT TOWN 0F SOUTHOLD EOUSING CODE INSPECTION REPORT VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. NOTE: 8 ROOM ACCESSORY BUILDING IS NON-H~ITABLE Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR.CERTIFICATE OF OCCUPANCY A. This· application must be filled in by tyPewriter OR ink a~d~submitted 'to t~e inspector with the following: for new building or new use: . i, Final survey of .property with accurate location of a'll-~-d~i~di~g~, 'P~operty 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 Oh 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 buildin~ and installations, a certificate of Code Comp!lance 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 an~ '.~pre-existing" land uses: ~ 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. ~. A properly completed application and a.consent to inspect signed by the applicant. If a Certificate of Occt~pancy is denied, ~the Building Inspector sh. all state the reasons therefor in writing'to the applicant. 'Co ~ees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling' $25.00, Alterations to dwelling $25.00, swimming pool $25.00, Accessory building $25fO0, Additions to accessory building $25.00. Businesses $50.O0.. 2. Certificate of Occupancy on Pre-existing Buildin~ - $100.00 3. Copy of Certificate of Occupancy - ~ 4. Updated Certificate of Occupancy - $50.00 · 5, Temporary Certificate of Occupancy - Residential $1~.0C~ 'Commercial $15.00 S treat H-~ et Couuty Tax Map No i000, Section ........ . ...... Block ................ Lot ..... S~bdivision .... , -~* ............................ Filed Map ......... Lot ........ ~ ............ ~ermit D Of rmi Appli No ................ ate Pe t ................ cant Health Dept Approval Underwriters Approval.,. Planning Bpard Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... CONSENT TO INSPECTION Owner(s) Name(s) do(es) hereby state: · the undersigned, That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at ~ ~%-~(~ .~-/(jO ~'~a,-~)~/ , which is shox~ and designated on the Su~ County tax map as District 1000, Section ~ , Block 02 , Lot Z3 ~ That the undersigned (has) (have) filed, ~or caused to be filed, an applica- tion in the Southold To~ Building Inspector's Office ~or the follow~g~ 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, trules 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 lations of the laws, ordinances, rules or regul.~~ the To7 of Southold. Dated: '3 1 ~'~ ~ 1~') ~. t.-~,._.,_~ .~ (signature) (print name) (si~nMure) (print name 3ul 12 O! 05:4!p ROBERT N/F BARUCCO BARUCCO N 6 28' 00" E 100.12' SET WOOD FRAME S TRUC TURE ( 8 CAB/NS ) LOT 1 TAX MAP NO. I000- 144-0.3-27 LOT 2 TAX MAP NO. 1000-1,1,4-0,.t-28 hO ~.3'FRAME GARAGE , CELLAR ENT. I STORY RESIDENCE S 71' JO' 00' W BAR TLEY FM.~ 770 FILED JUL Y27, 1922 GUARANTEED TO VIRGINIA H, GILMOUR ALL SHORE ABSTRACT LTD. 100' ROAD SURVEY OF LOTS 1 & 2 IN MAP OF PROPERTY OF L/DA BARTLEY SITUATE MA TTITUCK, TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. SURVEYED FOR: VIRGINIA/vi. GILMOUR N LOT $ TIE= 317.5' SURVEYED 27 JUNE, 200l SCALE I"=20' AREA= 16,702.896 SF OR 0.~3 ACRES SURVEYED BY STANLEY J. ISAKSEN, JR. P.O. BOX.294 NEWi.SUFFOLK, NY I19~.~ / ///' /iCEN~D ,LAND ~VEYOR NYS LIC. NO. ~927~ n~p~n?~