HomeMy WebLinkAboutZ-26970FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 26970
Date: 03/10/00
THIS CERTIFIES that the building DWELLINGS
Location of Property 10270 SOUND AVE
(HOUSE NO.)
County Tax Map No. 473889 Section 122
subdivision
MATTITUCK
(STREET) (HAMLET)
Block 0002 Lot 012
Filed Map No. Lot No.
conforms substantially to the Requirements for a ONE FAMILY DWELLING
built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z- 26970 dated MARCH 10, 2000
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 ONE FAMILY DWELLING WITH
DECK ADDITION.*
The certificate is issued to WENDY DAVIS
of the aforesaid building.
(OWNER)
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
N/A
N/A
N/A
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION ~AEPORT
LOCATION: 10270 SOL~D AVE
SUBDIVISION:
~U%ME OF OW~R (S): WENDY DAVIS
OCCUPANCY: A-1 P. ESIDENTIAL
ADMIT'fED BY: WENDY DAVIS
MAP NO.: __ LOT (S) __
WENDY DAVIS
ACCOMPANIED BY: ~AME
KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 122.-2-12
SOURCE OF REQUEST: WENDY DAVIS DATE: 03/10/00
TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 1,0 # EXITS: _~
FOUNDATION: CE~NT BLOCK CELLAR: PART. CRAWL SPACE: __
TOTAL ROOMS: 1ST FLR.: ~ 2ND FLR.: _~l 3RD FLR.: ~
BATHROOM(S): 1,0 TOILET ROOM(S): Q,Q UTILITY ROOM(S): __
PORCH TYPE: DECK TYPE: PATIO TYPE:
BREEZEWAY: FIREPLACE: GARAGE:
DOMESTIC HOTWATER: YES TYPE HEATER: OIL AIRCONDITIONING:
TYPE HEAT: OIL WARM AIR: ~ HOTWATER:
OTHER:
GARAGE, TYPE OF CONST.:
SWIPING POOL:
OTHER=
STORAGE, TYPE CONST.:
GUEST, TYPE CONST.:
VIOLATIONS:
LOCATION
CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
SEC.
RE~Ut~KE: BP#21002 INSTALL WINDOWS CO#Z26847.
DATE ON INSPECTION: 03/01/00
TIME START: 9:50 AM END: 10:30 AM
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
SOUSING CODS INSPECTION REPORT
LOCATION: 10270 SOUND AVE MATTITUCK
SUBDIVISION: MAP NO.: __ LOT (S) __
NA~ OF OWNER (S): WENDY DAVIS
OCCUP~CY: A-1 RESIDENTIkL WEN'DY DAVIS
ADMITTED BY~ WKNDY DAVIS ACCOMPANIED BY: SAF~
KEY AVAILABLE: SUFF. CO. TAX MAP NO,: 122. -2-12
SOURCE OF REQUEST: WENDY DAVIS DATE: Q3/10/00
TYPE OF CONSTRUCTION: WOOD FRAME ~ STORIES: 1.0 # EXITS: ~
FOUNDATION: CQNCRETE POST & CEMENT PIERS CELLAR: CP. AWL SPACE: X
TOTAL ROOMS: lST FLR,: __~ 2ND FLR.: --0 3RD FLR.: --0
BATHROOM(S): l~Q TOILET ROOM(S): O,O UTILITY ROOM(S): --
PORCH TYPE: DECK TYPE: WQQD FP. AME PATIO TYPE:
BREEZEWAY: FIREPLACE: GARAGE:
DOMESTIC EOTWATER: YES TYPE HEATER: PROP/GgE GAS AIRCONDITIONING:
TYPE HEAT: ~WA~M AIR: HOTWATER:
OTHER:
GARAGE, TYPE OF CONST.:
SWIPING POOL:
OTHER:
STORAGE, TYPE CONST,:
GUEST, TYPE CONST.:
VIOLATIONS:
LOCATION
CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
; DESCRIPTION ART.
SEC.
RE~KS: BP14278 ADD. CO~Z13958:BP26377 DECK C0#Z26969,
INSPECTED BY~ DATE ON INSPECTION: 03/01/00
TIME START: 9:50 AM END: 10:30 AM
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 sub~
inspector with the following: for new building or new use:
1. Final survey of property with accurate location of all buil~
streets, and unusual natural or topographic features.
2. Final Approval from Health Dept. of water supply and sewerag
3. Approval of electrical installation from Board of Fire Under
4. Sworn statement from plumber certifying that the solder used
less than 2/10 of 1% lead.
Rtted q,o th~ ~uildin~
ings, property lines
e-disp0~al(S-9 form)
writers.
in system contains
5. Commercial building, industrial building, multiple residences and similar buildi~
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.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings a~
"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 applican~
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
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.
2. Certificate of Occupancy on Pre-existing Buildin~?.0~0~
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
New Construction ........... Old Or P.~e-existing Building ............
Location of Property ..................................
House No. Street Hamlet
Onwer or Owners of Property ...........................
County Tax Map No 1000, Section .... {.~.~ ..... Block .............. Lot ..............
Subdivision .................................... Filed Map ............ Lot ..................
Permit No ........... Date Of Permit ........... Applicant ..........
Health Dept. Approval .......................... Underwriters Approval .....................
Planning Board Approval ........................
Request for: Temporary Certificate ........
'F~e Submitted: $.../.~.0~.~. ......
. Final Cer ticate ...........
wner(s)
CONSENT
TO
INSPECTION
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 lg)~./)O ~n/..~c/ .~V~.
/Cfl~'/ff~ , which Is sho,~ and designated on the Suffolk
County tax map as District 1000, Section /~ , Block ~ ., Lot
That the undersigned (has) (have) filed· 'or caused to be filed, an applica-
tion in the Southold Town Building Inspector's Office for the following:
J . /
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, ~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.
v ~--'(sig~at~r e)
(l~rint name)
(signature)
(print name)
SURVEY OF PROPERTY
A T MA TTITUCK
TOFgN OF SOUTHOLD
SUFFOLK COUNTY, NEY YORK
1000-1~2-0;~-12~
SC,al.R: 1"--30'
FEB 14, 2000
S B6'56'00' E
~43 64'
{EPTIFIEI} TO:
T)'I,,1 E SUENTENS
AOUEBDGUE ABSTRACT
AREA = tSp$1 mq ft.
ANY AL I£~RA[IUN ij]P ADDITION TO THIS 5URVEY IS A VIOLATION
£1f '7£CF[ON 7209 ~g iHE NE~ Y~RK STATE EDUCATION LA~
EX(7[PT A5 F)L~ ~i !]~N 7809-SUBDIVISION ~ ALL CERTIFICATIONS
HER[ON AR[ vAI IB FO~ THIg ~AP AND C~PIES THEREOF O~ Y Ii
~AID ~AP DR OPIE:~ BEAR THE IMPRESSED SEAL OF THE SURVEYOR
WHOSE JIGNATURE APPEAP~ HEREDN
I FA)<: 6319 765-1797
~'[.~ [.L T