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Home My WebLink AboutZ-22663FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-22663 Date OCTOBER 18{ 1993 THIS CERTIFIES that the buildin~ ONE FAMILY DWELLING Location of Property 855 KNOLLWOOD LANE MATTITUCK~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 107 Block 6 Lot 5 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a One Family Dwelling built Prior to: APRIL 9t 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-22663 dated OCTOBER 18~ 1993 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 WIT~ GARAGE UNDER HOUSE * The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. Rev. 1/81 DOROTHEA DELA~k%NTY N/~ N/~ // Building Inspector BUILDING DEPARTHENT TOWN OF SOU~IOLD HOUSING CODE INSPECTION REPORT LOCATION: SUBDIVISION 855 ~OLL~OOD LANE (number & street) N~ OF OvJNER (s) NATTITUCK, N.Y. MAP NO. (municipality LOT · DOROTHEA DKL~NANTY OCCUPANCY A-I RES. (type) (o~ner-tenaut) ADMITTED BY:DOROrflY DELEHANTY ACCOMPANIED BY: SAI~ KEY AVAILABLE ' SUFF. CO. TAX MAP NO. 107-6-5 SOUKC~ OF REQUEST: PAUL CAMINIT , A'i-rI DATE: 9/16/93 DNELLING: TYPE OF CONSTRUCTION WOOD FRAI~ FOUNDATION C~fliNT BLOCK TOTAL ROOMS: IST FLR. '6 BATHROOM (s) 2 FobL BATHS. PORCH TYPE SIDE ENCLOSED BREEZEWAY DOMESTIC HOT~ATER YES. TYPE HEAT OIL OTHER: 2ND FLR. 2 TOILET ROOM (s) DECK, TYPE FIREPLACE ONE TYPE HEATER WAP~ AIR # STORIES I-1/2 ~ EXITS 4 CELLAR FULL CRAkIL SPACE 3RD FLR. OIL UTILITY ROOM PATIO, TYPE GARAGE I CARUNDER HOUSE AIRCONDITIONING HOT~ATER XX ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. S~II'IMING POOL OYtt~;R: DOLL HOUSE STORAGE, TYPE CONST. , GUEST, TYPE CONST. VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFOP, H FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. REMARKS: Gai'yy ~h DATE ON INSPECTION OCT, I, 1993 TIME START I0:00 ENq~ 10:30 Form No. 6 A. TOWN OFSOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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: i. 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 Building - $100.00 3.Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4.Updated Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction ......... Old Or Pre existin Buildin'''~ ................... [''['[['['[313 Location of Property.. i ..... ~-~ ~OLL [1~/0 "~ House No. Street Hamlet 0nwer or Owners of Property ....... ~.~.~..~C..~....~.~..~.~..~.~..~.!~. ..... County Tax Map No 1000, Section . /.0 .7 ..... Block....~.~ ot Subdivision ....................... Filed Map ........... Lot ................... Permit No ................ Date Of Permit ....... Applicant ............ Health Dept. Approval ..... ..................... Underwriters Approval ..................... ;21arming Board Approval .................... Request for: Temporary Certificate ..... Final Certicate ........... ?ce Submitted: $ ./.~.~ . .~... CONSI~NT TO INSPECTION Oxwmr(s) Name(s) do(es) hereby state: · the undersigned. That the undersigned (is) (are) tl~e Owner(s) of the premises in the Town · which is shoxwn and designated on the Suffolk That the undersigned (has) (have) filed. 'or caused to be filed, an applica- 'tion in the $outhold Tox~ Buil¢ing Inspector's Offi.ee for the following: 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 s, uch 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 re~-mlations ~e Town of Southold. (print name) (signature) (print name)