HomeMy WebLinkAboutZ-24476 FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building inspector
Town Hall
Southold, N.Y.
PRE E%ISTING
CERTIFICATE OF OCCUPANCY
No Z-24476 Date JULY 1, 1996
THIS CERTIFIES that the building ONS FAMILY DWELLING
Location of Property 1165 FACTORY AVE. MATTITOCE, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 122 Block 2 Lot 19
Subdivision 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 5-24476 dated JIILY 1, 1996
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate ie
issued ie ONS FAMILY DWELLING WITH ACCESSORY GARAGE
The certificate is issued to PATRICLA & GEORGE FASIO
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
ld ng Inspector
Rev. 1/81
l?llll.D1NG UEl'AR'PMBNT
'T'OWN OP SO(I'L'li(N.U
IIOl1S 1 NG COUI; LNSI'EG'L' LON Itl?POIt'1'
1165 FACTORY AVE. MATTZTDCR, NSW YORK
LOCH"PION:
number 6 sCreeC ~(ahuuc~paliCy
Sl1Ul)IYLSLON NAP NO. _ LO'l'(s)-
NAME OC OWNER (s) PATRICIA & GEORGE FAZIO
OCCl1PAl?~:y A-1 RES. ~R _ _
- Cyr--- --~~owner-LenanL~-
AUMI'1"I'IiU 1SY: DOIIGLAS SULLIVAN ACCOMPANIED I?Y: SAMB
KEY AV All,Al11,E SI1CIi.(;O. 'CAX HAP NO. 10 - - _
SOl11ti:E OP REC~IniS'I': _ GEORGE S_PATRICIA_FAZIO _ Un'I'E: MAY 18, 1996,__
DWELLING:
'CYPE OC CONS"fRIICTTON WAD F~ 1 S'CO{tIES_ 2 ~ ERL1'S 2
FOl1NDA'fION CEMENT BLOCK __CELI.AR -~F~'I' - CItAWI. SPACE
'T'OTAL ROOMS: IS'1' PLR. 3 __2ND FLR. 3 3RD PLR.,__,
l?n'rn ItooM (e) oNE FIILL •ro LI,E•r Roorl (R) ONE _ u r li.ITY aoorl
1'OllCll '!'YPE _ OfiCK, '1'YPL' EA"1'IO
I?REE7.EWAY PIRIsPLACI? GARAGE'
DOMESTLC 110'I'WATEIL YES _ TYPE IIEA'rER OII' AII(CONDL'PLONIN(:
'I'Yl'I: IIEA'(' OIL WAItM AIR _ IIO'l'WATEK ~ _
O'I'l I I: R : REAR ENTRY WAY
ACCESSORY S'I1tUCTURL'S:
GARAGE, 'TYPE UC CONS'I' WOOD FRAME S'1'ORAGI?, TYPE CONS'l'.
SWLMFIING P001. Glll?S'1', 'I'YI'li CONS'I'. _
o'rnElt:
VLUl.ATLUNS: (:f1APTER 45 N.Y. S'1'Kl'lB i1Nli!URM PIItE PIt1iVL'N'1'ION 6 R1111,DING CODE
LUCA'I'ION ~ UESCItlI''I'lUN _ _ AR'I. SEC_
RI?MAIiKS
INSPEC'T'ED ItY ~ DA'1'I? OC INSI'CCl']ON MAY 30, 1996
GARY I 'L'IME S'IART 10:00 AM ENU 10:15 AM
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
G0962 BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NY 10038
Date JUhf t7. ,1996 Application No. on file 1 59591 95 /95 H 050715
THIS CERTIFIES THAT
only the electrleal equipment w described 6sAno and introduced by the eppNcarst named on the sboee application number in the premises of
GEOR~3E FAZIO, 1155 FACTORY AVENf1E, 1fATTITUCK, N.Y.
in thefollowiny locotion; ~ Basement ~ Ist FL ®Pnd Fl. OUT .Sertion Block Lot
seas exomined on JUNE 25 , 1995 and found to be in compliance with the National Electrical Code.
RXTUtl VTACLK SWITCHES RXTURES RANOlS COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
ODTIETS INCANDE]CEM FlUGI1ttCEM OTHER AMT. K. W. /JAI. K. W. AMi. R.W. AML. K. W. NAi. N. P.
DRYERS FURNACE MOTORS NTURt AFKIANCE wtlDeRS SNK;IAL RELIT TIME ~ S Yu UNIT HEATERS MULTIAMITIET DIMMERS
AMi. K. W. Oll N. I. GAS M. P. NAT. NO. A. W.O. AM}. AMP. AMT. AMP]. TRANS. AMT. H. P SYSTEMS WATTS
No. or wet
fERVIC! DISCONNtCT te0. OF S E R V 1 C E
Nni. AMP. fYR I / tW 1 / Jw ] / TV ] / AN' NO. OF CC. COND. A. W.O. NO. Of NI-lFG A' W.G. NO. Of NFUTRNS A. W G.
PER / Ot CC. CDND. Of NbIEG OF NFUTRAt
O1NER AM41MTU5:
:iAtGKE DETECTOR:
*NG VISUAL DEFECTS: "An electric°~L
survey hati been made of the expo.°~+'d
electrical equipment in the
p]'r--miles indicated. " "No obvious?
unsa*_isfactory ~-onditioll wrns fnuntl.
GEORGE FAZIO
22 GZLCHRIST ROAD OMNAI
)ONGERS , NY , 11 THE
'A Per
This certificate must not bs aHarad in any manner; return to the offin of 1M Board if incorracl. Inspectors may be identified by their credentials.
COPY FOR BVI LD[N6 DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
- form No. G
TOWN OF SOUTIIOLD ~D
BUILDING DEPQRTHENT
TO4lN IIALL
- 7G5-1802 ~ a`-; `
APPLIC,\-CION FOR CERTIFICA'CE OI' OC~UI'A~ ~ '
t,,,,, 7b a<OG.
A. 71iis application muse be filled in by typewriter OR ink and s ~'X kuilding
inspector with the following: Eoc new building or new use: UrHOCO
1. Final survey of property with accurate location of all buildings, pros cy lines,
streets, and unu:;ual tta~ural or topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-O form).
3. Approval of electrical installation from Board of Fire Underwriters.
G. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 17. lead.
S. Commercial build in industrial building, multiple residences and similar buildings
and xnstallations,~a cerCJ.ficaCe of Code Compliance from architect or ensineer
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 proporly 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 CheYefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy - New dwelling $25.00, .ldditions to dwellinS $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, ~
Additions to accessory building $25.00. Ausinesses $50.00. .
2. Certificate of Occupancy on Pre-existing Cuildinr - 5100,00
3. Copy of Certificate of Occupancy - $20.OU
4. Updated Certificate of Occupancy - $50.00
S, Temporary CertifxCate of Occupancy - Residential $15.00-, Gornmercial 515.00
Date MaY,.li.1996
.Jew Construction.........., Old Or Pre-eristing building....X.......
Location of Property....~~f3~.k'~SC4zX .7lY~'}u?~ .~~t535riG15~ . . . .
}louse Nv. Street Hamlet
Patricia Fazio and George Fazio, devisees
Onwer or Owners ~!E Property...u/w,C~7}ROLINE~A:,GL()ECKLER,,,Dece~~ed,,,,,,
County Tax Map No 1000, Section...l??........Block......?.........Lo t.....19
Subdivision ....................................Fil.cd M:tp............Lot......................
?ermit No ................Date Of Permit....... :ApPlic:tnt........................
:lealth Dept. Approval........ ..................Underwriters Approv:11-....•........•.._......•
?fanning Board Approval
request for: Tempor,ry Certificate........... Fi~n'al Certicate.
'ee Submitted: 5,100..00 ~/lC ~i~~. - ~ 7
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COA'SENT
TO
INSPECTION
PATRICIA FAZIO and GEORGE FAZIO the undersigned,
Owner(s) Name(s)
do(es) hereby state:
That the undersigned kip) (are) the owner(s) of the premises in the Town
of Southold located at 1165 Factory Avenue, Mattituck, NY
_ which is shown and designated on the Suffoll:
County tax map as District 1000, Section 122 Block 2 ,Lot 19
That the undersigned (}gas) (have) filed, 'or caused to be filed, an applica-
tion in the Southold Town Building Inspector's Office for the following:
U~
Certificate of Occupancy (pre=existing use)
That the undersigned do(~ 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(e~ so with the
kno~•ledge 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.
Dated: s ~ ~/7~~- ~ _ ~
(signature
Patricia Fazio
(print names)
t ~
( na
George Fazio
(print name)