HomeMy WebLinkAboutZ-26049 FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building inspector
Town Hall
Southold, N.Y.
PR8 EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 26049 Date: 10/21/98
THIS CERTIFIES that the building DWELLING
Locution of Property 200 WALNUT PL MATTITUCR
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 142 Block 0001 Lot 022
Subdivision Filed Map No. Lot No.
conforms substantially to the Requirements for a ONS FAMILY DWELLING
built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NOMBER Z- 26049 dated OCTOBER 21, 1998
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate ie
issued is ONE FAMILY DWELLING WITH ACCESSORY GARAGE & SHED
The certificate ie issued to JOHN FIYALKOWSRI
(OWNER)
of the aforesaid building.
SUFFOLK COONTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. H-061209 - 9/3/1998
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
Buildi Inepecto
Rev. 1/81
BUILDING DBPART[•~TP
TOWN OP 6O0THOLD
^OUSIA CD?8 TNBPBCTTON 4RPnRT
LOCATION: a00 WALNUT PL MaTTITUCR
BUBD]VISION: MAP NO.: LOT (8)
NAME OP OWNER (8): TnRN Prvsr YnmaYr
OCCUPANCY: BjNGLR anvrr.V ?mRT.T.TNG TORN PTVAT.YONAYT
ADMI'1TSD SY• aTUnPRm n. RTYPB ACCOMPANIHD BY: BAaR
RBY AVAILABLE: SUFF. CO. TAX MAP NO.: 1d' •T •9~
SOURCH OP R8QUS8T: nnrr_arr mmBYaaT a/t9/9B DATE: r0/al/og
DNR
.Tr
IBC;
TYPE OP CONSTRUCTION: WOOD PRAMS # 6TORI8S: # BXIT3:
FOUNDATION: ^^°^OA"D =r~nCY CELLAR: 50# CRAWL SPACB: 508
TOTAL ROOMS: 18T PLR.: 2ND PLR.: 3RD PLR.: ~
BATHROOM(S): 1.0 TOILET ROOM (8): _ 0^0 UTILITY ROOM(S): ~$.9-
PORCH TYPE: °"^r.nRRn FRONT s RRa4• DBCR TYPE: PATIO TYPE:
BRE82BWAY: FIREPLACE: NO GARAGE:
DOlDS6TIC HOTWATBR: Y88 TYPE NEATER: OIL AIRCONDITIONZNG:
TYPE HEAT: OIL WARM AIR: HOTWATSR:
nm? RRAR PORCH HEATED
n^nRBBORY BTRUCT?TFRe:
GARAGE, TYPE OF CONBT.• mnn carte 6TORAGE, TYPE CONST.: WOOD PRaMR
84fLMMING POOL: GUHST, TYPE CANST.:
OTHER:
VIOLATIONS: CHAPTER 45 N.Y. BTATB UNIFORM PIRH PREVENTION & BUILDING CODS
aTION D86CRIPTION I cam I SHC. -
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n uneena .e v_ee nee rnnn nv: annRCRnRVI RRTNBPECTHD 10/6/98
INSPECTED HY: DATE ON INBPHCTION: r0/21/9B
MICHAEL J. VERITY TIME START: 10:45 END: 1~:a0
.
Form No. 6 ~ rN ~ i
L
TOWN OF SOUTHOLD
BUILDING DEPARTMENT AUG ~ 3
TOWN HALL
765-1802 T _
~r.~
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 iX 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 - .25~.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date ,August ..L Li.1998
New Construction........... DSn Or Pre-existing Building..............
Location of Property..~QQ......Waln~,t,Place,,,,,Mattituck
House No. Street Hamlet
Onwer or Owners of Property ..,TPk10.F3Y~~~fQF'5~~.§~.Wife,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
County Tax Map No 1000, Section...142........Block..1 .............Lot??•....................
Subdivision ....................................Filed Map............Lot......................
Permit No ................Date Of Permit................Applicant.............................
Health Dept. Approval ..........................Underwriters Approval.........................
Planning Board Approval
Request for: Temporary Certificate........... Fz1ra1 Certicate.for,Pre;existing use
Fee Submitted: $.100.00•
c~o.~~
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APPLICANT
Abigail Wickham, Esq., Attorney for Owner
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MAP OF LF.NC7
suRVtvir. F4rz
JJHri s MATTE F~IYALKCWSKI
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Suvveyed Juv+a I 19toz
MATT{Tt.7CK atto ~~W~v.~u~r+ Tuyly{ /f
TOWN GF SOUTHOLD~ N.Y. ~l.~f/I/ • ~f~ti'~~.K.~y~..
t_iccNS~~:I fiord 5uv{ia.3ora
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tHE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
8072363 BUREAU OF ELECTRICITY
~ ~ 40 FULTON STREET, NEW YORK, NY 10058
Hate SEPTEMBER 03,1998 Application No. on file 16673598/98 H 061209
9' THIS CERTIFIES THAT
} only tke e(ectricdegnipment osdescribed below and introduced by the applicant named on the above app(icaNon number rs in the premises of !
STEINER, 170 WALNUT STREET, MATTITUCK, NY
in the followJng location; ®Barement ®Ist FL ®2nd FL GAR Sectbn Block Lot
was examined on AUGUST 25x1998 and found to be in compBancs >TJth the National Electrical Code.
3 FIXTURE RECEPTACIEb SWITCHES FIXTURES RANGES coOIUNO DECKS OVENS DWH WASNERS EXHAUST FANS
i OUTLETS INCANDIECI IWORIECIM OTNER AMT. K.W. AMi. K.W. AMT. K.W. AMT. K.W. AMT. X.P. }{I
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS SELL~~ UNIT HEATERS M SYSTEMlUT DIMMERS j
AMi. K.W. OIL N.P. OM X.P. AMi. NO. A. W.O. AMT. AMP. AMi. AM%. TRANS. 4MT. M,P. NO. OF FEET AMT. WATtl
l
SERVICE DISCONNECT .HO. or ! E .g. V. I _._C... _._...,E...___..,....,,.,.-_.._._._.~..:
METER A. W.O. A. w. A.
AMT. AMP. TYPE EQUIP. i S RW 1 e DW S E DW S 0 ~W PER a 0/ CC. COND. NO. O! XI•LIO O! XI-LTG NO. OF NRUTRAY O! NR R~L i
Y I
OTHER APPARATUS:
'NO VISUAL DEFECTS: "An electrical
survey has been made of the exposed ~t
electrical equipment in the
premises indicated." "No obvious ' S~
J unsatisfactory condition was found.
~5 FEE PAID PLEASE REMYT BOY CH CK OR MONEV j
YYY ORDEq TO THE ORDER OF THE NEW J
YORK BOARD OF FIRE UNDERWRITERS (
i JANET GEASA WICKHAM OF SENDERNT BV MAIL WILL BE AT RISK
MAIN ROAD
MATTITUCK, NY, 11952
{ 11
Per 1
THIS IS YOUR BILL FOR SERVICE RENDERED AND IS NOT A CERTIFICATE OF COMPLIANCE. THIS BILL PAYABLE AT THE NEW YORK OFFICE, IO FULTON STREET, NEW YORK, N.V. 10038