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Home My WebLink AboutZ-26679FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 26679 Date: 09/13/99 THIS CERTIFIES that the building DWELLING & ACCESSORY Location of Property 18625 MAIN RD (HOUSE NO.) County Tax Map No. 473889 Section 108 MATTITUCK (STREET) (HAMLET) Block 0004 Lot 001.001 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 Z- 26679 dated SEPTEMBER 13, 1999 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 COVERED FRONT PORCH AND ACCESSORY BARN.* The certificate is issued to AGNES B. GRABOWSKI (OWNER) of the aforesaid building. 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 REPORT LOCATION: 18625 MAIN RD SUBDIVISION: NA~4~ OF OW~IER (S) : AGNES B. GRABOWSKI OCCUPANCY: SINGLE FAMILY ADMITTED BY: VICTOR GRABOWSKI MATTITUCK MAP NO.: __ LOT (S) __ AGNES B. GRABOWSKI ACCOMPANIED BY: KEY AVAILABLE= -- SUFF. CO. TAX MAP NO.: 108.-4-1.1 SOURCE OF REQUEST: LARK & FOLTS. ATTORNEYS DATE: 09/13/99 TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 2.0 # EXITS: 4 FOUNDATION: STONE CELLAR: 1/4 CRAWL SPACE: $/4 TOTAL ROOMS: 1ST FLR.: __~ 2ND FLR.: _3_ 3RD FLR.: __~ BATHROOM(S): 1.0 TOILET ROOM(S): 0,0 UTILITY ROOM(S): -- PORCH TYPE: FRONT COVERED DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: ~ * GARAGE: DOMESTIC HOTWATER: YES TYPE HEATER: OIL AIRCONDITIONING: TYPE HEAT: OIL WARM AIR: HOTWATER: X OTHER: FIREPLACES: 1 OPERATIONAL & 1 CLOSED OFF ACCESSORY STRUCTURES: C4%~AGE, TYPE OF CONST.: SWI}94ING POOL: OTHER: 2 CAR WOOD FRAME STORAGE, TYPE CONST.: GUEST, TYPE CONST.: BARN STRUCTU~ VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION : ART. SE¢. REb~DJ[S: BP{46SS-Z C4%RAGE CO~Z-3928 INSPECTED BY ~ ~AR¥ ~ DATE ON INSPECTION: 08/13/99 TIME START: 10:00 AM END: 10:30 AM Form No. 6 TOWN OF SOUTIIOLD / TOWN / APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in bv tvneWr~ ........ ~'?'~'~, .. inspector with the following: for new building or new use: .... ~=~ um mnm and submitted to the bui~ 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approvai 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 Plan~ing 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-existinR Buildin~ - $i00.00 3.Copy of Certificate of Occupancy - $20.00 4.Updated Certificate of Occupancy - $50.00 5.Temporary Gertificate of Occupancy - Residential $15.00, Commercial $15.00 Date August 2, 1999 New Construction ........... Old Or Pre-existing Building .... X Location of Property..l~ ........ Main Road .% .... Mattituck House No. ' ......... tree ....... ........................ Hamlet Onwer or Owners of Property Agnes B. Graboski County. Tax Map No 1000, Section...~9~ ........ Block .... 4 ............ Lot...1'1 Subdivision . .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept Approval' · ' .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted. $ . i00.00 . . ........... . .. ~gnes B. ~raoosK~ by-Fran~s ~sk~ as ~torne¥-±n-Fa~t CONSENT TO INSPECTION AGNES B. GRABOSKI · the undersigned, of Southold located at Owner(s) Name(s) do(es) hereby state: That the undersigned (is) (l~r~ the owner(~) of the premises in the Town 18625 Main Road, Mattituck, New York 11952 · which is shown and designated on the Suffolk County tax map as District 1000· Section 108 , Block 4 , Lot 1.1 . That the undersigned (has) (~1~I~) filed, 'or caused to be filed, an applica- tion in the Southold Town Building Inspector's Office for the following:' Pre-existing Ce{:tificate of Occupancy for the one and one-half story frame house and frame barn 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 ~vith 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. Dated: August ~ , 1999 5/~ . ~ ~.~f~. /.~ ~/~2.~/ · . (signa~re) ~' Agnes B. Graboski by Frances H. Grabowski, as Attorney-in-Fact (print name) (signature) (print name) THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGe. I .URE^U OF ELECTR,C,TY --- 40 FULTON STREET, NEW YORK; Ny 10038 Date SEPTEHBER O1,1999 Application No. on file 18907499/99 N 499521 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of AGNES GRABOSKI, 18625 ROUTE 25, POLE in the following location; [] Basement [] 1st Fl. was examined on AUGUST 26,1999 427, }[ATTITUCK, NY [] 2nd Fl. OUT Section Block and found to be in compliance with the National Electrical Code. Lot FIXTURE OUTLETS RECEPTACLES SWITCHES DRYERS FURNACE MOTORS FIXTURES RANGES COOKING DECKS FLUORESCENT OTHER FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS OVENS DISH WASHERS EXHAUST FANS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT OTHER APPARATUS: *NO VISUAL DEFECTS: "An electrical survey has been made of the exposed electrical equipment in the premises indicated." "No obvious unsatisfactory condition was found. S E R NO. OF CC COND. A.W.G. PER ffi OF CC. COND. V I C E A. W.G. NO. OF NO. OF HI-LEG i OF HI-LEG NEUTRALS A. W. G. OF NEUTRAL BOX 16, STII~LrWATER AVE. CUTCHOGUE, NY, 11935 llG£N~gAt MANAG£R This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. TOVN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: (number & street) suBDIviSION NA~E OF o~g (s) IdAP NO, .(municipality LOT (s) OCCUPANCY (ty~pe) _ (o~uer-tenant) KEY AVAILABLE SOURCE OF REQUEST: ACCOMPANIED BY: SUFF. CO. TAX HAP NO. DATE: DNELLING: TYPE OF CONSTRUCTION FOUNDATION. ~-~.~--~)~ .1[ TOTAL ROOMS: ] ST FLR. # EXITS CRAHL SPACE BATBROOM (s) ~ TOILET ROOM (s) ~ UTILITY ROOM PORCH nE F~G~/- uEc~, T~E - ~ ~~~o, ~ , - ~ ~ J~ -~ - ~ ~ B~EZEWAY FI~PMCE ~ ~.f~~Gg ~ ~ -~ -- ~ ', - ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. SWIMMING POOL OTHER: · GUEST, TYPE CONST. VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE UATE ON INSPECTION N S SUR',ZEY OF PRORERT'f BI TUATF.. I'dATTITUGt< TOIAIN OF 50UTHOLP 5UFFO/t< GOUNT¥, NY SURVE'fEP 10-15-qs SUFFOLt< GOUNT¥ TAX ~ I000 - 108 - 4 - I.I NOTES: E)e~ail Scoa I-e,~l-''= \ \\.. · HONUMENT FOUND 0 PIPE POUND ~ZC~¢%~ HE~®E AREA = 24.18 AORE5 ,¢°~ ~0 244.00' ®~PHIO SOALE Road ~ND SURVEYOR EAST MAIN STREET RZVERHEAB, N,Y. ll§Ol ~ Y S LIC NO 50202