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Home My WebLink AboutZ-22541FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-22541 Date AUGUST 23~ 1993 THIS CERTIFIES that the buildin~ Location of Property 14005 MAIN ROAD House No. County Tax Map No. 1000 Section 140 Subdivision ONE FAMILY DW~J,LING MATTITUCK~ N.Y. Street Hamlet Block 3 Filed Map No. Lot 28 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-22541 dated AUGUST 23~ 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 WITH ACCESSORY GARAGE & STORAGE SHED * The certificate is issued to ROBERT J. GRR~VES (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTHAPPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *P~ASE SEE ATTAC~D INSPECTION REPORT. ~uilding Inspector Rev. 1/81 LOCATION: SUSDIVISION NAME OF ObrNER (s) BUILDING DEPA~THENT oF soul,OLD HOUSING CODE INSPECTION REPORT 14005MAIN ROAD MATTITUCK, NEW YORK · (number & street) (municipaLity 'HAP NO. LOT ROBERT J. GRKEVES OWNER OCCUPANCY A-! RES (type) (owner-tenant) ADMI'i-rED BY:. ROBERT GREEVES KEY AVAILABLE SOUKC~ OF REQUEST: ROBERT GREKVKS ACCONPANIED BY: SAMES SIIFF. CO. TAX MAP NO. 140-3-28 DATE: AUG. 11, 1993 DNELLING: Ilrg OF CONSTRUCTION WOOD FRAME FOUNDATION STONE, CENENT BLOCK & BRICK TOTAL ROOMS: IST FLR. '4 2ND FLR. 4 { STORIES 2 { EXITS CELLAR l/2 CRAWL SPACE 3RD FLR. -- BATHR00H (s) ONE PORCH TYPE ~ AROUND COVERED DECK, TYPE BREEZEWAY FIREPLACE DOHESTIC HOTWATER YES TYPE HEATER TYPE HEAT LILCO GAS WARHAIR OTHER: TOILET ROOM (s) NONE LILCO l UTILITY ROOM PATIO, TYPE GARAGE AIRCONDITIONING HOTWATER X"g ACCESSORY STRUCTURES: GARAGE, TYPE OF cONST. SOIMMING POOL OTHER: WOOD FRAME I CAR STORAGE, TYPE CONST. · GUEST, TYPE CONST. WOOD FRAM~ VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. INSPECTED BY: DATE ON INSPECTION AUG. 19, 1993 TIME START 9:35 EI~J 10:00 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 · --- ' ....... : 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 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. ~5 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 unus~ai-~lural---dY~Uopd~h~c features. 2.. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspec{or 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. '~ Certificate of Occupancy on Pre-existing Building - $i00.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10~0 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ...,.......~ ............................. New Construction...~.~ .... .~ Old Or Pre-existing Buildin~ XX ~ Location of Propert/y?.~.M~jO ~O~d, Mattltuc~, New Yo~k 11952 House No. Street Hamlet Onwer or Owners of Property. Robert ~reeves County Tax Map No 1000, Section..~0 ......... Block...9~ ........... Lot.. ~8 bdi ' Su vision ................................ Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ............. '...Applicant. ...... Health Dept. Approval .......................... Underwriters Approval. Planning Board Approval ............. ~ ....... ~.... Request for: Temporary Certificate ........... Fin~icate ..... ~ .... Fee Submitted: $ ...... ~99~ .... i ............ ~KHA~,~C~iC. ~ t.e :o ~Sql Main Road, ~Iz~PlPcZiOe~', New Yor.k 11952 CO~_.~,.~q~ (516) 298-8353 ROBERT GREEVES CONSENT TO INSPECTION · the undersigned· Oxm~er(s) Name(s) do(es) hereby state: That the undersigned (is) gav~~) the owner(~ of the premises in the Town of Southold located at ~ Main Road, Mattituck, New York 11952 · which is shown and designated on the Suffolk County tax map as District 1000, Section 140 , Block 03 , Lot 28. That the undersigned (has) (~0~e) filed, or caused to be filed, an applica- tion in the Southold Town Building Inspector's Office for the following: 01d or pre-existing Building Certificate of Occupancy (Final Certificate) 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 xvith respect to the aferesaid application, including inspections to determine that said premises comply with ali 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~lations of the Town of Southold. Dated: //~ugust' 1993 ( sign,/ur e) ' ROBERT GREEVES (print name) (signature) (print name) POC to coordinate time of inspection is: Daniel C. Ross, Esq. at WICKHAM, WICKHAM & BRESSLER, P.C. Main Road, P.O. Box 1424 Mattituck, New York 11952 (516) 298-8353 W ~ S > ~- l %