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Home My WebLink AboutZ-21127FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-21127 Date NOVEMBER 2~ 1992 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 1600 WESTPHALIA ROAD MATTITUCK~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 114 Block 7 Lot 13 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-21127 dated NOVEMBER 2~ 1992 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 DW~.IJ,ING * The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PI.FASE SEE ATTACBr~.n INSPECTION REPORT. AM¥.LIA VIRGINIA GUIT.W.R Rev. 1/81 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 1OWN OF SOUTHOLO APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted ~ ~==ma~a to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic featu res. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy New Dwelling.$25.G0, Accessory !$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .... Q~.t.o.b.~r. ~.7.,. ~.9.9.~... NewConstruction ...... OId or Pre-existing Building ...~; ........ Vacant Land ............. Location of Property . .1.4,8,9. ,W,e.s. ~P,h.a. 1. ~9.~ .R,o, .a.d ........................ ,H.a, ~,t~.~u. ,c,k ....... House' No. Street Ham/et Owner or Owners of Property . . .A.~..e.l.i.a,..V.i.r.g~.n.i.a...G.u.i.l.e..r ................................ County Tax Map No. 1000 Section ...];,1, .4:,0.0, ..... Block ... P.7...99 ...... Lot...0.~.3.: ,0,0.0. ..... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....... .X ............... Fee Submitted $ .1..0.0...0.0. ..................... Construction on above described building and permit meets, all applicable cod, es and regulations Apphcan,.~'~..,,....,... ~. :~. ~ .... ~/~e±za vlrcu_nla ~ul±er Dy [Jarl ]3. %fl'tleoDa±ct Rev. 10-10-78 attorney-in-fact TO'.,][ CF ZCUT~iQLD, H. '£. Location Subdivision HGUSi::G ~- C~ IUS?ECTIO;; REYC.~T 1600 ~ESTPHALIA ROAD NATTITUCK, N.Y. _;4np Ho. Lot(s) Nm-ne off Owner(.~_),. AMELIA GUILER Oc cup a nC]; RESIDENTIAL ~ype) Ad~.n~ed by: MICHAEL LKSSARD Key available Source of request_ ^ccomp&nied by: MICHA~LLBSSARD Suffolk Co. Ta~c Lro. i!4-7-13 C~ 'r-~.O~M.,, A'T~-~-FACT _Da~e O~T. 30, 1992 Dr'FELL I L~G: ,Type of construction Foundation RED BRICK Total roomS, lat. F1 Bathroom(s ) ! Porch, t~-pe 2 ENCLOSED Breezeway_ Type Heat 011 Fireplace(s)' 4 Dcmestic ho Other WOOD FI~L~E Deck, Garage NO 'Warm. Air NO No. ~its 4 Type heate? "-,- · 2-1[2 Cellar PARTIAL Crawl space PARTIAL 2nd. Fl._. .Std. F1 i Toilet room(s) 2 --- Patio, type. Utility roan, NO Hotwater xx Airasnditicnin~_. OIL~EATER NO ACCESSORY STEUC~_L~E2: Garage, type const. Swim. ming pool,. Other' Storage, type Const. Guest, type const. V ,_-OLATrO~,,S . g_~_~cat !on [ Remarks: Inspccted by:, .CIIAPTER 4S--N.y. STA'£E UHIFOI~I FIIU{ PI~VENTIO~ D .-.c. zD,.zon I Art.,.[ Sec. I I I i I I VICTOR G. LESSARD _.Date of Insp. NOVEMBER 2, 1992 · Time start_8:45 AM end 9:52 AM