HomeMy WebLinkAboutZ-20198- FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-20198 Date
THIS CERTIFIES that the building
Location of Property 1015 SIGSBEE ROAD
House No.
County Tax Map No. 1000 Section 144
Subdivision
SEPTEMBER 9~ 1991
ONE FAMILY DWELLING
MATTITUCK~ N.Y.
Street Hamlet
Block 2 Lot 2
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-20198 dated SEPTEMBER 9~ 1991
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
The certificate is issued to ESTATE OF JEROME GUTH
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*PT~SE SEE ATTACHED INSPECTION REPORT.
/ B~ld~ng Ifispector
Rev. 1/81
Location
Subdivision
Name of Owner(s)
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
1015 Sigsbee Road Matt£tuck, N.Y.
(n%unber & street) (Municipality)
Map No. Lot (s)
ESTATE OF JEROME GUTU
Occupancy A
(type)
Admitte~ by: JO~NMOO~E OF
SILK~/ORI~ REAL ESTATE
Key available
TENANT
[owner-vcn~n~)
Accompanied by: SAME
Suffolk Co. Tax No. 144-2-'2
Source of request Jo~N L. MOO~E, AGENT
Date AUG. 29', 1991
DWELLING:
Type of construction FRAME
Foundation CEMENT BLOCK
Total rooms, let. F1 5
Bathroom(s) !
Porch, type~TED SUN PORCH Deck, type
Breezeway.
Type Heat OIL
Fireplace(s) - -
Domestic hotwater
Other
#stories I
Cellar PART Crawl space
2nd. FI -- 3rd. FI --
Toilet room(s) --
- - Patio, type.
Garagq - - Utility room - -
Warm Air - - Hotwater x
No. Exits 2 Airconditioning
xx ~ype heater
ACCESSORY STRUCTURES:
Garage, type const.
Swimming pool
Other
FRAME
Storage, type const.
Guest, type const.
VIOLATIONS: Housing Code, Chapter 52
...... Location
CELLARWAY
GARAGE
Descriotion
NAIN/ENANCE ~QUI~D
NAINTZNANCE ~EQUIRED
Remarks: BP ~7606/CO Z-6321 for addition
S~c.
! 24.2.5a
1242.9
Inspected by:
T~OMAS J. FISHER
Date of Insp. SEPT. 6, 1991
Time start 9:30 amend 9:55 am
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
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 prope{ty 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.
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.
~ Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $i0.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date ...... /'~-~' J- -~- · · · -~. ~. · .~ ~ 2 f ......
~:ew Construction ........... Old Or Pre-existing Building .... .~...~ ........
Locat£on of Property...79/..~..~.[~.~.~v..-.~[ ....... ~~.~. ..~.%~.~
House No. ( S;;ge; ............... H~i~t .......
Onwer or Owners of Pro t
per y... ~_-~..-~...~.% .............. ~.~. ~, ..........................
County Tax Map No 1000, Section ......... Block ..... Lot
Subdivision .................................... Filed Map ............ Lot ......................
Permit No ................ Date Of Permit ................ Applicant .............................
llealth Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate ...........
Fee Submitted: $ ............................ i ,~,.'.'f~ ..~?f~. ( ..~...~
.......... .- .
I~OT£~
o -- PIPE
SUBDIVISION MAP FI£ED IN THE OFF~CE
OF THE ¢1ERK OFSUFFO£1q CO UNT Y ON
dAN. 12,1926 A S FIL