HomeMy WebLinkAboutZ-20559FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-20559 Date MARCH 3~ 1992
THIS CERTIFIES that the building. ONE FAMILY DW~TJ.ING
Location of Property 2922 ROW OFF PARK AVE. MATTITUCK~ N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 123 Block 8 Lot 16
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-20559 dated MARCH 3, 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~.I~.ING *
The certificate is issued to RUTH HANLON
( owner )
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTAC~W.D INSPECTION REPORT.
N/A
N/A
Building Inspector
Rev. 1/81
Location
BUILDi~.:C DEP:L~T:.ZENT
TOW],! OF SOUT[iOLD, N. Y.
HOUSIi~G CODE Ii'iSPECTION REPORT
2922 ROW OFF PARK AVE. MATTITUCK, NEW YORK
Subdivision
(nua,noer ~ szreec)
ki,iun~cipa±±sy )
~ap Mo. Lot(s)
Name of Owner(s)
RUTH I~ILON
Occupancy
Ad. mitt ed by:
A-I RES.
~ype)
PAUL HEFF ~.RNAN
Oi~IER
(owner- ~enanv)
Accompanied by: SAME
Key available
Suffolk Co. Tax No. 123-8-16
Source of request
PAUL HEFFEP~IAN
Date 12/15/91
D%'fELLIMG:
Type of construction
Foundation PIERS
Total rooms, 1st. F1
Bathroom(s )
Porch, type ~D~D~"
Breezeway.
Type Heat OIL
Fireplace(s) ONE
Domestic hotwater
Other
WOODFRAME #stories ONE
Cellar F~LL Crawl space
4 2nd. F1 3rd. F1
Toilet room(s) ONE
Deck, type Patio, type
Garage Utility room
'Warm Air Hotwater x
No. ~its 2 Airconditioning
YES .Type heater OFF BOILER
SHO~ER STALL SEPARATE FR(]~ TOILET RO0~
ACCESSORY STRUCTURES: NoNE
Garage, type const.
Swimming pool
Other
Storage, type const.
Guest, type const.
VIOLATIOMS:
.CHAPTER 45--N.Y. STATE UNIFORM FI~E PREVENTION & BUILDING CODE
Location Description --- --I~rt'.'l Sec.
Remarks: BP ~20460-Z CO Z-20558 ISSUED FOR FOUNDATION
Inspected by:~~/[i/~ Date of Insp.
G~. ~/ISH ' Time start 9:55
FEB. 21, 1992
end 10:10
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.
B. ,,F°r existing, o buildings,, (prior to April 9, 1957) non-conforming uses, or buildings and
pre-exzst~ng, land uses:
-- i. 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
Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date . . ~ A-~. ! f.-'..~.,l ........................
New Construction ........... Old Or Pr~./existing Building.~ ...........
Location of Property.~ .~ ~ ...... '~'~ '~''' '~ ~'--~1-~.~.~.~.· .M~.~...~./..~ ~..y./J~.
House No. Street
~~ Hamlet
Onwer or Owners of Property...~.~.~ .... .~...~. ....................... ~ ...............
' County Tax Map No IOOQ, Section.~ ...... Block
Permit No ................ Date Of Permit ................ Applicant .............................
Health Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final/~tic~t~ ..... ,/..~.
Fee Submitted: $..I~.O.i.~.O~ ...............
o ? .... - .....................
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