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Home My WebLink AboutZ-25803FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 25803 Date: 06/29/98 THIS CERTIFIES that the building Location of Property 17275 MAIN RD (HOUSE NO.) County Tax Map No. 473889 Section 115 Subdivision Filed Map No. DWELLING MATTITUCK (STREET) (HAMLET Block 0002 Lot 005 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- 25803 dated JUNE 29, 1998 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 WITB ACCESSORY GARAGE, BARN & SHED* The certificate is issued to BEATRICE D HARDY (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. Rev. 1/81 N/A N/A N/A lng I~spector LOCATION: SUBDIVISION: 17275 MAIN RD NAME OF OWNER (S): BEATRICE D HARDy OCCUPANCY: A-1 RES, ADMITTED BY: BEATRICE HARDY KEY AVAILABLE: SOURCE OF REQUEST: BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT MATTITUCK MAP NO.: -- LOT (S) -- BEATRICE D ACCOMPANIED BY: SAME SUFF. CO. TAX MAp NO.: 115.-2-5 GARY FLANNER OLSEY. ATTY - 6/12/9 DATE: 06/29/95 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME FOUNDATION: BRICK TOTAL ROOMS: 1ST FLR.: ._~ 2ND FLR.: __~ BATHROOM(S): 2.0 TOILET ROOM{S): PORCH TYPE: WRAP AROUND ENCLOSED DECK TYPE: DECK BREEZEWAY: FIREPLACE: DOMESTIC HOTWATER: YES TYPE HEATER: LILCO GAS TYPE HEAT: Q~.WARM AIR: HOTWATER: OTHER: # STORIES: 2.0 # EXITS: ~ CELLAR: PART. CRAWL SPACE: ~. 3RD FLR.: ~ UTILITY ROOM(S): -- PATIO TYPE: STONE GARAGE: AIRCONDITIONING: XX ACCESSORY STRUCTURES; GARAGE, TYPE OF CONST.: WOOD FRAME-GARAGE&BARN STORAGE, TYPE CONST.: WOOD FRAME SWIS~4ING POOL: GUEST, TYPE CONST.: OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION ~ DESCRIPTION ~ ART. SEC. REMARKS: BP #12022-Z-CO Z-25802-{ADDITIONS) DATE ON INSPECTION: 06/24/98 TIME START: 10:05 END: 10:40 Form No. 6 TOWN 0 F'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 ail 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 " r ' ' ~~tf property showing all property lines, streets, building and ~,, "'~ y~u,,i~r topographic features. ~g,~ _A_prop_erl~y_c~ted application and a consent to inspect signed by the applicant. ~1~1 ~ ~ .~ic~.f Occupancy is denied, the Building Inspector shall state the I~~!~~~n writing to the applicant. 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-existin~ Buildinm -~~ 3. Copy of Certificate of Occupancy - = .25~. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date June 11, 1998· X Two story frame house with porch New Construction ........... Old Or Pre-existing Building ..... ~' ~' ~'/garage Location of Property 17275 Main Road, Mattituck, New York House No. Street Hamlet Onwer or Owners of Property...~%q~.qq~.~l~X ........................................... County Tax Map No 1000, Section...!~ ........ Block...~ ............ Lot...~ .................. Subdivision .................................... Filed M~ap ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ .... 1OO,OO ................... GARy FLANNER P.O. m:)x. 7.~ ............................................ CONSENT TO INSPECTION Beatrice Dudek Hardy by Gary Flanner Olsen, Esq. - As Attorney , the undersigned, Ovmer(s) Name(s) do(es) hereby state: That the undersiRned (is) (are) the owner(s) of the premises In the Tovm of Soul:hold located at 17275 Main Rd. Mattituck, NY 11952 . which is shown and desi~,nted on the S,ffolk County tax map as District 1000. Section 115 __. Block 2 . Lot 5 That the undersigned (has) (have) filed, or caused to be filed, an applica- tion in the Southold Town Building Inspector's Office for the following: Two story frame house with porch, shed and barn/garage That the undersJl~ned do(es) hereby Rive consent to the 13uilding Inspectors of the Town of Southold to e,ter upon the above described property, tncl.dh~ any and all buildings located thereou, to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that said premises comply with ali of the laws. ordinances, rules and regulations of the Town of Southold. The nndersigned, in consenting to such inspections, do(es) so ~vith the knowledge and understandin~ that any information obtained In the conduct of such inspections may be used as evidence in subsequent pro-~~for vio- lations of the laws. ordinances, rules or regnlatio~. Dated: June 12, 1998 (m'~nature~ (signs ute) Gary Flmnnar Olman. 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