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Home My WebLink AboutZ-23883FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. EXISTING ~RTIFICATEOFO~JumANCY No Z-23883 Date SEPTEMBER 18, 1995 THIS CERTIFIES that the building. Location of Property 680 RILEY AVE~U~ House No. County Tax Map No. 1000 Section 143 Subdivision ONE FAMILY DWELLING MATTITUCK, N.Y. Street Hamlet Block 5 Filed Map No. Lot 13.1 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-23883 dated SEPTemBER 18, 1995 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 DWR~.TNG * The certificate is issued to GEORGE HESSE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *Pr.~%SE SEE ATTACHED INSPECTION BEPORT. / ~ildi~ Inspector Rev. 1/81 I'dl I I.I) I NG I)EI'^I~. I [II':H'F T()~/N OF ~OIJFIIOIA) IIOUS!NC COI)I'~ INSPECT!ON RF, PORT I.OC^TION: 680 RILEY AVE. .';UIlI)I V I S I ON I'tAt-II,: O1: O~NER (~;) ~EOR~E I1E~SE OCCIII'fitlCY A-I RES. HAl' NO. HATTITIJCK, N.Y. I,OT( s ) OI4NER AI)tilTTF. I) IIY: ACCOI'II'AN l El) BY: 1)%4E1,1, 1N(;: 'I'YI'E OF CONSTRII(;TION 14OOD FRAHE FOUNI)AT ION CENENT BLOCK CEI,I,AR TOTAl, ROOHS: I ST FI.R. 3 21'11} FI,Il. BATIIIH)OH (s) ONE TOIl.ET ROOH (s) I'ORCII TYI'F, FRONT ENCLOSED/BACK SCREEN IH{F.F, ZIrAJAY Ir l I{F~I'I.ACIr. I)OHF. STIC IIOTI4A'I'ER YES TYPF~ IIF~ATIr. R TYI'F. IIEAT LILCO GAS 14Ali['l Ail{ XX OTII F, P,: FULL 3RI) Fl,Il. IIECK, 'FYPE I, ILCO GAS ! STORIliS ONE CRAWl, SI;ACE UTIL'I'FY ROOH ~IOOD PATIO GARAf;E A'I RCONI) IT iON I HG II01~qATEIt I F.×ITS TI,/O ACCI~S,SOI{Y S'I'IiUCTUI~,ES: CARA(;F., TYI'F. (}ir CONST. S~ltlHING POOl, OTIIER: NONE S'I'ORACI[, TYI'E CONST. , (;tlEST, 'I'YPI[ COffST. VIOI,ATIONg: CIIAI'TER /sS N.Y. S'I'ATE IINIFOIIH FIRIr. I'REVENTI. ON & BUII,I)INC CODE I,OCAT 1 ON EXTERIOR I,IALI,S DESCEIPT1ON EXTERIOR SURFACES SHALL BE HAINTAINED IN GOOD CONDITION. SURFACES NOT INUERENTLY RESISTANT TO DETERIORATION StlALL BE TREATED I4ITtl A PROTECTIVE COATING OF PAINT OR OTItER SUITABLE PRESERATIVE. ART. SEC. NYCRR VOL 9 (B) PART. 1242.5 (Ii. I{ F. HAI~,K S: SEPT. 13, 1995 END 10:05 Form No. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town HALL 765-[802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Au 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: i. 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and '~re-exisking" land uses: i. Accurate survey of property showing all property lines, streets, building and' unusual natur~ or topographic features. 2. A properly completed ap li~n and a consent to inspect signed by the applicant. If a Certificate nE Occupancy is denzed, cbc Building Inspector shall state the reasons therefor in writing to the applicant. 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. 2. Certificate of Occupancy on Pre-existin~ Buildin~ - $I00.00 3. Copy of Certificate of Occup~7~y--~20.'OO 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00., Commercial $I5.00 ate ........ ?. .I ...................... ~ew Construction ........... Old Or Pre-existing Building ...... ~.. ........ Location of Property...~ ........... :~.i~y., .~.V6 ................. ~.~. !'.~..i.~-~ .......... House No. Street ttamiet Onwer or Owner~ nE Property...Th.e. ..... ~5':'~e,..~ ~.e~r~ :oun~ z~× ~ap ,o 10oo, ~oct~o....!~.3 ....... B.~,,~ ..... ~ ......... Lot...!.a.,.! ............. Subdivision .................................... Filed Hap ............ Lot ...................... ?ermZ~ No ................ Dote Of r~=~i~ ................ ~pZ~=~n= ..... Ltkl., .............. 7tealth Dept. Approval .......................... Underwriters Approval ......................... 'ianning 'Board Approv[~l ........................ :~equest for: Temporary Certificate ........... Final CerticaCe ........... Fee Submitted: $ ...... ! .O.O.,. e .~) ................ CONSENT TO INSPECTION Owner(s) Name(s) do(es) hereby state: · the undersigned, That the undersigned (is) (are) the owner(s) of the premises in the Town / , which is shox~ and designated on the Suffolk County tax map as District 1000, Section /~ . Block C . Lot / 7.[ Tha. t the undersigned (has) (have) filed, or caused to be filed· :an applica- tion in the Southold To~ Building Inspector's Office for the follow.g: Dated: 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 with respect to the aforesaid application, including inspections to determine that said premises comply with all 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 regulations of the To~vn of Southold. (signature) (print name) (siffnature) (print name) S~P --f 19.q5 ~'