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Home My WebLink AboutZ-21004FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-21004 Date SEPTEMBER 11, 1992 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 2875 HYATT ROAD SOUTHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 54 Block 1 Lot 12 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-21004 dated SEPTEMBER 11, 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 DWELLING WITH ACCESSORY WORK SHOP & PUMP HOUSE The certificate is issued to ROBERT L. HYATT (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. ui ding Inspector Rev. 1/81 TO°,11 OF SCUT:iOLD, N. Y. HCUGI::G CCD:. I11C?3CTION i =`MT Location 2875 HYATT ROAD SOUTHOLD, NEW YORK Subdivision Name of Owner(.-) Occupancy_ Admitted by: 1tilau No. ROBERT L: HYATT A-1 RES. stype) RUTH HYATT Key available Source of request OWNER �riur,1C1(7a11 Cy ) Lot(z) t owner- (;enanti ) Accompanied by: ROBERT.HYATT Suffolk Co. Ta:; No. 54-1-12 ROBERT L. HYATT Date SEPT.8, 1992 MCE L L TIG : Type of construction WOOD FRAME 2 Foundation CEMENT BLOCK & BRICKCellar „stories PARTIAL CraWl PARTIAL Total rooms, lst. Fl __2nd. Fl space 4 Bathroom(s) 1 3rd. Fl Toilet room(s) 1 Porch, type Deck, type p atio, type_ Breeze,aay Garabe Utility room Type Heat OIL 'alarm Air;. Hot �,-r xx ,"'- Fireplace(s) DECORATIVE No. axi-s 2 Domestic hot,.iater � YES A.ircor_diticr.irg Type heater OIL Other ACCESSORY .T?UCTTRES: G.r —y type const. Storax Storage, ' , type const. WORK egOp S�•�i;. �i no pool Guest, type const. Other POMP HOUSE C VIOLATIONS: C11APTER 45--N.Y. STATE UNTPORAt r. rtn: Remar.cs Inzzccted Date of Insp. SEPT. 10, 1992 Time Start 2:3OPM end 2:50 PM 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. 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. 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 - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date Yew Construction....... .. Old Or Pre-existing Building•,,,,,,,,, .•.... ......•...••...... '.ocation of Property :............ .... ....»........ House No. SS' �� Street f�- 7"? 6R-�c/} i5Hamlet �G t'T �' L j) )nwer or Owners of Property./7e)43 T .:..% %�.1../ ..•.••. •••• •••. .•..••• 'ounty Tax Map No 1000, Section...... I...... / .Block..../............Lot.. ........ ..... ubdivision....................................Filed Map ............ Lot ...................... ermit No................Date Of Permit ................ Applicant ....... ealth Dept. Approval ....................... ..Underwriters Approval.... fanning Board Approval ........................ equest for: Temporary Certificate........... Final Certicate........... ee Submitted: $...................... .................. ��160 APPLICANT 1,92 co�•sr:;T TO Vtrncrts) Namc(;;) tv, uncle r_.i ned, do(es) hereby state: That the undersigned (is) ("re) the otvncr(c) of the premise:; in the Totm OP Southold located at ,�}" 11VA A t'hich is hot:n and desir n: ted on the Suffolk County tat ma as District 1000 p Section r/v7 Block Lot That the undersigned (has) (have) filed, or caused to be filed, an applica- tion in the SOuthcld Tonvn Building Inspector's Office for the folio;:irk: 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 inspectionsas they may deem necessary with respect to the aforesaid application, including inspections to determine that said premises comp?y t:•ith all of the laws-. ordina^ccs, rules and regulations of the Town cf Southold. The undersigned, in consenting to such inspections, do(es) so with the l:no:rledge 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 latus, ordinances, rules or regulations of the Town of Southold. Dated: Z (sibnature) (print name) (siiinature) L&+7 -r (print name) J. _• ti �' Ai d ��tiq a { P'{ '1 W,k Stafc du' tl n 1xw oa rni "y tb oni Nond M/yip. a + 0 Y 1 .� � ni• ' ov MAP CSF' t—^ ND r ki l NEAR If � a SOOTHOLD g.� ,w SusrFmx Coua4�rY,-N. Y. 49QLL z -�accAle ', Pump NnNsc ' uF` , „• � • IYat'1 pipes s °J a. Suffolk C'oUe19y TO Parcel: ,\ „ V �. 1000— 64 -- l— t2 in W tlt d .c1 a}sa —�— W lb ,gyp°P?F.NEAl N `per i �efw ',� ,T'SI P• - 4 N ,"4*, y �` urtse %--a4 9; agg�, E3 S ,arc ti@4t4f"'! a±e Tzs 'v t a -.140 14 19 "cx 41, � �, � Yl t � fav fa tet. � << ,S '� 5..,..'.J �- �vn%��711 ��,a}�Y •PA.,�.R�J7+kR�'O_9�4tt. w1 4 ��.r�;; Locz+; ..r+vn TOpIIr SC""QLD •,T C Y. 1 . T 19 7T l•.L.zoer Vic: ee� j Subdivision i•I�D i V4�e of Owner(s) 03E,�- G Occuoanc Admitted Ulu-, a No. --�7J 1� by -Ac..cun-a aniL-d 0I.-Mnan-J Key available Suffolk Co . Tax, No. Source of request Date L Dr.r^T L1NG Type of construction Foundation�a S-" ies o2 ENI r/i �! i�r� y� Cellar Crawl sac Total roo.:Is, 1st. Fl Bathrooms) 2nd. Fl 3rd. F1 Porch, type Toilet rocm(s) Deck, Breezeway type Patio, type Garan e Ut Air ility room � e Heat � .,� FlrePlace(s) c cQ ivG NO F;ri --HoL:'/a VJ Domestic --� Air conditioning ho water �f S Other .Type heater O/C ACCFSSC?v G SmRLTCTLR L'S : araoe, type const. S"'i.:..:�i n, pool Storage, type const.��.Y S � CD d� Other Guest, type const. a VIOLATIm"TS : Lncaticn u n Remarks : STATE UNIFORM FI RE P MENTION S BUILDING CODE Descri-Pticn Sic Inspected by: ��-��Datc of Ins p. • /� y • Time start c 2 ,Telwend 2: SZ� `'j S -� TOWN i OF SOVTHOLD Pn'�OPERTY LLRECORD'' CARD v6 z..z. OWMIER STREET VILLAGE DISTRICT SUB. LOT FORMER OWN111 E ACREAGE S : ' W� ' TYPE OF BUILDING =� 1 RES SEAS. VL. FARM COMM. I IND. CB. I MISC. ec<_ LAND IMP. TOTAL DATE REMARKS 1 6.d 2, ^p �o vv-.-- }M/A �,p O J_ y J 6� AGE o UILDIN CO I I �� yy 2 7/ / Q9 NEW NORMAL BELOW ABOVE " Farm Acre Value Per Acre Value Tillable 1 Tillable 2 M. Bldg..` ` X.3- G' Z I o Foundation t�� OR;GK Bath Extension t � ` �%� � Basement �, � Floors �. , ;, �� o � Extension - 10,4 Bxt. Walls (% ••- `: •• Interior Finish , W9�` Extension `,✓ ' • � y f l �{ �L•1 � C ■S■®_■�_' Fire Place .� is Heart �e, a\n.� . tiu,4 it"+NWL`Wtows, S r.ff off 2 4k;w , 1 n tows, \i \:�• Porch , ,,�,� ,,. , � ■O��®ill Porch Rooms 1 st Floor Breezeway Patio Rooms 2nd Floor Garage Driveway 0. B. Zo Y goo r yam° 9' X y o .NNO■■1 M. Bldg..` ` X.3- G' Z I o Foundation t�� OR;GK Bath Extension t � ` �%� � Basement �, � M. Bldg..` ` X.3- G' Z o o Foundation t�� OR;GK Bath Extension t � ` �%� � Basement �, � Floors �. , ;, �� o � Extension - 10,4 Bxt. Walls (% ••- `: •• Interior Finish , W9�` Extension ._ a x s i 3vv G Fire Place .� •-h-o Heart Porch Attic Porch Rooms 1 st Floor Breezeway Patio Rooms 2nd Floor Garage Driveway 0. B. Zo Y goo r yam° 9' X y o