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Home My WebLink AboutZ-10641FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z106~1 No .................. Date August 20 19 81 THIS CERTIFIES that the building ................................................ L ..... 15705 Main Road, 50 Village Lane, Mattttuck N.Y. ocarlon o[ rroperry ............. , ......... House No. Street Hamlet County Tax Map No. 1000 Section .~..1.5 ........ Block i .Lot 2 Subdivision ............................... Filed Map No ......... Lot No .............. Requirements for a One-Family Dwelling Built Prior to conforms substantially to the 'A'FPfic-~i~n -~r 'l~itd'i~g d~nrrit ql~r~tcrl~r~- fi}ed-in"hhi~-cfffi~e- da'ted- - - Certificate of Occupancy _ .... A. p..r.i.1.. 2..3 ......... 195.7.. pursuant to whicll'l~tlgml~ P~lYrlt' NB.- ........... Z 10 6.4.1 .... dated ...... .A.u.g.u.s..g..2.0. ...........19~.1.., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which tlfis certificate is issued is ......... One Family Dwelling with two Accessory Buildings The certificate is issued to Stanley J. Jermusyk & Mary F. & ORS. ..................... t'o¥.'o; i ................... of the aforesaid building. Suffolk County Department of Health Approval N/R UNDERWRITERS CERTIFICATE NO. N/R ***KITCHEN AREA UNSAFE FOR HABITATION UNTIL REPAIRED. Rev. 1/81 Location Subdivision BUILDING DEPY~,THENT TO¥~ OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT ~5705 Main Road, 50 Village Lane, Mattituck, New York ~number & stree~ (Mumicipality) Map No. Lot(s) Name of OYmer(s) R-] Occupancy A~mitt ed by: Stanley J. Jermusyk & Mary F. & ORS Unoccupied {owner-tenm~t~ Accompanied by: Key available Jane Flatley Suffolk Co. Taxx No. 115-1-2 Source of request Richard J. Cron I)at~ August 14, 1981 DVfEI,LING: Type of construction Foundation Brick Total rooms, 1st. Fi Bathroom(s) 1 Porch, type Wood~ roof ov~mck, type Breezeway Garage, ~ype }{eat Oil Fired Warm Air Fireplace(s) 2 No. F~xits 3 Domestic hotwater Other Wood Framed #stories 2 Cellar Partial Crawl space, est 4 2nd. F1 3 3rd. F1 Toilet room(s) 1 Patio, type Utility room 1 Hotwater x Airconditioning Yes Type heater Gas ACCESSORY STRUCTURES: Garage, type const. Wood 3 Car Swimming pool Other Storage, type const. Guest, type const. Wood VIOLATIOUS: Housing Code, Chapter 52 . ..L0ca'tion. Description Art. Sec. Kitchen Rear wall of kitchen is completely rott~ ¥~ 52-30-A " Roof leaking,floor sagging III ~2-31-B,C Cellar Some floor io~nt~ b~dly ~-~ ~++ed II! 52 32 " Cellar steps~ broken and narrow II ~2-~7-A Outside Mee~ na~nt~ng ~ly III 52 Front Po~ch D~k ~gd floor ioint~ h~ __ ____J_.%_~_ Cellar Outside cellar doors bad __ I. II 52-31-B ~oilet R ~om No outside ventilation TI Rea? Bedr'oom Very low ceiling ... II 52 25 Storage luilding posts bad, door bad roof l~aking III ~P-31-a,~ ,C Remarks: The kitchen of this Dwelling is UNSAFE TO OCCUPY. Inspected by: ~~~. ~_~_. Date o~' Inst. August 19, 1981 Curtis W. Horton T~me start3:00 end 3:30 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. Bo For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topographic featu res. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date... ~.~.~ .~..2.,.. ~.9.8.]; ........ New Building ............. Old or Pre-existing Building ..... ~. ...... Vacant Land ............. Location of Property Main Road Fmttituck ~treet Ham/et Hou~eNo. Stan.ley J. and~ Mary F. Jerm_usyk Owner or Owners of Property . W%lll~.n~ .T,..a.n.d...J.a.n..e..W....F.l.a.t.l.e. y ....................... County Tax Map No. 1000 Section ...1.]...5~.0. ....... Block ...0..],.0.0 ........ Lot .... 9p.2.'.°. 9 ..... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant ............................... ~. Health Dept. Approval ........................ Labor Dept. Approval ..................... ~. U nderwriters Approval ........................ Planning' Board Approval .................. Request for Temporary Certificate ..................... Final Certificate .............. ,-~... ,~.~. Fee ' 5. O0 Submitted $ t~ . ,,,~, ~ ,~,, ............................ : Construction on above described building and p~ ~3Fr'~plic~ and regulations. Applicant~nt~~.' . .~./~/~.'.~,/, .~./~,....: .............. ~ Urea utho~ized alteration m' add'rtto~ t~ ~ ~ ~ 8 vi~e - t~ of se~ 7~ ~ ~e N~Y~ S~e E~tion ~w. ~Dies of ~is su~y m~ n~ ~rl~ t~ le~d sumeyor's inked seal or em~ =~ I~ll ~ ~ consider~ to he e valid co~. Guarantees or ce~ns i~ hereon 8hell rw'. ~dy to the per~n for w~m the ~ is prepared, and nn hl~ behalf to the tale ~e~, ~emmontat agency and len- ding institution li~ he~oN, and ~ the assignees ~i the lending institution. Guarantees ~ codifications are not ~an~era~e ~ ~l i~ut~ or ~ ~uem owners. Z 8108-085628 9.6 H~GH~ '1000-115-01-02 SURVEY FOR ELM/NE ROSS AT A4ATTITUC~ TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. SCALE: 1":30' JULY 30, 1981 L~ J~CQUELINE PLEET REF£RENCE: