HomeMy WebLinkAboutZ-20841 FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-20841 Date JULY 10, 1992
THIS CERTIFIES that. the building ONE FAMILY DVPFJ•r.rNG
Location of Property 905 CAPTAIN KIDD DRIVE. MATTITUCK, N.Y_
House No. Street Hamlet
County Tax Map No. 1000 Section 106 Block 5 Lot 10
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-20841 dated JULY 10, 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 WITA ACCESSORY GARAGE
The certificate is issued to RICHARD G. KIRBY & ANO
(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.
/ '
Buil ng Inspect r
Rev. 1/81
~ -
BUILDI:•:C• DEPPil'~T:•LiiT
TO'r~~i OF SOUTf-TOLD, N. Y.
HOUSIi:G CODE Ii•iSP~CTIOid REPORT
Location 905 CAPTAIN KIDD DRIVE MATTITUCK, N.Y.
trw~.ber do street ~~•iur.tcipality)
Subdivision ivlap No. Lot(s)
Name of 0~•mer(s) RICHARD G. KIRBY 6 ANO
Occupancy 011E FAMILY Of1NER
hype o~•fner-tenant
Ad.-aitted by: DAVE KIRBY Accompanied by: SAl'>B
Key available Suffolk Co. Tax No. 106-5-10
Source of request DAVID RIRBY - Date JUNE 19, 1992
D?~ ~LLI.iG:
Type of construction FRn>!>E rstories 1
Foundation CElIENT BLOCK Cellar DDTCH Crawl space
Total rooms, 1st. Fl 5 2nd. Fl 3rd. F1
Bathroom(s) 1 Toilet room(s)
Porch, type DPEN Deck, type Patio, type_
Breezer~ay Garage Utility room
Type Heat OIL 'alarm Air Hotwater ~
Fireplace(s) No. E:cits 2 Aircor_ditioning
Domestic hotwater ~ Type heater oiL
Other PORCH (OPEN)
ACCESSORY STRUCTURE'S:
Garage, type const. FRAME Storage, type const.
Swi-~.;~ing pool Guest, type const.
Other
VIOLATIONS: -CHAPTER 45--N.Y. STATE UNIFORM FIRE PREVENTION fi BUILDING CODE
Location Description ~Art.~ Sec.
BP #366bjC0 Z-3194 (Add), 6 BP #50172/CO 24148 (Add. 5 Alt.)
Remar'.ts • DNDERWBITERS PENDING SLIP UED 7/7/92
Inspected Date of Insp. JUNE 25, 1992
Tao J I R -Time start lo: ]0 end 10:30
-
` Form No. 6 - ~ _ ~j ~~C
t; TOWN OF SOUTIfOLD
BUILDING DEPARTi`IENT
JU~ 3 ` . TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. This application must be filled in by Cypecariter OF, 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-O 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 17 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
"pre-existing" land uses: `
1. Accurate_ su_rvey_Qf ~roQerty_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.
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 o Certi icate of Occupancy - -5.00 over 5 years - $LQ00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
• Date 5', ~s:L .
ew Construction........... Old Or Pre-existing Building....`.......
ocation of Property... ll~.~......~~:2~~:.:'" ~ ~J.~:..... f??u./7~.':~" c. , .G~'~/..5 . / /.9 ~ L
IIouse No. Street .Hamlet .
ewer or Owners of Property.... , .i~t;) !i:.c+...K.. `7 .
aunty Tax Map No 1000, Section. , , rr.......Block.... V. ~.........LOt.... c:~ c7 .
:bdivision ....................................Filed Map............Lot......................
rmit No ................Date Of'Permit................Applicant...................:.
alth Dept. Approval.. ........................Underwriters Approval.........................
anning Board Approval
quest for: Temporary Certificate.........,. Final Certicate...........
- Submitted: w. ~
co~ao~y) .~r._~
i _
a y
9
cOiysrr~-r Jll,~ 2 3'
TO
I\:~PGC'I'ION
/~fi v, c~ j~ ~ ~ thc~ undcrsi~ncd,
Uwncr(s) Na c(;,)
do(es) hereby state:
That the undersigned (is) (are) t}le ovmcr(s) of the premiscu in the Tovm
of Southold located at j ~c.~> ~ /t , r( r(
~'Y~:f'~.•~c., c l~ l ~~95z lr}lich is :;hol~rn and designated on the 5uffol
County tam map as District 1000, Section Ip L'loclc p 5 Lot G i C ,
That the undersigned (has) (have? filed, or caused to be filed, an applica-
tion in the Southcld Town L'uilding Inspector's Office for the follovrin~*:
.l
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 resper_t to the aforesaid application, including inspections
to determine that said premises comply with all of the laws, ordinances, rules
• and regulations of the Town cf Southold.
The undersigned, in consenting to such inspections, do(es) so ~~Zth 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 lays, ordinances, rules or regulations of the Town of Southold.
Dated • ~ ~ f ~ 'Z. _ 'i`<<-..-c < ! ~t ~J'-i
• (signature)
tii~ ~ k_ K , ~ 1,
(print mine)
(S 1(*IlatU L'C)
(print Hanle)
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IJCTES: - T antymtha oaraaa for Vrher^Pla atv,Jep Y (C .,L C1~~~1~ j'J/`~i r~~~l D` 'C~ ++,i ""~`I' 0
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FILEC !hi THE UFF CO CLEt2{C'~ OFfIC "^l"mtnatsaalfarrlncac^t,~ Y A ~Fo
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THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 ~
1000273 BUREAU OF ELECTRICITY
BS JOHN STREET. NEW YORK, NEW YORK 10038 i
Pete JULY 15,1992 gpplicationNo.onfile 03258092{92 N 242801
THIS CERTIFIES THAT
only the electrical equipment a. described 6skMO and introduced by the applicant nomad on the above application numher in the premises of
DAVB KIRBY, 905 CAPTAIN CIDD, NAT4IfUCK, N. Y,
in the foiloleinl( lucotion; ®Baaement ®I at Ft. ? Ynd F1. GAR ,Sertiun Block Lot
moa examined un JULY 07,1992 ondfound to he in complianre uith the requirements q(thia Buard.
RXTURE RXTURES RANGES COOKING DECKS OVENS qSN WASHERS EXHAUST FANS
OUTLETS ECEFTACIK SWITCHES INUNDESCENi.FIVORESCENi OTHER MAT. K.W. AMT. K.W. ANT. W. ANi. K.W. AMT. X.I.
4
DRYERS RJRNACE MOTORS NTURE AMBIANCE FEEDERS fFECIAI REC'FT 71ME CLOCKS eEll UNIT HEATERS MULTI-OUTIET gMMERS
AMi. K.W. dl NJ. GAS N.I. AMT. NO. A.W.G. AMT. AMI. AMT. AMPS. TRANS. AMT. N.I. SYSTEMS AMi. WARS
NO.OF RIFT
2 -
SERVIC! gSCONN[CT NO.Of S E R V I C E
AMT. AMI. TYPE METER t y ]N' I A tw L / 3V/ 3 / AW NO. GF CC. COND. A. W. G. NO. d XI-LEG A. W. G' NO.OF NEUTRALS A. W. G
EDUN. NR p d CC. COND. d NI-U:G d NEUIRAI
OTHER A??ARATUS:
PANEGBOARD911-2 CIR. 70
G. F.C.Ie-2
CONBBS ItILLIAN LIC.;454
3 COLUNBIN6 30UTN
NANPfON BAYS, NY, 11946 TiBiNAI MANAON
2~1
This certificate must not ba altered in any manner; return to the office of the Board if incorrect. Inspectors may ba identified by their crodsntials.
COPY FOR BUILDING DEPARTMENT. THIS COPY ~ CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.