HomeMy WebLinkAboutZ-17477 FORM N0.4
TOWN OF SOUTHOLD
BUILDWG DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE
Certificate Of Occupancy
No. 2.1.74 ~ NOVEMBER 1 , 1 988
Date
THIS CERTIFIES that the building . oNE ,FAMILY, DWELLING
Location of Property ..335, .SQUTH .DRIVE MATTITUCK
House No. ~ Street Hamlet
County Tax Map No. 1000 Section ~ 06.......Block ..1. ~ ...........Lot , ...19...... .
Subdivision . ,SHORE ACRES , , , , ..Filed Map No. ........Lot No. E
REQUIREMENTS FOR A PRIVATE ONE-FAMILY DWELLING BUILT PRIOR TO
conforms substantially to the ppid~tlbYiXQbx~~~N~~GX~#~elEdlfl~i~eX~DF~I$#1~'tlli~~~t~dated
,APRIL 23, 1957 CERTIFICATE OF OCCUPANCY
pursuant to which )1LJFiI'c~~'~~ No. . Z ] 7 4 7 7
dated NOVEMBER : 1 , 1988 was issued, and conforms to all of the requirements
of the applicable provisions of the law. Tlie occupancy for which this certificate is issued is .
ONE FAMILY DWELLING AND 2 ACCESSORY STORAGE BUILDINGS.
Tlie certificate is issued to VELJKO. J . KRSTULOV IC
(owner, /glblr~rl~iii3lrX
of the aforesaid building.
Suffolk County Department of Health Approval N / A
UNDERWRITERS CERTIFICATE NO . . N /A
PLUMBERS CERTIFICATION DATED: N/A
SEE ATTACHED INSPECTION REPORT L
Building Inspector
Rev. 7 /87
i
BUILDI_:C Dc.P u'~T:iF",iT
TO,vi~1 OF SOUTHOLD, N. Y. '
HOUSIidG CODE IiJSPECTION REPORT
Location 335 SOUTH DRIVE MATTITUCK
~nL:moer & s~reet) Municipality)
Subdivision Map No. Lot(s)
Name oi" 0~•mer(s) VELJKO J. KRSTULOVIC
Occupancy RESIDENTIAL
(type o~•mer-tenant )
Admitted by: VELJKO J. KRSTULOVIC ACCOmpanled by: SAME
Key available Suffolk Co. Tax No. 106-11-19
Source of request Date
D'^fELLI~?G
Type of construction WOOD FRAME rstories ~
Foundation BLOCK Cellar FULL Crawl space
Total rooms, lst. Fl 5 2nd. F1 3rd. F1
Bathroom(s) 2 Toilet room(s)
Porch, t,~pe Deck, type Pa~ioEN~ype3-2 rear
--T-'f r o n t
Breezeway Garage Utility room
Type Heat OIL ~rlarm Air Hot~r~ater BASEBOARD
Fireplace(s) l No. E;cits 3 Airconditioning
Domestic hot:aater Type heater GAS (PROPANE)
Other
ACCESSORY STRUCTURES:
Garage, type const. Storage, type const. 2
S~•~imming pool Guest, type const.
Other OUT HOUSE (PRIVY)
VIOLATIONS: Housing Code, Chapter 45 N.Y. State Uniform Fire Prevention
& Buildiz~g Code
Location Description Art.) Sec.
Remarks•
Inspected by: Date of Insp. l0/za/ss
GARY ISH Time start 9:25 end 10:15 a.m.
a.m.
FORM NO. 6 t! ~ ~ ~ ~ C~
~
TOWN OF SOUTHOLD
Building Department ~ 7 f~
Town Hall
Southold, N.Y. 11971 X33 D
765 - 1802 TOWhinFS`/~'I'HOLb
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted ~ eo~~ to the Building Inspec-
torwith 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, acertificate of Code compliance from the Architect or Engineer responsible for the building.
5. Submit Planning Board approval of completed site plan requirements where applicable.
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or
topographic features.
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.
C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00
1. Certificate of occupancy New Dwelling $25.00, Accessory -$10.00 Business $50.00
2. Certificate of occupancy on pre-existing dwelling $100.00
3. Copy of Certificate of occupancy $ 5.00 , over 5 years $ ] 0 . 0 0
4.Vacant Land C.O. $ 20.00 10~~.~~
S.Undated C.O. $ 50.00 Date <f'
NewConstruction,,,,,,OldorPre-existingBuildin~g//.. V........ Vacant Land
Location of Property ..........3~ ~f?~/,~lJ'~.: 7!?P``-v.. ` .a-G1,~`S /1~nr~
House No. Sheet Ham/et
Owner or Owners of Property 9. Ye~:`:~ ..~O.~.S~e// ~ .
County Tax Map No. 1000 Section (0~ Block .....~l......... Lot ~ .
Subdivision e:~.. /~Gf2 ~ ...........Filed Map No. ..........Lot No. .
Permit No. Date of Permit ..........Applicant .
Health Dept. Approval ........................Labor Dept. Approval
Underwriters Approval ........................Planning Board Approval .
Request for Temporary Certi~fi/ca$t~e ..................Final Certificate .
Fee Submitted $ ~ ~ . Y. J .
Construction on above described building and ermit m is all
aall pplicab es and regulations.
Applicant " . " " .
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CONSENT
TO
INSPECTION
'~y ,the undersigned,
er(s) Name(s)
do(es) hereby state:
That the undersigned (is) (are) the owner(s) of the premises in the Town
~a~~~ '
of Southold located at ~~~1'~- 7~ ~ G 'a _ '
~ ~L"1'Gb+~j
S r~ ~ which is shown and designated on the Suffolk
County tax map as District 1000, Section-, Block Lot
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:
~ ~~.a~ y2`t°l ~ tau -
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 Town of Southold.
Dated: ~~4./.2 _
(signnnature) ~
bepl' ~ ,(~C~~~,Cddi C
(p nt name)
5~~ c ~_~P
(signature')/
~7~~ ~4 yYIC yS yzc~7tz C
(print name)