The URL can be used to link to this page

Home My WebLink AboutZ-22585 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-225$5 Date SEPTEMBER 15, 1993 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 300 PACIFIC_STREET MATTITUCR, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 141 Block 4 Lot 19 Subdivision Filed Map No. Lat 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-22585 dated SEPTEMBER 15, 1993 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 STORAGE BUILDING * The certificate is issued to THOMAS G. & HELEN C. KOCH (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. Bui ing nspector Rev. 1/81 _ - BUILDING DEI'ART:IENT TOWN OE SOUTSfOLD HOUSING CODE INSPECTION REPORT LOCATION: 300 PACIFIC STREET MATTITUCR number S street municipality SUBDIVISION MAP NO. [.OT (s) NAME OF OWNER (s) THOMAS G. ~ HELEN C. ROCH OCCUPANCY 1 FAMILY DWELLING OWNER (type (owner-tenant) • T. ROCH ACCOMPANIED 6Yc SAME ADMITTED BY•. KEY AVAILABLE SUFF_ CO. TAX MAP NO_ 1000-141-4-19 SOUf.:::i OF REQUEST: pWNERS DATE- 9/1/93 DWELLING: TYPE OF CONSTRUCTION FRAME O STORIES 2 $ CXITS 2 FOUNDATION BRICK CELLAR 302 CRAWL SPACE 702 TOTAL ROOMS: 1ST FLR. 4 2ND FLR. 3 3RD FLR. BATHROOM (s) 1 TOILET ROOM (s) UTILITY ROOM PORCH TYPE CLOSED IN UNHEATED DECK, TYPE PATIO, TYPE BREEZEWAY FIREPLACE GARAGE . DOMESTIC HOT[JATER %S TYPE HEATER LPG AIRCONDITIONING TYPE BEAT OIL WARM AIR SPACE AOTIdATER OTiiER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. STORAGE, TYPE CONST. FRAME SWL`41ING POOL GUEST, TYPE CONST. OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION 3 BUILDING CODE LOCATION - DESCRIPTION ART. SEC. REMARKS: BP #185972-COZ-20249 FOR ALTERATION 5 REPAIRS TO PORCH INSPECTED „zr i DATIi ON INSPECTION SEPT. 14. 1993 OMAS FI§HER TIME START 9:30 END 10:05 Y ~ ~ ~fr~ _ Form No. 6 - 7 . ' ~ TOWN O F SOUTHOLD ` / C~~cIC n BUILDING DEPARTMENT ;iV TOWN HALL SEP ' 2 ~bs-laoz : ' ~ 3 . . . ~ BL.`~es L+er'F. App1,ICATION FOR CERTIFICATE OF OCCUPANCY TOWN OF &OUTi'?C , 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. 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. 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. 2. 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 I. New Construction........... Old Or Pre-existin Building............ ~/J Location of Praperty...3o0 ~~~!Fl.C.~...............! ;/,~/TU~ . House No'~~ [S.~tre/et Hamlet Onwer or Owners of Property...<t7Q.~~..~..~.J.~.E(_E~..~...i!,OC~ County Tax Map No 1000, Section.. { ~~•.~~....Block.. Q 1: ~Q.......Lot...CJ.~.{..~~d......... . Subdivision ....................................Filed Map............Lot...................... Permit No ................Date Of Permit................Applicant............................. Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate... V Fee Submitted: ~0 0,.O0 • ~~PR• ~I G 7gy APPLICANT c~ ~.a~s~s - - - p n M f .Q m ' p p N U = O ' ~ Hp Zp w Q2' - ~W.t ~U O _ ~pc~ ZN U Y N W ~ T ~ Oa>2 ' GY p¢ ~ OZ Q WQJN WD Z WpF 2 >Q K C7ZS~ NHS 1, ¢F WJ Wyk _ ..2~ff,.. LL.CW p 1J~ O a / ~ ~ U > VO to I % ~ ~o` O O U N Z _ ~ Z Z\~eJPi W U~ 0 ~ e / ae~ 9~F-Zl~ J I 8 G~~ ~OE'3tL Q1- ~0 09 ti ~O~ / O C7 ~ ~ cn (n O SZ 43 A~ .d~•Cd - ~doS. V d i ^ ~ Wr ~ ~ i~ , - ,p --~•-•---.,...,.w;.,.__ ~ : ,..^'/P.CG ~ ~ V ~ 6ri ~:~~t~* >},jMZAA..A.: +I.,r S~ ~ p +M1 I'rc 3 J 1• a •f~ ~i O n/ ' ~ tY 4 ~ d _ O O .1~ V ~f 6 L 'S , ~ . 7 rf~ _ ~y O "7 ~7 . , ~ \ O ~ ~1 ~ ' 4_ o~ ~ n 29~ v - 6.3,69 r _ N.14°433 S~ REED PA~1F~C ~ - \ r \ z V' W 'nA ~ ~ g 308-03813 '~~j~ _ 'tR4~ \ o . . CUA`SLJNT s , TO ~ INSI~>?cT1oN /t70/Y)~S ~ / j~~=L~/V ~ /.14C/{ ~ , ° the undersigned, Owner(s) Name{s) do(es) hereby state; That the undersigned (is) are the owne~of the premises in the Town , of S 300 outhold located at /~e/FjC ~7-' /~~7-(/G,~ y which is shown and designated on the Suffolk County tax map as District 1000, Section /~f/.OQ , Block 0 .OV , Lot O/ , OU That the undersigned (has) (have) filed, or caused to be filed, an applica- tion in the Southold Toi~m Building Inspector's Office for the follotiving: PRE - E /ST nlG' E~2.T ~ - O DCc_uP/~~C 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 cf 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 re~*ulations of the Town of Southold. . ' Dated: ~~~3 ~ (signature) (print name) (signature) I~~LE~ ~a~k (print name)