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Home My WebLink AboutZ-22600FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-22600 Date SEPTEMBER 22~ 1993 THIS CERTIFIES that the buildin~ Location of Property 1115 BUNGALOW LANE House No. County Tax Map No. 1000 Section 123 Subdivision ONE FAMILY DW~:f,riING Street Block 3 Filed Map No. MATTITUCK~ N.Y. Hamlet Lot 15 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-22600 dated SEPTEMBER 22~ 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 DWF/,LtNGWITHACCESSORYTWO CAR GARAGE * The certificate is issued to AGNES LINDSAY (owner) of the aforesaid building. SU~'~'OLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PT.RASE SEE ATTAC~ INSPECTION REPORT. Rev. 1/81 BUILDING DEPART}lENT TOWN OF SOUT]IOLD HOUSING CODE INSPECTION REPORT LOCATION: 1115 BIJNGALOWLANE (number & street) SUBDIVISION NAME OF OWNER (s) AGNES LINDSAY MATTITUCK, N.Y. MAP NO. (municipality LOT (s) OCCUPANCY A-I RES. (type) OWNER (Owner-tenant) ADMII-r~D BY: AGNESLINI}SAY KEY AVAILABLE SOUKC~ OF REQUEST: AgII~S LINDSAY ACCOMPANIED BY: SA~E SUFF. CO. TAX MAP NO. 1000-123-3-15 DATE: SEPT. 2, 1993 DWELLING: ~YPE OF CONSTRUCTION FOUNDATION CF~iENT WOOD FRAME TOTAL ROOMS: BATHROOM (s) PORCH TYPE BREEZEWAY DOMESTIC H0~ATER TYPE HEAT OIL O~IER: IST FLR. '7 2 FULL BATHS 2ND FLR. TOILET ROOM (s) DECK· TYPE FIREPLACE TYPE HEATER WARM AIR ~ STORIES ORE # EXITS CELLAR FULL CRAWL SPACE 3RD FLR. ELECTRIC UTILITY ROOM PATIO, TYPE COV~P~D PATIO SIDE YARD GARAGE AIRCONDITIONING HO~ATER XX ACCESSORY STRUCTURES: GARAGE, TYPE OF cONsT. S~IMMING POOL O~R: 2 CAR WOOD FRA~ STORAGE, TYPE CONST. · GUEST, TYPE CONST. VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ~RT. SEC. EX~KIOR SURFACES SHALL BE HAINTAINED IN GOOD CONDITION. N,Y.C.R R. 9 (B) SUP. FACES N~ INIil~F,.{iNTLY RESISTANT TO DETERIORATION SI~ PART. 1242.5 R~ TREATE. D WTTI~ A PROTI~CTIV~ COATING OF PAINT OR OTtt~g SOITABLE PRESERVATIVE. REMARKS: INSPECTED BY: DATE ON INSPECTION SEPT. 21, 1993 TIME START ii:00 AMENIJ l!:20 AM FORM NO. 6 TOWN OF SOUTHOLD · Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted -, ~ 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. 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: 1. Certificate of occupancy $25'00-- BUSINESS $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50 .. 00 3. Copy of certificate of occupancy $ 5,'00, over 5 years $I0.00 4.Vacant Land C.O. $ '20.00 5 Updated C.O. $"50.00 Date ~eDt.ember~., .199.3. NewC°nstruction ...... Old or Pre-existing Building X Vacant Land .. Location of Prope~Is'" Bungalow Lane, Rattituck, NY House No. Street Ham/et .Lindsay Owner or Owners of Property . ...A~].rt.e?. .................................................. County Tax Map No. 1000Section 123 Block 3 Lot. ]5 Subdivision ................................. Filed Map No ........... Lot No .............. Permit No Date of Permit Applicant '"' Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted$.. 100.00 Construction on above described building and permit meets all applicable codes and regulations. Rev. 10-10-78 Applicant .................................................... Gary Flanner Olsen P.O. Box 706 Cutchogue, NY 11935 CONSENT TO INSPECTION Agnes Lindsay , the undersigned, Owner(s) Name(s) do(es) hereby state: That the undersigned (is) (are) the owner(s) of the premises in the Town or Southold located at Bungalow Lane, Mattituck, New York , which is shown and designated on thc Suffolk County tax map as District 1000, Section 123 , Block 3 , Lot 15 That the undersigned (has) (have) filed, 'or caused to be filed, an applica- tion in'th~ Southold Town Bullcling inspect,,, 'o c, rr:<,o fo,, +h,, rc~llr~win~: house and detached garage That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southoldto 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 orthe 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 such inspections may be used as evidence in subsequent prosecutions for rio- lations of the laws, ordinances, rules or regulations of the Town of Southold. Dated: September 2, 1993 Agnes Lindsay (print name) (signature) (print name) '0