HomeMy WebLinkAboutZ-19694No Z-19694
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
Date JANUARY 29. 199
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 4690 BERGEN AVE. MATTITUCK N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 113 Block 7 Lot 2.5
Subdivision Filed Map No. Lot No.
conforms substantially to the requirements for a Private One Family
Dwelling built prior to: APRIL 9, 1957 pursuant to which
CERTIFICATE OF OCC. #Z-19694 dated JANUARY 29, 1991
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 TWO CAR WOOD FRAME GARAGE
AND TWO STORAGE BARNS AND TWO SHEDS *
The certificate is issued to WILLIAM A. LINDSAY, JR.
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. H-020156 - JANUARY 23, 1991
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
uilding Inspector
Rev. 1/81
BUILDIr'G DEPART'•L:iT
T0:1111 OF SOUTHOLD, N. Y.
HOUSI77G CODE INSPECTION REPORT
Location 4690 BERGEN AVE.
�numoer do street
Subdivision
Na,o No.
MATTITUCK, N.Y.
ipality)
Lot(3 )__
Name of Owner(s) WILLIAM LINDSAY JR.
Occupancy A-] OWNER
(type) owner -tenant)
Admitted by: WILLIAM LINDSAY Accompanied by: SAME
Key available
Suffolk Co. Tax No. 113-7-2.5
Source of request WILLIAM LINDSAY Date
D!'TELLI' TG :
11/10/90
Type of construction WOOD FRAME Ustories 2
Foundation BRICK Cellar ]/2 Crawl space 2/3
Total rooms, lst. F1 3 2nd. F1 4 3rd. Fl
Bathroom(s) ONE Toilet room(s) OPTS
Porch, type Deck, type REAR DECK Patio' type_
Breezeway Garage Utility room
Type Heat OIL 'Warm Air
.Hotwater
Fireplace(s) No. ExitS 2 Airconditioning
Domestic hotwater OFF BOILER Type heater
Other REAR ENTRYWAY
ACCESSORY STRUCTURES:
Garage, type const. 2 CAR WOOD FRAMEgtorage, type const. 2 BAiNS s 2 SHEDS
Swimming pool Guest, type const.
Other
VIOL AT IONS: CHAPTER 45—N.Y. STATE UNIFORM FIRE PREVENTION h BUILDING CODE
Remarks: BP #11402/0 Z-13672, BP #12819 /CO Z-17873, BP #1958OZ/CO Z-19693
77
Inspected by:
Date of Insp. DEC. 13, 1990
Time start 9:30 amend 9:50 am
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
J98,- yg63
APPLICATION FOR CERTIFICATE OF OCCUPANCY BLDG. DEPT. ■
TOWN Of SOU7iM
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.'
3. 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.
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
Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
Updated Certificate of Occupancy - $50.00
Temporary Certificate of Occupancy - Residential$5.00, Commercial $15.00
Date ..... ;0 V... ��� ..�� ....................
2.
3.
4.
5.
:ew Construction......... /Old Or
ocation of Property..... 9.0:9O ..P.r.e.-.e.x.i.s.t.i.Yn3g
BuildcinNg?...... .j9 Gc-Sf..„
:4, 1 y.v, . .... FX..
'louse No.
Street
Hamlet
)nwer or Owners of Property.......
((II,,
^: 1,Vkyv .,,,..N,,
�1N/(�S 1%
;ounty Tax Map No 1000, Section....3...... Block...!.` ....... Lot ... Q (A ..............
>ubdivision....................................Filed Map ............ Lot ......................
'ermit No................Date Of Permit ................ Applicant .............................
iealth Dept. Approval..........................Underwriters Approval...,......................
'lanning Board Approval ........................
request for: Temporary Certificate........... Final Certicate...........
'ee Submitted: $.............................
a-M.y)16y
12�/Iu C-0 -�_)96ry
.. ...........
APPSAN
Owner(s)
do(es) hereby state:
CONSENT
TO
INSPECTION
VA L- ( ui/Gt S lel
Name(s)
the undersigned,
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at 4
Ir t 4+L which is shown and designated on the Suffolk
County tax map as District 1000, Section/43 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:
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:
(signs re)
011/1,4M Wds0 �►Z
(print name)
(signature)
(print name)
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
8021809 BUREAU OF ELECTRICITY
F 85 JOHN STREET, NEW YORK, NEW YORK 10038
Date JANUARY 23,1991 Application No. ort file 71910090/90 H 020156
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of
WILLIAM A. LINDSAY, BERGEN AVE., MATTITUCK, N.Y.
in thefollowing location. F Basement EX Ist FL ❑X 2nd Fl. OUT .Sertion113 Block? Lot 2.5
was ezarnined on JANUARY 17 ,1991 andfound to be in compliance with the requirements qj this Board.
FIXTURE
ECEPTACLES
SWITCHES
FIXTURES RANGES COOKING DECKS
OVENS DISH WASHERS
EXHAUST FANS
INCANDESCENT. FLUORESCENT
OTHER µ1T.
K.W. AMT.
K. W.
AMT.
K.W. T.
K. W.
AMT.
H. P.
OUTLETS
DRYERS FURNACE MOTORS
FUTURE APPLIANCE FEEDERS SPECIAL REC'PT
TIME CLOCKS
I RELI UNIT
TRANS.
HEATERS
MULTI.OUTLET
SYSTEMS
NO. Of FEET
DIMMERS
AMT.
K. W. OIL H. P.
GAS
H. P.
AMT.
NO.
A. w. G. AMT.
AMP,
AMT.
AMPS.
AMT.
H. P.
AMT.
WATTS
SERVICE DISCONNECT
NO. OF
METER
EQUIP-
S E R V 1 C E
AMT.
AMP.
TYPE
A- tW
1 $ JW
3 9 3W
3,6- �W
PER $
Of CC. COND.
�OF MI-LEG
pf NI-LEG
�Of NEUTRALS
OF NEUTRAL
OTHER APPARATUS:
RESEDENTIAL SURVEY ONLY-1
WILLIAM LINDSAY
COX NECK ROAD
MATTITUCK, NY, 11952
This certificate must not be altered -in any manner; return to the office of the Board if incorrect.
V
GENERAL MANAGER
11
Per. m � � M 1
y be identified by their credentials.
a 9F- V& 3 6�tQ L�
HEALTH DEPARTMENT -DATA FOR APPROVAL TO CONSTRUCT
■ NEAREST WATER SSAIN_MI - *SOURCE OF WATER PRIVATE _ N PUIC _
if 811F CO TAX MAP DIST I000 SECTION 113 BLOCK 7 LOT 2.i aB PYU2.3
*THERE ARE NO DWELLINGS WITHIN 100 FEET OF THIS PROPERTY
OTHER THAN THOSE SHOWN HEREON
* THE WATER SUPftY AMD SEWAGE DISPOSAL SYSTEM FOR THIS 111010EHCi
WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY OEPARTMENT
Of WEALTH SERVICES
AP►L I C A.M T
ADDRESS
TEL
NOTE • = MONUMENT
RE LOT I, MINOR SUBDIVISION "CATHERINE LINDSAY
HINTERLITER 8 WILLIAM LINDSAY, JR."
HNAMUIS A SONS INC.
dsoy
0Y)a
elm
SURVEY FOR
WILLIAM LINDSAY, JR.
AT MATTITUCK
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
K UNAUTHORIZED ALTERATION OR AODITIoM TO THIS
SURVEY 4 A VIOLATION OF SECTION 7209 OF THE
NEW YORK STATE EDUCATION LAR
K COPIES OF THIS SURVEY NOT SEARING THE LAND
SUAVE MORS INKED SEAL OR EMBOSSED SEAL SMALL
NOT BE CONSIDERED TO BE A VALID TRUE COPY
K GUARANTEES INDICATED HEREON SMALL RUM ONLY TO
THE PERSON FOR WHOM THE SURVEY IS PREPAREO
AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERN-
MENTAL AGENCY AND LENDING INSTITUTION LISTED
HEREON, AND TO THE ASSIGNEES OF THE LEMOIN6
INSTITUTION GUARANTEES ARE NOT TRANSFERABLE
TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT
OWNERS
*DISTANCES SHOWN HEREON FROM PROPERTY LINES
TO EXISTING STRUCTURES ARE FOR A SPECIFIC
PURPOSE AND ARE NOT TO BE USED TO ESTABLISH
PROPERTY LINES OR FOR THE ERECTION OF FENCES
GUARANTEED
WILLIAML�
NORTH FORK
YOUNG a YOUNG
DATE FEB. 23,1990
SCALE I"=100'
NO 90-0132
/ �Pa"2t
�O OG
� O
ALDEN W YOUNG, PROFESSIONAL ENGINEER
AND LAND SURVEYOR N YS LICENSE NO 12845
HOWARD W YOUNG, LAND SURVEYOR
NY S. LICENSE NO 45893
400 OSTRANDER AVENUE
RIVERHEAD, NEW YORK
BU1' `T",: ;. D�?.� � 1.
..iT
1 l t1
T0.'r,1 OF SCUT' -:OLD, N. Y.
HOUSI::G CC IiS? R� ORT
�C1IGiti .
Loca ticn
knumoer
Subdivision
Name of 0wner(s)
s tree z )
cipa! 77y)
Map No. Lots)
Occupancy X_/ / V
L z�YPe owner-Lenar.�)
Ac:::li1tad by: l�J
-AC;.Cbmp,n1ed by: ,.
Key available Suffolk Co. Tax No.
.
Source of request GJ,�o�-w._ �%
Dat e /ofFo
DUELLING: -
Type of construction GJ
"�- o?
Foundation 1 _ stories—,7
��. Cellar /z Crawl space_::L/3
Total rooms, 1st. Fl 3 2nd. F1
3rd. F1
Bathroom(s) 8h..e Toilet
room(s)-
Porch, type D�-
--,-----.Deck, type Patio, type
Breezeway Garag? -----
Utility room
Type Heat ��larm Air
Ho twat er
Fireplace(s) No. E:ci is of�
Aircondi Lion; ng
Domestic ho twater-
Type heater
Other
ACCESSORY STRUCTLTRFS: !� /
Garage, type const.
� ca.�-w torzge,
Swimming pool
type const.
1
Other C - Guest, type const.
VIOLATIONS: CHAPTER 45--N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
Location DP���,pticn
J Art 1 Sec.
Rema,-!cS : Co #/ j6 7,t
Inspected by: Date of Insp.
Time start end ,'SO