HomeMy WebLinkAboutZ-23757FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PR~ EXISTING
CERTIFICATE OF OCcupANCY
No Z-23757 Date JULY 11, 1995
THIS CERTIFIES that the building. ONE FAMILY DWELLING
Location of Property. 420 NORTH RILEY AVE. MATTITUCK, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 122 Block 3 Lot 36.3
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-23757 dated 4u~¥ 11, 1995
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 *
The certificate is issued to RICHARD A. & CAROLYN E.
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N/A
N/A
*Pr~%sE SEE ATTAuHKu INSPECTION REPORT.
~ector
Rev. 1/81
LOCATION: 420 Ho RILEY AVENUE
(number & street)
SUBDIVISION
NAME OF OWNER (s) RICHARD A. LUHRS
OCCUPANCY A-] RES.
(type)
ADMITTED BY: RICHARD A. LUHRS
KEY AVAILABLE
SOURCE OF REQUEST: RICHARD A. LUItRS
BUILDING DEPARTHENT
TOWN OF SOUTilOLD
IlOUSING CODE INSPECTION REPORT
NATTITUCK, NEW YORK
(municipality)
HAP NO. LOT(s)
(owner-tenant)
SANE
ACCOHPANIEO BY:
SUFF.CO. TAX MAP NO. 10OO-122-O3-30.3
DATE:APRIL 7, 1995
DWELLING:
TYPE OF CONSTRUCTION
FOUNDATION
TOTAL ROOMS:
BATHROOM (s)
PORCH TYPE
BREEZEWAY
DOMESTIC HOTWATER' YES
TYPE HEAT LILCO GAS
OTHER:
IST FLR. 5
3
WOOD F~ t STORIES ONE
CELLAR FULL CRAWL S~ACE
2ND FLR. 2 3RD FLR.
TOILET ROOM (s) UTILITY ROOM
BECK, TYPE WOOD · PATIO
FIREPLACE ONE GARAGE
TYPE HEATER LILCO GAS AIRCONDITIONING
WAP~! AIR tIOTWATER XX
EXITS
ACCESSORY STRUCTURES: NONE
GARAGE, TYPE OF CONST.
SWIIqMING POOL
OTteR:
STORAGE, TYPE CONST.
, GUEST, TYPE CONST.
VIOLATIONS: ClIAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
REMARKS: BP Ji1895-CO Z-13382 (Solar Add.) BP #13809- CO Z-14453 (Add)
BP ~22868-C0 Z-23757 (Deck Add & Heating System)
INSPECTED B~~~ DATE OF INSPECTION
TIME START 9:50 Abi
I~AY 5, 1995
END 10:25 AI~
Form No. 6
TOWN OF SOUTIIOLD
BU [ LD l NG I)EPAP,'[¥1E}IT
TOWN HALL
765-1802
APPLICATION FOR CERT[17ICATE OF OCCUPANCY
This apPlication must be filled in by typewriter OR ink and submitted to the building
inspector with the following:
1.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
"pre-existing" land uses:
I. 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 ~he 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. '
Certificate of Occupancy on Pre-existing Buildint - $100.00
Copy of Certificate of Occupancy - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00., Commercial $15 O0
~ ' ......... ~' -~'sting Building....~...~iiiiiiill ....................
· · ......... /' .... ...... : .... .....
Street Hamlet
Onwer or Owners ,.,f Property..~.~..~...~..f~..~../~.y~..~..~p~.~..
County Tax Hap No 1000 Section. /c~ ~-~. ..Block..4] ............ Lot.~i~.,.~.
Subdivision .................................... Filed Map ............ Lot
Permit No ................ Date Of Permit.
............... Applicant .............................
Itealth Dept. Approval
.......................... Underwriters Approval...t .....................
Planning Board Approval
-lequest for: Temporary Certificate ........... Final Certicate..~.'. .......
~ee Submitted: $/. ..........................
-
?5?
for new building or new nsc: .
Final survey of property with accurate location of all buildings, property lines,
streets, and unusual natural or topographic features.
2. Final Approval from llehlth Dept. of water supply and sewerage-disposal(S_9 form).
3. Approval of electric?llinstallation from Board of Fire Underwriters.
4. Sworn statement from p umber certifying that the solder used in system contairs
less than 2/10 of 1% lead.
5. Co,mm.ercial buildin.g, industrial building, multiple residences and similar buildings
ann ~nstallations,~a certificate of Code Compliance from architect or engineer
responsible for the building.
6.~ Submit Planning Board Approval of completed site plan requirements.
FRANCIS J. MURPHY
SUPERVISOR
TELEPHONE
(516) 765-1800
FAX NO.
(516) 765-1823
OFFICE OF THE SUPERVISOR
TOWN OF SOUTHOLD
Dear Resident of the Town of Southofd:
TOWN HALL, 53095 MAIN ROAD
P.O. BOX 1179
SOUTHOLD, NEWYORK 11971
I am pleased to announce that your Town will introduce Enhanced 9-1-1
Emergency Service, This forward step into modern technology will greatly
assist in the dispatch of police, fire and emergency medical services, I'm
sure you can appreciate the difficulties encountered while attempting to lo-
cate the site of an emergency where there is no systematic house numbering to
guide emergency personnel. As part of the implementation process, we under-
took revisions to the address plan that affect many of your residential.
commercial and other properties. Many structures have been assigned a new
address, Others. however, will continue with their present address.
We consider the changes beneficial. Deliveries to your home or business will
be made easier. More importantly, they will improve the ability of your
police, fire or emergency medical services to respond to any emergency.
Effective immediately, your address at this location in Southold Town will be:
· '
420 N ' RILEY AV
' HATTITUCK :~; ~':' NY
I 11952 ~'~ *~'~ ~:,i':,'
Please use this address in all your future dealings. If it is a change in
what you now consider as your address, you ~nay wish to obtain a supply of
"change of address" forms from the Post Office to use in notifying your regu-
lar mailers.
IT I~ CRITICAL. however, that any chan~j~s be verified with 1) $outhold Iown
Building Department (516-765-1802) and 2) New York Telephone Company. who
supplies the data for our Enhanced 9-1-1 system. You may call New York
Telephone toll free at 800-462-7220. Monday through Friday between 9 A.M. and
5 P.M. In order for the system to work optimally. New York Telephone must be
informed of your new house number.
I close with the fervent wish that you may never require emergency services,
but you can rest assured that they will be there if you should ever need them.
// ~Sdpervis6~. Southold Town
C O '
INSPECTION
Ovrner (s) Name(s)
do(es) hereby state:
· the undersigned,
That the undersigned (is) (are) the owner(s) of tbe premises in the Town
of Southold located at ~/l_.ep /V C. ,~//~ ~ /l//~TZ?zT/-~'
~' 7. //~Z' , which is shox~ and designated on the Suffolk
County tax map as District 1000, Section/~2 , Block ~ , Lot~. ~ .
That the undersigned (has) (ha~e) ~iled, or caused to be riled, an applica-
tion in the Southold To~ Building Inspector's Office for the ~ollow~g:
/
That the undersigned do(es) hereby give consent to the Building Inspectors
of the Town of Southold to enter upon the above described pr. operty, including
any and ail buildings located thereon, to conduct such inspections as they may
deem necessary xvith 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.
(sig~Jture)
(print name)
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