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Home My WebLink AboutZ-23421FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCcuPANCY No Z-23421 Date DECEMBER 21, 1994 THIS CERTIFIES that the buildin~ Location of Property 370 PACIFIC STREET House No. Street County Tax Map No. 1000 Section 141 Block 4 Subdivision Filed Map No. ONE FAMILY DWELLING MATTITUCK, N.Y. Hamlet Lot 20 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-23421 dated DEu~MBER 21, 1994 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 ONE CAR GARAGE * The certificate is issued to DOR~£~ MEYER (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *P?.R~SE SEE ATTACHED INSPECTION REPORT. N/A N/A N/A Rev. 1/81 3~O P:ci[ic S£ree[ LOCA, ioS. (number & street) SUBDIVISION NAME OF OWNER (s) DOROTHY I~YER BUILDING DEPARTMENT TOWN OF SOUTIIOLD IIOUSING CODE INSPECTION REPORT Mattituck, New York NO. (municipality) LOT(s) OCCUPANCY A-I RES. OIOIER (type) (owner-tenant~ ADMITTED BY: CAROLINE DiBALTALO ACCOMPANIE~ BY: SANE KEY AVAILABLE SUFF.CO. TAX ~ NO. 1000-141-04-20 SOURCE OF REQUEST: GARY FLANNER OLSEN, ATTY DATE: DEC. 12, 1994 DWELLING: TYPE OF CONSTRUCTION FOUNDATION TOTAL ROOHS: BATHROOM (s) PORCH TYPE SCREEN BREEZEWAY DOMESTIC HOTWATER YES TYYE HEAT LILCO GAS OI~u~R: WOOD FRAME CONCRETE CELLAR IST FLR. 5 2ND FLR. 4 ONE TOILET ROOM (s) FIREPLACE TYPE HEATER WARM AIR PANTRY CLOSET OFF KITCHEN ~ STORIES PARTIAL CRAWL SPACE 3RD FLR. UTILITY ROOM DECK, TYPE PATIO NONE GARAGE LILCO GAS AIRCONDITIONING HOTWATER H 2 [ EXITS 4 ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. SWIMMING POOL ! CAR WOOD FRAME STORAGE, TYPE CONST. · GUEST, TYPE CONST. VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. DATE OF INSPECTION TIME START 9:i0 DEC. 20, 1994 END 9:30 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 ~9~ancy - New dwelling $25.00, Additions to dwelling $25.00, Alteratio~ ~w~lling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions~ 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 $I5~.00 Date . p~.C~f..~..?~. ...................... din X New Construction ........... Old Or Pre-existing Buil ~ ................. Location of Property 370 Pacific St., Mattituck, NY House No. Street Hamlet Onwer or Owners of Property. Roy A. Baker as Administrator of Estate of Meyer 2O County Tax Map No 1000, Section.............~4] .Block..........-....4 .Lot ...................... Subdivision .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval .......................... Underwriters ~1 Planning Board Approval ........................ / MNFR 0LSEN, . .~t~. ~.~ ....... Request for: Temporary Cert~a[~..'..? ~.~^~.. ~z~al Ce~ P,O, ~,~X/Ob_.~ ,.., /'~-'///.~ ~ ......... CONSENT TO INSPECTION Gary Flanner Olsen as Attorney for the Estate of Meyer Owner(s) Name(s) , the undersigned, do(es) hereby state: That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at 370 Pacific St., Mattituck, NY -- , which is shown and designated on the Suffolk County tax map as District 1000, Section 14t 4 L~-20 , Block .. , . That the undersigned (has) (have) filed, 'or caused to be filed, an applica- tion in'Yl~.Southold Town Bullcling lnspt~,~, .,, o~.tl,,,, to,, +h,~ f~lloxvinff: house and detached garage That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, incl.uding ...... 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 obtain/~/ the conduct of such inspections may be used as evidence in subseque~/zpr;secutions for vio- lations of the laws. ordinances, rules or regulatio ~tl~ '~Town of Sou~ihold. Dated: December 12, 1994 Y//~ Gary Flanner 01sen as Attorney (print name) (signature) (print name)