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Home My WebLink AboutZ-20816FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-20816 Date JUNE 19~ 1992 THIS CERTIFIES that the buildin~ ONE FAMILY DW~.T3.TNG Location of Property 1125 PRIVATE ROAD #21 (POINT PLEASANT) MA~TITUCK House No. Street Hamlet County Tax Map No. 1000 Section 114 Block 1 Lot 3.2 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-20816 dated JUNE 19~ 1992 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 FAM/t~ DWR. LLING WITH ACCESSORY BOAT HOUSE * The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PT~SE SEE ATTAO4~.D INSPECTION REPORT. Rev. 1/81 JOHN & VICTORIA MOLLRR~ JR. N/~ / ~ ' lding 'Inspector Location BUILDIiZ DEP:LRTi.~NT . T0':~Y[ OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT 1125 PRIVATE RD. ~21 (POINT PLEASANT RD) MATTITUCK, N.Y. [numoer & szree~) Subdivision Map No. ~i.iunic ipa±iuy) Lo (o) Name of Owner(s) JOHN & VICTORIA HOLLER, JR. Occupancy OI~FAMILY A~mitted by: ~. HOLLER Key available Source of request OI,INI~RS ( own er- ~ enan~ ) Accompanied by: SA~E Suffolk Co. Tax No. Date 1 14-1-3.2 ./lINE 12, 1992 D!,~TLT~T~. Type of construction FRAME Foundation CEMENT BLOCK Total' rooms, 1st. F1 6 #stories ! Cellar 60~ Crawl space 40Z 2nd. F1 5rd. F1 Bathroom(s) 2 Porch, t~e Breezewa~ .Type Heat OIL Fireplace(s) 1 Domestic hotwater Other Toilet room(s) Deck, type Patio, type MASO.N~Y Garage Utility room 'Warm Air Hotwater xx No. ~cits 2 Aircondition~ng ~ype heater OIL ACCESSORY STRUCTURES: Garage, type const. Swim,ming pool Other FHAME BOAT HOUSE Storage, type const. Guest, type const. VIOLATIONS: Location .CHAPTER 45--N.Y. STATE UNIFO~J~ FIRE PREVENTION & BUILDING CODE Description J Art. t Sec. Remarks: BP #20734-Z CO Z-20815 FOR WOOD STOVE /"3 .~~ Date of Insp. tomy 16 & 18, 1992 Inspected b~j. FfS~ER 'Time start 10:05 end 10:4o JUN I 2 Form No. 6 TOWN OF SOUTIIOLD 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: 1o 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· -~ For existing buildings (prior to April 9, 1957) non-c~nforming uses, or buildings and '-'pre-existing" land uses: 1. ~Hr~l~surv~-~gf p~operty ~howing all property lines, streets, building and unusual natural or topographic features. fp:o ' ~?n ~-d a~co~s~nt ~ iqs~gt~signed by the applicant. f P y ~s oenieo, the Building Inspector shall state the reasons therefor in writing to the applicant. ]. Fees I. 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-es~i~tip~g_Buil~i_~_ng. _ $100.00 3 Copy of Certificate of ....... ~ .... · Occupancy - $5.00 over 5 years - $i0.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 · Date ew Construction ........... Old Or Pre-existing Building ~ ................. ocation of Property .... il.~ ..... ~0,~ ~S~ IIouse fro. ' .......................................................... Street Hamlet ~wer or Owners of Property.· ~t~ .~..~ ~..~m~L~ ,.nty ?ax Map No 1000, Section Jl~ .... Block ..... :bdivision ................ .................... Filed Map Lot rmit No ....... .- .......... Date Of Permit ...... ' .......... Applicant .......... alth Dept. Approval .. ........................ Underwriters Approval ............... ; ....... anning Board Approval ........................ quest for: Temporary Certificate ........... Final Certicate ........... e Submitted: $ / ~. ~0 CO~'SE?~T TO do(es) hereby state: · thc: undcrsi~-ncd, That the undersigned (is) (are) the owner(s) of the pre,nise.~; in the To~;m __ . which is shown and desicnated on the SuFfolk County tax map as District 1000, Section /;~ . Block / , Lot 3.~ That the undersigned (has) (have) filed, or caused to be filed, an applica- tion in the Southcld Tox~ Buildin~ InspectoF,s office for the follow. E: Dated: That the undersigned do(es) hereby give consent to tl~e I3uildLng Inspectors of the Town of $outhold to enter upon ~h_ above described property, including any and all buildings located thereon, to conduct such inspections as they dee~ necessary with respect to the aforesaid application, ~c!udLn% inspections to determine that said premises comply with all of ~he laws; ordinances, rules and regulations of the Town cf Southold. The undersigned, in consenting to such ~spections, do(es) so %%/th the knowledge and understandin~ that any ~for~ation obtained in tile conduct of such inspections may be used as evidence in subsequent prosecutions for lations of the laws, ordinances, rules or re~lations of ~he Town of Southold. (print name) (siRnnluue) (print name)