HomeMy WebLinkAboutZ-26330FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 26330
Date: 03/18/99
THIS CERTIFIES that the building DWELLING
Location of Property 2600 SIGSBEE RD LAUREL
(HOUSE NO.} (STREET)
County Tax Map No. 473889 Section 144 Block 0001
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- 26330 dated MARCH 18, 1999
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 GARAGE *
(HA~ET)
Lot 023
The certificate is issued to HELEN M MCDONALD
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
N/A
N/A
~ui~ing Inspector
Rev. 1/81
LOCATION:
SUBDIVISION:
2600 SIGSBEE RD
NAM~ OF OWI~ (S): HELEN M MCDONALD
OCCUPANCY: SINGLE FAMILY
ADMITTED BY: TOM LIBR~IO
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LAUREL
MAP NO.: __LOT {S) __
HELEN M MCDONALD
ACCOMPANIED BY: SAME
KEY AVAILABLE: -- SUFF. CO. TAX MAP NO.: 144.-1-23
SOURCE OF REQUEST: WICKHAM. WICKHAM & BRESSLER PC. 2/1 DATE: 03/18/99
TYPE OF CONSTRUCTION: WOOD FRAME
FOUNDATION: C~MENT BLOCK
TOTAL ROOMS: 1ST FLR.: ~
BATEROOM(S): 1.0
PORCH TYPE: FRONT-SCrEEN PORCE
2ND FLR.: _.~
TOILET ROOM(S) .' 0,0
DECK TYPE .'
BREEZEWAY: FIREPLACE:
DOMESTIC EOTWATER: YES TYPE HEATER: OIL
TYPE HEAT: OIL WARM AIR: XX EOTWATER:
OTHER: REAR ENTRY WAY
# STORIES: 1.0 # EXITS: ~
CELLAR: PULL CRAWL SPACE: --
3RD FLR.: ._~
UTILITY ROOM(S): --
PATIO TYPE:
GARAGE:
AIRCONDITIONING:
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.:
SWIPING POOL:
OTHER:
ONE CAR WOOD FRAME STORAGE, TYPE CONST.:
GUEST, TYPE CONST.:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PP. EVENTION & BUILDING CODE
LOCATION DESCRIPTION ART,
INSPECTED BY=
DATE ON INSPECTION: 03/16/99
TIME START: 10~10 END: 10:40
TOWN OF SOUTHOLD
BUILDING DEPARTMEN~
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPAXCY
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.
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
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.
2. Certificate of Occupancy on Pre-existing Buildin~ - $100.00
3. Copy of Certificate of Occupancy - ~ .25~.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date .¥~r~¥y.~.~ .......................
New Construction. Old Or Pre-existing BuildingS. dwelliD~ wi~h, qutdopr,s~owe~screenporc~
................... ~nR'aetacnea frame garage.
Location of Property...2600.Sigsbe¢.goOd ......................... M~%%%%P~ ..................
House No. Street Hamlet
Onwer or Owners of Property ..... g~i~o.M,.M~DpgP%~ ............................................
County Tax Map No 1000, Section..l~,00 ...... Block..P.1..PP ......... Lot...Q~-.QQQ ............
Amended Map of p~o
Subdivision..Mattituck. Pa~k.P~Op~%~.%~q....Filed Map ............ Lot..~O~ ................
Permit No ................ Date Of Permit ................ Applicant .............................
Health Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate..X. ........
Fee Submitted: $ .1.0.0...0.0 ....................... .~..~d ~..d .~.~.....g.g.g.g.g.g.g.g~~', ,
/ APPLICANT (Agent)
o
765-1802
BUILDING DEPT.
INSPECTION
r *~ FOUNDATION 1ST
[ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[.~ FIREPLACE & CHIMNEY
CONSENT ?0 INSPECTION
Helen M. McDonald , the undersigned, do(es) hereby
Owner(s) Name(s)
state:
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at 2600 Si§sbee Road, Mattituck, New York
Which is shown and designated on the Suffolk County tax map as District 1000,
Section 144 00 01.00 023.00
· , Block , Lot
That the undersigned (h'aS) (have) filed, or caused to be filed, an applica-
tion in the Southold Town Building Inspector's Office for the following:
Pre-existing Use C.O. for dwelling with outdoor shower, screen porCh and detached
frame 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, including
any and all buildings located thereon, to conduct such inspections as they
may deem necessary with respect to the aforesaid application, including inspec-
tions 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: February 18. 1999 ~.~J~~~_
~ture
Ab~a~] A. W~e~hmm. a~ent
Print name -
Signature
Print name
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