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Z-20141
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING FICATE OF OCCUPANCY No Z-20141 Date AUGUST 13, 1991 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 19475 MAIN ROAD MATTITUCK N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 108 Block 4 Lot 8 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-20141 dated AUGUST 13, 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 The certificate is issued to ESTATE OF ANNE I. NEVILLE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. Building Inspector Rev. 1/81 BUILDI.IG ;i:T DEP IEiT T0:9N OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location 19475 MAIN ROAD (number do street) iity) Subdivision Map No. Lot(s) Name of Owner(s) _ ESTATE OF ANNE I. NEVILLE Occupancy A-1 RES (type) owner-tenan-u Admitted by: ROSIE NEVILLE Accompanied by: SAME Key available Suffolk Co. Tax No. 108-4-8 Source of request DWELLING: : LAWRENCE M. STORM, ATTY Date JUNE 3, 1991 Type of construction WOOD FRAME #stori.es 2 Foundation BRICK & STONE Cellar 1/2 Crawl space 1/2 Total rooms, 1st. F1 5 2nd. F1 5 3rd. Fl - - Bathroom(s) 1 Toilet room(s) 1 Porch, typeENCLOSED ON Deck, type Patio, typeSIDE_ Breezeway Garage Utility room Type Heat ELECTRIC 'alarm Air Hotwater Fireplace(s) NONE No. Exits 4 Airconditioning Domestic hotwater YES Type heater LILCO GAS Other 2 REAR ENTRYWAYS ACCESSORY STRUCTURES: Garage, type const._ Swimming pool Other NONE Storage, type const. Guest, type const._ VIOLATIONS: _CHAPTER 45--N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE Location Description `Art.) Sec. EXTERIOR EXTERIOR STAIRS, PORCHES, ENTRANCE PLATFORMS, CHAP. F. FIRE ESCAPES AND THE RAILINGS THEREON SHALL BE 1242. C MAINTAINED IN A SAFE AND SOUND CONDITION. ( EXTERIOR SURFACES SHALL BE MAINTAINED IN GOOD CHA*. F. CONDITION. SURFACES NOT INHERENTLY RESISTANT 1242. (E) TO DETERIORATION SHALL BE TREATED WITH A PROTECTIVE COATING OF PAINT OR OTHER SUIT LE PRESERVATIVE. Remarks: Inspected by:�Date of Insp. JUNE 26, & AUG. 12, 1991 F H Time start 9:00 am end 9:30 am u 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 Coda 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 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 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 $15.00 Date ......May.13;_1991....................... New Construction........... Old Or Pre-existing Building .... KK........... Location of Property ... Sno#), Main. Road ,,,,,,,,,,,,,,,Mattituck,..Ky...11152................... House No. Street Hamlet Onwer or owners of Property.... Mary. Neyi 11 e, as , �xgGytriK .Rf .the .�s.tdte .of, Anne, I,., Nevi 11 p, , , , County Tax Map No 1000, Section ... 14? ........ Block ..... Q4 ......... Lot ..., 08,,,,,,,,,,,,,,,, Subdivision....................................Filed Map ............ Lot ...................... Permit No................Date Of Permit ................ Applicant ............................. ,,Health Dept. Approval..........................Underwriters Approval......................... Planning Board Approval ........................ .Request for: Temporary Certificate........... Final Certicate... X....... Fee Submitted: $,100300 ...................... �' \ ........... ........�...................... . AY Y L I IANI Mary Neville, Executrix of the Estate of Anne I. Neville �c . `f23 cc CONSENT'' TO INSPEC'T'ION MARY NEVILLE , the undersigned, kkw" 6o), Namc(s) do(es) hereby state: the Executrix of the Estate of Anne I. Neville, That the undersigned (is)/(R;n0 the owner(A) of the premises in the Town of Southold located at (no#) Main Road Mattituck New York %vhich is shown and designated on the Suffolk County tax map as District 1000, Section 108 Block 04 Lot 08 That the undersigned (has) ( Xxyot) filed, or caused to be filed, an applica- tion in the Southold Town Building Inspector's Office for the following: Certificate of Occupany for Pre -Existing Building 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 thejown of outhold. Dated: May 13, 1991 (signature) Mary Neville, Executrix of the Estate of Anne I. Neville (print name) signatures print name) i_ J f , } t , \,.-� �t �. .lr� 'e �l �•-,J �.G� ' 1.1 1 ) r! ,.,-. L�.< r _ �r -`-. '•S :.. �{ t ' I'n � I�:xY l:re t,Y.. w, ,\_ ,. .)•J.� 7n ��. �i?- ! �� i2 �-r [., I � r,\Y -I 1� i r'l-ti xlv','\ '�..} et ..t�y.e � y J� a t zir., ,..1 •, is l 2 . t.. i_ �f.. r.i � )a> !.'� �\ �..J-F`A�j'.� r.'f. t'. ii i 7 �' z ..r k. ��J LY' t .� r r t 1 ._ k �. 1./�• j_ C d rr .I t I ^' n"-••'(;-°. L7lyt\' 17 t J I F.t{ tt - S,i� l,lOil�(1 i _I 1-�-I 17 _ t'_ ;(��C� -I. _ _ .c C' I ',,�4•.1r,}'�.� -ii r 12 af•,J'i frr}.:5 I J i t ). <v 05-��'� �j 1 r -I '� t io f `,� .�_ ). _ �a t izn ffY-•t�r�i�i t �.;'�� �'- ` - ' _ t�7�.r 2..5V �.' �i �' r y •...',-u t t �� qca c.• ._ .� I.J a , (-•-r -, q-r,� •� 1 ,. , [}y1h� c �. -,'r� .i.i �.[ �NirJ3 r�Y.:-(!'v ACL. 1 ." , r ' .. i rLtr�j f�i ,r -"ir '!� r�•N '' 0 0 , •� y t k _ r �_ > 'rr +•`,-'•�'`�t i= 't _ r _ t ,Ap �' �p,,.pr `, Off", i r. F} , t< CD i 50.58LJE IOp.O0 r ` N. •2- �'�.�(n \ '•rtesµ >��"' f`-:'r�qf �Iv-�,i' -t Z ;I .`. � � r , 7. f /ir r:,i -t C' [C V. N tt O N N N 0 OD p ^ r:.y •� S 'v-"'iY :�'r� =L.•- + � if - � Q !a'e• i /' 0. 13 r 50 5, g :� {5 N. 830 25 00 h - a . 267.57' -� SURVEY:' FOR JOSEPH NEVILLE B" ANNE NEVILLE MAT:TI TUCK i JOWN.OF. SOUTHOLD ; x: SUFE;:. CO,', N. Y. ~GUARANTEED TO i' r"•. et•.INTER -COUNTY TITLE GUARANTY C iI SCALE : 1" _ <}pr e,© MORTGAGE CO. 1 Z JAN' 8, 1964 FEB 6, 196t4 2}i��tJ%�••iu� i,4AR. 16 196 ;W. PROFESSIOJII 4r11NE 8 ' ;}'LAND 9URVEYOR,N.Y.S. IC. NO 12845 a'<] RI VERHEAD, N.Y. J� NOTE ■ MONUMENT Location T0,•Ii,r Or SCUT'—:OLD, HOU--I:dG CCDS IIS?ECl FORT (-*x szreez) Subdivision Nil e of Owner(s) Occupancy Av . li iunycipa! No. Lots) Tax �- pe) o•�ner-tie an-) Ac:_:,ilted by: �� r _ - _., 'J AC;j-'bmpani&d by Key available Suffolk Co. T Source of request DUELLING: Type of construction Fo d No. Date un anion stories " V --i a -I. -.Cellar �� Crawl sp Total rooms, 1st. Fl 2ace -- nd. Fl ,��" 3rdFl Bathroom (s) / . �` Toilet room(s) / Porch, type �Q _�_e►,v Deck, type •-ems �n BreezewayPatio,' type Garage Utility room Type Heat �ecr�?t c _ -- V,larm Air Ho tv�at er Fireplace(s) ivn /tib No.. F;t i t. s Domestic hot��ater_ Airconditioni,�g - �-s Type heater �.r � ' Other �o G 4S ACCFSSORy STRUCmL?�FS . Garage, type const. fdAJ� Storage, SxVimnmi ng pool type const. Other Guest, type const. VIOL ATTO,7\rS . CHAPTER 45--N.Y. STATF. TTNTRnDxf