HomeMy WebLinkAboutZ-27606FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 27606 Date: 04/03/01
THIS CERTIFIES that the building WORKSHOP
Location of Property 4780 CR 48 MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 141 Block 0003 Lot 025.001
Subdivision
Filed Map No. Lot No.
conforms substantially to the Requirements for a STRUCTURE
built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z- 27606 dated APRIL 3, 2001
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 UNHEATED WORK SHOP *
The certificate is issued to RAYMOND F NINE
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
c
Au orized Signature
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 4780 CR 48 MATTITUCK
SUBDIVISION: NAP NO.: LOT (S)
NAME OF OWNER (S): RAYMOND F NINE
OCCUPANCY: WORKSHOP RAYMOND F NINE
ADMITTED BY: RAYMOND NINE ACCOMPANIED BY: SAME
KEY AVAILABLE: SUFF_ CO. TAX MAP NO.: 141.-3-25.1
SOURCE OF REQUEST: ABIGAIL A. WICKHAM, 3/20/01 DATE: 04/03/01
DWELLING:
TYPE OF CONSTRUCTION: WOOD FRAME
FOUNDATION: LOCUST POSTS
# STORIES: 1.0 # EKITS: 1
CELLAR: CRAWL SPACE:
TOTAL ROOKS:
IST FLR.: 1
2ND FLR_: 0
3RD PLR.: 0
HATHROOK(S):
0.0
TOILET ROOM(S): 0.0
UTILITY ROOK(S)-
PORCH TYPE:
DECK TYPE:
PATIO TYPE:
BREEZEWAY: FIREPLACE: ONE
DOMESTIC HOTWATER: TYPE HEATER: NONE
TYPE BEAT: NONE WARM AIR: HOTWATER:
OTHER:
GARAGE:
AIRCONDITIONING-
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.: STORAGE, TYPE CONST.:
SWIMMING POOL: GUEST, TYPE CONST.:
OTHER:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION I DESCRIPTION I ART. SEC.
INSPECTED BY: DATE ON INSPECTION: 03/21/01
TIME START: 10:00 AM END: 11:00 AM
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 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 - � .25V;
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date ,March 20, 2001. .
New CoVstruction...... r.... Old Or Pre-e;cisting Building,X (two story. frame dwelling and
studio/shed, excavator s yard, equipment/material storage/repa'rs)
Love Lane & Route
Location of Property ......... .,,,,Matte}�pC,..... NY...11952.............
House No. Street Hamlet
Onwer or Owners of Property..., Raymond.
F. ..
Nine
............................................................
_MW 410 16
County Tax Map No 1000, Section.. 141......,,,Block..�............. Lot...Z5.1...............
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: $,100:00 ......................
cmc 5425. ............
�P CO oZ7GO(O *.aA. APPLICANT WickhAgent
CONSENT
TO
INSPECTION
RAYMOND F. NINE the undersigned,
Owner(s) Name(s)
do(es) hereby state:
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at Love Lane & Route 48, Mattituck, New York 11952
which is shown and designated on the Suffolk
as ! 4M
County tax map as District 1000, Section 141 Block 3 Lot 25.1
That the undersigned (has) (have) filed, 'or caused to be filed, an applica-
tion in the Southold Town Building Inspector's Office for the following: a
two story frame dwelling and studio/shed, excavator's yard, equipment/materials,
storage/repair
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 the Town of Southold.
D ate d: March 20, 2001
print name)
It
LOCATION:
number & street
SUBDIVISION
NAME OF OWNER (s)
municipality
MAP NO. LOT (s)
OCCUPANCY (A)
type owner -tenant a '
ADMITTED BY: d, ` ACCOMPANIED BY: f4w
KEY AVAILABLE I SUrF. CO. TAX MAP NO. /oco -/w- 03 -�S
SOURCE OF REQUEST : kWLc'4GqA*l DATE :VJfltO
DWELLING:
TYPE OF CONSTRUCTION STORIES �Jj(�Q� # EXITS 8''✓L�
FOUNDATION CELLAR CRAWL SPACE`
TOTAL ROOMS: IST FI.R. 2ND FLR. 3RD FLR.
BATHROOM (s)
PORCH TYPE `--------7
BREEZEWAY
DOMESTIC HOTWATER
TYPE HEAT^
OTHER:
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.
SWIMMING POOL
OTHER:
TOILET ROOM (s) UTILITY ROOM
DECK, TYPE —I
PATIO, TYPE —
F I REPLACE Uy��- GARAGE
TYPE HEATER AJO-V-4— AIRCONDITIONING `-
WARM AIR HOTWATER
STORAGE, TYPE CONST.
, GUEST, TYPE CONST.
------------------- ___________
------------ --- ------
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE.
REMARKS:
INSPECTED BY:
DATE ON INSPECTION_
TIME START
/�4/ 103
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