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Home My WebLink AboutZ-23750FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-23750 Date JUNE 30, 1995 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 655 LEGION AVENUE MATTITUCK NY House No. Street Hamlet County Tax Map No. 1000 Section 142 Block 2 Lot 5 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-23750 dated JUNE 30, 1995 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 A ONE FAMILY DWELLING The certificate is issued to LILLIAN OLKSTED (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. B ldi g Inspector Rev. 1/81 BUILDING DE:PAR114ENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 655 LEGION AVENUE MATTITUCK NY number 6 street municipality SUBDIVISION MAP NO. LOT(s) NAME OF OWNER (s) LILLIAN F. OLMSTED OCCUPANCY A-1 RES OWNER Cype owner -tenant ADMITTED BY: LILLIAN OLMSTED ACCOMPANIED BY: SAME KEY AVAILABLE SUFF.CO. TAX MAP NO. 1000-142-2-5 SOURCE 00 - - SOURCE OF REQUEST: LILLIAN F. OLMSTED DATE: 6/14/95 OWL• LL I IVU : TYPE OF CONSTRUCTION WOOD FRAME i STORIES ONE I EXITS 2 FOUNDATION CONCRETE CELLAR FULL CRAWL SPACE TOTAL ROOMS: IST FLR. 5 2ND FLR. 3RD FLR. BATIIROOM (s) ONE TOILET ROOM (s) UTILITY ROOM PORCH TYPE FRONT ENCLOSED DECK, TYPE _ BREEZEWAY FIREPLACE GARAGE DOMESTIC IIOTWATER YES TYPE HEATER LILCO GAS AIRCONDITIONING TYPE HEAT OIL WAIUI AIR HOTWATER YES OTHER• PANTRY OFF THE KITCHEN, REAR ENCLOSED ENTRYWAY PATIO ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. 2 CAR WOOD FRAME STORAGE, TYPE CONST. SWIMMING POOL GUEST, TYPE CONST. OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION S BUILDING CODE REMARKS: INcPrCTED BY GARY DATE OF INSPECTION TIME START 9:00 AM 6/29/95 END 9:20 AM Form No. 6 TOWN OF SOUT'HOLD BUILDING DEPARTMENT TOWN HALL JUN! 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: I. 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 - $20.00 4. Updated Certificate of .Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ..... JAAQ.14.,..199 ..................... New Construction........... Old Or Pre-existing Building... X ............ Location of Property.. ,655 ..... . ........ Lecjion.Avenue .............Mattituck ... _ ..... , .. . ... ... .. ........... House No. Street Hamlet Onwer or Owners of Property.... Lillian, F. ..Olmste.d .........,. County Tax Map No 1000, Section142-00 ........Block....9?. 0 ....... Lot .... M._.000 .......... 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 .............. PmAr 49 10 nrrr,TrnNT Lillian .F. Olmsted - P. awo* CONSENT TO INSPECTION Lillian F. Olmsted the undersigned, Owner(K) NameOg do(es) hereby state: That.the undersigned (is) (&xoy) the owner(s) of the premises in the Town of Southold located at 655 Legion Avenue, Mattituck, New York which is shown and designated on the Suffolk County tax map as District 1000, Section 142 , Block 2 , Lot 5 That the undersigned (has) (kwm) filed, or caused to be filed, an applica- tion in the Southold Town Building Inspector's Office for the following: Certificate of Occupancy on 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 the Town of Southold. Dated: June 14, 1995 _ �Q� L� — ( 6y/ -a, (signature) Lillian F. Olmsted (print name) (signature) (print name) Na"'i1+on 10 m io,0 MAP or L..ANo Sulaveyao FOR W i LL 1 A M NEWAL%s AT MATT rruC K TOWN 4*FSovTHOLJ:x;ttl. , W � N � 9 : K.... w, 01 N J'nt Uro N }0 pacific O. r. 30u4j, 5ca1e : 30'= lv4+aYarlteed to TLIs. GNararl-t.i�al� Te'4r lie Co. +► to +otic Novth FoYM. ";F3uatic :M1 �+ �'tHonurHerets FouHd Tvuel4 Co. cis survmyed L7}to W. VaH TWy 1 �► 5'H • 1 Y40 pipe LiccHscd LdHG��'3uwC40rs GYoeH pout , New Yogic 60 w Ilmd a00 — l 5/-) Q -,s- TOWN OF SOUTHOLD PROPERTY RECORD CARD /I - _, , bWNER STREET t VILLAGE DIST. ,SUB, LOT FORMER' OWNER N S Ao)? E E S's ACR. / -as 'L i 1 n FCOCl ? W S r W Fos K a - SID TYPE OF BUILDING r, w 6 r. ,! �::. ES. __ SEAS.VL. c FARM COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKS v C? � z �� o 00, ./ /s q s - 1 I Tal :J�� - ecvQ 1, 000 AGE BUILDING CONDITION N EVf NORMAL BELOW ABOVE FARP Acre Value Per Acre Value "illable 1 'illable 2 'illable 3 Joodland ampland FRONTAGE ON WATER rushland FRONTAGE ON ROAD D Ouse Plot DEPTH BULKHEAD 'otal DOCK °��1,��,�� . � ,-fir''' -�-�� - ►',� , , r, i LOCATION: SUBDIVISION NAME OF OWNER (s) OCCUPA BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT L.- 6too� er & street (municipality MAP NO. LOT(s) ADMITTED BY: L-1111,�`�✓ G4 --o JJ, -?X4 ACCOMPANIED BY: G. KEY AVAILABLE 7 SUFF.CO. TAX MAP NO. /fes_ --& SOURCE OF REQUEST: lo✓ A � �T ,(' DATE: 4;j�/jC%_ DWELLING: 4� 1� TYPE OF CONSTRUCTION ,Gi # STORIESC.IW # E%ITS FOUNDATION CELLAR /', CELLAR KCRAWL SPACE TOTAL ROOMS: IST FLR.2ND FLR. —` 3RD FLR. BATHROOM (s)yWZ TOILET ROOM (s) UTILITY ROOM PORCH TYPE I4W- ��✓G�D,! u� DECK, TYPE PATIO BREEZEWAY FIREPLACE GARAGE DOMESTIC HOTWATERS TYPE HEATER ��CO AIRCONDITIONING TYPE HEAT �Ze WARM AIR HOTWATER OTHER: ACCESSORY GARAGE, TYPE OF CONST. rftG,L L-Achy�� _ STORAGE, TYPE CONST. SWIMMING POOL , GUEST, TYPE CONST. OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION I ART. SEC. REMARKS: INSPECTED BY � DATE OF INSPECTION.-_!�� TIME START END