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Home My WebLink AboutZ-19621FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. No Z19621 CERTIFICATE OF OCCUPANCY PRE EXISTING Date DECEMBER 28~ 1990 THIS CERTIFIES that the building. ONE FAMILY DW~.LLING Location of Property 4060 OLE JULE LANE MATTITUCK House No. Street County Tax Map No. 1000 Section 122 Block 004 Lot 027 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a private one-family dwelling built prior to APRIL 9~ 1957 Hamlet pursuant to which Certificate of Occupancy Z19621 dated DECEMBER 28~ 1990 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 *** SEE INSPECTION REPORT The certificate is issued to NORMA R. PORDON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A Building Inspector Rev. 1/81 Location Subdivision BUILDING DEP:%RT:IENT -. TOl'~r OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT 4060 OLE JULE LANE MATTITUCK ~numoer & streeT) (~4unicipali~y) Map No. Lot(s) Name of Owner(s) Occupancy A~mitted by: Key ~vailable Source of request NOP~MA R. POP. DON A-I NORNA PORDON OWNER (owner-zenan~ Accompanied by: SAME Suffolk Co. Tax No. NORMA R. PORDON Date 122-4-27 9/13/90 D~,'~LLING: Type of construction Foundation CEMEI~BLOCK Total ~ooms, lat. FI Bathroom(s) I ~u~L BA~ Porch, type Breezewaz Type Heat OIL Fireplace(s) ONE Domestic hotwater Other WOOD FRAME (BRICK VENEE~) Cellar -- 2nd. F1 -- Toilet room(s) ! TOILET ~OOM Deck, type Patio, typ~__ Garage I CAE ATTAuHzD Utility room 'Warm Air Hotwater xx No. ~cits Airconditioning YES Type heater OFF BOILER #stories I STORY Crawl space xx 5rd. Fi -- ACCESSORY STRUCTURES: Garage, type const. Swimming pool Other NONE Storage, type const. Guest, type const. VIOLATIONS: Location Housing Code, Chapter 45N.Y. Descriotion State U~niform.Fire Prevention & Buzlmin~ Come I rt.t Sec. I t Form No. 6 ~i! !~ ~' ! TOWN OF SOUTHOLD .--~ ~ ~ ~ ~ ~-~L'~i : BUILDING DEPARTMENT ~11 ~ I ~ ~.-~ 765-1802 ~ PLICATION FOR.CERTIFICATE OF OCCUPANCY . ~ ~-be filled in by typewriter OR ink and submitted to the ilding inspector with the following: for new building or new use: Final survey of property with accurate location of all buildings, property ]~nes, 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 %lectrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying tha~ the solder used in system contm~ns 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, 1953) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building mud unusual natural or topographic features. 2. A properly completed application and a consent"to inspect signed by the applicant. If a Certificate o£ 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 - $I0.00 4. Upda~=d C~rtificate oi Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.~0, Commercial $15.00 Date ::ew Construction .... 2 ...... Old Or Pre-existing Building ..... ~ ......... House No. Street Hamlet Onwer or Owners of Property .... ~.~%~. County Tax Map No 1000, Section..~.~,~F.. Subdl~ision ' Filed Map Lot [lealth Dept Approval Underwriters Approval ?lanntng Board Approval ........................ Request for: .Temporary Certificate ........... Final Certicate. Fee Submitted: $..~.9.(:~.~..T ................... ' co. 2,, APPLICANT / CONSENT TO INSPECTION 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 , which is sho%~ and desifnated on the Suffolk County tax map as District 1000. Section [Y~ . Block ~ . Lot Vq That the undersigned (has) (have) filed, or caused to be filed, an applica- tion in the Southold To~ Building Inspector's Office for the follow,g: __ 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 ail buildings located thereon, to conduct such inspections as they may deem necessary ~vith 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: (signature) (print name)