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Home My WebLink AboutZ-22599FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-22599 Date SEPTEMBER 22{ 1993 THIS CERTIFIES that the building. Location of Property 11665 MAIN ROAD House No. County Tax Map No. 1000 Section 141 Subdivision ONE FAMILY DW~.T.T.TNG MATTITUCK ~ N.Y. Street Hamlet Block 4 Filed Map No. Lot 41 Lot No. conforms substantially to the Requirements for a One Family Dwelling built Prior to: APRIL 9r 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-22599 dated SEPTEMBER 22~ 1993 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 * The certificate is issued to STR. T.T~ S. RADFORD (owner) of the aforesaid building. SUFFOLK COUNTYDEPARTMENT OF HEALTHAPPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PT,~SE SEE ATTAC~.~ INSPECTION REPORT. J Bu~in~ Inspector Rev. 1/81 LOCATION: BUILDING DEPARTMENT TOWN OF SOUR[OLD HOUSING CODE INSPECTION REPORT 11665 MAIN ROAD MATTITUCK, N.Y. (number & street) SUBDIVISION NAME OF OWNER (s) STELLAS. RADFORD MAP NO. (municipality LOT (s) OCCUPANCY ON~ FANILY DWELLING (type) ADMI'i-rED BY:. WILLIAH CLARK KEY AVAILABLE SOULC~ OF REQUEST: · OW~R (VACA~rr) (owner-tenant) ACCOMPANIED BY: SANE SUFF. CO. TAX MAP NO. 141-4-41 WILLIA~ J. CLARK~ ATTY FOROWNER DATE: 9/9/93 DWELLING: TYPE OF CONSTRUCTION FOUNDATION TOTAL ROOMS: BATHROOM (s) PORCH TYPE BREEZEWAY DOMESTIC HOTWATER TYPE HEAT OIL OTHER: FRAI4E ~ STORIES 2 # EXITS 'MAsoNARy BLOCK CELLAR XX CRAWL SPACE IST FLR. 4' 2ND FLR. 4 3RD FLR. 2 TOILET ROOM (s) UTILITY ROOM 2 CLOSED IN DECK, TYPE PATIO, TYPE FIREPLACE ! GARAGE AIRCONDITIONING HOTWATER TYPE HEATER NATURAL GAS WARM AIR FLOOR FUPA~CE ACCESSORY STRUCTURES: GARAGE, T¥FE OF cONST. S~IMMING POOL OTHER: FRAME STORAGE, TYPE CONST. · GUEST, TYPE CONST. VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. REMARKS: DATE ON INSPECTION Sept. 17, 1993 TIME START 9:30 ENIJ 9:55 AM Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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. 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 ... August 31, 1993 New Construction ........... Old Or Pre-existing Building .... ×~ .......... Location of Property. 116-05 Main Road Mattituck, NY 11952 House No. Street Hamlet Onwer or Owners of Property.. Stella Radf0rd 141 4 41 County Tax Map No 1000, Section .............. Block ................ Lot ...................... Subdivision .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate Final Certicate...XX ...... Fee Submitted: $.I.QO.OO. ..................... ~-~ ~P~IC~T Stella R/adford ~ STELLA O~.mr(s) do(es) hereby state: ;RA~FORD Name(s) CONSENT TO INSPECTION · the undersigned· That the undersigned (is))~k~( the owner(s) of the premises in the Town of'Southold located at 116-65 Main Road Mattituck · which is show-n and designated on the Suffolk County tax map as District 1000, Section 141 , Block 4 , Lot041 That the undersigned (has) (~) filed, 'or caused to be filed· an applica- 'tion in the Southold Tox~-n Building Inspector's Office for the iollowing: certificate of o'ccupancy on pre-existing building That the u~dersigncd 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 To n of South Id. · . (d'ignatur e) ~ ' Stella Radford (print name) (signature) (print name)