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Home My WebLink AboutZ-27020FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 27020 Date: 04/03/00 THIS CERTIFIES that the building DWELLING & ACCESSORIES Location of Property 955 CONKLIN RD MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 139 Block 0003 Lot 030.001 Subdivision Piled 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- 27020 dated APRIL 3, 2000 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 DECK, ACCESSORY FRAME SHED, AND ACCESSORY METAL SHED.* The certificate is issued to BEULAH RICKETTS of the aforesaid building. (OWNER) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. Rev. 1/81 N/A N/A N/A '~~th~ i/ze~ig nature BUILDING DEPARTMENT TOW/q OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: ~$$ CONKLIN RD SUBDIVISION: NAME OF OWNER (S): BEULA~ RICKETTS OCCUPANCY: A-1 P~ESIDENTIAL ADMITTED BY: CARL AUSTIN MATTITUCK MAP NO.: __ LOT (S) -- BEULAH RICKETTS ACCOMPANIED BY: SAME KEY AVAILABLE: SUFF. CO. TAX MAP NO.: SOURCE OF REQUEST: C~%RY FLANNER OLSEN. ATTY. DATE: 04/03/00 TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 1.0 # EXITS: ~ FOUNDATION: CEMENT BLOCK CELLAR: PART CRAWL SPACE: PART TOTAL ROOMS: 1ST FLR.: ._~ 2ND FLR.: __~ 3RD FLR.: ~ BATHROOM(S): 2.0 TOILET ROOM(S): O,0 UTILITY ROOM(S): -- PORCH TYPE: DECK TYPE: WOOD PATIO TYPE: BREEZEWAY: FIREPLACE: NONE GARAGE: DOMESTIC EOTWATER: YES TYPE HEATER: AIRCONDITIONING: TYPE HEAT: LIPA WARM AIR: HOTWATER: ~ OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: SWI~4ING POOL: OTHER: WOOD FRAME STORAGE, TYPE CONST.: GUEST, TYPE CONST.: METAL & WOOD VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFOP~M FIRE PREVENTION & BUILDING CODE LOCATION I DESCRIPTION I ART, SEC, REMARKS: BP9511 ADD CO8998:BP9307 C4%~AGE CO7872:BP26429 DECK CO27Q1) GARY J. FISB / TIME START: 9:40 AM END: 10:00 AM TOWN h~LL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY ~. 'Th£si~lication must be filled in by typewriter OR ink and submitted to the buildi~ ~ ~ i~ L~uec~r with the following: for new building or new use: i. 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 buildi 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 a Ppre-exlsting" 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 applica~ 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-existinR Buildinm - $100.00 3. Copy of Certificate of Occupancy - = .255. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15~00, Commercial $15.00 Date .P!~!PP .............................. X 1 story frame house and shed New Construction ........... Old Or Pre-existing Building ................. Location of Property...~ZS.Ea~mar~ .... M~t~$~gk~..~f. ..................................... House No. Street Hamlet Onwer or Owners of Property.. ~,tl~_k ~.~ ........................... . .................. County Tax Map No lO00, Section.¢i_~ .......... Block..~ ............. Lot..~q,~ ........... Subdivision .................................... Filed Map ............ Lot ................. Permit No ................ Date Of Permit ................ Applicant ........................ Health Dept. Approval .......................... Underwriters Approval .................... Planning Board Approval ........................ ~ / / Request for: Temporary Certificate ........... Final Cert~at~eff..__ ......... ~oo.oo /// ~ S ml,,ed: ............................. " ~ q~ ~ ~ G~R¥ I:I.~NI~£R OE.SEII '~ ~~'~' ......... CONSENT TO " INSPECTION Beulah Ricketts by Gary Flanner 01~en as Attorney , the undersigned, Owner(s) Name(s) do(es) hereby state: That the undersigned (is) (are) tile owner(s) ofthe premises in the Town of Southold located at 725 Farmers Rd. Hattituck, NY · which is shown and designated on the Suffolk County tax map as District 1000, Section 139 , Block 3 , Lot 30.1 That the undersigned (has) (have) filed, 'or caused to be filed, an applica- tion in'th,~ Southold Town lJuxlcling lnsp~,,~ .~ ort~oo to., ~k,, tnllmvin~: One story frame house and shed 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 prexnises comply ~vlth 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 p~ecutions for / / lations o~ the laws· ordinances, rules or regulations/df~th,~Town of Southold. fz~/~''~ ~~// Dated: 14arch 2, 2000 ', ,~'"' ' yignature) Gary Flanner Olsen as attorney .(p. rint ,name) for BeuJ_ah Ric~etts (signature) ~iJ~V~,Y~t: ~'Or~ JX,'J A 'T'"tt. I "T'OWI',4 OF' ~:~Ou'rHOt--ID,, N