The URL can be used to link to this page

Home My WebLink AboutZ-15129FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building One family dwelling. . Location of Property 15505 MA'IN ROAD ' MATTITUCK House No. Street Hamlet County Tax Map No. ]000 Section . J .].4. ....... Block ...0.6 ........... Lot .... .0.4. ......... Subdivision ............................... Filed Map No ......... Lot No .............. REQU R M N S F ~ P.RI.V. ATF~ O~IE..~.AMILY .p~4EL.LI~NG J~.U~L.T..P. RIg~ TO.. CERTIFICATE OF OCCUPANCY Z15129 .... .~p.r.i 1....2.3. ...... ,19 5. .7. pursuant to which ]~~Xls~k~.X .X.X.X.X.X..X .............. dated ...9 E..C.E.M.B. ~..R..2.4. ............ 19.8..6, 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 ......... .9.n.e..~.a.m.i.l.y dwelling and small wood storalge buildinig. The certificate is issued to ...S.U.S.~..N..R. qA..C~.E. .......................................... (owner, le¥ __ffg,~t of the aforesaid building. Suffolk County Department of Health Approval ........ i I~.LA ............................. UNDERWRITERS CERTIFICATE NO ................. 1~./.-~ ............................. SEE ATTACHED INSPECTION REPORT Building Inspector Rev, 1/81 Location BUILDING DEPARTmeNT TOI'~ OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT 15505 MAIN ROAD MATTITUCK (numDer & streeT) Subdivision Nmme of Owner(s) SUSAN ROACHE Map No. (Municipality Lot(s) Occupancy A~mitted by: R-l (type) SUSAN ROAC~ OWNER (owner-tenan~ Accompanied by: SA~E Key available Suffolk Co. Tax No. Source of request SUSAN ROACHE ]]4-06-04 Date 12/2]/86 D~'~LLIMG: Type of construction Foundation BRICK Total rooms, 1st. F1 Bathroom(s) ~ Porch, type Breezewa~ Type Heat gas Fireplace(s) Domestic hotwater yes Other WOOD FRAMED #stories 2 Cellar PARTIAL Crawl space REST 2nd. F1 4 3rd. F1 Toilet room(s) Deck, typ% Garage 'Warm Air No. ~xits 4 Type heater Patio, type_ Utility room Hotwater xx Aircondition~ng gas ACCESSORY STRUCTURES: Garage, type const. Swimming pool Other Storage, type const, wood-small Guest, type const. VIOLATIONS: Location DWELLING HAS THREE SMOKE DETECTORS Housing Code, Chapter 45·N.Y. Stat¢.~iform~Fire Prevention & BuzA~lnq Come Description Art. t Sec. Remarks: NO VIOLATIONS WERE FOUND? CURTIS W. HORTON 'Time start 9:30 end FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A, This application must be filled in typewriter OR ink, and submitted I~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of properW with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. . For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of pzoperty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to Prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existinq dwellin.q 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5. Updated C.O. $15.00 NewConstruction ...... Old or Pre-existing Building . .../~ ..... Vacant Land ............. Location of Property ~).,~.~.,~P'~.(~. ~"'. ..... House No. ~ ~ Street Hamlet Owner or Owners of Property ~.. ~ .~...../~'~. ~:::~.,~.~-~ ~'...~.~"...~. .................... County Tax Map No. lOOOSection ...//..~. .... Block .... '.~....~. ..... Lot...i.O...~. ...... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Tempof Certificate ..................... Final Certificate ....................... Fee Submitted Construction on above described buildi~~ ~t meets all applic~de~l~n~g~ulations. CONSENT TO INSPECTION wner(s) Name~) ~ · the undersigned. do(es) hereby state: That the undersigned (is) f-~kthe owner(~-) of the premises in the Tox~rn of Southoldlocated at z/~.~--~_~--~ ~"~(f)x~ _~ County tax map as District 1000, Section // ~, Block O ¢ , Lot~ ~ That the undersigned (has) (1~,~ filed, or caused to be filed, an applica- tiT~rn~e Southold Town Building Inspector's Office for the following: ___ Th. at the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above deserFoed property, including any and all buildings located thereon, to conduct such inspections as ~hey may deem necessary with respect to the aforesaid application, ~clud~g inspections to determine that said premises comply with ail of the laws, ordinances, rules and r%~ulalions of the Town of Southold. The undersigned, in consenting to such ~sp~etions, do(es) so x~!h the knowledge and understanding that any information obtained in the conduct of such inspections may be used as evidence in subsequent prosecutions for ~lo- lations of the laws, ordinance,, rules or regulations of the Town o~uthold. - (print ~a~e) (si.~nature) (print name)