HomeMy WebLinkAboutZ-24759FORM NO. 4
TOWN OF SOUTBOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
C~diTIFICATEOFOCCUPANCY
No Z-24759
Date NOVEMBER 20, 1996
THIS CERTIFIES that the buildin~
Location of Property 215 ~DAY AVENUE
House No.
County Tax Map No. 1000 Section 113
Subdivision
ONE FAMILY DWRT.r. ING
MA'i-iq:TUCK, N.Y.
Street Hamlet
Block 8 Lot
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-24759 dated NOVEMBER 20, 1996
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 *
The certificate is issued to RICHARD & CAT~i~RINE ROMANCZYK
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N/A
N/A
SEE ATTAc~ED INSPECTION REPORT.
.,.... or
Rev. 1/81
LOCATION:
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
215 MEDAY AVENUE MATTITUCK, N.Y.
(number & street) (municipality)
SUBDIVISION MAP NO. LOT(s )
NAME OF OWNER (s) Richard & Catherine Romanczyk
A-1 Res.
(type)
Joan Whelan
RICHARD & CATHERINE ROMANCZYK
OCCUPANCY
ADMITTED BY:
KEY AVAILABLE
SOURCE OF REQUEST:
Owner
(owner-tenant)
ACCOMPANIED BY:SAME
SUFF.CO. TAX MAP NO. 1000-113-08-11
DATE:o~CT. 23,
1996
DWELLING:
TYPE OF CONSTRUCTION
FOUNDATION CEMENT BLOCK
TOTAL ROOMS:
BATHROOM ( s )
PORCU TYPE FRONT COVERED
BREEZEWAY
DOMESTIC HOTWATER yes
TYPE IIEAT OIL
OTI1ER:
WOOD FRAME
CELLAR F~ll
IST FLR. 4 2ND FLR. 2
ONE TOILET ROOM (s)
FIREPLACE
TYPE HEATER
WARM AIR
3RD FLR.
BECK, TYPE
NONE
propane
~ STORIES 1-1/2 ~ EXITS 2
CRAWL SPACE
UTILITY ROOM
PATIO
GARAGE 1-1/2 CAR GARAGE
AIRCONDITIONING
IIOTWATER
CENTRAL AIR
ACCESSORY STRUCTURES: NONE
GARAGE, TYPE OF CONST.
SWIMMING POOL
OTHER:
STORAGE, TYPE CONST.
, GUEST, TYPE CONST.
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
REMARKS:_ bp 54703 - CO ~,-2475R
GAj~ J// FISH
DATE OF INSPECTION OCT. 29, 1996
TIME START 10:00 END 10:15
This appllcacion must be filled in by typewriter OR ink and submitted to the building
inspector with the following: for new building or new use:
Final curve7 of properu7 with accurate location of ai! buildings, properu7 lines,
streets, and unusual aacurai or topographic features.
2. Final Approval from Health Dept. of water supp!7 and sewerage-disposa!(S-9 form).
3. Approval of a!ec:rica! insua!!acion from 3oard of Fire Unde~ariters.
4. Sworn statement from plumber certifying that :he solder used in system ,:oncain~
less than 2/!0 of I% lead.
Commercial building, industrial building, muinipie residences and similar buildings
and-insta!iacions, a cermificaua of Code Compliance from architect or eugineer
responsible for Uhe building.
Submit Planning Board Approval o'f completad siua plan requirements.
For existing buildings (prior ua April 9, 1957) non-conforming uses, or buildings and
"pre-existing" land uses:
l. Accurate su~zey of property showing ali property lines, streets, building and
unusual natural or ~opographic features.
2. A properly completed applicauion and a consent to inspect signed by ~he applicanu.
if a Carti£icaua of Occupancy is denied, the Building inspector shall state the
re'sons therefor in ~ining to ~he applicanm.
C. Fees
!. Certificate of Occupancy - Mew dwelling £25.00, Additions :o dwelling S25.00,
Alzerauions co dwelling $25.00, Swimming pool S25.00, Accessory building
Addi[ions co accesso~z building $25.00. Businesses $50.00.
oO Cartificana of Occupancy on ?re-~xisc~n~ ~ui!dinm - $t00.00
· Copy of Certificate of 0ccupanc7 - .
4. Updated Certificate of Occupanc7 - $50.00
5. Temporary Certificate of Occupancy - Rasidenmial $~5.00, Commercial
New Construction ........... 01d Or Pre-existing SuildinE .................
Eouse lo Street ~a~ac
O~r or O~ers of Proper~ ............................................................
O//,
.................................... .... o=.00 .........
~e~5~h Dept. Appr~va5 .......................... Unde~rS:ar~ Approve5 .........................
Planning Board Approval ........................ /
_Request for: Te.Ln~orarv Cer:i£icaze ........... ~2~& Ga::&o&s~ ...........
................. / i
CONSENT
TO
IN, I I~,C I ION
the undersigned,
Ox~mer (s) Name(s)
do(es) her'eby state:
That the undersigned (is) (are) the owner(s) oE the premises in the I(wn
f;ou,il.y tax map as District 100{I. Section/_(..3_.._~_0_. Block ~
That the undersigned (has) (have) filed, or caused to be filed, an applica-
tion in the Southold To~m Building [nspectm"s Office for the following: _.~
l
That the undersigned do(cs) hereby give consent to the Building Inspector.,;
of Ibc l'own of Soathold 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 dc. termine that said premises comply with all of the laws, ordinances, rules
and regulations of the. ']'own of Southold.
The undersigned, in consenting to such inspactions, do(es) so with the
knowledge and understanding that any information obtained in the conduct of
such in:spections may be. nsed as evidence in subsequent prosecutions for
rations of the laws, ordinances, rules or regulations of the Town of $outhold.
(signature) //
(print name)
/ /i/i
(point name)