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Home My WebLink AboutZ-19895FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-19895 Date MAY 6, 1991 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 1790 DEEP HOLE DRIVE MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 123 Block 4 Lot 1 Subdivision Filed Map No. Lot No. conforms substantially to the requirements for a Private One Family Dwelling built prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF OCC. #Z-19895 dated MAY 6, 1991 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 GARAGE & ACCY TOOL SHED * The certificate is issued to JOHN SAWICKI, JR. (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. Ming Inspector Rev. 1/81 BUIL _.G DEP^,RT:L:iT TO;PL,r OF SOUTHOLD, N. Y. HOUSI:JG CODs, INSPECTION REPORT Location 1790 DEEP HOLE DRIVE MATTITUCK, N.Y. �numoer be street) �i,tunicipalitiy) Subdivision Map No. Lots-) Name of Owner(s) JOHN SAWICKI, JR. Occupancy ONE FAMILY DWELLING (type) owner -tenant) Admitted by: OCCUPANT Accompanied by: OCCUPANT Key available Suffolk Co. Tax 110. 1000-123-4-1 Source of request OWNER REQUEST Date D?•IELLI`1G : May 6, 1991 Type of construction WOOD CONSTRUCTION rrstories Foundation BLOCK Cellar Crawl space Total rooms, lst. Fl 5 2nd. F1 3rd. F1^ Bathroom(s) 2 Toilet room(s) Porch, type Deck, type WOOD Patio, type Breezeway ENCLOSED Garage x Utility room x Type Heat OIL Warm Air Hotwater OIL Fireplace(s) xx No. E:cits # SEPARATE Airconditioning Domestic hotwater _Type heater Other I ACCESSORY STRUCTURE'S: Garage, type const. Storage, type const. TOOL SM Swimming pool Guest, type const. Other BULKHEAD VIOLATIONS: CHAPTER 45—N.Y. STATE UNIFORM FIRE PREVENTION 5 BUILDING CODE Remarks: BP#Z1484/COZ-1102(garage add.), BP #4831Z/COZ-3907 (bedroom Add) By-yfftfu 14j, --p Property in 9MY 600d ccy or g Inspected by: ej re *-L Date of Insp. May 6, 1991 Victor Lessard Time start 10'02 end 10:38 shape. Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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. B. 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 ...Q ......!............................. New Construction....... ¢¢.. Old Or Pre-existing uilding.....��..... Location of Property.00............. r J ... ........... House No. Street Hamlet Onwer or Owners of Property.. �,l��s:"�. Y:.4w;Ci///. ......�.//.................................. . County Tax Map No 1000, Section.. ��......Block....:7...........Lot....l ................ Subdivision....................................Filed Map ............ �Lot ...... .//... L'ermit No................Date Of Permit, ............... Applicad nt+il l�!EI/ I./. / iealth Dept. Approval..........................Underwriters Approval......................... Tanning Board Approval ........................ tequest for: Temporary Certificate........... Final Corticate........... Cee Submitted: $............................. 2G, N G3� APPLICANT. ... .... CONSENT TO INSPECTION Owner(s) Namc(s do(es) hereby state: the undersigned, That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at which is shown and designated on the Suffolk County tax map as District 1000, Section_, Block_, Lot That the undersigned (has) (have) filed, or caused to be filed, an applica- tion in the Southold Town Building Inspector's Office for the following: 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 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: S•— 4 (sig, n/ atu�re) W'/ rr(-'-e<4-' (print name) (signature) (print name) /0 oD - /.)3- 41-,l TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET VILLAGE DISTRICT — LOT /lA"—% 1 7-0,c. 'FORMER OWNERN �, v ACREAGE I IfHIVCNM S�D f w �'� S l� %9) 1yENN['LLyts�� W &t4 TYPE OF BUILDING RES. �O SEAS. VL. FARM COMM. -i I IND. I CB. I MISC. I Est. Mkt. Value LAND IMP. TOTAL DATE REMARKS 1-4 7 _ ^ S -� 3 SU G �f�3on �!�./�igyeo Ga'v pct - G O Z, CT 1�G0 30� �a'D D r% ,2 3° 76 3 z 2 a o 6 0 0 V 7 03 d o✓ 7-3 /613oD 000. T ScWm or i we jo . L 7 SAwieKi, — P aiJ AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FRONTAGE ON WATER /Q 0 �'- 6 = /�d0 Form Acre Value Per Acre Value FRONTAGE ON ROAD /Qp Tillable I BULKHEAD L Oct/ (W " Tillable 2 DOCK 3 y 31 Tillable 3 - Z/ Woodland Swampland Brus nv- r House Plot Total a M. Bldg.- — y x IY a`� b C D' Foundation Both j ( , Extension i Basement I 1 r Floors Extension Ext. Walls /f/lii AK Interior Finish Extension i Fire Place b Heat l I Porch { Roof Type DC X M. Bldg.- — y x IY a`� b C D' Foundation Both j ( , Extension ! Basement I 1 r Floors Extension Ext. Walls /f/lii AK Interior Finish Extension Fire Place b Heat Porch x b Roof Type DC X Porch Rooms 1st Floor Breezeway, 67 Patio Rooms 2nd:Floor Garage '� Y��Y ZSR Driveway Driveway Dormer o. B. ,� ,x 9 S SO 22 BUILDI_•:G DEPART:•IEiiT T0:•1N OF SOUTHOLD, N. Y. HOUSIi:G CODE INSPE CTION REPORT Location ) i 9 0 I �.e,p kntmoer do s ree-t Subdivision Name of Owner(s) 1nicipaiity) Map No. Lot (s ) Occupancy 1n_1" \"111\ \t_hX 2't- � (type)0 ' owner-tenan-t) Admitted by: p e c.c.s �,.�( Accompanied by: Key available o e c•�,vi2-wd Suffolk Co. Tax No. Source of request p Date MIELLING . Type of construction JL vs-tories— Foundation Cellar Crawl space_ Total rooms, lst. F1 S 2nd. F1 3rd. Fl Bathroom(s) a. Toilet room(s). Porch, type � Deck, type Patio type_ Breezeaay,Zgy�,( Garage XUtility room_ p� Type Heat p, ( Warm Air --- Hotwater o� � Fireplace(s)_No. Mc, ts- 3 Airconditioning Domestic hotwater Ot)L Type heater Other ACCESSORY STRUCTURES: Garage, type const. Storage type const. Swimming pool Q Guest, type const. Other 13.1,,9 ,%L, VIOLATIONS: CHAPTER 45—N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE Remarks: 14 Inspected by:N ,e4�'1 _... Date sof Insp. 0 Sj('0 q I Time start 0:v i end J o: 3'2