HomeMy WebLinkAboutZ-24479FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
FICATE OF OCCUPANCY
No Z-24479
THIS CERTIFIES that the build
Date JULY 3, 1996
ONE FAMILY DWELLING
Location of Property 2445 LAUREL WAY (PVT. RD. #18) MATTITUCK, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section
Subdivision
121 Block 4
Filed Map No.
Lot 7.1
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-24479 dated JULY 3, 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 WITH ACCESSORY GARAGE *
The certificate is issued to BARBARA B. SAYRE
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
Bu' ding Inspector
Rev. 1/81
111111MINC DEVAlt'1'F1EN't'
TOWN OF SOUTHOLD
HOUSING CODI± INSPN.CTION 1(E1,011T
LOCATION: 2445 PRIVATE ROAD 1118 MATTITUCK, N.Y.
(number t: rsCreel j _-- (nnnUc�pnI ICY
SUHOIVI'S
u)N-----------------F1nP No. l.o'T(A)-------
NANE, OF OWUltlt (rs) BARBARA SAY"
OCCHI'AlWY A -I RES. OWNER
------ (-ypej--------------- -------ow ner- —Ce nen_L7 J--------------..._._
AUHI7"TU) BY! BARBARA SAYRE ACCOMPANIED IIY:
KEY AVAl1.Alll.i -- FIAl' NO. 1000-121-4-7.1
SOIIItCI? OF RRQIIES'T: BARBARA SAYRE DATE. JUNE 25, 1996
rfaRi- iris
TYPE OF CONSITUCTION WOOD FRAME I STORIES 1-1/2 / ISX1'1'S 3
FOUNDATION CONCRETE CELLAI( POLL GRAW1. SPACE
TOI'AI, t(OONS: IS'r PI.R, 2 2ND PLR. 3 310n Fill(.
ONE 11'1' 1 I Il'Y ROOM WASHER h DRYER
IIA I IIRO(1M (rs) 2 10 1. , 1 ROOFI
e
PORCH 'I'Yt'F.--_FRONT COVERED—.---------�-
IIE(;K,
TYPR--------, PATIO-----
IIIO-,,rZ.WAY
171RETLACE
GARAGE ONE CAR
D(IF1R5,11C. 110TWATER YES
TYPE IIEATEI(
ELEC.
d SOLAR At)(CONDI'TIONING
TYPE IIIiA'1--_Q-_.--,---_ --
WARN Alit
NOTWATEI(
01111i1t: LOWER LEVEL REC.
ROOM
ACCESSORY STRUCI(11(ES:
GARAGE, 'TYPE Or CONST
SWIHFIING P001.
O'I'l lull
CEMENT BLOCK 2 CAR_ 81'ORAGE, 'I'YPR cotrs'r.
'---J- GUH.S1',CONS'I'-
----------------------------------------
VLOLA'TLONS: CNAI'7T.R 45 N.Y. STATE1 I1NLIt01(FI 1'111P. VREVRNTION 6 E1111,1)ING CODE.
.00AIION UESCIU.1''l'lON ARI. SIiC,
REHARK S : BP 14772 - CO Z-4499
- ------ -- -- -- — --- — - -- - -- — -- - --- -- - — --
1NSPEc:rliD Rv --�// DATE or IN,PEc"rroFl JULY 1, 1996
-- ----"moi --
GARY SH I'IFIE S'I'Alt't' 10: 15 ENO --10:35
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:
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 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 Buildine - $100 00
3. Copy of Certificate of Occupancy - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $1.5.00, Commercial $15.00
Date
New Construction........... Old O�rf�,Pre-existing Building
�.F...!��............ I
Location of Property...... �yI. ....... : C W.. ! :it e44 �tc�. { �d�.... /)I ......
House No. Street
LL Hamlet
Onwer or Owners of Property....!3gle.... ...5 .1` .....................................
County Tax Map No 1000, Section ..... !..... Block ....... i ....... 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...........
Fee Submitted: $14,4. •. Q40 ...............
I�R,JL< • s ►s6
��_:?_(ygVI
.......yam.. ... ...... .........
APPLICANT
CON,9E NT
TO
INSPECTION
.5kY2 6
Owner(s) n'ame(s
do(es) hereby state:
the undersigned,
That the undersigned (is) (a/re) the owner(s) of the premises in the Town
of nSouthold located attold c\att 4, Czd�[
'( IV j which is shown and designated on the Suffolk ��JJ
County tax: map as District 1000, Section_, Block 4 , Lot %,/
That the undersigned (has) (have) filed, or caused to be filed, an applica-
tion in the Southold Toxin 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
kno:cledge 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:
(signature)
BARa,M.Q- a- Ekto?r
(print name)
(signature
print name)
r
.TOWN OF SOUTHOLD
PROPERTY
RECORD CARD
,4 _
OWNER
STREET _ = 1
VILLAGE
DIST. SUB. LOT
rpr-
FORMER OWNER
1%t
N
E
c,
ACR. -
S
W
I � ML�C�o/ei -a Hc.I
TYPE OF BUILDING
- -
RES. 20 j
LAND
SEAS.
IMP.
VL.
TOTAL
FARM
DATE
COMM. CB. MICS. Mkt. Value
REMARKS '
J i
L-) beY j
,J
e
I _
I
_
-AG E
BUILDING CONDITION
NEW
NORMAL
BELOW ABOVE
FARM
Acre
Value Per
Acre
Value
Viable
FRONTAGE ON WATER
Woodland
!
FRONTAGE ON ROAD
Meadowland
DEPTH
House Plot
BULKHEAD
otI
Total
DOCK
n
1V%. Diag.
Extension
Extension
/s'� /
n
��'� - e'� 9
I
2 I I 1
I
� .3.—ic 27�n � I
Extension
rs-N,K�
Al j7
Foundation
Bath
Dinette
Porch
i Basement
Floors
CCK
j K.
Porch
r�`�
i1 X y �z
; 5L !~ 'Ext. Walls
az_
w s i�.
Interior Finish
s, �- LR.
Breezeway
j jFire Place
Heat
DR.
Garage
! 5`
.� i� B
�.� - jType Roof
4 �r <'
Rooms 1st Floor
BR.
Patio
!Recreation Room
Rooms 2nd Floor
FIN. B
0. B.
bormer
j Driveway
Total-
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I i
I
i
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UnswilhedeeAeller— Mt
to Oft survey b s sbYtlee d
Section 7208 of Ifie fele lbrkay8
Education Lees.
Copies of this survey map not bell
the tend surveyors hoed Mal or
embossed seal shall not be conddand
to be a valid true copy.
G.amnteos indicated hereon eha0 w
ONY M1: the person for whom the survey
C Fr -,.ion his behalfto dre
:-matentatagancyind
s: -,d hereon and
,o lending Ies14
are not transferable
- ..-:.miiwls w sabNQuard
W ers
�J t- E t � Y ASC f1 M i' I CCU ` 7,1
_—..-- . _ __... _
TITLE J�4 ;ZH95-1139
St1t�V�.YEO�F�6 26, t
MAP AMt iW[) - NCYN.9 1%5
JAN,8,0�96
GU2&ufTffP.. �'_
of
P GKVq,V�GO9
wC
fir Ar
m o� _
SAND J� LIC LANG, :UkVf `l��C� - .: f�twf htf='Cit;.'!,�la�_
fry.-.
i,
�i
i'
UnswilhedeeAeller— Mt
to Oft survey b s sbYtlee d
Section 7208 of Ifie fele lbrkay8
Education Lees.
Copies of this survey map not bell
the tend surveyors hoed Mal or
embossed seal shall not be conddand
to be a valid true copy.
G.amnteos indicated hereon eha0 w
ONY M1: the person for whom the survey
C Fr -,.ion his behalfto dre
:-matentatagancyind
s: -,d hereon and
,o lending Ies14
are not transferable
- ..-:.miiwls w sabNQuard
W ers
�J t- E t � Y ASC f1 M i' I CCU ` 7,1
_—..-- . _ __... _
TITLE J�4 ;ZH95-1139
St1t�V�.YEO�F�6 26, t
MAP AMt iW[) - NCYN.9 1%5
JAN,8,0�96
GU2&ufTffP.. �'_
of
P GKVq,V�GO9
wC
fir Ar
m o� _
SAND J� LIC LANG, :UkVf `l��C� - .: f�twf htf='Cit;.'!,�la�_
fry.-.
BUILDING DEPARPME-NT
TOWN OF SOUTHOLD
HOUSING CODE INSPIiCTION REPORT
LOCATION:
number h street
SUBDIVISION
NAME OF OWNER (s)
OCCUPA
HA I' NO
mu�xicipality
LOT
NCY jv I f -lLj'
type)
(�` — (owner—tenant)
ADMIT—FED BY: VI ACCOaPANIEI) BY:
KEY AVAILABLE SIIFF. CO_ TAX MAP NO
SOUr,;:,-. OF REQUEST:
DWELLING:
TYPE OF CONSTRUCTION /.
FOUNDATION
• STORIES � � 0 EMITS
-
CELLAR CRAI-IL SPACE
TOTAL ROOMS: IST FLR. 2ND FLR_ `j 3RD FLR-
BATHROOM (s) � � TOILET ROOH (s) a�w_ UTILITY ROOM
PORCH TYPE �,Q �
�,z DECK, TYPE PATIO, TYPE -�
BREEZEWAY -------
FIREPLACE (%nom
DOMESTIC HOTWATER kf
TYPE BEAT
GARAGE V -'Q uc,
TYPE HEATER LA,4. AIRCONDITIONING_ -
WARti AIR ROIT-IATER .�
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST. STORAGE, TYPE CONST.
SWU[MING POOL GUEST, . TYPE CONST.
OTHER:
VIOLATIOINS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION
REMARKS: IJr�
INSPECTED BY:
DESCRIPTION
ART. I SEC.
UA'I•I: ONtop
IP1.`iPECI'ION
TIME START