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Home My WebLink AboutZ-27074FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 27074 Date: 05/04/00 THIS CERTIFIES that the building DWELLING & ACCESSORIES Location of Property 4690 MILL LANE MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 100 Block 0004 Lot 002.001 Subdivision 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- 27074 dated MAY 4, 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 COVERED PORCH, ONE BARN AND TWO ACCESSORY SHEDS.* The certificate is issued to JOHN SIDOR JR. & ORS TRUSTEES (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. N/A N/A N/A Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 4S90 MILL LANE MATTITUCK SUBDIVISION: MAP NO.: __ LOT (S) -- NAME OF OWNER (S): ~OHN SIDOR JR. & ORS TRUSTEES OCCUPANCY: SINGLE FAMILY ~OHN SIDOR JR. & ORS TRUSTEES ADMITTED BY: ACCOMPANIED BY: KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 100.-4-2.1 SOURCE OF REQUEST: GARY FLANNER OLSEN. ATTY. DATE: 05/04/00 TYPE OF CONSTRUCTION: WOOD FRAME FOUNDATION: BRICK TOTAL ROOMS: IST FLR.: __~ 2ND FLR.: __~ BATEROOM(S): 1.0 TOILET ROOM(S): PORCH TYPE: QQVERED - SIDE OF HOUSE DECK TYPE: BREEZEWAY: FIREPLACE: DOMESTIC HOTWATER: YES TYPE HEATER: OIL TYPE EEAT: OIL WARM AIR: HOTWATER: OTHER: # STORIES: 2.0 # EXITS: 2 CELLAR: PART, CRAWL SPACE: PART 3RD FLR.: ._~ 1.0 UTILITY ROOM(S): -- PATIO TYPE: GARAGE: AIRCONDITIONING: ACCESSORY STRU~S: GARAGE, TYPE OF CONST.: ONE WOOD FRAME STORAGE, TYPE CONST.: TWO SHEDS SWIMMING POOL: GUEST, TYPE CONST.: OTHER: Q~'E LA~E BAR~ VIOLATIONS: LOCATION SHED REAR OF BA~N CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE DESCRIPTION , A~T, ROOFS SHALL BE MAINTAINED IN A WATERTIGHT NYCRR CONDITION. VOL. 9B SEC, 1242.5D DATE ON INSPECTION: 05/02/QQ TIME START: 9:50 AM END: 10:20 AM Bo TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the buildin inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property linea 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 buildJ 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 '~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 applicar If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees i. 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 Buildinm - $100.00 3. Copy of Certificate of Occupancy - 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date April 6, 2000 New Construction ........... Old Or Pre-existing Building~..(~Pf. 2. ~pfy.~rame housy, garage, barn, 2 small access structures) Location of Property..M.ill. Lane,.~attituck,.~Y ........................................... House No. Street Hamlet John Sidor, Jr., Edward Sidor Revocable Trust and Onwer or Owners of Property .... Melem. A,.K~mpski.Ravocah%a .%mu~ ........ . .................. County Tax Map No 1000, Section..)9? ......... Block. 4 .Lot Subdivision .................................... Filed Map ............ Lot ................. Permit No ................ Date Of Permit ................ Applicant ........................ Health Dept. Approval .......................... Underwriters ~roval .................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Cert/~cate ........... oo- .......D/. ' . .<%. . . . : ....... · c. 60 I , FLiC OARY FLANN£R OLSEI M~ Rd. PO Box 708 Cutchop,, NY J~935 O~ 0 :l:: CONSENT TO " iNSPECTION Gary Flanner Olsen, Esq. as attorney for John Sidor, Jr., , the undersigned, O~rner(s) Name(s) Edward Sidor Revocable Trust and Helen A. Krupski Revocable Trust do(es) hereby state: That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at Mill Lane, Mattituck, NY · which is shown and designated on the Suffolk County tax map as District 1000, Section 100 , Block 4 , Lot 2 That the undersigned (has) (have) filed, 'or caused to be filed· an applica- tion in'th,~ Southold Town ]3ull(ling lnsp~uL,,~ .~ or£[e, £o,. +h,~ fn]io%vinf: Two story frame house, ~ara~e, ,barn, two small access structures 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 laws0 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 maybe used as evidence in subsequent/~pm cutions for lations o~ the lawso ordinances· rules or regulations o~/~o~vn of Southold. /// April 6, 2000 ~.._------._~._ Dated: /~/ ,~si~f~tur e) Gary Flanner 01sen (print name) (signature) AT