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Home My WebLink AboutZ-25804FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 25804 Date: 06/29/98 THIS CERTIFIES that the building DWELLING Location of Property 965 BUNGALOW LA MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 123 Block 0003 Lot 012.001 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- 25804 dated .TUNE 29, 1998 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 SEASONAL DWELLING WITH ACCESSORY GARAGE* The certificate is issued to FRANCES SMITH (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. r Buil ng inspeaeor Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD LOCATION: 965 BUNGALOW LA MATTITUCK SUBDIVISION: MAP NO.: LOT (S) NAME OF OWNER (S): FRANCES SMITH OCCUPANCY: SINGLE FAMILY FRANCES SMITH ADMITTED BY: FRANCES SMITH ACCOMPANIED BY: FRED SMITH KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 123.-3-12.1 SOURCE OF REQUEST: FRED C. SMITH - 12/3/97 DATE: 06/29/98 TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 1.0 # EXITS: 2 FOUNDATION: CONCRETE BLOCK & WOOD PIERS CELLAR: TOTAL ROOMS: 1ST FLR.: -1 BATHROOM(S): 1.0 2ND FLR.: _Q TOILET ROOM(S): 1.0 PORCH TYPE: COVERED -ENCLOSED (2) DECK TYPE: BREEZEWAY: FIREPLACE: CRAWL SPACE: 3RD FLR.: UTILITY ROOM(S): _ GARAGE: PATIO TYPE: CONCRETE DOMESTIC HOTWATER: L.P. GAS TYPE HEATER: L.P. GAS AIRCONDITIONING: TYPE HEAT: ELECTRIC• WARM AIR: HOTWATER: YES GARAGE, TYPE OF CONST.: WOOD FRAME STORAGE, TYPE CONST.: WOOD FRAME(ADD TO GARAGE) SWIMMING POOL: OTHER: GUEST, TYPE CONST.: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE REMARKS: INSPECTED BY: DATE ON INSPECTION: 01/07/98 MICHAEL J. VERITY TIME START: 10:25 END: 11.20 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 OF, 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 17 lead. D. 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 Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building 325.00, 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 - .254�. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial 315.00 Date .:!.�o-oxi6oe 3� . I <, -7 .. . New Construction...... Q... Old Or Pre-existing Building.....!`..) Location of Property...! `...............�16'1�c �rt!uc, ; ........... L�if Z ?! �uCIL..... . House No. Street Hamlet Q Onwer or Owners of Property....o.' !Ln.C'e- ..W.`..971N/ �..Cr.�fSe �' ..... Uw..tFf i�c;Cvt�✓C County Tax Map No 1000, Section...` 3."......Black..... .......... Lat..l.� '................ Subdivision... f//�iX212 9 wok<� J J�?� .........Filed Sap.�!`".v4t`...Lot.. p,W......... Permit No... J.! ........Date Of Permit.../!........Applicant... s�/:f..../................ Health Dept. Approval.... N/i{................Underwriters Approval..... �!1.R.............. Planning Board Approval... &/A ............... Request for: Temporary Certificate... '. Final Corticate....... Fee Submitted: $.��........................ - ..... .. . "� APPLICANT CONSENT TO INSPECTION wner(s) tvame(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 96 which is shown and designated on the Suffolk County tax map as District 1000, Section %.23, 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: r n - n c vf*4 J c e rTi1 t l( t -S -'s- -7 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,'frules 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: /2-3- S7 (sign ure) 'es rn zi — r �t ^ yet CJ . &;4f, try (print name) signature (print name) FMS 19 FILED: 7 May, 1914 TM 1000-123-03-0012.1 SURVEYED: 28 October, 1997 SCALE. 1"=40' AREA= 13,858.24 SF OR 0.318 ACRES 4' Mride Mood th S 46'40'10' E 23.45' c;�k "� ) 19W 02' DEEP HOLE CREEK S 8137'29" E 37.46' t/H.W.L. f. p '.,• 1 ' Rester P/O � ,�t, LPT 9 LOT 9 oa y cceesspoatK k Overhead Fr�'f1e Elea. Svice. '�J 6 LOT 10 h 17?07 fo Mp ow N Awe 3%'3g•.r Guarantees indicated here on shall run to the for the only person whom survey BU�40• CM is prepared, and on his behalf to the %sAiO �y''//''Z %'y title ccmpcny, Govermental Agency, if listed hereon, /��, �/',Ve 'cndino inst;tution, and tc the assignees of the lending institution. Guarantees are nct trans'.eroble to additional institutions cr s,bsaquent owners. SURVEY OF - LOT g Unauthorized Unauthorized alteration or addition to this survey is a violation of Section 7209 a IN the i\ew lbrk State Education Law. PLAN OF MARR4TOOKA PARK SITUATE apses of this survey map not b- Ing MATTITUCK, TOWN OF SOUTHHOLD the Land Surveyors emboss -d seal shall not be considered to be true SUFFOLK COUNTY, NEW YORK a valid copy, SURVEYED FOR: ALAN A. SMITH SURVEYED By - STANLEY J. ISAKSEN, Jr. FREDRICK C. SMITH 1Y FRANCES SMITH P.O. BOX 294 GARANTEED TO: New Suffolk, N.Y. 1195(yj' Alan A. Smith 1 —734-5 5 Fredrick C. Smith 1!1 Frances Smith Town of Southhold Licens Land S or NYS. No. 49 3 97R656 LOCATION: 4511t�l number &- SUBDIVISION NAME OF OWNER (s) OCCUPANCY C. type ADMITTED BY: KEY AVAILABLE SOURCE OF REQUEST: DUILUINU UL'YAKIMNI TOWN OF SOUTHOLD SING CODE INSPECT ON REPORT sWreet) ' .(municipality MAP NO, LOT (s) J towner -tenant) ACCOMPANIED BY:�'C SUFF . CO. TAR MAP NO. 12 — /2. /_ DATE: 7 DWELLING: TYPE OF CONSTRUCTION Com"` # STORIES # E%ITS FOUNDATION (%Q2.[l� CELLAR CRAWL SPACE TOTAL ROOMS: IST FLR. 2ND FLR. 3RD FIR. BATHROOM (s) / TOILET ROOM (s) UTILITY ROOM —' PORCH TYPE �Is�DECK, TYPE PATIO, TYPE BREEZEWAY // FIREPLACE GARAGE DOMESTIC HOTWATER d..P TYPE HEATER .z AIRCONDITIONING TYPE HEAT_ %%L6 WARM AIR HOTWATER OTHER: I vAi, i,",, ) ACCESSORY STRUCTURES: r GARAGE, TYPE OF CONST. STORAGE, TYPE CONST. SWIMMING POOL GUEST, TYPE CONST. OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION b BUILDING CODE LOCATION REMARKS: INSPECTED BY: DESCRIPTION ter/ ART. I SEC. T, i6 14 DATE ON INSPECTION / 7 S TIME START �(J =Z� END Z3