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Home My WebLink AboutZ-20271FORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-20271 Date OCTOBER 9~ 1991 THIS CERTIFIES that the building. Location of Property 1155 BUNGALOW LANE House No. County Tax Map No. 1000 Section 123 Subdivision ONE FAMILY DWELLING Street Block 3 Filed Map No. MATTITUCK{ N.Y. Hamlet Lot 17 Lot No. conforms substantially to the Requirements for a One Family Dwelling built Prior to: APRIL 9r 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-20271 dated OCTOBER 9~ 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 DWFJ.LING WITH ATTAC~W~ TWO CAR GARAGE * The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *Pr~ASE SEE ATTACMRn INSPECTION REPORT. Rev. 1/81 ESTATE OF ELLRN STEIGERWAI~ "Bui~ldi~JgInspector Location BUILDI['[G DEP~LRT[.~iT · T0';~%r OF SOUTHOLD, N. Y. HOUSI~$G CODE IHSPECTION REPORT 1155 BIJ[IC~ ~ MA~IT~CK, N.Y. [number & streeT) Subdivision ~[ap No. Nmme of Owner(s) ESTATE OF ELaN S~IGEI~/AL~ Occupancy A-I Res. O~NER (i,iunlcipal ity ) Lot(s) [type) A~mitted by: JOA~q~ESTEICEa~ (owner-renanv) Accompanied by: S~ME Key available Suffolk Co. Tax No. 123-3-17 Source of request STE~EN A. Date 9/11/91 MOOD D%'FELLI~G: Type of construction Foundation CEME~ Cellar FDLL Total rooms, 1st. F1 2nd. F1 2 Bathroom(s) ONE F~LL ~Ar~ Toilet room(s) Porch, type Deck, type Breezeway Garage 2 cA~ Type Heat OIL 'Warm Air xx Fireplace(s) ONE No. F~it s 2 Domestic hotwater ~Es ,Type heater Other WALK IN P~N'I'KY, $~N~OOM, ATI:ACNED SHED #stories I-I/2 Crawl space -- 3rd. Fi Patio, Utility room Hotwater Airconditionin~ type BLOCK OIL ACCESSORY STRUCTURES: Garage, type const. Swimming pool Other Storage, type'const. Guest, type const. VIOLATIONS: Location .C~APTER 45--N.¥. STATE UNIFOI~M FIRE PREVENTION & BUILDING CODE Description t Art. I Sec. Remarks: BP [11393-Z CO Z-10917 FOR DECK ADD. BP [20180Z FOR BATHROOM ON 2ND FLOOR, Inspected by: . Date of Insp. SEFr. 20, 1991 'Time start 9:25 end 9:45 Ao Bo Form No. 6 TO~ OF SOUTHOLD ~ BUILDING DEP~TMENT ~PLICATION FOR CERTIFICATE OF OCCUPANCY 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. 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. 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 Buildin~ - $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 $15.00 New Construction ........... Old Or Pre-existing Building .... ~ .......... Location of Property.¢$~,DDD~g~PW.%~q9 ......................... ~%~%%qq~ .................... House No. Street Hamlet Onwer or Owners of Property...~P~9~.9~;~9.~%~(~9!~ .................................... County Tax Map No 1000, Section.~ .......... Block..~ ............. 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...Y.e.s. ..... Fee Submitted: $...1.0.0:.0.0 ..................... . .~. ?~ .~..~~~ ......... CONSENT TO INSPECTION Estate of-Ellen Steigerwald Owner(s) Name(s) do(es) hereby state: SiP 16 YO¢'~", ,z · the undersigned. That the undersigned (is) (are) the owner(s) of the premises in thc Town of Southold located atl155 Bungalow Lane, Mattituck, N.Y. which is shoxvn and designated on the Suffolk County tax map as District 100O, Section 123 , Block 3 , Lot 17 That the undersigned (has) (have) filed, or caused to be filed, an applica- tion in the Southcld Town Building Inspector's Office for the following: Certificate of Occupancy for Pre-existing Buildin~ 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. " (print nJ~e) f (siRnature) (print name)