HomeMy WebLinkAboutZ-26755 FORM NO. 4
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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 26755 Date: 10/27/99
THIS CERTIFIES that the building ACCESSORY
Location of Property 355 HOBSON DR LAUREL
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 122 Block 0006 Lot 025
Subdivision Filed Map No. Lot No.
conforms substantially to the Requirements for a ACOESSOff SMCTM
built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z- 26755 dated OCTOBER 27, 1999
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 ACCESSORY NON-HABITABLE GARAGE
The certificate is issued to WILLIAM WYCHE
(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.
ldir14
Inspector
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 355 HOBSON DR LAUREL
SUBDIVISION: MAP NO.: LOT (S)
NAME OF OWNER (S) : WILLIAM WYCHE
OCCUPANCY: A-1 RESIDENTIAL WILLIAM WYCHE
ADMITTED BY: SET.F ACCOMPANIED BY:
KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 122 -6-25
SOURCE OF REQUEST: ABGAIL WICKHAM ATTY DATE: 10/27/99
DWELLING:
TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 1.0 # EXITS: 2
FOUNDATION: CEMENT CELLAR: CRAWL SPACE:
TOTAL ROOMS: 1ST FLR.: 2 2ND FLR. : 0 3RD FLR.: 0
BATHROOM(S) : 1.0 TOILET ROOM(S) : 0.0 UTILITY ROOM(S) :
PORCH TYPE: DECK TYPE: PATIO TYPE:
BREEZEWAY: FIREPLACE: GARAGE:
DOMESTIC HOTWATER: TYPE HEATER: ** AIRCONDITIONING:
TYPE HEAT: WARM AIR: HOTWATER:
OTHER: **HOT WATER HEATER IS NOT IN WORKING ORDER
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST. : STORAGE, TYPE CONST.:
SWIMMING POOL: GUEST, TYPE CONST.:
OTHER:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION f DESCRIPTION i ART SEC
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NOTE: THIS STRUCTURE IS AN ACCESSORY GARAGE
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WITH FULL BATH AND KITCHEN SINK, REFRIGERATOR
NO STOVE.
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REMARKS: BP #9244Z-COZ-8014 (NEW-DWELLING
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INSPECTED BY: DATE ON INSPECTION: 10/12/99
GAR J FI TIME START: 10:30 END: 11:00
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.
i
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.
r 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 - s -2�V,
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date „September .29: .1999 . . . . . . . . . . . . . . . . . . . . .
New Construction. . . . . . . . . . . Old Or Pre-existing Building.x. .for.detached .frame garage
Location of Property. . . .355.Hobson.Drive,.Mattituck, .New.York. . .
House.No. .
. . .
. . Street. . . Hamlet
Onwer or Owners of Property. .William. . : .WXche. . . . . . . . . . . . . . . . .
County Tax Map No 1000, Section. . .•.. . . . . . . . .Block.
. .6 . . . . . . . . . . . .Lot. .25 . . . . . . . . . . . . . . . . . .
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
Permit No. . . . . . . . . . . . . . . .Date Of Permit. . . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . .
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . x . . . . . . .
Fee Submitted: $„ 100:00. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . .
APPLICANT
Abig 1 A: Wickham, hsq. , Agent
CONSENT
TO
INSPECTION
WILLIAM L. WYCHE the undersigned,
Owner(s) Name(s)
do(es) hereby state:
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at 355 Hobson Drive, Mattituck, New York 11952
which is shown and designated on the Suffolk
County tax map as District 1000, Section 122 , Block 6 Lot 25
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: Pre-
' r
Existing Use Certificate of Occupancy for detached frame garage.
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.
/ y
Dated:
(signature)
Abigail A. Wickham, Esq. , agent
(print name)
(signature)
(print name)
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Unauthorized alteration or addition to this survey is a viC NE
olation of O r.
section 7209 of the New York State Education Law. gER7 t'
Copies of this survey map not bearing the land 's inked �9
surveyor seal or embossed seal shall not be'considered to be a valid copy. ��
Guarantees or certifications ir;dicated hereon shall run only to the
Person for who m the survey is prepared,and on his behalf to the Ad.
title company,
governmental agency'and lending institution .listed hereon,and to the assignees of the lending institution. Guarantees'.• ^t.+, �S 2E72�� 0 �
or certifications are not transferable to
additional institutions or ytiv `
subsequent owners. N�
SURVEY FOR REFERENCE,
'WILLIAM L.& FANNYE. WYCHE
AT MATT►TUCK
TOWN OF SOUTHOLD GUARANTEED TO.1
S. UFFOLK. COUNTYI N.Y., SECURITY 71TL F a GUARANTY-COMPANY.
SOUTHOLD SAVINGS BANK.
SCALE : 1 11= 40'
MARCH 2, 1971
,DULY 5, 1977 � �• 'J
SEPT.'26,1977 LAND SURVEYOR
NYS. L I C.NO.28 725.
R VERHEAD N.Y.
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