HomeMy WebLinkAboutZ-18476 FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE
CERTIFICATE OF OCCUPANCY
No Z18476 Date OCTOBER 18, 1989
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 1480 FACTORY AVENUE MATTITUCK
House No. Street Hamlet
County Tax Map No. 1000 Section 142 Block 01 Lot 04
Subdivision Filed MaA No. Lot No.
conforms substantially to the Requirements for a PRIVATE ONE FAMILY
DWELLING built prior to APRIL 9, 1989 pursuant to which
CERTIFICATE OF OCC. Z18476 dated OCTOBER 18, 1989
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. ***
The certificate is issued to LETITIA YARRUSSO
(owner, xxxxxxxxxxxxxxxx)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTR APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*** SEE INSPECTION REPORT
B 'lding Inspector
Rev. 1/81
BUILDI,,:G DE PAR T;•IEYiT i
TO1.1IN OF SOUTHOLD, N-: Y.
HOUSING CODE INSPECTION REPORT
Location 1480 Factory Avenue MATTITUCK
number & street ,iunicipaiity)
Subdivision clap No. Lot(s)
Name of Owner(s) LETITIA YARRUSSO
Occupancy R-40 owner
(type) (owner-zenan-G
Ad4mitted by: LETITIA YARRUSSO Accompanied by: SAME
Key available Suffolk Co. Tax No. 142- 1-4
Source of request LETITIA YARRUSSO Date OCT. 5, 1989
Dl ELLING
Type of construction WOOD FRAME rstories ONE
Foundation CEDAR POSTS Cellar Crawl space i
Total rooms, lst. F1 FIVE 2nd. F1 -- 3rd. F1 --
Bathroom(s) ONE Toilet room(s) --
Porch, type Deck, type Patio, type_
Breezeway Garage Utility room
Type Heat OIL Warm Air %x floor heaterHotwater
Fireplace(s) -- No. Exits 2 Airconditioning
Domestic hotwater LILCO GAS Type heater
Other
ACCESSORY STRUCTURES:
Garage, type const. Storage, type const.
Swimming pool Guest, type const.
Other
VIOLATIONS: CHAPTER. 45--N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
Location Description Art. 1 Sec.
Remarks: B-P.#9070--C .0. #Z7847 FOR COTTAGE .
Inspected by: Date of Insp. 10/ 12/89
GA FISH Time start 2:00 end 2: 20
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turcia
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL m
• SOUTIIOLD, NEW YORK 11971 lJJ L5 I1 �J'I
765 — 1802 OCT •• 5 19M
APPLICATION FOR CERTIFICATE OF OCCUPANC TOWN OFSOUTHOLD
DATE� j__ ` 1�
N- p - - - 1.
NEW CONSTRUCTION . . . . .OLD OR PRE—EXISTING BUILDING_ _'ZC_ - _VACANT LAND. . . . . . . .
Location of Property. . . 1 L/ .0�- - - : . .
��G`-_I V (:110- I : - - mCk,�' ,4' o,k- iv, -Y
. . . . . . . . . . . . . . . . . . '-
HOUSE NO. STREET
/�, p HAMLET -
Owner or Owners of Property. . . _ �: _�. �1PrP, RLk -S:S- - - - - - - - - - - - - - - -
` J
County Tax Map No. 1000 Section !- - . Block ! 1_ - - -
Lot'
Subdivision- - - - - - - - - - - - - - - - - - - - - - - Filed Map . . . . . . .
Lot
Permit No. . . . . . ... . . .Date of Permit - - - - - - - - - -Applicant _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Health Dept _ Approval Underwriters Approval . . . . . . . . . . . . . .
P1'anninC Board Approval
Request for Temporary Certificate Final Certificate _ . . _
Fee Submitted : $ - _��lJ •_ li- - - _ . . _ . .
i
APPLICANT. .
. . . . . . . . . . . . . . .
. � .
f° C_ 0 41 Z
rev_ 10/ 14/88
FORM NO. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALT
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS
A. 'This application must be filed in typewriter OR ink and submitted to the Building
Inspector with the following; for new buildings 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 of 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 solder used in system contains less
than 2/10 of 1Z lead.
5. Commercial buildings, industrial buildings, multiple residences and similar
buildings and installations, a certificate of code compliance from the 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, buildings and
unusual natural or topographic features.
2. A properly completed application, a consent to inspect signed by the applicant
amd a siiWNiobw WM06nom dw 4waft iwnw* IV a Siam asupospy
vti" sib ;
Aftm valsow- am
VoM■nwLp E tie *she adt aw� to OPM 4� �.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
3. Date of any housing code or safety inspection of buildings or premises, or other
pertinent information required to prepare a certificate.
C. For Vacant Land Certificate of Occupancy:
1- An application for vacant land Certificate of Occupancy shall be submitted,
and a certified abstract of title issued by a title company showing single and
separate ownership of the entire lot prior to April 9, 1957 shall also accompany
the application. If a Certificate of Occupancy is denied, the Building Inspector
shall state the reasons therefor in writing to the applicant.
D- FEES:
I. CERTIFICATE OF OCCUPANCY - New Dwelling $25.00, Additions to Dwelling $25.00,
Alteration to Dwelling $25-00, Swimming Pool, $25-00_ Accessory building $25.00
Addition to Accessory buildings, $25-00 —Businesses $50.00.
2. Certificate of. Occupancy on -pre-existing dwelling = $100.00_
3. Copy of Certificate of Occupancy - $5.00 - over 5 years - $10_00
4. Vacant Land Certificate of Occupancy - $20.00
5. Updated Certificate of Occupancy - $50_00
6. Temporary Certificate of Occupancy - $25-00 Residential
$50.00 Commercial
1 -
ev- 10/14/88
Q9 I1 ll L�
CONSENT OCT 3I989
TO F
INSPECTION BLDG. DEPT.
TOWN OF SOUTHOLD_
Z_ �' 1 l CO3 S�S the undersigned,
Owner(s) Name(s)
do(es) hereby state:
That the undersigned (is)) (are) the owner(s) of the premises in the Town
1
of Southold located at O o / CTG RN/ R_V /V L1
which is shown and designated on the Suffolk-
County tax map as District 1000, Section , .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:
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.
Dated: LoG+6Lvwq�q ✓ .�
(signa e)
"',h c, ye.rru-s _S a
(print name)
(signature)
(print name)
I