HomeMy WebLinkAboutZ-29088 FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 29088 Date: 11/20/02
THIS CERTIFIES that the building DWELLING
Location of Property 290 OAK ST MATTITUCK
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 141 Block 0001 Lot 016.001
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- 29088 dated NOVEMBER 20, 2002
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 ACCESSORY METAL SHED
The certificate is issued to JOHN & DOROTHY V ZAWASKY
(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.
A
//Uth(,/rized Slignature
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 290 OAK ST MATTITUCK
SUBDIVISION: MAP NO.: LOT (S)
NAME OF OWNER (S) : JOHN & DOROTHY V ZAWASKY
OCCUPANCY: SINGLE FAMILY JOHN & DOROTHY V ZAWASKY
ADMITTED BY: JOHN J. ZAWASKY ACCOMPANIED BY: SAME
KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 141.-1-16.1
SOURCE OF REQUEST: JOHN J. ZAWASKY 9/23/02 DATE: 11 20/02
DWELLING:
TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 1.0 # EXITS: 2
FOUNDATION: CEMENT BLOCK CELLAR: FULL CRAXI. SPACE:
TOTAL ROOMS: 1ST FLR.: 4 2ND FLR.: 0 3RD FLR.: 0
BATHROOM(S) : 1.0 TOILET ROOM(S) : 0.0 UTILITY ROOM(S) :
PORCH TYPE: DECK TYPE: REAR WOOD PATIO TYPE:
BREEZEWAY: FIREPLACE: GARAGE:
DOMESTIC HOTWATER: YES TYPE HEATER: PROPANE AIRCONDITIONING:
TYPE BEAT: OIL WARM AIR: HOTWATER: XX
OTHER:
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.: STORAGE, TYPE CONST.: METAL SHED
SWIMMING POOL: GUEST, TYPE CONST.:
OTHER:
VIOLATIONS: . CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
RTZMARKS: BP #28871Z-COZ29087 (DECK ADD)
INSPECTED BY: DATE ON INSPECTION. 09 30/02
GARY J. H TIME START: 10:10 AM EIM: 10:35 AM
S r� Form No.6
��; P !2F3 2002
[ TOWN OF SOUTHOLD
__- — -��-_ BUILDING DEPARTMENT
RLCC�. E!'T.
T7;=/s, (,LY.4- RiOLD TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. 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.
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 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
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-$25.00
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy-Residential$15.00, Commercial$15.00
Date. MA3 /o z
New Construction: Old or Pre-existing Building:_� (check one),, Pre- I q s 7
Location of Property. `�`�o O'er k 57_._ee7' /4iS2'7-i&c K "y I/9152
House No. Street Hamlet
Owner or Owners of Property: o7-oHA./ ;Zdiyc4SEc y
Suffolk County Tax Map No 1000, Section It!f Block_ I Lot I t
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ f 0', cam&
pl ant Signat re
i
E SF-P 1213 2002 CONSENT
TO
INSPECTION
jaf v
•, the undersigned,
�< Own (s) Name(s)
do(es) hereby slate:
That the uni ersigned (is) (are) the owner(s) of the premises in the Town
i
of Southold located at
71,6 9, I which is shown and desigmi aced on the Suffolk.
County tax map as District 1000, Section 1q l Block I Lot ��•f
That the u dersigned (has) (have) filed, 'or caused to be filed, an applica-
tion iri the SoutY;<old Town Building lnspcscev.L o.rr.Lo4 to.. +hp fnllowina:
_lam s T .
That the undersigned do(es) hereby give: consent to the Building Inspectors
of the Town of I outhold to enter upon the above described property, including
any and all bull .ings located thereon, to conduct such inspections as they may
deem necessar with respect to the aforesaid application, including-inspections
to determine th t said premises comply with all of the laws, ordinances, rules
and regulations of the Town of Southold.
The under igned, 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 prosecutions for vio-
lations of the 1�ws, ordinances, rules or regulations of the Town of Southold.
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