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Home My WebLink AboutZ-30896 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- 30896 Date: 05/12/05 THIS CERTIFIES that the building DWELLING Location of Property 620 NORTH DR MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 106 Block 0006 Lot 026 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- 30896 dated MAY 12, 2005 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 LOIS P LESNIKOWSKI (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. Authorized Signature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 620 NORTH DR MATTITUCK SUBDIVISION: MAP NO.: LOT (S) NAME OF OWNER (S): LOIS P LESNIKOWSKI OCCUPANCY: SINGLE FAMILY LOIS P LESNIKOWSKI ADMITTED BY: LOIS LOCKWOOD ACCOMPANIED BY: JOHN LOCKWOOD KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 106.-6-26 SOURCE OF REQUEST: DEBORAH DOTY, ATTY 4/27/06 DATE: 05 12 05 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 1.5 # EXITS: 2 FOUNDATION: CEMENT BLOCK CELLAR: FULL CRAWL SPACE: TOTAL ROOMS: 1ST FLR.: 3 2ND FLR.: 1 3RD FLR.: 0 BATHROOM(S) : 1.0 TOILET ROOM(S) : 0.0 UTILITY ROOM(S) : PORCH TYPE: YES DECK TYPE: YES PATIO TYPE: BREEZEWAY: FIREPLACE: NONE GARAGE: YES DOMESTIC HOTWATER: YES TYPE HEATER: AIRCONDITIONING: TYPE HEAT: OIL WARM AIR: YES HOTWATER: OTHER: 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 I DESCRIPTION I ART. I SEC. I REMARKS: BP#9569Z-COZ8962(ADD&DECK) BP#10564Z-COZ13385 (GARAGE ADD) INSPECrEll BY: TE ON INSPECTION: 05 03 OS GEORGE GILLEN TIME START: 10:30 AM END: 11:00 AM Form No.6 --'"" TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN FIALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY DF S This application must be filled in by typewriter or ink and submitted to the Building Department wi o owing: 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 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 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. 04/27/2005 New Construction: Old or Pre-existing Building: x (check one) Location of Property: 620 North Drive, Mattituck House No. Street Hamlet Owner or Owners of Property: Lois Patricia Lockwood (f/k/a Lesnikowski) Suffolk County Tax Map No 1000, Section 106 Block 6 Lot 26 Subdivision Filed Map. 41 Lot: N Permit No. Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: x (check one) Fee Submitted: $ 100.00 pp icant �ipgtiature Deborah Doty, Esq, as attorney for for owner (0 0 25 �'nQ C 0 Z30g � G • NONE MEMO■ EMEM009INS®1rl■■■■■MENEM ■■■ ■E■■■■■ ■■E■°l�■■E■ ■ ■■■ W ■■MOM■ ■■■■MMM■M■iM■M■MMRooms 2nd Floor asement �Fire Place 1 TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET 620 . VILLAGE DIST. SUB. LOT s Wo if fh a r Yb' FORMER OWNER N E ACR. Z3 S W TYPE OF BUILDING n RES. SEAS. VL. . FARM COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKS pU j pQ � DOv �� rGfye�oo � M iv �1 ,� / �efG � �� J�3/ �y //�� ,f - a r'ea k dcel� an �e aye C' ? ✓. J D y ( r a/z��i ,(�•`' �C' �,l a wet a a..// UGEd `G G BUILDING CO ITIO NEW NORMAL BELOW j B VE e FARM Acre Value Per V. lue Acre Tillable 1 Tillable 2 Tillable 3 Woodland Swampland FRONTAGE ON WATER Brushland FRONTAGE ON ROAD House Plot DEPTH BULKHEAD Total "� DOCK CONSENT TO INSPECTION Lois Patricia Lockwood (f/k/a Lesnikowski) the undersigned, do(es)hereby state: Owner(s)Name(s) That the undersigned (is) (are)the owner(s) of the premises in the Town of Southold, located at 620 North Drive, Mattituck which is shown and designated on the Suffolk County Tax Map as District 1000, Section 106 ,Block_6 Lot 26 That the undersigned(has) (have) filed,or cause to be filed, an application in the Southold Town Building Inspector's Office for the following: pre-existing C/O on onP fermi 1 y resi dense 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 in subsequent prosecutions for violations of the laws,ordinances, rules or regulations of the Town of Southold. Dated: 04/27/2005 (Signature) DPhnrah DptT� Esq as attorney CONTACT: Owner at 298-8332 (Print Name) (Signature) (Print Name) \N C EYMAP SCALE I" 600 .S SUBJECT u_ PARGELW w = u r S I v Q n` 564A9' d 110 .folk M I 1�1 Z JI ef,P. /� 1 N82�44 2511� I yyy 1 O 36.66' C �o !9.3W 105 0' N, 9M _N' OQQ F y IQ �LL 61G.80' a z & - -' UI 1eq yl ;O ' ry tL i W I = Irr^^ I nbe.,. I tllk, etB I''tlod Pe Neck x Hood m I deck IttS 1 ctnin Ink I etoc kode fence 9ote l ' x�sse TABLE OF AREAS BEFORE BOUNDARY LINE ALTERATION LOT M = 5G,091 5F OR 1.36 AGRES LOT N = 51,525 5F OR 1.32 AGRES AREA OF PROPERTY BEING EXGHAN6ED = 4,114 5F `•.. ' AFTER BOUNDARY LINE ALTERATION s+:l;•s+ PARGEL I = 52,80G 5F OR 1.21 AGRES °•°°'"'�:�"'"°"" PAP-GEL 2 = 63,805 5F OR 1.46 AGRES xm- JOIN C. EHLERS ]LAND SURVEYOR 6 EAST MAIN STREET N.Y.S.LIC.NO.50202 RIVERHEAD,N.Y.11901 369-8288 Fax 369-8287 REF.—\\Hp serveAd\PROS\04-266.pro Ivy✓ T Y, NY '004 4, 1-12-2005 6IX u )od Lot O --- S88013'30"E 564.09' - --- ---- `stone _--arwe— ------------- -� m m 37p• ------- -------------- Parcell -_- ------------ ------- Area = 52,809 of or 1.21 acres Lot N S84 9'23"E 103 g CY a —S89 p o �� 689`03'10"E Q exlstin ro N 42-10-E ——�\ — — — '- — — — — — � 619.80' proposed property Ifne C V e Q Lot M Parcel 2 ----- ___ Q Area = 65,805 of or 1.46 acres --------- stone------ - ----------- drlvewoy , / choln lk* 1 5toekode fence on ' N89042'10"W j 623.40' Lot L GRAPHIC- 5GALE 1"= 40' ,GRE5 0 40 50 120 1 IJ� I .:JVV I T1VLL SUFFOLK COUNTY, NY SURVEYED 08-24-2004 MAP PREPARED 10-14-2004, 1-12-2005 SUFFOLK COUNTY TAX u 1000-106-6-26 1000-106-6-21 APPLICANT: Lois)Patricia Lockwood Ma Lesnikowski Lot O ----------------------- S88°13'30'E ---------------------- 403' --___ - -------------------------- oa --- " ----- / Q' Area = 52,809 of or 1.21 acres - -- 6 ' Lot N00 ti - -S89-°42'.107E - - - - �8a'os to°E-Z 3 p ell l — — — — — — — — ` — — � �exlStinL�7ro ertVine proposed property line I \A o Lot M - - Parcel '------__ _ acres Q Area 65005 of or 1.46 - ------ --e -Imo, L"Y^00 I V I I I M O17' N89042'10"W � r r Y Lot L Bayvi w Avenues NOTES: STAKE FOUND MONUMENT FOUND o PIPE FOUND GRAPHIG O LOTS SHOWN HEREON REFER TO MAP OF SHORE ACRES FILED JANUARY 3, 1914, MAP No. 41 AREA = LOT M =59,091 5F OR 1.36 ACRES LOT N = 51,523 5F OR 1.32 ACRES OVERALL AREA = 116,614 5F OR 2.65 ACRE5 1 LOCATION: 6 as O /vog_ry b ie-I y 11*77}"T��v-0-k (number& street) (municipality) SUBDIVISION: MAP NO.: LOT(S): NAME OF OWNER(S): L 0 I S fA-T"R1C-1.i3 L-0C!,K\AJ0vD IKJA OCCUPANCY: On/c- -Woo (type) (owner-tenant) ADMITTED BY: �'°I S L-O k�' °° "D ACCOMPANIED BY: KEY AVAILABLE: L015 e "v'° SUFF. CO. TAX MAP NO. 1000- Co SOURCE OF REQUEST: f}P P /a N , ba0f# WY DATE: q- A 7-o_s DWELLING: TYPE OF CONSTRUCTION: �D �ie�J/''1 # STORIES: �.2 # EXITS: FOUNDATION: Q,�E^e*T CELLAR: FyJ-L CRAWL SPACE: — TOTAL ROOMS: 1ST FLR: 3 2ND FLR: _ 'Off{/ 3RD FLR: BATHROOM(S): TOILET ROOM(S): UTILITY ROOM: . PORCH TYPE: DECK, TYPE: ES PATIO,TYPE: BREEZEWAY: FIREPLACE: IVDAJ,5 GARAGE: Yt7.5 DOMESTIC HOTWATER: - TYPE HEATER: AIRCONDITIONING: TYPE HEAT: O 1 L WARM AIR: YES HOTWATER: OTHER: 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 DESCRIPTION ART. SEC. Wd- REMARKS: c c F INSPECTED BY: -DATE OF INSPECTION: TIME START: �0 ; 3 0 �p-t� END: ^ o%o