The URL can be used to link to this page

Home My WebLink AboutZ-34888 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- 34888 Date: 04/07/11 THIS CERTIFIES that the building DWELLING Location of Property 18375 MAIN RD MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No_ 473889 Section 115 Block 0002 Lot 012 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- 34888 dated APRIL 7, 2011 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 REAR COVERED PATIO AND ATTACHED ONE CAR GARAGE.* The certificate is issued to IRENE RUTKOSKI ESTATE (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. Auth ized gnature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION- 18375 MAIN RD MATTITUCK SUBDIVISION: MAP NO.: LOT (S) NAME OF OWNER (S) : IRENE RUTKOSKI ESTATE OCCUPANCY: ONE FAMILY DWELLING IRENE RUTKOSKI ESTATE ADMITTED BY: ACCOMPANIED BY: ICEY AVAILABLE: SUFF. CO. TAIL MAP NO.: 115.-2-12 SOURCE OF REQUEST: WILLIAM & JUDITH BARKER DATE: 04/07/11 DWELLING: TYPE OF CONSTRUCTION- WOOD FRAME # STORIES: 1.0 # EXITS: 3 FOUNDATION: CEMENT BLOCK CElff.AR: FULL CRAWL SPACE: TOTAL ROOMS: 1ST FLR_: 5 2ND FLR.: 0 3RD FLR.: 0 BATHROOM(S): 2.0 TOILET ROOM(S): 0.0 UTILITY ROOM(S): PORCH TYPE: DECK TYPE: PATIO TYPE: COVERED IN REAR BREEZEWAY: FIREPLACE: 1 : 1 CAR DOMESTIC HOTWATER: TYPE BEATER: OIL AIRCONDITIONING: TYPE BEAT: OIL WARM AIR: HOTWATER: OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: STORAGE, TYPE CONST_: SWI14MING POOL: GUEST, TYPE CONST.: OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. REMARKS: RE-INSPECTED 4/5/11 INSPECTED BY: ` 1 DATE ON INSPECTION: 03/31/11 GARY J IS TIME START: END: Form.;No.6 TOWN'OF SOUTHOLD BUILDING DEPARTMENT ! �, i_' [I W_C� TOWN HALL 765-1802 �! 1 9 2011 APPLICATION FOR CERTIFICATE OF OCCUPANCY i This application must be filled in by typewriter or ink and submitted to the Building Department wONNN 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 Sitq°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$25.0,0,.A s to accessory building$25.00,Businesses$50.00. 2. Certificate of Occupancy on Pre-existing Building 100.0 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15.00, Commercial $15.00 Date. 0?— New Construction: Old r Pre-existin Building: (check one) Location of Property: CA House No. Street Hamlet Owner or Owners of Property: �`� 2G�Jc,. K jc-0Sib, ' l-A 61-n-x- Azg1 - .e L�L Suffolk County Tax Map No 1000, Section \ J� Block oZ Lot " Subdivision Filed Map. Lot: Permit No. Date of Permit: q. t Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate 'Final`Certificate: (check one) Fee Submitted: $ p ' ant§iVature * i CONSENT TO'INSPECTION L 5'17�'fl✓ � K-uTk oSle,a the undersigned,do(es) hereby state: Owners)Names) ' That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold, located at )�3Isl)11 e_ s CA - which is shown and designated on the Suffolk County Tax Map as District 1000, Section, Block c , Lot That the undersigned (has) (have) filed, or cause to be fi�d, an application in the Southold Town Building Inspector's Office for the following: — C GFf,77 F/Gg-77CC-- (7)CCA46:tj 0, 4 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: (Si gbQ ) (� L _... (Pr' t N e (S' 'nnature) 4 �.. (Print Name) /600 T F T PROPERTY RED - CARD OWNER STREET O '� _ VILLAGE DIST. SUB. LOT _n-e_ j�h 1 �� FORMER OWNER E AC . W TYPE 6F BUILDING • ! SEAS. VL. FARM COMM. B. MICS. Mkt: Value LAND IMP.. TOTAL DATE. REMARKS o S 9 00 G O ? a �e ✓ sect . r�� t3 AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE . FARM Acre Value Per Value Acre Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD �� j o o _ 7U Meadowl•and DEPTH House Plot BULKHEAD Total ,: o- �,,. DOCK .�v . Ion ■■.■■■■■■■■■■■■■■■■■■■■■ ■■■.�.■j.....■■....Y\.■■ 1COMM■■ ...■■■ram■�■i1■■Q!■1�!■■■■■■■...■. : .. ■■....■.II■...■.■...■..■■■.■■■ ■■■■.■■■■■■■■■■■.■Ott■■■.■■■■■ .■■..■■.■■■■■■■■■■■■■■■■.■■■■ M�Basement - Place • •• y ' •- '•• 'Ro6ms 1st Floor :' LOCATION: (number & street) (municipality) SUBDIVISION: MAP NO.: LOT(S): NAME OF OWNER(S): OCCUPANCY: (type) (owner-tenant) ADMITTED BY: ACCOMPANIED BY: KEY AVAILABLE: SUFF. CO. TAX MAP NO. 1000- SOURCE OF REQUEST: DATE: DWELLING: TYPE OF.CONSTRUCTION: # STORIES: tom- #EXITS: FOUNDATION: CELLAR: CRAWL SPACE: TOTAL ROOMS: 1ST FLR: 2ND FLR: 3RD FLR: BATHROOM(S): TOILET ROOM(S): UTILITY ROO PORCH TYPE: %&DECK, TYPE: — PATIO, TYPE:0vd_4.6T_i/ BREEZEWAY: FIREPLACE: GARAGE: DOMESTIC HOTWATER:4W TYPE HEATER: AIRCONDITIONING: TYPE HEAT. WARM AIR: HOTWATER: OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: STORAGE, TYPE CONST.: SWIMMING POOL: GUEST, TYPE CONST: OTHER: VIOLATIONS: CHAPTER 144 &N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. REMARKS: INSPECTED BY: DATE OF INSPECTION: 9' G( TIME START: END: •� Y N N/01F SK1 SURVEY OF PROPERTY HENRY RRu.os<l A T MA TTIT UCK HERE of SOUTH TO WN OF SO UTHOLD TOWN Neon SUFFOLK COUNTY, N. Y. 8 N 1000 115-02-12 120 O0 SCALE.- 1 A 20' N SEP7EMBER 21, 2010 Z 76'45 3�p E BRlcic �v' �n N 1l moo:. C.F- 29 - 0 . Z 47.8 c 7JG N 13 9• y O� �w STORY RAGE A ONE p GA � HOUSE AN o 2 w 14.3- to O o 7.2' y 15.9, 3 ROOFS.r N. 24.3- BR1 cy TO -� N 15q4 �LANE . .. 2k� _ , ELIJAN S W $ O cr N w N. 120.00 S ' 6.45 37 - `--- is� k'•�� ""�_, ji 49 r% NO. 49618 ANY AL7ERA77ON OR ADDI77ON TO THIS SURREY IS A V10LA77ON ECON.1C. §tWEYORS; OF SEC77ON 72090F 77-IE NEW YORK STATE EDUCA77ON LAW. (631) 765-5020 FAX (631) 765-1797 -: EXCEPT AS PER SEC77ON 7209—SUBDIVISION 2 ALL CER77FICA.77ONS I EDN�iRE�A ID FOR THIS MAP AND COPIES E�7E-OF._- P.O BOX-909 AREA-111369 SQ FT. SAID MAP OR COPIES BEAR 7HE IMPRESSED SEAL OF 77-IE SURVEYOR 1230-TRAVELER_ STREET q WHOSE SIGNATURE APPEARS HEREON. OLD, N 1 -204 SOUTH N. Y.. .11:9,71