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Home My WebLink AboutZ-22600 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-22600 Date SEPTEMBER 22, 1993 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 1115 BUNGALOW LANE MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 123 Block 3_ Lot 15 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-22600 dated SEPTEMBER 22, 1993 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 TWO CAR GARAGE The certificate is issued to AGNES LINDSAY (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A' *PLEASE SEE ATTACHED INSPECTION REPORT. ildi g Inspector Rev. 1/81 BUILDING DEPARTMENT ' TOWN OF SOUTHOLD HOUSING CODE, INSPECTION REPORT LOCATION: 1115 BUNGALOW LANE MAZTITUCK, N.Y. number S street municipality SUBDIVISION 'MAP NO. LOT (s) NAME OF OWNER (s) AGNES LINDSAY' OCCUPANCY A-1 RES. OWNER (type) (owner-tenant) ADMITTED BY: . AGNES LINDSAY ACCOMPANIED BY: SAME KEY AVAILABLE SUFF. CO. TAX MAP NO. 1000-123-3-15 SOUr,::Z OF REQUEST: AGNES LINDSAY DATE: SEPT. 2, 1993 DWELLING: TYPE OF CONSTRUCTION WOOD FRAME 0 STORIES ONE EXITS FOUNDATION CEMENT CELLAR FULL CRAWL SPACE TOTAL ROOMS: 1ST FLR. 7 2ND FLR. 3RD FLR. BATHROOM (s) 2 FULL BATHS TOILET ROOM (s) UTILITY ROOM PORCH TYPE DECK, TYPE PATIO, TYPE COVERED PATIO SIDE YARD BREEZEWAY FIREPLACE GARAGE DOMESTIC HOT14ATER YES . TYPE HEATER ELECTRIC AIRCONDITIONING TYPE HEAT OIL WARM AIR OTHER: HOT[aIATER %% ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. 2 CAR WOOD FRAME STORAGE, TYPE CONST. SWIMMING POOL , GUEST,- TYPE CONST. OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. EXTERIOR SURFACES SHALL BE MAINTAINED IN GOOD CONDITION. C.R R. 9 (B) SURFACES NOT INHERENTLY RESISTANT TO DETERIORATION SHALL PART. 1242.5 (e) SUITABLE PRESERVATIVE. REMARKS: INSPECTED BY: DATE ON INSPECTION SEPT. 21, 1993 GARY IS _ TIME START 11:00-AM END 11 :20 AM . �IJ FORM NO.6 TOWN OF SOUTHOLD Building Department lµs ;! Town Hall .,�.., Southold, N.Y. 11971 765 — 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink,and submitted am wwmawm to the Building Inspec- tor 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 or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 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. Sworn statement of owner or previous owner as to use, occupancy and.condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $25 .'00 -- BUSINESS $50 .00 2. Certificate of occupancy on pre-existing dwelling $ 50 . 00 3. Copy of certificate of occupancy $ 5 "00., over 5 'years $ 10 . 00 4 .Vacant Land. C.O. $ •20 .00 993 5.Uodated C.O. $ 5 0 . 0 0 Date . , . . . . . . ber•n7,,• 1. . . . . . . . . . Construction X New . . ... . . Old or Pre-existing Building . . . . . . . . . .... . Vacant Land . . . . . . . . . . . . . 1115 Bungalow Lane, Mattituck, NY Location of Property . . . . . . . . . . . . . . . . . . . . . . . . � . . . . . . . . . . . .. . . . . . . . . . . . . House No. Street Hamlet Owner or Owners of Property • • , Ames. Lindsay• • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . , . . . . County Tax Map No. 1000 Section . . . 123. . . . . . . . . Block . 3. . . . . . . . . . . . . Lot. • 15. . . • . • . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . . . .Lot No. . . . . . . ... . 'Permit No. . . . . . . . . . .. Date of Permit . . . . . . . . . .Applicant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval . . . . . . . . . . . . . . . . . . . . . . . .Labor Dept. Approval . .. . . . . . . : . . . . . . . . . . . . . . UnderwritersApproval . . . . . . . . . . . . . . . . . . . . . . . .Planning Board Approval . . . . . . . . . . . . . . . . . . . . ... Request for Temporary Certificate . . . . . . . . . . . . . . . . . . . . .Final Certificate . . . . . . . . . . . . . . . . . . . . . Fee Submitted $ . . . 100:90.. . . . . . , • • • • „ • , , , , , • Construction on above described building and permit meets all applicable codes and regulations. Applicant . . . . . . . . . .. . . . . . . . Gary�Flanner�Olser • Rev.10.10.78 P.O. Box 706 �� Cutchogue, NY 11935 CONSENT TO INSPECTION Agnes Lindsey 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 Bungalow Lane, Mattituck, New York which is shown and designated on the Suffolk County tax map as District 1000, Section 123 Block 3 Lot 15 That the undersigned (has) (have) filed, 'or caused to be filed, an applica- tion in-tho Southold Town Building tnspacL,1. +ho Pnllnwinr: house and detached 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, inc.ludind-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: September 2, 1993 (signat. re) Agnes Lindsay �`` (`,► I f (print name) �\L F SEP 1 41993 (signature) t E �i_'��. 0 T. T G TOWN OF: SO r0--lo .�..� . .� m. (print n a m e) •% -- i l H•--fr:tl :•� i' '. . � -, � lit. � �� f :2 ri' �s.�� s v •• i Z OA as s t. Y� f (�` ..5:"2►3'�SO Oo v+t . . . . �6T � - ;, i r- 4t R' MAP, C)r- 1: _A t-10. _ SU2vcY a rt7 _ MA?"TtTUiK L�ccrts� L.Crtd;Si;tYvey�rs