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Home My WebLink AboutZ-22584FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-22584 Date SEPTEMBER 10r 1993 THIS CERTIFIES that the building. Location of Property 1285 CALVES NECK ROAD House No. Street County Tax Map No. 1000 Section 63 Block 7 Subdivision Filed Map No. ONE FAMILY DW~.T,T,ING SOUTHOLDr NEW YORK Hamlet Lot 36 Lot No. conforms substantially to the Requirements for a One Family Dwelling built Prior to: APRIL 9r 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-22584 dated SEPTEMBER 10r 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 DW~.LLINGWITHATTACBr~.DGARAGE & ACCESSORY STORAGE SHED * The certificate is issued to PHILIP & KATHRYN VAN BOURGONDIEN (owner) of the aforesaid building. S~'~'OLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PT.RASE SEE ATTAC~.D INSPECTION REPORT. Rev. 1/81 ~~Bui~ld~ing Inspector LOCATION: SUBDIVISION NAME OF OWNER (s) BUILDING DEPART}bENT TOWN OF SOU~qIOLD IIOUSING CODE INSPECTION REPORT 1285 CALVES NECK ROAD SOUTHOLD, NE~ YORK (number & s~reet) (municipaLity MAp NO. LOT (s) PHILIP & KATHRYN VAN BOURGONDIEN OCCUPANCY A- ! RES . (t~p~) (o~ner-tenanC) ADMITTED BY:. PHILIP BAN BOURGONDIEN KEY AVAILABLE SOU&CE OF REQUEST: MR. VAN BOURGONDIEN ACCOMPANIED BY: SAME SUFF. CO. TAX MAP NO. 1000-63-7-36 DATE: SEPT. 2, 1993 DWELLING: TYPE OF CONSTRUCTION WOOD FRAME FOUNDATION CEMENT BLOCK TOTAL ROOMS: IST FLR. 5 2ND FLR. BATHROOM (s) 3 FULL BATHS TOILET ROOM (s) PORCH TYPE COVERED PORCH REAR DECK, TYPE BREEZEWAY FIREPLACE DOMESTIC HOTWATER YES. TYPE HEATER TYPE HEAT OIL WARM AIR O~IER: ~ STORIES !' ~ EXITS 3 CELLAR PARTIAL CRAWL SPACE PARTIAL 3RD FLR. ONE · ELECTRIC UTILITY ROOM PATIO, TYPE FLAG STONE GARAGE TWO CAR AIRCONDITIONING CENTP, AL AIR HO~{ATER ACCESSORY STRUCTURES: GARAGE, TYPE OF cONST. SQIMMING POOL OTHER: STORAGE, TYPE C0NST. · GUEST, TYPE CONST. SHED VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION -' DESCRIPTION" ART. SEC. REMARKS: INSPECTED BY: DATE ON INSPECTION SEPT. 10, 1993 TIME START 9:40 ENIJ 10:10 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: 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)~on-conforming uses, or bu~ildings and "pre-existing" land uses: 1. Accurate survey of property showing all/~roperty lines, streets, buildimg and unusual natural or topographic featurzds. ' ~ . 2. 'A properly completed application a~a consent to inspect signed by the applicant. If a Certificate of Occupancy is~enied, the Building Inspector shall state the reasons therefor in writing t?e applicant~ ' 1. Certificate of Occupancy.~ew dwelling $25.00, Add~tzons to dwel ing $25.00, Alterations to dwellingS25.00, Swimming pool $25.00, Accessory building $25.00, ·Additions tO accessory/~uilding $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-exi.sting Building - $100.00 3. Copy of Certificate ~f Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate Ipf Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction ........... Old Or Pre-existing Building...~ - . ..... House No. Street Hamlet Onwer or Owners of Property P/~'L~f ~.~-F~YH ~AN County Tax Map No 1000, Section .... ~J ....... Block...~.? .......... Lot,..~ ................ Subdivision .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $./..~.~¢.~..~.. ................ ?)_2, ' · .................. Unauthorized aJferalion or add;lion ia this survey is a vio!,~l;on of reel;on 7209 of Ihe New Yerk Stale [.ducalion Law. ¢co~ cr cmbo.,~rd ,.c-~l 'd'::.!! nc'l be ccr,,.-:d~:...d ~o L~ o voJid ~c CONSENT TO INSPECTION ~/4/L,'F ,r-K~4 F/fRY^! ~/qt~ ~0 UR ~i D t~-/d , the undersigned, Oxvner(s) Name(s) do(es) hereby state: That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at i.%F$- (-.j]L~'i~ ~q~_-c--i~ RD · 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 6f 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: f(signature) (print name) ~(siRnature) (print name)