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Home My WebLink AboutZ-24763FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z--24763 Date NOVEMBER 27, 1996 THIS CERTIFIES that the building. OWE FAMILY DWELLING Location of Property 630 SOUTHERN CROSS RD. CUTCHOGRE, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 110 Block 3 Lot 9 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-24763 dated NOVEMBER 27, 1996 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 OWE FAMILY DWELLING * The certificate is issued to AR'£~uRVANDERBECR (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PT~ASE SEE ATTACHED INSPECTION REPORT. Rev. 1/81 N/A N/A N/A //uil/ing Inspector BUILDING DEPAR'rNENT TOI4N OF SOUT[10].I) HOUSING CODE INSPECTION RRPORT I,OCATION: 630 SOUYHISRN CROSS RD. (number & street) SUBDIVISION NAHE OF OWNER (s) AR'i'HNR VANDERBECK NAP NO. CUTCHOGUE, N.Y. (municipality) I.OT(s) OCCUPANCY A-I RES. OILIER ADHITTED BY: F. HICHAEL HEI~IER ACCOMPANIED BY: SAME KEY AVAILABLE SUFF.CO. TAX MAP NO. 1000-110-3-9 SOURCE OF REQUEST: F. MICHAEL ~Rtl,~ UATE: NOV. {8, 1996 I)WELLI NG: TYPE OF CONSTRUCT]EON FOUNDATI ON TOTAL ROOMS: IST FLR. BATII ROOM ( .~ ) ONE I'ORCII TYPF. BREEZEWAY DOMESTIC IlOTI~ATER YES TYPE IIEAT ELECTR]~C OTIIER: WOOD FRAME CEMEI'~IT BLOCK CELLAR PARTIAL 6 2ND FI.R. 3RD FI.R. TO ILET ROOM ( .q ) # STORIES ! # EXITS 3 CRAWL SPACE UTIL[TY ROOH DF. CK, TYPE PATIO COMC~~REAR) FIREPLACE GARAGE TYPE IlEATER ELECTRIC AIRCONDITIONING WARM A1 II IIO'I3sIATER ACCESSORY STRUCTURESx." ', ..':. GARAGE, TYPE OF CON;$T.~ ', SWlHHING POOl, OTIIEB: STORAGE, TYPE CONST. , GIIEST, TYPE CONST. METAL SHED VIOLATIONS: CIIAPTER 65 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCEIPTION ART. SEC. REMARKS: BP {4304-CO Z-3668 (ADD) BP ~23828Z-.CO Z-24762 (ACCY SHED) I)ATE OF INSPECTION NOV. 19, 1996 TitHE START I0:00 ENU 10:30 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 buildiqg, 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. 'For (prior to April 9, 1957) buildings and existing buildings non-conforming uses, or "pre-existing" land uses: 1. Accnrate snrvey 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. ~. Fees i. 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-existin~ Buildin~ - $i00.00 3. Copy of Certificate of Occupancy - . .25~ 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residentialf$15.~, Commercial $15.00 Date ....... iew Construction ........... Old Or Pre-existing Building ..... .~... ....... ,ocation of Property....~..~,.~...~~..~,..~..~.~ ............. ' House No. Street Hamlet 'nwer or Owners of Property...V.~.~...~.~.~~....~.~.. ...................... ounty Tax Map No 1000, Section .... t.~..O. ...... Block ..... ..~. ........ Lot .... .~.. ............... ubdivision .................................... Filed Map ............ Lot ...................... 'ermit No ................ Date Of Permit ................ Applicant ............................. ~ealth Dept. Approval .......................... Underwriters Approval ......................... lanning Board Approval ........................ equest for: Temporary Certificate ........... Final Certicate. ~ 'ee~,Submitted~q~: CONSENT TO INSPILC FION ~~ ~F~~ ~ ~'.~,'e,l~t~ ~ , the undersigned, Owner(s) Name(s) (~r/~) do(es) hereby state: That the nndersiRned (is) (are) the owner(s) of the premises in the To~ or Southold located at ~ ~ ~~ , which is shown and desianated on the Suffolk Count.y tax map as District 1000, Section [~O , Block ~ , Lot ~ That the undersigned (bas) (have) filed, m' caused to be filed, an applica- tion in the Southold 'toxin 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 of Southold. The undersigned, in consenting to such inspections, do(es) so xvith the knowledge and understanding that any information obtained in the conduct of such i.nspeetions may be used as evidence in subsequent prosecutions for rio- lations of the laws, ordinances, rules or ~t~ regulations of the Town of tthold. (signature) (print name) W