The URL can be used to link to this page

Home My WebLink AboutZ-25486FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-25486 Date JANUARY 15, 1998 THIS CERTIFIES that the building. Location of Property 3975 $Ob'£H HARBOR RD. House No. Street County Tax Map No. 1000 Section 78 Block 3 Subdivision Filed Map No. ONE FAMILY DWELLING SOUTHOLD, N. Y. Lot 12.1 Lot No. Hamlet conforms substantially to the Requirements for a One Family Dwelling built Prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-25486 dated JANUARY 15, 1998 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ONE FAMILY DWELLING WITH ACCESSORY TWO CAR GARAGE * The certificate is issued to sTANLEy VANDEN}XED-v-EL (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PENDING - JANUARY 7, 1998 PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 // BII II.I!III(~ I)I,~VAR'IIII,~III' 'I'()~IH ()F !;011'1'11(11.1! · IH)H!;III(; COI)I~ l.:')C,'VL'lorl: 3975 SO. HARBOR ROAD SOUTHOLD, N.Y. tIAI-IIt, OF O~/NEI{ (n) STAlq-I.EY v~dqDEIq-HOUVEL oc(3um'^,{}¥ SINGLE FAMILY AI)HI'I'TEI) BY: dO~ De,EDEN A(]CI)llI'AlilIEI} IIY~ S~ LzO{IIlI)A'['] O[I C~ BLOCK I~ATIIILOOH ( n ) O~ TOI I.ET IH)OIl (,) IFFI I.ITV Ill)OH ['{)}{(;ll 'l'Yl'15 SIDE SC~E~D IIE('.K, TYI'E FA'flO {)TIIEIt: A(2CIt. SS()Ry UTR1JG'I'UIH~$: OTIIIHI ~ VIOI.6TIOH~[I CIIAI'TI{R 4~ }I.Y. !Yl'fi'l'l{ Ill{ll:Ol{[I I/IIIE I'IIICVI{flTION & Illlll,lllff~ CIII)I{ I.(}GAT ! OH lIE Ui21L I CT I Oil AliT . BEC . FORM NO. 6 TOWN OF SOUTHOLD · Building Department · ' Town Hall Southold, N.Y. 11971 76,5- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted ,.. am.m~ma 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. -For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p:operW 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 D December 17, 1997 ate .. ,~ . . · · .,. · ,, · ~, · · o · · · ,, ..... ,, 5.Updated C.O. $"50.00 with screeneo porch and garage NewConstruction Old orPre existing Building X. · Vacant Land Southol d N,Y. Location of Property ..... ~7.~ .S. qN1;h' .H.~.b.'q~..~q~.d. ........................................ Hou~ No. Street Ham/et Owner or Owners of Property ~I~Q~.~ °! .0! CounW Tax Map No. 1000 Section ............... Block ....................... · Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor. Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $...!.QO,QQ'. ................... Construction on above described building and permit meets all applicable codes and regulations. Rev. 10.10.76 Applicant ................................... P.O. CUTCHOGUE, NY CONSENT TO INSPECTION Stanley Van Den Heuvel , 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 3975 South Harbor Road, Southo]d, New York , which is shown and designated on the Suffolk County tax mai, as District 1000, Section 078 , Block 03 , Lot 012.001 · That the undersigned (has) (have) filed, 'or caused to be filed, an applica- tion in'th. Southold Town Lguxlciing lnspeuL~,. '~ o~rroo ro. +ha {nllnwin~: House with screened porch and framed garage Dated: That the undersigned do(es) hereby give consent to the Building Inspectors o£ 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 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. /- (signature) (print name)