HomeMy WebLinkAboutZ-25200FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
$outhold, N.Y.
PRE EXISTING
CERTIFICATE OF O~CUPAN~Y
No Z-25200
Date AUGUST 13, 1997
THIS CERTIFIES that the building.
Location of Propert~ 2600 TAEAPOSHA ROAD
House No. Street
County Tax Map No. 1000 Section 87 Block 6
Subdivision Filed Map No.
OWE FAMILY DWELLING
SOD'£~OLD, N. Y
Hamlet
Lot 4
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-25200 dated AUGUST 14, 1997
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 ATTA~D GARAGE *
The certificate is issued to
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PT.~SE SEE ATTACHED INSPECTION ME~.
Rev. 1/81 J
MARGARET WAGNER
N/A
N/A
Buikd[n~ ~n~ctor
LOCATION: 2600 TAKAPOSHA ROAD
~number & .~
SUBDIVISION
NAME OF OWNER (s) HARGARET WAGNER
BUll. DING I)EPAR'I~ENT
TOWN OF SODTtlOI,I)
IIOUSING CODE INSPECTION REPORT
SOUTHOLD, N.Y.
(municipality)
HAP NO. LOT(s)
OCCUPANCY SEASONAL
(type)
ADMITTED BY: HARGARET WAGNER
KEY AVAILABLE
SOURCE OF REQUEST: MARGARET WAGNER
(owner-tenant)
ACCOMPANIED BY:
StIFF.CO. TAX MAP NO. 1000-87-6-4
DATE: JULY 8, 1997
DW-EI.I. ING:
TYPE OF CONSTRUCTION
FODm)ATION
TOTAL ROOMS:
BATIIIIOOM (s)
PORCll TYPE
BREEZEWAY
DOMESTIC HOT~ATER XX
~PE HEAT HEAT PUMP
OTIIER:
WOOD F~ I STORIES__.~.__ ~ EXITS
CEMENT BLOCK CEI,LAR PART CRAWl, SPACE P~-[~T
IST ELR. 6 2ND FLR. 3RD FI,R.
2 TOILET ROOM (s) IJTII. ITY RO()M~es
BECK, TYPE WOOD __ PATIO
FIREPLACE ONE GARAGE ONE
TYPE llEATER ELECTRIC AIRCONDITIONING
WARM AIR XX IlOTWATER
HEAT PUMP
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.
SWIMMING POOl.
OTI1ER:
STORAGE, TYPE CONST.
· GUEST, TYPE CONST.
VIOLATIONS: CliAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
REMARKS:
INSPECTED BY
BP #ll109-Z COZ-10650 (GARAGE ADDITION) BP #14218Z- CO Z-[3994 (DECK ADDITION)
__ DATE OF INSPECTION AUGUST 12, 1997
TIME START 10:40 AH END I I :00 AH
FORM NO. 6
TOWN OF SOUTHOLD
. Building Daparmmnt
· ' 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 m ~ to the Building Inspec-
tor with the following; for new buildings or new usa:
1. Final survey of property with accurate location of all build!ngs, property lines, streets, and unusual
natural or topographic feature~. ·
2. Final approval of Health Dept. of water supply and sewerage disposal-IS-9 form or equal).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings,' Multiple Residences and similar build~n§s and Installa-
tions, a certificate of Code compliance from the Architect or Engineer responsible for the building,
5. Submit PJanning 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 sur~ey 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 _ Ouly $, 1997
5.Updated C.O. $*'50.00 frame house wit~.~dh'dd'~__v______o___~_ .... ~ .......
NewCons t,ruc tion Old or Pre-existing Building X. · Vacant Land
2690 ' TakaDos~ Rd S. qu.t.h.o.]d N.e,w. Y.o.r.k.
Location of Property ...................... ~ ~...., .........................
Hou~ iVo, Street klamler
Margaret Wagner
Owner or Owners o~ Prope~ .............................................................
County Tax Map No lO00Section 98..7 Block 0~ ' Lot 9,0,4
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 $ 1 O0 .
Constr'uction on above described building and permit meets all applicable codes and regulations.
Applicant ....................................................
Rev. 10-10.78
co 3.5 o0
GARy F ~_ NER OLSEN, ESQ
~.o. 80X 706 '
CUTCHOGUE, NY 11936
CONSENT
TO
INSPECTION
Ma.r~aret Wagner , , 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 Sou[hold located at 2600 Takaposa Rd., South01d, New York
· which is shown and designated on the SuF[olk
County tax map as District 1000, Section 087 , Block 06 , Lot 004
That the undersigned (has) (have) riled, 'or caused [o be Filed, an applica-
tion in'th. Sou[hold Town L~ullcling lnspeut~,. '~ ot£~o, ro~, 'fha, rnllmvinR.:
ONE STORY FRAME HOUSE WITH ATTACHED GARAGE
That the undersigned do(es) hereby give consent to the Building Inspectors
of the Town oF Sou[hold 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 or the Town oF Sou[hold.
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 Sou[hold.
Dated: 3u]y 8, 1997
f(signature)
'~" Margaret Wagner
(print name)
(sitznature)
(print name)