HomeMy WebLinkAboutZ-27787FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 27787
Date: 07/03/01
HIS c~TIFIES that the building DWELLING
Location of Property ALPINE AVE
(HOUSE NO.) (STREET)
County Tax ~4ap No. 473889 Section 010 Block 0008
S~ivision Filed~4ap No. __ Lot No. __
conforms substantially to the Requirements for a ONE FAMILY DWELLING
built prior to APRIL 9, 1957 pursuant to which CERTIFICA~q~ OF
OCC UPANCYN/~4BER Z- 27787 dated JULY 3, 2001
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 DECK.*
FISHERS ISLAND
(HAMLET)
Lot 009
The certificate is issued to STEVEN M & MARY A WALTER
(OWNER)
of the aforesaid building.
SUFFOLK COU1FI"f DEPART~4ENT OF ~r~ALT~ APPROVAL
ELEC~rKICAL CERTIFICATE NO.
PLUMBERS C~TIFICATIONDA'£~a3
*PLEASE SEE ATTACHED INSPECTION REPORT.
N/A
N/A
N/A
/~//d~ignat ure
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: ALPINE AVE FISHERS ISLAND
SUBDIVISION:
~IA/~E OF OWI~ER (S): STEVEN M & MARY A WALTER
OCCUPA~ICY:
AD~l'l-l-ill~ BY:
NAP NO.: LOT (S)
STEVEN M & MARy A WALTER
ACCONPA]qII~)BY:
SNFF. CO. TAX NAP NO.: 10.~8-9
STEVEN & MARY WALTER DATE: 07/03/01
DWELLING:
TS~PE OF CON~rl/UCTION:
FOUNDATION:
TOTIi R00~S: 1ST FLI/.: __0 21fl) Fbi/.: __0
BA'rltl(OO~ {S): 0.0 TOIl~l~r ROON (S):
# S~ORIES: 0.0 # EIITS: 0
CELLAR: CRAIg5 SPACE:
3RD FI.,R.: 0
0.0 UTILITY ROO~ (S):
PATIO
GARAGE:
AIRCONDITIOIII~G:
EXISTING DWLG PER ASSESSORS CARD & SURVEY(3/30/01)
ACCESSORY STRUCTURES:
TYPE OF CON~T.:
SW/]~IlqGPOOL:
~TOP3%GE, T"fpE CONST.:
~uK~T, ~"~PE COI~ST.:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
EXISTING DWELLING PER ASSESSORS CARD & SURVEY DATED 3/20/01
BP#197~0 Dlii:l~0:B~.2744,1 ADD & ALT C0~Z27786
Form No. 6
TOI~FN OF SOUT~O~D
BUILDING DEPARTMENT
TOWN ~LL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
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 lihes,
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.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
"pre-existing" land uses:
1. Accurate survey 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.
C. Fees
1. 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-existing Buildinz - $100.00
3. Copy of Certificate of Occupancy - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
-~,~[~,~,~,/ . .
/
v/ Date ....... ~.~ ..... ,..,.,.. ................
New Construction ....... ;... Old Or Pre-existing Building. ;. ~': ............
House No. ' ~.O./~507f//~5 Street Hamlet
Onwer or Owners of Property.~.~e~..~.f~..? ........M~f.~ ~.~. ..................................... / .~.Z
County Tax Map No 1000, Section....~./~ .Block.. ~. ..Lot. ~.
Sub division .................................... Filed Map ............ Lot ......................
Permit No ............. Date Of Permit.. .Applicant .......... · ...................
.... t ...........
Health 'Dept. Approval ...... .~.. ~ ............. Underwriters Approval..,~..../:.f~..
Planning Board Approval ...... .~../.~r ............ . ...~...,
Request for: Temporary Certificate ........... Final Certicate..
Fee Submitted: $..(.~ ................. f.~..-~, ,-~ /~ ./ .'~ .~
~cb~q>? . '" ~' ' 'f' ' ' ~'JJ~£1~A~' -'~ ..... : .................
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