HomeMy WebLinkAboutZ-26189FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
pRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 26189
Date: 12/24/98
THIS CERTIFIES that the building
Location of Property 630 OAK ST
(HOUS~ NO.)
County Tax Map No. 473889 Section 136
Subdivision Filed Map No. __
DWELLING
CUTCHOGUE
(STREET) (HAMLET)
Block 0001 Lot 042.001
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- 26189 dated DECEMBER 24, 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.*
The certificate is issued to HELENE S. WECHTEPJ~ANN
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
N/A
N/A
N/A
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
MAP NO.: -- LOT (S) __
~LENE S. WECHTERB~
ACCOMPANIED BY: SAME
KEY AVAILABLE: SUFF. CO. TAX MAp NO.: 136.-1-42.1
SOURCE OF REQUEST: SELENE WECET~P34AN DATE: 12/24/98
TYPE OF CONSTRUCTION: WOOD FRAM~
FOUNDATION: ~ENTBLO~K
TOTAL ROOMS: 1ST FLR.: 3
BATHROOM(S}: ~,Q
PORCB TYPE:
BP~EEZEWAY:
FIREPLACE:
DOMESTIC HOTWATER: YES TYPE HEATER: ~J~
TYPE HEAT: OIL WAP. M AIR: ~ BOTWATER:
OTHER:
# STORIES: 1,0 # EXITS: ___~
CELLAR: ~_~ CRAWL SPACE: __
2ND FLR.: O 3RD FLR.: O
TOILET ROOM(S): Q,O UTILITY ROOM(S): --
DECK TYPE: WOOD ON WATER SIDE PATIO TYPE:
AIRCONDITIONING:
C~GE, TYPE OF CONST.:
SWI}94ING POOL:
OTHER:
STORAGE, TYPE CONST.:
GUEST, TYPE CONST.:
VIOLATIONS:
LOCATION
CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODB
DESCRIPTION ART.
INSPECTED BY:
DATE ON INSPECTION: 12/22/98
TIME START: 11:15 AM END: 11!45
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
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 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 i% 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
Vpre-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.
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~ - $100.00
3. Copy of Certificate of Occupancy -
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
House No. Street Hamlet
,unty Tax Map No 1000, Sectlon...~.~.~.%~..Block...O.Z'.q~ ...... Lot.q~.~.~.¥.~ .........
abdivision .................................... Filed Map ............ Lot ......................
~rmit No ................ Date Of Permit ................ Applicant .............................
· alth Dept. Approval .......................... Underwriters Approval .........................
tanning Board Approval ........................
eguest for: Temporary Certificate ........... Final Certicate.. ...~.. .....
_ Submitted:
..................................
CONSENT
TO
INSPECTION
Owner(s) Name(s)
do(es) hereby state:
That the undersigned (is) (are) the owner(s) of the premises in the Town
· 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 of 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 o~ the laws, ordinances, rules or regulations of the Town of Southold.
· . , (signature)/
(print name)
(signature)
(print name)