HomeMy WebLinkAboutZ-29070FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 29070 Date: 11/08/02
THIS CERTIFIES that the building DWELLING
Location of Property 880 VILLJ~GE LA ORIENT
(HOUSE NO.) (STREET)
County Tax Map No. 473889 Section 025 Block 0001
Subdivision Filed Map No. L<)t No.
conforms substantially to the Requirements for a ONE FAMILY DWELLING
built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPi~/~CY B~OMB~ Z- 29070 dated NOVEMBER 8, 2002
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
(HAMLET)
Lot 016.001
issued is ONE FAMILY DWELLING.*
· 91e certificate is issued to THOM3~S WEISS
of the aforesaid building.
( OWNER )
SUFFOLK COU1Fi"f DEPARTMENT OF ~EALTE APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
3/27/02 1038094
PLUMBERS CERTIFICATION DA'£~u
N/A
Rev. 1/81
*PLEASE SEE ATTACHED INSPECTION REPORT.
- Aut hori~d Signature
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 880 VILLAGE LA
N/~ OF OWN~ (S): THOMAS WEISS
OCC~ANCY: SINGLE FAMILY
ORIENT
NO.: LOT (S)
THOMAS WEISS
ACC~)MPANIED BY: S~4E
CO. TAX M~ NO.: 25, 1 16,1
DATE: 11/08/02
ACCESSORY STRUCTURES:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
N~: BP 186 CO Z1626i BP 28824 DECK, GAS NEAT CO Z29069
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
"~ :A~rION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. 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 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.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses:
1. Accurate survey o f 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 Building - $100.00
3. Photocopy of Certificate of Occupancy - $ 0.25
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date.
New Construction: Old or Pre-existing Building:
Location of Property: ~80 V; llCt~ e ~IC
House No. (J Street
Owner or Owners of Property: '~f ~Ol~ ~e;SS
Suffolk County Tax Map No 1000, Section '2 ~-~ Block
(check one)
O ;c 'Y
Hamlet
Lot I
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $ i 0 ~
Final Certificate:
(check one)
Applicant Signature
BY THIS CERTIFICATE OF COMPLIANCE THE
NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
40 FULTON STREET ~ NEW YORK, NY '1OO38
CERTIFIES THAT
Upon the application of
upon premises owned by
Located at
Q.C. ELECTRIC iNC.
P.O. BOX 518
LAUREL, NY 11948-0518.
VILLAGE LANE BOX 543 ORIENT, NY 11957
TOM WEISS
VILLAGE LANE
BOX 543
ORIENT. NY 11957
Application Number: 103~094
Certificate Number: 1038094
Section: Block: Lot: Building Permit: BDC; N$11
Described as a Roside~tia] occupancy, wherein the premises eJectrical system consisting of
electficaJ devices and wiring, described t~elow, located Jrt/on the premises at:
was inspected in accordance with the National Electrical Code and the detail of the instaJlation, as set forth below, was
found to ~e in compliance therewith on the 27th Day of ~rcl~ 2002.
Name ~[~ Rate Ra~in_g Circuit ~e
Wlrin~ ~d De~ce~
F~t~e 6 0
S~ 2 0
I~cladcsce~t
seal
1 of 1
This certificate may not t~e altered in a,.v way and is validated a,Jy by t~a presenCe of a ralsacJ seal at the location indicated.
CONSENT
TO
INSPECTION
O~ner(s) Name(s)
do(es) hereby state:
· the undersigned,
That the unders~ned (is) (are) the owner(s) of the premises in the To,~n
of Southold located at
, ~vhich is sho~ and designated on the Suffolk
County tax map as District 1000, Section ~ ~ , Block ~ , Lot [6 ~ ~
That the undersigned (h~s) (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 lay;s, ordinances· ~rules
and regulations of the Town of Southold.
The undersigned, in consenting to such inspections, do(es) so ~vith the
knowledge and understanding that any information obtained in the conduct of
such inspections ma), be used as evidence in subsequent prosecutions for
lations of the laws· ordinances, rules or regulations of the Town of Southold.
(signature)
(print name)
(siEnature)
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