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Home My WebLink AboutZ-19979FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-19979 Date JUNE 13~ 1991 THIS CERTIFIES that the buildin~ Location of Property PENINSULA ROAD House No. County Tax Map No. 1000 Section 10 Subdivision ONE FAMILY DWELLING FISHERS ISLAND~ N.Y. Block 3 Filed Map No. Street Hamlet Lot 9 Lot No. conforms substantially to the Requirements for a Private One Family Dwelling built prior to: APRIL 9, 1957 ~ursuant to which CERTIFICATE OF OCC. #Z-19979 dated JUNE 13~ 1991 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 ROBERT K. WHITE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. /f~ulldlng Inspector Rev. 1/81 BUILD F.,'G DEP J~RZ.LE,~iT TO','C,I OF SOUTh[OLD, N. Y. HOUSIiZ CODE Ii'[SPECTIOD~ REPORT Location Subdivision PENINSULA ROAD FISRERS ISLAND, N.Y. ~i,iunzcipa±iuy) Lot(:)_ Name o£ O~.Jner(s) ROBERT K. WHITE 'Occupancy A-I A~nitted by: [type) ROBERT K. WHITE (o~.mer- cenan~) Accompanied by: SAME Key ~vailable Source of request ROBERT K. ~HITE Suffolk Co. T~c ~{o. 10-3-9 Date JUNE I1, 1991 DtnrT TT,~Tf! o Type of construction WOOD FRA~ Foundation CEMENT BLOCK Total rooms, tst. F1 4 Bathroom(s) I ~oLL BATH Porch, type Br e ez eway.. Type Heat OIL Fireplace(s). NONE Domestic hot:vat er Other WOOD STOVE #stories Cellar ~ Crawl space 2nd. F1 3rd. F1 Toilet room(s) Deck, type. Patio, type.__ Garage_ Utility room · Warm Air .Hotwater xx No. F~cit s 3 Airconditioning YES Type heater OFF BOILER I STORY ACCESSORY STRUCTURES: Garage, type const. S%.dm~ing pool Other Storage, type const. Guest, type const. V_IIOLATIO~S: L__ncation .CHAPTER 45--N.Y. STATE UNIFORM FIRE PI~VENTION & BUILDING CODE Descrimtion I Art. } Sec. Remarks: BP # I840Z-CO z- 1532, BP # 10533Z-CO Z-9815, BP #3348Z-C0 Z-2779, G~ ~ FISH ~ .' ~ ~ 'Time start 10:30 end Il:00 Form No. 6 TOWIq OF SOUTIIOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCU?ANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with ~he 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). 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 archiuect or engineer responsible for the building. 6. Submi~ 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 ali 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. Fees 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-existing Building - $I00.00 3.Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4.Updated Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ............. r/. . ew Construction ........... Old Or Pre-existing Bsildi~ ........ ~[,... ocation of Property" Housc No. Street Hamlet ewer or Owners of Property ' unty TaX No ion0, Suction ..... ..... Bioe ..... ~bdivision .......................... Filed Map ............ Lot ........... :trait No. .. . . . .Applicant 7~¢~.-~. .~. ~t~ ............. Date Of Permit ........ · ................ ~alth Dept. Approval ......................... · Underwriters Approval ....................... .. anning Board Approw~l ....... quest for: Temporary Certificate........... Final Certicate ........... e Submitted: ~ /C?o,6~ ~ C)I~1 7 ...... APPLIC2NT CONSENT TO INSPECTION Owmer(s) Name(s) do(es) hereby state: · the undersigned. of Southold located at That the undersigned (is) (are) the owner(s) of thc premises in thc To~wn · which is shown and desi~n,ated 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 Southcld Totem Building Inspector's Office for the following: __ That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southotdto enter upon the above described property, including any and alt 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 re,~ulations 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 of the laws, ordinances, rules or regulations of the Town of Southold. (signature) (print name) (sianaturc) (print name)