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Home My WebLink AboutZ-24224FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. P~E EXISTIN~ CERTIFICATE OF OCcupANCY NO Z-24224 Date MARCH 21, 1996 THIS CERTIFIES that the buildin~ Location of Property 5005 NEW SUffOLK House No. Street County Tax Map No. 1000 Section 110 Block 8 Subdivision Filed Map No. SEASONAL DWELLINO NEW SUFFOLK~ N.Y. Hamlet Lot 32.7 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 E-24224 dated MARC~ 21, 1996 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 F~MILY SEASONA~ DWELLING * The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *P~.~ASE SEE ATTA~HKn INSPECTION ~EPORT. JOHN WICKH~M & OP~. N/A N/A Rev. 1/81 lllJ I l.l} I iIG lIE PAIITHENI' 'I'O~i~ OF SOUTII()I.D IIOIIS I NG COI)E INSI'L~'CTION IIIH;(IRT I,OCATION: 5005 NE~ SUFFOLK ROAD NEll SUFFOLK, N.Y. (-number & ~e~) (~Ipal [ ty) SUIH)IVISION HAP HO. L()'I'( ~ ) NAHE OF ()~NEI{ (~) JOHH ~IC~ & ORS~ OCCII ['hlOt; ¥ A{)HITT{~.O BY: THO~S llICKltAl~ AC'COHPANIED I{Y: KEY AVA 11.AI{I.E ~JF~AX HAP HO. 11~-32. / SOUIICE ()F I~I[({UES'I': ~O~S WIC~ DATE: ~RGH 12, 1996 I)WEI.LING: TYI'E OF CONSTIIUCTION WOOD FRA~ i~OiiNDAT l ON CEHENT PIERS CEI,I,AI{ TOTAl. I~OOHS: [ST I?I,R. 5 2Hi) Fl,Il. 3111) ITl,Il. IIATIIItOOH (s) TllO TO I I,ET ItOOH (n) I'ORCII TYPE COVERED PORCH IIECK, TYPE JIREEZEWAY F I lie PI,ACE ONE I)OHESTIC I[O'I'WATER YES TYPE IlEA'FEE ELECTRIC TYI'E IIEA'F NONE WAIIH Alii I S'['ORIES ONE {{ EXITS 3 CRAWl, SPACE UTII,ITY ROOH PATIO STONE PATIO GARAGE A1 RCONI)ITION lNG IIOT~4ATER ()TIllS. I{: ACCESSORY S'I'EUCTUItE$: GAIIAGE, 'I'Yt'E OF CONST. SWIHH1NG POOl. OTIIER: s'rOIIAGIt~, TYPE CONST. (,ULSI, 'rYI'lr. CONST. VtOI,ATIOHS: CIIAP'I'EIt 65 N.Y. STATIr. UNIFOIIH FIItE I'IO~VIr. NTION & IIIlil.l)[N(; CODE I,OCATIOH DESCRIPTION iI~ AlIT. SEC. lilt. ti^IlK S: 'I'IFIE START 9:20 AM END 19, 1996 9:40 AM Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ~C '/~; O~i SOUT~O!.O )APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter 0K 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) ~on-conforming uses, or buildings and '3pre-existing" land uses: 1. Accurate survey of property showing ail 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-existinR Buildinm - $100.00 3. Copy of Certificate of Occupancy - $20200 &. Updated Certificate of Occupancy - $50.00 5. :Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . March 15, 1996 New Construction ........... 01d Or Pre-existing Building ................. Location of Property .... 5005 NEW SUFFOL~ ~D. ~ S~FFOLK, N.Y. ~ouse No. Street ~amlet _ JO~l~'& ANNg WICI~iAI{, T~O~IA$ & ~I~EE WICl~t~l Onwer or Owners of ~roperty .................................................................. County T~x Map No 1000, Section .... ]JO ...... Block. 8 ...Lot. 32.7 Subdivision . . Filed Map Lot .... Permit No ................ Date Of Permit ................ Applicant ........................... . . Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ...................... Request for: Temporary Certificate ........... Final Certicate ........... I00.00 Fee Submitted: $ ............................. Wick~em APPLICANT · the undcrsiljnad, That Ihe undersigned (is) (at'e) tile owner(s) of thc premises in lhe Town which i.'~ .'sho~vll and desi/,umled on lite Stlffotll County tax map ,is District 100lb Sectien_l(o Block ~ . Lot ~?.~' . That the unclersitlned (has) (have} flied, or caused lo b~ filed, an applies- tlon iii the Southold Town Baildinf{ Inspector's Office for the followi%~: That the undersigned do(es) hereby give consent to the 13(Hiding Inspectors of the Town o£ Sou(hold to enter upon the above described property, iHcluding any find all buildings located thereon, to conduct such inspectloHs as they may deem necessary with respect Lo the aforesaid application, (naiad(rig inspect(oHs to determine that ~nid premises comply with all,of the laws, ordinances, rules and re[lulations of the Town of Sou(hold. The midol'signed, iii aoHsenthH~ to such inalmelions, do(es) so with the linim'll!cl~a ttll{l un(lerstlu~dhli[ that ally infer'marion obtailmd IH the eomluet of stlch inspu(:tlons }nay be used ns evidence in stll)sequen~'osecutions for // let(ohs of the laws, ol'(linaneos, i'ules el' re/lulations ~ the 'ro~n of S~ulhold. (silHlatuFe) (print name) ,,.,.~.~ ..... ~ ' 4 ,, ~ -. . ~- /.4~, ~ "~,¢ ,,~ . . . , I ,, ~¢ ~ ~ ' ' ' ~ ~' f ~ ~' - ~ .~(~:.7 ",~ ::.~'~:~',:'~:' ,... ~ . ' x ,"//' . 1 ' '~ ..... ' ..... " ' , .... ~'''~ '/'7 ~ . " , .f , ., . /. , .. ":.,,... ,..'. .,, ' . ,/,"... . "' , /Nq/-%~ .. 'i '~ ' ~' ~ [ ,' ~ ~ ' / :" . J'~ ;'.' , "' '; -- ~ .... ' .':.; .: ~ .