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Home My WebLink AboutZ-28567FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUP~LNCY No: Z- 28567 Date: 07/02/02 THIS CERTIFIES that the building DWELLING & ACCESSORY Location of Property 1620 VILLAGE LA ORIENT (HOUSE NO.) (STREET) (FLAMLET) Co%u~ty Tax Map No. 473889 Section 024 Block 0002 Lot 016 Filed Map No. __ Lot No. -- Subdivision conforras substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 28567 dated J~JLY 2, 2002 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 REAR SCREENED PORCH AND ACCESSORY WOOD SHED* T~le certificate is issued to SAR3Lq A WIGGS of the aforesaid building. (OWNER) SUFFOLK COUNTYDEPARTMENT OF HEALTHAPPROVAL ELEC;iaICA~ CERTIFICATE NO. PLUMBERS CERTIFICATION DATmU *PLEASE SEE ATTACHED INSPECTION/~RT. Rev. 1/81 N/A N/A N/A Authorize~Signature BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT I~TION: 1620 VILLAGE LA SUBDIVISION: 1~ OF O~ (S): SAPJ%H A WIGGS OCCI/PANC"~: SINGLE FAMILY ;%~IT'I~ BY: ESTELLE ADAMS ORIENT MAP NO.: LOT (S) SARA/t A WIGGS 1~ A~LABLE: SUFF. CO. TAX ~ NO.: 24.-2-16 SODRCN OF P~$T: GARY FLANNER OLSEN~ ATTY DATE: 07/02/02 DWELLING: TYPE OF CO~STRIJCTION: WOOD FP~E FOUNDATION: STONE 0.0 ~IYPR H~AT: OIL & GAS ~IARM AIR: X HO'I~TER: (~rii~K: FIREPLACES SHOULD BE INSPECTED BEFORE USING ACCESSORY STRUCTURES: WOOD VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. 1~: BP#255353~TADD T CO Z9906; BP#7270 ADD CO Z7282; BP#10655 GAR. COZ10002 Ao 765-1802 APPLICATION FOR CERTIFICATE OF OCCUP~,~r'~{ dUN Z 5 2002 This application must be filled in by typewriter OR ink andI su~nit~-~-.~e b~il~i~ inspector with the following: for new building or new use:[ 1. Final survey of .property with accurate location of all ~uil~i'~g~,"pro'pe~Ey""£ines 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 build~ 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 'Tpre-existing" land uses: i. Accurate survey of property showing all property lines, streets, building and unusuml natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicar If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. 1. Certificate of Occupancy - New dwelling $25.00,'Additions to dwelling $25.00, Alterations to dwelling $25.00, Sw~mming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existinA Buildinz - $i00.00 3. Copy of Certificate of Occupancy - ~ -25~. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ..49~.~.~0~ ...................... New Construction ........... Old Or Pre-existing Building.~. ~9.ry. ~.a~. ~ .house and Location of Property.. 1620 Village La~e, Orient accessory building House No. Street Hamlet Robert John Ad-mm as Executor of the Estate of ~arah Wigggs Onwer or Owners of Property ............................................ . ............. County Tax Map No 1000, Section..~ .......... Block..~ ............. Lot 1~ ........... Subdivision .................................... Filed Map ............ Lot ................. Permit No ................ Date Of Permit ................ Applicant ........................ Health Dept. Approval .......................... Underwriters A~roval .................... // Planning Board Approval ........................ ~/ //// ~]]u~]~mfi~i:ed:Te~i~i~aoZ~,~iii~iiiiiiiill iii Final ~~'''' 5(, ................ ~ o gq ~" APPLICANT C I I.D5 GARYFLANNEROLSEN Main Rd, PO Box 706 Cutchogue, NY 1193,5 Jun-24-O2 09~46A Wm H Price Jr 516-477-0130 P.02 Z CONSENT TO INSPECTION Gary F]~nner 01sen as attorney for the Estate of , [he undersigned, Owner(s) Name(s) ~aran wxggs do(es) hereby state: That the undersigned (is) (are) the owner(s) o[ the premises in the Town of Southold located at 1620 Village Lane, Orient · which is shown and designated on the Su[folk County tax map as District 1000, Section 24 , Block 2 , Lot 16 That the undersigned (has) (have) filed, 'or caused to be filed, an applica- tion in'th~ Southold Town l~ullaing lnsp~u~ .~ c~c£~ ro,~ +~,~ fnllnwinf: T~o stor~ frame house and access, ory buildings. That the undersigned do(es) hereby give consent to the Building Inspectors o[ 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/A~ ,. lations of the laws, ordinances, rules or regulat~on~/6~ ~ Dated.'2002 .... //////, lecutlons for vlo- hold. / ' (signature) Gary Flanner Olsen (print name) (signature) (print name)