HomeMy WebLinkAboutZ-20548FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-20548 Date FEBRUARY 26, 1992
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 340 PINE ROAD SOUTHOLD, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 54 Block 9 Lot 10
Subdivision Filed Map No. 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-20548 dated FEBRUARY 26, 1992
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 ATTACHED SCREENED PORCH
The certificate is issued to HELEN I. WISBAUER
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
uilding Inspector
Rev. 1/81
Locat
Subdivision
BUII.DI::C DE�:u T:L:IiT
TO' OF SOUTIIOLD, N. Y.
HOU I:1G CODE Ii'iSPECTION REPORT
340 PINE ROAD
(num Der cc sneer,
Name of Owner(s)
HELEN I. WISBAUER
Occupancif A-1 Res.
(type)
Admitted by: JOAN HAMILTON
N.Y.
l viun
No.
cipaiiLY/
Lots)
OWNER
owner-cenanz
Accompanied by: SAME
Key available Suffolk Co. Tax No. 54-9-10
Source of reques
WILLIAM H. PRICE, JR.
Date FEB. 14, 1992
DWELLING
Type of construction WOOD FRAM -Ustories ONE
Foundation CEMENT BLOCK Cellar PARTIAICraW1 space
Total rooms, lst. F1 3 2nd. Fl 3rd. Fl
Bathroom(s) 1 FULL BATH Toilet room(s)
Porch, type SCREEN PORCH Deck, type Patio, type_
Breeze,aay Garage Utility room
Type Heat OIL Warm Air KS Hotwater
Fireplace(s) No. Exits Airconditioning
Domestic hotwater YES Type heater OIL
Other OUTDOOR SHOWER ATTACHED TO HOUSE AS SHOWN ON SURVEY DATED 2/10/92.
ACCESSORY STRUCTUR79 : NONE
Garage, type const. Storage, type const.
Swi,z=ing pool Guest, type const.
Other
VIOLATIONS: ,CHAPTER 45--N.Y. STATE UNIFORM FIRE PREVENTION 6 BUILDING CODE -
Remarks:
Inspected by:
Date of Insp.^
Time start 9:10
FEB. 25, 1992
end 9.25
Form No. b
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
FEB 2' 0 TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. 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 1% lead.
5. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliance frow 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 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.
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. 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
Date .....�loftl4zy. r.AA . 19AZ ................
New Construction........... Old Or Pre-existing Building..0.............
Locption of Property .... iiQ.Pine Roads Southoldi New.York ...............
...... ... .................
House No. Street Hamlet
Onwer or Owners of Property...., Helen I. Wisbauer
County Tax Map No 1000, Sectio n. 054 ,,,,,,,,Block.. 59 ........... Lot ...... QIQ..............
Subdivision................................ ....Filed Map ............ Lot .......................
Permit No................Date Of Permit ................ Applicant .............................
Realth Dept. Approval..........................Underwriters Approval........................':
Planning Board Approval ........................
Request for: Temporary Certificate........... Final Certicate...........
Fee Submitted: $.......1.QQaP.0...............
Z 3(f ✓c ......... .............................
APPLICANT
y_- William H. Prices, Jr.,
co Laos yg
4
PINE
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CALLANhN
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5UFFOU[ CO T'AY MAG DATE: 1000.054-09.010
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CONSENT
TO.
INSPECTION
William H. Price,.Jr. , attorney for Helen I. Wisbali%i undersigned.
Owncr(s) Name(s)-
do(es) hereby state:
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at
340 Pine Road, Southold, NY
which is shown and designated on the Suffolk
County tax map as District 1000, Section 054 . Block 09 , Lot 010
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:
one-story frame dwelling with -outside shower, screened porch
and gravel.parking area
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 of the laws, ordinances, rules or regulations of the Town of Southold.
Dated: 2/14/92
(. gnature)
WILLIAM) H. PRICE, JR.
(print name)
a
(signature)
(print name)
IO;IL•; OF SCUT:;OLD, M. Y.
FOUSI::G CCLS
(:.t•= -Der' � s �: ee �
Subdivision
of Owner(s)� t�C _-
l�•iu
Man No.
Occupa,-c j�-�--
zyPe)
ncl:,i1tzd by=:
"AGs-,Um-0Cn1ed
Key availabl
Suffolk CO.
Source of request � r
�o:•mer-� ar��
by
Tax No. % /-U
Date jC j
DWELLING:
Type of construction
—"&.
Foundation -;"s-tories ,
Cellar A ' Grawl space
. Fl
Total roo-�s, "lst
2nd. F1 — 3rd, Fl
Bathrooms)
Porch t- Toilet ro or, (s )
' y�e Deck, type
Breezeway Patio,' type
Garage Utility room
�e Heat ��Tarm Air
• Fireplace(s) H L.",aater
No. Frit;
Domestic hotwater Aircor_dition;,nc
• Other
Type heater c—
ACC:-:SSGRY Tprr m
TTRE
Garage, type const. IIII-10
Storage, type const.
Slll�T,'7i ng b001
Other Guest, type const.
VIOL ATIO�-;S
!�1
_L�cat�on
Remarks:
In-pccted by:
CHAPTER 45--N.Y. STATEiJNII'oI2III TIRE 7PR. & BUILDING CODE
W�� � ... — `•Lid
Art. i S.
o -c
ate of Insp.,ozl� Y
• Time start ; d end
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