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Home My WebLink AboutZ-23960FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING FICATE OF OCCUPANCY No E-23960 Date OCTOBER 17, 1995 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 925 TOWN HARBOR LANE SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 63 Block 4 Lot 11 Subdi 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 23960-Z dated OCTOBER 17, 1995 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 ONE ACCESSORY BARN WITH LOFTS & 4 ACCESSORY OUTBUILDINGS & 1 OUT HOUSE The certificate is issued to FRANCES WOODWARD (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECT Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOI.D HOUSING CODE INSPECTION REPORT LOCATION: 925 TOWN HARBOR LANE SOUTHOLD, N.Y. number 6"street municipality SUBDIVISION MAP NO. LOT(s) NAME OF OWNER (s) FRANCES WOODWARD OCCUPANCY SINGLE FAMILY type owner—tenant ADMITTED BY: MARION KING ACCOMPANIED BY: KEY AVAILABLE SUFF.CO. TAX MAP NO. 100 —63-4-1! -- SOURCE OF REQUEST: ALAN G. BENNETT DATE: JULY 25, 1995 DWELLLNU: TYPE OF CONSTRUCTION WOOD FRAME / STORIES 2 i E%ITS 5 FOUNDATION BRICK CELLAR PARTIAL CRAWL SPACE PARTIAL TOTAL ROOMS: IST FLR. 5 2ND FLR. 4 3RD FLR. BATHROOM (s) 2 TOILET ROOM (s) UTILITY ROOM SMALL OUTSIDE REAR PORCH TYPE FRONT,SIDE,REAR COVERED DECK, TYPE PATIO__ BREEZEWAY FIREPLACE NONE GARAGE DOMESTIC UOTWATER YES TYPE HEATER LILCO GAS AIRCONDITIONING TYPE HEAP OIL WARM AIR HOTWAPER II OTHER: MUD ROOM REAR, 2 FOYERS ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. I LARGE BARN w/LOFTS STORAGE, TYPE CONST.( 2 STORY BARN — 3 ACCESSORY SWIMMING POOL BUILDINGS — 1 OUT HOUSE—BUILDINGS IN OTHER: DISREPAIR VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION S BUILDING CODE REMARKS: INSPECTED BY DATE OF INSPECTION TIME START OCTOBER 11, 1995 END CONSENT TO INSPECTION Owner(s) Name(s) do(es) hereby state: the undersigned, That the undersigned 0(are) the owner(s) of the premises in the Town of Southold located at �� &,e Z4AI = which is shown and designated on the Suffolk County tax map as District 1000, Section Block /-/ , Lot J That the undersigned (t (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( ) 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, does) 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: I�S�9J 7 (signature) ►4LA,11 6�, P&eV.Irft (print name) (signature) name) 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 17 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 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, m�aapp Additions to accessory building $25.00. Businesses $50.00. ltl Certificate of Occupancy on Pre-existing Building - $100.00 Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date New Construction.........p... Old Or Pre-existing Building [%�. v g,5........ Location of Property ... 9.r 5...............rL)(A) .�^. .4?�1�14 ..........YGiVi �G� House No. �/� '^ /� Street - f' Hamlet Onwer or Owners of Property....141-4T :/....4�.t...�s]T�Nf:.! .............\................. County Tax Map No 1000, Section... V3 ....... Block .... 11 .......... Lot ... `. ................ Subdivision....................................Filed Map ............ Lot ...................... Permit No................Date Of Permit ................ Applicant .............................. HealthDept. Approval..........................Underwriters Approval......................... PlanningBoard Approval ........................ Request for: Temporary Certificate........... Final Certicate.../\..... Fee Submitted: $..... lez) .................. ............ APPLICANT- "C'n� Form No. 6 TORN OF SOUTHOLD BUILDING DEPARTMENT q TOWN HALL 7 8LDG1rJNMV 765-1802 OF §OU HOLD 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 17 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 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, m�aapp Additions to accessory building $25.00. Businesses $50.00. ltl Certificate of Occupancy on Pre-existing Building - $100.00 Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date New Construction.........p... Old Or Pre-existing Building [%�. v g,5........ Location of Property ... 9.r 5...............rL)(A) .�^. .4?�1�14 ..........YGiVi �G� House No. �/� '^ /� Street - f' Hamlet Onwer or Owners of Property....141-4T :/....4�.t...�s]T�Nf:.! .............\................. County Tax Map No 1000, Section... V3 ....... Block .... 11 .......... Lot ... `. ................ Subdivision....................................Filed Map ............ Lot ...................... Permit No................Date Of Permit ................ Applicant .............................. HealthDept. Approval..........................Underwriters Approval......................... PlanningBoard Approval ........................ Request for: Temporary Certificate........... Final Certicate.../\..... Fee Submitted: $..... lez) .................. ............ APPLICANT- "C'n� ,50E ao 2$ 2 O �Q X30 5 55 NOTES I. THIS SURVEY WAS COMPLETED FROM T)#' FOLLOWING DEEDS, LIBER 3502, pope 209 LIBER 3438, pope 548 LIBER 6101, pope 515 MAP OF TDWN ) MAP FILED IN OFFICE AS 70BER 21, 1968 3. THIS SURVEY WAS PREPARED USING THE PREVIOUS STATED INFORMATION AND PHYSICAL EVIDENCE FOUND ON THE PREMISES. Uncuthorized clteration Cr adeUic.n to ihi, survey is a violation of Scction 7209 of the New York State Education Law, �910104 of this survey mop ncr orcr,ng the Land Surveycrs embossed s�ci sial! not be considorad t: ua a vo;;d true COPY. Guarantees indicated here on shall rtes only to the person for whom the survey is prepered, and on his behalf to the Et{C com?er lCr:n.r .-. LOT 3 MAP OF TOWN HARBOR TERRACE FM 115192, OCT. 21,1968 SURVEY OF DESCRIBED PROPERTY SITUATE SOUTHOLD, TOWN OFSOUTHOL SUFFOLK CO., N.Y. SURVEYED FOR : DANIEL JONES LUCILLE JONES TM # /000 - 063-04 -ll SURVEYED 25 AUGUST, 1995 SCALE 1"z 40' AREA z 65,733 128 SF or ' 1.4636 Acres GUARANTEED TO: DANIEL JONES LUCILLE JONES FIDELITY NATIONAL TITLE INS. CO. THE GREATER NEW YORK SAVINGS B. TOWN OF SOUTHOLD SURVEYED BY: STANLEY J. ISAKSEN, JR P.O. BOX 294 NEW SUFFOLK, N.Y., 11956 (516) 734-5835 LOCATION: SUBDIVISION NAME OF OWNER OCCUPANCY ADMITTED BY: ` ,fP KEY AVAILABLE SOURCE OF REg1JEST: BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT number b street type (municipality) MAP TNOO . LOT(s) owner -tenant ACCOMPANIED BY: T- SUFF . CO . TAX MAP DATE � r DWELLING: TYPE OF CONSTRUCTION , i � I STORIES I EXITS t) FOUNDATION nv�/ CELLAR CRAWL SPACE�- TOTAL ROOMS: IST FLR.-_T 2ND FLR. 3RD PLR. ' BATHROOM (s) _ TOILET ROOM (s) UTILITY ROOM "11Z�4-1 PORCH TYPE; y§ DECK, TYPE "_ PATIO BREEZEWAY FIREPLACEGARAGE DOMESTIC HOTWATER-7 TYPE BEATER �.f��J �. j AIRCONDITIONIN TYPE BEAT P WARM AIR HOTWATER OTHER:`�- ACCESSORY STFii1CTURES: on► blas'/�-� �t�E, TYPE OF CONST. �: , � STORAGE TYPE CONST. e Lf/+ , �?/� — SWIMMING POOL �GUIS;T�rn T.�5' VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE NTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. en / ��i.G:s'�`I��kf �4ir'' �""Y.mvE*�1m6�'�, .'C. Go�lr �" _ � $ti�'cr'✓ \ 1. REMARKS: INS•PE-CTED BY E DATE OF INSPECTION o6�ci1(ij v a TIME START END