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HomeMy WebLinkAboutZ-29088FORM N0~ 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 29088 Date: 11/20/02 T}{IS CERTIFIES that the building Location of Property 290 OAK ST (HOUSE NO.) County Tax Map No. 473889 Section 141 Subdivision DWELLING MATTITUCK (STREET) (HAMLET) Block 0001 Lot 016.001 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 ~C~3PANC~f NNMBHR Z- 29088 dated NOVEMBER 20, 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 ACCESSORY METAL SHED * The certificate is issued to JOHN & DOROTHY V ZAWASKY ( OWNER ) of the aforesaid building. SUFFOLK COUIF/~fDEPARTM}~qT OF ~EALTEAPPROVi~J~ ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DA'£~a3 *PLEASE SEE ATTACHED INSPECTION REPORT. N/A N/A N/A Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTH©LD HOUSING CODE INSPECTION REPORT LOC3%TION: 290 OAK ST MATTITUCK S~IVISION: ~ NO.: LOT (S) N~ OF O~ (S}: JOHN & DOROTEY V ZAWASKY OCC~CY: SINGLE FAMILY ADMl'rr~u BY: JOHN J. ZAWASKY ACCOMPANIED BY: SAME JOHN & DOROTHY V ZAWASKY ACCESSORY STRUCTURES: METAL SHED VIOI~TIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. R~: BP #28871Z-COZ29087 (DECK ADD) DATE ON INSPECTION: 09/30/02 TI~ START: 10:10 AM E~D: 10:35 AM Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department 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 from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. Bo 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 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. Co 1. Certificate of Occupancy - New ~lwelling $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 - $25.00 4. UpdatedCertificateofOccupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Location of Property: Old or Pre-existing Building: O,~l lt House No. Street (check one). Hamlet Owner or Owners of Property: t~'oPl~ _~X~lq~t~$l~)/ Suffolk County Tax Map No 1000, Section Subdivision Permit No. Health Dept. Approval: Planning Board Approval: Date of Permit. Block I Lot /t~ , / , Filed Map. Lot: Applicant: Underwriters Approval: Request for: Temporary Certificate Fee Submitted: $ /~, c,o Final Certificate: (check one) ff 6!6plaint Signatttt3e Ownez (s) Name(s) do(es) hereby si ate: of Southold loca County tax ma That the t/on in-th,~ Senti ex, CONSENT TO · INSPECTION · the undersigned, That the un~tersigned (is) (are) the owner(s) of the premises in the Town · which is shown and delighted on the Su[folk as District 1000, Section /~l , Block / ., Lot 'dersigned (ha~) {have) filed, 'oc caused ~o be filed, an applica- old To~ ~uzlOing lnsp~c~ '~ ortr.~ z~ +h. ~nllowin~: That the unflers~ned do(es) hereby give consent to ~e Build~g Inspectors of the Town of outhold to enter upon the above described property, incl9ding an3 and all bu[ll[n~s located thereon, to c~nduct such i~spections as they may deem necesSar~ with respect to th* aforesaid application, ~elud~'inspections to determine that said premises eompl~ with all or th* laws, ordlnanees, rules and regulations, of tho Town or Southold. The under igned, in consenting to such ~sPectlons,, do(es) so x~th the knowledge and Onderstanding that any ~format~on obtained In the conduct such inspection~ may'be used as evidence in subsequent prosecutions for vio- lations o[ the l~ws, ordinances, rules or regulations o£ the Town of Southold. Dated: (print name) (signature)