HomeMy WebLinkAboutZ-29535FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 29535
Date: 06/20/03
THIS CERTIFIES that the building ACCESSORY
Location of Property 2000 BROADWATERS RD CUTCHOGUE
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 104 Block 0009 Lot 012
Subdivision Filed Map No. Lot No.
conforms substantially to the Requirements for a
built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY BII~BER Z 29535 dated JLrNE 20, 2003
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 ACCESSORY TWO CAR GAR3~GE WITH STORAGE AREA.*
The certificate is issued to HOWARD R MEINKE
(OWNER)
of the aforesaid building.
SUFFOLK COUNTYDEPARTME~T OF HEALTH APPROVAL
ELEt-rKICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DA'r~3
*PLEASE SEE ATTACHED INSPECTION REPORT.
N/A
N/A
N/A
// A~oriz~d Signature
Rev. 1/81
BUILDING DEPARTMENT
TOW~ OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 2000 BROADWATERS RD
OCCN3PANCY: ACCESSORY GARAGE
ADMI'I-~'~ BY: HOWARD R MEINKE
CUTCHOGUE
NkP NO.: AOT (S)
HOWARD R MEINHE
ACC~PANIED BY: S~E
SI]FF. CO. TAX ~ ~O-: 104. 9 12
DATE: 06/20/03
ACCESSORY STRUCTURES:
C~E, T~PE OF CONST.: 2 CAR WOOD FRAR4E* STOR~R, TYPE Cf~ST.:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
DATE ON INSPECTION: 05/01/03
TI~ START: 10:00AM E~fD: 10:10AM
Form No. 6
TOV~N 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:
A. 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.
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 consent to inspect signed by the applicant. Ifa 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- $.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date. ~/~/~/L. ~'- LT~,
New Construction:
Location of Property: ~/,/~,~,~O
House No.
Owner or Owners of Property:
Suftblk County Tax Map No 1000, Section /~--
Old or Pre-existing Building: ~ _ (check one)
Street
Block ?
Hamlet
Lot
Subdivision Filed Map.
Lot:
Permit No. Date of Permit. Applicant:
Health Dept. Approval:
Planning Board Approval:
Underwriters Approval:
Request for: Temporary Certificate
Fee Submitted:~
Final Certificate: (check one)
~~A~pplicant Si~ature
CONSENT TO INSPECTION
Owner(s) Name(s)
That the undersigned (is) (are) the owner(s) of. the premise~n the Town of
Southold, located at 'Zd'~-~o ~_~9,~4 Z) ////,,t:/~'t'-~ ~> I~_~t
which is shown and designated on the Suffblk County Tax Map as District 1000,
Section /'~,4-,Block ~ ,Lot ,/~_
That the undersigned (has) (have) filed, or cause to be filed, an application in the
Southold Town Building Inspector's Office for the following: __
Fi
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, roles 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 in subsequent prosecutions for violations of the laws, ordinances, roles or
regulations of the Town of Southold.
Dated:
(Signature) rv
(Print Name)
(Signature)
(Print Name)
?
LOT
LOT NUMBERS ARE REFERENCED TO "AMENDED
MAP A OF NASSAU POINT" FILED IN THE OFFICE OF
THE SUFFOLK COUNTY CLERK ON AUG 16,1922 AS
MAP NO 156,
SURVEY FOR
HOWARD MEINKE
AT NASSAU POINT
TOWN OF SOUTHQLD
SUFFOLK COUNTY, N. Y.
IOOO- 104 - 09- 12 8 1.3
SCALE,~ = 30'
MAY 15, 1986
N.~S. LIC. NO. 49615