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Home My WebLink AboutZ-29602 FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 29602 Date: 07/29/03 THIS CERTIFIES that the building DWELLING Location of Property 200 HARBOR LIGHTS DR SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No_ 473869 Section 071 Block 0002 Lot 010 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- 29602 dated JULY 29, 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 ONE FAMILY DWELLING The certificate is issued to WILLIAM JONES (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. uth ized ignature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOC]\TION: 200 HARBOR LIGHTS DR SOUTHOLD SUBDIVISION: MAP NO.: LOT (S) NAME OF OWNHR (S): WILLIAM JONES OCCUPANCY: SINGLE FAMILY DWELLING WILLIAM JONES ADMITTED BY. WILLIAM JONES ACCOMPANIED HY: SAME RHY AVAILABLH: SUFF. CO. TAX MAP NO.: 71.-2-10 SOUACH OP RSQUHST: RUDOLPH HRUER ATTY - 7/16/03 DATE: 07 29 03 DWELLING: TYPE OP CONSTRUCTION: BRICK WALLS # STORMS: 2.0 # HXITS: 6 FOUNDATION: BAICK CHLLAR: FULL CRAWL SPACE: TOTAL ROOMS: 1ST FLR.: 5 2ND FLR.: 7 3RD PLR.: 0 BATHROOM(S): 4.0 TOILHT ROOM(S): 2.0 UTILITY ROOM(S): PORCH TYPH: 1 COVERED-1 SCREEN PORCH DECK TYPH: PATIO TYPH: BRHHZHWAY: PIRSPLACH: 4 GARAGH: DOMESTIC HOTWATSR: XX TYPH HEATBR: OIL AIRCONDITIONMG: TYPE HHAT: OIL WARM AIR: HOTNATHR: STEAM OTRER: PANTRY OFF KITCHEN ACCESSORY STRUCTURES: GARAGE, TYPH OF CONST.: STORAGH, TYPE CONST.: ACCESSORY METAL SHED SWIMMING POOL: GUEST, TYPH CONST.: OTHHR: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIAE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. RRYDRKC• MSPECTSD BY: DATH ON INSPHCTION: 07/15 03 GARY SH TINE START: 10:00 AM HND: 10:30 AM Form No.6 TOWN OF SOUTHOLD -Q~~y'~~~ BUILDING DEPARTMENT ~ rti~ TOWN HALL 765-1802 ,n APPLICATION FOR CERTIFICATE OF OCCUPANCY ~~~1 ' ~~N~~ 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. Swom 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 azchitect 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) uon-conforming uses, or buildings and 00pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or ta,_ 1.,' features. 2. A properly completed application and consent to inspect signed by the applicant. If a'C9ryrtificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the appliclirit, ' 6 ~ ~ , JUL C. Fees ~ r - - j 1. Certificate of Occupancy -New dwelling $25.00, Additions to dwelling $25.00, Alter lions-to dweliiittg $,~'S Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $ S.OO,TBi1~ihtcsses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $25.00 4. Updated Certificate of Occupancy - $50.00 S. Temporary Certificate of Occupancy -Residential $15.00, Commercial $15.00 ~~pp Date. ~ °~1Y New Construction: Old or PlIre"~-existing B1uilding: ~ (check one). Location of Property: ~ n I'ICl/L YXJr ),_,l Q Y1~S ~r~ _ v ~r House No. II -re~e't Hamlet Owner or Owners of Property: ~ l ~ f ~ r~'VY~ - ~O I'~2_ S Suffolk County T,ax M1~a,,p No 1 f000, Section "-7 O Q Block c bu Lot Q/(~• C~(~(1 Subdivision ~INVV~ F-~Gl~~ Filed Map. y~p~ ( Lot: LI a Permit No. Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval^ Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ ) 0-p, o-0 -~T Applicant Signature C~.~, ~ y38s co ~ ~ 9~0 T-502 P-0941905 f-93ti 6313886192 q~ ~ ~1\1~;11C~,rf~gi~ 09:21 from-Clardll 1 DpayceY ~ i4~-, Ju1-14-93 ~1~$ 1~ r6t ;o r ~`""~atl>" -~'jx•os;y~s ~ 1~ P i i t;. r ~ I ~ 4 ( a l1 s ~ ~ ` ~ ~ . / ~ hQf~ ~ LL}~h ~ A d7~ ~ ~zzrq~ _ _ - q ; ~ gf ~ 1' a" ~ - ''iLt~1.L1.1~~~Wt11i1~~u.~sat~~~~g ~ a' ~4 ,~;x:~ Jul-id-03 OB:22 Frpm-Ciaralli 8 Dempsey 6313685132 T-502 P.005/005 f-931 W~E I S ~T B W ~ ~ ~Q\\` _ ~ ~ - _ R 7 g~; ~ ; _a tr //~RY d~' ea 1 ~ a4 _ O'~\ V \ -Y ~ ,~awfsMrgr~'- y l Sy-s~ gip, w ~~3~~~ - _ IOI IN C. EHLERS LAND SUP.VfiYOP mYws~~en09 sfRFEI N.YS.LG NO. SO]@ n RIYPFIU:M. N.Y. 11901 '169-B: rtI P¢Y4dHT YR: wHPWmWPPd5V3-~nago CONSENT TO INSPECTION ~ t 1 ~ ~,Lj~ (,~YIQ~S ,the undersigned, do(es) hereby state: Owner(s) Name(s) That the undersigned (is) (are) the owner s) of the prem ses in the Town 9f Southold, located at ~iO ~'~/.t_}1'/1 ~ ~i~s.ltr9 I~[.Y (,~L~~~C~~O% , which is shown and designated on the Suffolk Cou y- Tax Map as District 100 , Section ,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: ~ f ~/1~ 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 in subsequent prosecutions for violations of the laws, ordinances, rules or regulations of the Town of Southold. Dated: ~/~rj/G ~ ~ c"C~' Oda (Signa re) (Print Name) (Signature) (Print Name)