The URL can be used to link to this page

Home My WebLink AboutZ-29916FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 29916 Date: 12/15/03 THIS CERTIFIES that the building I~)cation of Property 30640 9L~IN RD (HOUSE NO.) Cou/lty Tax Map No. 473889 Section 103 Subdivision FiledMap No. DWELLING CUTCHOGUE (STREET) (HAMLET) Block 0001 Lot 006 Lot No. conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCC~JPANC~f NL~4B~ Z- 29916 dated DECEMBER 15, 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 WITH ACCESSORY 2 CAR GARAGE * The certificate is issued to LEONARD GREEN II & ANO. (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELEC~rRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DA'£~U3 *PLEASE SEE ATTACHED INSPECTION REPORT. N/A ~/A N/A ~o/r i ~e d/S i ~n~t ur e Rev. 1/81 RUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT I~TEON: 30640 MAIN RD CUTCHOGUE SUBDIVISION: W2%P NO.: LOT ($) N;~ OF O~ (S): LEONARD GREEN II & ANO. O{iC~/PANCY: SINGLE F/~4ILY DWELLING LEONARD GREEN II & ADNI',-rI~3 BY: LEONARD GREEN II ACC~)MRANIED BY: S~34E SODRCE OF IAEQUEST: LEONARD GREEN II 11/21/03 DAT~: 12/15/03 WOOD FRAME CEMENT BLOCK TOILET RO(IM (S): 0.0 DECK ~"/PE: FIP~EPLACE: YES ~"IPE ItEAT~R: KEYSPAN-GAS ACCESSORY STRUCTURES: G~H, TYPE OF C~)NST.: 2 CAR WOOD FP~E STOP~I%GE, TYPE CONST.: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. REINSPECTED ON 12/12/03 DATE ON INSPECTION: 12/02/03 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY ?_ I 2.003 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 requiremm~ts. 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. 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 - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Location of Property: House No. Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Old or Pre-existing Building: Street Date. //- fi/- o__7 J (check one) Hamlet / - ~, Block 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: $ 6520 Final Certificate: (check one) ,~c~Apglicant Sigmatun~ CONSENT TO INSPECTION ARb ~R~Z-,d ~'- ~ , the undersigned, do(es) hereby state: Owner(s) Name(s) R2-~/,o.~ 7-. m/tg~ That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold, located at -To ~.5/o ].~.4 ,,.o SD. C~ 7c.,,,o c,,.,,5 ~ ~/ which is shown and designated on the Suffolk County Tax Map as District 1'000, 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: CF:R7-/,C, cd,?£ 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: /t-2/-o2 ,/1 (Signa(ure) · 7 (Print Nwne) (Signature) (Print Name)