HomeMy WebLinkAboutZ-30097FORM NO. 4
TOW/q OF SOUTHOLD
BUILDING DEP~RTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUP~NCY
No: Z- 30097
Date: 03/18/04
T~IS CERTIFIES that the building DWELLING
Location of Property MANSION HOUSE DR
(HOUSE NO.) (STREET) (H3%MLET)
County Tax Map NO. 473889 Section 006 Block 0005 Lot 008
Su]~division FiledMap No. Lot No.
conforms substantially to the Requirements for a ONE FAMILY DWELLING
built prior to APRIL 9, 1957 pursu~nt to which CERTIFICA~q~ OF
OCCUPAMC~f NUMBER Z- 30097 dated MARCH 18, 2004
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 ATTACHED GARAGE *
FISHERS ISLAND
The certificate is issued to WALLACE CALNEY
of the aforesaid building.
( OWNER )
ELECTI~ICAL CERTIFICA~ NO.
PLL~BERS CERTIFICATION D~mu
*PLEASE SEE ATTACHED INSPECTION REPORT.
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: MA/~SION HOUSE DR
SDBDIVISION:
N~ OF O~ (S): WALLACE CALNEY
OCCUPANCY: RESIDENTAIL
FISHERS ISLAND
MAP NO.: LOT (S)
WALLACE CALNEY
ACC~PANIED BY:
1/07/04 DATE: 03/18/04
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
P~: BP#2489Z-COZ2778(ADD)BP#28727Z-COZ30080(ADD)BP#29974Z-COZ30081-CHIMNEY
DATE ON INSPeCTIOn: 03/18/04
TIME START: ~:
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF occUPaNCY
,!AN
This application lnust be filled in by typewriter or ink and submitted to the Building Department with tbe followiog:
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.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses:
I. 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. Ifa Certificate of Occupancy
is denied, the Building Inspector shall state the reasons therefor in writing to the applicant.
C~3_~7' Certificate of Occupancy on Pre-existing Building - 5;100.00 3. Copy of Certificate of Occupancy - $25.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
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.
New Construction:
Location of Property:
Old or Pre-existing Building: ~/ (check one)
House No. Street
Owner or Owners of Property: /~/,~ t t ,~ ~ t~ d ,~ c ~ ~: )/
Suffolk County Tax Map No 1000, Section 006.
Snbdivision
Permit No.
Date of Permit.
Hamlet
Block
Filed Map.
Applicant:
Lot
Lot:
Health Dept. Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $ /oo. O o
300 q '?
Underwriters Approval:
Final Certificate:
(check one)
nt Signature
~ LOCATION MAP SCALE 1"=400'
CONV~ED TO WAL~CE CALNEY; FISHERS IS~ND, NEW YORK; SCALEr 40 ~ 0 ~ Z
~; CHANDLER ~ PALMER, ENGRS; SEPT, 1955
FOR THE PAR~IES AND PURPOSE INDICATED
// HEREON, ANY E~ENS~ON OF THE USE B~OND TNE PURPOSED AGREED TO
~ENGAGEMENT.BETWEEN THE CLIENT AND THE SURVEYOR EXCEEDS THE SCORE OF THE
UNLESS ACTING UNOER THE DIRECTION OF A LICENSE~ ~ND SURV~OR, TO
ALTER AN ITEM IN ANY WAY,
PAUL/NE D. wr~.L~~~° / 0'7¢~~ X, ~ 5.)SURVEY TRIANGU~T'ON STATION ""ROS"siTE IS IN THE TOWN OF
-
dANE ~. GOSS ~ >
/
dALI~ CONTROL CERTIFICAT(ON m o
~,~,~ DATE: 06/09/2003
F2534
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