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Home My WebLink AboutZ-30355FOP~M NO- 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Tova~Hall Southold, N.Y_ PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 30355 Date: 08/12/04 THIS CERTIFIES that the building DWELLING ~ ACCESSORY Location of Property 1340 FOURTH ST (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 117 Block 0007 Filed Map No. __ Lot No. __ Subdivision NEW SUFFOLK (H~/~LET) Lot 007 conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCI/PA/~CY NUMBER Z- 30355 dated AUGUST 12, 2004 was issued, and conforms to all of the requirements of 5he applicable provisions of the law. The occupancy for which this certificate is issued is ONE FAMILY DWELLING WITH ENCLOSED FRONT PORCH AND ACCESSORY GARAGE.* THe certificate is issued to WILLIAM & SOTIRA SHIBLEY (OWlqER) of the aforesaid building. SUFFOLK COUNT~ DBPART~4ENT OF ~ALTE i~PPROVAL ELECTRICAL CERTIFICATE NO. PLI~4BERS CERTIFICATION DA'~mu *PLEASE SEE ATTACHED INSPECTION REPORT. N/A N/A N/A ~_,-' Authorized Signature Rev. 1/81 ACCESSORY STRUCTURES: WOOD VIOLATIONS: CHAPTER 45 N.Y. STATE UHIFORI4 FIRE PHEVEHTI0~I & BUILDING CODE LOCATION DESCRIPTIOf] A~T. SEC. CHRISTOPHER M TALBOT ( ~'~ DATE (Z~ INSPECTION: 08/13-/04 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF 0CCITP.~CY This application must be filled in by typewriter OR ink and sub,it ;e~j_.t.o the building inspector with the follo~cing: for new building or new use: ~_~~ 1. Final survey of property wzth accurate location of all 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 eiectrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less thegn 2/10 of 1% lead. 5. Commercial building, ir~dustri~ul building, multiple residences and similar buildings amd instp3_lations, 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-ex~sting" land uses: 1. ~ccurate survey of property showing all property lines, streets, building and unnsual natural or topographic features. 2. A properly completed application and a consent to inspect signed, by the applicant. tfa Cert~-ficate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing ~o the ~pplicant. 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 budding $25.00. Businesses $50.00. " 2. CertJ_ficate of Occupancy on Pre--existing Buildinm-- $i00.00 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 .¢~!y.g?,.¢PP¢ ........................... New Construction ........... Old Or Pre-existing Building. ~.- for a frame dwelling with front & side ""~6~&~&~'~'a d~tached frame garage. Location of Property..~}~? ............ ~9~IY~.PYYPYY .................. ~F% P~!P~A ............ House No. Street Hamlet Onwer or Owners of Property. William Shibley and Sotira Shibley County Tax Map No 1000, Section...~ ....... '.Block..,7 ............ Lot...? .................. Subdivision .................................... Filed Map ............ Lot ...... . ................ Permit No ................ Date Of Permit ................ Applicant ............................. Kealnh Dept. Approval .......................... Underwriters Approval ...... ~ ........ · .......... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicata...X. Fee Submitted: $..tpp.. ........................ ,,' - ' ' ~ 'f'~ 'O'~ers ~ d--~,~D~ -~b~ga~A. APPLICANT W~ckh m, Agen o Z > H J_'~ U CONSENT TO INSPECTION WILLIAM St{IBLEY AND SOTIgA SHIBLEY , · the undersigned, Owner(s) Name(s) do(es) hereby state: That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold lo~ated at 1340 Fourth Street, New Suffolk, New York 11956 which is shown and designated on the Suffolk County tax map as District 1000, Section 177 ., Block 7 , Lot 7 That the undersigned (has) (have) flied, 'or ~aused to be filed, an applica- tion in the Southold Town Building Inspector's Office for the following: a Pre-Existing Use C.0, for a frame dwelling with front and side porches and a detached frame garage. That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southoldgo enter upon the above described property, including any and all buildings located thereon, ~o conduct such iuspeotlons 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 as evidence in subsequent prosecutions for vio- lations of the laws, ordinances, rules or regulations of the Town o~ Southold. Dated:July 27, 2004 //~F~/ , -. ~bigail A. Wickham, Agent (print name)