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Home My WebLink AboutZ-30739FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 30739 Date: 02/03/05 THIS CERTIFIES that the building DWELLING Location of Property 1080 OLD SHIPYARD RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 064 Block 0004 Lot 024 Subdivision Filed ~hap 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- 30739 dated FEBRUARY 3, 2005 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 TWO CAR GARAGE * The certificate is issued to ALI & WENDY AZMOUN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTHAPPROVAL EI~L-rKICAL CERTIFICATE NO. PLUMBERS CERTIFICATION D~£~ *PLEASE SEE ATTACHED INSPECTION REPORT. N/A N/A N/A Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT I~)CATIO~: 1080 OLD SHIPYARD RD l~ OF O~ (S): ALI & WENDY AZMOLrN OCCUPANCY: SINGLE FAMILY DWELLING SOUTHOLD ~ NO.: LOT (S) ALI & WENDY AZM0UN SOURCE OF P.~T: SHIMRON LEAVITT, 05/09/02 DATE: 02/03/05 STORIES: CRLIJ%R: FULL 1.5 # EXITS: 4 ACCESSORY STRUCTURES: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. P~: BP #30759-ZC0 Z-30738 (ENCLOSE PORCH) Form No. 6 TOWN 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 inspector with the following: 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 I% 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: 1. 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. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees i. 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 - $5.00 over 5 years - $I0.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ........ ............ Date New Construction ........... Old Or Pre-existing Building...K ............. / uthold Location of Property...104O.Ql~ ........ So. . . $~$py@r~ Lane~ ........................................... House No. Street Hamlet Onwer or Owners of Property ........................... . ....... County Tax Map No I000, Section, 064.00 .Block..Q~:99. L^t 024.000 SubdivisionFo~der~.~ ........... 83~ t 93 ......... Map ....... L ............. Filed .... o ......... Permit No ......... Date Of Permit ............... ~ ~' ~ Sharon Leavitt ....... .app±mcann. ............................ Health Dept. Approval .......................... Underwriters Approval .... Planning Board Approval ..... Request for: Temporary Certificate ........... Final Certicat~,,. X Fee Submitted: $.lOO,OO ...................... / ~ . .... .. ............... ~/l~ C0"~' %~.%~ APAP~LICANT ' SHARON LEAVITT L~T NUNBERS REFER TD 'SUBDIVISION ,YAP OF F~UNDERS ESTATES* FILED i~ THE ~UFFDLK C~UNTY CLE~K'~ ~FFICE ON NAr JO. i9~7 AS FILE NO 834 9~ 9~ · =~NUMENT AREA=Ii,2£7 S,F, SURVEY OF PROPERTY AT SOUTHOLD TO~N OF SOUTHOLD SUFFOLK COUNTY, NE~ YORK 1000-64-04-~4 SCAI~: 1"=20' ~^UCH ,~, 2002 CERTIFIED LAURA P. Y~UNG NORTH FORK BANK ~DUTH BAY ABSTRACT, INC. 1830 TRAVELER STREET S~]OTHGLD, N Y 11971 02-t#0 CONSENT TO INSPECTION Sharon Leavitt, Executrix of the E~tate of Laura P. Young , 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 located at 1040 01d Shipyard Lane, Southold, New York , which is shown and designated on the Suffolk County tax map as District 1000, Section 064-09 Block 04.00 , Lot 024.000. That the undersigned (has) (have) filed, or caused to be filed, an applica- tion in the Southotd Town Building Inspector's Office for the following: PreExisting Certificate of Occupancy 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 as evidence in subsequent prosecutions for vio- lations of the laws, ordinances, rules or regulations of the Town of Southold. Dated: (signature) Sharon Leavitt {print name) (signature) (print name)