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Home My WebLink AboutZ-30543FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 30543 Date: 11/10/04 T~IS CERTIFIES that the building DWELLING & ACCESSORY ORIENT Location of Property 38200 MAIN RD (HOUSE NO.) Cou/~ty T~-x Map No. 473889 Section 020 (STREET) (HAMLET) Block 0003 Lot 014.003 subdivision Filed Map No. __ LOt No. __ conforms sL~bstantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 30543 dated NOVEMBER 10, 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 UNHEATED COVERED FRONT PORCH ~dfD ACCESSORY The certificate is issued to HENRY W BURDEN, TRUSTEE (OWNER) of the aforesaid building. SUFFOLK COI/N~YDEPAR~]~qT OF ~I~2%LTEAPPRO~q~L ELECTEIC~J~ CERTIFICATE NO. PLI~BERS C~TIFICATION DA'r~3 *PLEASE SEE ATTACHED INSPECTION REPORT. N/A N/A N/A Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT I~TION: 38200 MAIN RD NACRE OF OW~ (S): HENRY W BURDEN, TRUSTEE OCCUPANCY: SINGLE FAMILY DWELLING ORIENT MAP NO.: LOT (S) HENRY W BURDENI TRUSTEE ACCOMRANI]~D BY: SAME K~ A%L%II~AR: ~trFF. CO- TAX ~ NO_: 20.-3-14.3 SOL~RCE OF P~QI~EST: HENRY BURDEN DA~: 11/10/04 DWELLING: TYPE OF CONS~UCTION: WOOD FR3%ME FOUNDATION: BLOCK & STONE # STORIES: CEI~I~: FULL 2.0 # EXITS: __3 ACCESSORY STRUCTURES: C~N, ~PE OF CONST.: WOOD FR/LME BARN ~roP.~E, ~PE CONST.: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. R~: BP6863 ADDITION COZ5934 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 Department with the following: A. For new building or new use: 1. Final su~ey of property with accurate location of all buildings, property lines, streets, and u~usual 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. 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 venting to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, 3. 4. 5. Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. Certificate of Occupancy on Pre-existing Building - $100.00 Copy of Certificate of Occupancy - $.25 Updated Certificate of Occupancy - $50.00 Temp°rary Certificate °f Occupancy - Residential $15'00' C°mmercial $15'00 ti~--~ / L-0 16~Date. New Construction: Old or Pre-existing B_uilding: ~ (check one) Location of Property: 3 ~'t~ 01) '~t~ ,,n ~'~C] House No. Street Owner or Owners of Prope y: I Suffolk County Tax Map No 1000, Section Subdivision Hamlet eaegO Block ,~ Lot It"/, 3 Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Final Certificate: / / Applicdnt Signature CONSENT TO INSPECTION Owner(s) Name(s) , the undersigned, do(es) hereby state: That the undersigned (is) (are) the owner?).of the~remises in the Town of Southold, locatedat 3$&0B l'¥~.~,a ~ (3f-Ie-¢c~' which is shown and designated on the Suffolk County Tax Map as District 1000, Section o~ , Block ~ , Lot Iq. · That the undersigned (has) (have) filed, or cause to be filed, an application in the Southold Town ~uilding Inspector's Office for the following: 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 respe~,zt to the aforesaid application, including inspections to determine that said premises con, ply 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. ,/ [ (Sig~ a ,t~) '~(Print Name) (Signature) (Print Name) SURVEY OF PROPERTY SITUATED AT ORIENT TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1OOO-20-03-14.3 SCAL[ 1"=20' Joseph A. Ingegno Land Surveyor 98-161