HomeMy WebLinkAboutZ-30922FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPA~qTMENT
Office of the Building Inspector
Town Hall
Southold,
PRE EXISTING
CERTIFICATE OF OCCUPANCY
NO: Z- 30922 Date: 05/18/05
THIS CEi~TIFIES that the building DWELLING
Location of Property 480 AKA ~40 WASHINGTON AVE. GREENPORT
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 041 Block 0001 Lot 037
Subdivision FiledMap NO. __ Lot No. __
conforms substantially to the Requirements for a ONE FAMILY DWELLING
built prior to APRIL 9, 1957 pursuant to which CERTIFICA~ OF
OCCUPANCY NUMBER Z- 30922 dated MAY 18, 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*
The certificate is issued to CHARLES L. DIMON III & ANO
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF ~ALTH APPROVAL
ELE~-£RICAL CERTIFICATE NO.
PL~4B~S C~TIFICATION D~r~u3
*PLEASE SEE ATTACHED INSPECTION REPORT.
N/A
N/A
N/A
oryed S~ature
Rev. 1/81
BUILDING DEPARTMENT
TO~R4 OF SOUTHOLD
ROUSING CODE INSPECTION REPORT
ACCESSORY STRUCTURES:
VIOL4~TIONS: CHAPTER 45 N.Y. STATE LR4IFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
DATE ON INSPECTION: 05/13/05
TI'M~ START: 10:15 AM ~D: 10:35 AM
I'oUN 0P SOUIIIOLD
765-[802
A~PLICAT/ON FOR.CER~IFICAT£ OF OCCUPA|ICY . ?""~; .. ,-m
Z'hf~ appiicatlon'must be [filed ~n by t~p~rtk~r OR {nk'an~ sabra/tied to tim bulldth~
tn~pector with the follow~ngt [o~ ne~ building or ne~ Oset
Final A~toval [role Itealth Dept~' of ~ater s~pply and sa~e~ge-dispos~l(S-~ [ot~) ~
Appraval of electrical instelldtio~t [rom Board of Fire Un~erwrite~d~
S~oru statmhent from plumber certffy~ng that the sol'er used iu system coht~a
and instailatfons~ a tariff/cate of coda Compliance from: arFi,~tec~ or englnner
responsible Eot the bu/ldln~ ,
6, Submit P~ann~ng ~oard Appravai u[ Completed site pla~ ~qu~remente~
For axfatfn8 bafldfngs (p~foc to April 91 [957} hoc-conforming use~ or bu{id~ga nnd
hpre-exfstfngU land Usesl '
[~ Accurate survey of property shooing ail property lines1 streetss building sod.,
unusuat natural or topographic [eatU=aa,
2, A properly completed application and d consent to inspect signed by the upptlcuat~
if a Certificate of Occupancy is deniedi the Building Inspector shall state the
reasons therefor in uriting to tim upplfeant~
Certificate of OcCupancy - Hew dwelling $25,O01 Additions to dweilt, u8 $25.00,
Alterations to dwelling $2~,001 S~ilmniu8 pool ~25~00~ Accessory hal. Idling ~ZS,00,
2, Certificate of Occupancy on Pru-exfstfn8 Bu[~dfitg - ~[00~00
Cope of Certificate of OccUpancy - ~5.00'Sveu 5 years -
Updated Certificate of OccUpancy -
HoUse Uo. street
Cha~kes L. Dkmon, [[[ an~ B~uce ~. D2mon
. 041.00 0~.00 037.000
'
100.00 ,
~FLlc~rr '
William H. Price, J.r. ..
WASHINGTON (50') AVENUE
~ f~, ~~ P.O. Box a. MatUtuck. N,w York.
CONSENT
TO.
INS I~EC'I'ION
William H. Price, Jr., as agent' for
Charles L. Dimon, .III and Bruce W. Dimon
thc undersigned°
O~vner(s)
do(es) hereby state:
That the undersigned (is) (are) thc owner(s) o(tbe premises [n the Town
of Soutbold located at 40 Washington Avenue, Greenport, New York
0 which ts shown and designated on tile Suffolk
County tax taupes District 1000, Section 041.000 Block 01.00. Lot 037.009
That the undersigned (has) (bare) filed~ or caused to be filed, au applica-
tion in the Southold Town Building Inspector,s Office for the follo%vin~:
Certificate' of Occupancy
That the undersigned do(es) hereby ~ive consent to tile Building Inspectors
of the Town of Souibold to enter upon the above described property~ including
any and all buildings located [bereon, [o conduct such [nspedtions as they may
deem necessary %v~th respect to tile aforesaid application, ~clud~g inspections
[o determine that said premises comply with all of the laws. ordinances, rules
and reRulaitons qf the Town of Soutbold.
The undersigned, In consentln~ to such ~spec/ions, do(es) so with the
knowledge and unde~s~andin~ that any information obtained in the conduct of
such inspections may be used as e~idence in subsequent prosecutions for vio-
lations of the laws, ordinances~ rules or re~laiions of the Town of Southotd.
~pri~ 29,' 2005
Dated/,
(signature)
William H. Price, Jr.
(print name)
(pr tnt name)
LOCATION:
(number & street)
SUBDIVISION:
NAME OF OWNER(S):
OCCUPANCY:
MAP NO.:
(municipality)
LOT(S):
(type)
ADMITTED BY: ~~
KEY AVAILABLE:
SOURCE OF REQUEST:
(owner-tenant)
ACCOMPANIED BY:
SUFF. CO. TAX MAP NO. 1000-
DATE:
DWELLING: U~TION:
TYPE OF CONSTR # STORIES: ~ # EXITS: c,/--
FOUNDATION: ~ ttx-Eo-.~t~ CELLAR: ~ CRAWL SPACE:
TOTAL ROOMS: 1ST FLR: ~ 2ND FLR: ~ 3RD FLR:
BATHRO..O,~M,(S):, o*~..~.~ TOILET ROOM(S): UTILITY ROOM:
PORCH T~ PE:~X~d~.~x. DECK, TYPE: PATIO, TYPE:
BREEZEWAY: " FIREPLACE: GARAGE:
D.O. MESTIC HOT.W~TER: ~t'._c TYPE HEATER: ,ff.t-o~4~,'~- AIRCONDITIONING: --
T~PE HEAT: ~ WARM AIR: ~ HOTWATER:
OTHER:
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.:
SWIMMING POOL:
OTHER:
STORAGE, TYPE CONST.:
GUEST, TYPE CONST:
VIOLATIONS: CHAPTER 45 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
REMARKS:
INSPECTED BY:
TIME START: d'~'?'"/~'~''' z/END:t/