HomeMy WebLinkAboutZ-31070FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPA/~CY
No: Z- 31070
Date: 08/01/05
THIS CERTIFIES that the building DWELLING
Location of Pr~erty 925 FIRST ST
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 117 Block 0008 Lot 016
Subdivision Filed Map NO. -- Lot No.
conforms substantially to the Requirements for a ONE FAMILY DWELLING
built prior to APRIL 9, 1957 pursuant to which CE~TIFICATH OF
OCCUPAlqCY NO]~BER Z- 31070 dated AUGUST 1, 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.*
NEW SUFFOLK
The certificate is issued to LAURA M AVENT
of the aforesaid building.
(OWNER)
SUFFOLK CODlqT~DEPARTMENTOF~r~ALTHi%PPROVAL
ELEC'~RICAL CERTIFICATE NO.
PL~MBERS CERTIFICATION DA'rKU
*PLEASE SEE ATTACHED INSPECTION REPORT.
N/A
N/A
N/A
Rev. 1/81
BUILDING DEPARTMENT
TO?R~ OF SOUTHOLD
ROUSII~G CODE INSPECTION REPORT
NEW SUFFOLK
NO.: LOT
LAURA M AVENT
2ND FAR.: --3
TOIIB RO~ ($)
DECK TYPE
FI~EPLACE: YES
ACCESSORY STRUCTURES:
VIOL4%TIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. BEC.
[~: BP20851 PORCH COZ22036f BP21145 ADD COZ22592
BP25746 SHED COZ26590
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEP?LRTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF' OCCUPANCY
This application mnst be filled in by typewriter or ink and submitted to th~Building Department with the following:
A. For new building or new use: 1. Final survey of property with accurate location of all bnildings, property lines, streets, and unusual natural
topo~aphic 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 statmnent from plumber certifying that the solder used iu system contains less than 2/10 of 196 lead.
5. Conmaercial building, industrial building, multiple residences and similar buildings and installations, a ce~1ificate
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-cottforming uses, or buildings and "pre-existing" land uses:
1. Accurate smwey ot'property showing all property lines, streets, building and mmsual natural or topographic
features.
2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occnpancy ~s
denied, the Building Inspector shall state the reasons therefor itt writing to the applicant.
C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00,
Swinmdng 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 - $.25
4. Updated Certificate of Occupancy- $50.00
5. Telnpm ary, Certi-ficate of Occupancy - Residential $15.00, Conm~ercial $15.00
Date. July 20, 2005
New Construction:
Location of Property:
Old or Pre-existing Building:
925 1st Street. New Suffolk
House No. Street
X (check one')
Hamlet
Owner or Owners of Property: l.~,,w~ M_ Avont
Suffolk County Tax Map No 1000, Section 117.00
Block 08.00
Lot 016.000
Subdivision Filed Map. _ Lot:
Pennit No. Date of Permit.
Health Dept. Approval:
Planning Board Approval:
Request for: femporary Certificate
Fee Submitted: $ 1.00.00
Applicant:
Unde~xvriters Approval:
Final Certificate: /('Ehegk one}
CONSENT
TO "
INSPECTION
Gary Flanner Olsen as attorney for Laura M. Avent the undersigned,
Owner(s) Name(s)
do(cs) hereby stab::
That the undersigned (is) (are) the owner(s) o£ thc premises in the Term
of Southold located at q?5 1¢~- ¢~r~=~; u .... Su~e!k
which is shoxm and designated on thc Suffolk
County tax map as District 1000, Section 117.00 , Block 08.00 , Lot 016.000.
That the undersigned (has) (have) filed, 'or caused [o be filed, an applica-
tion in'th~ Southold To~ ~u~lGing lllsp~u~ '~ ocfi~ f~ +~ fallowing:
Two story frame house
That the undersigned do(es) hereby give consent to the Building inspecLors
et the Town of Southold to enter upon the above described property, including
any and all bu[ldings 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.
Thc undersigned, in consenting to such h~spec[ions, do(es) so x~th the
knowledge and understanding il]at any ~[ormation obtained In the conduct of
such inspections may be used as evidence in subsequent ~cut[ons for vie-
/
lations of the la%va, ordinances, rules or re.latins ~ ~Toxvn et Southold.
(prkot name)
(si~nature)
(print name)
(number & street)
(municipality)
SUBDIVISION: '- MAP NO.: "'"--- LOT(S):
NAME OF OV~NER(S): ]~/4~ /n~ '. ~V~-~A/7 . , ~
(t~e) (owner-ten~t)
ADMITTED BY: ~..~P~M/~ ~ /~l. /)-k]~-~AJ ~7"~ACCOMPANIED BY:
KEY AVAILABLE: I I ' ~ SUFF. CO. TAX MAP NO. 1000-
SOURCE OF REQUEST: ~"/t~/~ y OZ....~ ~-/~ DATE: O-
DWELLING:
TYPE OF CONSTRUCTION: ~0oj~ ~('/}~q ~'- # STORIE~: ~2. # EXITS:
FOUNDATION: ~'/e/~/~7~:: /ggO~ CELL~: ]°~'~7"- CRAWL SPACE: ~---~--~7-
TOTAL ROOMS: 1ST FLR: ~.. 2ND FLR: ~ 3RD FLR:
ll.A-'I~ROOM(~: ] TOILET ROOM(S):
/77 PORCH_~~/F~'/} ~ 0 ~J~bDECK, TYPE: .~
/ -~'-]~REE-~L~AY: , · , FIREPLACE: ~
DOMESTIC HOTWATER: ~ ~ TYPE HEATER:
TYPE HEAT: O ~ ~ WA~I ~R: ~ ,
ACCESSORY STRUCTU~S: ~o~
GAUGE, TYPE OF CONST.:
s~rIMMING POOL:
OTHER:
UTILITY ROOM: -----
PATIO, TYPE: ~
GARAGE: ---..-
oAIRCONDITIONING:
HOTWATER: /~r~
STORAGE, TYPE CONST.:
GUEST, TYPE CONST:
VIOLATIONS: CHAPTER 45 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
REMARKS:
TIME START: