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Home My WebLink AboutZ-31155FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 31155 Date: 09/12/05 THIS u~KTIFIES that the building DWELLING Location of Property 100 TERRY CT SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map NO. 473889 Section 059 Block 0011 'Lot 009 subdivision Filed Map No. -- LOt No. -- conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 91 1957 pursn~nt to which c~TIFICATE OF OCCUPANCY i~0MBER Z- 31155 dated SEPTEMBER 12, 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 ACCESSORY 1 CAR GARAGE * The certificate is issued to AiJ%N G BENNETT of the aforesaid building. (OWNER) SUFFOLK COLST~YDBPARTMENT OF~ALTHAPPROVAL Rr~-£KICAL c~KTIFICATE NO. pLUMBEHS cKKTIFICATION DA'r~u *PLEASE SEE ATTACHED INSPECTION REPORT. N/A N/A ~A~hojS~'nature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD NOUSING CODE INSPECTION REPORT SOUTHOLD RUNOLPN BRUEK, ESQ. 9/1/05 ~AT~: 09/12/0S DWELLING: TYPE OF ~ONS~U~'TEO~: WOOD FP3%ME FO~TIO~: CEMENT BLOCK OIL ACCESSORY STRUCTURES: ~, ~PE OF CO~T.: 1 CAR WOOD FRAME STO~E, T~/PE CONST.: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. Form No. 6 TOWN OF $OUTHoLD BUILDINGTOWN. DEPARTMENT HALL ~65-1802 APPLICATION FOR CEKTIFICATE OF OCCUPANCY A. This application must he filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: i. 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-dlsposal(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 IZ 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 P~nning Board Approval of completed site plan requiremen%~. 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 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 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 building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $i00.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . .~.~.~ 3 .............................. . .......... ................. HouseNo. ~ Onwer or Owners of Froperty. Z .., .:, ........................ . . . ,., County T= ~ap No 1000, Sectio~...~....q ..... Bloc~... J. 1 .......... ~o~...~ ................. Subd~v~5on .................................... F~led ~ap ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................ . Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ . Request for: Temporary Certificate ........... Final Certicate. ' COI~$ENT TO INSPI~CTION Ox~eris) Name{s) do(es) hereby state: · the umh~r.~iImed. That the undersigned do(es) hereby give eo~sent to the 13uildh~g ln.~pectors of the Town of Southold to enter upon the above described property, i,~ch, dln~ any and all buildings located thereon, to co~d,~ct such inspections n~ they ,nay deem necessary with respect to the ~fnresald nl,plicntion, iueluding iusp~ctious to determ[n~ that said premises comply with all of the laws; ordb~ance5, rt~le5 and recuiattons of the Town o[ Southold. The undersigned, in eonse,]ttn~ to such bmpectious, do(es) ~o with the knowledge and understandh{E that any hfformatio,] obtained lu the co,~duct o[ such i,~spuutions may be used as evidence in subsequent prosecutiou5 [or v[o- lation~ o~ the laws, ordh~auec., rules or regalatious o[ the Towu o[ Southold. Thnt the Undersignr~d (is) (:xre) the owt]er(~) of tho pretnises [~ xvb[eb [~ SIIOWll ri)id d~si~nated o~1 Ille That the bt]derslg~ed (has) (have) filed, or ea~]sed to be Hied. tton tn the Soathold Town Building Inspector's Office for the LOCATION: (number & street) SUBDIVISION: NAME OF OWNER(S): OCCUPANCY: MAP NO.: (municipality) LOT(S): (type) (owner-tenant) ADMITTED BY: /~-~ ~. ?~_~-~n~.Z7'" ACCOMPANIED BY: ~ KEY AVAILABLE: SUFF. CO. TAX MAP NO. 1000- SOURCE OF REQUEST: DATE: DWELLING: TYPE OF CONSTRUCTION: ~t~ # STORIES: ~ # EXITS: FOUNDATION: C~---~.<~'"-/~w~=_'" CELLAR: /a:,~.~ CRAWL SPACE: ------. TOTAL ROOMS: 1ST FLR: ..~ 2ND FLR: BATHROOM(S): ~ TOILET ROOM(S): PORCH TYPE: ~.'e.~-o4-~.,~.., f~o~DECK, TYPE: -' BREEZEWAY: ~ ' FIREPLACE: ~ DOMESTIC HOT.W/.ftTER: ~$ TYPE HEATER: TYPE HEAT: ~ WARM AIR: OTHER: 3RD FLR: UTILITY ROOM: PATIO, TYPE: - GARAGE: -- AIRCONDITIONING: HOTWATER: / ACCESSORY STRUCTURES: TYPE OF CONST.:t'c TORA E, TYPE CONST.: GARAGE, SWIMMING POOL: "'-- GUEST, TYPE CONST: OTHER: VIOLATIONS: CHAPTER 45 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. REMARKS: INSPECTED BY: ~)~ DATE OF INSPECTION: ~}/~/Q-5~ TIME START; t~O.'gA9 END: