HomeMy WebLinkAboutZ-31289 FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 31289 Date: 11/18/05
THIS CERTIFIES that the building CHURCH
Location of Property 21405 CR 48 CUTCHOGUE
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 096 Block 0001 Lot 013.001
Subdivision Filed Map No. Lot No.
conforms substantially to the Requirements for a STRUCTURE
built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z- 31289 dated NOVEMBER 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 CHURCH BUILDING*
The certificate is issued to FIRST BAPTIST CHURCH OF CUTCHOGUE
(OWNER)
of the aforesaid building.
SUFFOLP. COUNTY DSPARTM@Tr OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
Aut orized Signature
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 21405 CR 48 CUTCHOGUE
SUBDIVISION: MAP NO.: LOT (S)
NAMH OF OWNBR (S): FIRST BAPTIST CHURCH
OCCUPANCY: CHURCH FIRST BAPTIST CHURCH
ADMITTBD BY: JESSE MILES, (TRUSTEE) ACCOMPANIBD BY: PATRICIA SANCHEZ
RHY AVAILABLE: SUPP. CO. TAR MAP HO.: 96.-1-13.1
SOURCE OF RHQUBST: DENISE ROSS, 7/26/05 DATH: 11 18 OS
TYPH OP CONSTRUCTION: WOOD FRAME R STORIES: 1.0 ~ ERITS: 3
POIINOATION: CEMENT BLOCK CBLLAR: FULL CRAWL SPACH:
TOTAL ROOMS: 1ST FLR.: 1 2ND PLR.: 0 3RD PLR.: 0
BATIHLOOM (S): 0.0 TOILBT ROOM(S): 2.0 UTILITY ROOM(S): 1
PORCH TYPE: DHCR TYPE: PATIO TYPE:
BRSHZHWAY: FIREPLACH: NONE GARAGH:
DOMHSTIC HOTWATER: YES TYPH NEATER: HOT WATER AIRCONDITIONING:
TYPE IIHAT: OIL WARM AIR: YES * HOTWATHR: YHS
OTIIHR: BASEBOARD
ACCESSORY STRUCTURES:
GARAGE, TYPH OF CONST.: STORAGH, TYPH COHST.:
SWIMMING POOL: GUEST, TYPE CONST.:
OTHHR:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
_ LOCATION _ DESCRIPTION ART. SEC.
RFMaRxG; HP$(31414 Z-COZ-31288 (ALT)-B Pg31616Z-(DEMO AGCY SHED & WALKWAY)
INSPHCT® BY: DATH ON INSPHCTION: 11/17/05
GSORGH GILLffiI TIME START: 9:95 AM HND: 10:30 AM
' Form No. 6 _ _
' TORN OF SOUTHOLD _ ~ ~ V ~`t, ~ r
BUILDING DEPARTMENT i~' . ~ ~ Y
E ~ .
TowNlsoz L ~ JUL 2 6 2005
APPLICATION FOR CERTIFICATE OF OCCUPAN i I ~
n• -t
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 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 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.
or existing buildings (prior to Apri19, 1957) non-conforming uses, or buildings and "pre-existing" land uses:
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 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 - $100.00
3. Copy of Certificate of Occupancy - $.25
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy -Residential $15.00, Commercial $15.00
Date.
New Construction: Old or P__rfe--~existinQng Building: _ ? (check one)
Location of Property: oZ~~~J~ C~(.NTt~.I /Wre~l y~ ~LG~li.11.DGI.t~,
House No. r Stre/e1t'-' " ~ Hamlet
Owner or Owners of Property: ~ r~ tg~~~ lA]LU t;i'
l~_
Suffolk County Tax Map No 1000, Section qty Block ~ Lot ~.3-
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval: /
Request for: Temporary Certificate Final Certificate: V (check one)
Fee Submitted: $ ~ Q Q ~ Dr7
Applicant Signature
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