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Home My WebLink AboutZ-22173FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-22173 Date MARCH 2~ 1993 THIS CERTIFIES that the building Location of Property 38100 MAIN ROAD House No. County Tax Map No. 1000 Section 20 Subdivision ONE FAMILY DWELLING Street Block 3 Filed Map No. ORIENT~ N.Y. Hamlet Lot 9.3 Lot No. conforms substantially to the Requirements for a One Family Dwelling built Prior to: APRIL 9t 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-22173 dated MARCH 2r 1993 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 GARAGE * The certificate is issued to ETHEL ANDERSON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 38100 MAIN ROAD (number & street) SUBDIVISION NAHE OF O~R (s) E'FH~L ANDERSON ORIENT, N.Y. NAP NO, (mun~c[paIiry LOT (s) OCCUPANCY A- 1 RES . OWNER (type) ADMITTED BY: DAVID KAPELL KEY AVAILABLE SOURCE OF REQUEST: HAVE KAPELL (o~mer-tenant) ACCOMPANIED BY: SA~E SUFF. CO. TAX HAP NO. 1000-20-3-9.3 DATE: FEB. 24, 1993 DWELLING: TYPE OF CONSTRUCTION FOUNDATION TOTAL ROOMS: BATHROOM (s) WOOD FRAME CONCRETE & CF2~NT BLOCK IST FLR. 5 2ND FLR. I FULL BATH TOILET ROOM (s) - { STORIES 1 { EXITS 2 CELL/HI FULL CRAWL SPACE 3RD FLR. NTILITY ROOM PORCH TYPE COVERED FRONT PORCHHECK, TYPE SCREEN PORCH SIDE BREEZEWAY FIREPLACE DOI4ESTIC NOTWATER YES TYPE HEATER LILCO GAS TYPE HEAT LILCO GAS WARM AIR CENTRAL FLOOR OTttER: REATER PATIO· TYPE AIRCONHITIONING HOTHATER ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. SWII~IING POOL OTHER: i-1/2 CAR WOOD FRAME STORAGE, ~YFE CONST. · GUEST, TYPE CONST. STORAGE BUILDING REMOVED VIOLATIONS: CItAPTgR 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. DATE ON INSPECTION MARCH I, 1993 TIME START 9:30 AM END 9:50 Ali 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 inspector with the following: 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. 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 $25100, 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. Temporar~y Certificate of Occupancy - Residential $15.00~ Commercial $15.00 / / Date ....... -~ :..~7..~' ~ ...................... Location of Property ................... .~c7.~.'~ ?'. 7.~...~., .t..~..v. 5..~ .~, ................ ' House No. Street Hamlet / Onwer or Owners of Property .... .~.' . ....... .~..V.-j+~..\,~o72 .~. ~_%..~. County Tax Map No 1000, Section ................ oc .................. Lot ...................... Subdivision .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval .......................... Underwriters Approval ......... Planning Board Approval ..................... .. . Request for: Temporary Certificate ........... Final Certicate....~... .... Fee Submitted: $...~?..v~..~ .............. ~ ~ . . APPLICANT Ov co- : 193 CONSENT TO INSPECTION Ox~rner (s) Name(s) do(es) hereby state: undersigned, That the undersigned (is) (are) the owner(s) of the premises in the Town · which is shown and designated on the Suffolk County tax map as District 1000, Section ~.-C~ , Block ~ , Lot That the undersigne~ (have) filed· 'or caused to be filed, an applica- tion in the Southold Town Building 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 dee~t 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. 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 as evidence in subsequent prosecutions for vio- lations of the laws, ordinances, rules or regulations of the To~vn of Southold. (signature) (print name) (siffnature) (print name)