HomeMy WebLinkAboutZ-22571FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-22571
Date SEPTEMBER 8r 1993
THIS CERTIFIES that the building
Location of Property 975 NAVY STREET
House No.
County Tax Map No. 1000 Section 25
Subdivision
ONE FAMILY DWELLING
ORIENTr NEW YORK
Street Hamlet
Block 3 Lot 17
Filed Map No. Lot No.
conforms substantially to the Requirements for a One Family Dwelling built
Prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z-22571 dated SEPTEMBER 8r 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 WOOD FRAME STORAGE SHED *
The certificate is issued to
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
Rev. 1/81
JOSEPH H. ANDRADEr JR.
N/a
N/A
/~,~uilSing Inspector
LOCATION:
SUBDIVISION
NAME OF OWNER (s)
BUILDING DEPARTHENT
TOWN OF SOU~IOLD
UOUSING CODE INSPECTION REPORT
975 NAVY STREET
(number & s£rcet)
MAP NO.
ORIEK[, ~ YORE
(municipality
LOT (s)
~SEPH H. ANDRADE, JR.
OWI~R
OCCUPANCY
A-I RES.
(type)
(owner-tenant)
ADMI'i-i'ED BY: JOSEPH M. ANDRADE, JR. ACCOMPANIED BY: SAME
KEY AVAILABLE SUFF. CO. TAX HAP NO. 25-~03-17
SOU[,C~ OF REQUEST: JOSEPH M. ANDRADE, JR. DATE: SEPT. 3, 1993
DWELLING:
TyPE OF CONSTRUCTION ~K)D FP, AI~
FOUNDATION CEmeNT BLOCK
TOTAL ROOMS:
BATHROOM (s)
PORCH TYPE
BREEZEWAY
DOMESTIC HOT~ATER
TYPE ttEAT OIL
OTHER:
IST FLR. 8
ONE FULL BA~i/
YES
2ND FLR.
TOILET ROOM (s)
DECK, TYPE
FIREPLACE
TYPE HEATER
WARH AIR XX
# STORIES ORE ~ EXITS 3
CELLAR FULL CRAWL SPACE
3RD FLR.
ONE
ELECTRIC
UTILITY ROON
PATIO, TYPE RAISED (C~NT)
GARAGE
AIRCONDITIONING
HOTWATER
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.
S~IMNING POOL
0TieR: RAISED ~NT PATIO
STORAGE, TIFE C0NST.
· GUEST, TYPE CONST.
SHED, WOOD FRAME
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
RFaMA RK S:
Gary~ish~
DATE ON INSPECTION SEPT. 7, 1993
9:40 10:00
TIME START ENIJ
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.
Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
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 appl'icant.
C. Fees
I. 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 - $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 . .~.-
New Construction ........... Old Or Pre-existing Building...~ ............
Location of Property....~.~.~. .... ~..~.~..~ .............. .~.~.~ ~.~. .~.~.7..~.~.~.. .......... .~. -/./ /. /. ?.~.-~.
House No. Street Hamlet
Onwer or Owners of Property .... .........~ ~P 9~..~.........../~ ..~.~.~.~j~'O, .... .~.~.. ~., ...............
County Tax Map No i000, Section ..... .~. ..... Block .... .~. .......... 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: $ .............................
~ C 0 ~-~5'~/ - APPLICANT ~ z ....
CONSENT
TO
~NSPECTION
Oxw~6r(s) Name(s)
do(es) hereby state:
· the undersigned,
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at
O ~ [ ~ A.) ~- ~).~/ . , which is shoxvn and designated on the Suffolk
County tax map as District 1000, Section
That the undersigned (has) (have) filed, 'or caused to be filedo 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
deem necessary with respect to the aferesaid application, including inspections
to determine that said premises comply with all of the laws, ordinances, rules
and regulations of the Town Gf 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 vlo-
lations of the laws, ordinances, rules or regulations of the Town of Southold.
(print name) "
(signature)
(printname)