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Home My WebLink AboutZ-29800FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 29800 Date: 10/28/03 THIS CERTIFIES that the building COMMERCIAL BUILDING Location of Property 50000 MAIN RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 070 Block 0005 Lot 006.002 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a BUSINESS STRUCTURE built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 29800 dated OCTOBER 28, 2003 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 COMMERCIAL BUILDING.* The certificate is issued to LISA G JEROME (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECT Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 50000 MAIN RD SOUTHOLD SUBDIVISION: MAP NO.: LOT (S) NAME OF OWNER (S): LISA G JEROME OCCUPANCY: BUSINESS - HARDWARE STORE LISA G JEROME ADMITTED BY: BILL GOODALE ACCOMPANIED BY: SAME KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 70.-5-6.2 SOURCE OF REQUEST: LISA G JEROME DATE: 10/28/03 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 1.0 # EXITS: 0 FOUNDATION: CEMENT BLOCK CELLAR: CRAWL SPACE: X TOTAL ROOMS: IST FLR.: 6 2ND FLR.: 0 3RD FLR.: 0 BATHROOM(S): 0.0 TOILET ROOM(S): 1.0 UTILITY ROOM(S): PORCH TYPE: DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: GARAGE: DOMESTIC HOTWATER: NO TYPE HEATER: AIRCONDITIONING: TYPE BEAT: NAT GAS WARM AIR: X HOTWATER: OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: SWIMMING POOL: OTHER: STORAGE, TYPE CONST.: METAL SHED GUEST, TYPE CONST.: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE SEC. INSPECTED BY: DATE ON INSPECTION: 10/23/03 15AM Form No. 6 / TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 1- „ ... This application must be filled in by typewriter or ink and submitted to the Building Depa t 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 installatiolt from Board of Fire Underwriters. 4. Sworn statement from plumber cert fying.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. B. r existing buildings (prior to April 9, 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, A to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildin - $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. /0-20-03 New Construction: Old or Pre-existin Building: ✓ (check one) Location of Property: House No. / t eet Hamlet Owner or Owners of Property: L /,5i��O/�l Ic Suffolk County Tax M;fz 1000, Section 70 Block Subdivision Filed Map. Permit No. IJ JA' Date of Permit. Applicant:_ Health Dept. Approval: N 'Pr- Underwriters Approval: Planning Board Approval: o, Request for: Temporary Certificate Lot (V . 7 -- Lot: Final Certificate: V"'- (check one) Fee Submitted: $ C) 9 � y Ap licant Signature CONSENT TO INSPECTION 6, k .. f— , the undersigned, do(es) hereby state: Owner(s) Name(s) That the undersigned (is) (are) the owneits4 of the premises in the Town of Southold, located at !Srj 4&Yj AX /A1 40 - y T 60 which is shown and designatepn the Suffolk County Tax Map as District 1000, Section 70 , Block �!. Lot !o • �� That the undersigned (has) (law -a) filed, or cause to be filed, an application in the Southold Town Building Inspector' Office for the following: RW - Cts Z? AIA ,2 D u/A R e --n3 MQc-- 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 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 in subsequent prosecutions for violations of the laws, ordinances, rules or regulations of the Town of Southold. Dated: (Signature) �-� (Print Name) (Signature) (Print Name) ass-saox suiwa BUILDING or. N [ ]FOUNDATION IST [ ]ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ J FIREPLACE 8 CHIMNEY REMARKS. O 46Fl%P DATE IVIP 31oO.3 INS IN -K -so •p , I i -N, LIR fr bid,. duo L --J N.79W�10"W tort .-Zi,- M4P C-jr-- f j e. Scale' ., 40 O fr bid,. duo L --J N.79W�10"W tort .-Zi,- M4P C-jr-- f j TO THE A- wi VUTI C; I. W. 7 4 -WW VW 0 �Vk 9 e. Scale' ., 40 J AL ?'ax Map Ooz lo 4:>,'S+. 1000f 5ecf.0'70 2 lc-ak 15, /Loft "7. -Ai L"AUTHORUED ALURATION OR AD-J)ITIOt TO THIS SURM IS k y; 'AII0 OF 3rCTlCK' 7209 OF Thi 4to litv YC) STATE EDUCATION LAW. Merit COPIES 6F TNi, Y M,�,� Tc t's, i LAWP, TO BE A ie is TO THE A- wi VUTI C; I. W. 7 4 -WW VW 0 �Vk 9 M-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION IST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ J INSULATION [ ]FRAMING [ ]FINAL [ ]FIREPLACE 8 CFIIMNEY ��--I �- L /S� REMARKS: DATE <()l 2:f:)1 0-3 INS LOCATION: e`-0600 SUBDIVISION: NAME OF OW OCCUPANCY: (number & street) (type) MAP NO.: (municipality) LOT(S): s A404t d( -1001- f GR (owner -tenant) ADMITTED BY: !�R 1 l t O d G �•�+ ACCOMPANIED BY: �5 444f = TOWN, OF SOUTHOLD PROPERTY RECORD CARD YWNER , STREET „ , l VILLAGE , DIST. ( COUNTY TAX MAP NO. I L% S Q�iir-je. I /V,4 /N, l�C I �O u7Y1 Uf X4 f LL K43 tic' /G{ i , u _ LAND IMP. TOTAL DATE REMARKS: �Q �' ✓ O / G Z- �"''r ` �. �/' Q !</fl ."'��. - Q. .: l;i "' �r'r �, lii��i . j- , Q L3 i 4t� 2.-. 26 e� aq ;oy)S taiteAa 6-n OWNER STREET VILLAGE DISTRICT SUB. LOT FQf MER QWNER N E A ACREAGE ,� ^ "�� '�� '-: • 1 :.-w� all ,_ _�r � � S W ��.L-, It �„�, TYPE OF BUILDING RES. SEAS. VL. FARM COMM — I ' INq. CB. I MISC. _LAND IMP. TOTAL DATE REMARKS ZWX 714 . ® q700 Cid® 60 � / A/ 3}0--0 3 /B G �,d•,_!/ „�, i� V ii Q I/ ,-3&,,L 1C, 6 D d Z % /h �"` 6c�G�'�3�/i6/y3" 's AJ $o�� a E ff ht Q BUILDING C DITIO NEW NORMAL BELOW ABOVE Farm Acre Value Per Acre Value Tillable 1 Tillable 2 Tillable 3 Woodland Swampland Brushland House Plot El M. Bldg. Foundation Both Extension 2 Basement Floors 6 Extension — �— 2 - Op Ext. Walls A5b Interior Finish Extension Fire Place Heat Porch Attic Porch Rooms 1st Floor E Breezeway Patio Rooms 2nd Floor Garage Driveway 0. B. 5�4 I Wd •A V-,