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Home My WebLink AboutZ-28092FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 28092 Date: 11/30/01 T~IS CERTIFIES that the building DWELLING & ACCESSORY I~Dcation of Property 100 TERRY PL (HOUSE NO.) County Tax ~ap No. 473889 Section 076 Subdivision SOUTNOLD (STREET) (HAMLET) Block 0002 ~t 012 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- 28092 dated NOVEMBER 30, 2001 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 AND ACCESSORY SHED.* The certificate is issued to BESSIE RAIqDEL AUSTIN (OWNER) of the aforesaid building. SUFFOLK COI~qT"fDEPAN~ OFB]~L~{APPROV;%L ELEC~fRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DA~r~U *PLEASE SEE ATTACHED INSPECTION REPORT. N/A N/A N/A ut h~ri ze~/Signature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTROLD HOUSING CODE INSPECTION REPORT LOCATION: 100 TERRY PL SUBDIVISION: NAME OF OW~ (S): BESSIE RANDEL AUSTIN OCC13P2%NC"E: SINGLE FAMILY SOUTROLD MAP }{O.: LOT (S) BESSIE R~DEL AUSTIN F~ A%r~I,ABI~: SUFF. CO. TAX 14A~ NO.: 76. 2 12 SO{3RC]~ OF R~QW~ST: PETER & CAROL MILLER DATE: 11/30/01 DWELLING: TYPE OF CONSTRUCTION: WOOD FRI<ME FOUNDATION: CEMENT BLOCK CRAWL SPACE: PART ACCESSORY STRUCTURES: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. P,~: RE INSPECTED 11/28/01 GARY J FISH DATE ON INSPECTION: 11/09/01 TIME START: 10:35AM END: ll:05/LM BLDG. D '[ ,: ! 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 submJ inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all build ~gs,_p~B~;~.nes, streets, and unusual natural or topographic features. - ~S~ ' 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 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 - $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 ............ '. ~/.~../~ .~ ................ .. New Construction ....... .'''' Old Or Pre-existing Building~.ff~ ..... ~. ......... ~Ocx ~o~ Location of Property ..... LO.~ ........ .-~..~ .~.~ .... ~ ~ ..................... / .~. House No. --Street Hamlet Onwer or Owners of Property ....... ~ .~-[..¥.¢ ...~...~.....~...~..' ...... County Tax Map No 1000, Section .... .~..~.~-...Block ..... .~.. ........ Lot..~,~ .............. Subdivision .~. ~.~.~.~.,...~-. ~Q~ ....... .... Filed Map.. J. ~.~. ~.Lot ..... Z.~f~. .......... No ...... .. ........Date Of Permit ...... .... ......Applicant...~.~.~...~.. ............. Permit Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate .... ~.. .... Fee Submitted: ~..?...~..,..~. ................. I to%t01 '" .......... CONSENT TO INSPECTION Owner(s) /Name(s) ~. do(es) hereby state: · the undersigned, That the undersigned (is) (are) the owner(s) of the premises in the Town County tax map as District 1000, Section ~ ~ . Block ~ . Lot That the undersigned (has) (have) filed, or caused to be filed, an applica- tion in the Southold To~ Building Inspector's Office for the follow~g~ 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 as evidence in subsequent prosecutions for lations of the laws· ordinances, rules or regulations of the Town of Southold. (signatfre) (pri~t name) (signature) (print name) ~ X~ ~ , ~. KULak& pr.~ ~ ;~ 11/01/01 TIiU 22:03 [T~/ILIE NO 995§1