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Home My WebLink AboutZ-18579FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-18579 Date NOVEMBER 20r 1989 THIS CERTIFIES that the building. Location of Property 200 FOUNDERS PATH House No. County Tax Map No. 1000 Section 64 Subdivision ONE FAMILY DW~LT.TNG 80UTHOLD r NEW YORK Street Hamlet Block 2 Lot 25 Filed Map No. Lot No. conforms substantially to the requirements for a private one family dwelling built prior to: APRIL 9r 1957 pursuant to which CERTIFICATE OF OCC. Z-18579 dated NOVEMBER 20~ 1989 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 DW~,LLING ** The certificate is issued to ALFRED S. BAKER ( owner ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NO RECORD PRE EXISTING UNDERWRITERS CERTIFICATE NO. NO RECORD PRE EXISTING PLUMBERS CERTIFICATION DATED NO RECORD PRE EXISTING **PLEASE BEE ATTACHED INSPECTION REPORT. ~J' Bui/l~ Inspector Rev. 1/81 BUILDI..G DEP >J{T,'.LENT T0:'~[ OF SOUTHOLD, N. Y. Location ~00 FOUNDERS PATR (numoer & s~reer) Subdivision Nmme of Owner(s) HOUSI~ CODE INSPECTION REPORT SOUTROLD, NE~ YORK (i,iunicipali~y) Map No. Lot(s). ALFRED S. BAKER Occupancy A~mitted by: R-40 (type) MADELYN BAKER (owner-=enan%) Accompanied by: SANDY RAVE Key available Suffolk Co. Tax No. 64-2-25 Source of request RUDOLPR BRUE~ Date NOV. 9, 1989 D~,'~LLI~: Type of construction Foundation CEMENT BLOCK Total rooms, 1st. F1 Bathroom(s) ONE WOOD FRAME Cellar 5 2nd. F1 Toilet room(s) Porch, Breezeway ..... Garage. Type Heat OIL 'Warm Air Fireplace(s) No. Domestic hotwater LILCO GAS Other type FRONT SCREENED Deck, type xx #stories 3/4 Crawl space 3rd. F1 Patio, Utility room Hotwater !-1/2 1/4 Airconditioning. Type heater t,u~Y ACCESSORY STRUCTURES: Garage, type const. Swimming pool Other NONE Storage, type const. Guest, type const. V_IOLATIONS: Location .CHAPTER 45--N.Y. STATE ~NIFOEM FIRE PREVENTION & BUILDING CODE Description I-A~t.'l Sec. ' Remarks: Inspected Ca~//Fish Date of Insp. November 14, 1989 · Time start I~:0~ end FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ma,.------ to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriter~ 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory ,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $100.00 f 3. Copy of certificate of occup,~ncy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ! I NewCOnstructiOn ...... Old_9_[Fre-ex~sting RuiJding.~.. ~.. ...... Vacant Land ............. Location of Proper ty ,,'~,(~h'~ ....................... ~ .~.~ ...... ~ ...... Owner or Owners of prH~r~/°' ...~./ ..... ~...~...; ................. HTI~i County Tax Map No. 1000 Section .... .~...('~. ...... Block ..... (~ ....... Lot...~.. A ,~'~. ...... Subdivision .~. ~. ~..~.~ .Filed Map No.. ~)...'~...2-/.. Lot N o .... ~ ....... Permit No ........... Date of Permit .......... Applicant .~.~/~~ ......... Health Oept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $../.~.. ...................... Construction on above described building a~>a_ll ~pl~/~co,des and regulations. Rev. 10-10-78 CONSENT TO INSPECTION · the undersigned· do(es) hereby stats: That the undersigned (is) (are) the owner(s) of the premises ha the Town of Southold located at ~ · which is shoxvn and designated on the Suffolk County tax map as District lO00, Section 6 qoBlock & , Lot That the undersigned (has) (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 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 vio- lations of the laws, ordinances, rules or regulations of the Town of Southold. (pr~int name) (signature) (print name) ,), lliLE NO. 5-IOOO/[8ro.