HomeMy WebLinkAboutZ-20696FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-20696 Date MAY 4~ 1992
THIS CERTIFIES that the buildin~
Location of Property 2971 LIGHTHOUSE ROAD
House No. Street
County Tax Map No. 1000 Section 50 Block 3
Subdivision Filed Map No.
ONE FAMILY DWi.LING
SOUTHOLD ~ N.Y.
Hamlet
Lot 11.1
Lot No.
conforms substantially to the Requirements for a One Family Dwelling built
Prior to: APRIL 9e 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z-20696 dated MAY 4~ 1992
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 SEASONAL DW~JJ.ING WITH ACCESSORY WOOD FRAME
GARAGE & PUMPHOUSE ATTACHED TO GARAGE.
The certificate is issued to
HENRY & BETTY BANGERT
(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
-~~'~ui~ldin~gInspector
Location
BUiLDi][C DE?/~J2.LiiiT
T0'.',]I OF SCUTHOLD, N. Y.
HOUSI2;G CODE IiiSPECTION REFCRT
2971 LIGHTHOUSE ROAD SOo'FHOLD, NEIg YORK
Subdivision
~ ~.iun±c lpali uy )
Map No. Lot(z)__
Nm,me of Owner(s)
HENRY & BE'FI'¥ BANGERT
Occupancy
A~nitted by:
A-i RES
~type)
CARL AUSTIN
(owner- u enanz )
Accomp~ied by: CARL AUSTIN
Key available
Suffolk Co. T~ No. 50-3-11.1
Source of request
JA~ES A. SCHONDEBAiiE~ ATTY
Date APRIL 28, 1992
D%~ELLING:
,Type of construction
Foundation POST
Total rooms, 1st. F1
Bathroom(s) ONE FULL BATH
Porch, type FRONT & SIDE
Breezeway UOV~-rd~u
Type Heat NONE
Fireplace(s ) ONE
Domestic hotwat er
Other
Deck,
Carage
~/OOD FRA/~
Cellar
2nd. Fi
Toilet
type.
Warm Air
No. Fzcit s 3
YES
#stories
PIT Crawl space
4 5rd. Fi
room(s)
Patio,
Utility room
Hotwater
~ype heater
type
Ai~ ~o,.dl~lO~_~g .
LILCO CAS
ACCESSORY S~U~C~'~q ·
Garage, typo const. 2 CAR WOOD FRAM~torage, type const.
Swiuming pool Guest, t~pe const.
Other PUMPHOUSE ATTACHED TO GARAGE
2 STORIES
V~0LATIONS:
_~Location
.CIL~PTER 45--N.Y. STATE UNIFO[~! FIRE PREVENTION & BUILDING CODE
D ~C~ 1D ,.!on I Art. [ Sec.
Remarks: SEASONAL RESIDENCE (NO HEAT)
'Time start 9:00
FAY I, 1992
end 9:30
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.
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,
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
New Construction ............ Old Or Pre-existing~l~i~.....''~'--~]~..]i] ....................
Location of ~r~oTJrty...~.' .~-."~fi~.~.~'. ~-~d.~..~..~..~..~3-. ..~. o .~.~.~. ~..~?.:'~'~"..~9~..~.~. :.
House No. Street Hamlet
Onwer or Owners of Property. '"~'~' "4/~'~ /~ '' ?"' / ~- ....................
County Tax Map No 1000, Section...-~..~. ........ Block ..... ~ ....... Lot... ~--~. ~.~-. ........
Filed Map Lot
Subdivision .................................................. ... .
Permit No Date Of Permit Applicant
Health Dept. Approval ............... ...~..] .... Underwriters Approval ........................ .
Planning Board Approval ......................
Request for: Temporary Certificate ........... Final Certicate ...........
CO~NSE?~'T
TO
INS PEC'FION
do(es) hereby state:
undersigned,
That the undersigned (is) (are) the Owner(s) of the pre,niser; in thc Tovzn
County tax map as District 1000, Section~o ~. Block~ Lot~ .
That the undersigned (has) (have) filed, or caused to be filed, an applica-
tion in the Southcld Totem Euilding Inspector,s Office for the follow, g:
That ~he unders~ned do(es) hereby give consent to the Build~g Inspectors
of the Town of Southold to enter upon ~h_ above described property, iucluding
any and all buildings located thereon, to conduct such inspections as they
dee~ necessary with respect to the aforesaid application. ~c!ud~g znspoctions
to determine that said premises comply with all of ihe laws~ ordinances, rules
and regulations of the Town cf Southold.
The undersigned, in Consenting to such ~spections. do(es) so %%ith the
knowledge and understanding that any ~for~ation obtained in the conduct of
such inspections may be used as evidence in subsequent prosecutions for vio-
lations of the lay/s, ordinances, rules or re~lations of lhe Town of Southold.
(signa[ure)
(print name)
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