HomeMy WebLinkAboutZ-20037FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-20037 Date JUNE 26~ 1991
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 1480 OLD WOODS PATH SOUTEOLD~ N.Y.
House No. Street
County Tax Map No. 1000 Section 87 Block 1 Lot 21
Subdivision Filed Map No. Lot No.
conforms substantially to the requirements for A Private One Family
Dwelling built prior to: APRIL 9~ 1957
Hamlet
pursuant to which
CERTIFICATE OF OCC. #Z-20037 dated JUNE 26r 1991
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~.TJ,INGWITHACCEESORY WOOD FRAME GARAGE *
The certificate is issued to JOAN BAYLEY
(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 ATTA(~IED INSPECTION REPORT.
/ ~uilding Inspector
Rev. 1/81
BUILD I..'.:G DEP.*=RT:.LENT
TO:'~! OF SOUTHOLD, N. Y.
HOUSI]iG CODE IHSPECTION REPORT
Location
Subdivision
Name of Owner(s) JOAN BAYLEY
~numoeP ~ s~ree~)
Map No.
,qOIITHOLD. N.Y.
U'iunlclpall~y)
Lot(s)
Occupancy
Ad.mitt ed by:
RESIDENTIAL
[type)
MARY ANNE FEAVEL
Key available
oWNER
(owner-~enan=)
SAME
Accompanied by:
Suffolk Co. Tax No. 1000-87-1-21
Source of request
JOAN BMYLEY
DateMAY 13, 1991
D~'fELLIMG:
Type of construction
Foundation
Total rooms, let. F1
Bat.hroom(s )__2 FULL BATRS
Porch, type
Breezeway
Type Heat (ITl,
Fireplace ( s ) ONE
Domestic hotwater
Other
WOOD FRAME
_Deck, type
Garage
· Warm Air xx
No. F~it s
REAR ENTRY WAY
#sTories 2
Cellar Crawl space xx
3 2nd. F1 2 5rd. F1
Toilet room(s)
WOOD ~atio, type
Utility room
· Ho twat er
4 Airconditionin~
Type heater
~CCESSORY STRUCTURES:
Garage, type const, wnnn W~E
Swim-ming pool
Other ~-~n NAg R~N REMOVED
Storage, type const.
Guest, type const.
V~IOLATIONS:
_Lncation
.C~APTER 45--N.Y. STATE ~NIFORM FIRE PREVENTION & BUILDING CODE
Oezcriotion I-A~t.'l Sec.
Remarks: BP #8722-z CO Z-7813 FOR ADDITION
Inspected by: ~~//..~ Date of Insp.
J. FISH Time start..9:30
MAY 24, 1991
end 10:00
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. Cor~ercial 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
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 - $100.0~
3. Copy of Certificate of Occupancy - $5.00 over 5 year~ -~0.00
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../.~. ~?...~..~./.,..~.2)..~./.D. ~.~.,...~..~...~.~.~.~..~..~. ............ . .~..C~..&/777...~..L~ .....
House No. Street Hamlet
Onwer or Owners of Property..~.'..~../~. ..... ~. .... ~. .
County Tax Map No 1000, Section .... ~. ~.. ..... Block ....... L ....... Lot .... ~.../. .............
Subdivision ................................... Filed Map ......... .. . Lot ..................... .
Permit No ................ Date Of Permit ............... Applicant ............................ .
Health Dept. Approval ......................... Underwriters Approval .........................
Planning Board Approval .................
Request for: Temporar~/~ertificate .....
Fee Submitted: $ ..... ~.~ ...............
..... Final Certicate.~ .......
APPLICANT
CONSENT
TO
INSPECTION
Owner(s) Name(s)
do(es) hereby state:
, the undersigned,
of Southold located at
County tax map as District 1000, Section
That the undersigned (is) (are) the owner(s) of the premises in the Town
· which is shown and designated on the Suffolk
. Block / . ,,or
That the undersigned (has) (have) filed, or caused to be filed, an applica-
tion in the Southcld Town Building Inspector's Office for the folloxving:
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, includLng 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 regulat~ns of the To%vn of Southold.
~)J~N-(signa~re)/
(print name)
(signature)
(print name)