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Home My WebLink AboutZ-23683FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCt;u~ANCY No E-23683 Date JUNE 5, 1995 THIS CERTIFIES that the buildin~ Location of Propert~ 555 WEST I~OAD House No. County Tax Map No. 1000 Section 110 Subdivision ONE FAMILY DW~.LING uuTCHOGUE, N.Y. Street Block 7 Lot Filed Map No. Lot No. Hamlet 7 conforms substantially to the Requirements for a One Family Dwelling built Prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-23683 dated ~ 5, 1995 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~J.ING & ACCESSORY 2 CAR GARAGE * The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE BNEATTA~D INSPECTION MEPORT. Rev. 1/81 GUSTAVE C. BICKERT & WF. N/A N/A LOCATION: SUBDIVISION NAME OF OWlfliR (s) (number b street) BUILDING DEPARTHENT TOWN OF SOUTHOLD IlOUSING CODE INSPECTION REPORT 555 ~est Road Cutchogue, N.Y. (mun£clpality) NAP NO. LOT(s) GUSTAVE C. BIu~I~RT & WF. OCCUPANCY A-I RES. (type) ADH1TT~D BY: SELF KEY AVAILABLE SOURCE OF RE~.I/EST: DORIS ROBINSON O~NER (owner-tenant) ACCOMPANIED BY: SUFF.CO. TAX PJkP NO. 1000-ii~-~7-07 DATE: SEPT. 19, 1994 DWELLING: TYPE OF CONSTRUCTION WOOD FP, AI~ FOUNDATION LOCUST POSTS & ~T CELLAR TOTAL ROOHS: IST FLR. 2 2ND FLR. 4 BATItROOH (s) 2 TOILET ROOH (s) PORCH TYPE WRAP AROUND CO~ERED BREEZEWAY FIREPLACE DOMESTIC HOTWATER YES TYPE HEATER TY~E HEAT ~O1~ WARM AIR OT~R: PAKrRY IST FLOOR 3RD FLR. DECK, TYPE ONE ~ STORIES T~O [ EXITS 3 CRAWL SPACE UTILITY ROOM PATIO GARAGE AIRCONDITIONING HOTWATER ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. 2 CAR, WOOD F~ STORAGE, TYPE CONST. SWIMMING POOL , GUEST, TYPE CONST. OTHER: STEPS TO WATER VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. REMARKS: BP [22604Z - CO Z-23682 ACCESSORY DECK ON WATER SIDE DATE OF INSPECTION OCT. 6, 1994 TIME START 10:05 END 10:30 L_ ~ OF sOUl'~OLO Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTblENT TOWN }L~LL 765-1802 - 21ill .... ;,,~ ~,.~:.~u~ OLD APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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 Pianning Board Approval of completed site plan requirements. B~ 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. Certificate of Occupancy on Pre-existinR Buildinm - $100.00 3.Copy of Certificate of Occupancy - $20.00 4.Updated Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $15.00, Commercial 415.00 Date ...... .; .................... New Construction ........... Old Or Pre-existing Building/ ...... ~ ....... ~ Location of roperty...47.o'7?.. ................... ........ .... House No. Street Hamlet Onwer or Owners ofProperty...~.~./.~ .... ..~.~ .... :~---~-~.~.C~.~..7~. .......................... County Tax Map No 1000, Section...~Z..f~. ..... Block .... 2 .......... Lot .... 2 ............... Subdivision .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant .......... ~ .................. Health Dept. Approval...~ ...................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $. Z.f?.~. ,. ~.~..' ................ · ........... CONSENT 'FO INSPECTION Ox;mcr(s) Namc(s) do(es) hereby state: That the nndersigned (is) (are) the owner(s) of the premises in thc Town · which is shoxmu and designated on the Suffolk County tax map as District 1000, Section ///7, Block 7 , Lot That the undersigned (has) (have) filed· or caused to be filed· an applica- tion in the Southold Toxvn 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 lotions of the laws, ordinances, rules or regulations of the Town of Southold. Dated: .~./~'~. / ~/~z_/ ~/, ~~_. .. (print name) (signature) (print name) M,~ F:, THE NEW YORK BOARD OF FIRE UNDERWRITERS ~AGE ~ ~ ~sev7 SUREAU OF E-ECTR,Cr~ ~ 85 JOHN STREET. NEW YORK, NEW YORK 10038 ~ ~CH 2~, 1995 Application ~o. on file ~6983795/95 N 345777 THiS CE~IFIES THAT o~y t~ e~t~ ~u~ment ~ ~ ~w ~ int~ ~y t~ ~t ~ on the a~ ~at~ numar in t~ ~m~ o~ ERNEST ROBINSON, 555 WEST ROAD, CUTCHOGUE, N.Y. i. th. lotlowi.~ I,,catio.; [] B.~.~.t [] I.~ FI. [] 2mi FI. GAR/OUT wos examlned on ~[ARCH 13,1995 and found to be in compliance with the National Electrical Code. RXTU~ES RANGES PEClAL RK'P OTHER AFflARATUS: TIME CLOCKS ULL UNIT HEATERS MULTI-OUTLET SYSTEMS a. MT. AMPS. TRANS. NO. OF FEET V I C A' W' G' NS. Of HI-LEG A' W' G' EXHAUST FANS DIMMERS DEFECTS REMOVED AS PER O2-O7-95-1 ROSLAK ELECTRIC P.O.BOX 164 CUTCHOGUE, NY, 11935 LIC.#3677-E 11 Per '- ~ This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.