HomeMy WebLinkAboutZ-12025FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No...Z.1.2. q2..5 ......... Date .... O..c.~.qb.e. r' .3.1 ......... 19.8.2.
THIS CERTIFIES that the building s... ( 3. l .......................
Location of Property .267. Q.0 ..... .M.a.~.n. Road Orient
Hou~ No. ' '
County Tax Map No. 1000 Section . .q q..8 ....... Block . .0.6. ........... Lot 016
Subdivision X X
............................... Filed Map No. X .Lot No:
Requirements for a private one-family dwelling built prior to
conforms substantially to the APPtieatio~'fo~-t~ildi~g-Perrni-t~crctofo~e-~ited-i~-this-offierdated-
Certificate of Occupancy
.... Ap.r .i.1. ?.3 ........ 19 .5.7. pursuant to which Ik61din~-Permit- No..Z..q .~.0.2.5. .............
dated ... 9.c).°. ~. ??..2. ! ............. 19...,83 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 .........
a..p.r.i.v, ate one-family dwelling, an accessory one-car garage, an
The certificate Js issued to RICHARD F. BINZLEY & WIFE
..................... /o¥.'e;, ......................
of the aforesaid building.
Suffolk County Department of Health Approval .... L~ p. ?.e. ~ 9? ~. ..................
UNDERWRITERS CERTIFICATE NO ............ ~ ~..r. ~ ~ p.~.~ ...........................
SEE ATTACHED INSPECTION REPORT.
Building Inspector
Rev. 1/81
BUI~DI.,= DEPARTMENT
T0~,'~'[ OF SOUTHOLD, N. Y.
HOUSI~[G CODE INSPECTION REPORT
Loc .... n 26700 Main Road
Subdivision
[numoer & szree~)
x
Map No.
Orient
(~4un±cipa±~y)
X Lot(s) X
Name of Owner(s)
Richard F. Binzley & Wife
Occupancy R-1
~type)
A~ed by: Mr. Scott
Key available
unoccupied
(owner-~enanz~
Accompanied by: same
Suffolk Co. Tax No.18-6-16
Source of request
Richard Binzley '
Date 10/18/83
D!'~LLi~:
Type of construction
Foundation
Total rooms, F1
Bathroom(s)
Porch, type wood
Breezeway
Type Heat oil fired
Fireplace(s). 4
Domestic hotwater
Other Butler's
wood framed #stories 2
block & stone Cellar 2-parti~rawl space_ rest
1st. 4 2nd. F1 4 3rd. F1
2 Toilet room(s) 1
Deck, type Patio, type slate
Garage. Utility room
Warm Air Hotwater x
Mo. ~its 5 Airconditioning
pantry, stairs
Type heater
to attic.
ACCESSORY STRUCTURES:
Garage, type const. 1-car wood Storage, type const.
Swim~ing pool Guest, type const.
Other 2-car wood storage, large fenced in dog run.
~IOLATIONS: Housing Code, Chapter 52
--Location
utility ro
.kitchen
DescriDtion
Dm floor in room weak
I Art. I S eb.
I III 152-30-A
side door bad
52-31-B
Remarks:
Curtis W. Horto~ 'Time start 9:50
10/27/83
end 10:00
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted in duplicate 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 Underwriters.
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 peoperty 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:
1. Certificate of occupancy $5.00 /
2. Certificate of occupancy on pre-existing dwelling/ land use
3. Copy of certificate of occupancy $1.00
--Pre-Existing C.O. $15~00
Vacant land C.O. $ 5.00
Date .....
New Building ............. Old or Pre-existing Building ....v~. ....... Vacant Land .............
Location of Property ...... .~..o... ~o~,~ ~,~o.¢J~. I~-~.~- .~.:.~.
House No. }Street Ham/et
Owner or Owners of Property ¢~'~,ct~-~ ~','-'~,N ~..~.~
County Tax Map No. 1000 Section ....t.~. ......... Block ....0..~ ......... Lot ..... I.~o .........
Subdivision .................... Filed Map No ........... Lot No ..............
Permit No ........... Date of Permit .......... Applicant ..................................
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate
Construction on above
described building and per, mit meets all applicable~,~des and r,egulations.
CONSENT
TO
INSPECTION
· the undersigned,
(print name)
Owner(s) Name(s)
do(es) hereby state:
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at ~O ~,~;~) z~co~ !
· which is shoxwa and designated on the Suffolk
County tax map as District 1000, Section I~ , Block O~ · Lot
That the undersigned (has) (have) filed, or caused to be filed, au 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.
.A
Z
MAP OF PROPERTY
3U~VEYED FOR
CONSTANCE BAR.WISE BINZLEY
3tTUATE AT
0RIENT, N.Y.
5 c...a, u ~: 30': 1"