HomeMy WebLinkAboutZ-22251FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-22251
Date APRIL 9~ 1993
THIS CERTIFIES that the building.
Location of Property 680 MIDWAY ROAD
House No.
County Tax Map No. 1000 Section 90
Subdivision
ACCESSORY
SOUTHOLD r N.Y.
Street
Block 2 Lot
Filed Map No. Lot No.
Hemlet
9.1
conforms substantially to the Requirements for an Accessory Structure built
Prior to: APRIL 9~ 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z-22251 dated APRIL 9~ 1993
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 ACCESSORY GARAGE LIKE STRUCTURE
ARNOLD & KAREN BLAIR
The certificate is issued to
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
~Buil~ing Inspector
Rev. 1/81
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN lb%LL
765-1802
5
. ~LPPLICATION ~OR CERTIFICATE OF OCCUPANCY
This application'musc 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 unu~ual natural or topographic features.
2. Final Approval from Health Dept.' of water supply and sewerag¢-dis~osal($-9 form).
3. Approval of ~lectrical installation from Board of Fire Underwrirera.
4. Sworn state,bent from plumber certifying that the solder used in system contn~n~
less than 2/10 of 1% lead. "
5. Commercial building, lndu~trial building, multiple rnsideeces and similar buildings
and installations, a certificate of Code Compliance fro~ architect or engimee~
responsible for the building.
6. Subm£g 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:
l. 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 Certificat~ o£ Occupancy is denied, the Building Inspector shall state tho
reasons therefor 15 writing to the applicant.
C. Fees
I. Certificate of Occupancy - New dwelling $25.00, Additio~s to dwelling $25.00.
Al~erations to dwelling $25.00, Swln~ning pool $25.00, Accessory building $25.00,
Additions to accessory building $25,00. Businesses $50.00.
2. Certificate of Occupancy o~ 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
~o Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
March 31~ 1993
New Construction ........... Old Or Pre-existing
Loc~tlon of Property... 680 Midwav Road, Sou~hold. ~¥ ~p.~ . .
Hous~ No. Stree~ Hamlet
Onwer or Owners of Property .... %~p~.~ .~;~ .I~;% .~. ....................................
County Tax Map No 1000, Section .... 0.~O ....... Block...~]~?. .......... Lot ........ 9.~.1 ...........
SubdiQision Filed Map Lot '
Permit No ................ Date Of Permit ................ Applicant .............................
]lealth Dept Approval Underwriters Approval "
Planning Board Approval ........................
Request for: Temporary Certificate. i ......... Final Certicate.g .........
s b irked , Aqq PP '
APPL~CAh~
__4~-_~7q~ ' William H. Price, Jr. .
APR 5 1993
CONSENT
TO
iNSPI~cTiON
· WILLIAM H. PRICE, JR., Atto.rney for the Owners.
O%~ler(s) Name(s) the undersigned.
do(es) hereby state:
That the under.~i~ned (is) (are) the Owner(s) of the premises in the Town
of Southold located at 680 Midway Road, Southold, New York 11971
· which is ~ho~vn and designated on the Suf¢olk
County tax map as District 1000o Seetion~090 _o Block 02 o I. ot 9.1
That the undersigned (has) (have) filed° or caused to be filed° an applica-
tion in the Southold Town ]2uilding Inspector,s Office for the following:
detached frame 9arage
That the undersigned do(es) hereby give consent to the Building Inspectors
of the Town o¢ Southold to enter upon the above described property, includ~n~
an), and all buildings located thereon, to conduct such inspections as the~
deem necessary %vi[h respect to the aforesaid application, ~clud~ inspections
to determine tha~ said premises comply with all of the l~ws. o~dinances, rules
and reRulations of the Town of
The undersiRned, in consent[n~ to such ~spec~ions. do(es) so %~th the
knowledEe ~nd understanding that any ~formation obtained in the conduct of
such inspections may be used as evidence in subSequen~ prosecution~ for
la,ions of the laws, ordinances, rules or re,la, ions of the Town of Southold.
March 31, 1993
William H. Price Jr.
(print name)
(si~,%ature)
(print name)
State of New York WIt.lAM R. Sa~aONS III
UCensed Land Surveyors 138 WOOOIJ~JD ST.
~ W/LUAM R. S~MIdON$, 3rd EAST ISLI~. L I~ N. Y.
F~E MO. /~.~.~./,..No. 49237 PAGE (~RFD