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Home My WebLink AboutZ-19355FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE CERTIFICATE OF OCCUPANCY No ZI9355 Date SEPT. 12, 1990 THIS CERTIFIES that the buildin~ ONE FAMILY D~3.LING Location of Propert~ 260 HORTON ROAD CU~CHOGUE House No. Street County Tax Map No. 1000 Section 104 Block 01 Lot 13 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a private one-family dwelling built prior to Hamlet APRIL 9~ 1957 pursuant to which Certificate of Occupancy Zi9355 dated SEPT. 12, 1990 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 DWELLING ~FiTH 2 ACCESSORY SHEDS. The certificate is issued toLOUIS S. BOURGUIGNON & ELIZABETE BOURGUIGNON ( owners ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NOT RF~UIRED PRE EXISTING UNDERWRITERS CERTIFICATE NO. NOT REQUIRED PRE EXISTING PLUMBERS CERTIFICATION DATED NOT REQUIRED PRE EXISTING **SEE INSPECTION REPORT /Building Inspector Rev. 1/81 Location 260 HORTON ROAD ~numoer & s~ree~) Subdivision Name of Owner(s) Occupancy A- I (type) Ad~mitted by: ~s. m3z. ~ Key ~vailabl e Source of request LOUIS BOURGUIGNOH BUILD I,.":G DEP:~d{T:.LENT · T0%'~ OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT uu'l'CHO~u,.: (~,iunic ipali ~y) Map No. Lot(s) LOUIS S. BOURGUIGNON (owner-Tenant Accompanied by: SAME Suffolk Co. Tax No. 104-1-13 Date JU~E 8, 1990 D~,'~ELL ING: Type of construction Foundation CIg~NT BLOCK Total rooms, 1st. F1 5 Bathroom(s) O~ ~u~ Porch, type -- Br e e z eway Type Heat ECEC. ~ASEBOARD' Warm Air Fireplace(s)~ NONE No. F~cits. 2 Domestic hotwater PROFANE Other wooD~ #stories Cellar PARTIAL Crawl space 2nd. F1 -- 3rd. F1 -- Toilet room(s) -- Deck, type -- Patio, typ~-- Garage-- Utility room Hotwater Airconditioning ~ype heater ~EM ONE ~CCESSORY STRUCTURES: Garage, type const. Swimming pool Other Storage, type const. Guest, type const. yIOLATIONS: Housing Code, Chapter 45 N.Y. ..Location I Descriotion FE~MITREQ~REDFOR 2 S~EBS State Uniform Fire Prevention & Buildin~ Code t Art. I Sec. PERMIT FOR BEBRO(~ ~INBO~S DO NOT NEET E~RESS ALL ABOVE I~lS CORRECTED 9/12/90 G. FISH B.P. 19174z ALT. C.O. ZI9352 Remarks: B.P. 19282Z ACCY ~1 C.O.Z19353 B.P. 19~82z A~CY [2 Inspected by." /W¢'o-,,~ /~ Date of Insp. 6/12/90 GARY F~SH ' Time start 9:35 end 10:05 a.m. Form No. 6 ~PLICATION FOR CERTIFICATE OF OCCUPANCY TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 8 i990 L TOWN 01: .S~UiTH OLD · 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 limes, 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 contm~-s ~ less than 2/10 of 1% lead. ,. 5. Commercial building, indus.trial building, multiple residences and similar bu~/dings 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. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildimgs and "pre- ' · land uses: exlstzng" 1.Accurate survey of property showing all property lines, streets, building amd unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate o£ Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees I. 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 Date ................ New Construction ........... Old Or Pre-existing Building..~.~/. ............ Location of Property ..... .2_d.? ......... H~ rm ~ House No. Street Hamlet Onwer or Owners of Property...~/.~. ~ ................................ County Tax Map No i000, Section .... l...C/. .... Block .... CD .~.~...Lot.. Subdivision - .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................. Dept Approval Underwriters Approval Realth ........................... . ...................... ,.' Planning Board Approval" Request for:.Temp°rary Certificate .......... . Final Certicate ........... Fee Submitted: $.. '.~.~. ........... CONSENT TO INSPECTION BLDG. DFPT TOWN OF SOUTH~OL,~O _~ Owner(s) Name(s) · the undersigned. do(es) hereby state: That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located · which is shown and designated on the Suffolk County tax map as District 1000, Section / ~y-~, Block o/Po, Lot oi3 ~'~ That the undersigned (has) (have) filed, or caused to be filed, an 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. ' Dated: "~-'-','¢'~ Y /7 ~'~ ~ ~ ' (signature) ~7 (print name) (signature) (print name)