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Home My WebLink AboutZ-23137FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. No Z-23137 PRE ~XISTING CERTIFICATE OF O(aJumANCY Date AuGUsT 2, 1994 THIS CERTIFIES that the building Location of Property 9487 MAIN ROAD House No. County Tax Map No. 1000 Section 122 Subdivision ONE FAMILY DW~T.?.ING H~TTIT~Cl( ~ N.Y. Street Hamlet Block O~ Lot 1S Filed Map No. Lot No. conforms substantially to the Requirements for a One Family Dwelling built Prior to: APRIL 9f 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-23137 dated AUGUST 2~ 1994 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 DM~T~.~N~ * The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTA(:HK!~ INBPECTIONREPORT. N/A N/~ N/A Rev. 1/81 BUILDING DEPARTHENT TOI~NOF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 9487 NAIN ROAD NATTITUCK, NE~¥ORK (nmuber & street) (~unicipality) SUBDIVISION HAP NO. LOT(s) N~IE OF Ob/NER (s) ANCE BOIIRISQUOT .. OCCUPANCY A-I RES. O~NER (type) (owner-tenant) ADMI'n'EO BY: BARBARA BOUBISQi~If ACCO~PANIE~ BY: S~ KEY AVAILABLE SUFF.CO. TAX NAP NO. 1000-122-06-15 ~ SOURCE OF REQUEST: BARBARA ROURISQUOT DATE: . JULY 15, 1994 DI~ELLING: T¥~E OF CONSTRUCTION FOUNDATION TOTAL ROOHS: BATHROOH (s) PORCH TYPE BREEZEWAY DOHESTIC HOTI/ATER T¥~E NEAT OIL WOOD FRA~4~ ~ STORIES I ~ EXITS 2 CEHENT BLOCK PIERS CELLAR I/2 CRAI~L SPACE IST FLR. 5 2ND FLR. 3RD FLR. ORE TOILET ROOH (s) UTILITY ~ BECK, TYPE I~A~TIO FIREPLACE GARAG~ 'l'~ ~'E NEATER ELECTRIC AIRCONUITIONING I~ARH AIR HOT~ATER KE FRDHT COVERED YES ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. S~/II~fING POOL OTHISR: NONE STORAGE, TIFE CONST. , GUEST, TYPE CONST. VIOLATIONS: CHAPTER 45 N.Y. STATE UNI~ORIg FIRE PP~v2NTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. INSPECTED BY DATE OF INSPECTION JULY 20, 1994 TIN~ START 10:00 AN END Form No. 6 TOWN OF SOUTHOLD ' ' BUILDING DEPARTMENT TOWN HALL 765-1802 BLDG. DE CATiN TOWN OF SO~ T 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 Planning Board Approval of completed site plan requirements. ~or existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and f'pre-existing" land uses: 1. A~curate survey of property showing all property lines, streets, building and unusual natura~z~r to~aphic features. 2. A'properly completed a_pplication and a ~onsent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building I~sspector 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 - $100.00 3. Copy of Certificate of Occupancy -]~O0-~9~ years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction ..... i ..... Old Or Pre-_exist. ingE:~'elji~~[][[][[[[ ........ ~'''~ Location of Property.....~.~.f .~. .... ~''~'~'''~''..''~''~-~.[~-... MC ...... House No. ~ S~ree~ X~. Hamlet._ .. Onwer °r Own°rs °f Pr°p°rt '~2~~..~y · ,., ,-~, · · ~W~ 000, .... .... ....... .... z ............. Subdivision .................................... F~led Hap ............ Lot ...................... Permit No ................ Date Of Permit .............. .. Applicant ........................... . . Health Dept. Approval ........................ · · Underwriters Approval .................... Planning Board Approval .................... . . .. Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ ............................ . co "Co 3 / $ 7 · APPLICANT ' .~ CONSENT TO INSPECTION Ow~er(s) Name(s) do(es) hereby state: · the undersigned, That the undersigned (is) (are) tile owner(s) of the premises in the Town" · which is shown and designated on the Suffolk County tax map as District 1000, SectiOn._./.2~_, Block ~ , Lot /~ That the undersigned (has) (have) filed, or caused to be filed, an applica- tion in the South01d Town Building Inspector's Office for the ~ollow~g: 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 aferesaid application, in'cluding 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: P~b~ic, State of New No. (:k~ffle~ in New York Goo~,t~ (signatfire) (prznt /' U -(si~n'Hr~re) / " (print name) f..\ &o\ Go, O' -N