HomeMy WebLinkAboutZ-25835FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
NO: Z- 25835 Date: 07/22/98
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 235 CAROLE RD SOUTHOLD
(HOUSE NO.) (STREET)
County Tax Map No. 473889 Section 052 Block 0002
Subdivision Filed Map No. __ Lot No. __
conforms substantially to the Requirements for a ONE FAMILY DWELLING
built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z- 25835 dated JULY 22, 1998
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 *
(HAMLET)
Lot 007.004
The certificate is issued to THOMAS BRENNAN
of the aforesaid building.
(OWNER)
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
N/A
N/A
N/A
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 235 C. AROLE RD SOUTHOLD
SUBDIVISION: MAP NO.:
NA~ OF OWNER (S): THOMAS BP~ENNAN
OCCUPANCY: A-1 RESIDENTI;UL
ADMITTED BY: THOMAS B. BRENNAN
-- LOT (S) --
KEy AVAILABLE: SUFF. CO. T;G( MAP NO.: 52.-2-7.4
SOURCE OF REQUEST: THOMAS BRENN~ FEB. 19. 1998 DATE: 07/22/98
TYPE OF CONSTRUCTION:
FOUNDATION:
TOTAL ROOMS:
BATHROOM(S):
PORCH TYPE:
BREEZEWAY:
DOMESTIC HO~ATER:
WOOD FRAME # STORIES: 1.0 # EXITS: ~
CE~4ENT BLOCK CELLAR: __ CRAWL SPACE: XX
1ST F~R.: 2 2ND FLR.: O 3RD FLR.: O
1.0 TOILET ROOM(S): 0,Q UTILITY ROOM(S): --
YBS
TYPE BEAT: LIL~ GAS WARM AIR:
OTHER:
DECK TYPE: WOOD (REAR) PATIO TYPE:
FIREPLACE: GARAGE:
TYPE BEATER: ELECT~LIC AIRCONOITIONING:
HOTWATER:
GAUGE, TYPE OF CONST.:
OTHER:
STORAGE, TYPE CONST.: 2 WOOD FP~E SEEDS *
GUEST, TYPE CONST.:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNI?O~M FIRE PREVENTION & BUILDING CODE
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
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.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
"pre-existing" land uses:
1. Accurate survey of property showing ali 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.
2. Certificate of Occupancy on Pre-existinR Buildin~ - $100.00'~ --
3. Copy of Certificate of Occupancy - . .25~
4. Updated Certificate of Occupancy - $50.00
~5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date ..~f'.~:~...... . ............................
New Construction ........... Old Or Pre-existing Building.~ .............. '
Location of Fro e= ~.$:. G~.~°~ ~ :o~ ~, ~. ~ ~ ~i
P Y ................ ~ ................ , ..... ~ .................
House No. Street Hamlet
Onwer or Owners of Property..../.-~..~?..~4..~.~.. ~/ZZ.~..A~O~ . .
county ,= ~p No 1000, S~ction..O:.~ ....... Bloc~ ...... .g. ........ Lot... ~.~ ...............
......... Filed Map ............ Lot ......................
Subdivision ...........................
Permit No ................ Date Of Permit ................ Applicant .............................
Health Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate..~. .......
Fee Submitted: $~'~ .....
&~c.z~7 ~6 ....................
':a_CO Z-o~58 3 5
CONSENT
TO
iNSPECTION
· the undersigned,
Owner(s) Name(s)
do(es) hereby state:
That the undersigned (is) (are) the owner(s) ct the preln[ses in the Town
of Soutirold located at ,~ J6'"- ~_~/~,g-~c c /~9. ~o ~c~ ~ ~- ~
, which Is sbown and designated on the Suf[olk
Coml.y tax map aa District 1000, Section ~ , Block ~ , Lot Y ~
'l'ha~ the undersigned (has) (bare) flied, or caused robe tiled, an applica-
tion in the Southold To~ Building Inspector's Office [or the followin~
That the undersigned do(es) hereby give consent to the Bnilding Inspectors
of the Town of Soutbo]d to enter upon the above described property, including
any and all buildings located ti~ereon, to conduct sucbinspectlons 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 tire Town of Southold.
Ti~e undersigned, in consenting to such hrspections, do(es) so with the
knowledge and understandin[~ that any information obtained iu the conduct of
such inspections maybe used as evidence in subsequent prosecutions for vic~
latious of the laws· ordinances, rules or regulations of the Town of Southold.
Dated: ~//~'~ff '
/
(sigflature)
(print name)
(ailmature)
(print name)
Young dc Young, Land
400 Os~ra~der Ave~e, Rtverkead,
5tG-727-2303
NOTE: 1 · = MONUMENT FOUND
2 AREA = 17745 S.F
SURVEY FOR:
'H-lOMAS BRENNAN
At: ARSHAMOMOQUE Town
Suffolk County, New York
of: $OUTHOLD
Surf. Co Tax Mop:
DATE ,BEC 22, 1997
SCALE :1"=50'
JOB NO, :97
SHEET NO,:1 OF 1
i®
60459 (970843.DWG)