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Home My WebLink AboutZ-23992FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Pl~ EXIETIN~ L:F,~TIFIC~T~ OF OC~u~AIqCY No Z-23992 Date OCTOBER 30, 1995 THIS CERTIFIES that the buildin~ Location of Property 165 PARKWAY House No. County Tax Map No. 1000 Section 70 Subdivision ONE FAMILY DWELLIN~ 80u-ruOLD, NEW YOi~ Street Hamlet Block 12 Lot 6 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-23992 dated O~TO~ER 30~ 1995 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 DW~.ING * The certificate is issued to ~ BRIC,HI (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PT~a~E SEE ATTAC~n INSPECTION REPORT. Rev. 1/81 N/A N/A N/A uilding Inspec~r BIII I.D I lit; I)I*~i'ARTHI'~H i' '1'O%4~ OF .'~OUi'ilOLD ilOUS ] ri(; COi)E IHS PIe(TI'ION REPOR'Z' 1.OCA'I*I ON: 165 F~AY SO--OLD, N.Y. ~;IJI%I)[VI~;ION HAl' HO. I,OT(~) }{AHE OI: O~NER (~) WARREN BRZCCH] OCCUI'AHCY S]NGLE F~ILY AI)H ITTEI) I%Y: KEY AVA l I,AIH,~ SOIJRCI,: OF I{E~III<~'I': J. Kevin McLaughlin, Arty I)ATE: OCT. 18, 1995 I)%VI,I.I.I H(,.- 'I'YI'E OF CONSTI{IICTION W~D F~ I STORIES J I EXITS 3 C~flT }~'1' FLR. 5 2ND FI.R. 3RD FI,R. I:O{INI)A'[' I TOI'AI. I(O(]HS: llA'I'III(OOH (s) I'OI(CII TY I'F. Ii RI*:I': ZI<%VAY ENCLOSED I)OHICS'I' I C IIOT~ A'I'I': I~ 'I'Y I'1': IIF, AT O'I'IIEI~.: BILCO BASEMENT ONE TOll,ET ROOH (s) [IECK, TYI'E I; I IH':I'I.ACE NO YES 'I'YPI~. IIEA'fl':l{ ELECTRIC T'/ARH AI R UT1 I,['I'Y IR)OH ' PATIO REAR CONCRETE (;AI{AfiE ~NE A lltCONI)]TIOHI II(}'I~/A'I:E I~ ACCI':SSORY S'I'IHICTURI",S: (;AIJA(;E, 'I'YI'I~. OF CONST. . ..................... S'I'OI~A(;E, 'I'YPI~, CONS'£. WOOD SHED $ilIH[-IING I'OO1. , (;IJEST, TYPE CONST. OTIIICR: V~(~)t,^'?I_(J?~L CII^PTICR l~5 H.Y. ST^'I'E UNIFOI,tZ-I FiRE I'm{EVENTION & {TUII.DIHG CODE I.OCA'I'I Ott I)ESCI{ l I'T I ON ART. SEC. I(I<HAI(K~: BP { 11246-Z-COZ- I m 340 (Accessory Shed) Form No. 6 TOWN OF SOUTItOLD BUILDING DEPARTMENT TOWN NALL 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-~xisting"'land uses: 1. 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 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. Certificate of Occupancy on Pre-ex~stin~ Buildin~ - ~100.0~__0 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate ef Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $]5.00, Commercial $15.00 Date .~.....~..~.~.~.e~..~ ..................... New Construction ........... O].d Or Prew,~xisting Building..~............__.~..~!~..............~ ..~. Location of Property ..... !.~..~. ........ ..~..n~.~.. ~..~ ........ ttouse No. , Stree{ Hamlet Onwer or Owners of Property ~-~v--, ~-- ~ County Tax Map No lO00, Section O~O~..B]ock ~-.O.~. ~,O~ Subdivision.. ~..~xr.~...c~.~ .............. Filed Map...~. !.~..[ .... Lot ..... .~...~. ............ Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval ........................... Underwriters Approval ......................... Piaaning Board Approval ........................ Request for: Temporary Certificate ........... Final Cer!i~ Fee Subnlitted: $ ............................. ~ ~'[/ ~ n ,( iV( )'ZI ~!, )':IN [NSPECTiON - ,._b~ ~ ~(k~k_~..~._~ ~c~., ~ ~O~' O , the undersigned, O~mer(s) Name(~ do(es) hereby state: That the undersianed (is) (are) the owner(s) of the premises in thc To~ of Southold located at ~ ~ ~,,~~ , which is sho~m and designated on the Suffolk County tax map as District 1000, Section ~0 , Block [~ Lot That the undersigned (has) (bare) filed, or caused to be filed, an applica- tion in the Southold Tram Building Inspector's Office for the following: That the unders~ned do(es) hereby give consent to the Buildin~ Inspector~ of the Town of Southold to enter upon the above described p~operty, includin~ any and all buildln~s located thereon, to conduct such inspections as they may deem necessary wiU~ respect to the aforesaid application, ~clud~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 h~spections, do(es) so ~th the knowledge and understandin~ that any information obtained In the conduct such inspections maybe used as evidence in subsequent prosecutions for vio- lation~ of the laws, ordinances, rules (sianature) (print name)