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Home My WebLink AboutZ-23296FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PI~ EXISTING C~RTIFI~TE OF OCCUPANCY No Z-23296 Date OCTOBER 20, 1994 THIS CERTIFIES that the building Location of Property 420 ~OGEP~ ROAD House No. County Tax Map No. 1000 Section 66 Subdivision ONE F/%MILY DWELLING SOu'£uOLD, N.Y. Street Hamlet Block 2 Lot 14 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-23296 dated OCTOBER 20, 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 D~-ING WITH ACCESSORY WOOD F~AME ~AP~%GE * The certificate is issued to JOHN J. BUCKLEY (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 N/A N/A *pT.~E SEE ATTA~D INSPECTION HNPORT. LOCATION: 420 ROGER~ ROAD (number & street) SUBDIVISION NAME OF OWNER (s) JOHN J. BUCKI~EY BUILDING DEPARTMENT TOWN OF SOUTIIOLD tlOUSING CODE INSPECTION REPORT SOlr[HOLD, NE~YORK MAP NO. (munieip~l£ty) LOT(s) OCCUPANCY SIN~ FAMILY DI~LLING (type) (owner-tenant) ADM1T£~D BY: KA'I'm~RII~ BOUKLEY F~ ACCO~ANIED BY: S~ ~Y AVAI~LE S~F.CO. T~ ~ NO. 100~66-2-14 SO.CE OF ~Q~ST: C~S R. C~DY. AT~ DA~: SEPT. 19. 1994 WOOD FRANg ~ STORIES 2 ~ EXITS CELLAR PART. CRAWL SPACE NONE DWELLING: TYPE OF CONSTRUCTION FOUNDATION C~I~NT BLOCK TOTAL ROOMS: IST FLR. 3 2ND FLR. 3 3RD FLR. BATHROOM (s) O1~ TOILET ROOM (s) ON~ UTILITY ROOM PORCH TYPE SIDE SCReENeD (COVERED) DECK, TYPE NONE PATIO BREEZEWAY NONE FIREPLACE ONE GARAGE DOMESTIC HOTWATER EI.xCTRIC TYPE [~ATER ELECTRIC AIRCONDITIONING lIYE HI, AT ELECTRIC WARH AIR HOT~ATER OT~R: 4 ACCESSORY STRUCTuEES: GARAGE, lIFE OF CONST. S~I3~ilNG POOL OT~gR: WOOD FP, AM~ STORAGE, TYPE CONST. · GUEST, lIFE CONST. ATTACHED TO C.,A[~f:R * VIOLATIONS: CItAPTER 45 N.Y. STATE ITNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. P,F~IARKS: *NOTH: 1D~ERARTICLE VII-SEC. ?03 SOo~OLO ~ CODE· APRIL 1958, NO U~NG_PE/I~. ~R ADDITIONS TO ACCESSORY BUILDINGS. B TS REQUIRED P BY "-~_ ~~ DATE OF INSPECTION OCTOBER 3, INSPECTED ~ M. BOUFIS / TIME START 9:30 END 1994 I0:00 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 submitt~5~~ldin~ 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 ' ~ ~--~ ~,P~qP~r~Z showmng all proper~.~ streets, building and unushal natural o~'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-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 September 19 Date ................. .. .. ~ ............... New Construction ........... Old Or Pre-existing Building .... ~ ........... House No. Street Hamlet 0 0 of ~rope ty Katherine M Buckley Deceased po _ 01 .000 County Tax Map No 1000, Section. 066.00 .Block. : .mon .......... Subdivision ........................ ............ Filed Map ............ ]47g Lot ...................... Permit No ................ Date Of Permit ............ .. .. Applicant ......................... .... Health Dept. Approval ...................... -- · . Underwriters Approval ....................... .. Planning Board Approval .................... .. .. Request for: Temporary Certificate ...... Final Certicate.. . Fee Submitted: $ ...................... .. . .... ..... ' .... e. ..... , PLi ANT R. ~ttorney CONSE:;T TO Ch~aarles~RR. Cuddy, Attorney for,Owner do(ex) hereby state: That the Undersigned · the attorney for the (ts) f(;X~xe) the owner(s) of tile premise:; in the Town °rs°nth°Id located at 440~.R0c/~rs R0_~aad, S0uth01d, New York ~ -~- _, which is :shown and desir, na ed on the SuD'ols County tax map as District 1000, Section 066 00. Block02.00 L, ot 014.00~0. That the undersigned (bas) (~(ex) tiled, or Caused to be filed, an applica- tion in the Southold Tox~nn Building Inspectot,,s Office for the following: Ce~te of Occupanc~yo~n Pre~existing Building ~ That the undersigned do(es) hereby give consent to the Buildlng Inspectors o£ the Town of~outhold to enter upon the above described property, including an...- and all buildings located thereon, to conduct such inspections as they may deem necessary with respect to the aforesaid application, including '-nspeczzens to determine that said premises Comn ,:. with all of the laws; ordinances, rules and re.~ulations of the Town cf Southold. The undersigned, in consenting to such inspections, do(es) so x~ith the k?-o:'.'ledge and understanding that any info"m · ' - .atmn obtained in the 'conduct of such inspections may be Used as evidence in subsequent prosecutions for ~-io- lation$ of thc laws, ordinances, rules or regulations of the Town ofSouthold. ' Dated:September ~9 ~994 ~ Charles R. Cuddy ~ ^ttorn$ for g}e2 tor or Estate oF Katherine Buckley (s i~ n a t u r e~-T"------~ ~ (l z'lnt name) r- ~3 2010 97,0'3