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Home My WebLink AboutZ-28067FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 28067 Date: 11/15/01 T~IS CERTIFIES that the building ACCESSORY Location of Property 250 SMITH DR NORTH (HOUSE NO.) County TaxMap No. 473889 Section 076 Subdivision SOUTHOLD (STREET) (HAMLET) Block 0002 Lot 019 Filed Map No. __ Lot No. __ conforms substantially to the Requirements for a ACCESSORY STRUCTURE built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCuuPANCY l~uq~BHR Z- 28067 dated NOVEMBER 15, 2001 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 ACCESSORY GAP~kGE The certificate is issued to ARTHUR BULLOCK of the aforesaid building. ( OWNER ) SUFFOLK COUNTYDHPARTM]~TOFHEALTHAPPROVA~ HI~L-rKICAL C~TIFICATE NO. PLUMBERS C~U~rIFICATION DA'~43 *PLEASE SEE ATTACHED INSPECTION REPORT. ~/A N/A N/A Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOLV/HOLD HOUSING CODE INSPECTION REPORT 250 SMITN DR NORTH N~ OF O~ (S): ARTHUR BULLOCK SO.CE OF NF~: A/~THUR BULLOCK 11/7/91 SOUTHOLD NO.: LOT (S) DATE: 11/15/01 0.0 # EXITS: O UTILITY RO(~ (S): ACCESSORY STRUCTURES: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. P~: BP33027.Z COZ2507(DWELL)BP#11864Z-COZl1489(DECK)BP#14231Z-COZ14683-ADD DATE UN INSPECTIUN: 11/14/01 TI~ START: ~D: APPLICATION Form No. 6 TOWN OF SOUTHOLD UILDING DEPARTMENT TOWN HALL 765-1802 FORCERTIFICATE 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 s~milar buildings and installations, a certificate of Code Comp!lance from architect or engineer responsible forthe building. 6. Submit Planning Board Approval o[ completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and · ~pre-existing" 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. · -'2. Certificate of Occupancy on Pre-existinR Buildinm - $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 ....~...~.: .~. ,~.(~./ ................... New Construction ........... Old Or~Pr~-existing Building...~.~f~9.~.~.. -- Location Property... .. ........... ........ House No. Street Hamlet Onwer or O ers of Froperty .... ................................. County Tax Map No 1000, Section...~.~ ........ Block ..... ~ ........ Lot../.~. ................ Subdivision .................................... Filed Map ............ Lot ...................... Permit No Date Of Permit Applicant ~ Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... APPLICANT CONSENT TO INSPECTION Owner(a) do(es) hereby state= · the undersigned. That the undersigned (is) (are) the owner(s) of the premises in the Town · of Southold located at ,,~ .~/~/~ ~. , which is shown and designated on the Suffolk County tax map as District 1000, Section ~ , Block ,,~ , Lot /~ 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 regulatio'ns 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: (aignature) . (si{~nature) (print 'name) ~ o