HomeMy WebLinkAboutZ-19902FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-19902 Date MAY 10~ 1991
THIS CERTIFIES that the buildin~ OWE FAMILY DWELLING
Location of Property 40635 COUNTY ROAD #48 SOUTHOLD~ N.Y.
House No. Street
County Tax Map No. 1000 Section 59 Block 7 Lot 30
Subdivision Filed Map No. Lot No.
conforms substantially to the requirements for a Private One Family
Dwelling built prior to: APRIL 9~ 1957
Hamlet
pursuant to which
Building Permit No. 19902-Z dated MAY 10, 1991
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 OWE FAMILY DWRI~.ING WITH ACCESSORY 2 CAR WOOD FRAME GARAGE &
2 ACCESSORY STORAGE SHEDS *
The certificate is issued to CLEMENT CHARNEWS
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
Rev. 1/81
//~uil~ing Inspector
Location
BUILDIi:G DEP.~qT:.LENT
TO'.'g,[ OF SOUTHOLD, N. Y.
HOUSI:;G CODE IHSPECTION REPORT
40635 COUNTY ROAD #48 SOUTHOLD, NEW YORK
~numoer ~ s~ree~) ~i'iunzczpa±z~y)
Subdivision
Nerve of Owner(s)
;~ap No.
CLEMENT CHARNEWS
Occupancy
A~itted by:
A-1
~type)
CORNELIA CHARNEWS
OWNER
(own er- 5 enan~ )
Accompanied by: SAME
Key available
Suffolk Co. Ts~c No. 59-7-30
Source of request
CLEMENT CHARNEWS
Date MAY ], 199]
?~LL!MG:
Type of construction
Foundation
Total rooms,
Bathroom(s)
Porch, type
Breezeway
Type Heat OIL
Fireplace(s)
Domestic hotwater
Other
WOOD FRAME
#stories I- ]/2
%]rpe_CEMENT IN REA~
CEMENT BLOCK Cellar FULL
Crawl space
let. F1 4 2nd. F1 2 5rd. F1
1 FULL BATHROOM Toilet room(s)
Deck, type. Patio,
Garag~ Utility room
· Warm Air Hotwater xx
No. Fzcit s 2 Airconditioning
YES Type heater OFF BOILER (ELEC
~CCESSORY STRUCTURES:
Garage, type const. 2 CAR WOOD
Swi,-uning pool
Other
Storage, type const.
Guest, type const.
2 ACCY SHEDS
V~IOLATIOMS:
L_~ocation
.CDAPTER 45--N.¥. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
Descriotion J Art. I Sec.
Remarks:
Inspected by: ~f ~-/~
Gary/~ FiSh
Date of Insp. MAY 3, 199]
Time start 1:20 end ]:45
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
A~PLICATION 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 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.
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,
3~. Additions to accessory building $25.00. Businesses $50.00.
Certificate of Occupancy on Pre-existing Building - $100.00
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
New Construction ........... Old Or Pre-existing Building...~... ..........
Location of Property .......................... ~ ...........
House No. Sfreet Hamlet
Onwer or Owners of Property....~..Y/.~.~.~...~.~.~ ................................
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 ...........
CONSENT
TO
INSPECTION
0 wn e-r'(s) "N~{me(s)
· the undersigned,
do(es) hereby state:
That the undersigned (is) (are) the owner(s) of the promises 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 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.
(signature)
(print name) '
(signature)
(print name)