HomeMy WebLinkAboutZ-20393NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-20393
Date DECEMBER 4, 1991
THIS CERTIFIES that the building
Location of Property 1050 PINE AVENUE
House No.
County Tax Map No. 1000 Section 77
Subdivision
ONE FAMILY DWELLING
SOUTHOLD~ NEW YORK
Street Hamlet
Block 3 Lot 2
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-20393 dated DECF~4BER 4~ 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 ONE FAMILY DWELLING WITH ACCESSORY ONE CAR WOOD FRAME GARAGE *
The certificate is issued to
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
Rev. 1/81
ERNEST CHRISTENSEN
/~/~' ~/~il/~ing Inspector
BUILDIL~G DEP.~%RTitENT
TO','~$r OF SOUTHOLD, N. Y.
HOUSIi[G CODE INSPECTION REPORT
Location
Subdivision
1050 PII~ AVgl~Fgg
(number & s~reev)
SOo'rHOLD~ ~ YOEK
(i,iunicipa±ity)
~ap No. Lot(s)_
Name of Owner(s)
ERNEST CHRISTENSEN
Occupancy
Ad,mitt ed by:
A-I
(type)
SCOTT RUSSELL
SCOTT RUSSELL, COI~I~.ACT V~NI)EE
(owner-tenanz)
Accompanied by: sang
Key available
Suffolk Co. Tax No. 77-3-2
Source of request SCOTT A. RUSSELL
.Date
ROV. 22, 1991
DWELLI~IG:
Type of construction
Foundation CE~NTBLOCR
Total rooms, 1st. F1
Bathroom(s) I FULL BATH
Porch, type
Breezeway..
Type Heat OIL
Fireplace(s).
Domestic hotwater
Other
MOOD FRAME
Deck, type.
Garage
Warm Air
No. Fzcits 2
YES
#stories
Cellar FULL Crawl space
2nd. FI 5rd. FI
Toilet room(s)
Patio, type_
Utility room
Hotwater xx
Airconditionin~
Type heater OFF,OILeR
ACCESSORY STRUCTURES:
Garage, type const. ! CA~ WOOU
Swim,ming pool
Other
Storage, type const.
Guest, type const.
VIOLATIONS:
_Location
.CHAPTER 45--N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
Description I-Ar~'. ] Sec.
Remarks:
Date of Insp. DEC. 2, 1991
' Time start IO:00 end lO: 15
Form No. 6
TOWN OF SOUTNOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
A~PLICATION FOR CERTIFICATE 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 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-ex~stzng land uses:
~. 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
l. 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-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 $I5.00, Commercial $15.00
Date
......... ~¥ ~../.~. .............
Xew Construction ........... Old Or Pre-existing B~.ldin~..~../i.iiiillI
Location of Property...[.Q~.O ................... ././.. ~ ...~.~. .......... ~.~.~.~[~.. .......
House No. Street Hamlet
Oower or Owners of Property ...... ..~...~...~.,..~.~..~./~] .~.~.?.~.y~.~..~..~. ~/~,} ~,~, ....
dounty Tax Map No 1000, Section .............. Block ................ Lot .... ~ ...............
,~ubd ~vis~on .... ~. T ~ .Filed Map ........ Lot.
Permit No ................ Date Of Permit ................ Applicant ....................
Health Dept. Approval ......................
.... Underwriters Approval .....................
Planning Board Approval ..............
!~,equest for: Temporary Certificate.. . Final Certicate. ..
" /~ oO
$ .
~ee Submitted: .......
........ .
~:0 'Zo~ 03, ? :3 A~P~ICANT
CONSE?4T
TO
INSPECTION
~Fo0// ~. /~.~c~d7 I/ the undersigned,
Owner(s) Name(.~;)
do(es) hereby state:
That the undersigned ~ (are) the ~~of thc premises in thc Tov~
of Southold located at__ ~'~'C ~ fo~p~o/j
~ . which is shovm and desl~n.,ated on the Suffolk
That the undersigned (has) (have) filed, or caused to be filed, an applica-
tion in the Soutbcld Totem Building Inspector,s Office for the follow.g:
That the undersigned do(es) hereby give consent to the Building Inspectors
of the Town of Southoldto 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 cf Southold.
The undersigned, in consenting to such inspections, do(es) so x~4th 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.
(sige~ure)
_
(print na~ne)
(si~natur-e)
(print name)
SURVEY OF
L 0 TS 50, 51 & 52
MAP OF GOOSE~L4 Y ESTATES
IqtED NOV. 19,1B94 MAP NO. ~
A T SOUTHOLD
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N Y.
1000 - 77- 03- 02
Scale: 1" = 30'
Nov. 21, 1991
P~ ~YORS,
P. O. BOX 909
MAiN ROAD
$OUTHOLD, N. Y. 11971
L/C, NO. 49618
P.C.
CERTIFIED TO"
SCOTT A. RUSSELL
PECONtC ABSTRACT~ INC.
# 605-S'9475
Prepered in accordance wifh file minimum
slendurds for l/tie surveys ns established
by fhe L.I.A.L.S. off# approved o~d adopfed
for such use by The New York Stale Land
T/fie Association.
91-285