HomeMy WebLinkAboutZ-20986No Z-20986
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
UPDATED
PRE EXISTING
CERTIFICATE OF OCCUPANCY
Date AUGUST 28r 1992
THIS CERTIFIES that the buildin~
Location of Property 555 VITW~GELANE
House No.
County Tax Map No. 1000 Section 25
Subdivision
O{~ FAllILY DW~T,LING
C~TRI',,'Tr NEW YORK
Street Ham] et
Block 2 Lot 5.1
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-20986 dated AUGUST 28r 1992
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 F~ILY DW~.INGWITHACC~.~RYBARN*
The certificate is issued to
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*NOTE: THIS UPDATES PRE CO Z-5455 DATED SEPT. 18, 1973.
BP #2885 CO Z-2656 ADD - BP #12510 CO Z-16313 ADD
BP #17365 - CO Z-20988 ADD - BP #20924-Z CO Z-20987 ADD TO ACCY
Rev. 1/81
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
AU6 2 11992
: APPLICATION 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:
l. 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-conformi
,, . . . . ng uses, or buildings and
-pre-exzstzng land uses.
1. .Accurate survey Of property showing all property lines, streets, building and
unusual natural or topographic features.
2. A properly completed application an~'~ consent to inspect signed by the applfcant.
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
.Copy of Certificate of Occupancy - $5.00 over 5 years - $i0.00
.Updated Certificate of Occupancy - $50.00
Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
· -
Date .............. . ................
few Construction ........... Old Or Pre-existing Building...C-f/ ............
· ocation of Property; '
'.. House No. Street Hamlet
ty ·
;nwer or Owners of Proper ....................
oun y ,ax Map No 1000, Seetioa... >/.. ..... Blo=k ..... ......... Lot ..... AT,.I ..........
ubdivi-sion .
..................... ;. ............. Filed Map ............ Lot .....
ealth Dept. Approval ......................... Underwriters Approval .........................
tanning Board Approval .......................
-'quest for: Temporary Certificate ........... Final Certicate..~.~.~qrC '
:) c.:z, e J-O !
AUG 2 11992