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Home My WebLink AboutZ-25526FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 25526 Date: 01/23/98 THIS CERTIFIES that the building DWELLING Location of Property 1050 AKA 412 CHAMPLIN PL. GREENPORT (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 034 Block 0005 Subdivision 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- 25526 dated JANUARY 23, 1998 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 * (HAMLET) Lot 002.001 The certificate is issued to SANDRA DAVIDS of the aforesaid building. (OWNER) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. N/A N/A // ~lding Inspector Rev. 1/81 BU1LDING DEPARq~ENT TOWN OF $OUTBOLD [lOUSING CODE INSPECTION REPORT LOCATION~ 1050 AKA 412 CH.~MPLIN PL. SUBDIVISION: NAMB OF OWNER (S): SANDRA DAVIDS OCCUPANCY~ SINGLE FAMILY GREENPORT MAE NO.: __ LOT (S) __ SANDRA DAVIDS ACCOMPANIED BY: SAME KEY AVAIIJ%BLE~ SUFF. CO. 'PAX MAp NO.~ SOURCE OF REQUEST~ SANDBA DAVIDS DATE: 01/23/98 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME FOUNDATION~ CONCRETE. STONE & BRICK TOTAL EOOMS~ 1ST FLR.~ _~. BATHROOM(S) ~ ~,Q PORCH TYPE~ * BREEZEWAY: DOMESTIC BOTWATER: YES TOILET ROOM(S) ~ DECK TYPE: FIREPLACEi NONE TYPE BEATER: OFF BOILER CELLAR: FULL CRAWL SPACE~ __ UTILITY ROOM(S): -- PATIO TYPE~ CONCRETE GARAGE: AIRCONDITIONING~ TYPE HEATi OIL WARM AIR: HOTWATBRi OTHER: REAR ENq'RYWAY WITS PAltRY *WRAP AROUND/PARTIAL SCREEN ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.~ 1 CkR WOOD FRAME STORAGE, TYPE CONST.~ SWIM,liNG POOL: GUEST, TYPE CONST.: OTHER~ VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. REMARKS~ ED ~5238-Z-CO Z-4299 ACCESSORY GARAGE Form No. 6 '7~'~g~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 tPPLICATION 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 D~pt. 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 ;I]lcl i.sta].]ations, a cert:Lfic~te of Code Cump11. nt~(~e from n~chlLect or e.gfseer responsible for the building. 6. Submit Planniug Board Approw~l nf 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. 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 Buildin~ - $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 $15.00 Date .. '~"x! ~'}' ~9~. ~ ....................... New Construction ......... Old Or Pre-existin~Building...~5- .... Location of Prope~y .......... ~..\~n...p_~..~..e .............. House No. Street Hamlet Onwer or Owners of Property...~.~...f.%..'~f.~ .................................. County Tax Map No 1000, Section...O.~ ........ Block...a ......... Lot..O.$.'.! .............. Subdivision ................................. ... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant..~f.O~..~,..~.~d.~ Health Dept. Approval .... Underwriters Approval Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $..[~ ~ ................... [~-.A~-5~6 ~ APPLICANT CONSENT TO INSPECTION _~"I~IFO- E. ~/~ ' , the undersigned, Owner(s) Name(s) do(es) hereby state: That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at 141 ~t~ ~-~GUq~(¢_~ AVe. reea0or t- , which is shox~ and designated on the Suffolk County tax mapas District 1000, Section ~q__, Block 05 , Lot 0~. I That the undersigned (has) (have) filed, or caused to be filed, an applica- tion in the Southold To~ 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 ali 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 rio- rules or regulations of the Town of Southold. lations of the laws, ordinances, Dated: ~ o~3, qqg (signature) (print name'~ (signature) (print name)