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Home My WebLink AboutZ-22468FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUP;%NCY No Z-22468 Date JULY 22~ 1993 THIS CERTIFIES that the building Location of Property 620 ROGERS ROAD House No. County Tax Map No. 1000 Section 66 Subdivision ONE FAMILY DWELLING SOUTHOLD{ NEW YORK Street Hamlet Block 2 Lot 35 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-22468 dated JULY 22~ 1993 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 DW~T~JNG WITH ACCESSORY STORAGE SHR. D * JOHN & ELIZABETH DAVIS 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 *PLEASE SEE ATTACHED INSPECTION REPORT. ~~'~ ~ ~g Inspector Rev. 1/81 LOCATION: BUILDING DEPARTMENT TOWN OF SOU~IOLD HOESING CODE INSPECTION REPORT 620 ROGERS ROAD soIrrlIOLD, HEW YORK (number & street) SUBDIVISION NAME OF OWNER (s) JOHN DAVIS & WIFE MAP NO. (municipality LOT (s) OCCUPANCY ONE FAMILY DWELLING OWNER (type) (owner-tenant) ADMITTED BY: OWNER KEY AVAILABLE SOURCE OF REQUEST: OWNER ACCOMPANIED BY: SAI4E SUEF. CO. T~K MAP NO. 66-2-35 DATE: JULY 9, 1993 DWELLING: TYPE OF CONSTRUCTION FRAME FOUNDATION CEMENT BLOCK & CONCRETE TOTAL ROOMS: IST FLR. 4 2ND FLR. 3 BATHROOM (s) 2 TOILET ROOM (s) PORCH TYPE I ENCLOSED UNHEATED DECK, TYPE I OPEN BREEZEWAY FIREPLACE DOMESTIC HO~gATER XX TYPE HEATER TYPE }~AT OIL WARM AIR O~{ER: ~ STORIES 2 # EXITS 2 CELLAR PARTIAL CRAWL SPACE PARTIAL 3RD FLR. 2 OFF FURNACE UTILITY ROOM l PATIO, TYPE GARAGE AIRCONDITIONING HOTWATER XX ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. STORAGE, TYPE CONST. FRA~ sWIMMING POOL , GUEST, TYPE CONST. OTHER: BP ~I014?Z-CO Z-10269 FOR ADD. & BP #1394lZ-C0 Z-13836 FOR ADD. VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. CELLAR DRYER VENT SHODLD BE EXHAUSTED TO EXTERIOR INSULATION HANGING DOWN IN CRAWL SPACE. REMARKS: OATE ON INSPECTION JULY 19, 1993 TIME START 9:40 EN~ I0:00 Form No. 6 TOWN OF SOUTHOLD BUILD iNG DEPARTMENTTOWN765-1802 HALL APPLICATION FOR CERTIFICATE OF OCCUPANC~ 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. 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 Inspect'or 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 - $i00.00 3. 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 House No.~ Street . Hamlet County Tax Map No 1000, Section.. Eg .... Block... ~-- ...Lot. ~ -~ Subdivision ..... .~.~ L , ...... Filed Map .... ~ . .Lot ................... Permit No Date Of Permit Applicant ' Health Dept. Approval ........... · ..............Underwriters Approval....... ................. . Planning Board Approval ........ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ ..... ~.~.~ .................... ¢.. ....... .............. Owner(s) Name(s) do(es) hereby state: CONSENT TO INSPECTION · the undersigned, That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at ~''2.-~ ~----07 ~ %~4a~ · which is shown and designated on the Suffolk County tax map as District 1000. Section ~__. Block ~_- . Lot ~ ~ . That the undersigned (has) (ha~e) filed, or caused to be ~iled. an applica- tion in the Southold To~ Buildin~ Inspector's Office for the follow,g: 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. Dated:_ k~) (print name) (signature) (print name) L(Wr I Guva~no I?s b~ak;ate~ horeon shall nm