HomeMy WebLinkAboutZ-26318FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 26318
Date: 03/05/99
THIS CERTIFIES that the building DWELLING
Location of Property 380 INLET LA
(HOUSE NO.) (STREET)
County Tax Map No. 473889 Section 043 Block 0005
Subdivision
Filed Map No. __ Lot No. --
GREENPORT
(~MLBT)
Lot 002
conforms substantially to the Requirements for a ONE FAMILY DWELLING
built prior to APRIL 9~ 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z- 26318 dated MARCH 5, 1999
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 *
The certificate is issued to PETER N & CLAIRE DESANCTIS
(OWNER)
of the aforesaid building.
SUFFOLK ~OUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
Rev. 1/81 ~
N/A
N-320224 7/12/94
N/A
BUILDING DRPARTM~
TOWN OF SOUTHOLD
TYPB OF CONSTRUCTION= W(~D
FOUNDATION = C~/~P BLOCK
TOTAL ROOMS= 1ST FLR. = ._~
BATHROOM{S) = 1.0
VIOLATIONS: CHAPTER 45 N.Y. STATB UNIPORM FIR~ PREVI~ION & BUILDING CODE
LOCATION
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BUILDING DEPARTMENT
'i ......... BLDG. DE~T.~ 1!~/ TOWN HALL765_1802
L_ PL CATIO C T FICA E OF OCC CY
L TQ~N.OF $OU~HOLD J
.~,~ ap~A~cat~on must be filled in by t~riter OR ink and submitted to the building
~spector with the following: for new building or n~ u~e:
1. Fimal su~ey of .property with accurate location of all buildings, property lines,
streets, and unusual natural or topographic features.
2.F~al Approval from Health Dept. of water ~upply and sewerage-disposal(S-9 fo~).
3.Approval of electrical installation from Board of Fire Unde~iters.
4. Sworn statement fr~ pl~ber certify~g that the solder used in syst~ contains
les~ than 2/10 of 1% lead.
5. C~ercl~ build.g, ~dustri~ build.g, ~ltiple residences amd s~ilar buildings
and lnst~lations, a certiflcate of Code Compliance from architect or e~ineer
rempomsible fo= the
6.Su~t Pla~g Board ~pr~ of co~leted ~ite plan requir~ent~.
Fo: ~t~g bu~ld~gs (prior Co ~ril 9, 1957) nom-co~fo~g uae~, or build~gs and
'3pr~is~g" l~d uses:
1. Accurate su~e~ of proper~
unusu~ ~tural or topo~raphic features.
2. A properl~ c~leted application ~d a co~s~t to ~spect si~ed by the applicant.
If a Cert~icate of Occup~c~ is denie4, the Buildin~ Inspector shall state the
reasons therefor in ~itin~ to the applicant.
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Sw~-~,~-$ 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 - , .~5~.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupaucy'- Residential $15.00, Commercial $15.00
D,ta .....
Construction ........... Old Or Pre-existing Building.. ??. ............ .~.
~tion o~ Property .................... ' ''
House Ho. Street H~wl et
~er or Owners of Property ....... . ' .............
.o ..............
fancy Tax No 1000, Section ......... Block ............. Lot ........
lhdivision .................................... Filed Map ............ Lot .....................
Date Of Permit Applicant ..............
· ~lth Dept. Approval .......................... Underwriters Approval ........................
auning Board Approval ........
~quest for: Temporary Certificate ........... Final Certicate ...........
· e Sub~cced:
..... · ....
CONSENT
TO
INSPECTION
Owner(s)
do(es) hereby state:
~ame(s)
· the undersigned,
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at ~-~//0 ~ h ~--~- i/'q ,
· which is shown and designated on the Suffolk
County tax map as District 1000, Section (p ~/'_~ , 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 £ollowing: __
oF
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7
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, trules
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 regulatiol~ of the Town of S.~Athold.
..._~ (signature)
(print name)
-- --~ (~'i~nature)
(print name)
THE NEW YORK BOARD OF FIRE UNDERWRITERS
~ee~e93 BURE^U O,=
85 JOHN STREET. NEW YORK. NEW YORK
~ ~Y 12,1994 ~pplicati~No. on~l~ ~6119194/94
THiS CE~IFIES T~T N 32~224
TN CrOCKs
E R V
MU~t'kOUT~E DIMMERS
SYSTEMS
I C E
S
DOROSKI ELEC. INC.
425 MONSELL LANE
CUTCHOGUE, NY, 11935
LIC.#2941-E
This certificate must not be oltered in any manner; return to the office of the Board if incorrect. Inspectors
by the · credenfiaJs~-