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HomeMy WebLinkAboutZ-22203FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-22203 Date MARCH 23~ 1993 THIS CERTIFIES that the building Location of Property 735 SMITH ROAD House No. County Tax Map No. 1000 Section 98 Subdivision INDIAN RECK PARK Filed Map No. 551 ONE FAMILY DWELLING PECONIC~ N.Y. Street Hamlet Block 4 Lot 8 Lot No. 16 conforms substantially to the Requirements for a One Family Dwelling built Prior to: APRIL 9~ 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-22203 dated MARCH 23~ 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 ~ASONAL DWEJJJNG * 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. Building Inspector JOHN R. DEMPSEY & SALLY P. CARROZZI Rev. 1/81 LOCATION: BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT 735 SMITH ROAD PEGONIC, N.Y. (number & street) SUBDIVISION MAP NO. NAME OF OWNER (s) JOHN R. DEMPSEY & SALLY P. CARROZZI (municipality LOT (s) OCCUPANCY A-I Residential (type) ADMI'rrgO BY:. SELF KEY AVAILABLE SOURCE OF REQUEST: JOHN R. DEMPSEY (o~uer-tenant) ACCOMPANIED BY: SUFF. CO. TAX ~ NO. 1000-98-4-8 DATE: MARCH 17, 1993 DWELLING: TYPE OF CONSTRUCTION WOOD F~ FOUNDATION PIERS & CONCRETE (SLABS) TOTAL ROOMS: IST FLR. 5 2ND FLR. BATHROOM (s) 2 TOILET ROOM (s) PORCH TYPE SCREEN PORCH FRONT DECK, TYPE BREEZEWAY FIREPLACE DONESTIC HOTHATER YES TYPE HEATER TYPE HEAT ELECTRIC IN NEW WARM AIR ~ STORIES ONE { EXITS 3 CELLAR CRAWL SPACE H 3RD FLR. UTILITY ROOM PATIO, TYPE ONE C~GE ELECTRIC AIRCONDITIONING HOTHATER ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. SWIIgIING POOL OTm~R: -- . R: SMALL OF HOUSEm HATCHWAY TO 5t~n~LL GKLLAR NONE STORAGE, TYPE CONST. · GUEST, TYPE CONST. VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. REMARKS: BP ~8998Z-C0 Z-7725 for addition INSPECTED BY: DATE ON INSPECTION MARCH 19, 1993 TIME START END Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 · A. APPLICATION 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 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-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. 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~.00. 2. Certificate of Occupancy on Pre-existing Building - WOO 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $i0.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date...~..~..'.~ ,.~1~.~) ............. .. New Construction ........... Old Or Pre-existing Building .... o .... Location of Property...~ ...... ~..~..~ ..... ~.~.~.~. ....................... House No. Street Hamlet Onwer or Owners of Property.~..~,.~.~.~..~W...~'...~.~.*..~.......Zl'i ..... County Tax Map No 1000, Section....~ ....... Block....~ ........... Lot...~ ................. Subdivision.~'~..~k..~ ........... 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: $.J~.,..~.~.. ............ .. . ... o ....... CONSENT TO INSPECTION Owner(s) Name(s) do(es) hereby state: the undersigned, That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at · which is shown and designated on the Suffolk map as District 1000, Section (~ , Block q , Lot~ ~. County tax That the undersigned (has) (have) filed, or caused to be filed· an applica- tion in the Southold Town 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 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:~~)  / (print nam,~e) (s~/gnature) ~ ' (print name) LOW $T0¢ IFjI..D J~ ~. ~9°B7' W. . .L. tgT NO'_5-F21EFE~ TO_MAP OF' INC)lAki F~LEO IkJ mE sure ~C~),CL_EI~..'$ OFF!CE ~._gJFF ~0 TAX ~A? I2ATA !.j~:X) OF 'PF4bPERTY 5URV[YED ,._J J J""'l ,--IALL J PECONIC TOVJN OF... ¢:]_uLjT'____~.. ©,... ¢ ,' ........ N.Y', SCALE- BO'- I" MONUMENT O:Ple[