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Home My WebLink AboutZ-22160FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTME/~T Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-22160 Date FEBRUARY 25~ 1993 THIS CERTIFIES that the building Location of Property 1140 PARK AVENUE House No. County Tax Map No. 1000 Section 123 Subdivision ONE FAMILY DWF/,LING MATTITUCK ~ N.Y. Street Hamlet Block 8 Lot 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-22160 dated FEBRUARY 25~ 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 DWELLING WITH 2 ACCESSORY GARAGE STRUCTURES PUMP HOUSE & BEACH HOUSE * The certificate is issued to of the aforesaid building. ESTATE OF GILDA DODGE (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERE CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTAC~ED INSPECTION REPORT. ~~2uil~d~nspector Rev. 1/81 LOCATION: SUBDIVISION 1140 PARK AVE. (number & street) NAME oF O~R (s) BUILDING HEPAR~MENT TOI~N OF SOUTHOLD HOUSING CODE INSPECTION REPORT NATTITUCK, N.Y. (municipality NAP NO. LOT (s) ESTATE OF GILDA DODGE OCCUPANCY A- I RES. (type) ADMI'I-rED BY:. DAVE KAPELL KEY AVAILABLE SOURCE OF REQUEST: DAVID KAPELL (owner-tenant) ACCOMPANIED BY: 'SAME SUFF. CO. TAX NAP NO. 123-8-1 DATE: FEB. 5, 1993 DNELLING: TYPE OF CONSTRUCTION FOUNDATION BRICK WOOD TOTAL ROOMS: I ST FLR. 4 BATHROOM (s) 2 FULL BATHS PORCH TYPE FCI~t. BREEZEWAY I)O~STIC HOTWATER TYFE HEAT OIL ~Yi'm~R: 2ND FLR. 5 TOILET RO~4 (s) DECK, TYPE FIREPLACE YES. [ STORIES 2 ~ EXITS CELLAR FULL CRAWL SPACE 3RD FLR. 2 UTILITY ROOM PATIO, TYPE ONE GARAGE 'rIFE HEATER OFF 'rflii BOILER AIRCONDITIONING WARI4 AIR HOTWATER XX ACCESSORY STRUCTURES: GARAHE, TYPE OF CONST. 2 GARAGE STRUCTURES STORAGE, TYPE CONST. SWII~4ING POOL , GUEST,'I'/'PE CONST. ~l'kl~R: ~ HOUSE, BEACH HOUSE VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORI4 FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. ~ AROUND E~F~RIOR STAIRS, PORCHES, ENTRANCE PLATFORM, FIRE NYCRR 9(B) COVERED ESCAPES AND Tfl~ RAILINGS IBi~REON SHALL BE NAINTAINED IN 1242.5 (C) PORCH A SAFE AND SOUND CONDITION. REMARKS: BP ~21240 CO Z-22161 FOR ALTERATIONS TO ACCESSORY GARAGE INSPECTED BY: DATE ON INSPECTION FEB. II, 1993 TlR START 9:35 AM END 10:00 AM Form No. 6 TOWN OF SOUTHOLD ~ ~ BUILDING DEPARTMENT · TOWN HALL 765-1802 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: 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-exist~ng" land uses: 1. Accurate survey of property showing ali 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 Building - $100.00 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.Q0, Commercial $15.00 · Date ...~../.~/?..~. .... ;ew Constructzon ........ ~.. Old Or Pre-existing Building_. '..~... ......... ~ ....... ~ocation of Property...~...~.o.~...~...c~...c~..~:~-, ~ ~''''~x''~ ~J~l~o ~ ~ · H~se No. ' ...... ~e; ............... ~'~..'.~..~7.'.'.~. .'..'~....'~A~ )nwer or Owners of Prop~rty.~.~_~..~-..~..~...(~..~.. ~i ~ ~ - \nam~t ~ounty Tax Map No 1000, Section ......... Block.. Lot ...... iubdivision .......................... .......... Filed Map ............ Lot .... ermit No Date Of Permit ' ....................... Applicant ]ealth Dept. Approval ......................... Underwriters Approval ......................... lanning Board Approval ..................... equest for: Temporary Certificate ........... Final Certicate ........... P.,-oL. q3s3 7 FEB" 5 1993 CONSENT TO INSPECTION ~-~xX~_ ~= \/~tk.~)V~-~ · the undersigned, Ox~er(s) Name(s) do(es) hereby state: of Southold located at County tax map as District 1000, Section That the undersigned (is) (are) the owner(s) of the premises in the Town · which is shown and designated on the Suffolk , 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 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 ~vith 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. (signature) (print name) (signature) (print name) DAVID ;~. KAbELL,AS AGgNT GRE~NP~RT, NY, ll~4a RANGES R TIME CLOCKS BELL UNIT HEATER MULTI-OUTLET OF CC. COND. NO OF HI.LEG OF HI-LEG EXHAUST FANS ~IDIMMERS This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. / ~. ~. ,' ,roe- - ~. , ,. , ~ ~a - ,' LOT · 1~ ....... " ~ ~ LOT ~ ~¢ PAECEL. I '", ¢ , : ' ] ' ~-' - .................. ., - .................. ':~ ....... .~ ............. M-~ .... ~t ~ 1' -- ~. ~e ~'oo-v. -'- ' - ~z~.'~ ............... 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