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Home My WebLink AboutZ-23762FOP~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-23762 Date JULY 12, 1995 THIS CERTIFIES that the building. Location of Property_ 1150 SMITE ROAD House No. County Tax Map No. 1000 Section 98 Subdivision ONE FAMILY DWELLING PECONIC, N.Y. Street Hamlet Block 3 Lot 27 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-23762 dated JULY 12, 1995 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 ACCESSORY TWO CAR GARAGE * The certificate is issued to DONALD A. DOHi~I4AN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 N/A N/A *PLEASE SEE ATTACHED INSPECTION REPORT. ~/ Building Inspect~ liIl 11.I) IH(; DI'; I'ARTHENT TD~/II OF S(]U'DIOLI) IIODSING CODF. INSI'EGTION REI'ORT I,OCATION: 1150 SHITH ROAD PECOHIC, NE}/ YORK (number & streW) ,qlllll)l V IS ION HAl' NO. l.OT(s) NAHE ()Ir ()~4NER Is) DONALD DOIIPO4AN OCCIIPANEY RES IDENTIAI. ADH ITTEI) llY: DON DOHRHAN ACC()HPANIED BY: S~ KEY AVAII.ABI,~ ................ ~j~j:j7.{~(~. ,i~AX HAP NO. 1000-98-3-21 SDllRCE DE RIqqJH5S'I': ~N~D H. ~H~N IlAr: FEB. Ill4EI,L 1NG: TYPE O1: CON,qTRIICTION l~OOD F~ FOIINI)ATIOH _ __G_EJq~N'f_ B~LO~_CK . CEI,1,AP, FULL TOTAl, ROOHS: [S'I' FI,R. 4 2ND FI.R. 3t11) FI,R. IIATIIRODH Is) ONE TOIl.ET Ill)OH Is) PORCI1 TYPE REAR&FRONT COVERED SCREENED HEGK, TYPE F l REI'I,AGE NOblE 15, 1995 I1REE ZE~/AY IIOHEST IE IIOTI4ATEI{ YES TYPE llEAT GAS L.P. OTIIER: TYPE IIEATER GAS L.P. STORIES C RA'dL SPACE I ! EXITS 2 II'FII, ITY ROOH blEAR PATIO GARAGE AIRCONI)ITIONING IdA Rlq Alii XX llO'I~/ATER AE(H';SS()RY STRIICHIRES: GARAGE, TYPE I)F CONST. 2 CAR }/ODD FRAME S'I'ORAGI.;, TYPE CONST. NOblE 5141HHING POOl. , C, UEST, TYPE GONST. OTIIER: VIOI./~T_ION_S: GIIAI'TER 65 N.Y. ,qTATE UNIFI)RH EIRE PREVENTION & BUILDING CODE LOCATION I)I". SCR 1 ['T ION ART. SEC. IH.;HARES: BP ff17799Z-CO Z-23763 (FOUND.& GAS HEATING SYSTEH) BP ~[22804Z-CO Z-23690 HAY 5, 1995 END 10:30 Form No. 6 TOWN OF SOUTtIOLD BUILDING DEPARTMENT TOWN HALL 765-I802 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. 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 - $i0.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $I5.00 ~e~r~ary 9 19~5 Date ......... , ........................... New Construction ........... Old Or Pre-existing Buiiding.~...~pp~.Jg~.~tached garage Peconic Location of ?ro~erty.. Smith Road House No. Street Hamlet Donald A D h Onwer or Owners of Property ...... ' o rman S ' 98 ~ 27 County Tax Map No I000, ec~ion .............. Block ............... Lot ...................... Subdivision .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ....... .-.-.... . Applicant ............................. llealth Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ..... Request for: Temporary Certificate Final Certicate Fee Submitted: $.. JO0.O0 %=_, ............... CONSENT TO iNSPECTION the undersigned, Donald A. Dohrman ' ----------~ (s) Name(s) do(eS) hereby state: That the undersigned (is) (are) the owner(S) o[ thc premises in thc Town Smith Road, Peconic, NY ~ of Southold located at._____.____- ..., which is shown and dcslgna[ed on the Suffolk County tax map as District 1000, Section 98 , Block 3 , Lot 27 ... That the undersigned (has) (have) filed, 'or caused to be filed, an .~pplica- tion in'th,~ Southold Town l~u~lGing lnsp~uL,~- '= ore;.°° ~o~' "'~' {nllowinf: house and detached garage. That the undersigncd do(es) hcreby give consent to the Building Inspectors of the Town oFSoutholdt° enter upon the abovc dcscribedproperty, h%cluding any and all buildings located thereon, to conduct such inspections as they may deem necessary with respect to the aforesaid application, includmg'~nspeCtt°n to determine that said premises comply with all of the laws, ordinances, rules and regulations of thc Town of Southold. Thc undersigned, in consenting to such inspections, do(es) so withthe knowledge and understanding that any information obtained in thc condo{et of such inspections may be used as evidence in subsequent prosecutions for vio- lations o[ thc laws, ordinances, rules or regulations of the Town o~ Southold. D~ted: February 9, 1995 _ (signatur~--~' Donald A. Dohrman - (print name) (signature) -- (print name) I. Z Lo+ Lo4- ~___.5 I[~)ONALD