HomeMy WebLinkAboutZ-20671FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-20671 Date APRIL 23~ 1992
THIS CERTIFIES that the building ONE FAMILY DW~JJ.?NG
Location of Property 43100 NORTH ROAD SOUTHOLD{ NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 59 Block 4 Lot 1
Subdivision 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-20671 dated APRIL 23~ 1992
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~-TJ,T~G WITH ACCESSORY ONE CAR WOOD FRAME GAR~GR. *
The certificate is issued to ESTATE OFANASTASIADONAHUE
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. PENDING - APRIL 22~ 1992
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTAC~ED INSPECTION REPORT.
/ Building Inspector
Rev. 1/81
Location
BUiLDE[G DEP f~,T[.iEDT
TO';,?[ OF SOUTHOLD, N. Y.
HOUSIXG CODE IDSPECTIOH REPORT
43 I00 NORTH ROAD SOu'l'ltOLD, I~W YORK
Subdivision
blap bio.
Ne~me of 0wner(s ) ESTATE OF ANASTASIA BONA~uK
i.~unlc/pal- 5y )
not(z)_
Occupancy_
A~mitted by:
A-I RES.
[type)
PATRICK C, ORF~N
(Owner- c erla~)
Accompanied by: SAME
Key available
Suffolk Co. T~c No. 59-4-1
Source of request
GAILY FLAI~ER OLSE~, 'ATTY
Date
APRIL 23, 1992
DE~ELLI~[G:
,Type of construction
Foundation CONCRETE
Total rooms, 1st. F1
Bathroom(s ) ONE
Porch, type
Breezewa~
Type Heat OIL
Fireplace(s) NONE
Domestic hotwater
Other
WOOD FRAME
mstorles l-l/2
Cellar ~unL Crawl space - -
4 2nd. Fl_ 2 3rd. F1
Toilet room(s) ONE
Deck, type Patio, type.
Garage Utility room
Warm Air Hotwater xx
No. ~cits 2
-- Airconditioning_..
· ES Type heater OFF x-~ BOILER
~CCESSORY ST..UC~UR.S:
Ga~==
-=o~, type const._l CA~OOD F~Storage, type const.
Swim~ning pool Guest, type const.
Other
V~rOLATIONS:
_~Lncation
.CID%PTER 45--N.Y. STATE UNIFO[~ FIRE PREVENTION & BUILDING CODE
D.-c~lu,.!on {-~rt.'{ Sec.
Remarks: "
· Time start 10:20 end 10:35
FORM NO. 6
TOWN OF SOUTHOLD
, Building Department "~'
Town Hall ~
Southo d, ,.¥. ,,97 '
765 - 1802 i
APPLICATION FOR CERTIFICATE OF OCCUP/~NCYrOW:~
Instructions
A. This application must be filled in typewriter OR ink, and submitted m am..a,mmm to the Building Inspec-
tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal}.
3.Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa-
tions, a certificate of Code compliance from the Architect or Engineer responsible for the building.
5.Submit Planning Board approval of completed site plan requirements where applicable.
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or
topographic features.
2.Sworn statement of owner or previous owner' as to use, occupancy and condition of buildings.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
C. Fees:
1. Certificate of occupancy $25:00 -- SUSTNg8$ $50.00
2. Certificate of occupancy on pre-existing dwelling $ $ 0.00
3. Copy of certificate of occupancy $ §,'00, over 5 'years $10.00
4.Vacant Land C.O. $ 20.00
5.Updated C.O. $'50.00 Date ..A.p.r.J.l,.].5.,. 1992
NewC°nstruc~i°n Old or Pre existing Building ;~
...... ' ........... Vacant Land .............
Location of Property 43]00 North Road Southo]d New York
House No. Street Hamlet
Owner or Owners of Property E~t~te of Anastasia Donahue
County Tax Map No, 1000 Section , .~9. ........... Block . ,4. ............ Lot,, ,]. ............
Subdivision ................................ Filed Map No .......... Lot No ..............
Permit No ........... Date of Permit .......... Applicant ..................................
Health Dept. Approval ........................ Labor Oept, Approval ........................
Underwriters Approval ...................... ~ .Planning B,~.r~L~Ap~roval .....................
Request for Temporary Certificate ................... /nal/~rtihcate. ~)/'~..~/¢~. ..........
Fee Submitted $.. [ .00. :0.0. ................... /
Construction on above described bu ildin; °a'n'd'~:~p~[llcabl~odes and regu ,ations.
Gary F]anne~0~se~, Esq. ~ .....
n~.~o.~o.~a P. 0. Box 706 ' ·
Cutchogue, NY 11935 ~
oq0 9/
CONSENT
TO
INSPECTION
Anne Lao as Executrix of the Estate of Anastasia Donahue , th~ undersigned,
Owner(s) Name(s)
do(es) hereby state:
That the undersigned (is) (are) the owner(s) of the premises in the Towu
of Southold located at 43100 North Road, Southold, New York
· which is shown and designated on the Suffolk
County tax map as District 1000, Section 59 , Block 4; , Lot 1
That the undersigned (has) (have) filed, 'or caused to be filed, an applica-
tion i~i'tha Southold Town ]~u~laing lnsp~;~,,..~ Oe~.'.o £o. +½,~ fallowing:
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 ot 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 To~vn of Southold.
Dated: April 15, 1992 ~~jf~
(sign~tu~e~-
Garv Flanner Olsen (print name)
(signature)
(print name)
MAP OF' P~OPERTY SUI'Z',/EYED I::QI;Z -
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