HomeMy WebLinkAboutZ-22901 FORM NO. 4
TOWN OF SOVTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE E%IBTIEG
CERTIFICATE OF OCCUPANCY
No 8-22901 Date MARCH 14, 1994
THIS CERTIFIES that the building ONS FAMILY DWSLLIEG
Location of Property 54800 MAIR ROAD SODTHOLD, M.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 64 Black 1 Lot 16
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 8-22901 dated MARCH 14, 1994
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate ie
issued ie ONS FAMILY DWELLING WITH ACCBSSORY ONE CAR GARAGE
The certificate is issued to LSWIS L. EDSON
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*PLSASS SEE ATTACHED INSPECTION REPORT.
NOTE: ACCESSORY ONE CAR GARAGE MOVED TO NEW LOCATION UNDER
BP #6620 CO Z-5374.
wilding Inspector
Rev. 1/81
{ ~ BUILDING DEPART:fENT
TOWN OF SOUTIIOLD
?OUSING CODE INSPECTION REPORT _
LOCATION: 54800 MAIN ROAD SOUTHOLD, NEW YORK
number S street municipality
SUBDIVISION MAP NO. LOT (s)
NAME OF OWNER (s) LSWIS L. EDSON
OCCUPANCY SINGLE FAMILY
type ~(ovner-tenant)
ADMITTED BY: NARY GRIMBS ACCOMPANIED 6Y: MARY GRII~S
REY AVAILABLE SUFF. CO. TAX MAP N0. 1000-64- -
SOU[;;.; OF REQUEST: LEWIS L. EDSON DATE• FEB. 21, 1994
Dl1ELLING:
TYPE OF CONSTRUCTION WOOD FRAME # STORIES 2 # E3ITS 3
FOUNDATION - CELLAR FULL CRAWL SPACE
TOTAL ROOMS: IST FLR. 4 2ND FLR. 4 3RD PLR.
BATDROOM (s) 2 TOILET ROOM (s) OTILITY ROOM WASHHR DRYER
PORCD TYPE DECK, TYPE WOOD IN REAR WITH PATIO, TYPE
BREEZEWAY FIREPLICE ONE GARAGE
D041ESTIC DOT[dATER Y6S TYPE HEATER OFF BOILER AIRCONDITIONING
TYPE UEAT OIL WARM n/~IIR AOTWATER ~
OTIiER: NSTALLED
ACCESSORY STRIICTURES: (2)
GARAGE, TYPE OF CONST. l CAR WOOD FRAME STORAGE, TYPE CONST.
SWL`L*lING POOL GUEST, TYPE CONST.
OTHER:
VIOLATIONS: CIIAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION ~ BDILDING CODE ~
LOCATION? ~ DESCRIPTION ~ ART. SEC.
REMARKS: BP #5811 CO Z-4701 -DECK BP #6620 CO Z-5374 ACCESSORY 3 CAR GARAGE
INSPECTlSD BY: DA'1'li ON INSPECTION FEB. 24, 1994
' SH TIME START 9:30 CND 9:55 AM
_
. Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTII'ICATE 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 17 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-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 - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date .......:~!/Z. L/~ ~
New Construction........... Old Or Pre-existing Building...
Location of Property..~l
~~~.U............~? A/w/• • ~dA b ..........:SD.RT.~/~q~
House No. Street Hamlet
Onwer or Owners of Property....^~~.G//r/'i//+5,....~t.. LS.,~..'~~.41!t/•••••••••••••••••••••••••••
County Tax Map No 1000, Section...../p,.7.....Block.......(........Lot...~..6
Subdivision ....................................Filed Map............Lot......................
Permit No ................Date Of Permit................Applicant.............................
n y
Health Dept. Approval....../` L
................Underwriters Approval./..~ C.~
Planning Board Approval
Request for: Temporary//Certificate........... Final Certicate... '
Fee Submitted: $.....f.~
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