HomeMy WebLinkAboutZ-26267 FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 26267 Date: 02/08/99
THIS CERTIFIES that the building ACCESSORY
Location of Property MADELINB AVE FISBERS ISLAND
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 006 Block 0008 Lot 003.001
Subdivision Filed Map No. Lot No.
conforms substantially to the Requirements for a ACCESSORY STROCTORE
built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z- 26267 dated FEBRUARY 8, 1999
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 ACCESSORY WOOD FRAME GARAGE
The certificate is issued to RICHARD & BARBARA EDWARDS
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
B 1 ing ~ epector
Rev. 1/81
BUILDING DBPARTMHNT
TOWN OP SOUTHOLD
untrcrur rnnR TNSPRCTTON PRPORT
LOCATION: Mn-DELILAH AVE PISHERS ISLnn1D
SUBDIVISION: MAP NO.: LOT (S)
NAME OP OWNER (S): RTrRARn c AARAARn EDWARDS
OCCUPANCY: Rmunun AARAann RDWAiLD3
ADMITTED BY: ACCOMPANIED BY:
KEY AVAILABLB: SUFP. CO. TAX MAP NO.: 6 -8-3 1
SOURCE OF RBQUSST: AAGr RV RRRn 2/8/99 DATH: 02/08/99
DWBLLING:
TYPE OF CONSTRUCTION: # STORIES: 0.0 # 8XIT5: ~
FOUNDATION: CHLLAR: CRAWL SPACH:
TOTAL ROOMS: 1ST FLR.: ~ 2ND PLR.: ~ 3RD PLR.:
BATHROOM(S): 0.0 TOILBT ROOM(S): 0.0 UTILITY ROOM (SI:
PORCH TYPe: DBCR TYPB: PATIO TYPH:
BRBEZEWAY: FIRHPLACH: GARAGB:
DOM85TIC HOTWATBR: TYPH HHATBR: AIRCONDITIONING:
TYPH HEAT: WARM AIR: HOTWATBR:
OTHBR:
nrrRSSORY STAUC74roRS:
GARAGE, TYPE OF CONST.: WOOD PR_aMR CnaaGE STORACH, TYPH CONST.:
SWIEM7ING POOL: GUEST, TYPH CONST.:
OTHER:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODH
TOCnTION DESC TpTION I jtAT ~ SHC
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R$MARRS: AD H7t S'li-7-rn 7-tC~61 lOnTR RLMTTV nWRTf TNC-1
INSPECTED B DATH ON INSPHCTION: 02/06/99
ROB W TIME START: EIiD:
Form No. 6 ~ ~ ~ ~ ~ .
TOWN OF SOUTHOLD
BUILDING DEPARTMENT _ ~
TOWN HALL v ~ ,
765-1802
OIDG. DEPT.~~
1NN F S TH L
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 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 requiremenr_s.
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. ,~i?ees
~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 $15.00
Date ..~:ebruat:y•7~..1999•••••••••••••••••-••
~Iew Construction........... Old Or Pre-existing Building...X
Location of Property ..................mddaliaP. A)IeiUl@.... F.~.~b€X:5 . FS~dr1S1.. rI~~9. York....
House No. Street Hamlet
Onwer or Owners of Property.. RIGI~~X$.~Pd.$a~bara,Edwards
County Tax Map No 1000, Section....006.......B1ock...QOS..........Lot.. 03.7
Subdivision ....................................Filed Map............Lot......................
Permit No ................Date Of Permit................Applicant.............................
Health Dept. Approval ..........................Underwriters Approval.........................
Planning Board Approval
Request for: Temporary Certificate........... Final Cerricate....~......
Fee Submitted: $•••$tOfl•.40•••••••••••••• "
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