The URL can be used to link to this page

Home My WebLink AboutZ-28170 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- 28170 Date: O1 15/02 THIS CERTIFIES that the building DWELLING AND ACCESSORY Location of Property 1160 GOOSE CREEK LA SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 078 Block 0008 Lot 005.001 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 OP OCCUPANCY NUMBER Z- 28170 dated JANUARY 15, 2002 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 SAMUEL EPSTEIN & WF (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 REPO i Authorized Signatu Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 1160 GOOSE CREEK LA SOUTHOLD SOHDMSION: MAP NO.: LOT (S) NAME OP OMNHR (S): SAMUEL EPSTEIN S WF OCCUPANCY: SINGLE FAMILY SAMUEL EPSTEIN & WF ADMITTHD BY: CAROL COAKL EY ACCOMPANIHD BY: SAME RHY AVAILABLB: SUPP. CO. TAX MAP NO.: 78.-S-B.1 SOURCH OP RSQUHST: RUDY BRUER, AGENT DATE: O1 15 02 DWELLING: TYPH OP CONSTRUCTION: WOOD FRAME # STORMS: 2.5 # EXITS: 3 FOUNDATION: STONE CHLLAR: CRAWL SPACH: TOTAL ROOMS: 1ST FLR.: 3 2ND PLR.: 4 3RD FLR.: 0 BATHROOM (S): 2.0 TOILHT ROOM(S): 0.0 UTILITY ROOM(S): MUD RM PORCH TYPH: DHCR TYPH: PATIO TYPH: BRHHZHIU\Y: PIRHPLACH: 1 GARAGH: DOMHSTIC BOTWATHR: X TYPH HBATHR: ELECTRIC AIRCONDITIONIHG: TYPH HHAT: OIL NARM AIR: X HOTWATHR: OTHHR: 3RD FLOOR IS AN UNHEATED ATTIC, BILCO EXIT ACCESSORY STRUCTURES: GARAGH, TYPH OP CONST.: TWO CAR WOOD STCIRAGH, TYPH CONST.: SNI}B/ING POOL: GUHST, TYPH CONSL.: OT®t: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION ~ DESCRIPTION ~ ART. ~ SEC. Rra~aaxS: NOTE: H SE I VERY OLD i INSPHCT® BY: TH OH MSPHCTION: O1 14 02 TOBN HOUPIS TDMB START: 9:30AM HND: 10:00AM ~ _ 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/TO 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" ),and uses: 1. Accurate sirvey of property showing all property lines, st t9E Yn1iJc~iiHigNhn~ unusu~ natural or topographic features. D IS l~ t5 U V 2. A properly completed application and a consent to inspect ed b th~a~ic If a Certificate of Occupancy is denied, the Building Insp r ~]pr th reasons therefor in writing to the applicant. C. Fees BLDG. D'?PT. ~N O'JTHO D 1. Certificate of Occupancy - New dwelling $25.00, Additions we ing , 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 $15.0/0, /Commercial $15.00 Date ~.(..?f.~ L New Construction........... Old/O~r~,P,~r~e~-existing Bhuildi/n-g..... Location of Property...~~~0~ (,ZV~d~...~~-7C..i~Y~.f...~~~t.O.~~ House No. SS Street ~ Q Hamlet Onwer or Owners of Property.....}~-77 QQ ..l....~Q!~~__'.".~.~ County Tax Map No 1000, Section.......(.P....Block.....~.........Lot.....`.'../........... Subdivision ....................................Filed Map............Lot......~..~..~.~.D..~........ Permit No ................Date Of Permit................Applicant....~,.~ !-y 1,,,,,,, Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate..~,,.... Fee Submitted: ~ ~y ? ~ ~ ~ g 17~ C., b~ 6 ~ J PLICANT `L~17 . . CONSENT TO n INSPECTION _ ~Q^/I1~C ~~-C1-~ ,the undersigned, Owner(s) Na e(s) do(es) hereby state: That the undersigned (is) ((are)~t^he owner(s/) of the pj~remises in the Town of Southold located at 1 (CYO C~~ C~'K.r~ //.r/(i~ n•hich is shown and designated on the Suffolk County tax map as District 1000, Section 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: Q~ n 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 lav.•s, 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 vlo- lations of the laws, ordinances, rules or regulations of the Town of Southold. O Dated: f L (sig lure) d~hl~ l~ ~ic~ ( rint name) (signature) (print name) xN N0.693 r. ~ae;~. n~ r _ - ~ nGV 1N _ - ~ PM.t T1G A1VEflHEPD '._~ti.,~ ~ C. 5 'CL . 5-'a'~ z 3.2401_ :19 ..l'ti,~' ~ x. ..i1~~y+•. Y~r•M'S`~. L Y'j( a.' e'~ r'r:.• .~,r' :t Y^r•, '"*J•'~N: r~ Y+3r ~~'a. S~>'~_ ~tez• .YVt •'t!'~• . • ~ ~ 3T~• pigs 4 e,. . ~ t • n~ N D U ~ ~ ~ sa` M ~ ~ 3. h.~~' bra : c ~ ~1 ~ 4 >a o . ~ .a r 3~ _ , 1& ;.r. 1t. ` N ` s a N y .p0 ' a ~ .no' ,w, rsa.°° R aA a rr{prMe~rY ~ X p ~ry•IG r ~ _ MAP OF o~~o^N...e^~ •Si•/RV4'YECJ FaPt . •,~'f3lKtJ~L., E'PST~'1N AND . 8',g'RYL W/t L/~1MS EPS7rE1N ~~~ntece/,~the /nf~r-Curt^t} tar ~ Tr't/e~~nlyet~r!/~Fat'X9u9~ Go• B A YV i E vV os ,xut•+~cyed APri 1 ro, X959. 7"OWN Of SOUrNOLO ~y"ow.Vor+~j'/~'S°r+ SU~'F04KGbtJN'TY' N.Y• ~-~/rb.. ~ G Liaarrrsel o/t° N~1~ rJ ac ~ ~a'# i'' Grr~np ~ ' M tcvl~ :'n i ~i T~~ ~ . fn