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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building inspector
Town Hall
Southold, N.Y.
PRS BBISTIRG
CSRTZFICATB OF OCCUPANCY
No E-22898 Date MARCH 11, 1994
THIS CERTIFIES that the building ORE FAMILY DWELLING
Location of Property 150 SUBSET WAY 30UTHOLD, R.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 91 Block 1 Lot 5
Subdivision Filed Map No. Lot No.
conforms substantially to the Requirements for a One Family Dwelling built
Prior to: APRZL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER 5-22898 dated MARCH 11, 1994
was ieeued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate ie
ieeued ie ORS FAMILY DWELLZRG WITH ACCESSORY STORAGB HIIILDIRG*
The certificate ie ieeued to GRACE FIORB
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. R/A
PLUMBERS CERTIFICATION DATED R/A
*PLEASE SEE ATTACHED IRSPECTION REPORT.
c~~,
Building Inepecto
Aev. 1/81
• [BUILDING DEI'ART:UiNT
TOS1N OF SOUTIIOLD •
iIOUSINC CODE INSPECTION KEPOItT
3100 CEDAR BEACH ROAD ) SOUTHOLD, NEW YORK
LOCATION:
number ti street municipality
SUBDIVISION MAP NO. LOT
NAME OF OWNER (s) GRAS FIORE
OCCUPANCY SINGLE FAMILY
(type (owner-tenant)
' JULIE BORN ACCOMPANIED By, JULIE BORN
ADMITTED BY:
REY AVAILABLE SUFF. CO. TAIC_MAP NO. 1000-91.-1-5
SOUL;::; OF REQUEST: GRACE FIROE~ DATE• MARCH 7, 1994
D4IELLTNG: 4
TYPE OF CONSTRUCTION WOOD FRAMB S STORIES 1 ~ E%ITS
FOINDATION GENT BLOCK CELLAR NONE CRAWL SPACE
TOTAL ROOMS: 1ST FLR_ 6 2ND FLR. 3RD FLR.
2 TOILET ROOM (s) - UTILITY ROOK 1
BATIIROO:i (s)
PORCII TYPE DECK, TYPE WOOD -FRONT PATIO, TYPE
SID
BREEZEWAY FIREPLACE NO GARAGE •
~ TYPE HEATER ELECTRIC AIRCONDITIONING ~
DOl~STIC IIOT[dATER
TYPE [TEAT OIL WARM AIR AOTS•IATER
OTHER:
ACCESSORY STRUCTURES: '
GARAGE, TYPE OF CONST., STORAGE, TYPE CONST. WOOD FRAME WITH ELECTRIC
~ PLUMBING
SWL`L`IINC POOL GUEST, TYPE CONST.
OTIU:R- CONCRETE PATIO AT ACCESSORY BIIILDING
VIOI.ATIO~IS: CIIAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION b BUILIIING CODE
LOCATION DESCRIPTION ART. SEC_
REMARRS• BP #82172- CO Z-22897 FOR ADDITION
It1SPECTi'.D BY- ~ DA"1'E ON INSPECTION MARCH 10, 1994
John M. Boufis TIME START 9:30 ENp 10:00
~L?1G-O; C._J`+1.; . tGC'' 1 CLV ,v
VC~V; _ -
• TUWti DF SDUTHOLD
EUILnING DiiPARTbiLN'f
'1'USJN FiALl,
765-1802
APPLICATIUP: FOP, CEP,TSFICAT_E DF UCCU°ANCT .
i C9~,:
1. This application must be £illec? ir. b.:• typewriCer UP, inl: nttd r;ubptitted to the building
ictrpticto`.~ with Cite following: fo.' net: building or new use:
1. Final survey of property witi: accurate location of all buildings, property lines,'
'streets, and unusual natural or [opograp?tic features. '
2. Fine, Arrnroval from iisalti. lae~~:.. o.° water aupp.}• and asweraQe-disposal (S-9 foam} ,
3. ApprovaW cf elet:trical instniartcio:. fzam Hoard of Sire Underwriters.
G. Sworn s~a~ement from plumber ce_~~%ying that she coldrzr used is system contains
less tae: '10 of 17. lead.
5. Gorraer~__~ wilding, industri~:~ building, multiple residences and sirpiltsr buildings
and insta~.ations, cartificnte of Code Complicrree from architecC or engineer
t'osponsic_c for the building.
b. 6ubmit F~L:;ning Board Approva_ of completed site plan requirements.
For existing buildings (prior to April 5, 1957) nor-conforming uses, or buildings and
'-'pre-eristin~;" and uses:
1. Accurat¢ s:=-v4y oP prapart~• c:tc .ping all propert.• litres, atreatc, building attd
unusual nacu:al or topograptic features. '
2. A properly completed applicxc:.on and a consent tr •ittspack sig=ied by the applicant.
If a Certificate of Occupancy, is denied, Che Building bnspector shall. t~eute the
reasons there£az in wzitinb tits applicant;
Feeb
1. Certificate of Occupancy - Nt~c,• ciwt:?ling 525.00, Additions to dwelling 525.00,
Alterations to dwelling $25.00, Swimming pool 525.00, Aeca$aory building 525.00,
AddiGiane to accessary building 525.00. $vsinaeaes 530.00,
ti. Certificate of Occupancy or; Pre_existing Euilciin$ - 5100,Otl
3. Copy of Certificate Of UCCUpat1C:}' - 4S.OU over 5 yeaxs - $10.00
h. Updated Certificate of Occupant-: - ~5^.00
5, Tempvrary Certificate of Uccupancg -Residential $]5.00, Commercial S15.U0
Date
.w Cottstruccion... , , , Old Or Pre-existing F1uLlding.~~S~,Pr:.~x{S~:r: ~ .
,action o° Fraperty.....~ ,f~..~ S~ 601 SeT , ,W.~.`:~........ , ...s~~~cL~ .
itou&e No, Street Aatnlet
.wet ar OwnerS of Praparty ~ p.~~' ,
ant Tar. Ma NoR , , .
Y P f~.000 Section... ~'.......B1ock:... ..........Lot.. !s.8.,i,
.,division..Ci~Y~YX:n..~e~~°V:.Qt~~^:~ ....Filed Map............Lot,..............,......
-raft No . ............!Jere Df Pandit................Applicant....
.lk2t Aept. Approval ..........................Underwriters Approval.........
ginning So4rd Approval..,.......' •
u¢st for: Tempora/r/y~C~rtificate.....,..... Final Certicata.........,.
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