HomeMy WebLinkAboutZ-26912 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- 26912 Date: 02/04/00
THIS CERTIFIES that the building STRUCTURE
Location of Property CRESCENT AVE FISHERS ISLAND
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 006 Slock 0006 Lot 011
Subdivision Filed Map No. Lot No.
conforms substantially to the Requirements for a BUSINESS STRUCTURE
built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z- 26912 dated FEBRUARY 4, 2000
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
issued ie ONE STORY WOOD FRAME STRUCTURE WITH DECK
The certificate is issued to AMERICAN LEGION POST k1045
(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.
t rized Signature
Rev. 1/81
BUILDING DLPARTMENT -
TOWN OF SOUTHOLD
HOUSIN COOR NcpECTTON REPORT
LOCATION: CRPSCENT AVE FISHERS INLAND
SUBDIVISION: MAP NO.: LOT (S)
NAME OF OWNHR (S): AMRRTrnN rHGION POCT k1045
OCCUPANCY: AMRRTrnN r.RGION POST #1095
ADMITTHD BY: RT('u aRn iTMAN ACCOMPANIED BY: SAME
KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 6 -6-11
SOURCE OF REQUEST: Rnwann J SCROXTON. 9/3/99 DATE: 02/04/00
TYPE OF CONSTRUCTION: WOOn RR AME # STORMS: 1.0 k EXITS:
FOUNDATION: rRMRnrr BLOCK CELLAR: FULL CRAWL SPACE:
TOTAL ROOMS: 1ST FLR.: ~ 2ND PLR.: ~ 3RD FLR.: ~
BATHROOM(S): o.a TOILET ROOM(S): 2.0 UTILITY ROOM(S):
PORCH TYPE: FRONT COVEIZRD DECK TYPE: WPPD PATIO TYPE:
BREHZBWAY: FIREPLACE: GARAGE:
DOMESTIC HOTWATER: YES TYPH HHATER: ELECTRIC AIRCONDITIONING:
TYPB HHAT: OIL WARM AIR: XX HOTWATER:
OTHER:
nrrHSCORY STRUCTURES:
GARAGH, TYPE OF CONST.: STORAGE, TYPE CONST.:
SWIMMING POOL: GUEST, TYPH CONST.:
OTHER:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION fi BUILDING CODE
rOCSTION ' DRSC_R IPTION ' aRT ~ SFC
~ i
' i
:
' i
i
~ i i
i
i
i
i
i
i
i i i
i i
i i
i
i i
i i
RHMARKS: BP k170H0-Z-COZ-26911 (ADDS)
INSPECTED BY: DATH ON INSPECTION: 10/01/99
GARY SH TIME START: 3:00 AM END: 2;3p_.
~ ~ ~ ~q ~ua.uTOWNunHA~Liiscni
r.~ ~ ~ 765-1802
''fflIllf
Ulit Cr" T I9~
APPLICATION FOR CERTIFICATE OF OCCUPANCY
~_.._._----...I
7~.~•,~~~~;~';,, ~~pli ation must be filled in by typewriter OR ink and submitted to the buildir.
'th 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 1Z lead.
5. Commercial building, industrial building, multiple residences and similar buildi
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 (prier tc April 9, 1957) non-conforming uses, or buildings a
"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 applican
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 Buildine - ;100.00
3. Copy of Certificate of Occupancy - .25C.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00,~Co'~mrm]ercial ;15.00
Date ~.~~1-1
New Construction... (~OOl,~~d.__~~Or P11r~~e-exis//t+*i,~~ng~~B~u~~i~l~~d~~,i,~njjg... t,~,,,, 1
Location of Property~~::::~~F. ~'.~f...lrl.C=r'X~C'i.~.L~... .....~~~.-~!?^~l~.C.
House No. Street Hamlet
Onwer or Owners of Property..4~7: 7~1:.~-~cC\ J. nti.MUJ`.'...// . ~ ~Q~...........
County Tax Map No 1000, Section.............Block......}a.........Lot..~.~
Subdivision ....................................Filed Map............Lot........... ' .
1
Permit No ................Date Of Permit................Applicantn~'.~G~a.1.~A.~~
Health Dept. Approval ..........................Underwriters Approval.....................
Planning Board Approval
Request for: Temporary Certificate........... Final Certicate..~......
Fee Submitted: r.~~.~ •
PLICANT
„Z~c,. S ~'fs5 VpMcnq~~ F'r~CT~Gflt~ oc~
co~a64i2 Pmt ~ c
CONSENT
TO
~INSP1ECTION '1~
i'llp~l the undersigned,
Owner(s)- Nair (s)
do(es) hereby state:
That the undersigned (is) (are) the owner(s) of the pr((e]~m~ises in the Town
of Southold locat__e__d-- at~(`~~j~jC1-} `.~X
1~1'~Y~'!+-L'S1H~T which is shown and designated on the Suffolk
Count tax ma as District~~~ection Block Lot
Y P ,
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:
~j"~ ~G d~ ~ C~P?1Y'
y
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 laws, ordinances, krules
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 Ln the conduct of
such inspections may be used as evidence in subsequent prosecutions for vio-
lations of the flaws, ordinances, rules or regulations of the Town of Southold.
Dated:Q ~ __1
sig a re) C671'f1~Jr
. ~ Scc'dnc~Cl
(print name-
, (signature)
(print name)