HomeMy WebLinkAboutZ-21098 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-21098 Date OCTOBER 19, 1992
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 20775 MAIN ROAD ORIENT. NEW YORR
House No. Street Hamlet
County Tax Map No. 1000 Section 17 Block 4 Lot 4
Subdivision Filed Map No. Lot No.
conforms substantially to the Requirements for a One Family Dwelling built
Prior tc: APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z-21098 dated OCTOBER 19, 1992
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 ATTACHED GARAGE & 2 ACCESSORY
STORAGE BUILDINGS
The certificate is issued to LEROY & ANN FITTING
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N/A
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
c~
Building Inspector
Rev. 1/81
FUL...J_.... _.~...1._.,..1L
TO'..~t Cc CCJT:iOLC, i!. Y'.
~CL'CI::C CCCC IIiC?~CTI0:1 ilc C:~T
Location 20775 MAIN ROAD ORIENT, N.Y.
t, r.u.:.ocr ac .:crest) ~~iu :~.c~~~11Gy1
Subdivision ~~lap Cto. Lot(s)
va.::e oI' O~:ner($_) LEROY ~ ANN FITTING •
Occupancy A-1 RES. OWNER .
l~Ine) ~o~:mer-cen~nt)
Ad.~itted by: LEROY FITTING /lcconpanicd by: SAME
Key available Suffolk Co. Ta:; D?o. 1000-17-4-4
Source of request LEROY A ANN FITTING' Date OCT. 14, 1992
D~;rr I,T~?0. PARTIAL 2
Type of construction WOOD FRAME ;:stories PARTIAL 1
Foundation STONE Ce11ar PARTIAL Cra~.~l space
Total roo:.ls, lst. Fl ~ 2nd. F1 ~~3rd. Fl '
Bathroo:~(s) ONE ~ Toilet roon(s) ONS
Porch, t'y~pe FRONT ~ SIDE Deck, type Patio, type
OP + ~ ,
Breeze~•:ay Garaos 2 CAR U~i__~y roon
Type Heat OIL • 'rlarin. Air Ho ~.•:a,.=r ~
Fi. eplace(s) 2 D?o. E::its 4 A.ircorditioniro
Dc:~estic hot:•:ater ~ Type hee.ier oIL
0 they
ACC=SSC=:'r S^?UCTI~°S
2 WOOD: FRAME
Gzrco°, type cons t. Storage, type cors~TORAGE BUILDING
S~•:i;.~ino pool ~ Guest, type const.
Other ~ POOL HOIISE WITH BATHROOM
V=OLaT?01`?S: •C3IAPTER 45--N.Y. SPATE U:IIPOI:M fIlUi PN1iVCNTION S IUILDING CODE
~nrction I DP°_crintion I Art...I Sec.
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Cabana ~ .
Re74r'.a: BP #61052-COZ-6081 Pool BP 11 1 4 9 602- COZ16342 Kitchen
In:,pccted by: _n?tc of Insp. ocT. ,og,
Gary Fis ~ • Tine start 11:00 end 11 030
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co~sr;.T
TO
[i\G[~CC'r[ON
~l ~ ~d>.t ~ . T ~ fi,~v~ f 5 . T~- inc~ tl,{. ~{nci{.r.i!,•n~.d,
~rncrls) Namc1:;)
do(es) hereby state:
That the undersi~ncd (is) (arc) the ovincr(c) ofrthc premise:: is the To~:-n
of Southold located a[ ~_S 7 ~ 5 M ee ~ - D ~ ~ e /
, which is ~hov:n and cfcsirnaicd on the Sui;oi+
County tax map as District 100(1, Section L'loclc Lot
That the undersigned (teas) (have) filed, or caused to be filed, an applica-
tion in the Southold Totivn Luilding Inspector's Office for the follo;sir.C:
That the urders~ned do(es) hereby give consent to the Building Inspectors
of the To1vn of Southold to enter upon the above described property, including
atty and all buildings located thereon, to conduct such inspections as they may
deem necessary with respect to the aforesaid application, inclcdir: inspecticns
to determine that said premises comnl;• ~:•ith alt of the laws; ordinances, rules
• and regulations of the Town cf Southold.
The undersigned, in consenting to such inspections, do(es) so u-ith the
kno:^ledge and understanding that any info: ^;ation obtained in the conduct of
such inspections may be used as evidence in subsequent prosecutions for vio-
lations of the laws, ordinances, rules or regulations of the Town of Southold.
Dated:~Q ~ •
• (sign lure)
(print name)
• ~ iS [!natl{C~ •
~PU 17T I Yljr
(pr nt name)
Form No. 6
TOWN OF SOUTHOLD _
BUILDING DEPARTMENT
' ~ ~ ,Q 761 02L
•
_,,,e` ~ APPLICATION FOR.CERTIFICATE OF OCCUPANCY
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.
G. Sworn statement from plumber certifying that the solder ysed in system contains
less than 2/10 of 17. lead.
S. Commercial building, industrial building, multiple residences ands 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.
1. 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. '
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 Euilding - $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 ~ ~.l ~
:••r Construction........... Old Or Pre-existing Building..~•
,cation of Property:... ~ ~7.~~ MQ . RDG ~ Y~ ~e Vl~:..........
House No. p Street c Hamlet
y...
wer or Owners of Property.... ~~4.Q. • • • • ~ ~ ~ • J ~ ~ ~ •
only Tax Map No 1000, Section...~~.r/.......Slock.....~ •/•......Lot.....~
division ................................'....Filed Map............Lot...................
emit No ........:.......Date Of Permit................Applicant.......
~lth Dept. Approval ....Underwriters Approval.....
Inning Board Approval .
ucst for: Temporary Certificate........... Final Certicate...........
. ,
Submitted: /
u U Q j ~ f "Y1 ~
Q~.C~ I ) ~ 1 ( APPLICANT
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