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Home My WebLink AboutZ-31270 FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED PRE EXISTING CERTIFICATE OF OCCUPANCY No 31270 Date NOVEMBER 14.2005 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 50915 MAIN ROAD SOUTHOLD. N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 70 Block 1 Lot 5 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 OF OCCUPANCY NUMBER Z-31270 dated NOVEMBER 14. 2005 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 The certificate is issued to JANE M. FRANKS (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE N0. N/A PLUMBERS CERTIFICATION DATED N/A *THIS UPDATES PRECO Z-9305 DATED 11/16/78 TO CORRECT SUFFOLK CO. TAX MAP NUMBER. ~ ,~1~~ Authorized signature Rev. 1/81 Form No. 6 TOWN OF SOUT$bLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. 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 2110 of 1% 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" 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 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. Fees 1. Certificate of Occupancy -New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accesspry building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildiug - $100.00 3. Copy of Certificate of Occupancy - $.2S 4. Updated Certificate of Occupancy - $50,00 5. Temporary Certificate of Occupancy -Residential $15.00, Commercial $15.00 Date. ~ ~ I Z I Q S New Construction: Old or Pre-existing Building: ~ (check one) Location of Property: S~ J ~ UJ.c~v ti~~e~r~ ~J~-LI(q~ e{ House No. Street Hamlet Owner or Owners of Property: -~a~e V..1. ~ ~c.~tA~C~ Suffolk County Tax Map No 1000, Section '1 CJ Block l Lot Subdivision Filed Map. Lot: Permit No. Date of Permit _ Applicant:. Health Dept.. Approval ~ .Underwriters Approval: Planning Board Approval: J Request for Temporary Certificate Final Certificate: (check one) Fee Submitted: $ $Q . p~ Applicant Signature 6Z~.: 69 2 y 9 ,a,P; , E'3~ cd-~ '3 Ia2 70 BUILDING DEPARTMENT TOWN OF SOUTHOLD, N. Y. Y:OUSING CODE INSPECTION REPORT Location ~O /yAj//J /~.c~ ~~~i~~%r~/OLt7-~~ gnumber & street Municipality Subdivision Map No. Lot(s) Name of Owner-{mss) % f/UFfAI 5 f /~i4N.~c Occupancy /C - l /`T~5 . /`1ti2 ~'t?<..4..~-/J type ten t Admitted by: 1`7~/~.5. f-lZAf~1Kc Accompanied by: /`~i~5 f2A~~c Key-available ~ Suffolk Co. Tax No./(~~jCi-TG-I-~~' Source of request ~It~i>l_/!.Q % OGJ - o u/w Date 3~~ DWELLING: Type of construction Cwooe r-/c'Art'~E #stories!- f?-,srri. /~2. Foundation~,y~-,~~~/,a-~- .8 ,:J/Q =Ce11ar~~i• Crawl space Total rooms, lst. Fl 5! w ~sti~T 2r_d. F1 ~,L t~/ZS 3rd. Fl BathroomO sc`c~i?r~ ~~r,o~Z- Toilet rooms} Porch, type Deck, type Patio, type T Breez{e}way Garage Utility room e Heav ~JL ~.Caon Ous ~Gl Typ ~12c't7 Warm Air ,err. Hotwater Fireplace(s) ~'e~i-No. Exits T!-/.~,~ Airconditioning i Domestic hotwater,4~~ f`,~~ F~,~Type heater SAS ~r/~~p -r-°- Other ~.d5 c'o~J,r'r,c.Jr' ,c~,g,~Fi~ 5 - ~7.c~~- ! ifof~ .=~~i3 fr~T.c`i~ ACCESSORY STRUCTURES: ~riy tv.4%~~ Garage, ty~ae const. Storage, .type const.iwa cuoov r-,?aMc Swimming pool- Guest, type const. Other VIOLATIONS: Housing Code, Chapter 52 Location Descri tion Art, Sec. " « , ~ ~ ra O - J S'Tniiur~a ___iG ' ~Z ° 5`~. fi. ~ x,- .z- - ~~.~r t ~ arm Gl'.~ ~z--~i i Remarks• Inspected b}~: i` ate of Insp. Time start/.GO - f/ end j: a%O ~N• FOn1H NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk'e Office Southold, N. Y. Certificate Of Occupancy No. . 2..9305• ~ • • Date .........;iAVembez.lb......., 19.T8. THIS CERTIFIES that the building located at .50915 . Main .Road Map No..... XXX Block No.....XXX• • .Lot No.... g.;~ . REQUIREMENTS FOR ONE-FAMILY DWELLING built ,prior to conforms substantially to the ~4A~7~g~~RI474j# heretofore filed in this office CERTIFICATE OF OCCUPANCY x~ltR9t Apz i.1...23 , , 19 5.7. , pursuant to which No. Z 9305 dated btoveml~ex .16.,..... , 19.7.8. , was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . P.AZS7ATE.ONE-FAMILY. AWELLING . The certificate is issued to ....THOMAS .and . JANE; . FRANKS . (owner, 3~s~cs~c3le[~k) of the aforesaid building. Suffolk County Department of Health Approval k8.E-lXxSTZNG . UNDERWRITERS CERTIFICATE No. PRE-EXIST,~tq~, , , , , , , , , , , , , , , • , , , HOUSE NUMBER ..5?x.15...... Street ..Main. Tioad.,..Sou~hold,..~iew..York . 1000-70-1-4 ~,,,~A ,1 . Building Inspector CONSENT TO INSPECTION F~ c~ 50.. ka ~-rcx.~l~c f ,the undersigned, do(es) hereby state: Owner(s) Name(s) That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold, located at Sba l Cvl~ar a ~~c?~ ~ > which is shown and designated on the Suffolk County Tax Map as Distnct 1000, Section "t 0 ,Block i , L,ot That the undersigned (has) (have) filed, or cause to be filed, an application in the Southold Town Building Inspector's Office for the following: t~"~et c Ire 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 detennine that said premises comply with all of the laws, 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 in subsequent prosecutions for violations of the laws, ordinances, rules or regulations of the Town of Southold. Dated: t1~2\~ (Sr a re) ~~~I W ~alxl~kr~ ~ (Print Name) (Signature) (Print Name) FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- torwith the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property Tines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equall• 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, acertificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 ? Date l~ .L~J.. 3 y~~. . _ New Building .............Old or Pre-existing Building Va nt Land . Location of Property ....~~-~'„J House No. D Street ~ ,~c Hamlet Owner or Owners of Property • . County Tax Map No. 1000 Section Block Lot . Subdivision .................................Map No. ..............Lot No.............. . Permit No. Date of Permit ..........Applicant . Health Dept. Approval ........................Labor Dept. Approval . Underwriters Approval ........................Planning Board Approval . Request for Temporary~ertificate .....................Final Certificate . Fee Submitted $ .....OS . . Construction on above described building and rmit meets all applicable codes and regulations. Applicant _,,.x_ ~Z 7 ~ ~c:a~,Q~~__, Rev. 10-10-76 ~ -lr , i'C Z n ~3~3