HomeMy WebLinkAboutZ-20078FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No
Z-20078 Date JULY 16~ 1991
THIS CERTIFIES that the building. ONE FAMILY D~.LLING
Location of Property 2780 BOISSEAU AVENUE
House No. Street
County Tax Map No. 1000 Section 55 Block 6
Filed Map No.
Subdivision
SOUTHOLD~ N.Y.
Hamlet
Lot 10
Lot No.
conforms substantially to the requirements for a Private One Femil¥
Dwelling built prior to: APRIL 9r 1957 pursuant to which
CERTIFICATE OF OCC. #Z-20078 dated JULY 16~ 1991
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 WOOD FRAME GARAGE *
The certificate is issued to
(owners)
of the aforesaid building.
SU¥~'OLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PT~SE SEE ATTACHED INSPECTION REPORT.
Rev. 1/81
ROBERT P. & MARGAI~ET M. GOLDSMITH
B~ilding Inspector
Location
BUILDI[,~ DEP~%%T:.~NT ..
TOV~ OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
2780BOISSEAU AVENNJE SOU'r~OLD, N.Y.
(numoer & streeT)
Subdivision
Map No.
~idunl¢ipalizy )
Lot(s)
Name of Owner(s)
ROBERT P. GOLDSMIIIt & ~&'~T M. GOLDSMITH
Occupancy
Ad,mitt ed by:
A-i
(type)
ROBERT GOLDSMITH
Key available
Source of request
( own er- ~ enanv )
Accompanied by: ROBERT GOLDSMITH
Suffolk Co.
ROBERT GOLDSMITH
Tax No. 55-6-10
Date JULY 8, 1991
D¥~ELLIMG:
Type of construction wood F~
Foundation CEMENT BIlK
Total' rooms, 1st. F1
Bathroom(s) I FULL BATH
Porch, type SIDE OF HOUSE Deck, type
Breezeway ENCLOSED. Garage
Type Heat OIL 'Warm Air xx
Fireplace(s) ONE No. Fzcits 2
Domestic hotwater
Other
#stories 1-1/2
Cellar FULL Crawl space
2nd. FI 3rd. FI
Toilet room(s)
Patio, type
Utility room
Hotwater
Airconditionin~
~ype heater ELECTRIC
ACCESSORY STRUCTURES:
Garage, type const. I CAR WOOn FRAMgStorage, type const.
Swimming pool Guest, type const.
Other
VIOLATIONS:
--Location
.C~L~PTER 45--N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
Description I-A~r~.) Sec.
,
Remarks: BP ~I5Z,?.Z-CO Z-1228
Inspected by:
Date of Insp. tomy 12, 1991
· Time start 12:15 end 12:30
TOWN OF SOUTIIOLD
BUILDING DEPARTMENT '9~
TOWN HALL
765-1802 I __ BLDG. O~i.
· TOWN OF SOUTPOLD
2~PPLICATION 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.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 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 fo:: the building.
6. Submit Planning Board Approval of completed site plan requirements.
3. 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 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 $15.00, Commercial $15.00
Date ..
~ew Construction ........... Old Or Pre-existing B~ilding ..... ~. ........
.ocation of Property.~.~.Z~.~. ..... .~.~ ~.~..o/~.... ~..O~... ............ 5'.~...~.~. ............
House No. Street Hamlet
Inwer or Owners of Property ........... ~.[~.~:..1.. .B .....................
:ounty Tax Map No 1000, Section ..... .~...~. ..... Block ...... .~. .Lot .... /.2
ubdivision .................................... Filed Map ............ Lot ......................
ermit No ................ Date Of Permit ................ ........
ealth Dept. Approval .......................... Underwriters Approval .........................
lanning Board Approval ........................
equest for: Temporary Certificate ........... Final Certicate..~. .......
po.
ee Submitted: $../ .........................
.......... :,v .... : .....