HomeMy WebLinkAboutZ-22948FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
~EIFICATE OF OCuumANCY
No Z-22948 Date APRIL 14, 1994
THIS CERTIFIES that the building.
Location of Propert~ 26350 MAIN ROAD
House No. Street
County Tax Map No. 1000 Section 109 Lot
Subdivision Lot No.
ONE FAMILY DW~T.?.ING
UuTCHOGUE, NEW YORK
Block 4
Filed Map No.
Hamlet
5
conforms substantially to the Requirements for a One Family Dwelling built
Prior to: APRIL 9~ 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z-22948 dated APRIL 14, 1994
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 DNE?~.ING WITH ACCESSORY 2 CAR GARAGE *
The certificate is issued to MARIAN A. ~OUBEAUD
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N/A
Rev. 1/81
N/A
N/A
*PT.RqSE SEE ATTAu-K,] INSPECTION REPORT.
Buildi~or
BUILDING DEPARTHENT
TOb/N OF SOU~flOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 26350HAIN ROAD
(v,~ber & street)
SUBDIVISION
NAHE OF O~INER (s) HARIAN.A. GOUBEAUD
CUTCHOGUE, NE~ YORK
NAP NO.
(municipality)
LOT(s)
OCCUPANCY SINGLE FAHILY DI~ELLING
(type) (owner-tenant)
ADMITTED BY: HARIAN GOUBEAUD ACCOHPANIED BY: SAHE
KEY AVAILABLE SUFF.CO. TAX HAP NO. 1000-]09-4-5
SOURCE OF REQUEST: 14ARIANA. GOUBEAUD DATE:APRIL 5, 1994
DI~ELLING:
TYFE OF CONSTRUCTION
FOUNDATION BRICK
TOTAL ROOHS: IST FLR.
BATRROOH (s) ONE
PORCH TYPE
BREEZEWAY NONE
DOHESTIC HOT,lATER
TYFE HEAT
OTI~R:
FRONT COVERED
I,/OOD FRAME
YES
LILCO GAS
TYFE HEATER
WA1OIAIR
PANTKY OFF KITCHEN TO BASEHENT
CELLAR PART.
3 2ND FLR. 4 3RD FLR.
TOILET ROOH (s) NONE
BECK, TYFE
FIREPLACE 'NONE
LILCO GAS
STORIES 2 ~ EXITS
CRAI~L SPACE PART.
UTILITY ROON REAR ENTRY
NONE ~ . PATIO NONE
GARAGE
AIRCONDITIONING
HOTI~ATER XX
NONE
ACCESSORY STRUCTuKES:
GARAGE, TYPE OF CONST.
s~/n~ING POOL
OTHER:
2 CAR WOOD STORAGE, TYFE CONST.
,.GUEST, TYPE CONST.
NONE
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORNFIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
INSPECTED BY ~0UE
DATE OF INSPECTION APRIL 8, 1994
'TI]4E START 12:20 END 12:35
Form No. 6
i ~ ~ ii BUILDING DEPARTMENT
[i~' ii TOWN HALL
TO--OLD
A. 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 comtains
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 for the building.
6. Submit Planning Board Approval of completed site plan requirements.
For existing buildings (prior to A~) non-conforming uses, or buildings and
"pre-existing'! land uses:
1. Accurate survey of pro_perty__~howing ~11 property lines, streets, building and
unusual natural or topographic features.
2. A properly completed application and a consent to inspe~ct signed by the applicant.
If a Certificate of O~upancy £s 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.
~ Certificate of Occupancy on Pre-existin~ Buildinm - $100.00
3. Copy of Certificate of Occupancy - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.O0
Date ....... ~..'7.~. ,.. !..~...~". ~.. ......
New Construction ........... Old Or, P~-exis~ing_~u%ldir~L .................. ~
Location of Property..~..~.~.~...~.~.~l..~~ ~ /f~--
House ~o. ~ S~r~'~) ' [ ........ ~' .... ~i~{ ~ Ed ...........
Onwer or Owners of Property..../.?..~..~.~r...~......~.[..~...~......~.....~.;..--% .............
County Tax Map No 1000, Section .... /.~..~....Block .... ..~...~...Lot ...... ~.. ............
Subdivision .................................... Filed Map ............ Lot ......................
Permit No ................ Date Of Permit ................ Applicant .............................
Health Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate ...........