HomeMy WebLinkAboutZ-23241FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
cERTIFICATE OF OCCUPANCY
No z-23241
Date SEPT~4BER 21, 1994
THIS CERTIFIES that the buildin~
Location of Property 1030 WEST ROAD
House No.
County Tax Map No. 1000 Section 110
Subdivision
ONE FAMILY DWELLING
Street Hamlet
Block 5 Lot 46
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-23241 dated SE~£~4BER 21, 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 A ONE FAMILY DWELLING WITH A ONE CAR GARAGE AS APPLIED FOR.
The certificate is issued to
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
ANGELA ~RMAT,I~
N/A
N/A
N/A
Rev. 1/81 ~ Bu'ildi~g Inspe~ ~
LOCATION:
SUBDIVISION
NAME OF OWNER (s)
1030 West Road
(number & street)
BUILDING DEPARTMENT
TOWN OF SOUTIIOLD
HOUSING CODE INSPECTION REPORT
Cutchogue, ~
(municipality)
Angela Governale
HAP NO. LOT(s)
OCCUPANCY Single F~ily (type)
ADMIII~D BY: Louis governale
KEY AVAILABLE
SOURCE OF REQUEST: dngela g~enale
{~er
(owner-tenant)
ACCOMPANIE~ BY: Same
SUFF.CO. TAX MAP NO. 100o-11o-5-46
DATE: 715194
DWELLING:
TYPE OF CONSTRUCTION Wood Frame { STORIES 2 { EXITS
FOUNDATION Cement Blocks CELLAR 3/4 CRAWL SPACE Partial
TOTAL ROOMS: IST FLR. 3 2NDFLR. 4 3RD FLR.
BATHROOM (s) 2 TOII~T ROOM (s) I UTILITY ROOM None
PORCH TYPE None DECK, TYPE Rear, Wood PATIO None
BREEZEWAY None FIREPLACE 'None GARAGE None
DOMESTIC HOTWATER Yes TYPE HEATER Gas - Lilco AIRCONDITIONING None
TYPE HEAT Gas WARMAIR HOTWATER Yes
OT~R:
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST. Wood, 1 Car STORAGE, TYPE CONST.
SWIMMING POOL None , GUEST, TYPE CONST. None
OTHER:
None
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
REMARKS: BP#I6~-Z - ADDITION CO{Z-23242
rM. Soof{s
DATE OF INSPECTION
TIME START 9:45
7/8/94
END 10:15
Form No. 6
TOWN OF SOUTHOLD
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
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 for the building.
6. Submit Planning Board Approval of completed site plan requirements.
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.
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 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 $15.00
· Date .TJ.~-/.?~r-
New Construction ........... Old Or Pre-existing Buiidin~ ................. ..
Location of Property ........ (~. [ .~..~. ........... ~.' .~.- ~,~. ....... ~..
House No. Street
Onwer or Owners of Property ...... .~..~...~......~.~...~.~ ..................................
County Tax Map No 1000, Section ..... IJ.O.., ..... Block 5-- .Lot..~.~
Subdivision .................................... Filed Map ............ Lot ......................
Permit No..i..~..~..~...~.l..Dane Of Pe~r~it ................ Applicant .............................
Health Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate ...........
Fee Submitted:
/ .. ' ...............
~. 50.00.
¢0
SURVEY FOR
LOUISE GO VERNALI
A T CUTCHOGU£
TOWN OF SOUTHOLD
SUFFOLK COUNT)',
1000-110-05-4~
Scale.. 1" = 30'
April 5,1994
Prepored in occordence with lhe minimum
sfendords for lille surveys os estob#shed
by /he L./.A.L.$. end opproved end odopled
for such use by The New York Slate Lend
Title Associalion.
(516) 765 - 5020
P. 0. BOX 909
MAIN ROAD
SOUTHOLD, N. Y. 11971
94- 143