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Home My WebLink AboutZ-25500FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-25500 Date JANUARY 23, 1998 THIS CERTIFIES that the building OWE FAMILY DWELLING Location of Property 41900 MAIN ROAD PECONIC, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 86 Block 1 Lot 8 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--25500 dated JANUARY 23, 1998 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 OWE FAMILY DWELLING WITH ACCESSORY GARAGE * The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *Pr~ASE SEE ATTACHED INSPECTION REPORT. Rev. 1/81 THOM~ & D~T~ GI:~.TTAN N/& N/A Buildi~ng/nspect or IIIII I.l!llll~ IIl,:l'All'llfl':ltl' 'Il)Uti Ill." !II)IITIIOI.I~ · IIt)ll!|lll(; Ct)III~. IIl!H'l~.C'l'l()tl llllt, l'OtFI' 1 )WI~. l,I, I ti(}: '1'¥1'1~. (IIr CONS'I'IIUI=I'IOII ~/OOD FRAt.~ I I~'l'()ltll~. ] I I(Xl'l'~l 2 VOIIIII)A'I'IOtl CE~ BLOCK Cl~l.l.AIt F~..L CIIfiYl. BI'ACI~ TO'I'AI. IIOOtl~l~ I~'F IZl.ll. 5 7111) Itl,lt. -- -- 31HI VI,It.--- 1 'l'OIl.ffl' IH)I)II (.) II'l'll. If~ I~()()tl REAR-~ASHER & DR~R FRO~ IIECK, 'I'YI'I~ ,~TIO Cg~ REAR It I Itl~l'l ,fiCl{ 'l'Y I'l~IlfffiTl~ll OIL UAIIII Alit I IO'I'U fi'l'E It l;~IIItfltIG POOl, , (HII(!I'I', 'I'YI'I~ 1)'1'111[1~ ~ .~.l(~J.~'l~tJ~ CIIfiP'I'I~IT 1~5 N.Y. fITfi'l'l~ IItlIFOIlII I'IIHT I'III~VI~TITION & IIIIIl.l)lttO CI)I}IT Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY JAN 1 6 I BLDG. DEPT. TOWN OF SOUl. OLD This application must be filled in by typewriter OR ink and pubmitted 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 UndeCwriters. 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 Buildinm - $100.00 3. Copy of Certificate of Occupancy - ~ .25~ 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date .....~7~. ........ Zz~. ~. ................ New Construction ...... Old Or Pre-existing B~ilding Location of Property.. i i~..~QJ~. ............ ~../~/~.~/. .... ~iiiiiii 7~. '.~..~..~/.~ 4. ~,./~..//.~.~ House No. Street ~ Hamlet -- Onwer or Owners of Property ....... . .~'"~.~/~,,~.....~...-...'~. J~.~..~.. .... ~...~..~...'~..~...~. ........ 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 ........... Fee Submitted: $... /.~..~.~ ...... Owner(s) do(es) hereby state: CONSENT TO INSPECTION Name(s) · the undersigned, of Southold located at That the undersigned (is) (are) the owner(s) of the premises in the Town · which is shown and designated on the Suffolk County tax map as District 1000, Section ~;~& , Block / , Lot ~7~ That the undersigned (has) (have) filed, or caused to be filed· an applica- tion in the Southold Town Building Inspector's Office for the following: o$ o cc That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, iucluding any and all buildings located thereon, to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that said premises comply with all of the laws, ordinances, rules and regulations of the Town of Southold. The undersigned, in consenting to such fl~spections, do(es) so with the knowledge and understanding that any ~nformation 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/ff~le Townof/~ut~.old~._:~ (print (siRnature) (print name) UN.~;'THORIZED ALTERATION OR ADDmON TO THIS SURVEY IS A VIOLATION OF SECTION 72C9 OF THI! NEW EDUCATION LAW. OF THIS SUZ~P NOT COPIES JH[ LAND 5URVE~ ',- , : LD 5~AL OR 14467 HAP OF cGU~VLVL-D , ! A f fO'~/ht OF F~UI'~ tOL.D