HomeMy WebLinkAboutZ-20183FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-20183 Date AUGUST 28~ 1991
THIS CERTIFIES that the building ACCESSORY
Location of Property 860 MAIN BAYVIEW ROAD SOUTHOLD~ N.Y.
House No. Street Hamlet
County Tax Map No. 1800 Section 70 Block 7 Lot 16.2
Subdivision Filed Map No. Lot No.
conforms substantially to the Requirements for an Accessory Structure
built prior to: APRIL 9~ 1957
pursuant to which
CERTIFICATE OF OCC. #Z-20183 dated AUGUST 28~ 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 ACCESSORY GARAGE *
The certificate is issued to
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PT~ASE SEE ATTACH~.D INSPECTION REPORT.
Rev. 1/81
JOHN GRIGONIS~ DECEASED
N/A
N/A
Location
Subdivision
Name of Owner(s) JOHN GRIGONIS, DECEASED
BUILDING DEPARTMENT
TOk~ OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
860 MAIN BAYVIEW ROAD SOUTHOLD, N.Y.
(number & street) (Municipality)
Map No. Lot(s)~
Occupancy A-I
(type)
Admitte~ by:
Key available
Source of request
OWNER
( o~mer-tenant
Accompanied by:
Suffolk Co. Tax No.?0-?-16-2
PAUL A. CAMINITI'
Date AUG. 26, ]99]
DWE~.LING:
Type of construction
Foundation
Total rooms, 1st. FI
Bathroom(s)
Porch, type
Breezeway
Type Heat
Fireplace(s)
Domestic hotwater
Other
Cellar
2nd. F1
Toilet room(s)
Deck, type.
Garage.
Warm Air
No. Exits
#stories
Crawl space
3rd. F1
Patio, type
Utility room
Hot-water
Airconditioning
~ype heater
ACCESSORY STRUCTURES:
Garage, type const. WOOD FRAME
Swimming pool 2 CAR
Other
Storage, type const.
Guest, type const.
VIOLATIONS: Housing Code, Chapter 52
.... Location Description J Ar,t,. .Sec.
Remarks:
Inspected by:
Date of Insp. AUG. 27, 1991
Time start 2:30 end 2:40
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
2 6199i
BLDG. DEPT.
TOWN OF SO.j.~!~_O.I:2
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 ~/~ ~ q ~
New Construction ........... Old Or Pre-existing Building ~. ~./~/~
Location of Property...~./././.~.f.A/....~?..~!~.~.....~..~...'''''.'''''''' ....................
House No. Street Hamlet
Onwer or Owners of Property ..................................................................
County Tax Map No 1000, Section. O 7~ .Block ...... Z ........ 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: $../.~.~...~....: ...............
...... i ............
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