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Home My WebLink AboutZ-24684FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTIN6 C2f~TIFICATE OF OCCUPANCY No Z-24684 Date OCTOBER 10, 1996 THIS CERTIFIES that the building Location of Property 1050 ~&TT ROAD House No. County Tax Map No. 1000 Section 50 Subdivision ONE FAMILY DWELLING SOuTHOLD, N.Y. Block Filed Map No. Lot No. Street Hamlet Lot 13 conforms substantially to the Requirements for a One Family Dwelling built Prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-24684 dated OCTOBER 10, 1996 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 * The certificate is issued to EDNA HARNAN & AMO (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PT.~SE SEE ATTA~HK~ INSPECTION REPORT. / ~Building 'Inspe / Rev. 1/81 IIIIII.IIIIIH I)l;.l*~l~l'tll~lll' I()UII OF !;OU'III()I.I! I1011(~111(; COI)I~, III!;I'IHiI'I()II ItEl'Or{l' LU(:^TlUI(: 1050 HYATT RD. SOOTHOLD, N. Y. rIAl' U(), I.OT(~) OCCUI'AI~C i SINGLE F~ILY ................................... .... - .... ~ I),'r ~: OCTOBER 7, 1996 Fi)IIIII)AT I Oil C~ BLOCK - __ ( El A L PART. - ....... IIATIII[()()II (~1) O~ -' ....... ..................... TOII,I~T I{{H)II (o) IIl'll,l'l'~ I{OOII Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 di:', - "t' 1996 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 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. B. 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-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 $15.00 10/7/96 Date New Construction ........... Old Or Pre-existing Building .... Y~? .......... . 1050 Hyatt Road, South Location of rropernv.. ' old House No. Street Hamlet Virginia Bennett Moore Trust Onwer or Owners of Property. County Tax Map No 1000, Section..S¢ .......... 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: $.JQQ.QQ ....................... ..~....~ ........ CONSENT TO INSPECTION Janet T. Swanson, as Trustee O~ler(s) Name(s) do(es) hei-el)y state: , the undersigned, That the undersigned (is) (are) the owner(s) of the premises in lite Town Southold located at 1050 Hyatt Road, SI~X Southold __ , which is shown and designated on file Suffolk County tax map as District 1000, Section 50__, Block 1 , Lot 13 That the undersigned (has) (have) filed, or caused to be filed, an applica- tion in the Southold Tox~m Building Inspector,s Office for the following: Pre-Existing Certificate of Occupancy 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 alt0 all buildings located thereon, to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that §aid premises comply with all. of the laws, ordinances, rules and regulations of the Town of Southold. The undersigned, iii consenting to such hmpections, do(es) so with the knowledge and understanding that any information obtained In the conduct of such inspections }nay he used as evidence in subsequent prosecutions for vio- lations of the laws, ordinances, rules or regnlations of the Town of Southold. Dated: 10/7/96 Ca1~:~3_257~"~'~5 ...... (si~,,ature) Janet T. Swanson, as Trustee of Moore Trust (print name) (signature) ~ --- (print name) THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE `1(~(~} '12 '1 BUREAU OF ELECTRICITY [--- 85 JOHN STREET. NEW YORK, NEW YORK 10038 Dat, OCTOBER 07 , 1993 ~pplication/~o. onfile 05121893/93 N 291905 THIS CERTIFIES THAT o/~.~ e~.~trlc~l equipment as described I~low and introduced by the applicant n~n~t on the above application n~rnber in the prernlses TERRY HARNAN) EAST HYATT LANE, POLE# 8, SOUTH HOLD, --~._... rotto~to~atlon;~ [] .~,e,.e.t [] t., rt. [] ~na r~. OUT OCTOBER ~4,'1993 and found to be in compliance with the National Electrical Code. RANGES ~PECIAL REC'PT COOKING DECKS OVENS I DISH WASHERS AMT. K.W. AMT. K.W. , .*4T. K.W. TIMECLOCKS BELL JUNITHEATERS MULTI-OUTLeT SYSTFJAS AMT. AMPS. TRANS. AN, T, H.P. NO. OF FEET teas examined on FIXTURE OUTLETS ECEPTACLES SWITCHES DRYERS J RJRNACE MOTORS I FUTURE APPUANCE FEEDERS I .o. o~ [ s SERVlC~ DISCONNECT ~T, ~. ~ ~[ 1~2w 1~ 3g~ 3W4W ~.~ CC.C~D,PER 1 1OO CB 1 X 1 OTHER A~ARATUS: R V I C A. W.G. NOOF Hi-LEG A, W. G. OF CC. CONO. Of HI-LEG 3 EXHAUST FANS DIMMERS E . ,Of= NEUTRALS A, W. G. PAUL R. BURNS 275 TOWN HARBOR LANE LIC.#282-E $OUTHOLD, NY, 1197~Per'11 7~R This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. 6 ~J