HomeMy WebLinkAboutZ-20519FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No
Z-20519 Date FEBRUARY 5~ 1992
THIS CERTIFIES that the building. ONE FAMILY DW~.LLING
Location of Property 1565 SMITH DRIVE SOUTH
House No. Street
County Tax Map No. 1000 Section 76 Block 2
Subdivision Filed Map No.
SOUTHOLD~ N.Y.
Lot 37.3
Lot No.
Hamlet
conforms substantially to the Requirements for a One Family Dwelling built
Prior to: APRIL 9~ 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z-20519 dated FEBRUARY 5~ 1992
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 DWELLING WITH ACCESSORY WOOD FRAME GARAGE~ AND TWO WOOD FRAME SHF~S. *
The certificate is issued to
CHART.RS J. HART
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*PI.RASE SEE ATTACHED INSPECTION REPORT.
uilding Inspector
Rev. 1/81
TO.~'I OF SOUTI[OLD, N. Y.
HOUSI[[G CODE INSPECTION REPORT
~lap No.
Location 1565 SMITH DRIVE SOUTH
[n~moer ~ szree'z)
Subdivision
Name of Owner(s)
CHARLES J. HART
SOUTHOLD~.HEW YORK
[i,iunzcipa±/zy)
Lot(s)
Occupancy ONE FAMILY
~type)
A~mitted by: MICHAEL BURKE
Key available
(owner-uenanv)
Accompanied by: MICHAEL BURKE
Suffolk Co. Tax No. 1000-76-3-37.3
Date FEB. 5, 1992
Source of request
GARY OLSEN, AT~'Y'
D~'~LLI~IG:
Type of construction
Foundation CRAWL SPACE
Total rooms, 1st. FI
Bathroom(s) ! FULL
Porch, type OPEN PORCH
Breezeway.
Type Heat GAS
Fireplace(s) ONE
Domestic hotwater
Other
WOOD FRAMED
Cellar
6 2nd. F1 2
Toilet room(s)
peck, type
Garage
'Warm Air xx
No. ~its 2
x ~ype heater
SMOKEDETECTOR PRESENT
#stories 2
Crawl space xx
5rd. Fi
Patio, ty~e
Utility room
Hotwater
Airconditioning...
GAS
ACCESSORY STRUCTURES:
Garage, type const. WOOD FRAME
Swimming pool
Other
Storage, type const.
Guest, type const.
2 WOOD SHEDS
VIOLATIONS: .CHAPTER 45--N.Y. STATE ~NIFO~M FIRE PREVENTION & BUILDING CODE
Location
Descrintion
I
Remarks: BP ~-~20-Z~512 ISSUED FOR SCREENED PORCH ADDITION
Victor Lessard ' Time start : l0 end ! I :44
CONSENT
TO
INSPECTION
Linda Burke
Owner(s) Name(s)
do(es) hereby state:
· the undersigned,
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southoldlocated at Smith Drive, Southold, NY
· which is shown and designated on the Suffolk
County tax map as District 1000, Section 76 , Block 2 , Lot 37.3
That the undersigned (has) (have) filed, 'or caused to be filed, an applica-
tion in"th~ Southold Town ~tuilcling lnsp~L~,~ .~ o~oo ~o,~ +~,~ ~nllo~vin~: pre existing Certificate of~ Occupancykq~ ~VN
, \ \
That the undersigned do(es) hereby give consent to the Building Inspectors
of the Town of Southold to enter upon the above described property, including
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 inspections, do(es) so with the
knowledge and understanding that any information obtained In the co~duct of
such inspections may be used as evidence in subsequent prosecutions for vio-
lations of the laws, ordinances, rules or regulations of the Town of Southold.
Dated: February 5, 1992 /~~ ,
linde Burke
(print name)
(signature)
(print name)
FORM NO. 6
TOWN OF SOUTHOLD
· Building Department
Town Hall
Southoldo N.Y. 11971
765- [802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted m m to the Building Inspec-
tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa-
tions, a certificate of Code compliance from the Architect or Engineer responsible for the building.
5. Submit Planning Board approval of completed site plan requirements where applicable.
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or
topographic features.
2. Sworn statement of owner or previous owner' as to use, occupancy and condition of buildings.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
C. Fees:
l. Certificate of occupancy $.25~'00-- BUSINESS $50.00
2. Certificate of occupancy on pre-existing dwelling $ 50.00
3. Copy of certificate of occupancy $ §.'00, over _5 'years $10.00
4.Vacant Land C.O. $ '20.00
5.Updated C.O. $"50.00 Date. February 5, .]99.2
NewConstruc tion ...... Old or Pre-existing Building X Vacant Land
Location of Property . .$r~tl~ .QC~.¥Q~ .~gul~h.'o. l.d. ~ .N.Y. ........ ~ ...............................
House No. Street Ham/et
Owner or Owners of Property I,~[QdQ [B. grke ,.~
C tyT N 1000S tio 76. Block 2 37.3
oun ax Map o. ec n ............................. Lot .............
Subdivision ................................. Filed Map No ........... Lot No ............
Permit No ........... Date of Permit .......... Applicant ...............................
Health Dept. Approval ........................ Labor Dept. Approval .....................
Underwriters Approval ...................... t .Planning Board Approval . ,~ .................
Request for Temporary Certificate ......... , ......../~/~'/~,~/~////- k ./~ Certificate .~.~...~.~.~_... i....-.
Fee Submitted $ · ! .0.0 ~ .0.0.. ...............
Construction on above described building and pe~p%cable/_odes and regulations,
Applicant ' ,~~'~'r~V~'. ~'~: -- · · ."~.. · .~, ....
~-.~o.~o.Ts P.O. Box 706
Cutchogue, NY 11935
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