HomeMy WebLinkAboutZ-23399No ~-23399
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCcOPANCY
Date DECEMBER 12, 1994
THIS CERTIFIES that the building
Location of Property. 51680 MAIN ROAD
House No.
County Tax Map No. 1000 Section 63
Subdivision
ONE FAMILY DWELLING
SOUTHOLD, NEW YORK
Block 6
Filed Map No. Lot No.
Street Hamlet
Lot 3
conforms substantially to the Requirements for a One Family Dwelling built
Prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z-23399 dated DEu~IBER 12, 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 ONE FAMILY DW~T~.ING *
The certificate is issued to JOHN HENRY
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N/A
N/A
*PT.R~SE SEE ATTA~D INSPECTION REPORT.
Rev. 1/81
BLDG. DEPT.
TOWN OF $OUTHOLD
Form No. 6
TOWN OF SOUTIIOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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 ~nd 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, cdnforming 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. Certi~'_lai~of~pancy on Pre-existing Buildin~ - $100.00
3:' Copy of Certificate~O~up .... y - $20.uo
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date peceinber 2, 1994
New Construction ........... %~d Or Pre-existing B~il~iDg X
Location of Property ..... ~16 Main Road, Southoim, '~'¥6~k ........
House No. Street Hamlet
Onwer or Owners of Property ~ohn Henr~
County Tax Map No 1000, Section .... ~ ........ Block. 6 .Lot 3
Subdivision ..... ~ ~ n~a
............................. Filed Map ...... R/~ · . Lo t .... ~ ..............
Permit No. n~a ..Date Of Permit. n/a
...... · .............. Applicant .............................
iIealth Dept. Approval n/a .~a
· '~ ..... · ................. Underwriters Approval ......................
~lanning Board Approval ..... ~/A ...............
{equest for: Temporary Certificate ........... Final Certicate..f~. .....
-~ee Submitted: $ .............................
?? ............... .