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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: $ ............................. ?? ............... .