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Home My WebLink AboutZ-24533FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING u~KTIFICATEOFOC=umANCY No Z-24533 Date JULY 30, 1996 THIS CERTIFIES that the building Location of Property 22135 MAIN ROAD House No. County Tax Map No. 1000 Section 17 Subdivision ONE FAMILY DWELLING ORIENT, NEW YORK Street Hamlet Block 4 Filed Map No. Lot 25.2 Lot No. conforms substantially to the Requirements for a One Family Dwelling built Prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-24533 dated ~u~Y 30, 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 ONE FAMILY DW~rW.ING * The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PT~%SE SEE ATTA~D INSPECTION REPORT. Rev. 1/81 E. GEOFFREY HIGH N/A N/A IHII I,I) I I1(; DF, I'^II'I ltl{Il I' 'I()UI1 HIr !;(HIIIIIH,I! II(HLqlII(~ IlOI)l~, III!iI'KCI I()11 IH~.l'gl{I' I.m:^'l r()H~ 22135 HAIN 'ROAD ORIENT, (.,.,,,l,.,. ~ ;,,il;~i} ~,,.,, ,,.11,.I, IIAIIE ()F IIIIIIFll (.) [ ' GEOFF~Y 't~l'l{ ()lr (}()II}FIIHIC'I'I(HI ~ F~ I:(HIIIIIAIIIiIII STO~ & CE~ BLOCK (:I{I.IIAI{ PARTIAL CIIAIII. [II'ACI{ PARTI~ IIAIIIIIiI()IT (*l) 2 'liJll.l{l' IT(ii}Il (.) ] 111 ll-IllV ..... III{CK, 'I'VYI{ J~A'lllj) BRICK & CONC~ IH}III[III lC IfiIIIIAIlI{I{ . ~- ll~l'l{ III{AlII{Il OFF BOILER IYl'l{ III{AT I OIL . lllAII[I All{ IliII~AII{I{ - . Jill(IlIA( I{ '1YI'I{ CI}It[iI'. G~EBO VI{II,A'I [{}li[J: {:IIAI'II{II 1~5 11.~. [I'I'A'II{ lllllF{)llll FIIII{ I'IH~I(Ilt'IOll ~ Illlll.l}llll} .- - ; I I .... lj~}~;i; Illl'l]im . Al(il... I [;l~i;. ................... I I II ,~lta~,: BP ~8811-Z-CO Z-10321 (Add) BP ~12315-CO Z-15413 (ACCY Form No. 6 BUILDING DEPARTMENT TOWN HALL' . A. This application must be fil~ed in by ~pewriter OR ink and submitted to the building inspector with the following: for new building or new use: I. Final su~ey of property with accurate location of all buildings, property lines, stree~s, and unusual, natural or topographic features. 2.Final Approval froTM Health Dept. of water supply and sewerage-disposal(S-9 fo~). 3.Approval of electrical installation from' Board of Fire Unde~iters. 4. Sworn statement from plumber certifying that the solder used ~ system contains less ~han 2/1'0.of 11 lead.' ~. Co~ercial building, ~duscrial building, multiple residences and s~ilar 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 requiremen~. .~. For existing buildings (prior to April 9, 1957) non-confo~ing uses, or buildings and Vpre-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 ~iting to the applicant.' C. Fees i. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, .. Alterations to dwelling $25.00, Swiping 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, ~o~ercial $15.00 On.er or O~ners of Property ......... ., County Tax ~p No 1000, Section .... Block ....... L~t ' ~oalth Dept '' · ......................... ~ndervr~ters ~pproval ....................... Planning. Board. Approval ............. .... ... ;'.... Requo~t for: Temporary Certificate ........... F~nal Certlcate ........ loO, 0 Fee Submitted: ~ ........ ~ ................... do(es) hereby state: CONSENT TO INSPECTION That the undersigned (is) (are) the owner(s) of the premises in the Town , which is shown and designated on the Suffolk Oo~n~ ~ ~ ~.~ ~ ~000. ~.o~ t,7. ~o~ ¥ .~o~ ~ That the undersigned (has) (have) filed, or caused to be filed, an applica- tion in the Southold Town Building Inspector's Office for the following: 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 conduct of such inspections may be used as evidence in subsequent prosecutions for vio- lations of the laws, ordinances, rules or regulation's o~the Town of Southold. (signature) (print name)