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Home My WebLink AboutZ-26500FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED PRE EXISTING CERTIFICATE OF OCcupANCY No Z-26500 Date JUNE 14, 1999 THIS CERTIFIES that the building ON~ FAMILY DWELLING Location of Property 2155 J~SON STREET NEW SUFFOLK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 117 Block 9 Lot 19.3 Subdivision Filed Map No. 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-26500 dated JUNE 14, 1999 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 n~ FAM?LY DW~r. LING WITH ACCESSORY STORAGE SHED * The certificate is issued to MARY HOT.T.~ND (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *pT~SE S~ ATTA~D INSPECTION REPORT. N/A N/A N/A NOTE:T~IS UPDATES PRECO Z-22830 DATE~ Inspector Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: ~155 JACKSON ST SUBDIVISION: NAME OF OWNER (S): ~kRY E HOLLAND OCCUPANCY: ~IN~LE FAMILY ADMITTED BY: ~4ARY HOLLAND NEW SUFFOLK MAP NO.: __ LOT (S) __ ~kRY E HOLLAND ACCOMPANIED BY: ~AME KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 117.-9'19.3 SOURCE OF REQUEST: ABIC, AIL WICFd~AM. ATTY 5/15/99 DATE: 06/14/99 D~I~LLING: TYPE OF CONSTRUCTION: WOOD FP. AME FOUNDATION: TILE BRICK & CEMENT TOTAL ROOMS: 1ST FLR.: _~- 2ND FLR.: -.~ BATHROOM(S): 1.0 TOILET ROOM(S): O,O PORCH TYPE: ~ FRONT COVERED DECK TYPE: BREEZEWAY: FIREPLACE: NO DOMESTIC HOTWATER: yES TYPE HEATER: LILCO GAS TYPE HEAT: QIL WARM AIR: HOTWATER: OTHER: W~LK IN ATTIC STORIES: 1.5 ~ EXITS: ~ CELL~R~ 3/4 CRAWL SPACE: 1/4 3RD FLR.: ._~ UTILITY ROOM{S): PATIO TYPE: GAP. AGE: AIRCONDITIONING: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: SWI~4ING POOL: OTHER: * WOOD FRAME SOME STUCCO STORAGE, TYPE CONST.: TOOL SHED* GUEST, TYPE CONST.: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ~ ART. I SEC. P,~S: NOTE= THIS UPDATES PRECO Z-22830 DATED JAN. 10. 1994 INSPECTED BY: ' GLY Z'. /' DATE ON INSPECTION: 06/10/99 TIME START: END: TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPAXCY 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 ail 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. For existing buildings (prior to April 9, 1957) non-conforming 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 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-existinK Buildinm - $100.00 Copy of Certificate of Occupancy - , .25~. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 6/8/99 Date ......................................... New Construction ........... Old Or Pre-existing Building ~.~axi~t!n~uildings Location of Property...~jS~.J~k~pD.~r~.,.~e.w.~.u~f~kk,.~y............(1 Family ..... Dwelling. ....... .........and She~) House No. Street Hamlet Onwer or Owners of Property.. Mary Holland County Tax Map No 1000, Section...1.17 ......... Block ...... ~ ......... Lot ....... 19,3.(f~k~a.~9,1) Subdivision .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certi~a~e .......... ,~ 50.00 ×~' /? - . ~ · Fee Submitted: ~, ............ ......... /'i,/~, . ..' ~,~ ,.> '. / . / .~ ....... Abigail,8. Wi~f~ Agent CONSENT TO INSPECTION Mary Holland Owner(s) Name(s) · the. undersigned, do(es) hereby state: That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at 2155 Jackson Street, New Suffolk, New York · ,. -, , which is shown and designated on the Suffolk County tax map as District 1000, Section 117 , Block 9 , Lot 19.3 (f/k/a 19.1) 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: __ One Yam±ly Dwell±rig and Shed 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 unde_Fsigned, in consenting to such inspections, do(es) so with the knowledge and understanding that any information obtained [n the conduct 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. :~,..,z, /// /~ ?,///:~ ' (sighatur e) Abigail A. Wickham, As Agent (print name) / L