HomeMy WebLinkAboutZ-25298FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
P~E EXISTING
CERTIFICATE OF OCcuPANCY
No Z-25298
Date OCTOBER 3, 1997
THIS CERTIFIES that the building ON~ FAMILY DWELLING
Location of Property. 6125 S~uNKLANE uuTCHOGUE, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 104 Block 4 Lot
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-25298 dated OCTOBER 3, 1997
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 ATTAutu~D GARAGE *
The certificate is issued to
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PI.R~SE SEE ATTACHED INSPECTION REPORT.
ELWOOD & CAROL HUGHES
N/A
N/&
N/A
Rev. 1/81
BU I I.D I NG I)F, PAIUI'HENT
TOWN OF SDUTIIOI.I)
!lOUSING CODE tNSPEC'r{ON REPORT
{.OCAT{D~: 6{25 SKU~ ~ CU.T~_~, N-X~ipa
....... ~number & street~
SIIBI) IVIHI()N NAP NO. 1,OT(
NAHE OF OWNER (s). ELW~~._.&_.~ ............................................................
OCCUPANCY
ADHI'I'TICI) BY:
KEY AVAIl,ABLE
SOURCE OF REQUEST:
A- I RESIDENTIAL
MR. HUGHES
OWNER . _ .................
(o~er-tenant ~
ACCOMPANIEI) BY :_.~AIq~
SUFF.CO. '[AX HAP NO. 1000-104-4-1
~ ELWOOD & CAROL HUGHES'
DATE: SEPT. 18~_199~_ ....
I)WEI.I.ING:
TYPE OF CONSTRUCTION WOOD FRAME ~f STORIES l-Ii_2
FOUNI)A'FION CONCRETE & CEMENT BLOCK CEI.I.AR FULL CRAWl. SPACE..ADD.~j_ON_- _
TO'FAI, ROOMS: l ST FLR. 5 2NI) FI.R. 2 3RI) FI,l{.
BATIIROOH Is) 2 TOIl.ET ROOH (~;) · UTII.ITY ROOH INCLUDING I/2 BATH
PORCll TYPE BECK, '['YPE PATIO
I~REEZEWAY FIREPI.ACE ____0~[~ .... GARAGE I CAR
DOMESTIC IIOTWATER YES TYPE IIEATER OIL AIRCONI)ITION1. NG
TYPE IIEAT OIL WARH Ail{ ' ilO'I~ATER XX
OTIIER: WALK IN CLOSET FIRST FLOOR
ACCESSORY STRDCTDRES:
GARAGE, TYPE OF CONST.
SWIMMING POOL
()'FLIER:
NONE
STORAGE, TYPE CONST.
, GUES'F, TYPE CONST.
VIOLATIONS: CIIAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
I.OCATION I)ESCRIPTION ART. SEC.
REMARKS: BP #14329Z-COZ-14274 (ADD) BP ~m722o-z-coz-17544 (ADD)
I NSPI~C'I'EI} RY
DATE OF INSPECTION SEPT. 23, 1997
TIME S'FART I :00 PM Ir, ND I :20 P~
TOWN OF SOUTHOLD
BUILDING DEPART~WENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
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 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 cSmpteted site plan requirements.
For existing buildings (prior to April 9, 1957) non-conforming 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.
Fees
i. Certificate of Occupancy - New dwellinE $25.00, Additions to dwelling $25.00,
Alterations to dwellin§ $25.00, Sw~mmin§ pool $25.00, Accessory buildinE $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existin~ Buildin~ - $100.00
3. Copy of Certificate of Occupancy - ~ .25~
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
New Construction ........... 01d Or Pre-existing Building .................
Location of Property .... ~%%~.~Rq~.~gq~.9?~9~P? ...........................................
House No. Street Hamlet
Onwer or Owners of Property ..... ~99~.99~.~9~9~.~P ......................................
138.00 02.00 030.000
County Tax Map No 1000, Section...~P~:P9 ..... Block. P~.'PP .......... Lot... PP~.'P9P ............
Subdivision .................................... Filed Map ............ Lot ......................
Permit No ................ Date Of Permit ................ Applicant .............................
Health Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate ...........
Fee Submitted: $ 100.00 ~ / LZ'/ ~I
.............................
..i.~%q..~.fi.~-T?..~.~..~At--~ ..................... A.SPLiC~./
{.( I'J~ I!;l"l'l'
Elwood Hughes and Carol Hughes , ,
'l'l)~t Ihe un(lur:~ll,{tiutl (i~)) (nj'u) Ihn ownt~r(~) ()t'
id' ?;otllhohl located ~tt 6125 Skunk Lane, Cutchogue
138 02.00 030.000
F~Existing Certificate of Occupancy
nli,y iLil(I ail hulldlnf~) l()¢:nl(:(I Ihel'uon, h) conduct suclt insp~(:lions
./