HomeMy WebLinkAboutZ-26689 FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 26689 Date: 09/14/99
THIS CERTIFIES that the building DWELLING
Location of Property WHISTLER AVE FISHERS ISLAND
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 009 Block 0010 Lot 019
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- 26689 dated SEPTEMBER 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 ONE FAMILY DWELLING
The certificate is issued to JONATHAN KIBBE
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
Bu lding Inspector
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSiN OD TjQ p mTf) r nFpORT
LOCATION: WHISTLER AVE F7 HFRG raraNn
SUBDIVISION: MAP NO.: LOT (S)
NAME OF OWNHR (S): JONATHAN KIBBE
OCCUPANCY: RRSSDRNTIA_T. JONATHAN KIBBE
ADMITTED BY: ACCOMPANIED BY:
REY AVAILABLE: SUPF. CO. TAX MAP NO.: 9.-10-19
SOURCE OP RE4UEST: JONATHAN KIBBE 9/7/99 DATE: 09/14/99
DWELLING:
TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 2.0 # EXITS:
FOUNDATION: GRANITE/STONE CELLAR: FULL CRAWL SPACE:
TOTAL ROOMS: 1ST FLR.: ~ 2ND FLR.: ~ 3RD FLR.: 0
BATHROOM(S): 3.0 TOILET ROOM(S): 0.0 UTILITY ROOM(S):
PORCH TYPE: WOOD WITH ROOF OVER DECK TYPE: PATIO TYPE:
BREEZEWAY: FIREPLACE: ONE GARAGE:
DOMESTIC HOTWATSR: YES TYPE HEATER: OIL FIRED AIRCONDITZONING:
TYPE HEAT: OIL FIRED WARM AIR: XX HOTWATER:
OTHER:
ACCESSORY STRUCTURES:
GARAGE, TYPB OF CONST.: STORAGE, TYPE CONST.:
SWIMMING POOL: GUEST, TYPE CONST.:
OTHER:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODfi
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REMARKS: I
INSPECTED BY: DATE ON INSPECTION: 09/08/99
ROB RT E. WALL TIME START: END;
BUILDING DEPARTMENT
TOWN HALL n ~ ~
765-1802 W
i
APPLICATION FOR CERTIFICATE OF OCCU S~ r 7 ~
A. Thi's application must be filled in by typewriter OR ink a d..ta..i~1i bui'ldir
inspector with the following: for new building or new us BLDF.DE;~
1. Final survey of .property with accurate location of all fines
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 lz lead.
5. Commercial building, industrial building, multiple residences and similar buildi
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. Fnr existing buildines (prior to April 9, 1957) non-conforming uses, or buildings
"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 applicar
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-existing Buildine - $100.00
3. Copy of Certificate of Occupancy - _ .25C.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial'$1GG5.00
Date ...RJGuS~........... j(4.~1.......
New Construction........... Old Or Pre-existing Building.......
Location of Property...~~ti.Sr~CQ?-..~1~.F.,..`~,SIIP;iL.S..-~:5~!c1C([~
House No. Street Hamlet
Onwer or Owners of Property.:~UcSl,R.7.`~Cianl.../~ • . • • • • •
County Tax Map No 1000, Section.G).d~:~.~Q.....Block.~~'. U ~ .......Lot. Q1.~1 ~ .~.v•4•
Subdivision......Iy°•!`l.~ ....................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: ~ A / ~j~
.......k~~Y:
`
APPLICANT
S~Qc~ Sh ~"2.(
~nx c~ 6 G ~ ~
CONSENT
TO
INSPECTION
Jo/~/1t6t,~gN ~-(3 (3 e: ~ the undersigned,
Owner(s) Name(s)
do(es) hereby state:
That the undersigned (is) !Pa-~e) the owner(s) of the premises in the Town
of Southold located at js s~G ~ 2 0( ~I E~~C v f
which is shown and designated on the Suffolk
County tax map as District 1000, Section~~ Block gyp, ua, Lot~~~p
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:
~ ac. ~ ~ ~ ~ c <a to a l= ~ C L ~ ~ ~(c /t c~ 2 I"'/~2 t~ ~ ~X r S 7%` ~1 <r
c~ w e GL; .v G
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 regulations of the Town of Southold.
Dated: /-~c1G~rs i ~,~I~C.cig (L
1 (signature)
f~ ~c, h1~
(print name)