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Home My WebLink AboutZ-24060FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-24060 Date DECEMBER 6, 1995 THIS CERTIFIES that the building Location of Propert~ 3475 WELLS ROAD House No. County Tax Map No. 1000 Section 86 Subdivision ONE FAMILY DWELLING PECONIC, N.Y. Street Hamlet Block 2 Lot 9 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-24050 dated DECEMBER 6, 1995 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 ATTA~D GARAGE* The certificate is issued to LURAKRUEGER (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A t1111 I.I) I IIG I)EI'AIITFIEItT T()~/N OF $OUTIIOLD IIOU$INC, CODE IHSPEC'I'ION EEPORT PRGONIG~ ~ YORK (mu n i c i p a ~y ) flAP HO. I.OT(s) O(:{:III'^NCY S Il16%E FA[lILY -(Yy pe ) ADH IT'I'EI) IIY: KE~r~ & NANCY DeLoiselle KEY AVA I 1,ABI,E S(}[IRCI.~ OF RI~,QIIEST: NANCY deLOISl~l.l.~. (owner-tenant) SALVE ACCOHI~ANIED BY: · qIJFI".CO. TAX HAP NO. ]OOu-tib-Z-9 i)ATF-': Sept. 18, 1995 I)I4E I.I, 1NG: 'i'~i,E (j~r CONSTRUCTION C]~NT BLOCK I $'FORIES I-!/2 it EXITS ! F()IINI)AT i DH CEIqRtqT BLOCK CEI.I.AR FULL CRAWL SI;ACE TOTAl, RDDHS: IST FI. lt. 4 2ND F1,R. I 3RI} FLIt. I~ATIIRODH (s) O~-E TOIl.ET ROOH (s) ONE IJ'I'II.ITY ROOH I'ORCII TYPI,: DECK, TYPE ' PATIO IIIH~.E ZE~/Ay ONE F I RI,~PLACE Ol~ GA RAGF. Ol~ CAR I)OHESTIC IIO'I'UATER YES TYPE IIEATEIt OIL F[RED AIRCONI)ITION1NG TYPE IIEAT OIL I~ARH Alit IIO'I~/A'I'ER' XX O'I'IIE R: OUTSIDE SHOI~ER ACCESSORY S'i'I{IICTIJI{ES: GAl{AGE, TYPE OF CONST. S~IttH I NG POOl. O'FIIER: STOl{AGE, TYPE CONS'F. , GUEST, TYPE CONST. V IOI.ATIONS: ],OCATION CIIAPTEIt 45 N.Y. STATE UNIFORM FlltE PREVENTION & ilUILi)ING CODE DESCRIPTION ART. SEC. RF.H^RKS: I)AIT~ ()F JNSI'ECTION Title s'rA RT 9:30 SEPt. 20, 1995 END I0:00 Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN HALL 765-1802 · APPLICATION FOR CERTIFICATE OF OCCUPANCY BLDG. DEPT. TOWN OF $OUTHOtD A. This application must be filled in by typewriter OR ink and submitted to the bu'ilding 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 Jolder 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-conforming uses, or buildings and '-'pre-exist_C%~_~ land uses: i. Accurate survey of property showin8 ail pro erty lines, 2.' unusual natural or topographic features. ~ _ streets, building and A properly completed a_~iication and a consent to inspect signed by the applicant.' ~If a Certificate of Occupancy is denied[~e ~u~din~--nnspector 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. ~ Certificate of Occupancy on Pre-existing Buildin~ - $100.00 3. Copy of Certificate of Occupancy _ $20.O0~· 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of' Occupancy - Residential $15~00, Commercial $15.O0 . ........ mew Construction ........... Old Or Pre-existing Buildi ~.~/' ........................ Location of Property j~z ~l~Jf~ )nwer or Owners of Property ~.~ ......... ................ :OUnty Tax Map No 1000, Section... .Block. ;ubdivision ............. ''~ .................... Filed Map ............Lot ...................... ermit No ...... .Date Of Permit .. .............. Applicant ............................. ealth Dept. Approval .......................... Underwriters Approw~i ......................... lanning Board Approval ........................ equest for: Temporary Certificate ........... Final Certicate. ee Submitted: $..f~.~.C~. ................... ....... . CONSENT TO INSPECTION Owner(s) Name(s) do(es) hereby state: · the undersigned, That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at ,~ ~/ ~c;LLD co,~t r.~ x.'hmn is shoxwn and designated on the Suffolk County tax map as District 1000, Section ~ , Block ~ , Lot 7 That the undersigned (has) (have) filed, or caused to be filed· ian applica- tion in the Southold Toxvn 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 nece_ssary with respect to the aforesaid application, including inspections to determine that said premises comply with all of the laws· c, rdinances, rules and regulations of the Town of Southold. The undersigned, in consenting to such inspections, do(es) so xvith 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. SEP I 8 1995 (print name) BLDG. Db. PT. TOWN OF $CUTNO[ U I OA O ~ .O0 ¢o'q--' O