HomeMy WebLinkAboutZ-22267FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-22267 Date APRIL 16~ 1993
THIS CERTIFIES that the buildin~ ONE FAMILY DWELLING
Location of Property I575 MINNEHAHA BLVD.~ SOUTHOLDr N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 87 Block 3 Lot 51
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-22267 dated APRIL 16~ 1993
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
(owner)
of the aforesaid building.
SU~'~'OLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PT~SE SEE ATTACHR. D INSPECTION REPORT.
Rev. 1/81
JOHN LaGUARDIA & ANO
N/~
N/~
/ Building Inspector
LOCATION:
BUILDING DEPAR~IENT
TOI~lq OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
1575 MINNEHAHA BLVD.
SOUTHOLD, NEW YORK
(number & street)
sUBDIvISION -MAP NO.
NANE OF OWNER (s) JOHN LaGUARDIA & ANO.
(municipality
LOT (s)
OCCUPANCY A-I RES. OWNER
(type) (owner-tenant)
ADMI'I-rED BY: KATE KUHI.NANN ACCOMPANIED BY: SAME
KEY AVAILABLE ' SUFF. CO. TAX HAP NO. 1000-87-3-51
sOuRcE OF REQUEST: C~I'~ERINE FISH PETERSEN & DATE: APRIL 12, 1993
JOHN LaGUAKDIA
DWELLING:
TYPE OF CONSTRUCTION
FOUNDATION 'CEMENT BLOCK
TOTAL ROOMS:
BATRROOM (s)
PORCH TYPE
BREEZEWAY
DOI~STIC HOTWATER
· ¥~E HEAT OIL
O~Hi~R:
IST FLR.
ONE FULL
WOOD FRAME
5 2ND FLR.
TOILET ROOM (s)
DECK, TYPE
FIREPLACE NONE
xx TYPE BEATER
WARHAIR
OOTSlDK ~HUWKK IN RI~AIiYARD.
{ STORIES ONE ~ EXITS 2
CELLAR PARTIAL CRANL SPACEPARTIAL
3RDFLR.
ONE UTILITY ROOM
PATIO· TYPE STONE REAR YARD
GARAGE ONE CAR ATTACHED
OIL AIRCONDITIONING - -
HO~ATER XX
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.
SWII4MING POOL
O~m~R: B.B.Q.
STORAGE, TYPE CONST.
· GUEST, TYPE CONST.
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
/~/J. FISH
INSPECTED BY:
DATE ON INSPECTION APRIL 16, 1993
TIME START 8:55 END 9:!0
Form No. 6
.- ~ TO~ OF SOUTIIOLD
BUILDING DEPARTMENT
TOWN HALL
A. 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 i% 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.
3. For existing buildings (prior to April 9, 1957) non-c~nforming uses, or buildings and
'-'pre-existing" land uses:
i. 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
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 Building - $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $i0.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
~w Construction ........... Old Or Pre-existing Building ..... ~ ..........
unty Tax Map No 1000, Section. ~ .Block... .~. ...... Lot.
bdivision .............
....................... Filed Map...~/.7 ..... Lot ......................
rmit No ................ Date Of Permit ................ Applicant ................... ~ .........
al~h Dept. Approval .......................... Underwriters Approval .........................
~nning Board Approval ........................
~uest for: Temporary Certificate ........... Final Certicate..
Submitted: $.. [~ ~ ~
0
(./-:
1
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