The URL can be used to link to this page

Home My WebLink AboutZ-19373FORN ~O. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE CERTIFICATE OF OCCUPANCY No. Z19373 Date SEPT. 19r 1990 THIS CERTIFIES that the building Location of Property 6390 House No. County Tax Map No. 1000 Section ONE FAMILY DWELLING NEW SUFFOLK ROAD NEW SUFFOLK Street Hamlet 117 Block 04 Lot 35 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a private one family dwelling built prior to APRIL 9, 1957 pursuant to which Certificate of Occupancy ZI9373 dated SEPT. 19r 1990 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 AND ACCESSORY 2 CAR GARAGE. *** The certificate is issued to DOROTHY E. LAKE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *** SEE INSPECTION REPORT Rev. 1/81 N/A N/A BUILDI~[G DEPART[.~NT '. T0':~I OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location 6390~SUFFOLKRD. IqE~/SU~OLK (numoer & s~rees) Subdivision Name of Owner(s) DOaO'r~ E. LAKE Map No. ([~iunzcipalityJ Lot(s) Occupancy A-I (type) A~mitted by: DOROw~ E. LA~E Key available Source of request DORO'l'tl¥ E. LAKE OWNER ( own er- 5 enanz ) Accompanied by: SAME Suffolk Co. Tax No. 117-4-35 Date SEPT. 12, 1990 DYfELLIMG: Type of construction Foundation CEMENT Total rooms, 1st. F1 4 Bathroom(s) 2 FULL BATHS Porch, type FRONT ENCLOSED Deck, Breezeway. ~'~ Garage Type Heat LILCO GAS 'Warm Air Fireplace(s) NONE No. Fz~its 3 Domestic hotwater LILCO GAS Other ~ ENTRY WAY wood F~ #stories 2 Cellar PART'AL Craw1 space PARTIAL 2nd. F1 4 3rd. F1 Toilet room(s) ONE type -- Patio, typ~-- Utility room Hotwater xx Airconditioning Type heater ACCESSORY STRUCTURES: Garage, type const. 2 cAR CEMENT Swimming pool Other Storage, type const. Guest, type const. VIOLATIONS: Housing Code, Chapter 45 N.Y. Location Descriotion State Uniform Fire Prevention & Buildin~ Code I rt.I Sec. Remarks: Inspected by. ~z/~g/' /~ GARY J//SH/ Date of Insp. 9/14/90 · Time start i0:15 end 10:49 LIL L .... BLDG DEFT, TOWN OF 'SC UTHOt-£) Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 i ' APPLICATION FOR.CERTiFiCATE OF OCCUPANCY ~ ., '%. This application'must be filled in by t'ypewriter 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 ~lectrical installation from Board of Fire Underwriters. · 4. Sworn statement from plumber certifying that the solder used in system conta/ns ~ less than 2/10 of 1% lead. 5. Commercial building, indus, trial building, multiple residences and s/milar bu~/dings , and installations, a certificate of Code Compliance from'architect or engineer responsible for the building. 6. Subm/= Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or build/rigs 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 CertiPicate o£ 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 buildin 2 , 2. Certific' ~¢ ..... g $ 5.00. Businesses . ~ . ~-~ at~v~ u~mancv on ......... $50_00. ~u~=~u ~erulzlcate ot Occupancy - ~50.~0over o years $10.00 5. Temporary Certificate of Occupancy _ Residential $15.00, Commercial $15.00 House No. ~&reet Hamlet ~ Property.· , Section ...... ................................... Filed Hap ' ' Permit ~o ............ Lot ....... Date Of Permit.'. ' .......... ffealth Oept ApProval .............. Applicant ............................. .......................... Underwriters ?lanning Board Approval Approval tequest for: Temporary · Certificate ........... Final Certicate. CONSENT TO INSPECTION / Owntr (s) Name(s) do(es) hereby state: · the undersigned, That the undersigned (is) (are) the owner(s) of the premises in the Town ~ A " , which is shown and designated on the Suffolk County tax map as Distri 1000, Section , Block , Lot 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: ~ 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 ~vith 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. / ~" / (signat~e) (print name) (signature) (print name) ~W_mN LL _z ............................... 0 '1