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Home My WebLink AboutZ-20728FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-20728 Date MAY 14~ 1992 THIS CERTIFIES that the building ONE FAMILY DW~.LL/NG Location of Property 5875 PECONIC BAY BLVD. House No. Street County Tax Map No. 1000 Section 128 Block 1 Filed Map No. Subdivision LAURV. L ~ N.Y. Lot 3 Lot No. Hamlet conforms substantially to the Requirements for a One Family Dwelling built Prior to: APRIL 9~ 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-20728 dated MAY 14~ 1992 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 DWK~,INGWIT~ACCESSORYNETAL STORAGE S~ * The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLRASE SEE ATTACHED INSPECTION REPORT. Rev. 1/81 JOHN J. & A~.LIA M. MARTIN Location BUYLDZi:C TO',';N OF SCUTIiOLD, N. Y. HOUSI::G COCE IDS?ECTION REPORT 5875 PECONIC BAY BLVD. LAUREL, N.Y. ~nLa~,oer c< ~ree~) ~i.iun±c±pa±zcf) Subdivision Name of Owner(s) 0ccupan~y_ A-I [type) JOHN & AMELIA MARTIN not(z) RES. OWNER (owner-tenant) JOEN MARTIN __Accompanied by: T~c No. Date Ad.mitt ed by: Key available Source of request Suffolk Co. JO~N MARTIN . SAME 128-1-1.3 Dh~LLI~IG: 'Type o£ construction Foundation CEMENT BLOCK Total rooms, 1st. F1 5 Bathroom(s) 2 FULL RA1NiS Porch, type FRONT ENCLOSED Breezeway_ Type Heat OIL Fireplace(s) ONE Domestic hotwater Other WOOD FRAME #stories Cellar 3/4 RualCraw1 space 2nd. F1 3rd. F1 Toilet room(s) Deck, type YES Garage 'Warm Air No. ~cits 3 YES Type heater S~OWER STALL ATTACHEDTOWEST SIDE ONE ~/2 Patio, type Utility room Hotwater xx Airconditioning OFF BOII~gR AC~.~0RZ Sm~U~m~ Garage, type const. Swir. ming pool Other J Storage, type const. ~TALS~ED Guest, type const. VIOLATIONS: L_~oqcation .CILAPTER 45--N.y. STATE UNIFOI~! FIRE PREVENTION & BUILDINC CODE Description I Art. [ Sec. I I Remarks: BP #9324 CO Z-8029 FOR ADDITION, BP #20619Z-CO Z-20727 FOR DECK Inspected by: ~~ / ~ ' Date of Insp. APRIL 30, 1992 ~y~IS~ 'Time start 9:00 end 9:30 Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT 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 completed 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. C. Fees i. 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 Occupanc~y on Pre-existin~ Building - $100.00 ' 3. Cop~ ~ ~-e-Tt~i~atat~ of Occ~p~nc~ 2 ~5.00 ~e~ ~--yea~ , $~00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date .. 7. ......... New Construction ........... Old Or Pre-existing Building. Location of Property. Z~.??.~.E~.C-~.f ~ .~.. ~..Oc..~.. ' .~./..~.~. ....... .~..q<. ?..'.~..~. ( .......... ....House No. ' ...... ~get' Hamlet Property....~.~..~. Onwer or Owners of .~. ' .~.,...(.~..+.~-.?./.~.....~.~..~.4~.~.~./..~,.~.~.~.~ County Tax Map No 1000, Section /'c~C? ~ . .............. .............. Block / .Lot .................... Subdivision .................................... Filed Map ............ Lot ...................... .Applicant.'.0....~ ~ . Permit No .... Date Of Permit ' ~ .- ~...~ '~ ~ .... Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ ./. ?..~..'..~'..~.. ............. ~ .e " q .. ...... x .............. CONSENT TO (Dwner (s) Name(s) -- - do(es) hereby state: the undersigned, That the undersigned (is)~the owner(s) of thc pre,niseu in the Tovrn __, which is shovrn and desirmated on the Suffolk County tax map as District 1000, Section/_~ ~_. Block / , Lot ,_~' That the undersigned (has) (have) filed, or caused to be filed, an applica- tion in the Southcld To,va ]3uilding Inspector,s Office for the following. ~--o~- That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southoldto enter upon the above described property, including any and ali buildings located thereon, to conduct such inspections as they maw 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 cf Southold. The undersigned, in consenting to such inspections, do(es) so xwith the knowledge and understanding that any hnformation 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. (s' ature) (print name) (si~natur-e) - (print name) UNAUTHCRIZED ALTERATION OR ADDITION TO THIS SURVEY IS A V[OLATION OF SECTION 7~:09 OF THE NEW YORK STATE EOUCATION LAW TH/ LAND SURVEYOR'S ~NKED SEAL OR · -' MONMMENr REWSaONS YOUNG & YOUNG JUNE~,/.,,qX~ 400 0STRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG PROFESSIONAL ENGINEER AND LAND SURVEYOR ' SURVEY FOR: JOHN J. MAHTIN ~r AMEII~ M. M~TIN AT L ~ UREL TOWN OF SOUTHOLD BY ~ ~o~ D~'~: ?~*:~ I ~ /I SUFFOLK CO., N.Y. ,CAL,: '"= 40'