HomeMy WebLinkAboutZ-23491 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-23491 Date FEBRUARY 14, 1995
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 425 DIAMOND LANE SOUTHOLD, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 68 Block 2 Lot 13.1
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-23491 dated FEBRUARY 14, 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 GARAGE UNDER *
The certificate is issued to ELLIOTT V. MEYER & WIFE
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
•
Building Inspe- or
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 425 DIAMOND LANE SOUTHOLD, NEW YORK
(number & street) (municipality)
SUBDIVISION MAP NO. _ LOT(s)
NAME OF OWNER (s) ELLIOTT V. MEYER & WIFE
OCCUPANCY SINGLE FAMILY OWNER
(type) (owner-tenant)
ADMITTED BY: MARJORIE MEYER ACCOMPANIED BY: SAME
KEY AVAILABLE SUFF.CO. TAX MAP NO. 1000-68-t-I3. 1
SOURCE OF REQUEST: PAUL CAMINITI, ATTY DATE: JAN. 25, 1995
DWELLING:
TYPE OF CONSTRUCTION WOOD FRAME # STORIES 1 # EXITS 2
FOUNDATION PIERS CELLAR NO CRAWL SPACE NONE
TOTAL ROOMS: 1ST FLR. 5 2ND FLR. 3RD FLR.
BATHROOM (s) ONE TOILET ROOM (s) UTILITY ROOM
PORCH TYPE ENCLOSED FRONT-COVERED SIDE DECK, TYPE NO PATIO NO
BREEZEWAY NONE FIREPLACE ME GARAGE UNDER HOUSE (UTILITIES)
DOMESTIC HOTWATER YES TYPE HEATER OFF BOILER AIRCONDITIONING
TYPE HEAT OIL WARM AIR HOTWATER XX
OTHER:
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST. STORAGE, TYPE CONST.
SWIMMING POOL , GUEST, TYPE CONST.
OTHER:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
REMARKS:
INSPECTED BY ���
�''/ DATE OF INSPECTION JAN. 30, 1995
JOHN M. BOUFIS TIME START 9:30 AM END 9:50 AM
Form No. 6
TOWN OF SOUTHOLD ? �-
BUILDING DEPARTMENT
TOWN HALL 4 1995
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY TrF
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 17 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-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
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. Businesse 4 00.
2. Certificate of Occupancy on Pre-existing Building '100.00
3. Copy of Certificate of Occupancy - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $1/5,A0, Commercial_
$1"5.00
Date . . . , ,JiqAJo7� (97j
New Construction Old Or Pre-existing Building. .
Location of Property 5 )9/44/0/0 mitk. �uT/f9�
House No. �J �Street / Hamlet
Onwer or Owners of Property e4A�-/ C / /VIZ
County Tax Map No 1000, Section. . . / 25 Z '3,
Block Lot
Subdivision
Filed Map Lot
Permit No Date Of Permit
Applicant
Health Dept. Approval
Underwriters Approval
Planning Board Approval
Request for: Temporary Certificate
� Final Corticate
Fee Submitted: $„� A
1-3
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CONSENT
TO
INSPECTION
4
F ' a 1E_ the undersigned,
Owner(s) Name(s)
do(es) hereby state:
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at Q.( 0/,9046Aid / kiE
, which is shown and designated on the Suffolk
County tax map as District 1000, Section 66 Block Z , Lot 1.3. 1 ,
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:
(ONE -,40 a c v D we l f i u9 `1 �P14(EUNor,,e
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 he used as evidence in subsequent prosecutions for vio-
lations of the laws, ordinances, rules or reb lat"-..s of the Town of Southold.
Dated: J/4,t/071 , iggs
.
(sigAl, 1
Air
110 WISP
411 (print n. . )
COSI TCT (signature)aL 74 . C,444/U/i I �S
(signature)
MARoele 4E�/E
1 76 ! - /40 /
7�QS- 3M 4 (print name)
-- - o0
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: Ve,..)3# , ° , /ebrt»,1 -0 C,, J
(number & street) (municipality)
SUBDIVISION �� MAP NO. LOT(s)
NAME OF OWNER (s) C��GYT 4 ' ei 9'' /"; n
OCCUPANCY .7,# t' ' ,►9/-7i� Q�� ��
(type) (owner-tenant)
ADMITTED BY: et ,/4 Ayee...._ ACCOMPANIED BY: ,,50��KEY AVAILABLE SUFF.CO. TAX MAP NO.
SOURCE OF REQUEST: , /0 7'Q -- 4,-,<Z4--4Ai DATE: ".2*C--
DTYPELING: STRUCTION / f C' r2sh�e
# STORIES / # E%ITS
FOUNDATION 4e& r CELLAR CRAWL SPACE /t dJG/lE___
TOTAL ROOMS: 1ST FLR. S 2ND FLR. 3RD FLR.
BATHROOM (s) d/r/ TOILET ROOM (s) UTILITY ROOM
PORCH TYPEAC�AS !>3L7I --40Y1.t4r./J/, DECK, TYPE C/a' PATIO �ffC
BREEZEWAY 2•/1,14)-e.._ FIREPLACE 4/ GARAGE /#, _ 41 Z'h.eS-)
DOMESTIC HOTWATER yee5 TYPE HEATER //- 3)/4 AIRCONDITIONING
TYPE HEAT (r) // WARM AIR HOTWATER " I 4.J,40 ._
OTHER:
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST. STORAGE, TYPE CONST.
SWIMMING POOL , GUEST, TYPE CONST.
OTHER:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
i _
9., -
_dLL. .L� . i.1it. 14°I''
4, °.)-C.°-' .-e ‘
irire......•■.""'"1".1*.."*.....gr".
REMARKS:
INSPECTED BY DATE OF INSPECTION
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TIME START /3 d END