HomeMy WebLinkAboutZ-20611 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-20611 Date MARCH 26, 1992
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 520 OAK DRIVE SOUTHOLD, NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 80 Block 2 Lot 13
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-20611 dated MARCH 26, 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 DWELLING WITH ATTACHED CARPORT & ENCLOSED PORCH*
The certificate is issued to IRENE & GEORGE MILLER, JR.
(owners)
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.
.2// 7:-'1-4 -----
7 Building Inspector
Rev. 1/81
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BUILDINC D PART :iT
TOWN OF SOUTEOLD, N. Y.
HOUSIN:G CODE INSPECTION R 2ORT
Location 520 OAK DRIVE SOUTHOLD, NEW YORK
�numoer 64 screec) (i•iun.c1palicy)
Subdivision Map No. Lot(c)
Name of Owner(s ) GEORGE MILLER JR. & LILLIAN MILLER
Occupancy A-1 RES OWNER
(type) (owner- cenan-c)
Admitted by: MATTHEW LIONETTI Accompanied by: SAME
Keyavailable ,
Suffolk Co . Tax No. 80-2-13
Source of request GEORGE & LILLIAN MILLER Date MARCH 16, 1992
D1 ELLING: •
Type of construction WOOD FRAME on
Foundation CEMENT BLOCK Cellar Crawl space XX
Total rooms , 1st. Fl 3 2nd. Fl 3rd. Fl
Bathroom(s) ONE FULL BATH. Toilet room(s)
Porch, type REAR ENCLOSED Deck, type Patio , type_
Breezeway Garage CARPORT Utility room
Type Heat PROPANE 'farm Air FLOOR HEATER HotWater
Fireplace(s) NONE No. Exits 2 A.irconditioring .
Domestic hotwater YES Type heater GAS
Other
ACCESSORY STRUCTURES: NONE
Garage, type const. Storage, type const.
Swimming pool Guest, type const.
Other
VIOLATIONS: .CHAPTER 45--N.Y. STATE UNIFORM FIRE• PREVENTION & BUILDING CODE -
Lncation Description IArt. I Sec .
INSIDE THE
TUB AREA CEILINGS, WALLS, FLOORS SHALL BE MAINTAINED IN ICRAFT 1 F
A SAFE AND SOUND CONDITION. 1242. 7 (C) .
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Remarks:
Inspected by: CAoiri Date of Insp. MARCH 25, 1992
J. FISH • Time start 9:30 end 9:50
Form No. 6 ' '_m.
• TOWN OF SOUT[IOLD Dr-
. pBUILDINGfuin'2 3 X992
DEPARTMENT 4, a
TOWN HALL
765-1802 E'
TOWN t, r
APPLICATION FOR CERTIFICATE OF OCCUPANCY
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.
iN
' 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. Businesses $50.00.
. 2: Certificate of Occupancy on I're-existing Building - $100.00
3. Copy of Certificate of anc Occu py - $50.0 over 5 years - $10.00
4. Updated Certificate of Occupancy orar - $50.00
S. Temporary y Certificate of Occupancy - Residential $15.00, Commercial $15.00
•
Date . . 3/1
ew g Building
Construction Old Or Pre-existin
Oar Pr1 �,-
Location of Property 6-24:› 50c44-40 '
House No. Street Q
Hamlet
%nwer or Owners of Property �j✓ M
2 1 t it --}-c Zl r, e* L ( ' �� � ; (�r
:uunty Tax Map No 1000, Section � Block / `
Lot. . /�
:ubdivJ.sion.144?.of yaStuticsThc. • (3 .( 2 iSlack)
Filed 1i:ip Lot. ,f3, 1 .1 1 w
ermit No Date Of Permit
Applicantaa5e�13/!/3r', f I—IL" me Ike
calif) Dept. Approval
Underwriters Approval
I:uming Board Approval
•
=quest for: Temporary Certificate
Final Certicate
ce Submitted: $.(170,0`
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Lo f numbers refer to BlockDsurved
I yeJune 1, 1971
617 "MOP of Eetidott 5hore.,5 -,
filed In .5uffolk, Couffly elerk's VAAJ Tayi... ct SON
of/Ice 4,1 trial; no. 63/ . 17-1• - \I A.-‘1.-. .........,.4__Q
0 ! _ LiCertSeat Land SurVeyOre
arceriparf, N. Y,
loR,
i '' MAR 2 3 igq2 . I
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CONSENT
TO
INSPECTION
leo jC e Hi 11.441 1i L r I f i o...- k t Ile/ . the undersigned,
Owner(s) Namc(s)
do(es) hereby state:
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at 52.0 696 k brl,I ? SOCa c� c+
i_ i I
New Yo( '
which is shovm and designated on the Suffolk
County tax map as District 1000, Section eb , Block 2.— , Lot /3 ,
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:
--I-o
C .O . r ex,s+, .s 1o. .•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 cf 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 be used as evidence in subsequent prosecutions for vio-
lations of the laws, ordinances, rules or regulations of the Town of Southold.
Dated: .002-- 2 �� /
rt /��
(signat`u^re)
ii
�2�Ce I-` I' ilr--v- .11—
(--)1.-int
—
(•)i'int naive)
- ' r \ Q
(signature)
�`��` � --- - /I) 1(lM,. p. ( i ✓
(print name)
!It1( MAR 2 31992
2
TOWN C.3
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
/
Location (.3049i/at ,/ _ I
-4...4........„: d
number & street Municipa ity
Subdivision Map No. Lot(s)
Name of Owner(s) 4'1' ' - A-1-6-x, V- 21� .�
Occupancy /1 -/ i&a. i.' '
type , owner_ t/�
Admitted. by: / 0(2,4 Accompanied by
Key available Suffolk Co. Tax No. R —„7-4.f
Source of request )4-v% 11-4,46, Date 00?"1--
DWELLING:
Type of construction //9r# c� #stories G e_
Foundation Ce..,„ t.....46_,A____ Cellar Crawl space /, '--
Total
�
Total rooms, 1st. Fl ,5 2nd. Fl 3rd. Fl
Bathroom(s) , /9/ Toilet room(s)
Porch, type ' , !eck, type Patio, type
Breezeway Garage 4. Utility room
Type Heat le%p"� Warm Air G;, Hotwater
Fireplace(s) 4w. No. Exits Airconditioning
Domestic hotwater Type heater Gf O,
Other 74.
ACCESSORY STRUCTURES:
Garage, type const. Storage, type const.
Swimming pool Guest, type const.
Other
VIOLATIONS: Housing Code, Chapter (S
Location Descript'on Art. Sec.
�� G ,
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by .ed^c1(d.004.4ri /-Remarks:
Inspected by: 28 Date of Insp. j// 74 -.
Jay
Time start ?'iU e d ,/,0