HomeMy WebLinkAboutZ-19622FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
No Z19622
CERTIFICATE OF OCCUPANCY
PRE EXISTING
Date DECEMBER 28~ 1990
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Propert~ 715 VILLAGE LANE ORIENT
House No. Street
County Tax Map No. 1000 Section 25 Block 02 Lot 06.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Requirements for a private one-family
dwelling built prior to APRIL 9, 1957
Hamlet
pursuant to which
Certificate of Occupancy Z19622 dated DECEMBER 28~ 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 *** SEE INSPECTION REPORT
The certificate is issued to
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
JAN MOOR- JANKOWSKI
Rev. 1/81
BUILDIi':G DEP:~d%T:.LENT -.
T0¥fN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location 715 VILLAGE LANE ORIENT
(numoer & street)
Subdivision
Map No.
Name of Owner(s) JAN MOOR-JANKOWSKI
(£,iunicipa±isy)
Lot(s)
Occupancy A-I
(type)
A~mitted by: KEN STRACHAN
OWNER
(owner-zenana)
Accompanied by: SAME
Key available
Suffolk Co. Tax No. 25-2-6.1
Source of request
J. MOOR- JANKOWSKI '"
Date DEC. I1, 1990
DI'~LLI~:
Type of construction wood FRAME
Foundation STONE
Total rooms, let. F1 4
Bathroom(s) 3FULL
Porch, type
Breezewa~
Type Heat n~Lco-GAs
Fireplace(s)~~ No. ~cits
Domestic hotwater ~ YES
Other
Cellar % Crawl space
2nd. F1 3 ~rd. F1
Toilet room(s)
Deck, type
Garag%
Warm Air
#stories 2
Patio, type_
Utility room
Hotwater xx
Airconditioning
~ype heat'er
LILCO GAS
ACCESSORY STRUCTURES:
Garage, type const.
Swimming pool
Other
Storage, type const.
Guest, type const.
VIOLATIONS:
Location
Housing Code, Chapter 45 N.Y. State Uniform Fire Prevention
& Building Code
Descriotion I Art. I Sec.
ALSO:
Remarks :BP6276Z-COZS~86, BP834OZ-O)z7444, BP9576z-COZ ]3823
Inspected by:~~~///'t~'-' Da. to of Insp.
GARYA~FISH ' Time start l:
12/27/90
end 1:40 p.m.
Form No. 6
TOWN OF SOUTHOLD
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
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 Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date , . ! !.. · .~. · · ~.~.~... 1..~ .~..0 .......
New Construction ........... ~Old Or Pre-existing Building ................. t ~
z. t
Location of Property ............... ; .~r.. .~ .............. ~ .
Street Hamlet
House ~
0nwer or Owners of Property....~.~. .... ~.~.~..~.~.~.~ .............
County T~ ~p No 1000, Section ............. Block ................ Lot. ~ ................
Subdivision .................................... Filed Map ............ Lot ......................
Permit No ................ Date Of Permit ................ Applicant .............................
Health Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Finalf.xCerticate... .~ .....
Fee Submitted:' $ .... /O~)._... ....... ~...~.~.,~ O~- ..... ~~ ~ ~ . ~ ~ ~ 'J ~