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Home My WebLink AboutZ-28131FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 28131 Date: 12/20/01 THIS CERTIFIES that the building Location of Property 22540 MAIN RD (HOUSE NO.) County Tax Map No. 473889 Section 018 ACCESSORY ORIENT (STREET) (HAMLET) Block 0005 Lot 005 Subdivision Filed Map No. __ LotNo. conforms substantially to the Requirements for a ACCESSORY STRUCTUKE built prior to APRIL 9, 1957 pursuant to which CR~TIFICATE OF OCCUPANCY NUMBER Z- 28131 dated DECEMBER 20, 2001 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 ACCESSORY GARAGE * The certificate is issued to JONATHAN M & NOREEN MUDD (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A 8/50/99 N/A ELECTRICAL CERTIFICATE NO. N-499184 PLUMBERS c~KTIFICATION DA'r~u3 Rev. 1/81 *PLEASE SEE ATTACHED INSPECTION REPORT. v- Authorized fgnature BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT IX)CATION: 22540 MAIN RD ORIENT ~ OF OW-~ (S): JONATHILN M & NOREEN MUDD OCCUPANCY: ADMI'r£~u BY: ~Y A~FAII~%BLE: SUFF. CO. TAX MAP NO.: 18.-5-5 SOURCE OF p,~FEST: RUDOLPH BRUER ATTY 12/18/01 NO.: __ LOT (S) __ JONATHAN M & NOREEN MUDD ACCOMPANIED BY: DATE: 12/20/01 DWELLING: TYPE OF CONSTRUCTION: FO~gDAT I ON: TOTAL EOO~S: 1ST FLR.: __0 SA'r~L~.O0{{ (S): O. 0 PORCH TYPE: BREEZEWAY: DOMESTIC HOT~ATER: OTHER: # STORIES: CELLAR: 2ND FLR.: 0 TOII~T E00~ (S}: 0.0 DECK TYPE: FIP, EPLACE: TYPE HEA'£~K: ~a. RN AXR: H(Y14,IA'l'ISY.: 0.0 # EXITS: 0 3RD FLR.: 0 ~FrlLITY ROO~(S}: -- PATIO TYPE: ~R~ITION~G: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: SWI~ING POOL: OTHEE: ACCESSORY STOP, AGE, TYPE CONST.: GUEST, TYPE CONST.: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. INSPECTED BY: OHN M. BOUFIS ~ DATE ON INSPECTION: 12/19/01 TINE START: 10:00 AM END: 10:10 AM 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 requirement.s. 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 $%5.00, 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 ........ ~ .~../. · .~..~ .~..~ ........... ' ....... New Construction ........... Old Or Pre-existing Building,...~. Location of Property....~...~....~..~.P ..... .~..~.....~.~...;....~.'~ ...... House No. Street Hamlet 0nwer or Owners of Property... County Tax Map No 1000, Sect ion .... Subdivision .................................... Fzled Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................ Health Dcpt. ApProval .......................... Underwriters Approval ......................... Planning ~oard Approval ........................ Request for: Temporary Certificate ........... Final Certicate.~.. ....... Fee Submitted: $ .......................... EW YORK BOARD OF FIR'-:E,U:~DES~wRITERS THE N ,. ,.....,..: ~.195099 ,~ .' . . ' ,'~;, ,, ~ .; ,"-:: · 40 FULTON STREET, NEW YORK;,.~,~g03,,8:,.,' n-,. ,.a,.U~LI~'].' ~0 r '~ Application lvo. on jue ~ ',, : -,~, ", '~:3'; :~,,: HIS ES THAT ' ' ~ .... r ' ' T (;ERTIFI .............. ,.. tut: ' ~n'th~.~t~ov#'~P~Hcatt°n number ts in th~ pr~mises of ottly the electrical equipment as described betow aua uttroaucca o~ u,e .~.p.cant 'L~'~ ,~, 'c '~ ..... ,., ,~ ~'~ 30NATHAN MUDD, R?. 25, 0RZgNT, NY · ln the fotlowtng tocation; [] Basement [] lst FL [] 2ud FL ATTI¢'/.Q~, ." ,'' $~alon Block was cxamtn~ on AUGUST 24,1999 antt found to be in co~plfa.~ wtti~ t~Na~lO~l Electrical Cod~. . -- , ~ ~H WASHEll$ EXHAUST FANS ~ I~"1~'~ ~ I~ I II~ , I ~ ~::/i.. ~j;,?:,~'~ , -- '.', 3, !,.. L,:,'. *,' W'b-"LL PUHP-1 ,,,:.' ,.. ' ' '..,.. PADDLE FANS-9 :, "*' -';: ',. '* ,, G.F.C.I~-4 r':' , '.'.' : ;'' '*' SMOKE D~TECTOR'--7 :'"* ';~i ' "'"' ';" · ,.:., ::',, :.', ,' ,,,~ .... '::. ,,.':!. GRlggNPORT, NY, 11944-~38 , ~] GENERAL MANAGER ~ NER,, , CONSENT TO INSPECTION Owner(s) Name(s) do(es) hereby state: · the undersigned, of Southold located at That the undersigned (is) (are) the owner(s) of the premises in the Town , which is shown and designated on the Suffolk CountytaxmapasDistrict 1000, Section /~ , Block ~-. 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: 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 be used as evidence in subsequent prosecutions for vio- lations of the laws, ordinances, rules or regulations of the Town of Southold. Dated: [ ~/~0[0' ~(s~~ (signature) (print name)