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Home My WebLink AboutZ-29026FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 29026 Date: 10/29/02 THIS CERTIFIES that the building SEASONAL DWELLING Location of Property 5610 MAIN BAYVIEW RD SOUTHOLD (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 078 Block 0004 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to wb_ich CERTIFICA~ OF OCCUPANCY ~ER Z- 29026 dated OCTOBER 29, 2002 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 SEASONAL DWELLING * (HAMLET) Lot 039 The certificate is issued to WILLIAM BURKHARDT (OWNER) of the aforesaid building. SuF~OIA~ COUNTY DEPARTME~Ff OF~RALTHAPPROVAL ELEc£RICALu~TIFICATENO. 1069428 PLUMBERS c~u~TIFICATIONDA'£~u3 *PLEASE SEE ATTACHED INSPECTION REPORT. Rev. 1/81 N/A 8/]2/02 N/A Aut-hor i zed/ignature BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT I~DCATION: 5610 MAIN BAYVIEW RD NAME OF OWNER (S): WILLIAM BURKHARDT OCC~IPANCY: SEASONAL SOUTHOLD MAP NO.: LOT (S) WILLIAM BURKHARDT ACC~)~pANIED BY: SAME ~ A%rAILABLE: SUFF. CO. TAX ~ NO.: 78.-4-39 SOURCE OF P~EQ~3EST: KATE CARPLUK, 5/28/02 DA~: 10/29/02 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 1.0 # EXITS: 1 FOUNDATION: CEMENT CRL~%R: FULL CP=~ SPACE: BAT]~ROOM (S): 1.0 TOILET RO(O(S): 0.0 UTILIT"f ROO~(S): ACCESSORY STRUCTURES: G;~AGE, ~"fPE OF CONST.: SWI~ING POOL: OTHER: ~ST, T"/~PE CONST.: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. P~%~KS: BP#2864~Z28773-(STOOP ADD) BP #28747Z-COZ-29025 (ALT.FRONT PORCH) 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 Department with the following: Bo 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. 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- $25.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. New Construction: Location of Property: Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Subdivision Old or Pre-existing Building: ~ (check one) .o se o. tre Ha~et Block ~ ~ Permit No. Date of Permit. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ / O q ,u. c o Filed Map. Lot: Applicant: Underwriters Approval: Final Certificate: ~"'"'"'~(check one) '~t Si~ 76S*1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION l ST [ ] ROUGH PLBG. [ ] FOUNDATION 2NO [ ] INSULATION [ ] FRAMING [ ]FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ~ Owner~ (s) Name(s) do(es) hereby CONSENT TO .' INSPECTION · , the undersigned, That the undersigned (is) (are) the owner(s) ~f the premises in the Town of Southoldloca~ed at ~{0 HM'~.~ , which is shoxm and desigm~ted on the~ffolk That the u~dersigned (has) (have) filed, 'or caused to be filed, an applica- tion in'th~ Sout~old To~ Bu~lfling lnspec[o~ .~ orrr.~ r.~ +h. tnllmvinff: Tha~ the u~der~ned do(es) hereby give con~en~ to the Build~ng Inspectors or the Town or Southold, to enter upon the above described property, including any and all buildings located thereon, to conduct such inspections as they may deem neeessar~ with respect to the aforesaid appllcation,._~cludmg~mspections' '" to determine that said premises compl~ with all or the laws, ordinances, rules and ~e~ulations~of the Town of Southold. The undersigned, in consenting to ~uch ~sp~ctions, do{es) so x~th the knowledge and ~nders~anding that any ~formation obtained In the conduct of such inspeetion~ may'be used aS evidence in subsequen~ p~osecutions for lations o~ the l~ws,~, ordinances, rules or re~lat~ of the Town or Southold. {prh~t name~ (signature)