The URL can be used to link to this page

Home My WebLink AboutZ-20209FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-20209 Date SEPTEMBER 11, 1991 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 5195 SKUNK LANE CUTCHOGUE N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 138 Block 2 Lot 4 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-20209 dated SEPTEMBER 11, 1991 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 * The certificate is issued to GLORIA NIXON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. Building Inspector Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location 5195 SKUNK LANE CUTCHOGUE, N.Y. number & street (Municipality) Subdivision Map No. Lot(s) Name of Owner(s) GLORIA T. NIKON Occupancy A -I Res. OWNER type (owner -tenant Admitted by: ROY DeMOTT Accompanied by: SAME Key available Suffolk Co. Tax No. 138-2-4 Source of request GLORIA T. NIXON Date DWELLING: SEPT. 6, 1991 Type of construction WOOD FRAME #stories 2 STORY Found, tion CEMENT BLOCK Cellar 1/2 Crawl space 1/2 Total rooms, 1st. F1 3 2nd. F1 3 3rd. Fl Bathroom(s) I FULL BATH Toilet room(s) ONE Porch, type Deck, -type Patio, type SCREENED 'ENCLOSED Breezeway Garage Utility room Type Heat OIL Warm Air Hotwater II Fireplace(s) ONE No. Exits 3 Airconditi.oning Domestic hotwater YES Type heater OFF BOILER Other ACCESSORY STRUCTURES: NONE Garage, type const. Storage, type const. Swimming pool Guest, type const. Other VIOLATIONS: Housing Code, Chapter 52 Remarks: BP #2468-Z/CO Z-1911 Inspected by: q Date of Insp. SEPT. 10, Time start 10:05 end 1991 10:20 OWN! 3 SEP — 61991 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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 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. 3.1 For existing buildings (prior to April 9, 1957) non -conforming uses, or buildings and "pre-existing" land uses: Arc-ura- e._survey of property showing all property lines, streets, building and unusual natural or topographic features. 27. 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. Certificate of Occupancy on Pre-existing Building - $100.00 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......................................... "ew Construction........... Old Or Pre-existing Building ................. Location of Property....~ �.�� .........r:l3.i Ji ..... r�� .............................. House No. Street Hamlet Onwer or Owners of Property..... c� �' /. /^"t .....-....:�:) :. x.ti:.......................... County Tax Map No 1000, Section......:. ... Block ........ =ti.......Lot ........ X: ............. Subdivision....................................Filed Map ............ Lot ...................... Permit No................Date Of Permit ................ Applicant ............................. Health Dept. Approval..........................Underwriters Approval......................... Planning Board Approval ........................ Request for: Temporary Certificate........... Final Certicate........... Fee Submitted: $..... ?�.q. m ................ Q, _Wc.106 8-6 ct �_, a0a01 v... �...../ ............ APPLICANT 'i 40 E Cb 0 E,- 25 t 0) I GAP. ERW� u s E LOT, - NOTE - L-07 NO'S, SLIOWN PE:F:F-Q_ TO "MAP CF r,iAf,7FAt.1 FAPt-145 I * 4 T 1 4 V' LOT 107 co r - Li 250-00 oi 01 0 LU 61 - - Dor-K LO 0 Ln o 49.5 I GAP. ERW� u s E LOT, - NOTE - L-07 NO'S, SLIOWN PE:F:F-Q_ TO "MAP CF r,iAf,7FAt.1 FAPt-145 I * 4 T 1 4 V' LOT 107 co r - Li 250-00 CONSENT TO INSPECTION t ;, �671c; �� j V1 Xcm,/ 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 A7/1/L' eId7 " which is shown and designated on the Suffolk County tax map as District 1000, Section .13 F Block Lot 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 kno,. ledge 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: _ _ ��1 cam, 77 z76-%("-/ (signature) (print name) (signature) print name) BUILDI_'G DEP!,RT:•IE iT T0,•11,1 OF SOUTHOLD, N. Y. HOUSIi:G CODE INSPECTION REPORT Location (numoer do street Subdivision Name of Owner(S) Occupancy Ad,-nitted icip�i-ty clap No. Lot (s ) 1 /&0. (tYP e by: -9 — Accompanied owner -tenant) by: _ Key availableSuffolk Co . Tax No .-. ` 7 Source of request Date MTELLI: TG : Type of cons uction Ustories Foundation Cellar '�� Crawl space y Total rooms, 1st. Fl 2nd. Fl 3rd. F1 Bathroom(s) Toilet room(s) �, Porch, type Deck type Patio, type�� Breezewa Y Garage Utility room Type Heat Warm Air Ho twat er ,r..'� Fireplaces) No. Exits Aircond'tioning_ Domestic hotwater Type heater Other ACCESSOR`i STRUCTURES: Garage, type const. Storage, type const. Swimming pool Guest, type const. Other VIOLATIONS: CHAPTER 45—N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE - Remarks • �l � %�(�°Zz � � � (911t Inspected by: Date Time of Insp. start le r