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Home My WebLink AboutZ-26502FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 26502 Date: 06/14/99 THIS CERTIFIES that the building DWELLING Location of Property PRIVATE RD. (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 012 Block 0002 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- 26502 dated JUNE 14, 1999 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 * FISHERS ISLAND (HAMLET) Lot 005.003 The certificate is issued to JANSEN NOYES JR, (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. N/A N/A N/A ~r Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD EOUSING CODE INSPECTION REPORT LOCATION: PRIVATE RD. SUBDIVISION: NAM~ OF OWNER (S): JANSEN NOYES JR. OCCUPANCY: R~SIDENTIAL ADMITTED BY: ~LF FISHERS ISLAND MAP NO.: __LOT (S) -- JANSEN NOYES ACCOMPANIED BY: KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 12.-2-5.3 SOURCE OF REQUEST: RICHARD F. LARK. ATTY 4/2/99 DATE: 06/14/99 TYPE OF CONSTRUCTION: WOOD FRAME FOUNDATION: CONCRETE TOTAL ROOMS: 1ST FLR.: ~ BATHROOM(S): 4,0 PORCH TYPE= NONE BREEZEWAY: DOMESTIC HOTWATER: TYPE HEAT: OIL OTHER: 2ND FLR.: __~ TOILET ROOM(S): DECK TYPE: FIREPLACE: ~ YES TYPE HEATER: ~ WARM AIR: # STORIES: 1.5 # EXITS: CELLAR: 25% CRAWL SPACE: 3RD FLR.: __~ 1.0 UTILITY ROOM(S): -- NONE PATIO TYPE: GARAGE: UNDERNEATH HOUSE AIRCONDITIONING: HOTWATER: ACCESSORY STRUCTURES: GARA=E, TYPE OF CONST.: SWI~4ING POOL: INGROUND * OTHER: STORAGE, TYPE CONST.: GUEST, TYPE CONST.: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. I SEC, REMARKS: *BP ~8508Z - COZ-26502 INGROUND SWI~4IN~ POOL.FENCE & DECK INSPECTED BY: '- '-~ __ DATE ON INSPECTION: 04/20/99 TIME START: END: Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FORCERTIFICATE 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 VpreTexisting" 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 $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-existinR Buildinm - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction ........... Old Or Pre-existing Building ..... ~ ........... Location of Property ........... ~gb~ .q~. ~ .q~ .M. 9~P. ~qg~ ........ ~~ .~ ...... House No. Street Hamlet Onwer or Owners of Property...~q~9¥~,..~: ........................................... County Tax Map 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 ........... Final Certicate....X. ...... Submitted: ................. . . . ........ ''~f'"'"" ~APPhIC~NT Jan~n NoyeS, Jr. CONSENT TO INSPECTION JANSEN NOYES, JR. , , the undersigned, Ortner (~) Name(~) do(es) hereby state: That the undersigned (is) (~E~) the owner(~) of the premises in the Tovrn of Southold located at Right of Way off Main Road, Fishers Island, New York , which is shown and designated on the Suffolk County tax map as District 1000, Section 12 , Block 2 , Lot 5.3 That the undersigned (has) (~m) filed; 'or caused to be filed, an applica- tion in the Southold Town Building Inspector's Office for the following: __ Certificate of Occupancy on Pre-existing Buildin9 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: (s ~gnal~r e~/ ' Jansen No~;es, Jr. (print name) (sianature) (print name)