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Home My WebLink AboutZ-26813FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 26813 THIS CERTIFIES that the building DWELLING Date: 12/06/99 Location of Property 11920 MAIN BAYVIEW RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 088 Block 0005 Lot 028 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- 26813 dated DECEMBER 6, 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 WITH ATTACHED ONE CAR GARAGE * The certificate is issued to ROBERT MILLS OLSSON (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTI Rev. 1/81 SUBDIVISION: BUILDING DEPARTMENT 10C•1.^Idty WWYfltl1Y0(y•W MAP NO.: LOT (S) NAME OF OWNER (S): ROBERT MILLS OLSSON OCCUPANCY: SINGLE FAMILY ROBERT MILLS OLSSON ADMITTED BY: MILDRED NEUDECK ACCOMPANIED BY: SAME KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 88.-5-28 SOURCE OF REQUEST: ROBERT MILLS OLSSON 11/15/99 DATE: 12/06/99 TYPE OF CONSTRUCTION: WOOD PRAMS # STORIES: 2.0 # EXITS: 2 FOUNDATION: BRICK CELLAR: PART CRAWL SPACE: TOTAL ROOMS: IST FLR.: _A BATHROOM(S): 2.0 PORCH TYPE: BREEZEWAY: 2ND FLR.: _I TOILET ROOM(S): 0.0 DECK TYPE: 3RD FLR.: UTILITY ROOM(S): YES* FIREPLACE: ONE GARAGE: ONE CAR PATIO TYPE: SIDE SLATE DOMESTIC HOTWATER: YES TYPE HEATER: L.P. GAS AIRCONDITIONING: TYPE HEAT: L.P. GAS WARM AIR: XX HOTWATER: OTHER: * REAR MUD ROC ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: SWIMMING POOL: OTHER: STORAGE, TYPE CONST.: GUEST. TYPE CONST.: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE 19 N ".1 zi INSPECTED BY: of(r(/%—'e// / %,J_L9!fE/oi16L DATE ON INSPECTION: 11/30/99 M. BOUFIS / TIME START: 10:15 AM END: 10:45 AM 'LI!` 3 1999Lj 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. B. 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. CerLfica:,e 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 - Residentiaq $15.00, Commerciial $15/.000 Datef..�........ New Construction.....Y . .. 0 d Or Pre-existing Buil ngg/. ........�^ Location of Property.. ...... •'q/l)'7...... . /: /.�� ..........J.(1L�....... House No. Street Hamlet Onwer or Owners of Property...��rY .��r... �✓ KlIJY....................................0. County Tax Map No 1000, Section.... ....... Block... D—: ........ Lot .... if0................. Subdivisiony %....... Filed Ma� �6 �Lot.... ..............i Permit No ...Date Of Permit. (/.:��:.......Applicant444GJW 6/.`:N .. 7J/a/ylelj�[,0 ujL�'S Health Dept. Approval ...................... ..Underwriters Approval......................... Planning Board Approval ........................ I Request for: Fee Submitted: Temporary $.......................... Certificate........... Final Certicate...K....... 0V _- ... ........................................... C0 X46 Kj V APPLICANT CONSENT TO INSPECTION Robert Mills Olsson, the undersigned, Owner(s) Name(s) do(es) hereby state: That the undersigned (is)e) the owner ,(.R�of the premises in the Town of Southold located at 11920 Main Bayview Road, Southold which Is shown and designated on the Suffolk County tax map as District 1000, Section 088.00, Block 05.00 , Lot 028.000, That the undersigned (has) (ha e) filed, 'or caused to be filed, an applica- tion in the Southold Town Building Inspector's Office for the following: r PreExisting Certificate of Occupancy 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 deein 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, does 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: November (signature) Robert Mills Olsson t name signature print name LANp�G C6�D6D p Aj 2�Zo' Av 3/, Y DF reEas y a (I r t3 o. o 0 � Q v�ve os' ��t'T,rs�t• zoo � N a�•a� v KR M a G t Z 71 7295•F• � u o 0 0 �I.tlGEG 'rjhl4eES .Su�PVE'�-woe • .Po.�.er Mi��S O� s� '° �y �.e ��'i' y flB �ourswo.v y 'Joy>Nu/!P. �yF.toG C Lou t�Ty. IV' Y:RD.�t GU.�.e9ssvidEO Ta / 2oe�.eT MiLGg OL5✓a u , /t/O/zlHfo,�t.� �.q/u/r. �pEGot//G ��✓T.P'9lT% /cVo - 66- 10,!F - Zp 74eZCS 0 = /•ea,u AZpa- esu iLlilr� u�rA1c1•r�Nr TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: / �o?C� G�6►` e� number street municipality SUBDIVISION %MAP NO. LOT (s) NAME OF OWNER (s) OCCUPANCY 1>1 type c owner -tenant ADMITTED BY: G/�p� % �lC ACCOMPANIED BY: _ KEY AVAILABLE SUFF. CO. TAX MAP NO./gOOV SOURCE OF REQUEST: 6 t%o W4//,r Q/.S^ 'I DATE: / M-71op9 DWELLING: TYPE OF CONSTRUCTION �17G I'C-4 # STORIES C� # EXITS FOUNDATIONZ/ G CELLAR /riy%`" CRAWL SPACE TOTAL ROOMS: IST FLR. 2ND FLR. 3RD FLR. BATHROOM (s) TOILET ROOM (s) UTILITY ROOM 4414 PORCH TYPE DECK, TYPE - PATIO, TYPE /�iCi�-+► BREEZEWAY DOMESTIC HOTWATER FIREPLACE olk e-- TYPE HEATER L, P, GARAGE' - AIRCONDITIONING TYPE HEAT WARM AIR HOTWATER OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. SWIMMING POOL OTHER: STORAGE, TYPE CONST. GUEST, TYPE CONST. VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE REMARKS: INSPECTED BY: DATE ON INSPECTION TIME START Ia/ ' 1 1 END l Dl 1,A&6 _ S>,p _ s_ 2e TOWN OF SOUTHOLD PROPERTY RECORD CARD M-16 OWNER STREET^, �W VILLAGE DIST. SUB. LOT �0 bter mi'05 0/55toa Ma FORMER OWNER N E AC S _ W TYPE OF BUI,�DING 'e - RES. / SEAS. VL. FARM COMM. CB. MISC. Mkt. Value LAND D IMP. TOTAL DATE REMARKS 3 i, IV AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Acre Value Tillable 1 Tillable 2 Tillable 3 Woodland Swampland FRONTAGE ON WATER Brushland FRONTAGE ON ROAD House Plot DEPTH o 0 BULKHEAD Total DOCK -,,.e `o W77 I