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Home My WebLink AboutZ-23710FORM NO. 4 TOWN OF SOUTBOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICAT~ OF OCCUPANCY No E-23710 Date JUNE 16, 1995 THIS CERTIFIES that the building. Location of Property 2140 DEEP HOLE DRIVE House No. Street County Tax Map No. 1000 Section 123 Block 4 Subdivision Filed Map No. ONE FAMILY DW~T.T.ING ~TTIT~CK, N.Y. Lot Lot No. Hamlet 4.1 conforms substantially to the Requirements for a One Family Dwelling built Prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-23710 dated JDNE 16, 1995 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 & ACCESSORY STOI~AGE S~]gDS. * The certificate is issued to THOMAS A. PALMER (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PT~%SE SEE A'i"£ACHED INSPECTION REPORT. N/A N/A Rev. 1/81 LOCATION: ADHrl-rED BY: KEY AVAILABLE SOURCE OF RE~EST: SUBDIVISION NAME OF ONNER (s) THOHAS PALLOR OCCUPANCY A- l RES. (type) THONAS PALLOR BUILDING DEPARTHENT TOWN OF SOUTHOLD DOUSING CODE INSPECTION REPORT 2140 DEEPHOLE DRIVE MATT!TUCK, N.Y. (number & street) (municipality) HAP NO. LOT ( s ) THOHAS PALLOR O~IER (owner-tenant) ACCOHPANIED BY: SA_NE SUFF.C0. TAX HAP NO. 1000-123-4-~ DATE: HAY 19, 1995 DNELLING: TYPE OF CONSTRUCTION FOUNDATION CENENT BLOCK TOTAL ROOMS: ]ST FLRo BATHROOM (s) 2 PORCH TYPE SCREEH PORCH BREEZEWAY DOMESTIC HOTWATER YES TYPE HEAT OIL & ELECTRIC OTHER: WOOD FP. AI~ CELLAR 5 2ND FLR. TOILET ROOM (s) ~ STORIES I ~ EXITS CRAWL SPACE ALL 3RD FLR. UTILITY ROOM WASHER & DRYER BECK, TYPE PATIO FIREPLACE NO GARAGE NO TYPE HEATER ELECTRIC AIRCONDITIONING WARHAIR XX HOTWATER ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. SWIMMING POOL OTHER: STORAGE, TYPE CONST. · GUEST, TYPE CONST. 2 ACCESSORY SHEDS VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. REMARKS: BP ~22813-Z-C0 Z-23701 (LEAN TO ADDITION) DATE OF INSPECTION MAY 24, 1995 TIME START 9:20 END 10:00 Form No. 6 TOt,~N O~ SOUTI~O[D BUrI.D~C DEPARTHENT TOWN IIALL 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 H~hlth Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electricatl installation from Board of Fire Underwriters. 4. Sworn statement from/plumber certifying that the solder used in system contairs 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 th~ 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. 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. Certificate of Occupancy on Pre-existing Buildine - $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 House No. Street Hamlet Subdivision .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................. ilealth Dept. Approval .......................... Underwriters Approw~l ......................... :'lanning Board Approval ........................ ~equest for: Temporary Certificate ........... Fi~ . ....... ................ ;77 ................................................ · w $~"~OQ cj661 6 ^~. Owner(s) do(es) hereby state: CO? INSPECTION Name(s) }4A¥ 9 , the undersigned, That the undersigned (is) (are) the owner(s) of the premises in the Town County tax map as District 1000, Section W3 , Block ¢ , Lot ~ / That the undersigned (has) (have) filed, or caused to be filed, an applica- tion in the Southold Totem Building Inspector's Office for the following: 0. o. -IL, ,d 70, T /?d-cP 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 ail, 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- l~s~o_f i~I Town of Southold. lations of the laws, ordinances, rules or regu (signature) /~ (print name) (signature) (print name)