HomeMy WebLinkAboutZ-22588FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-22588 Date
SEPTEMBER 15~ 1993
THIS CERTIFIES that the building
Location of Property 40 FOUNDERS PATH
House No.
County Tax Map No. 1000 Section 64
Subdivision
ONE FAMILY DWELLING
SOUTHOLD e N.Y.
Street
Block 2 Lot 29.1
Filed Map No. Lot No.
Hamlet
conforms substantially to the Requirements for a One Family Dwelling built
Prior to: APRIL 9~ 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z-22588 dated SEPTEMBER t5~ 1993
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 DW~Y~,ING *
The certificate is issued to IRENE PETTIT & ANO
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*pr~ASE SEE ATTACHED INSPECTION REPORT.
Rev. 1/81
N/A
N/A
N/A
~ / ~/~uilding I~spector
LOCATION:
SUBDIVISION
NAME OF OWNER (s}
BUILDING DEPARTMENT
TOWN OF SOUT]IOLD
}lOUSING CODE INSPECTION REPORT
40 FOUNDERS PATH
(number & street)
1.11gl~ PETTIT & ANO
SOUTHOLD, N.Y.
(municipality
MAP NO. LOT (s)
OCCUPANCY ONE FAMILY RESIDENCE
OWNER
(type)
ADMI'I-rgD BY:. BETSY WIDIRS'£KY
KEY AVAILABLE
SOUKCZ OF REQUEST: BETSY WIDIRSTKY
(owner-tenant)
ACCOMPANIED BY: SAME
SUFF. CO. TAX MAP NO. 64-2-29.1
DATE: AUG. 26, ]993
DWELLING:
TYPE OF CONSTRUCTION FRAME
FOUNDATION BRICK
TOTAL ROOMS: IST FLR. '5
BATHROOM (s) I
TOILET ROOM (s)
~ STORIES I ~ EXITS 2
CELLAR CRAWL SPACE
3RD FLR.
UTILITY ROOM
PORCH TYPE CLOSED IN NO HEAT
BREEZEWAY
DOMESTIC H0~IATER ~
TYPE HEAT OIL
OTHER:
DECK,' TYPE
FIREPLACE
TYPE HEATER
WARM A~R
OIL
PATIO, TYPE
GARAGE
AIRCONDITIONING
HO~ATER XX
ACCESSORY STRUCTURES:
GARAGE, TYPE OF C0NST.
S~LMMING POOL
OTII~R:
STORAGE, TYPE CONST.
, GUEST, TYPE CONST.
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
REMARKS:
DATE ON INSPECTION SEPT. 8, 1993
TIME START 10:45 ENI~ !i:10
Form No. 6
TOWN OF SOUTtIOLD
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
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 emgineer
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 si~ned 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 - $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 .... ~ ..............................
New Construction ........... Old Or Pre-existing Building .... ~ ............
Location of Property .... ~qqq~.~ .... ~qq~ ~ ..... (~PYD~.P~.~9~.~9~] ................ '.
House No. Street Hamlet
Onwer or Owners of Property ....... ~X ..~t.k.y ............................................
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: Tempqrary Certificate ........... Final Certicate ...........
Fee Submitted: $ ....... ~OQ~QQ ................
APPLICANT·
CONSENT
TO
INSPECTION
Betsy Widirstky
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 Founders Path (corner of Korn ..St) Southold
, which is shown and designated on the Suffolk
County tax map as District 1000, Section . 64__, Block 2 , Lot 29.1
That the undersigned (has) (have) filed, or caused to be filed, an applica-
tion in the Sou~hold Town Building Inspector's Office for the following:
Pre- existing C/0
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.
(s hature)
_Betsy, Widirstky
(print name)
(si.&natu re)
(print name)