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Home My WebLink AboutZ-19170FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-19170 Date JUNE 26~ 1990 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 45195 MAIN ROAD House No. Street County Tax Map No. 1000 Section 75 Block 2 Lot 4.1 Subdivision Filed Map No. Lot No. conforms substantially to the requirements for a private one family dwelling built prior to: APRIL 9~ 1957 pursuant to which SOUTHOLD~ N.Y. Hamlet CERTIFICATE OF OCC. #Z-19170 dated JUNE 26~ 1990 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 1 CAR GARAGE * The certificate is issued to THOMAS & MARGARET PII.T~S (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NO RECORD PRE EXISTING UNDERWRITERS CERTIFICATE NO. NO RECORD PRE EXISTING PLUMBERS CERTIFICATION DATED NO RECORD PRE EXISTING *PLEASE SEE ATTACHED INSPECTION REPORT. /~B6ilding ~nspector Rev. 1/81 ~5195 N~IN ROAD Location Subdivision N~me of Owner(s) Occupancy Ad, mitred by: Key ~vailabl e Source of request ! BUILDIHG DEP~dKT:.~NT '. T0':&I OF SOUTHOLD, N. Y. HOUSING CODE I~PECTION REPORT SO~THOLD, N.Y. ~numuer & s~ree~) l~lap No. THONAS & MARGARET PILLES AC (i,iuniclpali~y) Lot(s) THOMAS PILLES OWNER (owner- cenan~ Accompanied by: SAME Suffolk Co. Tax No. MARGARET PILLES - Dar e 75-2-4.1 6119/9o D%'~LLI~IG: Type of construction Foundation CEMENT BLOCK Total rooms, let. F1 WOOD F~ME #stories 2 Cellar 3/4 Crawl space !/4 4 2nd. FI 3 ~rd. FI Bathroom(s) I F~nL Porch, type FRONT SCREEN Breezeway Type Heat OIL Fireplace(s) Domestic hotwater Other Deck, type Garage. ! C~ ' Waz-m Air No. Fzcit s 2 OFF BOILER SIDE ENTRY WAY, LAUNDRY ROOM Toilet room(s) I Patio, type Utility room .Hotwater xx Airconditionin~ Type heater ACCESSORY STRUCTURES: NOrm Garage, type const. Swimming pool Other Storage, type const. Guest, type const. VIOLATIONS: --Location .CHAPTER 45--N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE DescriPtion -- --J-~r't-.'t Sec. Remarks: Inspected by: - GA J. Date of Insp. JUNE 5, 1990 'Time start 9:30 end 9:45 Form No. 6 TOWN OF SOUTHOLD 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 conta/ns 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 "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 Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 S. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ...... Z ........ New Construction .... ~ ...... Old Or Pre-existing Building ............... Location of Property..~J.~$ .............. '~~.~.~.~.(~ .... House No. Street /~ Hamlet '. ............ Onwer or Owners of Property. . XCt..¢.. County Tax Map No 1000, Section ..... 7.~ ...... Block...~ .......... Lot...~.'.~ ............... Subdi$ision Filed Map Lot Permit No ................ Date Of Permit ................ Applicant ............................. Realth Dept Approval Underwriters Approval Planning Board Approval ........................ Request for: Fee Submitted: .Temp°rary Certificate ........... Final Certicate ........... ............. . .... N 60.0 - - C PILLES CONSENT TO INSPECTION (DW-ner (s) Nam~ s) do(es) hereby state: · the undersigned, That the undersigned (is) (are) the owner(s) of the premises in the Town , which is shown and designated on the Suffolk County tax map as District 1000, Section ~-~ , 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 ~vith 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. (~ignature) (print-game)' ' '(s'ign-at u r~)' (print name)