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HomeMy WebLinkAboutZ-13821FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED Certificate Of Occupancy No.. 213821......... Date .....September. 5 ............... 19 85 THIS CERTIFIES that the building ..One family dwelling ....................... Location of Property 405, Private Road #3.. Southold House Xio. Streei `. .haf; ei County Tax Map No. 1000 Section ? .......Block .....0 6 ........Lot .....015 . Subdivision ............... XX .............Filed Map No. ........Rt No. .............XX Requirements for a private one family dwelling built prior to conforms substantially to the AJ[0k3iMMi{6RTC6 aim ' p Certificate of Occupancy 213821 Ap r i .. 2 3 ...... 19 ? pursuant to which EiXYd1flWM h#B Vlo. ..... 3.. 1 ........... dated S q g t e m,b q r . 5 ............... 19 $ 5. , 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.......................................... The certificate is issued to ... GREGORY M& C A R O L E S. POWER (ownerX '9&")f ..................... 9& )...................... of the aforesaid building. Suffolk County Department of Health Approval ............... VA A ...................... . UNDERWRITERS CERTIFICATE NO .......... PENDING ................................ Update of Pre C.O. #211998 Building Inspector Rev. 1/81 BUILDI:C DE?:..?T:,U;iT T0.'4�i OF SCUT.IOLD, N. Y. HOUSI::G CC DE I113? :CT MI -RE-FORT Lcczzicn 405 Private Road #3 Southold �nummoer u szreec) (4'-iun1cipa! ity) Subdivision X iviap No. X Lot(S) X Name of O,::ner(s) Denise J. Deyer Occupancy R-1 unoccupied (type) olaner-zenan ) Admitted by:_Gregory Power Accompanied by: same Key available ' Suffolk Co. Tax No. 70-6-15 Source of request Gregory Power Date D., ,LLITNG: 10/18/83 Type of construction wood framed #stories 11 Foundation cement block Cellar Crawl space X Total rooms, 1st. Fl 4 2nd. Fl 2 3rd. Fl Bathroom(s) 1 Toilet roeri(s) Porch, type glassed in Deck, type wood patio, type Breezeway Garage Utility room Type Heat 'Harm Air iiot:.iater Fireplace(s) 1 No. axits 3 Airconditi.oning Domestic hotwater lbs Type neater gas Other ACC=SSCRY STRUCTURES: Garage, type const.` S1; i.. ming pool Other NONE Storage, type const. Guest, type const. VIOLATIONS: Housing Code, Chapter 152 Lncation Descrintion IArt. Sec. kitchen gas stove --no shut off IV +� 152-52-E bathroom no fresh supply for hot water heater LV 52-53-G, heat must be provided between 1st da of November thru 1st day of May V 52-53-A ,ear entranke & floor very springy ( 52-30-A )ath area THIS IS AN UPDATE OF PRE -CO Z5155, ISSUED MAY 18, 1973. Remarks: THIS DWELLING IS SUMMER OCCUPANCY ONLY. Inspected by: .t,1.� /1--��Dato of Insp. 10/ 18/83 Curtis W. HortoA Time start 2:15 end 2:30 L FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted W oMpiIIIIIIIIIIII1 to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal—(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non -conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 Q? �S Date ..... (� ........ New Building ............. Old or Pre-existing Building ... X ...... Vacant )Land ............. Location of Property �J J O, .o House No. Sir i Ham/et Owner or Owners of Property ... "..�6 .. St W� �, , , , , , , , , County Tax Map No. 1000 Section ...0_70 ..©_7 0 ...... Block .... Q(D ....... Lot ...0 5....... . Subdivision ............) ....................Filed Map No. . x ....... Lot No. ...)........ Permit No. ...X ..... Date of Permit ...%N ...... Applicant ...........x ..................... Health Dept. Approval ........................Labor Dept. Approval ........................ Underwriters Approval ........................Planning Board Approval ...................... Request for Temporary Certificate .....................Final Certificate ....................... Fee Submitted $............................. Construction on above described building and p(errmitmeets all applicably des and regulations. Applicant .... �,=k..�o R... :...OW:e C ................... Rev. 10-10.78 Owner s) do(es) hereby state: CONSENT TO INSPECTION ► A • (3�� �'P � ���e;�the undersigned, e(s) That the undersigned (2s) (are) the owner(s) of the premises in the Town of Southold located at t40 S '- 1 v �. -�,\oZ Co # 3 which is shown and designated on the Suffolk County tax map as District 1000, Section O�70 , Block ()Q�_, Lot 0 VS 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: on j 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 ofAASPev: Dated:� � (sig atur ) tA uj-e,/ (print n me) (signature) (print name)