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Home My WebLink AboutZ-22167FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-22167 Date THIS CERTIFIES that the building Location of Property 620 OAK DRIVE House No. County Tax Map No. 1000 Section 80 Subdivision FEBRUARY 26r 1993 ONE FAMILY DWELLING SOUTHOLDf NEW YORK Street Hamlet Block 2 Filed Map No. Lot 12 Lot Ne. conforms substantially to the Requirements for a One Family Dwelling built Prior to: APRIL 9~ 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-22167 dated FEBRUARY 26~ 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 DWVf.LINGWITHACCESSORYGARAGE * The certificate is issued to (owner). of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. Rev. 1/81 LAWRENCE PRESBY & ANO N/A Building Inspector LOCATION: BUILDING DEPAR~ENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT 620 OAK DRIVE SOUTHOLD, NEW YOP. K sUBDIvISION (number & street) NAME OF OWNER (s) LAWRENCE PRESBY &ANO (municipality LOT (s) OCCUPANCY A-! RES. (type) ADMITTED BY:. LAWRENCE PRESRY K~Y AVAILABLE sOuRcE OF REQUEST: 'OWNER (owner-tenant) ACCOIqPANIED BY: SUFF. CO. TAX MAP NO. 1000-80-2-12 LAWRENCE & ROSEMARIR PRESBY DATE:FEB. 23, 1993 DWELLING: TYPE OF CONSTRUCTION WOOD FRAME FOUNDATION CEI~NT BLOCK TOTAL ROOMS: IST FLR. BATHROOM (s) 2 PORCH TYPE BBEEZEWAY ~STIC HO'II,IATER ~S. I'YPE HEAT OIL 2ND FLR. 3 TOILET ROOM (s) DECK, TYPE FIREPLACE ONE TYPE HEATER OFF BOILER WARM AIR # STORIES !-1/2 # EXITS 2 CELLAR FULL CRAWL SPACE ~ 3RDFLR. I UTILITY ROOM PATIO, TYPE CONCRETE IN SIDE YARD GARAGE AIRCONDITIONING HOTWATER IIX OTHER: ACcEssoRY STRUCTURES: WALK la ULOSET$, BBQ ON PATIO ~CE, TYPE OF CONST, S~[NC POOL OTHER: 1-1/2 CAR. WOOD FRAME STORAGE, TYPE CONST. · GUEST, TYPE CONST. VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. 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 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and Upre-existing" land uses: 10 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 5. Temporar. y Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ............................... New Construction ........... Old Or Pre-existing Building. ................ Location of Property .... ~ ~? ................ g~.X.~.~.q~ .~.-..~ ......... ~--ff~ ~fi~.~. ......... . House No. Street ~ Hamlet Onwer or Owners of Property...~.~{~.~../~.q~..~.~ ..... ~l~.l~.....~..-.!7~'-~w~ ................... F.0 Bloc .. County Tax Hap No i000, Section ........... ........... Lot...~,~-, ............... Subdivision .................................... Filed Hap ............ Lot ...................... Permit No ................ Date Of Permit ....... ~. ....... Applicant ............................. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approyal ........................ Request for: Temporary Certificate ........... Final Certicate ........... APPLICANT. CONSENT TO INSPECTION Owner(s) Name(s) do(es) hereby state: · the undersigned, That the undersigned (is) (are) the owner(s) of the premises in the Town of Southotd located · which is shown and designated on the Suffolk County tax map as District 1000, Section yO , Block ~ , Lot /~ That the undersigned (has)_(_h~a_ye) filed, 'or caused to be filed· an applied- 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 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. '(print name)~ O'OZI - 'At..O~,.ll.O~, 'g · O~'O~ ,, 3A)~!CI 0 '3 ,. OZ,.II.OZ, 'N ~J. VAI~]d · )1'¢0 ,, ~0o