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Home My WebLink AboutZ-23363FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-23363 Date NOVEMBER 21, 1994 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 1725 OAK DR.&520 WEST SHORE RD. SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 80 Block 1 Lot 49 Subdivision Filed Map No. Lot No. — conforms substantially to the Requirements for a One Family Dwelling built Prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-23363 dated NOVEMBER 21. 1994 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 GARAGE & PORCH * The certificate is issued to MARJORIE KRUEGER (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A *THIS UPDATED PRE CO Z-7309 DATED OCTOBER 18, 1976. 6L' 2" Ll-e4- C41uilding Inspector Rev. 1/81 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector 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 installations, a certificate of Code compliance from the Architect or Engineer responsible for the building. S. 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 in- formation required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Date�...L.C!...1.6.... New Building ................ Addition ................ Old or Pre-existing Building ... ........ Vacant Land .............. Location Of Property.i?.r.�.......y Owner Or Owners Of Property3......✓�4� e�%................,.................................. I� 3 Subdivision .......... G�B�.....................lY ........Lot No.............. Block No............. House No............. Permit No. ..... .-..... Date Of Permit .p ...........Applicant ... 1�......................................................... Health Dept. Approval .../� -.... Labor Dept. Approval y! .... .............. / ............................ ��rr nn Underwriters Approval ..............................................Planning Board Approval ....... 1...,�{ .................. Request For Temporary Certificate ........................................ Final Certificate .......... ......................... Fee Submitted$4................................. Construction on above described building and permit meets all applicable codes and regulations. Applicant .....................................`.. f/.) ................................................ Sworn to before me this �� ...... ..... day of .... ...... ... (stamp or 7.3 Notary Public ... ... ... .. .. .... County / V SENT BY:Xerox Telecopie.r 7020 G11-18-94_:.9:45AM i ALBANESE & FIORE- 516 765 1823# 3 • I Tp1dN Or SOLM101.6 IIUILDiNC IIiPARTMRN'r TOWN HALL ' gas-lal�i ' Mrrl.iCA?lAtl FOR GERTIirtCA , ot of;WMAMT •111 ,10 appllrOtiell must hVa filled it1 by typewriter OR ti1k tinct aubraitted A0 cl.e t,.sl III lsrA i.I pectelr W101 Uwe Fol�owinSl foi -now building or naves uoal 1. final wasvey of pr party with .accurate 7e►eatiott of All, bul.1_41111P.S..t.rt+prorty I,L.IrM. ,stsrworw, and +anuIta i nsstusal or topeSTAP11lc fent.vrfa. 2.' Fluei ACpeovpL ";r ftaaltl� Dopt. o! wwtor supply n11d 9OWGVAA". 1ftP-XA1 (l1-9 fdr4b) . A. Approval of exact: ee1 inwtallation from Board elf. Fire urtdarwr.i,ters. 4. sworn wuatemrnt •rc ri p,lambc-r certifying that the tsoldel: ' used in toys4teirl C-ontrrirts i.eww thew 2/10 of 2 lewd. 5. r'omr�rervi,al basldin . induattial building, multiple rerideuees and eiint'tr11r bs+i)diiit;n elsd lnatallalivlla. a cectifican. of Code Compliance from A1rchl,tecr or r11R1214nr rwwpeneirle ier eh building. f►. 0a.brltit rlanning So rd Approval of completed site pinis caquirement's. 1. fi,it abrletirlAg buildIngel (prier to April. 9. 1957) 11011-evil form Iris ttoon. or b61ldinvin 1111.1. •� "�'� rm-tteti•s land, uejlst I. Aeerursto purvey of prerperty chow!=` wll property .1 Lara. streets+, hui.10.1111sx r,nd wn0sutel natursl or topogrophie feotutay. 2. A properly eowplot d.application and s consent to ins+rect-aigned by the trppllrnut. 1! w cert#fico 'a o Qeaepancy is denied, the Ifuildins xnRt�a.:cor atln,t,t iltntr tl,r• resee11w therefor i writing to the applicant. 1. ' • artifieats et Ono posey- =•'Ileo dwelling tsMOO, AddAtiosta to awellins 02S.M. l tr Xerstions to dwe ling *25.00v 9wimmin g pool. $25.00. Accessorly bulldths $25.00. AR•fitiona to sct:ee ory building =25.00. 1lusineeastr $50.00. Y. Cotrtitleate of Oce 1peney on Pre-existing Nuildlins - $100.00 I. Copy of Certificat of•Occupan:y - $3.00 over S, yeArs - 4. 11pc1ated Certifiast of oacuponoY - $10.00 5. Temporary Certific to of Occupancy - RaaiderCiol $13.00, cowmercirax $15.00 veto NOV. 21 1994•• _ ...... lav r0 ffift"tlm........... 014 OT Pres-existing Buildiax.... %x........... Locati a''eof property... 17.2. .Oak. AxAge. and .5?0. Mot. 131%q3;g.3FPAA,..$0pjtA4j,4A,. lfvp .XgFk... . ft0uee� qes. Street Ilrsn►,1at i 1"wer or Oitwtwrs of Property • .... FiftiT�Q.�Y. �� ..... . . .... :... .. .'. . .. • . . . ... . . . ...:..... . Coultty IWM Sbp 110 A800, dation...... PP......Blor:k.... ? ..........latt':...:49 ..... _ .. _ .. .... . Dub dt.vl.a9som.................. Filed Moil ....... ..,..,.Lrrt.......... ......... Permit: me ................Da 0 Of. Parmf.t.........::.♦...Apellensst ........... ................... 11t1n1t11 OfteewAtC•OQi1.........................►.W1dIr�=�tAr• ApprOVAL......................... i P:d11r1l� ' !1 lard t teoval • • .......... r a .. • • • ••'Old! Pre—Rx1at _;Lng IIp Datled Pre-$]CiBEi nQ C/O Itomirst fort T4"orary Certificate........... Fina! Fry SubbIttail l....50.DA :..............'.... Thomas Hoffmann, Atty .................:_:.............................