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Home My WebLink AboutZ-23078FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCcuPANCY No Z-23078 Date JUNE 30, 1994 THIS CERTIFIES that the buildin~ Location of Property 8985 MAIN ROAD House No. County Tax Map No. 1000 Section 31 Subdivision ONE FAMILY DWELLING EAST MARION, N.Y. Street Hamlet Block 3 Lot 17 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-23078 dated J~NE 30, 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 W1TH A~CESSORY STO~AGE PUMP HOUSE & BARN * The certificate is issued to of the aforesaid building. P~ELARANDOLPH (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *Pr.R~E SEE ATTA~D INSPECTION NEPORT. //Su flding Inspector Rev. 1/81 LOCATION: 8985 MAIN ROAD (number & street) SUBDIVISION NAME OF OWNER (s) PAMELA RANDOLPH BUILDING DEPARTMENT TOWN OF SOUTHOLD DOUSING CODE INSPECTION REPORT EASTHARION, NEW YORK (municipality) ~P NO. LOT(s) OCCUPANCY A-I RES. OWNER (type) (owner-tenant) ADMITTED BY: BARBARA CONDOM ACCOMPANIED BY: HUSBAND KEY AVAILABLE SUFF.CO. TAX MAP NO. 1000-31-03-1! SOURCE OF REQUEST: J. KEVIN McLAUGItLIN DATE: MAY 26, 1994 DWELLING: TYPE OF CONSTRUCTION WOOD FRAHE FOUNDATION TOTAL ROOMS: BATHROOM (s) PORCH TYPE BREEZEWAY DOMESTIC HOTWATER TYPE HEATER OIL TYPE HEAT WARM AIR OTHER: REAR ENTRY WAY I ST FLR. o.~ SCREEN PORCH REAR COVERED FRONT ~'ORUH FIREPLACE ~ STORIES 2 [ EXITS 3 CELLAR PARTIAL CRAWL SPACE 5 2ND FLR. 5 3RD FLR. TOILET ROOM (s) ONg UTILITY ROOM WASHER/DRYER DECK, TYPE WOOD PATIO 2 SEALED UP GARAGE i CAR AIRCONDITIONING HOTWATER X~ ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. STORAGE, TYPE CONST. SWIMMING POOL , GUEST, TYPE CONST. OTHER: SMALL GREEN HOUSE RENOVED I PUNP HOUSE I BARN STRUCTUKE I STORAGE SHED VJ=0LATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. [VING ROOM STOVEPIPE IS REMOVED BUT STOVE REMAINS IN LIVING ROOM. NYCRR PART I PERMIT REQUIRED W~N INSTALLED BEFORE USE. 1000 REMARKS: BP ~22152Z OPEN PERI4IT FOR HEW HEATING SYSTEM AND INSULATION TO BE INSTALLED. INSPECTED BY DATE OF INSFECTION 6/6/94 & 6/29/94 TIME START 10:05 END 10:55 10:20 to:J~ NAY 2 61994 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FORCERTIFICATE OF OCCUPANCY mo 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 "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 Buildinm - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential ~15..00, Commercial $15.00 ! ~ew Construction ........... Old Or Pre-existir~Building....~x..~ ........... oc tion of .... ................ ....... House No. ~ Street Hamlet Onwer or Owners of Property... ~-...~..SL~_ County Tax Map No i000, Section....~ ....... Block...~ ........... Lot..~. .................. Subdivision .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... ~__Final C~e~~ Fee Submitted: $ ...................... ' ...... ~f/ ~ ~ y / .................. C) do(es) hereby state: CONSENT TO INSPECTION 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 ~vith 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 rio- lations of the laws, ordinances, rules or regulations of the ~Tq. w4u of South( ~ignature) ( ] (print name) (signature) (print name)