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Home My WebLink AboutZ-16633FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE Certificate Of Occupancy No. z]6633 Date February 3, 1988 THIS CERTIFIES that the building ...0..n.c.. f. a..m.i.l.y...d.w.e. 1. 1..i.n.g. ...................... Location of Property 440 Midway Road Southold hi f sb hiol ....................... 's't/e i ....................... County Tax Map No. 1000 Section ...9.0 ........ Block .0. 2. ............ Lot 05 Subdivision ............................... Filed Map No ......... Lot No .............. REQUIREMENTS FOR A PRIVATE ONE FAMILY DWELLING BUILT cOnforms substantially to the l~l~ROalril~E~lilX$llRdlil~l'~rm~iEl~tfa~Rff$/~~~ CERTIFICATE OF OCCUPANCY PRIOR TO..Ap.r..i.1 .2.3. :..1.9.5..7... pursuant to which l~li~r~t{~RdlRiY~o. ,Z.1.6.6.3..3 .............. dated . .F.e.b.r..u .a.r.y...3 .,.. 1. 9. .8.8 ......... 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, accessory garage, guest house attached to garage. The certificate is issued toSUSAN C. RANSCHT ..................... /o¥,,'o;, ...................... of the aforesaid building. Suffolk County Department of Health Approval ......... .N./.A. ............................. UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED: N/A SEE ATTACHED INSPECTION REPORT Building Inspector Rev. 1/81 BUILDI?[G DEPART['LENT T0%'~[ OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location 440 Midway Road [num0er & s~reev) Southold (Fiunicipaiivy) Subdivision Map No. Lot(s) N~me of Owner(s) SUSAN C. RANSCHT Occupancy (type) A~mitted by: owner Key available Source of request A-Residential No ~ ~ owner- ~ enan~ ) Accompanied by: owner Suffolk Co. Tax No. 90-2-5 Susan C. Ransch~t' Date 10/20/87 DI'~LLI~: Type of construction Foundation Block Total rooms, 1st. FI Bathroom(s) 2 Porch, typ~ NONE Breezewa~ NONE Type Heat OIL Fireplace(s) Wood frame #stories I~ Cellar 25% Crawl space 75% 7 2nd. Fi 2 5rd. F1 Toilet room(s) Deck, type. Wood Garage 1 car 'Warm Air NO No. Exits Patio, type__ Utility room NONE Hotwater Airconditionin~ Domestic hotwater OFF THE BOILER Type heater Other ACCESSORY STRUCTURES: Garage, type const. WOOD FRAME Storage, type const. WOOD FRAME Swi.~ming pool NO Guest, type const. ATTACHED TO GARAGE Other IN GUEST HOUSE: BATHROOM, KITCHEN, LIVING ROOM, GAS HEAT VIOLATIOn,IS: Location Housing Code, Chapter 45 N.Y. State Uniform Fire Prevention & Buildin~ Code DescriDtion Art. I Sec. I, Remarks: Inspected ~ . by: _ Gary~Fish Date of Insp. ]0/27/87 'Time start 11:30 end 12 noon FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF C Instructions BLDG. DEPT. TOWN OF SOUTHOLD ;CU?ANCY A. This application must be filled in typewriter OR ink, and submitted m~ 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. (~For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty 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: Additions $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory ,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ..(~..d.~ .... .~./ ...... ./.?.?~ NewConstruction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . House No. Street Ham/et Owner or Owners of Property . . .~.~;~ ~ .... ~.....~ ~-~.~ .~..~.-T .......................... County Tax Map No. 1000 Section ..... ,~..~. ...... Block ..... .~, ........ Lot ...... "~7 ....... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. 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 permit meets all applicable codes and regulations. Applicant~¢¢¢~.-¢~ ~'~° ~'~--~~ Rev. 10-10-78 CONSENT TO INSPECTION c~ ~t& bi fi-, ~ ~ 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 Southold located at ~-h,'i) uoa? ~o ~-~ xfl q;>~ ~> · which is shown and designated on the Suffolk County tax map as District 1000, Section ~ C~ , 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 with the knowledge and understanding that any information obtained hu 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. Dated: (signature) (print name) (signature) (print name)