HomeMy WebLinkAboutZ-26649FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
EXISTING
C~RTIFICAT~ OF OCCUPANCY
NO Z-26649 Date JUNE 28, 2000
THIS CERTIFIES that the building, ONE F~uMILY DWRLLING
Location of Property 1045 ORCHARD STP~ET ORIENT
House No. Street Hamlet
County Tax Map No. 1000 Section 25 Block 2 Lot 20.22
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--26649 dated J~NE 28~ 2000
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 DW~ING WITH ACCESSORY GA~AGE *
The certificate is issued to
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SE~ATTACHED INSPRCTIONREPORT.
WI~IAM & JOAN~ E. RICH III
N/A
N/A
N/A
//Bui~ing Inspector
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
NOUSING CODE INSPECTION REPORT
LOCATION: 1045 ORCHARD ST ORIENT
SUBDIVISION: MAP NO.: __ LOT (S) __
NA~ OF OW~ (S): WILLIA~ & JOANN~ E. RICN III
OCCUPANCY: R~SIDENTIAL WILLIAM & JOANNE E. RICH III
ADMITTED BY: WILLIAM RICE. JR. ACCOMPANIED BY: SAME
KEY AVAILABLE: __ SUFF. CO. TAX MAP NO.: ~ .......
SOURCE OF REQUEST: WILLIAM RICH. III. 10/9/99 DATE: 06/28/00
TYPE OF CONSTRUCTION: WOOD FRAME
FOUNDATION: STON~
TOTAL ROOMS: 1ST FLR.: ._.t
BATHROOM(S): 2.0
PORCH TYPE: FRONT ~CLOSED
BKEEZ~WAY:
DOMESTIC HOTWATER: YES
TYPE NEAT: OIL WARM AIR:
OTHER: ~ST. FLOOR SUNROOM (NO HEAT)
# STORIES: 1.5 # EXITS:
CELLAR: FULL CRAWL SPACE: __
2ND FLR.: ~ 3RD FLR.:
TOILET ROOM(S): 0,0 UTILITY ROOM(S): --
DECK TYPE: PATIO TYPE:
FIREPLACE: ON~ GARAGE:
TYPE HEATER: OIL AIRCONDITIONING:
EOTWATER: STEAM
SLATE
ACCESSORY STRUCTURES:
GABAGE, TYPE OF CONST.:
SWI~4ING POOL:
OTBER:
WOOD FRAME STORAGE, TYPE CONST.:
GUEST, TYPE CONST.:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION ] DESCRIPTION ~ ART.
SEC.
R~S: BP~13055Z-COZ13272(ADD) -BP~14296Z-COZ-26648(ADD)BP~25814Z-COZ-26519
l~ ~8782Z-O~7 ]62 (I/C ~) ~-27 ~63 ~~ ~)
INSP~ur=D BY: , DATE ON INSPECTION: 10/26/98
~Y J.~IS~ TI~ ST~T:
BLDG. DEPT.
'I'~VN QF SQUTHOL~)
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
'!pre-existing" land uses:
1. Accurate survey of property showing all property lines, streets, building and
unusual hatural 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.
Fees
i. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
3.
4.
5.
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
Certificate of Occupancy on Pre-existinR Building - $100.00
Copy of Certificate of Occupancy - = .25~.
Updated Certificate of Occupancy - $50.00
Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date ............. '/'" .........................
few Construction ........... Old Or Pre-existing Building ...... .~.' ........
Jocation of Property .... !~ ~.~. .......... ~.~..~..O~.r.~.....~--4..~. ........... .C5. ~] ~ .¥k..~. ..........
House No. Street Hamlet
)nwer or Owners of Property...~[~.).c~..~.-'b. .... .~..~.Cr.~...'~.>..~....~.~.~'.~..v~..~..~.-....~..J.~ ~
- (
]ounty Tax Map No 1000, Section...~.~..~..Block ..... .~.5.].~..Lot..I..~) ................
{ubdivision .................................... Filed Map ............ Lot ......................
~ermit No ................ Date Of Permit ................ Applicant .............................
{ealth Dept. Approval .......................... Underwriters Approval .........................
>lanning Board Approval ........................
[equest for: Temporary Certificate ........... Final Certicate ...........
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 Southold located at l(~ ~ (~'vff--~ d~-~ ~--~ 6 ~ ~ ~ ~
, which is shox~ and designated on the Suffo~
County tax map as District 1000, Section ~)~Bloek....~, 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 In the conduct of
such inspections ,may be used as evidence in subsequent prosecutions for
lations of the laws, ordinances, rules or regulation~e T~h~Southold.
(~-ignature)
(print name)
765-1802
-~ BUILDING DEPT.
INSPECTION
J [ I FOUNDATION l ST [ ] ROUGH PLBG.
[ ] FOUNDATION2ND [ ]INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
DATE
765-1802
BUILDING DEPT.
INSPECTION
[ ] FIREPLACE & CHIMNEY
DATE [:~ (~- ,NSPE~O,~ '~~
[ ] FOUNDATION 2ND [ ] I/NSULATION
[ ] FRAMING [ r../] FINAL
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION l ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
/ '-/ ~'_/~ INSPECTO~
DA
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