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Home My WebLink AboutZ-22672FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-22672 Date OCTOBER 21~ 1993 THIS CERTIFIES that the building. Location of Property 1755 OLD ORCHARD ROAD House No. Street County Tax Map No. 1000 Section 37 Block 3 Subdivision Filed Map No. ONE FAMILY DWt~.LLING EAST MARION~ N.Y. Hamlet Lot 12.1 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-22672 dated OCTOBER 21~ 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 SEASONAL DWI~.LLING * The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PT~ASE SEE ATTACHED INSPECTION REPORT. Rev. 1/81 CLARA RICHARDSON & ORS N/A LOCATION: SUBDIVISION NAHE OF OWN3ZR (s) BUILDING DEPARTMENT TOWN OF SOU~{OLD tIOUSING CODE INSPECTION REPORT 1755 OLD ORCHARD RD. EAST I~ION, N.Y. (number & street) (mun£cipality MAP NO. LOT (s) CI~ RICl~SON & ORS. OCCUPANCY A-I RES. OWNER (type) ADMI'FrgD BY:. ANGIE JOHNSON KEY AVAILABLE SOUKC~ OF REQUEST: TItOMAS V. C_~TH (Owner-tenant) ACCOH1)ANIED BY: ANGIE JOHNSON SUFF. CO. T/~Y MAP NO. 37-3-12.1 DATE: JULY 22, 1993 DWELLING: TYPE OF CONSTRUCTION FOUNDATION cF~NT BLOCK TOTAL ROOMS: ]ST FLR. BATHROOM (s) 2 WOOD FRAME 2ND FLR. ] TOILET ROOM (s) ~ STORIES I-I/2 ~ EXITS 3 CELLAR CRAWL SPACE 3RD FLR. UTILITY ROOM PORCH TYPE FRONT COVERED RAISED CONCPaETE BREEZEWAY DOMESTIC HOTWATER YES. TYPE HEAT NONE OTtIE R: DECK, TYPE FIREPLACE TYPE HEATER WARM AIR PATIO, TYPE ONE GARAGE PROPAI~ AIRCONI)ITIONING HO~IATER ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. S~IMMING POOL OTHER: SCREEN HOUSE STORAGE, 1%PE CONST. · GUEST, TYPE CONST. VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION - DESCRIPTION ART. SEC. ~;Ag~f Flgll DATE ON INSPECTION TIME START 9:30 OCT. 21, 1993 ENO 9:50 FORM NO. 6 TOWN OF SOUTHOLD · Building Department Town Hall Southold, N.Y. 11071 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submit-ted -- .... to the Bu;Iding Inspec- tor with the following: tor new buildings or new use: 1. Final survey of properW 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 buildin0s 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 requiremunts where applicable. · For existing buildings (prior to April 1957), Non-conforming urns, or buildings and "pre-existing" land u~es: 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 per%inent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $25:00 -- ]tUSINES$ $50.00 2, Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancv $ 5,'00. over 5 years $10.00 4.Vacanl~ Land C.O. $ '20.00 5.u,odat a C.O. :'50.00 . Da,, ]99.3. nouse an(] gazebo , NewC°ns t'ruction Old orPre existing Building ~( Vacant Land Location of Properry 1.7.5.5 Old Orchara Rd., East .H,ari,on: N,,Y Hou~ No. Str~ut Ham/et Owner or Owners of Praperw Thomas Garth and others ,., County Tax Map No. 1000 Section . .3.7 ............ Block ..3. ............ Lot...12.:1.. ......... 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 ..................... Construction on above described building and permit able co'/es and regulations. A 'can .. " '~, Gary Flanner 01sen, Esq. n,,. m-~o.~s Main Rd. Thomas Garth CONSENT TO INSPECTION · the undersigned, Owner(s) Name(s) do(cs) hereby state: That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at 1755 Old Orchard Rd., East Marion, NY · which is show-n and designated on the Suffolk County tax map as District 1000, Section 37 , Block 3 , Lot 12.1 That the undersigned (has) (have) filed, 'or caused to be riled, an applica- tion in'th,~ Southold Tow~ lJuxlcling lnspeuc,.,~. '= o~t2..~, to.. +v,,. ~'cdlmvinff: house and qazebo (summer hous.e) see survey That thc undersigned do(es) hereby give consent to the Building Inspectors of thc Town of Southold to enter upon the above dcscribcd 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 o~ the laws, ordinances, rules and regulations of thc Town of Southold. Thc undersigned, in consenting to such inspections, do(cs) so w/th thc knowledge and understanding that any information obtained In thc conduct of such inspections may be used as evidence in subsequent prosecutions for vio- lations of the laws, ordinances, rules or regulations o[ thc Toxvn o[Southold. Dated: (signature) Thomas Garth (print name) (signature) (print name)