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Home My WebLink AboutZ-27220FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 27220 Date: 07/28/00 THIS CERTIFIES that the building Location of Property 36960 MAIN RD (HOUSE NO.) County Tax Map No. 473889 Section 097 Subdivision Filed Map No. __ DWELLING CUTCHOGUE (STREET) (HAMLET) Block 0003 Lot 005 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- 27220 dated JULY 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 DWELLING WITH ACCESSORY GARAGE * The certificate is issued to DORIS B RICHMOND (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. N/A N/A N/A '~/Aut~gnature Rev. 1/81 LOCATION: $6960 ~AIN RD SUBDIVISION: NAME OF OWNER (S): DORIS B RICHMOND OCCUPANCY: RESIDENTIAL ADMITTED BY: ROBERT WILLIAMSON KEY AVAILABLE: SUFF. CO. TAX MAP NO.: SOURCE OF REQUEST: J~3DITH R. WILLIAMSON 6/21/00 BUILDING DEPARTMENT TOWN OF SOUTEOLD HOUSING CODE INSPECTION REPORT CU~CHOGUE MAP NO.: __ LOT (S) __ DORIS B RICHMOND ACCOMPANIED BY: SAME DATE: 07/28/00 TYPE OF CONSTRUCTION: WQQD FRAME # STORIES: 1.5 # EXITS: $ FOUNDATION: STONE & CEMENT BLOCK CELLAR: 1/3 CRAWL SPACE: 2/3 TOTAL ROOMS: 1ST FLR.: ~ 2ND FLR.: ._~ 3RD FLR.: ._~ BATHROOM(S): 1.0 TOILET ROOM(S): 1.0 UTILITY ROOM(S): __ PORCH TYPE: DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: ONE GARAGE: DOMESTIC HOTWATER: YES TYPE HEATER: ~ AIRCONDITIONING: TYPE HEAT: OIL WARM AIR: XX HOTWATER: OTHER: ACCESSORY STRUCTU!~ES: GARAGE, TYPE OF CONST.: SWI~4ING POOL: OTHER: WOOD FRAME 1 CAR STORAGE, TYPE CONST.: GUEST, TYPE CONST.: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION ~ DESCRIPTION ART. REMARKS: DATE ON INSPECTION: 07/27/00 TIME START: 9:45 AM END: 10:00 AM TOWN 0i: SOUTllOLD B.U ILI) i~G DEPARTHENT TOWN BALL 765-180£ APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OE 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 ali buildings, property lines, streets, and unusual natural or topographic £eatures. 2. Final Approval from Health Dept. of water snpply and sewerage-disposal(S-9 form). 3. Approval of electrical instatlatien from Board of Fire Underwriters. 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. 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 Qccupancy on Pre-existing Buildin~ - $100.00 3. Copy of Certificate of Occupancy - _ .25~. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction ........... Old Or Pre-existing Building...X~. ............. Location of Property.R. :P.'.~.! ,..B.o.x...1.2.1.,...C.u.~.qh..o~!..e. ~..I~.....1.1.9.3.~...(.C.o.r.l~..e.~..~. ~. ~1~.. House No. Street Hamlet and Main Road) Onwer or Owners of Property Estate of .D.~).r.i.s. B, .R.~:~o.r~l,..J.~l~.t~% .Il,. ~I~]~i~4B~O~ ...... - "' County Tax Map No 1000, Section....9]. ........ Block....3 ............ Lot ..... ~ ................ Subdivision...~.o..t..a~.~.l.i.c.a.b..1.e ................. Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $..1.0.0.: .0.0. ......... ~ .......... .. ................. ~'~"~.~ 5 ~[ ~ H ~ ~/ -- APPLICANT CONSENT TO INSPECTION ESTATE OF DORIS B. RICHMOND, Judith R./Williams°n' Executrix · the undersigned, Owner(s) Name(s) do(es) hereby state: That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at R.D.#I, Box 121, Cutchogue, I~/ 11935 (Corner of Skunk Lane and Main Road); · which is shown and designated on the Suffolk County tax map as District 1000, Section 97 , Block 3 , Lot 5 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:__ ¢ Certificate of Occupancy on pre-existing building 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 tations of the laws, ordinances, rules or regulations of the Town of Southold. -/ (sighatur e) -- (p~int name) (siena{ute) (print name) 0 O~ /