The URL can be used to link to this page

Home My WebLink AboutZ-25762FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 25762 Date: 06/08/98 THIS CERTIFIES that the building DWELLING Location of Property 195 FISHERMANS BEACH RD CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 111 Block 0001 Lot 4].! 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- 25762 dated JUNE 8, 1998 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 ATTACHED GARAGE & STORAGE SHED * The certificate is issued to ANITA MARIE SAMUELS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPO~ Rev. 1/81 ~ N/A N/A N/A Building Inspector~/ ~ LOCATION: 195 FISBERMANS BEACH RD SUBDIVISION: NAME OF OWNER (S): ANITA MARIE SAMUELS OCCUPANCY: SINGLE FAMILY ADMITTED BY: MRS. SAMUELS KEY AVAILABLE~ SUFF. CO~ T;%X MAP NO.: _~[ ]~--]--4 ]. SOURCE OF REQUEST: THOMAS SAMUELS - JAN. 26. 1998 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT CUTCHOGUE MAP NO.: __ LOT (S) __ ANITA MARIE S~J~UEL$ ACCOMPANIED BY: SAME DATE: 06/08/9~ TYPE OF CONSTRUCTION: FOUNDATION: CEMENT BLOCK TOTAL ROOMS: 1ST FLR.: BATHROOM(S): 2.0 PORCH TYPE: FRONT BREEZEWAY: DOMESTIC HOTWATER: TYPE HEAT: OIL OTHER: * WASHER & OIL BURNER WOOD FRAME # STORIES: 2.0 # EXITS: { CELLAR: - - - CRAWL SPACE: ~ 2ND FLR.: ._~ 3RD FLR.: ~_~ TOILET ROOM(S): Q,Q UTILITY ROOM(S): * DECK TYPE: REAR & SIDE - WOOD PATIO TYPE: FRONT FIREPLACE: Q~ GARAGE: ONE XX TYPE HEATER: ~ AIRCONDITIONING: WARM AIR: HOTWATER: XX ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: SWIMMING POOL: OTHER: STORAGE, TYPE CONST.: GUEST, TYPE CONST.: STORAGE SHED VIOLATIONS: C~APTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION : DESCRIPTION : ART. SEC, REMARKS: BP #5776-~4938 (ADD) EP~-4~&48-Z-CO Z-14796 (~.WER~HOUSE) EOUFIS ~ ME START: LO:OO END ~ O0 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY -- BLDG, DEI~T,.-- t ~ OF $OLITHOI..D~ J 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 reqnirements. 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 - . .25~ 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ....................................... e o u d / N w C nstr ction ...... ~.O~d Or Pre-existing Buildin~ ................. Location of Property.--..'f~~.~.~...'~..'~..~.. .................. House No. Street Hamlet Onwer or Owners of Property.~~.~.~.~.~.~.~..~..~.i~ County Tax Map No 1000, Section. W~.3.~.~.~....Block.//.~ ........... not..<.'?..~..~. ............ Subdivision .................................... 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: $ ............................. ........ ............ ~f~ CC) 025 '7 ~'~'" APPLICANT (J CONSENT TO INSPECTION · 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 !~5~ ~ ~' County tax map as District 1000, Section ~'~ Block/// , Lot ). That the undersigned (has) (have) filed, or caused [o 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 vio- lations of the laws, ordinances, rules or regulations of the To~vn of Southold. (signature) (print name) I I '1