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Home My WebLink AboutZ-26750FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-26750 Date OCTOBER 20, 1999 THIS CERTIFIES that the building. STEUCYURE Location of Property 26481 MAIN RD. cuTC]{(:~-.-;CE, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 109 Block 2 Lot 13.6 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a Structure built Prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-26750 dated O~TOBER 20, 1999 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 BARN STRUCTURE WITH NO ELECTRIC The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED TH(~AS & LAURIE A. SANDE~3 N/A N/A Rev. 1/81 ~B~spector 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 building 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 qpre-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 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 Date ...~'.~...~.11 .~ ~ ................... / New Construction ........... Old Or Pre-existing Building..~. ............ Location of Property...~.~.~.J ....... /~.~...~..~ ................. ~ ........ House No. Street Onwer or Owners of Property....~q/Dmf~..P..~~..~.'.-~.~-~ .................... County Tax Map No 1000, Section...[.9.~. ....... Block ..... ~ ......... Lot..l.h'.¢ ............. 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: $ .... L~..%.~. .................. .............. ~:~,a.a...CO -'~-d/~ 75 0 APPLICANT CONSENT TO INSPECTION do(es) hereby state; · the undersigned, That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold looated at ,~4~ ~'~ rZO~ ~ ,~~ , which is shox~ and designated on the Suffolk Co~tx t~ m~ ~ ~i~t~iot ~000, Sec.on IO~ · ~o~ ~ , not ~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: 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 inspections0 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 regulations of the Town of Southold. Dated: (signature) (print name) 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION I ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY REMARKS: [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL DATE ..//~/~j/?? ,NSPECTOR~~/~ NOTE= LOCATION OF AI~JOINER$ WELLS AND CESSPOOLS BY OTHERS AND ARE NOT GUARANTEED. 8 - 25 - 1999 FOUNDATION LOCATION · well · well per Mop of Cr~ Lond ~ 4'I jHAU. laJN aelLy '1o IF~ I~lSC~ ~j~ LIS~D ~, AND ~O ~ ~I~EES ~ THE LENDING INSTITUTI~. ~UARANTEE~ AR[ JOB NO. 99 - 5S FILE NO. 711F SURVEYED FOR 'THOMAS AND LAURIE A. SANOERS SITUATED AT CU'TCHOGUE TOWN OF SOUTHOLD, SUFFOi..K COUNTY, NEW YORK SCALE !" = 50' DATE 3 - 2 - 1999 FILED MAP NO. DATE TAX MAP NO. I000 - 109 - 2 - 15.6 (REF. ONLY) DISK 197 HAROLD F. TRANCHON JR. P.C. LAND SURVEYOR SUCCESSOR TO WILLIAM G. MEIER