HomeMy WebLinkAboutZ-22661FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-22661
Date OCTOBER 15~ 1993
THIS CERTIFIES that the building ONE FAMILY DWRLLING
Location of Property 6645 PECONIC BAY BLVD. LAURRI,~ N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 126 Block 10 Lot 20
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-22661 dated OCTOBER 15~ 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 DWELLING & ACCESSORY GARAGE WITH BATHROOM *
The certificate is issued to
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLRASE SEE ATTACM~.D INSPECTION REPORT.
Rev. 1/81
JOSEPH P. SHERIDAN~ JR.
N/A
i%ding Inspector
LOCATION:
suBDIvISION
NAME OF OWNER (s)
BUILDING DEPARTmeNT
TOWN OF SOU~IOLD
HOUSING CODE INSPECTION REPORT
6645 Peeonic Bay Blvd.
(number & street)
JOSEPH P. SHERIDAN, Jr.
Laurel· N.Y.
MAP NO.
(municipality
LOT (s)
OCCUPANCY A-I Res.
(type)
ADMITTED BY:. ANGIEJOHNSON
KEY AVAILABLE
SOUKC~ OF REQUEST: JOSEPH SHERIDAN
(owner-tenant)
SAME
ACCOMPANIED BY:
SUFF. co. TAX HAP NO. 126-10-20
DATE: AUG. 4· 1993
DWELLING:
TYPE OF CONSTRUCTION WOOD FRAME
FOUNDATION cF~tENT BLOCK
TOTAL ROOMS: IST FLR. 5
BATHROOM (s) ONE
PORCH TYPE ENCLOSED
BREEZEWAY
2ND FLR.
TOILET ROOM (s)
DECK, TYPE
FIREPLACE NO
~ STORIES ONE # EXiTs TWO
CELLAR PARTIAL CRAWL SPACE
3RD FLR.
UTILITY ROOM
PATIO, TYPE BRICK
GARAGE
DOMESTIC U0~ATER TYPE HEATER
TYFE HEAT OIL WARM AIR
OTHER: WOOD STOVE (SEE AFFIDAVIT)
ACCESSORY STRUCTURES:
AIRCONDITIONING
HOTWATER
GARAGE, TYFE OF cONST.
SWIMMING POOL
I CAR WOOD FRAME WITH STORAGE, TYPE CONST.
BATHP. O(]~
· GUEST, TYPE CONST.
OTHER:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION D~SCRIPTION ART. SEC.
REMARKS: BP #21675Z-C0 Z-22660 ALTERATION TO PORCH
GARY~ F I SH
DATE ON INSPECTION AUGUST 17, 1993
TIME START 9:30 AMENI~ 9:55 am
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, 19_!~ non-conforming uses, or buildings and
"pr~_-exis~ting" land uses:
1. Accurate survey of j~roperty shQwing all property lines, streets, building and
unusual natur~or topographic features.
2.. A properly completed application and a consent to insp~ct signed by the applicant.
If a Certificate of ~pan~y~ denied, the Building Inspect'or 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~.~ of Occupancy on Pre-existing B~ui~lding
~,-~. Certificate - $100.00
3. Copy of Certificate of Occupancy - $5~00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $J5.0~, Commercial $15.00
New' Construction ........ ~... Old Or.Pre-existing B ilding ................. / '
Lo~ation
House No. Street Hamlet
County Tax Map No 1000, Section .... /~.~. ..... Block../.~.. .......... Lot. ~
Subdivision ................ Filed Map ............ Lot ......................
Permit No ................ Date Of Permit ................ Applicant .............................
Health Dept. ApProval .......................... Underwriters Approval .........................
Planning Board Approval .... ·
Request for: Temporary Certificate ........... Final Certicate ...........
/
l gPO
Fee Submitted: $ ........................
October 7, 1993
Building Department
Town of Southold
Southold, NY 11971
RE: 6515 Peconic Bay Blvd.
Laurel, NY
Dear Sirs,
I have owned the above mentioned property since November 30, 1977. The
home was purchased from Robert and Janet Bailey.
The current wood stove was in the house prior to my ownership. There have
been no alterations to said stove during the time of my ownership.
The undersigned makes these statements knowing that the town of Southold is
relying on these warranties.
NOTA,q¥ ?UBLIC OF NE~ JERSEY
CONSENT
TO
INSPECTION
Owner(s) Name(s)
· the undersigned,
do(es) hereby state:
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at ~5'~ b~' ~c o.o, c ~v/~
County tax map as District 1000, Section
· which is shown and deslffnated on the Suffolk
· Block , 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 vio-
lations of the laws, ordinances, rules or regulations of the Town of Southold.
Dated:
si~nature) ~
(print name)
POLL^I,<
,.._ 32':1:
8
HAP OF P~.OPF:_J~TY
SURVEYED FOR.
E~gL'LEVA I~.D
APPl2..O TO B[bkY AVE,
SCALE
Fi: PIONUMEN?
GUAP. ANTEED TO THE .5OUl HOLD SAVING.5
YAN T'UYL
C.~EE N PO~T, N,Y, '