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Home My WebLink AboutZ-24069FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING C~RTIFICATE OF OCCUPANCY No Z-24069 Date DECEMBER 7, 1995 THIS CERTIFIES that the building Location of Propert~ 310 OLD SHIPYARD ROAD House No. Street County Tax Map No. 1000 Section 64 Block 2 Subdivision Filed Map No. OWE FAMILY DWELLING SOu'£nOLD, N.Y. Hamlet Lot 49 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-24069 dated DECEMBER 7, 1995 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 OWE FAMILY DWELLING WITH ATTA~u GARAGE * The certificate is issued to DIANE E. SLAVONIK ( owner ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 310 OLD SHIPYARD ROAD -~number & stree~ SUIII) I V1 S lOt{ HAHE OF ()~HI':R (:~) BIII l.I) I t1(.; IH.,;I'AI('I'HI~ti'£ l'()~,/ti OF SOUTIIOLD Iff]US1NC, COI)E ItISI'ECTION REPORT SOIJTHOLD, ~ YORK (~unicipal ityJ HAl' HO. I.OT(s) . DIANE g. SLAVONIK ^DlqiTTEI) IIY: D]~/~d~l~ E. SLAVO~IK ACCOH[,^HIED BY'- KEY AVAII,AIH,F. ,qUFF.CO. TAX HAP HO. S()UI{CI'~ ()F EEq?I~,ST: DIAI~E E. SLAVONIK I)ATE: 12//+/95 l)~dEl,l,l ti(;: 'I'YI'Ir. OF CONSTRHCTION FOIINDATIOH TOTAl, I(OOHS: IIATIII{OOH ts) I'OI{CII TYi'E IIRI~.EZE~fAY I)OIqI:,ST lC IIO'i'~ATER TYPE IIEA'F OIL i~}OD FP. AI~ CEMENT BLOCK IST FLE. ONE ENCLOSED OIL ! S'FORIES I I EXITS CEI.I.AR FULL CRAUI, SI;ACE 2HI) F1.E. 3111) FI.R. TOIl,ET ROOH ts) UTII,ITY ]{()OH DECK, TYPE ' PATIO REAR BRICK i;'[I{I,:I'I.AC[~ Olt~ GARAGE OI'~l~ CAR TYPE IIF. A'fI~ I{ OFF Al RCONI}IT ION 1NG ~4ARH Alii IIO'IMATER' XX OTIIER: ACCESSORY STIIIICTUIH~S: GARA(;E, 'I'YPIr~ OF CONST. S~ 1 ~'t1'11 N(; POOl, O'I'IIE I{: S'FOIIAGE, TYPE COHST. , CUES'F, TYPE CONST. VIOI,AT1ONS: CIIAI'TE[{ 45 N.Y. STATE IINIFORH F'IRE I'IIEVEN'I'ION & IHJ'II,I)ING CODE LOCAT 1 ON DESCR1PTIOH ART. SEC. REtlA RKS: BP #918-CO Z-553 ALT I It,LI'CC'I'I(I) IIY I)A'IT: OF INSI'I,.'(:T1Otl DEC. 6, 1995 'I'IHF. START 9:30 kM El, ID lO:O0 Ali 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 Aoril 9, 1957) non-conforming uses, or buildings and i'pre-existi~g" land uses: 1. Accurate survev of property showing all property lines, streets, building and ~ natural or topographic features. 2. A properly completed~apRlication and a $onsent to inspec~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 Occupancy on ~r~-exis~n?_Duildin~ - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction ........... Old Or Pre-existing Buildin~ ................ Location of Property...~3Z~. .... ~: ~.. J~. [~.f~....~..~.' ............. ~O.~.~O.g.~ .......... House No. Street Hamlet Onwer or Owners of Property....~.i.~i.~.,..~.~..~.~.~i~ ................................... Coney 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 ........... Fee Submitted: $.~.~..~.~?.~ .................. .~.. ~/7~~~. C5 4x. 5033 ' ............... O~:mer(s) Name(s) do(es) hereby state: CONSENT TO INSPlgCTIOIN . the undersigned, That the undersigned (is) (are) the owner(s) of the premises in the Town //// , w~ich is shown and desiEnated on the Suffolk County tax map as District 1000, Section ~__, Block ,~L , Lot ~/? That the undersigned (has) (have) filed, or caused to be filed, an applica- lion in the Southold Tox~m 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, ineludlng any mid all buildings located thereon, to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that gaid premises comply with all. of the laws, ordinances, rules and regulations of the Town ¢f Southold. The undersigned, in consenting to such hmpections, do(es) so with the knowledge and understanding that any information obtained In the conduct of such inspections hmy he used as evidence in subsequent prosecutions for vio- lations of the laws, ordinances, rules o,' regulations of the Tmvn of Soulhold. Dated: (signature) {print name) (signature} (print name)