HomeMy WebLinkAboutZ-23695FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PREEXISTING
CERTIFICATE OF OCCUPANCY
No Z-23695
Date JUNE 12, 1995
THIS CERTIFIES that the building
Location of Property 220 SKIPPERS LANE
House No.
County Tax Map No. 1000 Section 25
Subdivision
ONE FAMILY DWELLING
ORIENT, NEW YORK
Street Hamlet
Block 1 Lot 21
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-23695 dated ~u~E 12, 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 ACCESSORY TWO CAR GARAGE *
The certificate is issued to FLORENCE W. SMITH
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PT.~SE SEE ATTAc-K~ INSPECTION REPORT.
Rev. 1/81
N/A
N/A
Building Insp~ o~r '
LOCATION:
SUBDIVISION
NAME OF OWNER (s)
OCCUPANCY
ADMI-i-f~D BY:
KEY AVAILABLE
SOURCE OF RE~,UEST:
220 Skippers Lane
(number & street)
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
llOUSING CODE INSPECTION REPORT
Orient, New York
(municipality)
MAP NO. LOT(s)
FLORENCE ~. SMITH
SINGLE FAMILY
(type) (owner-tenant)
INGE FLYNN ACCOMPANIED BY: SAME
SUFF.CO. TAX MAP NO. 1000-25-1-21
KEVIN J. McLAUGHLIN, Al'r¥ DATE: MAY 23, 1995
DWELLING:
TYPE OF CONSTRUCTION
FOUNDATION CEMENT CELLAR
TOTAL ROOMS: IST FLR. 7 2ND FLR. 3
BATHROOM (s) 2 TOILET ROOM (s)
WOOD FRAME ~ STORIES 2 ~ EXITS:~.4
PORCH TYPE FRONT COVERED & PART SCREENED
~SIDE PORCH ENCLOSED
DOMESTIC HOTWATER YES
TYPE HEAT LILCO GAS
OTHER:
FULL
3RDFLR.
CRAWL SPACE
PANTRY
UTILITY ROOM
BECK, TYPE
FIREPMCE ONE
TYPE HEATER LILCO GAS
WARM AIR YES
~A.TIO
GARAGE
AIRCONDITIONING
HOTWATER
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.
SWIMMING POOL
OTHER:
2 CAR WOOD STORAGE, TYPE CONST.
· GUEST, TYPE CONST.
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
// JOHN M.
DATE OF INSPECTION MAY 25, 1995
9:15 9:45
TIME START END
NAY Z 3 1995
Form No. 6
TOI.IN OF SOUTIIOLD
BU [I.D lNG I)EP^RTI~IENT
TOI4N IIALL
765-1802
APPI, ICATION FOR CERTIFICATE OF OCCUPANCY
A. This application ,lust be filled in by typewriter OR ink and submitted to the building
inspector with tile following: for new building or new use:
1. Final survey of property with accurate location of ail buildings, property lines,
streets, and unusual natural or topographic features.
2. Final Approval from Ilehlth Dept. of water supply and sewerage-disposal(S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4.' Sworn statement fromiplumber certifying that the solder used in system contairs
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 th~ building.
6. Submit Planning Board Approval of completed site plan requirements.
B. 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 tile
reasons therefor in writing to tile 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 - $20.00
4. Updated Certificate of Occupancy - $50.00 .
5. Temporary Certificate of Occupancy - Residential $1.5.00-,. Commercial $15.OO
New Construction ........... Old Or Pre-existing Buildin~..c~..~..4.x~. ~..lv~-.o..,*w,~./10~-~'?-
o a,ion Property .... . .... .......................
House No, Street tlamlet
Onwer or O~ners ,.~ Property. ,.~¢-~, o¢ ~o~,~e_
:o.nty Ta× ~ap ~o ~000, Section..C2~...%.~..C~. .... Block...~..'..~. ....... ~ot...~..~.l~,..O~,~.. ........
Subdivision .................................... Filed Map ............ Lot ......................
?ermit No ................ Date Of Permit ................ Applicant .............................
!lealth Dept. Approval .......................... Underwriters Approval .........................
i'lanning Board Approval ........................
f~r:
Temporary Certificate ........... Final Cer~~d~'O'~''/~'f~'t~'~cTk~C~l'~'~'/~r-~/--'~-
~equest
ubmitte : ,../. ..................
Ovrner (s) Name(s)
do(es) hereby state: 6._~or,~_/.O~__k_~_-
That the undersigned (is) (~) the ~wner(s) of the premises in the Tom
of Southold located at ~ ~,g~.%, % ~ ..~, ~ ,
. which is shox~ and designated on the Suffolk
County tax map as District 1000, Section ~ , Block ( , Lot ~.~
That the undersigned (has) (haue) filed, or caused to be filed, an applica-
tion in the Southold Tox~ Building Inspector's Office for the follow.g:
That the unders~ned do(es) hereby give consent to the Build~g 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, ~clud~g 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 ~spections, do(es) so x~th the
knowledge and understanding that any ~formation obtained in the conduct of
such inspections may be used as evidence in subsequent prosecutions for vio-
lations of the laws, ordinances, rules ~~
or re~lations th f S old.
IF ~i~ature~ ~ I '
(signature)
(print name)
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