HomeMy WebLinkAboutZ-23200FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICAT~ OF OCCuPANCY
No Z-23200
Date SEPTEMBER 7, 1994
THIS CERTIFIES that the buildin~
Location of Propert~ 7955 S~ulqK LANE
House No. Street
County Tax Map No. 1000 Section 104 Lot
Subdivision Lot No.
ONE FAMILY DWELLING
Block 4
Filed Map No.
cuTCHOGUE, N.Y.
Hamlet
23
conforms substantially to the Requirements for a One Family Dwelling built
Prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z-23200 dated SEP-£~a~BER 7, 1994
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 ATTA~D GARAGE*
The certificate is issued to
( owner )
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*P?.~%SE SEE ATTACHED INSPECTION REPORT.
Rev. 1/81
HAROLD & KA'£~L~EN SPREEN
N/A
N/A
N/A
' ~ Inspector
~Building
LOCATION:
SUBDIVISION
NAME OF OWNER (s)
7955 SKUNK LAI~
BUILDING DEPARTMENT
TOWN OF SOUTItOLD
HOUSING CODE INSPECTION REPORT
CUTCHOGUE, N. Y.
(number & street)
HAP NO.
HAROLD & KATIaI.F. EN SPREEN
(municipality)
LOT(s)
OCCUPANCY A-I RES.
(type)
ADMITTED BY:
KEY AVAILABLE
SOURCE OF REQUEST: KAT~LEEN SPleEN
O~IER
(o~ner-tenant)
ACCOMPANIE~ BY:
SUFF.CO. TAX HAP NO. 1000-104-4-23
DATE: AUG. 19, 1994
DWELLING:
TYPE OF CONSTRUCTION
FOUNDATION
TOTAL ROOMS:
BATHROOM (s)
PORCH TYPE
BREEZEWAY
DOMESTIC HOT~ATER
TYFE HEAT OIL
OT~ER:
WOOD FRAME
CEI~NT BLOCK
! ST FLR.
2 FULL BATHS
2 ENCLOSED
YES
CELLAR PARTIAL
2ND FLR. 3 3RD FLR.
TOILET ROOM (s)
DECK, TYPE
FIREPLACE ONE
TYFE HEATER OIL
WARM AIR XX
~ STORIES I-I/2 ~ EXITS
CRAWL SPACE PARTIAL
UTILIT~ ROOM
I~ATIO
GARAGE ATTACHED TO HOUSE
AIRCONDITIONING
HOT~ATER
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.
SWIMMING POOL
OT~ER:
STORAGE, TYPE CONST.
· GUEST, TYPE CONST.
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
REHARKS: BP ~3228-Z - CO Z-2793 ADDITION.
INSPECTED BY
DATE OF INSPECTION AUG. 31, 1994
TIME START 9:30 END 9:50
Form No. 6
TO~qW OF SOUTHOLD
BUILDING DEPARTMENT
TOWN IIALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
ao
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 lihes,
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, 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-existin~ Buildinm - $100.00
3. Copy of Certificate of Occupancy - $20.00
4. Updated Certificate of Occupancy - $50.00
5. T~mporary Certificate of Occupancy - Residential $15.00, Cgmmercial 515o00
New Construction ........... Old Or Pre-existing Building.....~. ...........
Location of Property. Z.~.7.°.-~.,.~.a~../ .... ~ ..................
House No. Street Hamlet
Onwer or Owners of Property ..~ ~ .~~, ~ .. ~ .......
· . .
County Tax Map No 1000, Section ...... %.~..,~'r~'.Block ..... ¥7 ......... Lot ...... ~..-~. ...........
Subdivision .................................... Filed Map ............ Lot ......................
Permit No ................ Date Of Permit ................ Applicant .......... · ...................
ilealth Dept. Approval .......................... Undcrwriters Approval .........................
~lanning Board Approval ........................
(equest for: Temporary Certificate ........... Final Certicate ...........
"ce Snbmitted: $ .............................
.
q ........... .........
O0 '-,
CONSENT
TO
INSPECTION
do(es) hereby state:
Narde(s)
· the undersigned,
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at 7 fizkJw'-~-- ~ ~K~/°~'~
which is shox~m and designated the Suffolk
on
County tax map as District 1000. Section /o~ . Block ~ . Lot ~ ~
That the undersigned (has) (have) filed, or caused to be filed, an applica-
tion in the Southold Toxxm Building Inspector's Office for the follow,g:
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 6f Southold.
Tile undersigned, in consenting to such inspections, do(es) so with the
knowledge and understanding that any iliformation 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.
/ (
signature) ~
(print name/
(signature)
(print name)
~ · .L O-1
- 'e ,,00,£0 ~1,"$