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Home My WebLink AboutZ-23525FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OFOCCUPANCY No Z-235~ Date MARCH 6, 1995 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 1020 ~OOSE CREEK LANE SOu'£~OLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 78 Block 8 Lot 3 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-23525 dated MARCH 6, 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 ONE FAMILY DWELLING WITH ACCESSORY 2 CAR GARAGE * The certificate is issued to WILMA SOLOMON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *Pr~%SE SEE ATTA~D INSPECTION REPORT. Rev. 1/81 N/A N/A N/A lding Insp~tor LOCATION: mo2o GOOSE CHEEK lANE (number & street) SUBDIVISION NAME OF OW~IER ($) WILMASOLOMON BUILDING DEPARTMENT TOWN OF SODYHOLD HOUSING CODE INSPECTION REPORT SOUTItOLD, N.Y. (municipality) MAP NO. LOT(s) OCCUPANCY SINGLE FANILY (type) ADMITTED BY: MR. SAM EPSTEIN KEY AVAILABLE SOURCE OF REQUEST: WlLMA SOLOMON (o~ner-tenant) ACCOMPANIED BY: SUFF.CO. TAX ~ NO. 1000-18-8-3 DATE: FEB. 17, 1995 DWELLING: TYFE OF CONSTRUCTION WOOD FRAI~ FOUNDATION CONCRETE TOTAL ROOMS: BATHROOM (s) PORCH TYPE BREEZEWAY FIREPLACE OOMESTIC HOTHATER YES TYPE HEATER TYPE ItEAT OIL WAKHAIR OTIi~R: REAR FOYER - BASF_~flgNT BILCO DOOR CELLAR ~uLL I ST FLR. 3 2ND FLR. 5 3RD FLR. ORE TOILET ROOM (s) ONE ENCLOSED FRONT - COVERED REAR DECK, TYPE ONE OFF BOILER ~ STORIES 2 ~ EXITS 2 CRAWL SPACE UTILITY ROOM PATIO GARAGE ONE AIRCONDITIONING HOT~IATER YES ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. SWL~MING POOL OTHF. R: 2 CAR CEMENT BLOCK STORAGE, TYFE CONST. , GUEST, TYPE CONST. VIOLATIONS: CtLAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. INSPECTED BY JOHN M. BOUFIS~~ DATE OF INSPECTION FEB. 24, 1995 Tll~g START 9:50 END 10:10 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 bnilding 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, 1957) non-conforming uses, or buildings and "pre-existing" land uses: i. 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. 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 $15.00-, Commercial $15.00 Date ..... . New Construction ........... Old Or Pre-existing ~uilding..,/..''''--''''~' A f' Location of Property[.~..~.....~,.C~?;.-;..~. House No. Street Hamlet Onwer or Owners of Property..~~.~...L~..O..~. ......................... n .Y. County Tax Map No 1000, Sectio ........... Block..'.~ ............ Lot ................... Subdivision .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Tcmporary Certificat~ ........... Final Certicate ........... ..... .... fi- cOrlc, wc~l] t~ 0 0 .~ 9~6 6.5 ,% \, , ..;vi,4 ~0~ OMON AT ~" ' ,, 1995 SCALE' ':,: '"~' e= Iron ~ip~ CONSENT "~ '' [995 TO INSPECTION :':. ? ': 7: Owner(s) Name(s) do(es) hereby state: · the undersigned, That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at · which is shown and designated on the Suffolk CountytaxmapasDistrict 1000, Section ?~, Block ~ , Lot d That the undersigned (has) (have) filed, or caused to be filed· an applica- tion in the Southold Totem Building Inspector's Office for the follo~ving: ~ 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 re,~ulations 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 rio- lations <~ i/ of the laws, ordin rices , rules or regulations of the Town of Southold. (signature}~--~' (print name) (signature) (print name)