HomeMy WebLinkAboutZ-23226FORM NO. 4
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
u~RTIFICATE OF O~.~uPANCY
No Z-23226
Date SEPTEMBER 15, 1994
THIS CERTIFIES that the buildin~
Location of Property 155 LAKE COUI~T
House No.
County Tax Map No. 1000 Section 59
Subdivision
ONE FAMILY DWELLING
SOuTuOLD, N.Y.
Street Hamlet
Block 5 Lot 8
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-23226 dated SEPTE~%~ 15, 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 F~MILY SEASONAL DW~.ING *
The certificate is issued to
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
H~BERT SONDE~tI u~%~R
N/A
N/A
N/A
Buildi
Rev. 1/81
LOCATION: 155 LAKE COURT
(number & street)
SUBDIVISION MAP NO.
NAME OF O~NER (s) HERBERT SONDERICI~R
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
DOUSING CODE INSPECTION REPORT
SOUTBOLD, NEI~YORK
(municipality)
LOT(s)
OCCUPANCY SINGLE FAMXLY SEASONAL
(type) (owner-tenant)
ADMI-rr~0 BY: NAUREEN WILINSKI ACCOMPANIE~ BY: SAME
KEY AVAILABLE SUFF.CO. TAX HAP NO. 1000-59-5-8
SOURCE OF REQUEST: HERBERT SONDERICKI~R DATE: JULY 5~ 1994
DNELLING:
TYPE OF CONSTRUCTION
FOUNDATION POST
TOTAL ROOMS: IST FLR.
BATHROOM (s) I
PORCH TYPE NONE
BREEZEWAY NONE
DOMESTIC HOTWATER YES
TYPE HEAT NONE
OTHER:
WOOD FRA}~ { STORIES 2 { EXITS
CELLAR NO CRANL SPACE
4 2ND FLR. 2 3RD FLR.
TOILET ROOM (s) UTILITY ROOH ATTACHED REAR
DECK, TYPE SIDE WOOD pA~'~IO
FIREPLACE NONE GARAGE NONE
TYPE HEATER AIRCONDITIONING
WARM AIR DOTWATER
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST. STORAGE, TYPE CONST.
SWIMMING POOL , GIJEST, TYPE CONST.
OTkIER: OUTSIDE SHOI/ER STAIJ. (STOCKADE FENCE ENCLOSED)
VIOLATIONS: CIIAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
REHARKS: BP {6065-Z-C0 Z-23224 (DORMER ADDITION) BP {19188Z-C0 Z-23225 (ALTERATION)
INSPECTED BY ~,
JOHN M. BOUFIS /
DATE OF INSPECTION SEPT. 15, 1994
TIME START 9:45 AM END 10:i5 AM
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN FLkLL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANC]
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, 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 $~.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-existinK Buildin~ - ~
3. Copy of Certificate of Occupancy - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
ate ............. .9. .................
New Construction ........... Old Or Pre-existing Building..~¢. .............
Location of Property...~. ~.. .... ~.~.~ ..... .C.~.~..~..T. .......................................
House No. Street Hamlet
Onwer or Owners of Property .... ~.~.~..~.....~.~.~.~.~.~.~. ............................
County Tax Map No 1000, Section...~.~ ...... Block .... .~..~. ....... Lot .... .~..~. .............
Subdivision .................................... Filed Map ............ Lot ......................
Permit No ................ Date Of Permit ................ Applicant ..............................
Health Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate ......... ,f..
.. . --
CONSENT
'FO
INSPECTION
/~Be~-]'~ ~-'e~'~/a~t~L. , the undersigned,
Oxmmr(s) Name(s)
do(es) hereby state:
That the undersigned (is) (are} the owner(s) of thc premises in the To~
of Southold located at ~ /~ ~ C~ ~-l
~00~$t¢ , which is shoxm and designated on the Suffolk
That the undersigned (has) (have) filed, or caused to be filed, an applica-
tion in the Southold Totem Buildinff 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 rio-
regulations of Toxvn o outhold.
(print name)
(signature}
g- /40 f
(print name)
Dated: