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Home My WebLink AboutZ-22912FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRM EXISTING ~ERTIFICATE OF O(~C~PANCY No Z-22912 Date MARCH 17, 1994 THIS CERTIFIES that the building ONE FAMILY Location of Property 850 ~O~NTY RD. ~48 & 75 BAILEY AV~. House No. Street Hamlet County Tax Map No. 1000 Section 34 Block 4 Lot 1.1 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-22912 dated M~RCH 17, 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 DW~LINGWITHATTA~ONE CAR GARA~E * The certificate is issued to ERNEST BTI?Z.~Y (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PENDING - MARCH 17, 1994 PLUMBERS CERTIFICATION DATED N/A *PL--%SE SEE ATTA~D INSPECTION REPORT. Rev. 1/81 // BUILDING DE I'A R~f?fENT TOWN OF SOUT~IOLD IIOUSINC CODE INSPECTION REPORT LOCATION: SUBDIVISION NAHE OF O~NER 850 CODNTY ROAD ~48 & 75 BAILEY AVE. GREENPORT, NEW YORK (number & street) (munic~patity MAI' NO. LOT ERNEST STILLEY & WIFE OCCUPANCY SINGLE FAHILY (type) ADMII~D BY:. MRS. STILLEY I~:Y AVAILABLE SOUKCg OF REQUEST: ERNEST STIIJ~Y fi/l/ER (o~-ner-tenant) MRS. STILLEY ACCOHPANIED ~y: SUFF. CO. T~ MAF NO. 1000-34-4-1.1 DATE: JAN. 2], 1994 DWELLING: ~ft'E OF CONSTRUCTION WOOD FRAME # STORIES 2' C-'I~NT'BLOCK & POURED CONCP. gTE FULL FOUNDATION CELLAR TOTAL ROOMS: IST FLR. '5 2ND FLR. 2 3RD FLR. BATHROOM (s) 2 TOILET ROOM (s) pORCH TYPE RgAR SCREEI~D CLOSF~cK, TYPE BREEZEWAY FIREP~%CE ! DO}~STIC H0~ATER XX TYPE HEATER 'LiLCO GAS TYPE HEAT LILCO GAS WARM AIR O~IER: ~u ~l~,~ UPS~a~K-~ ROOi~, PIPES CA~PED ~ # EXITS 3 CRAWL-SPACE UTILITY ROOM PATIO, TYPE REAR FLAGSTONE GARAGE I CAR ATTACHED AIRCONDITIONING HO~ATER ACCESSORY STRUCTURES: C,MIAGE, TYPE OF CONST. S~I~LMING POOL 0TIIER: STORAGE, TYPE CONST. · GUEST, TYFE CONST. WOOD F~ SHED VIOLATIONS: CI/APTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ,',.RT. SEC. REMARKS:~BP CO Z~!3635 ISSUED FOR ACCESSORY SHED' INSPECTED BY: ATE ON INSPECTION / ~' TIiE START 9:45 AM JAN. 25, 1994 END 10:15 AM Form No. 6 APPLICATION FOR CERTIFICATE OF OCCUPANCY TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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 i% 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 Eoard 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. 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 Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ...Jan~ar¥.2~.~994 ...................... New Construction ........... Old Or Pre-existing Building ................. . Location of Property. 850 .C.o.u.n.t.y. Road Greenport, N.Y. House No. Street Hamlet Onwer or Owners of Property ....... .~r~%% .S.t,iJ.l.e.y ............................................. County Tax Map No 1000, Section .... %% ........ Block...4 ............. L~t...1...1 ................. 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: $ ...... i~0.QO ................. APPLICANT ~ ,/ CONSENT TO INSPECTION Owner(s) Name(s) do(es) hereby state: That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at · the undersigned, · which is shmvn and designated on the Suffolk County tax map as District 1000, Section_~_~, Block t~ , Lot ], I · That the undersigned (has) (have) filed, or caused to be filed, an applica- tion in the Southold Town 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, 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 ali of the laws, ordinances, rules and regulations of the Town of Southold. The undersigned, in consenting to such inspections, do(es) so xvith the knowledge and understanding that any information'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. Dated: - (signature) (print name) --/ (signature) (print name)