HomeMy WebLinkAboutZ-24178FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
EXISTING
u~KTIFICATE OF OCt;umANCY
No
Z-24178 Date FEBRUARY 22¢ 1996
THIS CERTIFIES that the building
Location of Property 13075 SODIlD A¥~UB MATTIT~CK~ NEW YO~K
House No. Street Hamlet
County Tax Map No. 1000 Section 141 Block 4 Lot 8.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Requirements for a Commercial Building built
Prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z-24178 dated FEBRUARY 22~ 1996
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 ~CIAL BUILDING WITH DENTIST OFFICE *
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 ATT~,:~- INSPECTION RMPORT.
B~.~T & VICTORIA SUNSHINE
X/A
N/A
'7~dn/gin~s-pector
Rev. 1/81
I.OCATION: 13075 SOUND AVEI~u-E
(number & streeL)
SUIII)[V IS ION HAP NO.
NAME OF OWNER (si ~BERT A. & VICTORIA S~SHI~
BU I LDING I)I~I'AItTHENT
TOWN OF SOUTII(II,I)
IIOUS1NG CODE 1HSPEC'I'LON REPORT
~I~CK ~ ~
(~pality)
~.o'r ( s )
OCCUPANCY CO~4ERCIAL BUILDIHG
AI)HUi'TED BY: ALBERT SUNSHINE
KEY AVA [LAIII.E
SOUItCE OF RE(}IIEST: ALBERT SUNSHI]NE
(owner-tena..L)
ACCOMPANIED I1¥: SALVE
SUrF.CO. 'FAX MAr NO. 1000-141-~-8.1
I)ATE: ~B. 6, 1996
'tYPE OF CONSTRUCTION
F(}UNIIAT I ON BRICK
TOTAl. ROOMS:
IIATIIROOH (si
PORCII 'FY PE
BREEZEWAY
DOMESTIC IIOT~A'FER
TYPE IIEAT LILCO GAS
OTIIER:
I S'r FI,R. 9
I
FRONT COVERED
YES
WOOD FRAI~ I STORIES 2 I EXITS 5
CF4.I,AR PARTIAL CRAWl. SI'ACE
2NI) Fi. lt. 5 3R1} FI.lt.
TOIl,ET ROOH (SI 2 UTI. I.IT¥ ROOM
flECK , 'rYPg PATIO
F 1REPI.ACE GARAGE
TYPE IIEATER LILCO GAS AIRCONDITION[NG
WARH AIR iIO'I~A'FER XX
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.
SWIMMING POOl.
OTIIEIt:
S'FORAGE, TYPE CONST.
, GIIEST, TYPE CONST.
ACCY IN NEED OF REPAIR
VIOLATIONS: CIIAPTER 65 N.Y. S'FATE UNIFORH FIRE PREVENTION & IIU'[I,D[NG CODE
I.OCATION
IJESCRIPT1ON
ART. SEC.
REHAIIKS:
INSPECTED IIY
I)A'I'E OF INSPECTION FEBRUARY 8, 1996
'riFlE S'FART 9:30 AI~ END 10:00 AH
TOWN OF SOUTHOLD
BUiLDiNG
TO~-N ~l'LLL
765-1802
.%PPLiCATiON FOR '=
~,R-.I=_CA_~z OF OCCU?.~NCY
This appiicazion must be filled in by :ypewrizer OR ink and submitted to the building
~nspector 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-disposa!(S-9 form).
3. Approval of electrical instal!etlon from Board of Fire Under~rriters.
Sworn s~atement from plumber certifying :hat the solder used in system contains
!ess chat 2/10 of !% 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 Aori! 9, ~,~/) non-conforming uses, or buildings and
.___~r~-exzs=mng land uses:
1. Accurate survey of pr?pergvj~shgwing all property lines, streets, building and
unusual natural or copograpkic features.
2. A properly completed application and a c, oons~n5 tO inspe~.~_signed by =he applicant.
If a Certificate of O~cuoancv ms denied, che Bui!diS¥inspector shall state the
reasons therefor in writing co che applicant.
3. Fees
. . - ' ' . , $~ 00,
!. Certificate of Occuoancv New ~we!!zng $25 O0 Additions to dwelling ~.
.~i~erations to dwelling $25.00, Swia~ing pool S25.00, Accessory building $25.00~
Additions to accessory building $25.00. Businesses $50.00.
2.Certificate of Occuoancy on Pre-~xis:inA Buildlnz - $100.00
3.Copy of' Certificate'of Occu~ $20.00
4. Uodated ~
. Cer .... ca~e of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
a=e .... .(e. ..... [R.R ................
New Construction ........... Old Or Pre-ezis~ing Build~ng.~ .............
Location of Property... [~.~).~.~-~ ' .~O.~. ~.~.~'~. ........... .~.~.~.1.~. · .~-~. · · ·
House No. Street Hamie~
Dnwer or Owners of Property..~.~.~.~...A~...~..%~.
ooo, 1 ..............
......... Block .............
~um~zv~_slon .................................... Filed Map .......... , .Lot ......................
Pe.-mic No ................ Date Of Permit ................ App!icanc .............................
Hea!zh Depz. Approval .......................... Unaez-~ .... rs ADorovat
__=nnmng Board Approval ........................
?~equest for: Temporary Certificate ........... Final Certicaze ...........
?ee Sui:m~itred: $ .............................
O,,zc. 5o 802, .
Oumer(s) Name(s)
do(es) hel'eby state:
CONSENT
TO
1 N.q P I-::CT ION
That the undersigned (is) (are) the ow,mr(s) of the premises in the Town
of Southold located at [~ W ~ OO~) ~ O~
~~~ __, which is shown and desif~nated on the Suffolk
County tax map as District 1000, Section , Block , hot
That the undersigned (has) (have) filed, or caused to be filed, an applica-
tion in the Southold Totem 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 nnd all buildings located thereon, to conduct sueb inspections as they may
deem necessary with respect to the aforesaid application, iimluding inspections
to determine that gnid premises comply with all.of the laws, ordinances; rules
and regulntions 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 }nay be used its evidence in subsequent prosecutions for vio-
lations of the laws, ordinances, rules or regulations of the Town of Southold.
(prillt na lrle)
(print name)
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