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Home My WebLink AboutZ-25675FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 25675 THIS CERTIFIES that the building DWELLING Date: 04/23/98 Location of Property 865 OLD SHIPYARD RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 064 Block 0005 Lot 020 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- 25675 dated APRIL 23, 1998 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 * The certificate is issued to ELAINE TAYLOR (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. Rev. 1/81 SUBDIVISION: BUILDING DEPARTMENT TOWN OF SOUTHOLD MAP NO.: LOT (S) NAME OF OWNER (S): ELAINE TAYLOR OCCUPANCY: SINGLE FAMILY ELAINE TAYLOR ADMITTED BY: SUSAN E. MADIGAN ACCOMPANIED BY: SAME KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 64.-5-20 SOURCE OF REQUEST: HENRY SAXTEIN. MARCH 24, 1998 DATE: 04/23/98 110011640 TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 0.2 # EXITS: 3 FOUNDATION: CEMENT BLOCK CELLAR: XX CRAWL SPACE: TOTAL ROOMS: IST FLR.: -1 BATHROOM(S): 1.0 PORCH TYPE: BREEZEWAY: 2ND FLR.: _I TOILET ROOM(S): 1.0 DECK TYPE: FIREPLACE: 3RD FLR.: _Q UTILITY ROOM(S): -- GARAGE: ONE CAR PATIO TYPE: DOMESTIC HOTWATER: XX TYPE HEATER: OIL AIRCONDITIONING: TYPE HEAT: OIL WARM AIR: HOTWATER: XX OTHER: ** PANTRY & MUD ROOM ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: SWIMMING POOL: OTHER: STORAGE, TYPE CONST.: GUEST, TYPE CONST.: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION i DEECRIPTION J ART i SEC i i i REMARKS: INSPECTED BY: DATE ON INSPECTION: 04/03/98 JOHN M. BOUFIS TIME START: 10:00 END: 10:30 Fora No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY MAR 25 A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or neva 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 10 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. B. 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. �. 5ees 1. Certificate of Occupancy -New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, accessory build::; $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 S. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date......................................... New Construction........... Old Or Pre-existing Building..... ?LXX........ Location of Property.., 865 Old Shipyard Lane Southold House No. Street Hamlet Onwer or Owners of Property ....... Elaine Taylor 20 County Tax ?dap No 1000, Section ...... 64 ...... Block .......5 ........ Lot ...................... Subdivision..., Founders Estates ..............Filed Map,,, _83. ..Lot....1�...I........... Permit No................Date Of Permit ................ Applicant..,Elaine Taylor Health Dept. Approval..........................Underwriters Approval......................... Planning Board Approval ....................:... Request for: Temporary Certificate........... Final Cercicate........... Fee Submitted: $...100.00 .................... fc�.kc S 3'13 v t':0_56 7S Elaine Taylor APPLIC,;NT CONSENT TO INSPECTION Elaine Taylor the undersigned, .._ Owner(s) Name(s)' do(es) hereby state: That the undersigned (is) (a ind the ownerO of the premises in the Town of Southold located at 865 Old Shipyard Lane, Southold, New York M which is shown and designated on the Suffolk County tax map as District 1000, Section 64 Bleck 5 Lot 20 That the undersigned (has) (harW filed, or caused to be filed, an applica- tion in the Southold Town Building Inspector's Office for the following: Letter of Pre -Existing Use 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 lags, 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 vio- 1 lations of the laws, ordinances, Darted! March 20, 1998 rules or regulations of the 'Town of Southold. (signature) Elaine Taylor (print name) "� 03/20/1998 08:46 5167347702 DEBOPAH D07Y ES0 PAGE 02 ,V OZ76 G•Zo'B 41 IN 04~ N 1d7 rtw N ti W,towenreured N OF oft M"Vmw totem" r M..Yi Mr ow. OYY�MM YMIw� Mid � N� xy r b M� 1MM�M M M� M rw..4 rr wi M M1�rMr h w OWN-. rrot r wwrl Nauss «riw�wt a.wa v ��.< roto ��d• fir�•LE*,. 4, IN * °� °,► c les •lyr. AieW !� • h •'; �� Mew t O� V � � BS7. •.4.vr.�ro�ry,.t�le►w.awr�aw,�,rr' ararrcY�o�s • fes'/dG'%LLA �E�/GLY .q�d t�'/la'✓.r"Xa�e' Lor• /os, A/Aw f;rwaF" Eis+g.✓r! 6�ts�C�ws2'I� 78��IC•MlI/l.I�d.K6_yGNV71N�iVT.rE �7.#'L �� ' AAAttif?I./t1,rtLLwWO %/lam' d" "WewAndo jr �MlVXA.t�CQ c�wYsviVf� zr�d� %M��r�9e � ,,��r��,�y►r BUILDING DEPARTMENT TOWN OF SOUTHOLD LOCATION: eq ,s number 6 str e SUBDIVISION NAME OF OWNER (s) OCCUPANCY Sr CODE INSPECTION REPORT is (municipality MAP N0. LOT (s) (type) (owner -tenant) ADMITTED BY: P1 ACCOMPANIED BY: S - KEY AVAILABLE SUFF. CO. TAX MAP NO../dem Sl-- ,�`- 2. y SOURCE OF REQUEST :�/a4_41 - fe!. j /90-7 DATE: DWELLING: TYPE OF CONSTRUCTION G!%'i!i�.,c.�. # STORIES # E%ITS FOUNDATION txa CELLAR /I' CRAWL SPACE TOTAL ROOMS: IST FLR. 2ND FLR.__ 3RD FLR. BATHROOM (s) TOILET ROOM ( s ) UTILITY ROOM PORCH TYPE -"""" DECK, TYPE PATIO, TYPE BREEZEWAY .. . FIREPLACEGARAGE- DOMESTIC HOTWATER I/ TYPE HEATER Q AIRCONDITIONING - _ TYPE HEATWARM AIR HOTWATER OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. STORAGE, TYPE CONST. SWIMMING POOL , GUEST, TYPE CONST. OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE REMARKS: INSPECTED BY: ,/. V DATE ON INSPECTION TIME START /OY-O END ID,'