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Home My WebLink AboutZ-25340FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING C~TIFI~ATE OF Of A'UP/tNCY No Z-25340 Date OCTOBER 28, 1997 THIS CERTIFIES that the building Location of Propert~ 52645 MAIN ROAD House No. County Tax Map No. 1000 Section 63 Subdivision ONE FAMILY DWELLING SOuT~OLD, N.Y. Street Hamlet Block 5 Lot 14 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-25340 dated OCTOBER 28, 1997 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 OWE FAMILY DWELLING WITH ACCESSORY GARAGE * The certificate is issued to HELEN W. TERRY ESTATE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A *PLRASE SEE ATTA~D INSPECTION REPORT. I,OCATION: I~UI LI) I NG I)EPARTHENT TOWN OF SOUTIIOI,I) · HOUSING COI)E INSPECTION REPORT 52645 MAIN ROAD SOUTIiOLD, N.Y. -(number & street~j SIJI~I} [VIIS ION NAHE OF OWNER ts) HAl' NO. LOT(s) HELEN I~. TERRY EST. OCCUPANCY SINGLE FAHILY (type) (-owner: tenant ) ADI4ITTED BY: RENSSELAER G. TERRY ACCONPAN1ED BY: SANE KEY AVAII,ABI.E SIIFF.CO. TAX NAP NO. 1000-63-5-14 SOURCE OF REQUEST: PAUL CANINITI, A'n'I DATE: SEPT. 18, 1997 DWELLING: TYPE OF CONSTRUCTION FOIINI)AT ION BRICK TOTAl. ROONS: IST FLR. BATIIilOOH ts) 2 POItC{I TYPE SIDE SCREENED BItEEZEIJAY I)ONESTIC IIOTkIATER XX 'I'YPI! IIEAT OIL ¢)TIII!R: EILCO DOOR I{OOD FRAME { STORIES 2 { EX[TS 2 CEI.LAIt PART. CRAI4]. SPACE 4 2NI) FI.R. 4 3RI) FI.R. TOII,ET EOOH ts) ONE UT]I.ITY ROOH BECK, TYPE PATIO FIREPI.ACE ONE GARAGE TYPE UEATER LILCO AIRCONDITIONING I~ARH Alit I IO'I]4A'I'F.R XX ACCESSORY STRUCTURES: GAItAGI!, TYPE OF CONST. SM I fIHINg POOL O'I'IIEII: 2 CAR I~OOD STOEAGE, TYPE CONS'I'. · GUEST, TYPE CONST. VIOI.ATIONS: CIIAPTER 45 N.Y. STATE UN1FOI{fi FIRE PEEVENT1ON & I{UII.DING COI)E I.OCATION DESCRIPTION ART. SEC. DATE OF INSPECTION SEPT. 26, 1997 'i"lNl! START IO:20 END lO:~O Fo:m No. · 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUI kNCY BLDG. DEPT. TOWN QF SQUTHOLD' ~ This application must be filled in by typewriter OR ±nk and submitt'ed to the building inspector with the following: for new building or new use: 1. Final survey of _property with accurate location of ail 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. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. Submit Planning Board Approval of c~mpleted site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and Upre-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 $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory, building $25.00. Businesses.~ 2. Certificate of Occupancy on Pre-existinR Buildinm - ~100.00 ~ 3. Copy of Certificate of Occupancy - ~ .25¢. 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 Building ....... · ......... Location of Property .... ~ .~. ~..~.~. .......... . .~..~.~..~..~..~.~..~. ....... . .~..~..~. ,2~...~.. ,~. ........ House No. Street Hamlet Onwer or Owners of Property ........................... : ...................................... County Ta.. ~p No 1000, Section .... ~..¢. ..... Bloc~ ..... ,~ ........ Lot..AX ............... Subdivision .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval ......................... ,Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Cer=~/.._.~ Fee Submitted'~ $:,, /-~' ~l-~ ~ , ......................... ~.,~ C~,-z ~-~ ~ ~' o ...~_~_.~ ............. CONSENT TO INSPECTION Owner(s) Name(s) do(es) hereby state: · the undersigned, That the undersigned (is) (are) tile owner(s) of the premises in the Town of Southold located at ~-c~.~ ~d~'~ /z~/~,~/ ~c~&z c~--~OZ~'/ · which is shovm and designated on the Suffolk County tax map as District 1000, Section ~ , Block ~-- , Lot 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: __ o,, t 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 ii, at 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 ations o/fl't~~ of S or regulations o T ~ of Southold. (print name) CONTACT BECKY TERRY 0 765-3027 ~f~S~~ ~ ~ (signature) (print name) ~ddi~io~ "~ec~io n 7208 of the Ne~ Ya~ / to~a~. to acldi~ional ins~m~ions ~'