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Home My WebLink AboutZ-24029FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OFO~uuPANCY No Z-24029 Date NOVEMBER 16, 1995 THIS CERTIFIES that the building Location of Property 555 MART.~N~ LANE House No. County Tax Map No. 1000 Section 143 ONE FAMILY DWELLING LAUREL NY Street Hamlet Block 3 Lot 27 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-24029 dated NOVEMBER 16, 1995 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 A ONE FAMILY DWELLING* The certificate is issued to RALPH THOMPSON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *P?~E SEE ATTACHED INSPECTION REPORT. N/A N/A N/A ldi~g Inspector Rev. 1/81 I,OC^'I'ION: `5`5`5 [La. RLENE LANE {m.uber ~ stree~J SIHIDIVISlON OCCIII'ANCY ~-I R~. AIJtlITTED IIY: CARL AUSTIN KEY AVAII.ABI.E OTv-NER ACCOHI'ANIEI) IIY: SI/FI:.CO. TAX HAP NO. 1000-1~3-3-21 · ';OUIICE ()F IHcqIIF';T' BLANCHE 'rHOMPSON I)ATE: I I / ! ............. :___2_ £L .................................................................................. I)I4EI,I, I Fl(;: 'I'YI'F. OF CONS'I'RtlCTIOtl T~OOD F~ ! STOl{lES ONE FOUNI)AT 1 OFf ClgI~EIN~ CI~.I,I.AR FULL CRAT41. TOTAl, I{OOHS: IST FI.l{. .5 2NIl FI.R. 3RI) lq.l{. llATIII~I}OH (s) ONE TOIl.ET ItOOH (~) IITII,IT¥ ROOH I'ORCII 'I'YPI~ IIECK, TYPE · I~ATIO IHH~I~.ZET~AY I? 1RI'~I'I.ACI~, NONE C. AItAGE I CAR I)OTIF.$TIC IIOTT4A'I'ER YES '!'¥1'1'] IIIgA'I'F.R OFF BOILER ^II{CONI)ITIOtlIN(; TYI'I~ IIl,'.A'l' OIL T4AIIH ^111 II[YI~4A'I'EI{' EXITS 2 OTIIEII: ACCESSOIIY STIHIC'IURI~S: (IAIIA(;E, 'I'YI'E OF CONST. · ';~ I [ltl I NG POOl. (}TILER: S'I'(}I{A(;E, 'I'YI'I~ CONST. , GUI~.q'I', 'I'YPI~ CONS'i'. WOOD FRAlqB SHED VIOI,A'I'IONS: CIIAI'FF.I{ 45'N.Y. S'I'ATI': IINIF()IIH FIItE PIHCVENT1ON & BUll.DING CODI~- I.OCAT ION DESCRII'TIOIt RF~tt^t~t'.fi: BPff2052-Z - CO#Z-1698 - (ADD) BP#2813-Z - CO#Z-2209 - (ADD) ART. SEC. ol;' '~t~spF. criott ] !/14/95 TIHI,: START 10:30Al~ END TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN I-~LL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submittud 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 aud 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 sire 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 et Occtq~an¢:y is denied, the Buildin?, incH)utter shall state the reasons therefor in writing to the applicant. 1. Certificate of Occupancy - Nuw dM¢lling $25.00, Additions to dw(~ILing $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory buildlng $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 .No~ember. 6,.~995 ........................ Old Or Pre-exi~rin~ Bu~lnh~oOne family dwelling with attached New Construction ..... ~j~7_~.~.~ .... .o ; ~,~ °b~'~h~'~6t~ahed shed Location of Proper[¥..~. ~rJ999, ~99.,. ~.'. 93[[ ...................................... Onwer or Owners of ProperEy.. Blanche A. Thompson County Tax Map No [OOO, S~,c~ion ..... 1.(~ ...... Block...~ ............ Lei 27 Subdivision .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................. Nealth Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate .... ./ ..... SAR~' FLANNER OLSEN, ESQ. / Fee Submitted: $ l~ UU I ~ - ....................... CONSENT TO INSPZCTION Blanche A. Thompson .~ _ ~ Owne~is'i~Name(~), do(es} hereby state: · the undersigned, That the undersigned (is) (are) the owner(s) dC the premises in the Town i of Southoldlocated at ~ Marlene Lane, ~, NY ...... --: . . ...... ,. which is shown and desi:natecl on the Suffolk County tax map as District 1000, Section 143 , Block 3 , Lot 27 . That the undersig~ed (has) (have) filed, 'or caused to be filed, an applica- tion in'th~ -~authold Town L{~lding lnsp~,~ .~ ~rr[~ r~ +h~ tnll~win~: .O_n,e family dwell ingwith.~_ttached qaraae and dotach~d._~hma. That the unders~ned do(es) hereby give consent to tile Building Inspectors o£ the Town o~ Southold ~0 enter upon the above described property, including any and all buildings located thereon, to conduct such inspections as they may deem necessar~ ~i~h re~pect to the aforesaid application, includ~'inspectlons to determine that staid premises comply with ~11 of the laws, ordinances, rules and reRulations of the Town of Southold. The underskgned, tn oonsentin~ to such ~spe~tion~, do(es) so ~th thQ knowledge mhd undermtanding that any ~formation obtained [n the condu:t of such inspections may be used as evidence ~n subsequmnl prosecutions for v~o- lations of ~ho laws, ordinances, rules or re~lations of the Town of Southold. (siEnatur~) Blanche A. Thompson ,5~I~ I~ ~ 40' ., I" MAP oF' LAND SURVEYED FOR RALPH W. THOMPSON ~T MA T TI TUO I< Town OF' ,-~OU'7"lqOI.-.O SUImI=OLK Cou/v'TY, iV. ~