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Home My WebLink AboutZ-23063FORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No g--23063 Date JUNE 24, 1994 THIS CERTIFIES that the buildin~ Location of Propert~ 1125 MASON DRIVE House No. County Tax Map No. 1000 Section 104 Subdivision ONE FAMILY DWELLING CUTCHOGUE, N. Y. Street Hamlet Block 5 Lot 35 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-23063 dated JUNE 24, 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 DWELLING * The certificate is issued to EUGENE & DOLORES TRAVERS (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *P?.~%SE SEE ATTA~D INSPECTION REPORT. "/~7~ui~i/ng~i~nspector Rev. 1/81 LOCATION: 1125 NASON DRIVE (number & street) SUBDIVISION fLAP NO. NAME OF OWNER (s) EUGENE & DOLOR]iS TRAVERS BUILDING DEPARTHENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT CUTCHOGUg, N.Y. (municipality) LOT(s) OCCb-PANCY A-I RES. OWNER (type) (owner-tenant) ADMITTED BY: EUGENE TRAVERS ACCOMPANIED BY: SAHE KEY AVAILABLE SUFF.CO. TAX M_AP NO. 100u-i0~-05-35 SOURCE OF REQUEST: EUGEN~ & DOLORES TRAVERS DATE: ~ 16, 1994 DWELLING: TYPE OF CONSTRUCTION FOUNDATION CF~I~NTBLOCK TOTAL ROOMS: IST FLR. BATHROOM (s) ONE PORCH TYPE FRONT ENCLOSED BREEZEWAY DOMESTIC HOTWATER YES TYPE HEAT OIL OT~R: WOOD FRAME { STORIES OHE { EXITS TWO CELLAR PARTIAL CRAWL SPACE 4 2ND FLR. 3RD FLR. TOILET ROOM (s) UTILITY ROOM FIREPLACE TYPE HEATER WARM AIR DECK, TYPE ONE ELECTRIC PATIO CElqgNT & BRICK IN AIRCONDITIONING HOTWATER ACCESSORY STRUCTURES: NORE GARAGE, TYPE OF CONST. SWIMMING POOL O'l'~ ~:R: STORAGE, TYPE CONST. · GUEST, TYPE CONST. V~I~LATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. REMARKS: BP ~5624-Z - CO Z-23062 (Accessory Shed) INSPECTED BY DATE OF INSPECTION TLME START 10:15 June 23, 1994 END 10:45 Form No. 6 BUILDING DEPARTMENT TOWN HALL JUN -( 199~ 765-1802 i P ICATION FOR CERT FICA OF OCCUPANCY 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 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 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. 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 $50.00. 2. Certificate of Occupancy on Pre-existing Buildinm - $100.00 3. Copy of Certificate of Occupancy - $20.00 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......1~.... [/~..~. ...... ./~..~.~.~., .~.~. (?.~.~ ......... ~f~~., ~.~ House No. Street Ha~et Onwer or O~ers of Property.. ~ ~ County T~ Map No 1000, Section/~ Block ~ .Lot ~ 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: $.../..~.;.*~. ..................... ~. ~ / ~ ~ ~ ~$~ ~ APPLICANT CONSENT TO i'~ 9~-~ INSPECTION BLDG. DEPT. --7~7 v/~'-~'~ , the undersigned, O~ner (s) Name(s) do(es) hereby state: That the undersigned (is) ~re) tile owner(s) of the premises in the Tom of Southold located at · which is shown and designated on the Suffolk County tax map as District 1000, Section That the undersigned (has) (have) filed, or caused to be filed, an applica- tion in the Southold Tovm Building Inspector's Office for the folloxving: ~ / 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 buddings 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 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: nature) (print name) (siffnature) (print name)