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Home My WebLink AboutZ-23631FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCcuPANCY No Z-23631 Date MAY 11, 1995 THIS CERTIFIES that the building ORE FAMILY DWELLING Location of Propert~ 250 6TH STREET LAUREL, NEW YO~K House No. Street Hamlet County Tax Map No. 1000 Section 126 Block 1 Lot 10 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-23631 dated MAY 11~ 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 ONE FAMILY SEASONAL DWELLING * The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTI(1N'~NBORT. Rev. 1/81 ROBERT & ALISON KELLY N/A N/A N/A LOCATION: 250 6TH STP~ET (number & street) SUBDIVISION HAP NO. NAME OF 0NNER (s) ROBERT KELLY & ALISON F. KELLY BUILDING DEPARTHENT TOWN OF SOUTHOLD UOUSING CODE INSPECTION EgPORT LAUREL, NEW YORK (municipality) LOT(s) OCCUPANCY (type) [ ADHITTED BY: DOROTflY NINNICK KEY AVAILABLE SOURCE OF RE~,UEST: DORIS TSCHIEMBER SINGLE FAMILY DWELLING (SEASONAL) (o~ner-teuant) ACCOHPANIED BY: SA~E SUFF.CO. TAX ~ NO. 1000-126-1-]0 DATE: FEB. 4, 1994 DNELLING: TYPE OF CONSTRUCTION FOUNDATION TOTAL ROOHS: BATHROOM (s) PORCH TYPE BREEZEWAY DOMESTIC HOTWATER TYPE HEAT NONE OTHER: WOOD FRAME ~ STORIES I # EXITS 2 BLOCK (C~MENT) CELLAR PARTIAL CRANL SPACE XX IST FLR. 4 2ND FLR. - - 3RD FLR. -~- 2 FULL TOILET R00H (s) UTILITY ROOH (l) LAUI~RY & UTILITY FRONT OPEN COVEHED FIREPLACE YES TYPE HEATER I~ARM AIR SEASONAL COTTAGE DECK, TYPE PATIO__REAR SLATE ( I ) GARAGE NONE ELECTRIC AIRC01fl)ITIONING HOTI,/ATER ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. S~IN14ING POOL OTHER: STORAGE, TYPE CONST. , GUEST, TYPE CONST. VIOLATIONS: CltAPTER 45 N.Y. STATE I~IFOI~I FIRE PREVEIfrlON & BUILDING CODE LOCATION DESCRIPTION ART. SEC. INSPECTED BY BP i[i~7-Z_z~,~CO Z-23630 (ADDITION)- BP i~22408-Z-C0 Z-23629 (ACCY SHED) f_ ]~. BOUFIS ~' TIME START 9:30 AM END IO:O0 AM Form No. 6 TOWN OF SOUTltOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ~ APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submit~ed~tp 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. 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 $5Q.00. ~2. Certificate of Occup_~ancy 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.O0 Date ...~.~?.~..~.~.~.....~.. ............... New Construction ........... Old Or Pre-existing Building ................. Location of Property .... Z~) ~';-~ ' ~.~.~.~--~ A.~4~f. House No. Street Hamlet Onwer or Owners of Property..~O~S~..(]~-~..' .~.~.~.. ~...~'.¥i. !]~.~..~. ~ .~../~...~.~..~... County Tax Map No 1000, Seetion...f.Z.a ..... Bloe ..... .......... ............... S bdivision Filed Map Permit No .... -- ........ Date Of Permit.....-~.. ......... Applicant ........ IIealth Dept. Approval ..... ~ ~ .Underwriters Approval ' . ................ Planning Board Approval ........ ~ .............. Request for: Temporary Certificate ........... Final Certicate ........... ?ce Submit ted: $.. } O.Q..~. · ...... ~ ~.~ ~./.~.Fr~..~.~ -- APPLICANT CONSI~NT TO INSPECTION Oxm~cr(s) Name(s) do(es) hereby state: · the undersigned, That the undersigned (is) (are) the owner(s)of the premises in the Town of Southold located at Z ~O &TM ~'-~~ · which is shoxwn and designated on the Suffolk County tax r=p as ~istrict ~000, Section /~&, ~lo~ / , Uot 7~D.' That the undersigned (has) (ha~e) flied, 'or caused to be filed, an apptica- 'tion in the South01d Tox~m Building Inspector's Office for the [ollowing: __ That the u~dersigncd 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 lhereon; 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. (slgna~ure) (print name) (signature) (print name) "o. ® :-o N 20'46'50" W BRAY AVENUE LOT