The URL can be used to link to this page

Home My WebLink AboutZ-22765FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-22765 Date DECEMBER 7~ 1993 THIS CERTIFIES that the building ONE FAMILY DWFI.LING Location of Property 1950 BOISSEAU AVENUE House No. Street County Tax Map No. 1000 Section 55 Block 6 Filed Map No. Subdivision SOUTHOLD ~ NEW YORK Hamlet Lot 17 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-22765 dated DECEMBER 7, 1993 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 DW~3~.INGWITHACCESSORY STW~L STORAGE S~F~ * The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACH~.D INSPECTION REPORT. Rev. 1/81 MARK VAN BOURGONUIEN N~A /ldi~g Inspector BUILDING DEPART~IENT TOWN OF SOUTIIOLD tlOUSINC CODE INSPECTION REPORT LOCATION: 1950 BOISSEAU AVE. (number &strcet) SUBDIVISION NAME OF OWNER (s) MARK VAN BOURGONDIEN SOUTHOLD, N. Y. MAP NO. (munic ipal LOT (..;) OCCUPANCY A-! (type) (owmer-tenant) ADMIF£gD BY:. I~AP, K VAN BOURC~ONDIgN ACCOHPANIED BY: SAM~ KEY AVAILABLE SKIFF. CO. T~MAP NO. 1000-55~6-17 SOU~C~ OF REQUEST: GARY FLAI~R OLSEN, A~i'Y DATE: NOV. 23, 1993 DWELLING: ~fPE OF CONSTRUCTION FOUNDATION ~EMENT'BLOCK TOTAL ROOMS: IST FLR. BATllR00M (s} ONE FULL PORCH TYPE BREEZEWAY ENCLOSED D0}~STIC HO~ATER YES- TYPE H~AT LILCO GAS O~IER: WOOD FRAME { STORIES i-1/2 # EXITS 3 CELLAR FULL CRAWL SPACE ONE 3RD FLR. 2ND FLR. UTILITY ROOM . PATIO, TYPE GARAGE ]- I/2 AIRCONDITIONING HOTWATER TOILET ROOM DECK, TYPE WOOD REAR OF FIREPlaCE NO TYPE HEATER LILCO GAS WARM AIR ACCESSORY STRUC'i~RES: GARAGE, TYPE OF cONST. S~IIMMING POOL STORAGE, TYPE CONST. STEEL STORAGE SltED · GUEST, TYPE CONST. 0TIIER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE ~0CATION DESCRIPTION ART. I SEC. REMARKS: BP t14141Z- CO Z-13649 - DECK ADDITION DATE ON INSPECTION TIME START 9:30 DEC. 3, 1993 ENlJ 9:45 FORM NO. 6 TOWN OF SOUTHOLD · Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions Xo This application must be filled in typewriter OR ink, and submitted .= me,,,a.m= to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic featu res. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. Co Fees: 1. Certificate of occupancy $.25~00 -- ]~US[NES$ $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0.0 0 3. Copy of certificate of occupancy $ §;'00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $"50.00 Date..N.°.v.e,m.b.e.r. 23.: 1993.. New C on s t. ~. u c t, i on ......Old or Pre-existing Building . .)~ ......... Vacant Land ............. 1950 Boisseau Avefiue. Southold New York Location of Property ................................ : .................................. House No. Street Haffder Mark VanBourqondien Owner or Owners of Property ........................................................... County Tax Map No. 1000 Section ...0.5.5.:0.0, ...... Block 06.00. Lot. 017..000 Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ...................... ~ .Planning~roval/ / ................. Request for Temporary Certificate ................... . ,/~nal k;er~yficate ................. Fee Submitted $..!.QQ .... .................... / ~ ×/ . . Con st ruction on above described building and pe tm it ~all~~u l at,ohs. Applicant ...... .~..~.~..~...../.~. ........................ ~rA'RY~ FL'ANfll~R OL~SEN, ESQ, Rev. lO-lO-Ta P.O. BOX 706 (~Z,~,q,.~t]~,~'__ Cutchogue, NY 11935 CONSENT TO INSPECTION Gary FIanner Olsen ~' Owner(s) Name(s) do(es) hereby state: · the undersigned· of Southold located at That the undersigned (is) (are) the owner(s) of the premises in the Tomvn 1950 Boisseau Avenue. Southold, NY · which is shown and designated on the Suffolk County tax map as District 1000, Section 055.00 , Block 06.00 , Lot 017.000. That the undersigned (has) (have) fried, 'or caused to be filed, an applica- tion tn~ Southold Town Buliciing lnspe~,~, .o o~.f~o fo~ +h~ Cr~lloxving: one family dwelling That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, incl.uding ..... 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/nspections, do(es) so with the knowledge and understanding that any information obtained I t~nduct of / / such inspections may be used as evidence in subsequent pr cut ns for rio- / / lations of the laws, ordinances, rules or regulations of tJ~j~ To~fl of Southold. ~.~/~ ., / (sig7 Gary Flanner Olsen (print name) {'signature) (print name) haman l.I CHICAGO TITLE INSURANCE COMPANY - .-,.. (51~) 727-4455 .....