HomeMy WebLinkAboutZ-22071 FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-22071 Date DECEMBER 30, 1992
THIS CERTIFIES that the building ONE FAMILY DWELLING
6635 NEW SUFFOLK RD. &
Location of Property 6515 NEW SUFFOLK ROAD NEW SUFFOLK, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 117 Block 5 Lot 24
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-22071 dated DECEMBER 30, 1992
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 WITH ACCESSORY WOOD FRAME GARAGE
The certificate is issued to MICHAEL J. WITHERS
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
Building Inspector
Rev. 1/81
BUILDI::G DEP PT:•L:iT
TO:I;d OF SOUTHOLD, N. Y.
hOU ) ,G CODE INSPECTION REPORT
Location 6635 NEW SUFFOLK ROAD NEW SUFFOLK, N.Y.
' knum, Der 6c streeti) �iiunicipalizy�
Subdivision Tian No .
Lot(z )
Name of Owners) MICHAEL J. WITHERS
0 c c up a n c y ONE FAMILY DWELLING
type owner-Levan-u
Admitted by: Accompanied by:
Key available Suffolk Co. Tax No. 1000-117-05-24
Source of request MICHAEL J. WITHERS
Date DEC. 8, 1992
V'TELLI,TG
Type of construction WOOD FRAME
r
Foundation BLOCK stories 1-1/2Cellar
Crawl space xx
Total rooms , 1st. F1 3 2
2nd. Fl 3rd. F1
Bathroom(s) 1 Toilet room(s)
Porch, type
Deck, type WOOD Patio, type_
Breezeaa.y Garage Utility room 1
Type Heat OIL Warm Air XX Hotwater
Fireplace(s) 1-BRICK No, axits 3 Ai t
rcondiLianing
Domestic hotwater XX Type heater ELECTRIC
Other
. . ACCLSSORY STRUCTURES:
Garage, type const. WOOD FRAME
Storage, type const.
Swimming) pool Guest, type const.
ORNE
Other PUMP HOUSE (N.W. CR) PUMP SHED (S.E. OF HOUSE) SIX (6) DOCKS AD
VIOLATIONS- CHAPTER 45—N.Y. STATE UNIFORM FIRE PREVENTION & BIIILDING CODE .
Location Description
� Art. Sec.
I
I .
Remarks• BP #21 149-Z - CO Z-22072 DECK ADDITION
Inspected by: Date of Insp. DEC. 16, 1992
VICTOR LESSARD Time start 10: 15 end 10:45
• �, - Form No. 6
THOLD
SOU OF
TOWN ;�'� �d�3��.`�i i�"1�,f-•j
3 ~_
`- BUILDING DEPARTMENT
TOWN HALL DF('
765-1802
APPLICATION FOR-CERTIFICATE OF OCCUPANCY EIO`D f
A. This application must be filled in by typewriter OR ink and submitted to the buildin
inspector with the following: for new building or new use: g
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) ,
f 3. Approval of electrical- installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system conta ns
less than 2/10 of IZ lead, .
5. Commercial building, industrial building, multiple residences and sirnilar 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. '
3• For existing buildings (prior to April 9,G e-existing" land uses: 1957) non-conforming uses, or buildings and
r
-Accurate surve of g property lines, streets
y .property showing all building and
unusual natural or topographic features.
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.
Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,'
Alterations to dwelling $25.00, Swimming pool $25.00, Accessorybuildin
Additions to accessory building $25.00. Businesses $50 00, g $25.00,
2. Certificate of Occupancy on Pre-existing Building
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 . . . .
2w Construction. . . . . . . . Old Or Pre-existing Building• , e;! • .
3cation of
Property. . . . l.s .. ... . . .I! 'G,✓ .5dF�OLK . . . . . ;�Elv,SUFFDEK
House No. Street . . . . . . • •
Hamlet
:wer or Owners of Property.. . /W,Cf/AL�L:• •Lf/,!T E!1S . • . : . . . . . . . . . . . . . . . . . . . . . .. . . . . . . .
. .
unty Tax Map No 1000, Section. . . . . . . . ,Block. , 4;,
. . . . ... . . . . . .Lot. . . . �. . . .
bdiviaion. . . • • • •. .. . . . . . . . . . . . . . . . . . . . . . : . . . . . . . .Filed Map. . . . . . . . . . . .Lot:
. . . . . . . . . . .'
rmit No. . . . . . . . .. . . . . . . .Date Of Permit.. . . . . . . . . . . . . . .Applicant. . . . . . .
filth Dept. Approval. . . . . . . .. . . . . . . . . . . . . . .. . .Underwriters Approval. . . .
inning Board Approval. . . . . . .. 0 . ... . ... .
. . . . . . . . . . . . . . . . .
west for: Temporary Certificate. . . .,
. . . .. . . . . . . Final Certicate, , . , , , , , ,, •
Submitted: $. .. ..'. .. . . . . . . . .. .. . . . . .
_G!LC C.0 as 0 7 j APPLICANT - • '
CONSr:.T
.To
INS)I'EC•r10N L•
U«•ncr(s) Name thrr uncle r si: rzc�d,
do(es) hereby state:
That the undersigned (is) (;lre) t11e owner(- e) of the rernisc••
P .. Ln the To:•m
of Southold located at �j.S/ /1l**EI41ol Ro
::hick iS ,ho::n and dc'sir;rjated on tllc Sui,'o1�
County tat map as District 1000,
Section _//'] L'locic .S^ Lot Zef
That the undersigned (teas) •
(Gave) filed, or caused to be filed, an applica-
tion in the Southold Town 13uilding Inspector's Office for the follo::-ir.�;
That the undersigned do(es) hereby give consent to the Building Inspectors
of the Town of Southold to enter upon the above described property, includincT
any and all buildings located thereon, .to conduct such inspections as they ,-;gay
deem necessary Zvith res -
pect to the afOresaid application, includi.-:g inspect_o;;s
to determine that said premises comnly with all of ttie lags; ordina^c
• es, :ales
and regulations of the Town of Southold.
The undersigned, in consenting to such inspections, do(es) so «•it
h the
l:no::•ledge and understanding that any information obtained in the conduct of
such inspections may be used as evidence in subsequent prosec :lions for vio-
lations of the laivs, ordinances, rules or regulations of the Town of Southold
Dated: /Z -Z -
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