HomeMy WebLinkAboutZ-22410 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-22410 Date JUNE 21, 1993
THIS CERTIFIES -that the building ONE FAMILY DWELLING
Location of Property 100 WEST LANE SOUTHOLD, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 88 Block 6 Lot 12
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-22410 dated JUNE 21, 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 DWELLING WITH ATTACHED GARAGE
The certificate is issued to HAROLD & ESTHER WOHL
(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.
A&Z
uild' g Inspecto
Rev. 1/81 .
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 100 WEST LANE SOUTHOLD N.Y.
number S street municipality
SUBDIVISION 'MAP NO. LOT (s)
NAME OF OWNER (s) HAROLD & ESTHER M. WOHL
OCCUPANCY ONE FAMILY DWELLING OWNER
(type) (owner-tenant)
ADMITTED BY: . OWNER (HAROLD) ACCO`SPANIED BY:
KEY AVAILABLE SUFF. CO. TAX MAP NO. 88-6-12 .
SOURCE OF REQUEST: SHEA & COULD, ATTY ' DATE: JUNE 10, 199
DWELLING:
TYPE OF CONSTRUCTION FRAME # STORIES I # EXITS 2
FOUNDATION CEMENT BLOCK CELLAR CRAWL SPACE XX
TOTAL ROOMS: 1ST FLR. 5 2ND FLR. 3RD FLR.
BATHROOM (s) 1 TOILET ROOM .(s) UTILITY ROOM 1 .
PORCH TYPE DECK, TYPE PATIO, TYPE .
BREEZEWAY FIREPLACE .1 GARAGE xx
DOMESTIC HOTWATER .Xg TYPE HEATER ELECTRIC AIRCONDITIONING
TYPE HEAT BASE BOARD ELECTRIC WARM AIR HOTWATER
OTHE R:
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST. STORAGE, TYPE CONST.
SWIMMING POOL GUEST,. TYPE CONST.
OTHER: BULKHEAD
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
REMARKS:
INSPECTED 3� DATE ON INSPECTION JUNE 17 , 1993
T MAS ZVI. FISHER TIME START 9 :4.5 END 10:05
0 6 — 0 9 — 9 3 W E D 1 0 : 1 5 _ 0 1
1 - '
MAY-28--92G THU 0$ :09 SVMRI SE RESEARCH P- 04
Form No. 6
'OWN OF SOUTHOLT)
BUILDINC DEPARTMENT
TOWN BALL
765-1902
APPLICATION FOR CER'TIrICATE or, OCCUPANCY
A. This application must be filled in by typewriter OP, fink and oubmittod to the 1jul1dtnr
inspector with the following: for new building or new use:
1 . Flual survey of property with accurate location of all buildingsq, property 11opp,
streets, and unusual natural or topographic features.
2. Final Approval from Health Dept. of water supply and sewetrnge-dipposnl (S-9 form) .
ti 3. Approval of electri.cal installation from Board of Fire Undervei.ters.
4. Sworn statement from plumber certifying that the solder used in system contnins
less than 2/10 of 12 lead.
5. Commercial building, industrial building, multiple residences and similar Ijutldings
and instal,lstions, a certificate of Code Compliance From ;architect or angi.naer
responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
e For existing buildings (prior to April 9, 1957) non-conforming uses, or bul),(lings an(I
.� "pre--existing" land uses:
t. Accurate survey of property showing all property limos, streets, building; .�ncl
unusual natural or topographic features.
2. A properly completed application and a consent to inspect signed by the nppllcant.
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 oil Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy -- $5.00 over 5 yenrs - $t0.00
4. Updated Certificate of Occupancy - $50.00
S. Temporary Certificate of Occupancy - Reaidential $15.00, Commercial, $15.00
Date Ju n,e� `7� ) 99.3
. . . . . . . .
New Construction. . . . . . . . . . . `Old Or Pre-existing Building. . . , , , , , , , , , ,
Location of Property. 1�0. /�Sl. ,� � ,,. 4�= ���`. a L�
� . . . . . . . . . . . . . ,� . . . . . . .
1lpuse no. ' Str/�eet / Hnsn.lC.t
Onwer or owners of Property. .!:Q!��?'. . ,r!`!Q.�j�-;, , ,_5 f- r� . /y 4tJp L
. . . . . . . . . . . . . . . . . .
County Tax. Map No 1000, Section.0 180:®� . .D1ock. ®�.° � , , Lot_®12 '0aa„
. . . . .
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Mr1p. . . . . . . . . . . .I...t'. . . . . . . . . . . .
Permit No. a - -- - - i * - - - - - *.Date of Permit. . . . . . . . . . . . . . . .Appl.scant. . . . . . . . . . . . . . . . . . . .. . . . . . . . .
11401th Dept. Approval. . . . . . . . . . . . . . . . • . . . . . .. . .Underwriters Approv71 , . . . . . . . . . . . . . . . . . . . . . . . .
Planning Board Apptroval. . . . . . . . . . . . . . . . . . . . . . . .
Request for; Temporary Certificate. . . . . . . . . . . Final
Fee submitted: $.. ,����.Oa. . . .. . . . . . .. . . . .
tK. . . . . . . . . .
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MAY-Ze^9Z THU 03 :09 SUNRISE RESEARCH P. g5
CONSENT
TO
INSPECTION
col wn� I ,
Utivner(s) Name($) • the undersigned.
do(ea) hereby State:
That the undersigned (ia) (;%re) the owner(s) of the Promises in ilia Town
Of Southold located at `5H r�i4
%rhick 19 alhown And desirnittcl on the Suffolk
County tax map all District x0o0, Section®'$g,00, Block 0(,.00. Lotpl
ae000 .
That the undersigned ())as) (have) filed, ox caused to be filed, art npplica.
tion in the Southold Town 13ui1d1ri9 Yhspertor0s Office for the following:
V—
S4 r n el, h u f f I r
That the undersigned do(es) hereby give consent to the Building Znspectorn
of the Town of Southold to enter upon the above described property, including
any and all buildings located thereon. to conduct such inspections as they rnttiy
deern necessary with respect to the aforesaid a lie
pp gtion, including inspections
to determine that said premises eor"Ply with all of the laws; Ordinances, rules
and regulations of the Town of Southold.
The undersigned, in consenting to such insPecklons, do(es) so with the
knowledge and understanding that any information obtained III the conduct of
such inspections may be used ats evidence in subsequent prosecutions for vio--
lotions of the laws. ordinances. rules or regulations of the Town of Southold.
Dated: J-u n e—
g � 93
(signature)
PnroW
(Print merle)