HomeMy WebLinkAboutZ-19338 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-19338 Date SEPTEMBER 6, 1990
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 340 CEMETERY ROAD EAST MARION, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 31 Block 10 Lot 9
Subdivision Filed Map No. Lot No.
conforms substantially to the requirements for a Private One Family
dwelling built prior to: APRIL 9, 1957 pursuant to which
CERTIFICATE OF OCC. #Z-19338 dated SEPTEMBER 6, 1990
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 TWO CAR GARAGE
The certificate is issued to JOHN DAVID WYDUR
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NO RECORD PRE EXISTING
UNDERWRITERS CERTIFICATE NO. NO RECORD PRE EXISTING
PLUMBERS CERTIFICATION DATED NO RECORD PRE EXISTING
*PLEASE SEE ATTACHED INSPECTION REPORT.
Building Inspector
Rev. 1/81
BUILDI:;G DEPART:IE:iT
TO.'li\l OF SOUTHOLD, N. Y.
HOUSI::G CODE INSPECTION REPORT
Location 340 CEMETERY ROAD EAST MARION, N.Y.
knL;moer do street) Piunicipaiity)
Subdivision clap No . Lot(s)
Name of Owner(s) JOHN DAVID WYDUR
Occupancy A- ] OWNER
(type) owner-tenant)
Admitted by: SELF Accompanied by: SELF
Key available Suffolk Co. Tax No. 31- 10-9
Source of request MARIE ONGIONI Date 9/4/90
DWELLING
Type of construction WOOD FRAME #stories ONE
Foundation CEMENT BLOCK Cellar FULL Crawl space
Total rooms, lst. F1 4 2nd. F1 - - 3rd. F1
Bathroom(s) ONE Toilet room(s)
Porch, type _ _ Deck, type Patio, type_
Breeze:•iay Garage 2 CAR Utility room
Type Heat LILCO GAS * Warm Air Hotwater XX
Fireplace(s) ONE (BRICK)No. Faits 2 Airconditioning - -
Domestic hotwater LILCO GAS Type heater RUND
Other
ACCESSORY STRUCTURES. NONE
Garage, type const. Storage, type const.
Swimming pool Guest, type const.
Other
VIOLATIONS: CHAPTER 45—N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE -
Location Description � Art. 1 Sec.
EXTERIOR EXTERIOR SURFACES SHALL BE MAINTAINED I CHAIPT. F.
SIDING IN GOOD CONDITION. SURFACES NOT SEC . 1242 .5 E)
& TRIM INHERENTLY RESISTANT TO DETERIORATION
SHALL BE TREATED WITH A PROTECTIVE COAT I
OF PAINT OR OTHER SUITABLE PRESERVATIVE.
I -
Remarks:
Inspected by: Date of Insp. SEPT. 5, 1990
G J. FISH Time start 2 :00 end 2 : 15
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802 SEP " 4 i990
APPLICATION FOR.CERTIFICATE OF OC UPA DEPT
A. DLD�+. .
OF SOUTF�OLD
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.
S. 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
It 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,
g $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 Building - $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
Y. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date . :: . _
. . . . . . . . ...
New Construction. .... . . Old Or Pre-existing Bui-l-ding . . . .. . . .......
• • •• - - ••-•••- • -'•
Location of Property. . q-o . . .. ...........4 ,'us'.J��' . .�. . . . . . .. . . .. . .: P- . . . .
House No. '`� �• ••••--- • ••
Str9et Hamlet
Onwer or Owners of Property.. • :-:y�/<. ./,• :���•
. . •,...
. . . .. .. . . . . ........ ... .
County Tax Map No 1000, Section. ... t3.�. ... . . .Block. . . . � . , • - . • •
.Lot. . . . . ... .. ...
Subdivision.
..... . .. .. . ... ..... . o.o... .. . . ..
.. .Filed Map.. . . .. . . . . . .
Lot. . . . .. .. .. ........ .. ..
Permit No. ... .... .. . . .. ..Date Of Permit... .. . .. . .. . .. . . .Applicant. . . . . .. . . .. . . . . .. . .
...... .. . .
stealth Dept. Approval. . . . . . . .. .... .. . . .. .. ... . .Underwriters Approval. .. . . . . . ......
.���
Planning
Board Approval. . . .. . ... . ...
Request for:
. Temporary Certificate. .... . .. . . . Final Certicate.. .. .... .. . .
Fee Submitted:
C� . y® y3.� / . ..... ............... ..... .....
.CO 3� /�/ T�7/1/l�r�U�?G?.���APPLICANT. ' .. ..
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CONSENT
TOI Ir
INSPECTION sEP 4 1990
V 123 � � V�/ a��/2_ Tov �; ; � o igrie�d'
Owner(s) Name(s)
do(es) hereby state:
13'I�"o2h e�1�
That the undersigned-(is) (are) the owner(s) of the premises in the Town
of Southold located at
which is shown and designated on the Suffolk-
County tax map as District 1000, Section , Block f d , Lot .
That the undersigned (has) (have) filed, 'or caused to be filed, an applica-
tion in the Southold Town Building Inspector's Office for the following:
� 2Ge-Z
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 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 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.
e �
Dated:
(signature)
(print name)
X/ o2L%2�2.w
(signs r '
(print name)
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