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HomeMy WebLinkAboutZ-19944 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-19944 Date JUNE 5, 1991 THIS CERTIFIES that the building DWELLING Location of Property I100 VILLAGE LANE ORIENT, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 25 Block 1 Lot 19 Subdivision Filed Map No. Lot No. conforms substantially to the requirements for a One Family Dwelling with Apartment & Store or Office built prior to: APRIL 9, 1957 pursuant to which UPDATED CERTIFICATE OF OCC. #Z-19944 dated JUNE 5, 1991 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 NON-CONFORMING APARTMENT- & BUSINESS BUILDING (STORE OR OFFICE)& ACCESSORY BUILDING. The certificate is issued to SHEILA ZUHUSKY (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *NOTE: THIS UPDATES PRE-CO Z-7667 DATED MAY 19, 1977. Building Inspector Rev. 1/81 I @L! 1J c _ 2.81991 LDG. DEPT. lei T nbttie o 'r `� jI} off ch rfj op f r 1 OF N6} /r YOUNG Y O U G IL �pj �' 400 OSTRANDER AVENIUE, RJVFRH � (`�'�' ��e{ �! '� lil YOUNG AARLOCFEhU5 HYV. Y� l NG _ 4tirr�. �flYaOU �-4N� OXKGIHEEA AHD : T-Y• GliU. 3N.Y_5. LI{. KO. '264RLAr :! S ' { I SURVEY FGR., V, J/��} hl } JVHIV G'NEIL .W.J� S-000tlV Zr svr. `Y —_.---- t s $'p: .,`= - 1 r GUARANTEED T{]: FG OIL .t.vtL,O L•_:'- t ORfaL.'V r JLf70PdUPt� {,., suAxaN ees IH:<. cue ' r- cd sit_ :qua '�'�~�'.TifF I'IILE G1l fa'A1Ul-fFCO. TOWN OF ) THOU) ' _ 'Once To AHE PE SlJ�}[.J SCr. �,W+• �S H;u r.,E _ I - O SuFrecv :i PRF�&AFE'. + 30 TsE ?,TIC c:"vptNt, b �E :drIFN'0.S { ,(� N. ;I py�q,�f� ,{ _ - _ :N61f.NO,N$ N31-`J °G•4 ��S1 ED SUFFOLK CG.,� N.�, �Y d'i4 aA d-,A . KRE,iN, dAtr TG Thr S 0l !ME - = _ Gf�a6a.lEEt i.RE .- ,� ; - - ti FRJY 71calH$FERA BCE SE SCALE: tl -- r s� DA7 NO. _ ,`ems •Iasr+lue�oNs �;x ms�w.;T;::�raENs:. I �O rs•�tiY 1,�, 7T f3TT �� 300 A - 3 6 - Form No. - t TOWN OF SOUTHO.LD BUILDING DEPARTMENT MIRY TOWN .HALL 7 6 5-180 2 APPLICATION FOR CERTIFICATE OF OCCUPANCY b A. 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. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from archi•:ect or engineer responsible for the building. 6. Submif Planning Board Approval of completed site plan requirements. 3:• 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. 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 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 $15.00 Date . . . . . . e . o o . Z �. . . e e o o e Iew Construction. . . . . _ Old Or Pre-exist Building Building. . . . . 1_ . . . . . ,ocation of Property. /0 5U . , l�i ��CtCF �. .�C4,lf £. . . . . . . . . . . . . . . . Ct-Ie0c . . . . . . . . . . . . . . . House No. Street Hamlet )nwer or Owners of Property. . . . . �ff� . : . . .-Z(/H1���C/ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . :ounty Tax Map No 1000, Section. . . . .; � . . . . .Block. . . !. . . . . . . . . . . .Lot. . . . . . . 1,.,( . . . . . . . . . . . ubdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . ermit No. . . . . . . . . . . . . . . .Date Of Permit. . . . . . . . . . . . . .Applicant, . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ealth Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . .. . . . . . . . . lanning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . equest for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . ee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Q. C.419 q_5 . . . . . . . . . . . . . . . . . . . . . . . . . d Q� `I 9 9 Ll APPLIC v I CONSENT TO INSPECTION 05H,61 L Z 014 e)sl< the undersigned, Owner(s) Name(s) do(es) hereby state: That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at /0 56 1/ L L A A- r1_ 4--Ale T— which is shown and designated on the Suffolk County tali map as District 1000 Section aS , Block Lot lg 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: 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. Dated: A , - (signatur (print name) (signature) (print name) BLDG. DEFT. -roWN OF SosU HOP_O BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: number & street municipality SUBDIVISION MAP NO, LOT (s) NAME OF OWNER (s) OCCUPANCY (type) (owner-tenant) ADMITTED BY: ACCOMPANIED BY: KEY AVAILABLE SUFF. CO. TAX MAP NO. SOURCE OF REQUEST: DATE: DWELLING: TYPE OF CONSTRUCT ON STORIES CI�t'�- �� EXITS FOUNDATION CELLAR CRAWL SPACE z 3 TOTAL ROOMS: 1ST FLR. 2ND FLR. 3RD FLR. BATHROOM (s) TOILET ROOM (s) ©� UTILITY ROOM_ PORCH TYPE DECK, TYPE PATIO, TYPE BREEZEWAY ` FIREPLACE _ GARAGE DOMESTIC HOTWATER / TYPE HEATER G-CO 6;6AIRCONDITIONING TYPE HEAT WARM AIR HOTWATER OTHER: ` ✓ '��6; ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. C� � C"p') lORAGE, TYPE CONST. SWIMMING POOL GUEST, TYPE CONST. OTHER: ------------------------------------------------------------------=-------------�-------- -------------------------------------------------------------------------------------=---- VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. C._. Ads Ll l A q G/ Cc REMARKS: U INSPECTED BY: 7 Alit DATE ON INSPECTION TIME START END