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HomeMy WebLinkAboutZ-14379 FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. . Z 1.4 3 7 9 . . . . . . . . Date . . May 2. . . . . . . . . . . . . . . . . . . . . . . .119 . 86 THIS CERTIFIES that the building . ... . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Location of Property . , 1000 Old Harbor Road,' New Suffolk, N:Y: House No. Street Ham/et County Tax Map No. 1000 Section . . .:117. . . . . .Block . .G5 . . . . . . . . . . .Lot . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . . . e u rem n or. a One Family Dwelling 'Built prior to conforms substantially to the pg sa#�o-n- trrl rrrg- r -heretofore-:fitrd:zn:-fhis:-officc-ctatj . . ,Z�px.i!. 23.,, . . . . . . . . 1 19 .5.7 to pursuant whichertificate of Occupancy 4 3.7.9 . . . p - irll�iErtgeri +1e. , .� . dated . . .May .2. . . . . . . . . . . . . . . . . . . 198.6 ,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 .Ong . . . . Fam�,ly..dwellinq.,w.ith ,accessory s,tr.uctur.e (garage): w.itYi .guest. room and . . . . . . . . . . . . . . . . . . . . . . toilet toom; also a .pump house. IT The certificate is issued to SUSAN. . .H. KW KW (owner,%ssee eFterretrtf . of the aforesaid building. Suffolk County Department of Health Approval . . . . .N/A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . .N/A „ Building Inspector Rev.1/81 Update of .Pre C.O. #.Z10.318 FORM NO.6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application'must be filled in typewriter OR ink,and submitted in duplicate 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 features. 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. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.00 3.Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 Date April 29: 1986, • . • � , , , , ,,V-a. New Building . . . . . . . . . . . . . Old or Pre-existing Building . . . . .�. . . . . . . Vacant Land . . . . .. . . . . . . . Location of Property . , 100fJ . Old Harbor. Road, , . , , • , , Cutphpsvt.. , ,, , , , , , , , , , , . . . . . .. . .. . . . . . . . . . . . . . . . . . House No. street Hamlet Owneror Owners of Property . . . . . . . . . . . .an .. .wit. . . . . . .. , . , , , , . , • , , , , , , , , • „ . . . . . . . . . . . 117 County Tax Map No. 10 Section . . , , , 00 . . ... . . . , , Block . . . . . . . . . .5. . . . Lot . . . . . .l?;1; . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . . . .Lot No. . . . . . . . . . . . . . Permit No. . . . . . . . . . . Date of Permit . . . . . . . . . .Applicant . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .. Health Dept. Approval . . . . . . . . . . . . . .. . . . . . . . . .Labor Dept. Approval . . . . . . . . . . . . . .. . . . . .. . .. Underwriters Approval . . . . . . . . . . . . . . . .. . . . . .Planning Board Approval . . . . . . .. . . . . . . .. . . .. r Request for Temporary Certificate . . . . . . . . . . . . . . . . . . . . .Final Certificate . . . . . . . . . . . . . . . . . . . .. . . Fee Submitted $ .1�:AA. . . . . . . . . . . . . . . . . . . . . . . . Construction on above described building and permit.meet fl ulations. Copy of Pre-C.O. #z 10318 dated 12/23/80 attached. Applicant . . . . . . . . . . . . . . . . . . . . .. . . . •William W•c h m Rev.,o-,oaa s—rD./d,a I STATE OF NEW YORK) SS. . COUNTY OF SUFFOLK) WILLIAM WICKHAM, residing at Old Harbor Road, New 'Suffolk'- New York, being duly sworn, deposes and says that; I own property adjacent to the residence of Susan H. Kwit at Old Harbor Road, New Suffolk, New York and am personally familiar with the pump house located on her property. I have personal knowledge that the pump house was constructed prior to 1957 and that there have been no changes or additions to it requiring the issuance of a building permit or certificate of occupancy. I make this affidavit to request that the pump house be included in the Certificate of Pre-Existing Use for the other structures located on the property. WILL IA., cq Sworn to before me this 29th day of April, 1986. Notary Publ' JULIE BAUERNFEIND Notary Public,State of New York No.4796275,Suffolk Count�yy Commission Expires March 3 IC7 FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No. . Z 10318 Date . . . December 23, . . . 19 . 80 ./. . . . . . . . . . . . . . . THIS CERTIFIES that the building . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . Location of Property , , 1000 Old Harbor Road, New Suffolk, N.Y. House No. � Street •Hamlet 12 County Tax Map No. 1000 Section . . . �.?. . . . .Block . . .�5 . . . . . . . . .Lot . ..��,. . . & . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. . . . . . . . . . Requirements for a One Family Dwelling Built Prior to conforms substantially to the •Afl iefi-or-4u ag•-Pefmit-4ier-eWege—wed-4n-41ti&-effwe-iated- Cext f' at" Qgcupancy Z1Q318 . . . . . . . , 19 .57pursuant to whiel} i ttg . . . . . dated . . December 2 ,• , , , . • . • , . . . 19 .80,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 . OAQ. . . . a4jj-y, Dwelling• with Accessory Structure(Gara e} •with Guest, and Room Toilet Room. ASQ A O v's • • • . . . . Harold F. and Jane V. Lundine The certificate is issued to . . . . . . . • • (owner, of the aforesaid building. Suffolk County Department of Health Approval . . .NAR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . .N/R . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i Building Inspector Rev 4n9 , .tie -. ,.-., .3 ik ry. , �r+ f - }` I '1. a i - }t + _ c't } 1 S a t t ) 1• I '., - ` - .} T: S 4 q A r__� ! d {E.(r{`?.1.�."t r -5 iK;i — f 1 r = 1 z l MIAV[M011f[D A11iUT10N ,. - S !Y:.7 i K} x.{. L .2' 1 1 r.. :: -'- l r1 j r "r R .TO IHlE SUIVFY.IS A�V1pLA 01 AD f „y .,'..+,..,,,.. 5 + r y1�t -" :I, --y ( ",:: - • ,Wc7fotl 72o9 or iHe a �.5 r L y+3 '1#rl I. t i ) ;2 x 'A k A;: [ N[IY„Tory ETAi!r i k{ 1 ' ! .d•{. t - S` - a _ 1. ,:'� DUt�TIoN uw m _r t c-'�E r eiti _ i t.r R r 5�g;g ,F::. y}i,"3, _.•$ ,I - r .)cz + y r Y t0[Its Oi,iH13 SU14lT N,V noT� A.�;' tx`r r sP. 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