HomeMy WebLinkAboutZ-23212 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-23212 Date SEPTEMBER 14, 1994
THIS CERTIFIES that the building MULTIPLE DWELLINGS
'Location of Property 53250 COUNTY ROAD #48 'SOUTHOLD, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 ,Section 52 Block 2 Lot 1.2
Subdivision Filed Map No. Lot No. -
conforms substantially to the Requirements for multiple dwellings built
Prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z-23212 dated SEPTEMBER 14, 1994
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 MULTIPLE MOTEL UNITS
The certificate is issued to CAWLEYS SOUTHOLD BEACH MOTEL, INC.
(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
+ BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION• 53250 COUNTY ROAD #48 SOUTHOLD, NEW YORK
number &` street municipality
SUBDIVISION MAP NO. LOT(s)
NAME OF OWNER (s) CAWLEYS SOUTHOLD BEACH MOTEL, INC.
OCCUPANCY B-2
type owner—tenant
ADMITTED BY: ACCOMPANIED BY:
KEY AVAILABLE SUFF.CO. TAR MAP NO.. 100 — —2— .2
SOURCE OF REQUEST: JEAN C. LEONARD DATE: JUNE 9, 1.994
DWELLING:
TYPE OF CONSTRUCTION WOOD FRAME # STORIES ONE # ERITS TWENTY
FOUNDATION CEMENT BLOCK CELLAR CRAWL SPACE PARTIAL
TOTAL ROOMS: 1ST FLR. 14 2ND FLR. 3RD FLR.
BATHROOM (s) 11 TOILET ROOM (s) 1 UTILITY ROOM
PORCH TYPE t DIIUE FRONT OF' PATIO SOUTHSIDE
IREEZEWAY FIREPLACE GARAGE
DOMESTIC HOTWATER YES TYPE HEATER LILCO AIRCONDITIONING
TYPE HEAT ELECTRIC WARM AIR HOTWATER
OTHER: OFFICE FOR MOTEL
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST. STORAGE, TYPE CONST.
SWIMMING POOL GUEST, TYPE CONST.
OTHER:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION' ART. SEC.
REMARKS:
INSPECTED BY DATE OF INSPECTION JUNE 13, 1994
TIME. START 10: 10 END 11: 10
Form No. 6
(� TOWN OF SOUTHOLD
� BUILDING DEPARTMENT
UN - 9 TOWN HALL
765-1802
BLDG. DEPT APPLICATION FOR-CERTIFICATE OF OCCUPANCY
:'�VN OF SOUTHOLD
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 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
"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.
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 on Pre-existing Building - $100.00
3. • Copy of Certificate of Occupancy- $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
r
Date . . . . . . 9. . . . . . . . . . . . . . .
. . . . . . . .
New' Construction. . . . . . . . . . .
nOld Or Pre-existing Building. . . .;<. . . . . . .
CNI
Location of Property. . . . . . .tIJN `[. . /. . . . .. . . . . . . . . . . . . .House NO.• Street Vr;�et
Onwer or Owners of Property. . j'E'�n IV. .L'.EDN: . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
County Tax Map No 1000, Section. . . . . . .Block: ... . . . . . . . . .Lot.. . : . . .s . . . . . . . .
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed. Map. . . . . . . . . . . .Lot. .
Permit No. . . . . . . . . . . . . . . .Date Of Permit; . . . . . . . . . ... . . . .Applicant. . . . . . . . . . . . . .. . . . . . . . . . . . .
f
Health Dept. Approval.. . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . .. . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . .
Request for: . Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . .
Fee Submitted: • $.. . . . . . . . . ... . . ... . . . . . . . . . . . . ...
S jai
....__._.. . . .._ -.. - APRLICANT
CONSENT
TO
INSPECTION
Tthe undersigned,
Owner(s) Names)
do(es) hereby state:
That the undersigned (is) (awe) the owner( of the premises in the Town
of Southold located at e.0UyA PLO"
�1 Lil , which is shown and designated on the Suffolk-
County tax map as District 1000, Section o,s� Block — ra 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:
c . o
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: �f
(signature)
(print name)
(signature)
(print name)