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Home My WebLink AboutZ-23363 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-23363 Date NOVEMBER 21, 1994 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 1725 OAK DR.&520 WEST SHORE RD. SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 80 Block 1 Lot 49 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-23363 dated NOVEMBER 21, 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 ONE FAMILY DWELLING WITH ATTACHED GARAGE & PORCH The certificate is issued to MARJORIE KRUEGER (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *THIS UPDATED PRE CO Z-7309 DATED OCTOBER 18, 1976. uilding- Inspector Rev. 1/81 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Clerks Office 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 Inspector 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 installations, 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 in- formation required -to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Date :.!Lf.,. .L..��...7..�.... New Building ................ Addition..^.II.............. IOld or Pre-existing Building ....n.............. Vacant Land .............. Location Of Property .. J.4�4.r�.... ..�l.d.r.e; .. y��.�.�.. 0.4�..T�1. S .:::� .�J..!.l! ),I..�.- �!.�-1 1 OwnerOr Owners Of Property .. -. .:...!... .�� ......................................... .................................. Subdivision ............1 ...-.'' - ....Arm... .IIV!��D. Lot No. ....Y�. Block No. ............ House No............. Permit No. ......(�. .. Date Of Permit .J-1..........;Applicant ...,�. ,.. .... .............................................. . . ... Health Dept. Approval ... ...........Labor Dept. Approval ............... [..�.................... Underwriters Approval ..............................................Planning Board Approval ......., .... .................. Request For Temporary Certificate ......................................... Final Certificate .........� ..................... Fee Submitted $ ............................ Construction on above described building and permit meets all app 'cable codes and regulations. Applicant ............. :.. . . .�, . ..................................................................... Sworn to before me this �� ..... P... da of .... .... . 2730 y ��`'.!'.. .. .......... (stamp or 3 Notary Public ... ... .. ty SENT BY:Xerox Telecopie,r 7020 ;11-16-94.__9:45AM i ALBANESE & FIORE-► 515 765 1623;# 3 TOWN OF 60=1101.0 WILDING IMPARTMAM'r TOWN BALL ' • 7AS-18t)2 ArPL.1CATl091 FOR CUTIFICATKO' OP o4XIIrAN(,;Y •I I, .41 itplt1lrAti1e11 totude 4a filled Its by typewriter Olt Ink find Nul)f0itts(t ,U7 tllr. 17911 111IIIA 4a1 irector %flil. the Eoll♦owlnat foi 'new building or now uaet 3 . ftne27 survey of pr party with .Accurare 3ocatielt of nl l ltuli-dlt+ga. .T►et+1+1•rsy I tt�ra. oven Ara, and attusa 1 natural or topographic te6tvres. 2: Ylt,el Apl•rovat*41; Health Dept. of water puppIL7 nt1d eeaerAPs`-diapaenl i. t.l+provnl of el,ectr e*1 installation from Board rtf, Fire Undarwr.itern. 4. sworn statement •ft; t4 plumt+cr certifying t1lat, the !tolde,:'used In Ay14t:euti c'r,ntr�inr� 9.0918 then 2/10 of x ]ead. + oi S. neberclnl buLtaia induat riai building. multiple ivsldencna and aimt•I,nr l,tltlditivn .It1.1 luser�llai ianet. ;: cectiticat.s: al Code Compliatw4a fro.++ Fuel+Zteoe or r11f11210-k Yaspensibie for the building. R. 94mbrrit r3anning •Bo rd Approval of completed site pinit roquivatnent-s. ,I. ro .— &*Ust—lr.a buildings (prior: to -April 9. 1957) nott-c,otlformLTjg tte;oe. or hoildlltto rind. •/p ea-twrdntive" lend, ue et 1 . Aeolurate Purvey of .prorevty allowing ell proper ty .I Lama, etreatfi, 6xI1.td$:Ibx nn11 Vausual natur*1 or topearophle faaturas. 2. A properly completatd .applicatlon and s consent to inspect: -signed by thir 011pt I_rnut. ill w cart#ficoke of Occupancy to denied, the Building XPRIPector tahn,l.l bttate t11r• rensetta thasQfor 16 writing to the applicant. i,: ' Ciertifleate of Oee Panay• 'Ilew dwelling S23;00., Add1clolts to dwelling $29_f10, O teratiork to dwe lies $25.00, Swi0i Ing pool. $23.00. Accessoi.y bieU dins $ZS.00_. ARelAtiono to acres ory building $25.00. 1luelnessee $50.00. 2. Cottificato of Ocelponey on Pre-suiet3eg Building - $100.00 3. espy of Cartlficat or -Occupancy - $3.00 over S, years - ¢L0.00. 4. Updated Certiflcat: of Occupancy - $50.00 '3. Te"orary CertiNcLte of Occupaney - Rasidet7tial $13.00. CometorclaA $13.00 Date ... . NOV 21.. j 19 94 _ . . . . . . . . . . .. . . .. .. . a .. . -- - eta cortstsvetion. . ... . . ... old Or Pro-exidtia8 BuildiaR.. . .xx. . . . . . . . . . . Lsscutl d n'ad !•soplerl:y_. .17.2 .Oak.lkive. Brad.S2D.ife.9 . $liq�Qr.RQ�.�R .IF�31.�.�1R�$r� P.�"L.�F4= . . . . 1tt►uae� Street Ilrltn,la 9nwer a: 614mrs of Tropgrty . . . .:l $dPR "a.$$L�F i$... .. . . . . .. :. .. . . ... . . . . . . . ... . . . . .. : .. . . . . I CetfPtf 1/ 'Rive sbp No l0001 8 coon. . .B.toelc . . . .. . . . . . . .l.ept.. . 49 Dub Jtv I.RiAmo... . .. . . . . . . .'.: . ... . . . :.. .. ::. .,.... . .riled 11n1+. . .. . . . . . . ,,.LINf;. . . . . . .'., . . . . . . . . . . Perm.g1 No. ... .. .. ..• .._ • .Da 9 Of, . . . ... . . . . • a • • •a. .. . . . . .. . . . . 1 . . . . . . . . . . . . . IIftl+iktM a. Approval. .. .. . .,...... . ... . Und.... .... aerritoro Apl �nl rn . . . . . . .'. . j P�tlUttl'�I� �� Q'a AWrovel. .. .i . .. a . a a a a . a . ..a a. ■ ■ Temporary CerR 3,iicate... , .Old Pre-Ssistinq 1� Dafted Pre-�ai3s€tag C/O ROVI'llest fore Y Final Cartitate. . .. . . .. .. . Fos sutr ittod! 5.. . .56.0A !'. ..:. .. . ... . .. .'.. . . Thomas Hoffmann, Atty • / • ... . • • . a . ... ... . • . • • ■ . . • . . . • . . . . . . . . . . I r I 611, I ' i I