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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-22304 Date MAY 6, 1993
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 940 OAK DRIVE SOUTHOLD, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 80 Block 2 Lot 8
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-22304 dated MAY 6, 1993
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 ACCESSORY 2 CAR GARAGE
The certificate is issued to HERMAN REVERE ESTATE
(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.
i
B lding Inspector
A//
Rev. 1/81
y
BUILDING DEPARTMENT
TOWN OF SOUTHOLb
HOUSING CODE INSPECTION REPORT
LOCATION: 940 OAR DRIVE SOUTHOLD, NEW YORK
number & street) municipality
SUBDIVISION MAP NO. . LOT (s)
NAME OF OWNER (s) HERMAN REVERE ESTATE
OCCUPANCY A-1 Res.
(type) (owner-tenant)
BRIDGETTE DIA ACCOMPANIED BY: SAME
ADMITTED BY: . •
KEY AVAILABLE SUFF. .CO-. TAX MAP NO. 80-2-8
SvURCE OF REQUEST: WILLIAM PRICE, JR. .ESQ. DATE: MARCH 22, 1993
DWELLING:
TYPE OF CONSTRUCTION WOOD FRAME STORIES 2 # EXITS 2
FOUNDATION POURED CONCRETE CELLAR PARTIAL CRAWL SPACE
TOTAL ROOMS: 1ST FLR. 5 2ND FLR.. . I . 3RD FLR..
BATHROOM (s) ONE TOILET ROOT (s) UTILITY ROOM
PORCH TYPE DECK, TYPE PATIO, TYPE CONCRETE IN REAR
BREEZEWAY FIREPLACE . ONE GARAGE
DOMESTIC HOTWATER. YES TYPE HEATER PROPANE AIRCONDITIONING
TYPE HEAT ELECTRIC WARM AIR HOTWATER
OTHER:
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST. 2 CAR WOOD FRAME STORAGE, TYPE CONST.
SWIMMING POOL GUEST,.•TYPE CONST
OTHER:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
BATHROOM CEILINGS; WALLS, FLOORS SHALL BE MAINTAINED IN A SAFE NYCRR 9(B)
AND SOUND CONDITION: TOILET ROOM, BATHROOM AND
LAUNDRY ROOM. FLOORS SHALL BE MAINTAINED IN A WATER
TIGHT CONDITION.
REMARKS:
INSPECTED BY: DATE ON INSPECTION 3/26/93 & 4/29/93
G SH TIME START 9:25 END 9:45
Form No. b
TOWN OF SOUTIIOLD
BUILDING DEPARTMENT
c
TOWN HALL MAR 2 31993
765-1802
APPLICATION FOR.CERTIFICATE OF OCCUPANCY
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 lilies,
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 stateineut from plumber certifying that the solder used in system contains
� . less than 2/10 of 17 lead. '
5. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliance frow architect or engineer
responsible for the building.
' 6. Submit Planning{ Board Approval of completed site plan requirements.
Bir. For existing buildings (prior to April 9, 1957) non—conforminp 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 b • the applicant.
P P Y P PP P g y PP
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 — $5.00 over 5 years — $10.00
4. Updated Certificate of Occupancy — $50.00
Temporary Certificate of Occupancy — Residential $15.00, Commercial. $15.00
Date . . . .MaxCb. 22.,. .199.3 . . . . . . . . .. ..... . . . . .
New Construction. . . . . . . . . . . Old Or Pre--existing Building. . . XX. . . . . . . . . . .
Locyation of Property. ., 940 Oak Drive. . .. , . . ,Southold. . . . . . . , . . , . . ....... . .
House No. Street Hamlet
Onwer or Owners of Property.. ,Estate, of .Herman. Revere
County Tax Map No 1000, Section, .080ti 00 . . „Block. . . .92 . 00 . . . . . .Lot, , , ,008;0,00,... . . . . . .
Subdivision. , Mai . yd.Reon .Shores , Inc; , , ,Filed Map. . . 631 , , , . .Lot, , .�Q, , �7,,, ,1$.�jp�]c, D
Permit No. . . . Of Permit. . . . . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . ...... . . . . .
Ilealth Dept. Approval. . . . . . . . . . . , , . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . I.... . . . .. •'
.
n
Planning Board Approval. . . . . . . . . . . I . . . . . . . . . . . .
Request for. Temporary Certificate. . . . . . .. . . . Final Certicate. .X-V. . . . . . . ,
Gee Submitted: $. . . . . .� QO.A.Q .. . . . . . . . .. .. . ..
. . . . . . . . . . . . . . . . . .. . ... . . . 0 DWILI•J'AIV Tr.''PRICE; ' JR.
Lj5 APPLICANT
Leo -aJ3 Y
MAR 2
CONSENT
TO
INSPECTION
WILLIAVI H. PRICE, -Jr. ,
attorney for the Estate the undersigned,
Owners) Names) o Herman Revere
do(es) hereby state:
That the undersigned (is) (are) the owners) of the premises in the Town
Of Southold located at 940 Oak Drive, Southold, New York, .11971
which is shown and designated on the Suffolk
County tax map as District 1000, Section 080 . QOBlock 0�2.,00. Lot 008 . 0(10
That the undersigned (has) (have) filed, or caused to be filed, an app lica-
tion in the Southold Town Building Inspectors Office for the following: _
2 story frame dwelling and detached frame garage
-----------------
That the undersigned do(es) hereby give consent to the Building Inspectors
ectors
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 in
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; March 22,' 1993
(signature)
William H. Price- Jr FGq.
(print name)
(signature)
(print name)
d
1000-080.00-02.00-00 r-1.000
TITLE NO. S-1072079
S�►pR ;".
C\i
LOTS 16, 17, 18 BLOCK D
FtEVE>C), F-1 E:4S
cla
FILED JULY 2, 1931 MAP NO. 631
Lot 1s BAVVIEW
FRAME TOWN OF SOUTHOLD,
GARAGE SUFFOLK COUNTY, NEW YORK
2.2'\� 1 IN. = 30 FT. MARCH 9, 1993 S 70030' E 165.00'
MARBLE MON. MARBLE MON.
0.5'SOUTH 0.35'SOUTH 0
a 0.8'WEST 0.50'WEST O
O p
® N Lot 6 Q�
GUARANTEED TO:
j �3.0' — HERBERT & KATHLEEN QUINN
W a U Z c SECURITY TITLE AND GUARANTY COMPANY
w a C9 z Y w Lot 17 O
Er O om a W ¢
u- J U Q Q U w
a v cc w 5.4' m co
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o Z
W N N
20.4' o L
,a� O 26.0' w w 0
M 515' ► 0 M
.0 Lot 18 a
0 __
LL
Z CONC.MON. 3.3' t' '"�, A. C.4'f�f,; '
0.2'SOUTH I 1!' .•
OW WEST
N 70030' W 165.00'
MARBLE MON.
0.25'NORTH
0.25'WEST
Lot 19 ` •7;' v0. 3'1 �����
—25.00'
PAUL T. CANALIZO. 13URVEmY(DR
HAMPTON 13AY5. N1=W YC)F-4K