HomeMy WebLinkAboutZ-28618FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 28618
Date: 07/25/02
T~IS C~RTIFIES t~at the building DWELLING
Location of Property 2505 OLD ORCHARD RD EAST MARION
(HOUSE NO.) (STREET} (HAMLET)
County Tax Map No. 473889 Section 037 Block 0006 Lot 005.001
subdivision Filed Map No. __ Lot No. __
confounds sL~bstantially to the Requirements for a ONE FAMILY DWELLING
built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z- 28618 dated JULY 25, 2002
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 SCREENED PORCH AND COVERED BRICK PORCH.*
The certificate is issued to ROGER J WALZ & WF
(OWNER)
of the aforesaid building.
SUFFOLK COUNTYDEPARTMENTOF~E~J~T~APPROVAL
ELECTRICAL c~TIFICATENO.
PLUMBERS CERTIFICATION D~rKU
*PLEASE SEE ATTACHED INSPECT~POR~.
Rev. 1/81 ~
N/A
N/A
N/A
· A~t~or~ze~-Sig~ure~
L(~TIO~
~J~DI~SIO~
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
2505 OLD ORCHARD RD
~ OF OENER (H): ROGER J WALZ & WF
OCCUPANCY: SINGLE FAMILY
~.DMI~I~D BY: ROGER WALZ
EAST MARION
MAP NO.: LOT (S)
ROGER J WALZ & WF
ACC(tqPANIED BY: SAME
~ A%rl~IIJ%BI~E: SOFF. CO. TAX ~;~P ]~O.: 37,-6-5.1
SOURCE OF P, EQUEST: ROGER & LESLIE WALZ DATE: 07/25/02
DWELLING:
~"~PE OF CO~S~UCTION: WOOD FR3%ME
FOU~/DATION: CONCRETE BLOCK
TOTAL ROOMH: 1ST PLR.: _~5 2ND FLR.: __90
BA~R~K)~(S): 2.0 TOII~TROOM(S):
STORIES: 1.0 # EXITS: 3
CEIJ~AR: PART CRAWL SPACE: PART
3RD FLRo: 0
0.0 I~TILI~"f ROOM(S):
PATIO ~PE: BRICK
~E: 2 1/2 CAR
~R~ITION~G:
PORCH'TYPE: SCREENED
BR,~EZ~Y: FRONT
DO~ESTIC HO'f~/ATER: X
TYPE ~T: 0IL
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.:
SWIPING P(K)L:
STORAGE, TYPE CONST.:
TYPE C0~ST.:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
DATE ON INSPECTION: 07/18/02
TI~R START: 9:50 AM ]~D: 10:20 AM
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
L_ TD_'¢dN OF SOU'410LD
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. 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.
.or existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses:
Accurate survey of property showing all property lines, streets, building and unusual natural or topographic
features.
2. A properly completed application and 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- $25.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Old or Pre-existing Building:
Date.
V/ (check/ one)
New Construction:
Location of Property:
House No.
Owner or Owners of Properly:
Suffolk County Tax Map No 1000, Section
Subdivision ~tq, q_ D //Z E/~,J5
/
Permit No.
Health Dept. Approval:
Street
Hamlet
~,: Block ~ Lot
_22~/~/d',~ Filed Map. Lot:
DateofP~ermit. Applicant: /~/r~ ff)~/fr/~//~f~D/9
Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate
Final Certificate:
(check one)
Fee Submitted:
~ A¢icant Signature
~00/~ TEST HOLE
0 ~ ~,''~ 8Y McDONALD GEOSClENCE
APRIL 18, 2002 (EL. 12.6)
DARK BROWN
SANDY LOAM
~ - 1' BROWN
. ~ '¢o.~ ., SANDY LOAM
~ ~ ~ PALE BROWN FINE
~ ~ , ~ TO ~EmU~ SANO
~ ~ ' ~ ~ -11'
~~;~v~¢~ ~~~'~ ~ ~- BROWN FINE TO
~~., ~~* ¢/~"'"--~. ~ ~ ~ , MEDIUM SAND
' '" ~ ~E LINE ALONG
M~ HIGH WA~R
AREA: 12,8~4 S.~ = 0.295 AC. u~
2002.
CERTIFIED TO: SURV~ OF
J. PART OF LOT 5
LESLIE WALZ
MAP OF
GARDINERS BAY ESTATES, SECT/ON 2
~E NOT GUA~EED UNL~S P~I~LLY ~DENT ON ~E PREMIS~ AT
~E ~ o~ ~ su~ EAST MAR/ON
GUARAN~ INDI~ HEREON SHALL RUN ONLY ~ ~E PERSON{E) FOR
~o~ rH~ su~ ~s ~, ~o o~ ~s ~ ro ~ ~ co~- TOWN OF SOUTHOLD
~ co~ ~CE~Cr ~ L~m~ ~Sn~nO~S USr~O ~E~O~, SUFFOLK COUN~ NEW YO~K
NOT ~NS~BLE m ADDInONAL INtrONS OR SUBSEQUENT OWNERS.
1" 40'
mE 0~ (OR DIMENSIONS) SHOWN HEREON ~OU mE SmUCmR~ m SCAL~' = DATE: APR/L 2& 2
~E PROPER~ LIN~ ARE FOR A SPEClRC PUR~SE AND USE AND ~ERE-
FORE ARE NOT ~NOEO TO CmOS mE ERECnON OF ~NCES, R~N~N~ S.C.~M. DIS~ 1000 SEC. O57 BLK. 06 LOT¢05.001
WALLS, POOLS, PAnOS, P~NnN~ AR~S, ADDmONS TO BUlLOmCS AND
FILED:SEP~ 2& 1927 ~ ............................. :'>:':':':':':':':':~~~f~?:':~':':':':':"; .................................
//
REV/S/ONS: ? .............................
P~ul ~ C~ndizo,
license no. 050149 Good O~und Su~eyo~, P.e.
Owno]
CONSENT
TO ·
INSPECTION
'(s) Name(s)
of Southold loc-~
County tax map
That the ur
tion in'th,~ Soutt
the undersigned,
~old Town ~uxlding lnspeu~,~. °o or.£'~.o £o.- +ho tnllnxvfn~:
That the urders~ned do(es) hereby give consent to the Building Inspectors
of thc Town of ';outhold to enter upon the above described propertM, including
any and all buildings located thereon, to conduct such inspections as they may
deem necessar~ witl~ respect to the aforesaid application, ~elud~inspections
to determine ~h~t said promises compl~ with ail or the law~, ordinances, rules
and regulations, of the Town of SouthOld.
The undersigned, in con~ent[ng to ~uch ~spa~tion~,. do{e,) so x~th the
knowledge and Cnderstanding that any ~formation obtained In the conduct or
such inspection~ may'be used as evidence in subsequent prosecutions for
lations oF the l~vs,
ordinances, rules or regulation.~-~3f the Town of Southold.
. ',, " ~-~ (~signat e)~___ --
' ' (p:int na~e) -
do(es) hereby s/ate:
That the undersigned (is) (are) the owner(s) o£ the premises in the Town
/
/.A.z~% , which is shown and desigm'~ted on the Suffolk
as District i000, Section 37 , Block $ , Lot ~
dersigned (has) (have) filed, 'or caused robe filed, an applica-