HomeMy WebLinkAboutZ-22597FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-22597
Date SEPTEMBER 17r 1993
THIS CERTIFIES that the building
Location of Property 4635 PE~UAS~q AVE.
House No.
County Tax Map No. t000 Section 137
Subdivision
ONE FAMILY DW~TJ.ING
CUTCHOGUEr N.Y.
Street Hamlet
Block 4 Lot 6
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-22597 dated SEPTEMBER 17r 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 DW~.T~.ING *
The certificate is issued to JOHN & JOAN WETZEL
(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.
/ ~6ilding Inspector
Rev. 1/81
LOCATION:
SUBDIVISION
4635 PEQUASH AVg.
(number & street)
NAME OF O%~qER (s)
BUILDING DEPARTMENT
TOWN OF SOU~IOLD
HOUSING CODE INSPECTION ]LEPORT
CUTCHOGUE, NEW YORK
(municipaLity
MAP NO. LOT (s)
JOHN WETZEL & WIFR
OCCUPANCY
I FAMILY DWELLING
OWNER
(type)
ADMITTED BY: OWNER
KEY AVAILABLE
SOUKCZ OF REQUEST:
JOHN T. WETZEL
(owner-tenant)
ACCOMPANIED BY: SANE
SUFF. CO. TAX MAP NO. 137-4-6.
SEPT. 10,
DATE:
1993
DWELLING:
TXFE OF CONSTRUCTION FRAHE
FOUNDATION CEI~NT BLOCK
TOTAL ROOMS: IST FLR. 5 2ND FLR.
# STORIES i # EXITS Ii-
CELLAR CRAI~L SPACE
LOFT 3RD FLR.
BATHROOM (s) i TOILET ROOM (s)
PORCH TYPE I SCREENED PORCH DECK, TYPE
BREEZEWAY FIREPLACE XX
DOMESTIC HO~qATER XX. TYPE HEATER NATURAL GAS
TYPE HEAT FORCED WARM AIR XX
O~tER:
UTILITY ROOM
PATIO, TYPE
GARAGE
AIRCONDITIONING
HOTWATER
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.
S~IMMING POOL
OTHER:
STORAGE, TYPE CONST.
· GUEST, TYPE CONST.
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
ION-EXISTING (A1LAGE) CItA~GED TO LIVING SPACE.
(]
REMARKS: BP # 10767-Z CO Z-18428 DECK BP ~ 16862Z-CO Z-18347 FOR ADDITION & ALTERATION
TO CHANGE GARAGE TO LIVING SPACE.
DATE ON INSPECTION SEPT. 15, 1993
TIME START 9:40 ENI} I0:00
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
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 ~sed 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.
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 - $i00.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
· Date ..................... ...
New Construction ........... Old Or Pre-existing Building...iii~./.. .....
Location of Property., ..~.~...~.. ...... ~...~.~.~.~/~.. ~. ......... ~.f~..~.~.. ~. ...
House No. Street Hamlet
Onwer or Owners of Property ................ ~-~-- ~ ............
County Tax Map No 1000, Section .... f.~. ..... Block .... .~.~. ....... Lot ..... ~.~. .............
Subdivision...~.~..~-~. · .~..~..~.....~.~.~. ......... Filed. Map... ~.~..~..~...Lot ...... ~...~. ............
Permit No ................ Date Of Permit ................ Applicant ..................... .. . .. ...
IIealth Dept. Approval ........................ Underwriters Approval ..............
Planning Board Approval.........~ .......... .. ..
Request for: Temporary Certificate ...... Final Certicate ....
~a,~' -- pPLICANT i ~
Oxm~er(s) Name(s)
do(es) hereby state:
CONSENT
TO
INS [~EC'i'ION
the undersigned,
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at
County tax map as District 1000,
· which is shoxwn and designated on the Suffolk
Section /~7 · Bl°ck.,,O~ · Lot O~
That the undersigned (has) (have) filed, 'or caused to be filed, an applica-
'tion in the South01d Tox~m Building Inspector's Office for the ~ollowing:
That the u~dersigned do(es) hereby give consent to the Building Inspectors
of the Town of Southold to enter upon the above described property, including
any and ail buildings located thereon~ to conduct such inspections as they may
deem necessary with respect to the aferesaid 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 Toxvn of Southold.
Dated:
(signature)
(print name)
EUGENE CREEK
FLEETWOOD ROAD
LOT NOS. REFER TO MAP OF FL'EETWOOD COVE
FILED dULY I, 19;38 IN THE OFFICE
OF THE SUFFOLK COUNTY CLERK
AS MAP NO. 1263
JOHN
PLAN OF PROPERTY
FOR
WETZEL & JOAN WETZEL
AT CUTCHOGUE
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N.Y.
I000 - 137 - 04 06
SCALE I" : 30'
FEB. 2 , 1987
PECONIC SURVEYORS
(516} 765 - 5020
P.O. BOX 909
MA IN ROAD
SOUTHOLD~ N.Y. ll971
N.Y.S . LIC. NO. 49618
ENGINEERS, PC .
87 - 126