HomeMy WebLinkAboutZ-40528 f 'S'Fpp1,f Town of Southold 7/21/2019
�o`A c°Gyp 53095 Main Rd
Southold,New York 11971
co
dol � �,e011{S
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: 40528 Date: 7/22/2019
THIS CERTIFIES that the structure(s) located at: 179 Old Harbor Rd, New Suffolk
SCTM#: 473889 Sec/Block/Lot: 117.-34
Subdivision: Filed Map No. Lot No.
conforms substantially to the requirements for a built prior to
APRIL,9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 40528
dated 7/22/2019 was issued and conforms to all the requriements of the applicable provisions of the law.
The occupancy for which this certificate is issued is:
wood frame one family dwelling.
Notes: BP 575 move dwelling to new location on same lot COZ-389; BP 11442 deck add to kitchen attached garage
and alteration to dwelling COZ-14882;BP 28879 dormer addition COZ-29480; BP 43873 air conditioner COZ-40527.
The certificate is issued to Wickham,Nancy
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
u h ' d Signature
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 179 Old Harbor Rd,New Suffolk
SUFF.CO.TAX MAP NO.: 117.-3-1 SUBDIVISION:
NAME OF OWNER(S): Wickham,Nancy
OCCUPANCY:
ADMITTED BY:
SOURCE OF REQUEST: Wickham,Nancy DATE: 7/22/2019
DWELLING:
#STORIES: 2 #EXITS: 2
FOUNDATION: cement block CELLAR: partial CRAWL SPACE:
BATHROOM(S): 2 TOILET ROOM(S): 1 UTILITY ROOM(S):
PORCH TYPE: DECK TYPE: PATIO TYPE: front slate
BREEZEWAY: FIREPLACE: 1 GARAGE:
DOMESTIC HOTWATER: x TYPE HEATER: electric AIR CONDITIONING:
TYPE HEAT: oil WARM AIR: forced hot air HOT WATER:
#BEDROOMS: 4 #KITCHENS: 1 BASEMENT TYPE: unfinished
OTHER:
ACCESSORY STRUCTURES:
GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST:
SWIMMING POOL: GUEST,TYPE OF CONST:
OTHER:
VIOLATIONS:
REMARKS:
INSPECTED BY: JOHNJ DATE OF INSPECTION: 6/3/2019
TIME START: 10:43am END: 11:15am
Ll 1,-3 a
® �f0�� NWotj
_ n
�•/ Form No.6
APR 8 2019 TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
!P"UU' 1R 71 765-1802
TOWN OF S0Uj(0L3)
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 ihan 2/10 of 16/o 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 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$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00,
Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,Businesses$50.00.
2. Certificate of Occupancy on Pre-existing Building- $100.00
3. Copy of Certificate of Occupancy-$.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy-Residential$15.00,Commercial$15.00
Date. 3 /a 6 1a011
New Construction: Old or Pre-existing Building: ✓ (check one)
Location of Property: (9 I ��� 46-`rb0 G Q, �e-W S C Rl,
House No. `` Street Hamlet
Owner or Owners of Property: L", F_, W 1 b,6m
Suffolk County Tax Map No 1000, Section r7 Block 3 Lot
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ 10 n . (�Q '
e- "W*
App 'cant Signature
CONSENT TO INSPECTION
CA W the undersigned, do(es) hereby state:
Owner(s)Name(s)
That the undersigned (is) (are) the owner(s) of the premises in the Town of
Southold, located at_nq Old +�c:. o-c P—d WRA4 S Lk%tk I\j� ns (4,
which is shown and designated on the Suffolk County Tax Map as District TOOO,
Section, Block_ , Lot 1
That the undersigned(has) (have) filed, or cause to be filed, an application in the
Southold Town Building Inspector's Office for the following: Pyre—C.0
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 in subsequent prosecutions for violations of the laws, ordinances, rules or
regulations of the Town of Southold.
Dated: 3 a(,�
,Y�\�
Si nature)
1Q0,Y)- • W I�
(Print Name)
(Signature)
(Print Name)
TOWN, OF R
OWNER STREET f`7C VILLAGE DISTRICT SUB. LOT.
FO.,M� OWNER'\. r EP ACREAGE
�C .�1 � ��ciialc YAG . ,c� �1 1• I
Pz »D �` � ► S l�� /� W TYPE OF BUILDINGr
RES. , a SEAS. VL. FARM COMM. I' IND. I CB. I MISC.
LAND IMP. TOTAL DATE REMARKS / 1l oi-
t3 Ad0`�Td�t �
f �
' 1 ,�•-'� ® L� U ��� 1� ®• � r/ p %3%/ �. //Slr/� d 7�s'! �C o.�Aa�oli
2
�? Cad CrJ rej. cj _ n ] �r' --
_ z re
.. coq- otlli 74- 6P -_a8 ti ,
{
sr" .(Q 70o� BUILDING NDIT1
NEW ' NORMAL" BELOW ABOVE `' '
Farm -` Acre Value Per Acre Value
-
Tillable 1- r
Tillable 2
Tillable' -3
j Wcodland
Swampland
Brushland
House Plot =
t�Totol
; -
t
Z.
t� ~•11 .7 .tl • 7.,^ ` _
�.'"'•I.'wry � �-;T: .. Vf h��y.+•y. t 1P'
■■■■■■■■■■M■■■MMMM
MMM
r ■■■
y 3 -- �.. ■■■ ■■n e■n■■n
MMMINIMIRMIM
I ►3i� ■■��OMMr■■■n
■ . ■■■■■■■n■■■
® ■■■■■nn■E■■�■
n-
,io r o• �
••
Room s Ist Floor
Patio
• ••^ , Driveway
t � � •v
t
5U, RVEY OF PROPERTY i N
51TUATE: NEN 5UFFOLK ,
TOWN: 5OUTHOLD
5UFFOLK COUNTY, NY W E
SURVEYED: APRIL IT, 201cl
SUFFOLK GOUNTI' TAX # gND S
Np
1000 - 11-7 - 5 - 1 0 G `VpIR
CIE UMD TO: �,� �`� `�p `��SON l VNG MFS Y of
NANCY LANUMARK 4e00 5 7 o rR�S r
ko \�� NQ p9f4p,�
0 v
k p-k '
=0 y
Y �\✓ /
v 'D N MoD�o\o o
0� keQ \o\0 36/4g
o ASPHALT VFJV YVAY /
h /
All
y 3
ry
Q
0
u
�0O
/V-7/
` 26 3p ry
/1
0 m�
88 -7'
0 NoWrl l NES
OCOD� tj
r1yL/sA ,�FsKyA
J '*'Y ✓s 5020
LAND S
- - 1MCuthdNxed al[era[lon a addtket to a swvey
mqa bewtng o Ilce�od land surveb seal is a
btatlan,dF sectlon L 120-L
eub-dNelarl 3 the
Ya-kkE
StaFu mcatkm ov'
^GYAy cop,os frau the ongtrol oP the suvEy
ked with rn orynal of the Iartl erveyor5
stdrnped eepl 511x11 ba cateidered to be valitl tnro
NOTES: ��dP attar In"l d hereon 5 gfiy shot.twp
y ro9 prepa,ed N occord ce with the eK-
Is4ng Gcbe of F'rdctka fa•Laid 5v'veys mopFdd
�tho New cork stem ro5ouanan or Prore55tawl
Lald�i gyors '„ald cerk the
MONUMENT FOUND
IK 9 eF p p oA
to the p@PSafi or w eserve prepered,
orW on hH baholf b Me M1,cortipaey goverrmen-
tal ages le dmg�5MAtaa I s ed nerea a d
to n,e assignees aP the lendeg tnsntu[wr cer[tP�cq-
tlOrS oma noC troreferWle fe atldl[lonal IrebWttorp
AREA = 46,h-ra 5.P. OR 1.0'1 ACRES _ JOHN C. EHLERS LAND SURVEYOR
6 EAST MAIN STREET N.Y.S.LIC.NO.502OZ
GRAPHIC SCALE III=; 40' RIVrERHEAD,N.Y. 11901 3694288 Fax 369-8287
REF.-C:\UsersVohn\DMbox\19\19-12Q.pro
w c.
[{,PtAov �6. �JW �d�[W
oF sauryO{o
TOWN OF SOUTHOLD BUILDING DEPT.
co 765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ], FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS: S O mcs, O 6v
Go
NAAV4 41v 4* Chtl k
4 ds, J�
DATE INSPECTOR
1�-
x
tr
l
'�
x'
�,�
_�t.,''�
-`r
4 ._ _._ ...�yYre..
r �
+� � _
��
c
,�
>�
��
s
i
{
�. a
�.
=X°
�r4 �• }
,� -«> ���
�,.
f
i
Y
A
�..
�!',...
� y
'* `�"k
.;y,
a
7.:nS .•ta
v+4i'♦
... :'S��.L'I .. '
4
k
LOCATION; 7 T94
(number & street) .(municipality)
SUBDIVISION: MAP-NO.: _ LOT(S):
NAME OF OWNER(S)':
OCCUPANCY:
(typ ) (owner-tenant),
ADMITTED BY: ACCOMPANIED BY:
KEY AVAILABLE: SUFF. CO. TAX MAP' O.
SOURCE OF REQUEST: ^� DATE:
DWELLING
TYPE OF CONSTRUCTION: # S OMS: # EXITS:
FOUNDATION: L, 8ASEIVMENT: CRAWL SPACE:
# OF BEDROOMS: IST FLR: _ 2ND FLR: 3RD FLA:
BATHR O (S): TOILET AOOM(S): UTILITY ROOM:
PORC Y, : vREM TYPE:CID� ��$�� PATIO;TYPE:
Y
BREEZEWAY: FIREPLACE: r✓ AI2AGE: gg
DOMESTIC HOTPVATERe' TYPE HEA ER: Cs' AIRCONDITIONING: ` ,_,
TYPE HEAT: � WARM AIR: HOTWATER:
# OF KITCHENS j
FINISHED BASEMENT:- YES NO
" z
OTHER: tile)
ACCESSORY STRUCTURES,
GARAGE; TYPE OF CONST.: STORAGE, TYPE CONST.:
SWIMMING P'O'OL: GUEST,TYPE CONST:
OTHER:
VIOLATIONS: CHAPTER-144 &N.Y. STATE UNIFORM FSE PREVENTION & BUILDING CODE
LOC TON DESCPIPTIQN n ART. SEC.
a Its Xk L6 At
h by uyn1
REMARKS:
INSPECTED BY;J og►% �, ''1' -1 DATE OF INSPECTION:J"_
TIME START; ' END: �;