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Home My WebLink AboutZ-40552 ff'SUFFpt�. Town of Southold 7/26/2019 53095 Main Rd COD = Southold,New York 11971 1:5 PRE EXISTING CERTIFICATE OF OCCUPANCY No: 40552 Date: 7/26/2019 THIS CERTIFIES that the structure(s) located at: 500 Goose Creek Ln., Southold SCTM#: 473889 Sec/Block/Lot: 79.-1-4 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- 40552 dated 7/26/2019 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.* Note: BP 10780 deck addition& enlarge dining room COZ-14202; BP 37789 generator COZ-36235 The certificate is issued to Mallgraf, Phyliss (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. Wt BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 500 Goose Creek Ln., Southold SUFF.CO.TAX MAP NO.: 79.-1-4 SUBDIVISION: NAME OF OWNER(S): Mallgraf,Phyliss OCCUPANCY: ADMITTED BY: SOURCE OF REQUEST: Mallgraf,Phyliss DATE: 7/26/2019 DWELLING: #STORIES: 1 #EXITS: 2 FOUNDATION: cement block CELLAR: full CRAWL SPACE: BATHROOM(S): 1 TOILET ROOM(S): UTILITY ROOM(S): PORCH TYPE: DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: yes GARAGE: DOMESTIC HOTWATER: yes TYPE HEATER: oil AIR CONDITIONING: TYPE HEAT: WARM AIR: HOT WATER: radiators #BEDROOMS: 2 #KITCHENS: 1 BASEMENT TYPE: finished room with heat 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: 7/25/2019 TIME START: 10:00am END: 10:35am 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 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. 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, r 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. 7 f New Construction: Old or Pre-existing Building:: n/ (check one) n Location of Property: s®p 4 S L CJ1 P_Q ) Liz ,e 1::Z�l t I b1 o"�C House No. Street / Hamlet Owner or Owners of Property: � U / ��/ A-� 1 Ci' (�-Z- Suffolk County Tax Map No 1000, Section 77 Block 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: $ 0 0 • 00 ti Applicant Signatur CONSENT TO INSPECTION the undersigned, do(es) hereby state: Ow " r(s) Name(s) That the undersigned (is) (are) the owner(s) of the premi es in the Townof Southold, located at Soo ��o✓a—Q + 6� which is shown and designated on the Suffolk County Tax Map as District 1000, Section � 9 , Block / , Lot . That the undersigned(has) (have) filed, or cause to be filed, an application in the Southold Town Building Inspector's Office for the following::1.,",A� G� 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: 7 (Signature) c-P- D wh-i V1 ec calor (Print Name) (Signature) (Print Name) "-0 Building Department Application AUTHORIZATION (Where the Applicant is not the Owner) �A fl/C' residing at 5—Cnj C— a 0 (Print property owner's name) (Mailing Address) do hereby authorize (Agent) to apply on my behalf to the Southold Building Department. (Owner's Signature) (Date) Fd (Print Owner's Na e) MAP OF MO-VMTY 'GOOSE CREEl< .. off- ALLGQAF ' APPA)ZEN7 OBERT LOW WET C1 M�-0F "up)&C G S r k._ c�C < ~ E't5�) dt3CND.EEV.�.O TQ . t Q N.Y. - - �• - - - r, X710 �. tm this tatmrey It a t,6olnlon d t ,6eelk�n 72Dti of t�ha flew Ytlrlt S1tl� j :.1 `Edi!cation Lala - �Pb�a,od.st ymaanotbm&lo en,bo.,,e it a:r a mg or 3 ..�} Guarantee:tr,a�aeee trbraarr drab run onytothepereonbran ftSU,,,W is prepared and on hb bWmjf to nra LU tette-onwanr.9o+rerrrnarta,gpwrcy and _BRIG � t�,npe nstrtution+aeoed Mrrrorr arKf t r" ppuC �• tunon.Guuartg"aro ra Vwwbroby i to o tonal hgftoion&or Owners. 'Nrt i Km SEALS t 02 �! � - of Al ill R� e ! L&MF POST) N r �'Fri F5 G y - • _r f R PO\nfi2 LINE �g Y —) 0 ND LILC POLE As I t 50047t?Q W 7%3.0' 20 WIG HT SSE CQF_F_V.. LANE 1�!lAt2. { s Ol�NER 5 fRE \4 ILLAGE — DIST. SUB. LCT FC RAAER OV+ NEf. , E , ACRI 14� . TYPE OF ;U11.DING — RES.dip I S AS. — FARM C( IM•lvt: CB. 1v�ICS. P ikr. Value LAND IMP. TOTAI ____ Df TE RE. nAF,KS — py ,� le 711f A S ET- AGE BUILDII\ CONDITIOt NEW NORMAI BELC N Al OV Y FARM Acre — Value Per Slue — — — �- — Acr il�ibie FRONTAGE ON V ATER ;7 ' i LD Woodland — — -- FR( NT AGE ON R )A'[% — JUAI — Mec dowland DEI TH ,Ho,-se F Iot BU XF =AD :Tot. DO 'K Alf. MIN ME No M ...,-.w . �•.�„y tYi' Mr.+'.;ea.t.Ra '-a. �'3...:. � W� _ _ _ MIN .01 ■ w ' ME ON No MW 5.. r i..r�6�..,..+ =_C;irc ts_xs..� y,{; .c ,i'a �• ^ I ■ ■■ ■■ I.J� ■_� ■ 4"- I t� �~ �^` �"� fI' • .a; ■ ■ ■■ �ii="__ www � ■ ■■ ■■ �►!� ■® ■ ■■ ■ No No �■ ■ ■ ■ . No ■ ■■ ON . .. . :.th . •. : Heat- :. r • ' Dorr ierr • vim: `Suo cr tt b*Ae,- SaV40 OF SOUIyo� # TOWN OF SOUTHOLD BUILDING DEPT. cou - Pre,`yrm��' 765 1802 C. A.-lo 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: N 4,1T DATE INSPECTOR LOCATION: ,�iU S 6rveeJa (Amber & street) (municipality) SUBDIVISION: MAP NO.: LOT(S): .. NAME OF OWNER(S)': IS OCCUPANCY: I All Yln (type) (owner-tenant)- -- ADMITTED BY: --ACCOMPANIED BY: KEY AVAILABLE: SUET. 'CO. TAX MAP'NO. 1000^ •" SOURCE OF REQUEST; - roW ✓ , DATE: vIu. DWELLING TYPE OF CONSTI2UCTI'ON: # STO-=S: ` .9 EXITS: .-� FOUNDATION: ; ]�ASV,.MENT: -VIA 'CRAWL SPACE: _ # OF BEDROOMS: 18T FLR: 2ND FLR: 3RD FLA: BATHROOM(S)-: ' 1, TOILET AOOM(S): UTILITY ROOM: PORCH.TYPE: D'E•CK�TYP ✓ PATIO;TYPE: BREEZEWAY:' FIREPLACE: QARAGE: DOMESTIC HOTWATER: TYPE HEATS \: D V A7RC0& IT10NING-:__� \J Al , J� TYPE HEAT: OL✓ WARM AIR: HOTWATER:`-,,4" " # OF I{ITCHENS:k - -- -- ----- ----�- ---- FINISHED BASEMENT YES ✓ (eNO �f 4444OTHER:�y AW W 1Ch Ih 'rY�i ��• ACCESSORY STRUCTURES . ' N tT Pa GARAGE; TYPE OF CONST.: STORAGE TYPE CONST.: SWIMMING P'O-OL: GUEST,-TYPE CONST: OTHER: VIOLATIONS: CHAPTER]44 &N,Y, STATE:UNIFORM F;RE PREVENTION & BUILDING CODE LOCATION D.SCRTPTION ART. SEC. REMARKS: INSPECTED BY: 40'A!` DATE OF INSPECTION: '�_ TIME START; � '� END: 10