HomeMy WebLinkAboutZ-29292FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 29292
Date: 03/06/03
THIS CERTIFIES that the
building
ACCESSORY
Location of Property 1705
AKA 1650
TRUMANS PATH
EAST MARION
(HOUSE NO.)
(STREET)
(HAMLET)
County Tax Map No. 473889
Section 031
Block 0013
Lot 005
Subdivision
Filed Map No. Lot No.
conforms substantially to the Requirements for a ACCESSORY STRUCTURE
built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z- 29292 dated MARCH 6, 2003
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 ACCESSORY NON -HABITABLE STORAGE STRUCTURE*
The certificate is issued to ANTHONY & LOUISE GAMBINO
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL
NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
Rev. 1/81
N/A
N/A
A horized ignature
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 1705 AKA
1650 TRUMANS
PATH EAST MARION
SUBDIVISION:
NAP NO.: LOT
(S)
NAME OF OMMER (S):
ANTHONY & LOUISE
GAMBINO
OCCUPANCY:
ANTHONY & LOUISE GAMBINO
ADMITTED BY: MARYANN BOLLMAN
ACCOMPANIED BY:
SAME
KEY AVAILABLE:
SUFF. CO.
TAR MAP NO.: 31.-13-5
SOURCE OF REQUEST:
JENNIFER GOULD
2/21/03 DATE:
03/06/03
DWELLING:
TYPE OF CONSTRUCTION:
FOUNDATION:
TOTAL ROOMS: 1ST FLR.: 0
BATHROOM(S): 0.0
PORCH TYPE:
BREEZEWAY:
DOMESTIC HOTWATER:
TYPE HEAT:
# STORIES: 0.0 # EXITS: 0
CELLAR: CRAWL SPACE:
2ND FLR.: 0 3RD FLR.: 0
TOILET ROOM(S): 0.0 UTILITY ROON(S):
DECK TYPE: PATIO TYPE:
FIREPLACE:
TYPE HEATER:
MARK AIR:
HOTMATER:
GARAGE:
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.: STORAGE, TYPE COMST.: CONCRETE BLOCK
SWIMMING POOL: GUEST, TYPE CONST.:
OTHER: *WITH CONCRETE SLAB ROOF, BATHROOM WITH SHOWER & LIMITED ELECTRIC
VIOLATIONS: CHAPTER 95 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
**NOTE: NONHABITABLE ACCESSORY STORAGE ONLY.
REMARKS: BP#12870Z-COZ-12661 (N/D) - BP #28999-Z-(ADDS&ALT- OPEN PERMIT)
INSPECTED BY: ?Zor . DATE ON INSPECTION: 03/06/03
MICHAEL J. VERITY TILOS START: 10:20 AM END: 11:00 AM
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802 FEB 2 1 2003
APPLICATION FOR CERTIFICATE OF OCCUPANCY
i<.
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 $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.
Certificate of Occupancy on Pre-existing Building - $100.00 — - fir PrP - �'x ist,ny fj } N gp
3. Copy of Certificate of Occupancy - $.25 (p D�lPUldPc� G7 f{j .S
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
New Construction:
Old or Pre-existing Building:
Date. cZ d l - 200 3
(check one)
Location of Property: I �5C aklt 1%f.i 7,'ur)X4n1s At4k_. CQXyj Wale, ok.-
House
No.
Street / Hamlet
Owner or Owners of Property nt -�Y1 y G ,1 d t. --DN se 63 7
Suffolk County Tax Map No 1000, Section
Subdivision
Permit No.
Health Dept. Approval:
Date of Permit.
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $
Q,Z'C. G 3�l s�
� CO -2-- aqa 9a
Block ) 3
Lot 5
Filed Map. /J ILL= Lot: /J (cL _
Underwriters Approval:
Final Certificate: (check one)
Ct t t-/t,t'w CECa ri v<� b -f
Appli ant Signature
Ct ttDi u'Z j
CONSENT TO TO INSPECTION
D f PrP-Px15f,Y1
P -PA k - DL( ,
jl it Y, i e'_ 6 CSS �t- f , the undersigned, doles) hereby state:
Owner(s) Name(s)
That the undersigned (is) (are) the owner(s) oft e premises in the Town of
Southold, located at / b 5 O % uY"0,4's Q-� 14— a k 4 1
which is shown and designated on the Suffolk County Tax Map as District 1000,
Section , Block I '6_, Lot 5 -
That
That the undersigned (has) (have) filed, or cause to be filed, an application in the
Southold Town Building Inspector's Office for the following:
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: - 2 1- 200't�
(Si ture-,Q�
(Print Name)
(Signature)
(Print Name)
LOCATION:/ 705'
(number & street) (municipality)
SUBDIVISION:
NAME OF OWNER(S):
OCCUPANCY:
(type)
MAP NO.:
LOT($):
(owner -tenant)
ADMITTED BY: 04c . ACCOMPANIED BY:
KEY AVAILABLE: Cl A SUFF. CO. TAX MAP NO. 1000- 3 -S
SOURCE OF REQUEST: DATE:
DWELLING:
TYPE OF CONSTRUCTION:
FOUNDATION:
TOTAL ROOMS: 1ST FLR:
BATHROOM(S):
PORCH TYPE:
BREEZEWAY:
DOMESTIC HOTWATER: _
TYPE HEAT:
OTHER:
ACCESSORY STRUCTURES:
# STORIES: # EXITS:
CELLAR: CRAWL SPACE:
2ND FLR: 3RD FLR:
TOILET ROOM(S): UTILITY ROOM:
DECK, TYPE: PATIO, TYPE:
FIREPLACE: GARAGE:
TYPE HEATER: AIRCONDITIONING:
WARM AIR: HOTWATER:
GARAGE, TYPE OF CONST.: STORAGE, TYPE CONST.:
SWIMMING POOL: GUEST, TYrE CONST:
OTHER: ar "..e
VIOLATIONS: CHAPTER 45 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION I DESCRIPTION I ART. I SEC.
REMARKS:
INSPECTED BY: DATE ON INSPECTION:
TIME START: IP- 'X 0 END: �� • OO
MADYNE POST N32477