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HomeMy WebLinkAboutZ-30038FORM NO. 4 TOWN OF SOUTHOLD .BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 30038 Date: 02./23/04 THIS CERTIFIES that the building DWELLING. Location of Property 580 SMITH DR N SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County'Tax Pidp No. 473889 Section 076 Block 0002 Lot 015 Subdivision 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- 30038 dated FEBRUARY 23, 2004 .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 * The certificate is issued to JOHN H & ADRIENNE OLIVER (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A .ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 580 SMITH DR N SOUTHOLD SUBDIVISION: NAP NO.: LOT (S) NAME OF OWNER (S): JOHN. H.& ADRIENNE OLIVER :OCCUPANCY:. SINGLE FAMILY DWELLING JOHN H & ADRIENNE OLIVER "ADMITTED BY: ADRIENNE B': OLIVER ACCOMPANIED BY: SAME 'KEY AVAILABLE: SUFF. CO. TAX MAP. NO.: 76.-2-15 SOURCE OF. REQUEST: JOHN. H. OLIVER,.. 1/22/04 DATE: 02/23/04 DWELLING: 'TYPE OF CONSTRUCTION: .WOOD FRAME F STORIES: 1.0 F EXITS: 1 FOUNDATION: CEMENT BLOCK CELLAR: FULL * CRAWL SPACE: TOTAL ROOKS; EST FLR.: 4 2ND FLR.: 0 3RD FLR.: 0 BATHROOM (S): 1.0 TOILET ROOM(S): 0.0 UTILITY ROOM(S): :PORCH TYPE: DECK TYPE: PATIO TYPE: "BREEZEWAY: FIREPLACE: ONE GARAGE: ONE CAR DOMESTIC HOTWATER: XX TYPE BEATER: OIL AIRCORDITIONING: TYPE NEAT: OIL WARM AIR. XX HOTNATER: OTEER: *PART OF CELLAR FINISHED FOR STORAGE ONLY(NONHABITABLE) ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: SWBIFRHING POOL: . OTHER: STORAGE, TYPE CONST.: SHED & ACCESSORY DECK GUEST, TYPE CONST.' VIOLATIONS: CHAPTER 45 N,Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE INSPECTED BY: DATE ON INSPECTION: 01/23/03 OBN N. BOUFIS TIME START: 9:40 AM END: 10:10 AM ' Form No. . 6 I 'TOWN OF SOUTHOLD BUILDING DEPARTMENT '-530 Z I TOWN HALL (1 f t ' 765-1802 Z N 1 APPLICATION FOR CERTIFICATE OF OCCUPANCY � l i .This application must be filled in by typewriter or ink and submitted to the Building Depart s it- ollowing: 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). l 3. Approval of electrical installation from Board of Fire Underwriters. 4. $worn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. l 5. Comirlercia( build�g, industrial building, multiple residences and similar buildings and installations, a certificate of 6o4 e,Comp fiianoe from architect or engineer responsible for the building. 6. Submit Plarmrng BoardApproval of completed site plan requirements. B. For, existing buildings (prior to April, 9,1957) non -conforming uses, or buildings and "pre-existing" land uses: L Ac�uraie 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 dep ,ed, the Building Inspector shall state the reasons therefor in writing to the applicant. f C. Fees /// 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Altdrations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. �I 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $.25 q 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 't Date. To-,. a2D-, c9,004- a C; New Construction: Old or Pre-existing Building: / (check one) j Location of Property: 580 11�i• House No. Street Hamlet Owner or Owners of Property: 1 aL v ,A. O1 i Q 2x- o, T �c1V'i�n v�L' a j Suffolk County Tax Map No 1000, Section 'jb Block q Lot i E 1 Subdivision, Filed Map. Lot: 9 d Permit No. Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: "Request for: Temporary Certificate Final Certificate: ✓ (check one) Fee Submitted: $ \00,00 64z, G5 -93V &Jle c a 0G 3$ <c2 Applicant Signature TOWN OF S OUTHOL"6 -elf �"����� CAM OWNER STREET �j �j {, 1 VILLAGE DISTRICT SUB. LOT tt R�t FOR N E ACREAE rr .. 7Y ` , S W TYPE OF BUILDING RES. SEAS. VL FARM COMM. IND. CB, C. Est. Mkt. Value LAND '' IMP. -TOTAL DATE REMARKS -- _ ��� � fJC✓" u* Lr' ".e'er l ^✓ �,` xe: I � // p: ,..,.,.�..yd AGE BUILDING CONDITION•V �2 O ©®cd( NEW NORMAL BELOW ABOVE FRO O W Type 1 %CJ �! - Farm- Acre Value Per Acre Value —� FRONTAGE ON ROAD / 0 o @ ° �ap 0 Tillable 'I BULKHEAD LL _ Tillable 2 DOCK Tillable 3 -- — --- WSodlana -- — Swampland— -- - Brushland House Plot Total — — CONSENT TO INSPECTION �I ah/? �� �� %marten h.!%fi ✓Er 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 �S£J � ,fh's -rive (��, Soufhold N)/ which is shown and designated on; the Suffolk County Tax Map as Dystrct 1000, Section OV, Block Q.1- , Lot a*15- That the undersigned (has) (have) filed, or cause to be filed, an application in the Southold Town Building Inspector's Office for the following: 4hzqe - That the unc ersigned do(es) hereby give consent to the Building Inspectors of the Town of Southol.do 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 ,oto 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: -.y-�SgLT j (Signature) �0: flu ff• -G"02-1 (Signature) �DIZ/1CIVA E B- (Print Name) W GUARANTEES INDICATED HERE ON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY ISPREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY,. GOVERNMENTAL AGENCY, LENDING INSRWION IF LISTED HEREON, AND {{ TO THE ASSIGNEES OF THE LENDING INSTITUTION. GUARANTEES ARE NOT 7RANSFERABLE - TO AODIIIONAL INSTITUTIONS OR SUBSEQUENT OWNERS _ N 51-00'00WY LOT 95 150.00' PPE FOUND J PIPE UNAUTHORIZED AL7£RATION OR ADDITION TO THIS p - FOUN SURVEY IS A KOLA RON OF SECTION 7209 OF O :_ FRAME T V's � J i.}Y�'{ (.,®. THE NW. NEW YORK STATE EOVCA DON LA O SHED FENCE m.m COPIES OF THIS SURVEY MAP NOT BEARING _ 1.4 THE LAND SURVEYORS EMBOSSED SEAL SHALL RUDE - 1.4 - NOT BE CONSIDERED TO BE AVALID TRUE' �y CONq. - COPY. �L N .O' ONE-STORY -oursmc LOT 124 - _ O - RESIDENCE - - - - W - 131 38J' J �0 SII= LOCATION: G (number & street) (municipality) SUBDIVISION: MAP NO.: LOT(S): NAME OF OWNER(S--- OCCUPANCY: (type) (owner -tenant) ADMITTED BY: �G�% . Dl V&ACCOMPANIED BY: ��� KEY AVAILABLE: SUFF. CO. TAX MAP NO. 1000- SOURCE OF REQUEST: =./ 9l-,:V&—i v-_ 4V` VeA DATE: d DWELLING: t't;iqv'6 f4#�A� .TYPE OF CONSTRUCTIO%j : # STORIF�. © #EXITS: FOUNDATION: Ci/ CELLAR: f '��R_ AWL SPACE: TOTAL ROOMS: 1STT� FLR: 2ND FLR: 3RD FLR: BATHROOM(S): ®N- TOILET ROOM(S): UTILITY ROOM: . PORCH TYPE: DECK, TYPE: PATIO, TYPE: BREEZEWAY: --- FIREPLACE: ©11% -Q! GARAGE: DOMESTIC HOTWATER: _�� TYPE HEATER: 0 / AIRCONDITIONING: TYPE HEAT: C01 / WARM AIR: HOTWATER: OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: S Cf GE, TYPE CONST.: VIOLATIONS: CHAPTER 45 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION I DESCRIPTION I ART. I SEC. r& REMARKS: INSPECTED BffArt%ry��'/ I �ywi4 " DATE OF INSPECTION: �/ evo 40 r/ TIME START: 1 TO END: A0 1/40