HomeMy WebLinkAboutZ-30102 FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
7~' - Office of the Building Inspector
Town Hall
Southold, N.Y.
j PRE EXISTING
~ CERTIFICATE OF OCCUPANCY
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No= Z- 30'102 Date= 03/19/04
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THIS CERTIFIES that the building DWELLTNG
s Location of. Property 3875 MAIN BAYVIEW RD SOUTHOLD
I (HOUSE NO.) (STRE$T) (HAMLET)
County Tax MapNO. 473889 Section 078 Block 0.002 Lot 015.001
Subdivision F~ledMap No. Lot. No.
3 conforms substantially to the Requirements for a ONE FAMILY DWELLING
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built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF
$ OCCUPANCY NUMBER Z- 30102 dated MARCH 19, 2004
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
t
issued is ONE FAMILY DWELLING WITH SIDE PORCH.*
IL The certificate is issued to JAMES R FOSTER
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 85276C 3/17/04
PLUMBERS C$RTIFICATION DATED N/A
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*PLEASE SEE ATTACHED INSPECTION RE ORT.
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Authorize Signature
Rev. 1/81
I BUILDING DEPARTMENT
TOWN OP SOUTHOLD
' HOUSING CODE INSPECTION REPORT
S.OCATION[ 3875 MAIN BAYVIEW RD SOUTHOLD
SUBDIVISION: MAP PIO.: IAT (S)
P4I1Y96 OF O8'IHHR. (S) c JAMES R FOSTER
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j OCCOPAMCY: SINGLE FAMILY SAMES R FOSTER
( AdDP9IT3"HN BY: LORIE FE II.EN ACCOMPANSHD BY: SAME
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+HBY AVAIIsABLE: SUFF. CO_ TA$ MAP NO.: 78.-2-15.1
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i 'SOIIRCS OF RHQUHST: JPSNES FOSTER DATE: 03/19/04
DWELLING:
`TYP$ OF COPISTRIICFION: WOOD FRAME - STORZHS: 1..0 # H%ITS: 2
"FODNDATION: CONCRETE BLOCK CHLLAR: X CRAML SPACHc
.:TOTAL ROOMS: 1ST FLR.: 6 2ND FLR.: 0 3RD FLR.: 0
'BATRY20®M(S): I.0 TOILST ROOM(S): 0.0 UTILITY ROOM(S):
PORCH TYPH: SIDE DHCR TYPH: PATIO TYPH:
it BRHHZEMAYc FIRHPLACH: GARAGH:
I DOMHSTIC HOTQ3A°PSR.:. X TYPH HHATER: NAT GAS. AIRCOHDITIONING:
TYPEHE,AT: OIL F7ARP1 AIR: X HOT4~ATER:
bT'fIER:
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'.ACCESSORY STRUCTURES:
1 I cARACa. TYPS of CONST.: STORAGE, TYPa coHSr.: d,/j/1!v
i S4dIRR4IPIG POOL: GUEST. TYPH COHST.:
OTHBR.
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i VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
~~li LOCATION ~ - DESCRIPTION ART. ~ SEC.
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I -INSPaC°1'~ DATE ON INSPECTION: 03/19/04
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~ ~ HN M BOUFIS TIMH START: 9:40AM HND: 10:15AM
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Elc,~ch~icrrl liis~~ectiun Cc~rti~rclcrte 'Fbru'
v. Issue Date Electrical Inspection Service, Inc: Application ti
It 3/17{20(kY 373 Duhton Avenue 85276C
East Patchogue, New York 11772
F+~, ~ (631)286.6647 ~ -
Issued To: James Foster
Street: 3875 Main Bayview Street
Vipage Southold Zip: 11971 Towne Southall
~aN .
Section: Block: tot:
Contractor: Tuthill Electric (L) Loc. # 4210-E
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1. was examined andfoundto be in compliance with the National Electrical Code.
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? Commercial ? NV Defects ? Pool ?X 1st Floor ? Indoor ?X Basement ? Mot Tub -
Residential ? Det. Garage ? Attic ? 2nd Floor ? Outdoor ? Addition ?x Survey
3 ~ Switches Receptacles Fixtures GFI Heaters. A/C Fans
4 13 10 3 -ate-
( ~ _ Dishwasher WashedAmps Dryer/Amps Oven Range/Amps Microwaves
~ 1 30
S ' Furnace Oil Gas Circulators Smoke Detector $ell Transformer
~ h''
Mete[ Amps Phase UG70H Jacuzzi Television CO Detector
1 200 1 /
Bldg. Permit:
' Other Equipment
00 amp panel with main
Hugo S. Surdi
! President
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Rough Inspection: 03!02/2004
~ ~ Inspector: John Mc Mahon III
Final Inspection: 03/16/2004
Inspector: John Mc Mahon III
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This certificate most not be altered in any manner. Inspectors may be identified by their credentials.
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ior~rt No.'(r
` TOttN OF SOUTYIOLD
$UILDZNC, DC•PART.SENT
TOIJN itAI.L
' - y 765-1802.
' APPLIC.~.TION POR CERTIFICATE OF'nCCUP.INCY
This application must be ¢illed in by typewriter OF. nlc and. submitted to the building
inspector wit}c the following: far ndw buiidiag or new use.;
i. Final survey of property with accurate location of all buildings, property lines,
sweets, and unusual natural or topographic features.
2,. Final Approval from Health Depc. of water supply and sewerage-disposal (S-O form).
3. Approval of electrical installation. from Board of Fire Underwriters.
4: Sworn s[atemerac from,plunber certifying that the solder used in system contains
less than 2J10;of I~ lead.'
~ 5. Commercial building, industrial building., multiple residences and similar buildings
azxd;;j,xt5,lations, a oertifidate of Code C~:mpliande from arehi_ect or engineer
I rsESponsi'k1;e fora the buil.dirlS.
l 6. Su9btliir plantting Board Approval of completed site plan requiretae-rte' ~`r
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Far e:tisring buildings (prior to April 9, 1957) non-conforming u e ~ or buiZ3iii^s and~i~
I ~ "Pre-e~,aisting° land uses; ' t ~ `
I j 1. Ad,curate survey of property showing all property lines, streec~~buTd'ing and ~ ~
unusual natural or topographic features. q #
{ 2. e~ Ftoperly completed application and a consent to inspect signmd by h3:-~ ;~ew~ap,
f ~ If a Certificate of Occupancy is denied, the Building Inspectoi sha 'J:~-~~e°w t e
~ re¢sons therefor in writing co the. applicant.
G Ili Fees '
i is Certificate of Occupancy -New dwelling $25.00, AddiCions to dwelling $25.00,
I, Alterations to dwelling SZS.00, Swimming pool $25.00, .lccessory building $25.00,
f' Additions to accessory building $25.00. Dusir.esses $50.00..
2. Certificate of Occupancy on Pre-existing Building - $100.00
~ 3. Copy of C;ertfica e of Occupancy - $5.00 over 5 years - $10.00_
li 4. Upidated Certificate of Occupancy - $50.00
5. Tehaporary,Certificate of Occupancy -Residential-$15r.~00,l,Commercial $1.5.00
Date U
Np,,,/Construction.--.•-, Ofd or Pre-existing8uildino Vacant Land
III
l Location of Property ~ ~Ct.~.~... l.X~-L~.11)~aJ...~~1.~ - .
House No. ~ tre i Ham/et
~ ~~.m~s i~ ~5-}?~Z-
i Owner or Owners of Property a ~ - - • -
li. Couniy Tax Mlap No. 1000 SectionlJ.. l.p.~.•. ~U $Iock ~.~4J V..... Lot ~ ~ i.JJ®~ - -
~ Subdivision ...................:.............Filed Map No. ..........Lot No.
l Permii No_ Date of Permit ..........Applicant . .
~ Health Qept. Approval . ......Labor Dept. Approval .
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~ Underwriters Approval ........................Planning Board Approval - • • - • • -
if Request for Temporary Certificate .:...................Final Certificate .
~o~~t71v~. ,
I Fee Submitted S ~ C.`p~j~ ~J
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Construction on above described building and permit meets II applicable codes and regulaUOns.
V(~yl'l /V~(.t..~¢s~ Applicant
Jan 1-y U4 U3 cUUp 1
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MA/N ' BA YV/EW ROAD
NOTE-- F/EGL7 WORK
GONE /N SNONt
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MAP OF PROPERTY
$/ruw TED wr
6AYEi/E{4; TObYN OF 3`OUTHOLD
~ SUFFOL/{' COUNTY, NEW Yf?RK
CERP/F/ED TO: - ~Ty chrisfopher Nanny L.~
£OWARD ?ENSEN 46 Hunf/n9 Hi// Orive
MKM ABSTRACT SERV/CES /NC. ~ Oix Hi//s, NY J J746
F/RST AMER/CAN T/TLE /NS. CO. ~ N-YS L/C N0- 49857
.VORPGAGE CONCEPTS GATE T/>2/2004
T/TL£ NO.MKM-S-22103 LA RS ~C~ COPYRIGHP
` (631) 858-1673 REF_NO. 9J99 '
TAX MAPDEAGNAT/ON 7000-078-02-015.7 Fox 858-1678
f7EF_NO-9199.. REF.NO-9f99
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~ 765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ] ROUGFI PLBG.
[ ]FOUNDATION 2ND. [ ] INSULAT[ON
[ FRAMING [ ]FINAL
[ FIREPLACE 8~ CG~IM~EY [ FIRE, ~AFETIF INSPECTION
REMARKS: ~tl ~S`~~ m z%
1 \
DATE INSPEC
CONSENT
TO
INSPECTION
the undersigned,
Owner(s) Name(s)
i do(es) hereby. state:
~ That fihe und~xsigned (is) (are} the owner(s) of the. premises in the Town
of Southold located at
j 3B ~l ~ ~1?~-i ~ ~ ~-~n ri ~ ~~sa~
~;•hicn is shown and designated on the Suffoll:
~ County tax map as District 1000, Section (7 ~ g Block , Lot / s ff
That the undersigned (has) (:have) filed, or caused to be filed; an'applca-
tion in the Southold Town. Building Inspecfor~s Office for the followings
That the undersigned do(es) hereby give consent to the Building Inspectors
of the 'T`own 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 as evidence in subsequent prosecutions for vio-
Iations of the laws, ordinances, rules or regulations of the Town of Southold.
(signature)
-tom eS~os~'~~~
(print name)