HomeMy WebLinkAboutZ-30341FORM NO. 4
TO~ OF SOUTHOLD
BUILDING DEP.A~TMENT
Office of the Building Inspector
Town Hall
Southold, N_Y.
PRE EXISTING
CERTIFICATE OF OCCUP.~JCY
No: Z- 30341
Date: 08/09/04
T~IS CERTIFIES that the building ACCESSORY
Location of Property 2386 R-Z~ATT RD SOUTHOLD
(HOUSE NO.) (STREET) (~S-MLET)
County Ta~ Map No. 473889 Section 054 Block 0001 Lot 004
Subdivision Filed Map No. __ Lot No. __
conform~ substantially to the Requirements for a ONE FAMILY DWELLING
built prior to APRIL 9, 1957 pursuit to which CERTIFICATE OF
OCuuFANCY NUMBER Z- 30341 dated AUGUST 9, 2004
was issued, and conforms to all of the requirements of The applicable
provisions of the law. The occupancy for which this cersificate is
issued is ACCESSORY GAZEBO.*
· ~he certificate is issued to J~-~ET WOCKENFUSS - TRUSTEE
(Om~ER)
of 5he aforesaid building.
~gFFOLKCO~DEpARTMENT OF~ALT~APPRO~L~L
BLECTRIf3%L CERTIFICATE NO.
PLBMBERS CERTIFICATION
*PLEASE SEE ATTACHED INSPECTION REPORT.
N/A
N/A
N/A
Rev_ 1/81
BUILDII{G D E P.~3.TMENT
TO~'R! OF SOUTHOLD
ROUSIIlG CODE I~ISPECTIOif REPORT
~OT (s)
ACCESSORY STRUCIT/RES:
VIOLATIONS: CPLAPTER 45 N.Y. STATE UIIIFORM FIRE PREVEI, ITIOI7 & BUILDING CODE
P~: BP30542 REPAIRS COZ303~0
Form No. 6
OF SOUmOLD
.... ~ ? qT',. ~ 763-1802
:~PLICATION FOR CERTIFICATE OF OCC~CY
This application must be filled in by typewriter or ink and submitted to the Building Depamnent with the following:
A. For new building or new use: 1. Final snrvey of property with accurate location of all buildings, property lh~es, streets, and unusual natttral or
topographic features.
2. Vinal Approval from Health Dept. of water supply and sewerage-disposal (S-9 form).
3. Approval of electrical installation from Board of Fke Underwriters.
4. Sworn statemem fi.om plumber certii},ing that the solder used in system contains less than 2/10 of 1% lead.
5. Commercial buildin~ industrial build'rog, multiple residences and similar buildings and installations, a certificate
of Code Complianae kom arclfitect or en,mknaer responsible for the building.
6. Submit Plannkng Board Approval of completed site plan requirements.
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 unusnal natut al or topographic
features.
2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is
deined, the Buildiug Inspector shall state the reasons therefor in writing to the applicant.
Fees
1. ~ertificate 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.
2. Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $.25
4. Updated Certificate of Occnpancy- $50.00
5. Temporary Certificate of Occupancy - Readential $15.00, Commerc}al $15.00
New Construction:
Location of Property: 02 ~z~?
House No. Street
Owner or Owners of Property: l/~-~//2~-J~ ~¥~ C/'ce~47~-/~ ~
Suffolk Co~-mty Tax Map No 1000, Section ~'w.,/ Block C~[
Subdivision Filed Map.
Old or Pre-existin~ Building:
(check one)
Hamlet
Lot ~ 7
Permit No. Date of Pen]fit
Health Dept. Approval: P4'/~
Plamfing Board Approval:
Applicant:
Undenvriters Approval:
Request tbr: Temporary Certificate
Fee Submitted: $
Final Certificate:
(check one)
Applicant Signature
PATRICIA C. MOORE
A. ttomey at Lax,,'
51020 Main Road
Sourhold, New York 11971
Tel: (631) 765-4330
Fax: (631) 765-4643
Margaret Rutkoxx ski
Secretary
March 29, 2004
Michael Verity
Building Inspector
53095 Main Road
Southold, NY 11971
(BY HAND)
Re:
1000-54-01-04
Pre-C.O. for Gazebo
Janet Wockenfuss
Dear Michael or Damen:
Enclose is a application for pre-C.0, and consent
inspect for a gazebo on the above referenced property.
to
Attached is my client's picture of herself (she is
now in her 60's) and her sister with the gazebo in the
background. The gazebo was constructed in the 1940's by
Mrs. Wockenfuss's father.
Moore
CONSENT TO INSPECTION
r ~'~: ~297t~, the undersigned, do(es) hereby state:
Owner(s) Name(s)
~d
That the undersign_ e_d (is) xCar~r~hc 9wger(s.) oft. he premisqs h~ the To~m of
Southold, located at .~,~ /-d )t~ ~t,~ r ..~((1/~
which is shown and designated on the'Suffolk County Tax Map as District 1000,
Section ~-'-c/ Block ~/ , Lot ~t~'/t :
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 ~ve consent to the Building Inspectors of the
To,sm 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 afores"aid application, including inspections to detenuine that said premises
comply with all of the laws, ordinances, rules and regnlations of the Town of Southold.
The undersigned, m 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, roles or
regulations 6fthe Town of Southold.
Dated:
~f~Si~gn~ur~
(Print Name)
(Signature)
(Print Name)