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HomeMy WebLinkAboutZ-30395FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 30395 Date= 09/01/04 THIS CERTIFIES that the building DWELLING Location of Property 855 SHORE RD GREENPORT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 047 Block 0002 Lot 021 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- 30395 dated SEPTEMBER 1, 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 ELIZABETH GARDNER (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 INSPECTION REPORT. Authorized Signature Rev- 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 855 SHORE PD SUBDIVISION: MAP NO.: LOT (S) WANE OF OWNER (S)= ELIZABETH GARDNER OCCUPANCY_ RESIDENTIAL ELIZABETH GARDNER ADMITTED BY: ANY KIRINSIC ACCOMPANIED BY: SAME KEY AVAILABLE: SUFF. CO_ TAX MAP NO.: 47.-2-21 SOURCE OF REQUEST: ELIZABETH GARDNER 8/11/04 DATE: 09/01/04 DWELLIITG: TYPE OF CONSTRUCTION: WOOD FRANS # STORIES: 1.0 # EKITS: 2 FOUNDATION: BLOCK CELLAR: CRAWL SPACE: YES TOTAL ROOMS: 1ST FLR.: 4 BATHROOM(S): 1.0 PORCH TYPE: 2ND FLR.- 0 TOILET ROOM(S): 0.0 DECK TYPE: 3RD FLR.: 0 UTILITY ROOM(S): PATIO TYPE: BREEZEWAY: FIREPLACE: GARAGE: DOMESTIC HOTWATER: YES TYPE HEATER: ELECTRIC AIRCONDITIONING: TYPE HEAT: ELECTRIC WARM AIR: HOTWATER: OTHER: *BP#3222Z-COZ-2528 (GAP_r GE ADOITIOIT) ACCESSORY STRUCTURES - GARAGE, TYPE OF CONST.: SWIMMING POOL: OTHER: STORAGE, TYPE CONST_: GUEST, TYPE CONST.: VIOLATIONS: CHAPTER 4S I7.Y. STATE UNIFOR1N1 FIRE PREVENTION L BUILDIIG CODE LOCATIO17 I DESCRIPTION I ART. SEC. REMARKS: BP911835Z-COZ-11163(REAR DECK ADD. (BP42923OZ-COZ29820(FRONT DECK ADD INSPECTED BY:/ k, -&—'^AL, 1 e-�e CHRISTOPHER M. TALBOT DATE ON INSPECTION: 08/2x'/04 TIME START: 10:20 AM SND: 10:45 Aid Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN WALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department tzzth 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 io 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 bu}ldings (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 J 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. 2 certificate of Occupancy on Pre-existing Building - $100.00 Copy of Certificate of Occupancy - $.25 4_ Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy -Residential $15.00, Commercial $15.00-p Date. '4� / /0 New Construction: Old orPre-existingBuilding: y1 (check one) Location of Property: �J 5 10 re, House No. Street Hamlet Owner or Owners of Property: 1Zaj��Zgn Suffolk County Tax Map No 1000, Section r� Block �), Lot Subdivision Permit No. Health Dept. Approval: Planning Board Approval: Filed Map. Date of Permit. Applicant: Request for: Temporary Certificate Fee Submitted: $ 10 D 6, LC- uQ9NC Q,� C a'Z.- 3 C- 3 q5 Underwriters Approval: Lot: Final Certificate: ✓ (check one) Applicant Si tore CONSENT TO INSPECTION 01, v��"l{'ii'— the undersigned, do(es) hereby state: Owner(s) Name(s) That the undersigned (is)jFe) the owner(s) of the premises in the Town of Southold, located at '55 'iG Y which is shown and designated on the Section 4�:7_, Block —L— , Lot County Tax Map as District 1000, 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 laves, 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: (Signa re) (Print Name) (Signature) (Print Name) TOWN OF SOUTHOLD 1�` PERTY1 OWNER STREET. "" 3: `1,: j VILLAGE /� r cnDA d CD. n% A i A I ED W M A7Vr 1f1MA U,01730 k r... 1 � S Rivyr'La %%Nea�� A wf I RES. /] JA SEAS. SURD CARD FARM COMM. IND.I. REMARKS r� .MISC. Est."Mkt. Value - .17 ' �*^ "'" LAND IMP, TOTAL DATE 07/7S SOLD f3' 000, 4SyaE.Sa:C�4... c- A, _Q,Pf i0 7-, 40. CSI eL NMT -n-. :4 �T�'EWdF 91J)LDINGr RES. /] JA SEAS. VL, FARM COMM. IND.I. REMARKS r� .MISC. Est."Mkt. Value - .17 ' �*^ "'" LAND IMP, TOTAL DATE 07/7S SOLD f3' 000, 4SyaE.Sa:C�4... c- A, _Q,Pf i0 7-, 40. CSI eL . 'Y �o 6 r7 d .2V S15-167 o Z 2- paw X00 X00 29©C3 z 2z dmLr��l '92 AGE BUILDING CONDITION 9 i q&' j3,r_ NEW NORMAL BELOW ABOVE FRO TAE A6 E a6pcillieK Farm Acre Value Per Acre Value FRONTAGE ON ROAD" 5}, Tillable 1 61�lYcFt1Ab all jai 0''99a3o iOU'0"� 9P --qs-1&2– Tillable 3 DOCK Tillable, 3 Woodland Swampland Brushland House Plot Total Z -M M. Wig. Foundation Bath Extension 445._'Basement Floors 1.4 . Extension Ext, Walls NI NIL . Interior finish Extension 2_ 76' 2 - Fire Place Heat Porch Roof Type 2. Porch Roams 1st Floor Breezeway Patio Rooms 2nd Floor Garage/ I X . ,Driveway Dormer Op B. m5M L [.1 a f �n CA A ,f � l4i C� �t. t. 41, �% %1 �✓���'✓U f'WV yam/ . s' a a � _ � . - ..�„ t_ sy. .s, rT . icrx T, ��_rR. .. — r..�err - � -. ...--_<_•,_}�. f �n CA A � l4i C� �t. � _ � . - ..�„ t_ sy. .s, rT . icrx T, ��_rR. .. — r..�err - � -. ...--_<_•,_}�. LOCATION: S S 5 5 ko r -c �4 CL . G e.aDart. � (number & street) (municipality) SUBDIVISION: MAP NQ.: LOT(S): NAME OF OWNER(S): 1=- `Z "`�-� ar .1C4L OCCUPANCY:- }w, ( 0wNrQ (type) (owner -tenant) ADMITTED BY: 121 ACCOMPANIED BY: KEY AVAILABLE: N o SUFF. CO. TAX MAP NO.1 SOURCE OF REQUEST: A2da-tJl DATE: ? DWELLING: Z TYPE OF CONSTRUCTION: w o # STORIES: # EXITS: FOUNDATION: L oc fC r CELLAR: O CRAWL SPACE: _ TOTAL ROOMS: 1ST FLR: 2ND FLR: 3RD FLR: BATHROOM(S): TOILET ROOM(S): UTILITY ROOM: PORCH TYPE: - ow4tocet DECK, TYPE: S PATIO, TYPE: o a t BREEZEWAY: FIREPLACE: mo"c GARAGE: kiAs DOMESTIC HOTWATER:S TYPE HEATER: E( ec+tCc AIRCONDITIONING: NO TYPE HEAT: E <<ck4e- WARM AIR: ^"N W, HOTWATER: "0 N c OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: W6.4ir SWIMMING POOL: OTHER: NoNc' STORAGE, TYPE CONST.: 14% O N � GUEST, TYPE CONST: Cv d„j t VIOLATIONS: CHAPTER 45 & N.Y. STATE UNIFOFM FIRE PREVENTION & BUILDING CODE INSPECTED BY: DATE OF INSPECTION: _ �OS 1 TIME START: 10 '- Z a END: (z� : 45