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Home My WebLink AboutZ-30440FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 30440 Date: 09/16/04 THIS CERTIFIES that the building DWELLING Location of Property 52875 MAIN RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 061 Block 0001 Lot 005 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- 30440 dated SEPTEMBER 16, 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 NON -HABITABLE SINGLE FAMIL`I DWELLING WITH THREE PORCHES AND DECK.* The certificate is issued to TOWN OF SOUTHOLD (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. Auth rized Siffzature Rev. 1/81 BUILDING DEP .RTdEITT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 52875 FAIN RD SOUTHOLD SUBDIVISION: MAP NO.: LOT (S) NAME OF OMBER (S): TCVIII OF SOUTHOLD OCCUPANCY: SIUGLE FAI4ILY DWELLIIIG TOUT OF SOUTHOLD ADkII7 PED BY: SELF ACCOMPANIED BY: SAME KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 61.-1-5 SOURCE OF REQUEST: TON7N OF SOUTHOLD DATE: 09/16/04 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME it STORIES: 2.0 9 EXITS: 4 FOUNDATION: BRICK CELLAR: PART CRAWL SPACE: PART TOTAL ROOMS: IST FLR.: 7 2BD FLR_: 6 3RD FLR.: 0 BATHROOM (S) 3.0 TOILET ROOM(S): 1.0 UTILITY ROOM(S): PORCH TYPE: WOOD (3) DECK TYPE: WOOD (1) PATIO TYPE: BREEZEWAY: FIREPLACE: 1 GARAGE: DOMESTIC HOTWATER: YES TYPE HEATER: OIL AIRCONDITIONING: TYPE HEAP: OIL -RAD. MAARM AIR: HOTWATER: OTHER= ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST_: SEE BP#29374 STORAGE, TYPE CONST.: SWIMMING POOL: GUEST, TYPE CONST.: VIOLATIONS: CRAFTER 45 N.Y. STATE UITIFOFI•I FIRE PF.EVEIFIIOIT & BUILDING CODE REMARKS: BP4293^,4 GAR -AGE REMOVED INSPECTED BY: / �( DATE ON INSPECTION: 06/04/04 MICHAEL S VERITY TIME START: 9:30~14 ED: 10:352N Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TORN H_ LL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 Underwriter. 4. Sworn. statement from plumber certifying that the solder used in system contains less than 2/10 of I% 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 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, Swirnnung pool $25.00, Accessory building $25.00, Additions to accessory building 525.00, Businesses S50.00- 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.0�0A �f Date. /-15 r�0 i" New Construction: Old or Pre-existing Building: _� (check one) Location of Property: r f{ S'fA led- <_1 j,i-�j p/ House No 3tfeet Hamlet Owner or Owners of Property: yi _a (Jcu" %d Suffolk County Tax Map No 1000, Section Block Lot Subdivision Filed Map_ Lot: Permit No. Date of Permit. Applicant: Health Dept Approval: Underwriter Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ sic d o �fH� Y Applicant Sign�il�oatture�[ T OS1�.i4 t X /7, S Ue�'Yf CONSENT TO INSPECTION 10 r,J /I 0- 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 which is shown and designated on the Suffolk County Tax Map as District 1000, Section jn % , Block / Lot _51�: . That the undersigned (has) (have) filed, or cause to be filed, an application in the Southold Town Building Inspector's Office for the following: (10A -�7 C4 �-C That the undersigned 42fg§j 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, does 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. p �Y Sores! FYIo/G Dated: iGif t�0 `Y v ignature) T� shU a X (Le—r 1 SceeM sit - (Print Name) (Signature) (Print Name) TOW" OF SOUTHOLD PROPERTY RECORD CARD ")/) I 1 1. . - , 0 %'• " OWNER STREET VILLAGE DIST. SUB. LOT 1()Wr I FORMER Ir LJ _E" a �q So C 11 I. ACR. N 0�6 I )2y r, _�d W TYPE OF BUILDING ES. SEAS, VL. FARM COMM. CB. MISC. Mkt, Value LAND IMP, TOTAL DATE REMARKS lAe- W 6) e") In L I I �8 3 ms �Z—(_�Omqsrw) N A5 o(y o o I iq /I ---rho m 0i Y" e"'4AMe _2S lafmi, ��fm I 4-clWrak t rejocajim) of '60r) AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Acre Vulue -illable I 'illable 2 'illable, 3 Voodland warnpldfid FRONTAGE ON WATER rushland FRONTAGE ON ROAD louse Plot DEPTH BULKHEAD 'Otal DOCK r_ ".,% -� 1r 0, w" ;°+ k SURVEY OF PROPERTY SITUATED AT SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-61 —01-05 SCALE 1"=20' JULY 16, 1998 AREA = 18,069.49 sq. ff. 0.415 oc. CERTIFIED TO: COMMONWEALTH LAND TITLE INSURANCE COMPANY TITLE No. 7098-2003 TOWN OF SOUTHOLD PREPARED IN ACCORDANCE WITH THE MINMUM STANDARDS FOR TITLE SURVEYS AS ESTABLISHED BY THE LI.ALS. AND APPROVED AND ADOPTED FOR SUCH USE BY THE NEW YORK STATE LAND TITS ASSOCiATION. :U ,ofSEv NC�ll- UNATHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO- BE A VAUD TRUE COPY. CERTIFICATIONS INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED. AND ON HIS BEHALF TO THE TITLE COMPANY. GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING IN$TI- TUTKIN. CERTIFICATIONS ARE NOT TRANSFERABLE. THE EXISTENCE OF RIGHTS OF WAY AND/OR EASEMENTS OF RECORD, IF ANY, NOT SHOWN ARE NOT GUARANTEED. Joseph A. Itgegno Land Surveyor Tale Surveys — Subdivisions — Site Plans — Construction Layout PHONE (516)727-2090 Fax (516)722-5693 OFFICES LOCATED AT One Union Square Aquebogue, New York 11931 MAILING ADDRESS P.,O. Box 1931 Riverhead, New York 11901 65� a °._\ r"po i ¢c 3 '®\ -9YERHEAL1 WIRES ldlp'. S g, �(f3 je 1 Ilk. � S> PREPARED IN ACCORDANCE MTF STANDARDS FOR TRLE SURVEYS BY THE LIALS. AND APPROVE] FOR SUCH USE RY THE NEW 'i TrrLE ASSOCIATION. 0 0 A. LOCATION: .5� 8 7.5- IV� ,4W. . (number & street) (municipality) SUBDIVISION: MSP NO.: , LOT(S): NAME OF OWNER(S): ,�1: OCCUPANCY: ' (type) 9v (owner -tenant) ADMITTED BY: ACCOMPANIED BY: KEY AVAILABLE SUFF. CO. TAX MAP NO. 1000- li/-- / -S-' SOURCE OF REQUEST: DATE: 'iY .2s _ A dA& DWELLING: TYPE OF CONSTRUCTION: #STORIES: �- #EXITS: 31 FOUNDATION: 944,1�4 v ICELLAR: CRAWL SPACE: TOTAL ROOMS: IST FLR: �_ 2ND FLR:_ 3RD FLR: BATHROOM(S): J3 TOILET ROOM(S): / UTILITY ROOM: ^ PORCH TYPE: UrftsP (3) DECK, TYPE: bo-nQC/�_ PATIO, TYPE: BREEZEWAY: -- FIREPLACE: / GARAGE: DOMESTIC HOTWATER: -� TYPE HEATER: AIRCONDITIONING: -- TYPE HEAT: aril - ti.r%•�`�•►WARM AIR: HOTWATER: OTHER: ACCESSORY STRUCTURES: ' GARAGE, TYPE OF CONST.: STORAGE, TYPE CONST.: SWIMMING POOL: GUEST, TYPE CONST: _ OTHER: VIOLATIONS: CHAPTER 45 & N.Y. STATE UNIFOF,M FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION— ART. SEC. REMARKS: INSPECTED BY: DATE OF INSPECTION: oxvo TIME START: / : 3 d END: �� ;�