HomeMy WebLinkAboutZ-30416FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y_
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 30416
THIS CERTIFIES that the building DWELLING
Date: 09/14/03
Location of Property 675 LAKE DR SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473869 Section 059 Block 0005 Lot 018
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- 30416 dated SEPTEMBER 14, 2003
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 NEAL H & DEBRA A LOVETT
(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 IIISPECTION REPORT
LOCATION: 6'S LAKE DR SOUIHOLD
SUBDIVISION: MAP NO.: IAT (S)
NAME OF OWNER (S): PTEA -L H & DEBRA A LOVETT
.00CUPANCY: RESIDEIITIL HEAL H & DEERA A LOVETT
ADMITTED BY: 6LARK SCHWARTZ ACCOMPANIED BY: SAME
KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 59.-5-18
SOURCE OF REQUEST: MARK SCHWARTZ 7/2&/04 DATE: 09/14/03
DWELLIPIG:
TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 1.0 # EKITS: 2
FOUNDATION: MOOD POST CELLAR: NO CRAWL SPACE:
TOTAL ROOMS: 1ST FLR.: 5 2ND FLR.: 0 3RD FLR.: 0
BATHROOM(S): 1.0 TOILET ROOM(S): 1.0 UTILITY ROOM(S): NONE
PORCH TYPE: COVERED FRONT DECK TYPE: WOOD PATIO TYPE:
BREEZEWAY: FIREPLACE: GARAGE:
DOMESTIC HOT-WATER: YES TYPE HEATER: ELECTRIC AIRCONDITIONING: YES
TYPE BEAT:
ELECTRIC WARM
AIR: YES
HOTHATER:
ELECTRIC
OTHER:
ACCESSORY STRUCTURES:
GARAGE, TYPE OF COMST.:
SWIMMING POOL:
OTHER:
STORAGE, TYPE CONST.:
GUEST, TYPE CONST.:
VIOLATIONS: CHAPTER 45 II.Y. STATE UNIFORM FIRE PREVEIQTIOU & BUILDING CODE
REMARKS: BF #3210Z-COZ-3197 (DECK ADDITION)
INSPECTED BY: / V� -1 "\ r ➢ATs ON INSPECTION: 08/10/04
CHRISTOPHER M. TALBOT TIME START: 11:00 M4 END: 11:15 AI4
Form No. 6
TO«'N OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
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: F -�
1. Final survey of property with accurate location of all buildings, property lines, streets, atid'unusugl-natural-or '
topographic features. ,. JUL Z a &? i
2. Final Approval from Health Dept. of water supply and sewerage -disposal (S=9 form). 1 `�!
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains less t£ in {, ( 1. ; 1•'
5. Commercial building, industrial building, multiple residences and similar buildings anc_r i I t,i _,rf ::
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 a 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,
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.- $25.00
4- Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
New Construction:
Date. �27/� 4
Old or Pre-existing Building: _ ��_ (check one)
Location of Property: 7!)s Core okt UE 5007WOLV
House No. Street Hamlet
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section S g Block d ,j Lot
Subdivision
Pennit No.
Health Dept. Approval:
Planning Board Approval:
Filed Map.
Date of Permit. Applicant:_
Request for: Temporary Certificate
Fee Submitted: $
Underwriters Approval:
Lot:
Final Certificate: (check one)
OL eae_--
Applicant Siplre
/Ann s-9 Sr— A? TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER
STREET
STREET-
VILLAGE
DIST,
SUB. LOT
FORMER OWNER
N
4� A5:C
E-
.ca
ACR,
1 15
/n/ c,"o
S
� �4�- :—j ( 41H
TYPE OF'BUILDING
RES.
SEAS.
VL.
FARM
COMM• CB. MICS. Mkt, Value
LAND
IMP.
TOTAL
DATE
REMARKS 3
)qj
2a
cail 3
AGE
BUILDING CONDITION
NEW
NORMAL'
BELOW ABOVE
FARM
Acre
Value Per
Acre
Value
Tillable
FRONTAGE ON WATER
Woodland
FRONTAGE ON ROAD
Meadowland
DEPTH
House Plot
BULKHEAD
Total
DOCK
COLOR
TRIM a /--
• • s
I
i x
fie,
M. Bldg:
Extension
?
Extension
Extension
p
/e;
Foundation
/,1d p ' "
Bath
,
Dinette
Porch
Basement
Floorsn
K.
Porch
r
SS
5
Ext. Walls
3 r� .
Interior Finish
5J�✓ea''
LR.
Breezeway
Fire Place
�,
Heat
�t�
DR.
Garage
Type Roof
Rooms 1st Floor
BR.
Patio
Recreation Room
Rooms 2nd Floor
FIN. B
O. B.
Dormer
Driveway
Total
• • s
CONSENT TO INSPECTION
OFAf/LA- the undersigned, do(es) hereby state:
Owner(s) Name(s)
That the undersigned (is) (are) the owner(s) of the prettuses in the Town of
Southold, located at 7ZT Z -Ale e_ Ode[ vC Soc.VtAc 1O
which is shown and designated on the Suffolk C unty Tax Map as District 1000,
Section S � , Block O. r , Lot ( ���
That the undersigned (has) (have) filed, or cause to be filed, an applicatio�in the
Southold Town Building Inspector's Office for the following: rR F C a O
That the undersigned. do(es) hereby give consent to the Building Inspectors of the
Town of Southold to enterupon the above described property, including any and all
buildings located thereon, to conduct such inspections as they ma_v 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 in subsequent prosecutions for violations of the lacus, ordinances, rules or
regulations of the Town of Southold.
Dated: 76 ppo
(Signature)
(Print Name)
'4 j SURVEY OF PROPERTY
SITUATED AT
i
n ;/ b8a9 aOP� SOUTHOLD
s� a rz / �
1N 0.E��TX
n 111
N�,Ea1 TOWN OF SOUTHOLD
A 6 M ,.
IPE , s I SUFFOLK COUNTY, NEW YORK
SSA S.C. TAX No. 1000-59-05-17
1000-59-05-18
SCALE 1"=20'
�
/ o AUGUST 25, 2003
/',
JULY 16, 2004 UPDATE SURVEY
\� I
e --
% X'w o oa, I�
� Mrl+l / IT
,<sT H0LE�oRO wFat�.AREA = 29,217.60 sq. ff.
0
s I I � i 1 0� � Qti ?�l �(To TIE unlq 0.671 ac.
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NOTES. / 0�5
1. ELEVATIONS ARE REFERENCED TO N.G.V.D. 1929 DATUM / /;� X E
EXISTING ELEVATIONS ARE SHOWN THUS: /ORE �,�' �1 \v PREPARED IN nccoaonncF WITH THE MINIMUM
EXISTING CONTOUR LINES ARE SHOWN THUS: - to - N D, STANDARDS FOR TITLE su s AS N AF.1SHEO
/ / n �� �� h DT THE L nLs zNe nF ovED ArvD n00PrED
FIL - FIRST FLOOR / ( V !1 . ,1 FOR SUCH USE BT THE EW YORK STATE UJJD
I J TITLE ASSOLM1iDITv �-"b
2. FLOOD ZONE INFORMATION TAKEN FROM:
FLOOD INSURANCE RATE MAP No. 3610300154 G "c
ZONE AEBASE FLOOD ELEVATIONS DETERMINED I,
f
ZONE X', AREAS OF 500—YEAR FLOOD, AREAS OF 100 -YEAR FLOOD WITH AVERAGE 'yO
DEPTH OF LESS THAN 1 FOOT OR WITH DRAINAGE AREAS LESS THAN All,
1 SQUARE MILE, AND AREAS PROTECTED BY LEVEES FROM 100—YEAR FLOOD. -
ZONE X AREAS DETERMINED TO BE OUTSIDE 500—YEAR FLOODPLAIN. ,,�';�`
3. ANY WETLAND BOUNDARIES SHOWN ARE SUBJECT TO VERIFICATION l' . N.Ys TO No A9sse
BY NEW YORK STATE AND/OR OTHER REGULATORY AGENCIES.
h
TO THIS SIURKYLIS NA COLATION OFrloN
40 GO RE TOM 7209 OF THE NEW YORK STATE Jos ph Ac Inge gno
EDUCATO uw
HE LA OF THIS SDR'S MM NOT HEARING Land Surveyor
CO wuO SURVEYOR'S GOOD SEAL GO EA
EMBOSSED SEAL SHALL NOT BE CONSmrnED
TO BE n VALID TRUE COPY
CERRrrcATIONs INDICATED HEREON SHALL RUN
ONLY 10 THE PERSON FOR WHOM THE SURVEY Elf, Surve - Subdivrsrons - Sde PIvnS - Corehuclmn Layou
IS PREPARED, AND ON IIIS BEHALF TO THE Ye
TIDE COMPANY, GOVERNMENTAL AGENCY ANY
LE'
IDIND INmTunoN LISTED HEREON, AND
TOTHE ASSICNEa OF THE LGNDING DIN PHONE (631)727-2090 1.X (631)727-1727
TUTION CERTIFICATIONS ARE NOT TRANSFERABLE
OFFICES OG TEO AT NAILING ADDRESS
THE EXISTENCE OF RIGHTS OF WAY 322 ROANOKE AVENUE P.0 Bon 1931
AND/OR EASEMENTS OF RECORD, IF RIVERHEAD, New York 11901 Rrverheed, New York 11901-01
ANY, NOT SHOWN ARE NOT GUARANTEED.
4. Z ' 6" -/,.
M�4f21C t{v�7Arer w
p7/z��04
Lam,` F-T'.T_
70S
5�-tra.G.�..�p�•t�.�. T;-
LOCATION: —71-5 ,5 L byl 'C Sb'A'1'0
SUBDIVISION:
NAME OF OW
OCCUPANCY:
(number & street)
IT/\ I.Nti-Z
(municipality)
LOT(S):
(type) (owner -tenant)
ADMITTED BY: 0A'-fC K
5(L*-1LZ
ACCOMPANIED BY:
KEY AVAILABLE: No
SUFF. CO. TAX MAP NO. 10 0-
-57 - / a
SOURCE OF REQUEST: ti"`
4c"
DATE: 'R to
DWELLING: (�
TYPE OF CONSTRUCTION: # STORIES: ( # EXITS:
FOUNDATION: ra�o� CELLAR: CRAWL SPACE:
TOTAL ROOMS: IST FLR: 2ND FLR: 3RD FLR:
BATHROOMS • TOILET ROOM(S): I _ UTILITY ROOM: mol' -'c
PORCH TYPE: _ DECK, TYPE: W000 PATIO, TYPE: NOS c
BREEZEWAY: FIREPLACE: +,3 o GARAGE: NO
DOMESTIC HOTWATER: .!e TYPE HEATER: •c-�ct AIRCONDITIONING: _
TYPE HEAT: WARM AIR: `',i HOTWATER: I cr4u c
r
OTHER:
ACCESSORY STRUCTURES: n
GARAGE, TYPE OF CONST.: STORAGE, TYPE CONST.:�'t-''`� �'' C
SWIMMING POOL: — GUEST, TYPE CONST: --
OTHER:
VIOLATIONS: CHAPTER 45 & N.Y. STATE UNIFOFM FIRE PREVENTION & BUILDING CODE
I LOCATICA I A _ DESCRIPTION—P. _ e � I ART. I SEC.
o,c J "0 Ttrt �„a i
1411 hktll1 e
o f�..
N
REMARKS: C',, ( I j lM._ 'S c k- w./t n -�"t 1, (0 tF " N a�
Arbo'ji- Pt cva rol{ `M S D -Z
• g i/tib
INSPECTED BY: lti / DCi(/J . i DATE OF INSPECTION: b
TIME START: / t :0o END: it ' 5