HomeMy WebLinkAboutZ-30470FORM
TO%~I OF SOUTHOLD
BUILDING DEP~TMENT
Office of the Building Inspector
Town Hall
Southold, N.Y_
PP~E EXISTING
CERTIFICATE OF OCCUPAI~CY
No: Z- 30470
Date: 10/01/04
T}IT~ CERTIFIES ttzat t3ae building DWELLINGS ~kID ACCESSORY
Location of Property 8070 GREAT PECONIC BAY BLVD LALrREL
(HOUSE NO.)
County TaxMap No. 473889 Section 126
Subdivision
(STREET) (HAMLET)
Block 0011 Lot 017
Filed Map No. __ Lot No. __
conforms substantially to the Requirements for a ONE F~34ILY DWELLING
built prior to APRIL 9, 1957 pursuant to which CF=RTIFICATE OF
OCCUPANCY Iq~]MBER Z- 30470 dated OCTOBER 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 TWO ONE FAMILY DWELLINGS WITH SCREENED PORCHES ~iqD OUTDOOR SHOWERS
Ai~D AlU ACCESSORY TWO CAR G-~-P-AGE. *
· ~le certificate is issued to WILBUR F 0SLER III
(OWNER)
of the aforesaid building.
SUFFOI/~ COUNTY DEPARTMENT OF It/~ALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFIC/LTION
*PLEASE SEE ATTACHED INSPECTION REPORT.
N/A
N/A
Rev. 1/81
LOT (S)
WILBUR F OSLER III
8070 GREkT PECOI~IC BAY BL\rD LAUREL
WILBUR F OSLER III
2.0 ~ EXITS: ~0
CI~A~ SPACE: 4/8
kCCESSORY STRUCTURES:
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN H.~kLL
765-1802 ~Q.
APPLICATION 'FOR CERTIFICATE OF OCCUPANCY
This application must be filled, in by typewriter or ink and submitted to the Building Department with the folinwing:
A. For new building or new use:
1. Final survey of propert~ with accurate loca[ion of all buildings, property lines, streets, mad unusual natural or
rap,graphic features.
2. Final Appr°Y~ from l:[ealth Dept. ofwater supply and sewerage'dispusal ~S-9 f°rm)'
3. App,:oval of ~tectrical, ins~allation from Board~ of Fire Underwrkers-
4. ' Sa:om dar~m~nt fram pi'umber certif-fing that'the sold~used ~n ~ste~. ~nm,.~ less th_an 2/!.0 o.f 1% lead.._ .
5. Commercial building, industrial,building, multiPle r%~nces and ~ag buildings and mstanatt°ns' a cemncate
oYCod6 C0m?lianc6 from'architect or engineer re~OnS~I~;for thc buii~g-
6. Submixi l~laaning Board .~ppro~a~ ° f c°mp[ered site plan reqUrrements:
B. For Cxis~g~dings (grior'to ~pril 9; t9~,7) non-conforming uses, or buildings and "pre-existing" land uses:
1..Acanr}~e~s~wey of prOperS/Showing all:,lSroperty lines, s~reets, building and unusual natural or topographic
featu~s. ;.
2..~, L:~rOp~l~o~pl~ted apphcafion and a c°usant t° inspect sigaed bY the applicant' If a Certificate °f Occupancy
i~ d6rfiq~ ~e B~ildlnglnspector Shall state-the read,ns therefor in writing to the applicant.
C. Fees
1_ Certt~cate~f ~ccupancy~ New dwe~ing $25~ Additi~ns t~:dwe~ing $25~ A~terati~ns t~ dwe~ing $25.~
~wimmmgpoc~l $25.00, Accessory build/ag $25.00, Additions to accessory building $25.00, Businesses $50.00.
2. Certificat~ofOcanpancy on Pre-existing Building - $100.00
3. Copy ofG~rtificate ofOcanpancy - $25.00
4. Updatectcertificate of Occupancy - $50_00
5. Tampora~ ~ertificate of Occttpancy- Residential $15.00, Commercial $15.00
Date. September ~7' 2004
(check.ne)'
New Construction:
Location of Property:
Old or Pre-ex/sting Building: X
8070 Peconic Bay Boulevard Laurel
House No. Street Hamlet
Owner or Owners ofProperty: ~ilbur F. Osier, III
Suffolk County Tax Map No 1000, Section 126 Block 11 Lot 17
Subdivision Filed Map_ Lot:
Applicant:
Underwriters Approval:
Permit No. Date of Permit.
Health Dep~- Approval:
Plarming Board Approval:
Request for: Temporary Certificate
Fee Submitted: $ [00.00
Final Certificate: X (check one)
CONSENT TO INSPECT[ON
.Wilbur F...Osler, III
Owner(s-) Name(~)
, the undersigned, do(es) hereby state:
That the undersigned (is) (ate) the owner(s) of the premises in the Tox~m of
Southold. located at~ 8070 Peconic Bay Boulevard, Laurel, New York
' :which is shown'and designated on the S0.ffolk County Tax Map as Dislzict 1000,
Section 126 ,Block :11 ,Lot 17
That the undersigned (has) (t~v~) filed, or crease to be filed, an application in the
Southold Town Building Inspector's OtYme~ for the following:
Certificate of Occupancy on Pr~-existing Building
That the undersigmed de(es) hereby give consent to the Building Inspectors of the
Tow-n of Southold to enter updn the above des.cribed property, including any and all
buildings located thbreon, to conduct such inspections as they may deem necessary with
respect to the aforesgid'application, including inspecfi6ns to determine that said premises
comply with all ofthe law% ord/nances, rules and regulations of the Town of Southold.
The unders/gned, in consenting to such haspections, do(es) so with the knowledge
and understanding that any informatinh obtained in the conduct of such inspections may
be used i~nbaeqUent prosecutions for violations of the laws, ordinances, rules or
regnlationg Of the T6wn of Sonthold_
D~ed: September /7 , 2004
Wilbur F. Osier, 1II
(Print Name)
(Signature)
(Print Name)
N
S
0 ~ ,,,.,
O 0
SURVEY OF
NtD~R HA"FFITUC,F-,
~OLK C.,OUNTY, NY
SURVEYED 10-12-qq
PR.OPOEEiD POROH lO-lO-OD
COVE-RAGE
CI=RTtPIEO TO:
I~ILBU~ F. ODLER III
LOT C_,OVE:_P-.AGE TAf~LE
EXISTING C, OTTA~E f=OOTPRINT
DXIST~'N~ ~Af;~JKGE FOOTPRINT D&] S.F.
EXISTING HOUDE FOOTPRINT
TOTAL LOT COVERAGE 2q04
LOT COVERAGE q.&
PP-.OPO~ED PORCH FOOTPRINT ID& S.F.
LOT (.,OX/'EP--A~E 3040 k.P. OR lO %
NOTES:
· I"dONUI'dENT
0 PiPE
AREA :DO,ID4 5F OR O.,Eq ACRE5
SCALE I"= DO'
JOHN C. E~ERS LA~ SURVEYOr
6 EAST MA~ ST~ET N.Y.S, LIC. NO. 50~2
~VE~, N.Y. 11901
369-8288 F~ 369-8287 ~F.-~GER~ROSX99-2fi[