HomeMy WebLinkAboutZ-30513 FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 30513 Date: 10/26/04
THIS CERTIFIES that the building DWELLING
Location of Property 995 A/K/A #59 SUNSET LA. GREENPORT
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473689 Section 033 Block 0004 Lot 059
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- 30513 dated OCTOBER 26, 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 HUGH E. & EVELYN A. DRUMM
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMHNT OF BEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
c
tho ized gnature
Rev. 1/61
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 99HA/K/A #H9 SUNSET LA. GREENPORT
SUBDIVISION: HAP HO.: LOT (S)
HAMH OP ONNHR (S): HUGH E. & EVELYN A. DRUMM
OCCUPANCY: SINGLE FAMILY HUGH E. & EVELYN A. DRUMM
ADHITTHD HY: EUGENE DRUMM ACCOHPANI® BY: SAME
RHY AVAILABLE: SUPP. CO. TAX HAP HO.: 33.-4-H9
SOURCE OF REQUBST: H.EUGENE DRUMM 3/28/04 DATE: 10/26 04
DWELLING:
TYPH OP CONSTRIICTIOH: WOOD FRAME $ STORMS: 1.0 # B7IITS: 3
FOUNDATION: CEMENT BLOCK CELLAR: FULL CRANL SPACH:
TOTAL ROOMS: 1ST FLR.: 5 2ND PLR.: 0 3RD PLR.: 0
NATNROOH (S): 1.0 TOILHT ROOM(S): 0.0 DTILITY ROOM(S):
PORCH TYPH: FRONT DHCR TYPH: PATIO TYPH:
HRHEZENAY: PIRHPLACH: ONE GARAGE:
DOHHSTIC HOTNATID2: XX TYPH HEATER: OIL AIRCOHDITIONING:
TYPH NEAT: OIL HARM AIR: HOTNATBf[: XX
OTHBf[:
ACCESSORY STRUCTURES:
GARAGH, TYPE OP CONST.: STORAGE, TYPE CONST.: METAL SHED
SNIlHIMG POOL: GUHST, TYPE CONST.:
OTHHR:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION ~ DESCRIPTION ~ AAT. SEC.
RSHARRS: HP#28972-COZ2394 (ROOM ADDITION & FIREPLACE)
INSPECTBD BY: ~ DATE ON INSPHCTIOH: 05/12/04
TIMH START• 6ND-
Form No. 6
TowN of souTxoLD ~ .''AY S ~
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:
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% 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.
t~ 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 $25:0,
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 Occupancy - $50.00
5. Temporary Certificate of Occupancy -Residential $15.00, Commercial $15.00
Date. b
New Construction: Old or Pre-existing Building: ~ (check on/~e)
Location of Property: ~4 t~u~~'Ji{,6 A, E, (y f2 ~~~t.,to~~z ~
House No. Street Hamlet
Owner or Owners of Property: ~ 2 ~ m M N ~ ~ ~ ~ Lt~~
Suffolk County Tax Map No 1000, Section ~l ~f 'd g 8 q Block Lot ~1- 3~
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval: /
Request for: Temporary Certificate Final Certificate: Y (check one)
Fee Submitted: $ /(y O ~ nn//
pplicant Signature
c~~ cod 305?3
CONSENT TO INSPECTION
'~2L?Y~rr. /~l~.c,/+. ~ # ts, F ,the undersigned, do(es) hereby state:
Owner(s) Name(s)
That the undersigned (is) (are) the owner(s)/~f the premises in the Town of
Southold, located at~~ g L.tS ¢ ~~A at G ({F IZ &E o ~z r ,
which is shown and designated on the Suffolk County Tax Map as District 1000,
Sectionl./7?684, Block I,ot ~ 3q.
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 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 laws, ordinances, rules or
regulations of the Town of Southold.
Dated: -02 fr - b ~~~.~,",.r~
r (Si afore)
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