HomeMy WebLinkAboutZ-30509FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 30509
Date: 10/21/04
THIS CERTIFIES that the building DWELLING
Location of Property 450 E CEDAR POINT DR SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 090 Block 0002 Lot 015
subdivision Filed Map No. __ Lot No. __
conforms substantially to the Requirements for a ONE FAMILY DWELLING
built prior to APRIL 9, 1957 pursnant to which CERTIFICATE OF
OCCUPANCY1W~%~BER Z- 30509 dated OCTOBER 21~ 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 WITH GARAGE *
The certificate is issued to ALINA WIEDERMAN
(OWNER)
of the aforesaid building.
SUFFOLK COUNT~ DEPARTMEIqT OF ~RALTH APPROVAL
ELB~-£RICAL CERTIFICATE NO.
pLUMBERS CERTIFICATION
*PLEASE SEE ATTACHED INSPECTION REPORT.
Rev. 1/81
N/A
N/A
N/A
///riz$~ Signature
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 450 E CEDAR POINT DR
N~ OF O~ (S): ALINA WIEDERMAN
OCC~ANCY: RESIDENTIAL
SOUTHOLD
MAP NO.: LOT (S)
ALINA WIEDEP~
~ AVAILABLE= HUFF. CO. T~X ~ NO.: 90. -2-15
SO--CE OF I~ST: JORN NICKLES JR. 8/11/04/ DA~: 10/21/04
DWELLING:
TYPE OF CONSTRUCTION: WOOD
FODNDATI~: POURED CONCRETE
BATH~OC~ (S): 2.0
PORCH ~'PE: REAR COVERED
BP.F~ZEWAY:
DOMESTIC HOTWATER:
T"fPE H~T: OIL
ACCESSORY STRUCTURES:
NONE
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
R~: BP %30675-Z C0Z-30508 (DECK ADD)
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
76S-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 fonn).
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.
(~For to April 9, 1957) non-conforming buildings and "pre-existing" land uses:
buildings
( l or
1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic
features.
2. A propexly completed application and cousent 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 $~T6~.'~01~
3. Copy of Certificate of Occupancy - $.25
4. UpdatedCertificateofOccupancy- $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
New Construction: Old or Pre-existing Building: ~" (check one)
LocationofProperty: 2-t/,~ ~. ~ L~-~le.~ t9 O l '~J T .2)J~l l./ ~ .~ O l~ lTq: O & ~
House No. Street
Owner or Owners of Property: //)/~/'//)/O /,/]l~-~E)
Suffolk County Tax Map No 1000, Section tS~O Block ~
Date. ~[g~ /1, ~OO~
lr g 7/
Hamlet
Subdivision Filed Map.
Permit No. Date of Permit. Applicant:
Health Dept. Approval:
Planning Board Approval:
Underwriters Approval:
Request for: Temporary Certificate
' Fee Submitted: $ .//9t9. OtJ
Final Certificate: (check one)
~"~ Applicant Sd~nature
CONSENT TO INSPECTION
~A)/2.~ ~ ~tt~f) f) , 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 at
which is sho~ ~d desi~at~ on ~e Suffolk Co~ty T~ Map ~ DisMct 1000,
Section ~O , Block
That the undersigned (has) !~have) filed, or cause to be fil..~ed, an~ .apspli. cati? in the
Southold Town Building Inspector s Office for the follqwing: ~
That the undersigned do(es) hereby give consent to th9 Building Inspectors of the
Town of Southold to enter upon the above described proper~j, 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:
(Sigoature)
(Print Name)
(Signature)
(Print Name)
76S.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] FIREPLACE & CHIMNEY
[ ] ROUGH PLBG.
[ ] INSULATION
[ ] FINAL
REMARKS:
DATE
INSPECTOR ~)~.(X-(~-~'~.;
SURVEY OF
LOT 107 & P/0 LOT 108
" MAP OF
~, CEDAR BEACH PARK
N FILE No. 90 FILED DECEMBER 20, 1927
~ SITUA TED A T
'-~. . · BAYVIEW
~,, TOWN OF SOUTHOLD
,,, '~..,: .., SUFFOLK COUNTY. NEW YORK
~'~, S.C. TAX No. 1000-90-02-15
'~'. ~'". ' SCALE 1"=30'
~ ~ ~'L ' ~ JULY 26, 2004
A ,~6~ 5
,o..,,,u~,,,,~,o~,,o.o, Joseph ~k Ingegno
COp,E, OF ~r~ ~u~ MAP NOT .~,lNG Land Surveyor
FLOOD ZONE INFORMATION TAKEN FROM: c~r~cAT~o~s ~.~m~[D H~.m. SH*LL ~UN
FLOOD INSURANCE RATE MAP NO. 36103C0169 G ONL~TOm~ ~E.SO. rO. WHOa mE SU.V~
24-242