HomeMy WebLinkAboutZ-30574FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
NO: Z- 30574
Date: 11/22/04
THIS CERTIFIES that the building DWELLING
Location of Property 340 PRIVATE RD #3 SOUTHOLD
(HOUSE NO.) (STREET)
County Tax Map No. 473889 Section 070 Block 0006
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
OCC~tYPANC"fNUMBER Z- 30574 dated NOVEMBER 22, 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.*
(HAMLET)
Lot 005.001
The certificate is issued to PATRICIA A BUERKLE
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF ~IEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION D;Y£~3
*PLEASE SEE ATTACHED INSPECTION REPORT.
N/A
N/A
N/A
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 340 PRIVATE RD #3
SUBDIVISION:
NAME OF (~ (S}: PATRICIA A BUERKLE
OCCUPANCY: SINGLE FAMILY DWELLING
ADMl'rriim BY: PATRICIA BUERKLE
SOUTHOLD
MAP ~0.: LOT (S)
PATRICIA A BUERKLE
ACC~PANII~ BY: SAME
~ AVi~I~I%B~: SLIFF. CO. TAX PAP NO.: 70. 6 5.1
SOURCE OF P~I~ST: PATRICIA BUERKLE DATE: 11/22/04
DWELLING:
TYPE OF CONS~UCTION: WOOD FRAME # ~TORIES:
FODNDATION: CONCRETE BLOCK CEIl: 1/4
2ND FLR.: ~0
TOILET EOO#(S): 0.0
DECK TYPE:
TYPE HEATER: L. P. GAS
HOTNATER:
CRA~ SPACE: 3/4
ACCESSORY STRUCTURES
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
P~: BP4442 DECK C03581; BP6939 ENC PORCH C030573; BP10695 ADD C011099
DATE ON INSPECTION: 11/16/04
MICHAEL J VERITY TI~ START: 10:00AM l~qD: 10:45AM
BUILDING DEPARTMENT
TOWN HALL
76~-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be ~ietl in by typewriter or ink and submitted to the Building Department with the £ollowing:
A. For new b.~ldin~ or new n~e:
i. imal sm vey of propelty with accarate location of all buildings, property lines, streets, and unusual natural or
topographic features.
2. Final Appr°val from Health Dept. of water supply and sewerage_disposal (S_9 form).
3. Approva! 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 Plarming 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. Aocurate survey °f pr°partY showing all property lines, streets, building and unusual natural or topographic
features.
2. A pr°perly c°mpleted 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 Oocupancy- $.25
4. Updated Certificate ofOocupancy - $50.00 /
5. Temporary Certificate of Occupancy _ Residential $15.00, Commei:!cial $15.00
New Construction:
Location of Property:
Date. _ I 0' 21= -~
Old or Pre-existing Building: ~ (check one)
Home No. Street
Owner or Owners of Propca'ty:
Suffolk County Tax Map No 1000, Section
Subdivision
-70 Block ~ Lot
Filed Map.. t Lot:
Applicant:
Underwriters Approval:
Permit No.
Health Dept. Approval:
Planning Board Approval:
Request for:
Date of Permit.
Temporary Certificate
Final Certificate:
(check one)
Haml~t
~ oof
Fee Submitted: $
pRivATE ROAD
( 50, WIo~
hi. 7~
39. ~/ ,
cml
S. 8$'$4'40' W.
· ~o? 4~ ~.~
N/OfF ~;~,; ~ R R & F. LaRIVIERE
--PINE NECK ROAD
SEAL OF THE SURVEYOR
ADOIT'ION,4,~...L y TO COMfy IFITH ,.~ L~IF THE TERM 'ALTERED BY'
~XJST ~ U,,~ B.Y ANY ~ ALL SI.~YO~$ UT'~ ,4 COPY
OF' ANOTI,~ ~.,~YOt~$ M4P. ~ SUCH ~ 'IN.%e'ECTED' 4ND
"~T-TO-D,4 TE° ARE MOT IN CO~NCE F~ITH THE LAW.
AREA = 10,257 ~cI. ft.
SURVEY OF
PROPERTY
A T SOUTHOLD '
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N Y.
1000-,70-06-5.1
SCALE 1"= 20'
AUG_22. ~997
1230 TRAVELER STREET
$OUTHOLD~ N. Y, 11971
97- 264