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Home My WebLink AboutZ-30596FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 30596 Date: 12/04/04 THIS CERTIFIES that the building DWELLING Location of Property 275 MAIN BAYVIEW RD SOUTHOLD (HOUSE NO.) County Tax Map No. 473889 Section 070 Subdivision Filed Map No. Block 0005 Lot 053 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- 30596 dated DECEMBER 4, 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 ACCESSORY TWO CAR GARAGE * The certificate is issued to CHARLOTTE M SMITH (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. Autfaorized Signature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 275 MAIN BAYVIEW RD SOUTHOLD SUBDIVISION: MAP NO.: LOT (S) NAME OF OWNER (S): CHARLOTTE M SMITH OCCUPANCY: SINGLE FAMILY DWELLING CHARLOTTE M SMITH ADMITTED BY: JOSEPH MCCARTHY ACCOMPANIED BY: SAME KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 70.-5-53 SOURCE OF REQUEST: JOSEPH MCCARTHY 11/29/04 DATE: 12/04/04 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME FOUNDATION: CEMENT BLOCK TOTAL ROOMS: 1ST FLR.: 5 BATHROOM (S) 1.0 PORCH TYPE: COVERED FRONT BREEZEWAY: DOMESTIC HOTWATER: YES TYPE BEAT: OIL WARM AIR OTHER: # STORIES: 1.5 # EXITS: 3 CELLAR: FULL CRAWL SPACE: PART. 2ND FLR.: 1 3RD FLR.: 0 TOILET ROOM(S): 0.0 UTILITY ROOM(S): 1 DECK.TYPE: PATIO TYPE: FIREPLACE: ONE GARAGE: TYPE HEATER: OFF BOILER AIRCONDITIONING: HOTWATER: YES ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: 2 CAR WOOD FRAME STORAGE, TYPE CONST.: SWIMMING POOL: GUEST, TYPE CONST.: OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. REMARKS: BP 430710-Z-COZ-30556 (ALTERATION TO PORCH INSPECTED BY: GEORGE GILLEN NO DATE ON INSPECTION: 11/30/04 TIME START: 2:30 PM END: 2:55 PM Form No. 6 TOWN 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: 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. 13. 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 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. New Construction: Old or Pre-existing Building: (check one) Location of Property: 7�� /f/jiBJ�✓ �i9Yjl/L I gU� J0 G iP�� d L D House No. Street Hamlet Owner or Owners of Property; Lo j7;Lr Suffolk County Tax Map No 1000, Section Block Lot Subdivision Filed Map. Lot: Permit No. _ Date of Permit. _ Applicant: TDJJY.#'- Q /ht Y Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate C2_1 Fee Submitted: $ / U (Y,AQ-CO-E,3os 9G Final Certificate: � (check one) 4ulowl_ .. CONSENT TO INSPECTION �( Al 1 1/$ , (yk*14 77� , 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 S B_ /2W6Z 4VVI AI GCL14--o which is shown and designated on the Suffolk County Tax Map as District 1000, Section `70 ' Block _�— Lot 3,� That the undersigned (has) (have) filed, or cause to be filed, an application in the Southold Town Building Inspector's Office for the following: ®IZC C' o ?r D -- 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: (Signature (Print Name) (Signature) (Print Name) 9" Abddir -- — r r :: n. r.: C ac, ✓� i • �i a e o I 4]S - � - -- --'— •-- - ------ � - - _ __ .G G ° I J J °E ( Uel _ x i C7 �I . I oar � o. m I •.L' �_� da' tin � 4 �i p f :+I •JrW 1N t: Ali (:':.' . •'1 _. �] �Lu10 3 .2 rq o _-- ,_�4vAPPROVED A$'NOTED a 171 17. j DATE B.P. A �� f'" i� s. t FEE: ',L BY: - �° — NO 48'OO'W 75.00' NOTIFY BUILDING DEPARTMENT AT J `\ OCCUPANCY OR i " 4 ' = •765.1802 8 AM TO 4 PM FOR THE / FOLLOVONG INSPECTIONS: �5 UNLAWFUL ----- i:-•FOUNOATION - TW9 REQUIRED MAIN BA '�YSYy f OUT CERTIFICATE -FQR POURED CONCRETE' - F j- -- 2.. }JUGH - "I�RAMING'8 PLUMBING jk 31suLaSION PLOT PLAN &O OCCI.)RANCY = j! 4. 'FINAL - CQNSTR.'GT10N MUST c7t r r v1 t r ¢ r.�• • I ljE C.OMP(�7E FOR C.O: sCAle. t =ao 1 I' ALL.1 1 SHALL, MEET THE -RELEME�TSOFtHECODESOFNEW I WARRF,;AYOTATE: NOT FESPONSIBLE FORDEOR ODNSTRUCTIONt ERRORS, Gvr15U TING EHGNEdiI! j P.O 80X 10313 COX LANE of ' . e• .- t- CiJTCHC)GUE. NY ] IM r. •'ii "I 3` -- - ..._. _.. .�liLl CONSTRUCTION SHALL - -- — � _ ntb-75a-»wt ' MEET THE REO STH ' CODES OF NEW YORK STATE.j > ! l9 r ..---