HomeMy WebLinkAboutZ-30648FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 30648 Date: 12/21/04
T~IS CERTIFIES that the building
DWELLING
Location of Property 600 KOKE DR
(HOUSE NO.)
County Tax Map NO. 473889 Section 087
SOUTHOLD
Subdivision
(STREET) (HAMLET;
Block 0005 Lot 005
Filed Map No. -- Lot No.
conforms su]~stantially to the Requirements for a ONE FAMILY DWELLING
built prior to APRIL 9, 1957 pursuant to which CERTIFICAT~ OF
OCCUPANCY NUMBER Z- 30648 dated DECEMBER 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 *
The certificate is issued to HOWARD WEKERLE & ORS.
(OWNER)
of 5he aforesaid building.
SUFFOLK COUlF~Y DEPARTMENT OF ~ALT~t APPROVAL
ELEC~RICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DA'rmu
*PLEASE SEE ATTACHED INSPECTION REPORT.
N/A
N/A
N/A
~~uth'oriz ed Signature
Rev. 1/81
BUILDING DEPARTMENT
TOW~ OF SOUTHOLD
ROUSING CODE INSPECTION REPORT
LOCATION: 600 KOKE DR SOUTHOLD
SUBDIVISION: ~ NO.: LOT (S)
NAMK OF O~ (S}: HOWA~RD WEKERLE & ORS.
OCCUPANCY: RESIDENTIAL
ADMITTED BY: N~/ICY CERVELLI
HOWARD WEKERLE & ORS.
DATE: 12/21/04
ACCESSORY STRUCTURES:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION AR?. SEC.
R~: BP#14337Z-COZ16053{ADD)BP#19486Z-COZ20149 IENCLOSE DECK)
INSPECTED BY: - DATE ON INSPECTION: 12/00/04 & re[~s~ected 12/20/04
Form No. 6
TOXVN OF SOUTHOLD
BUILDING DEPARTMENT
TO%q~ H.&LL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This app cat on must be filled in bv 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 Underxvriters.
4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead.
5. Conunercial building, industrial building, multiple residences and si~rfilar buildings and installations, a certificate
of Code Compliance from architect or engineer responsible for the building.
6. Submit Plmming Board Approval of completed site plan requirements.
B. ,'*or existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses:
1. Accurate sm;,ey 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 xvriting 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 - $l 00.00
3. Copy of Certificate of Occupancy - $.25
4. Updated Certificate of Occupancy- $50.00
5. Tempora .ry--Ce?ti.ficate of Occupancy - Residential $15.00, Conunercial $15.00
Date. November 18, 2004
Nexv Construction:
Old or Pre-existing Building: X
(check one)
LocationofProperty: 600 Koke Dr., Southold, ~
House No.
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section 81
Subdivision
Street
Howard l,/ekerle and others
PernfitNo. DateofPernait.
Block 5
Filed Map.
Applicant:
Health Dept. Approval:
Plamfing Board Approval:
Request for: Temporary Certificate
Fee Submitted: $ 100o00
Unde~wvriters Approval:
Final Certificate:
OLSEN & OLSEN LLP
32495 MAIN ROAD
PO BOX706
CUTOHOGUE, NY11935
Hamlet
Lot 5
Lot:
X
(cbec k one )
.X
CONSENT
TO "
iNSPECTION
Gary Flnnner Olsen as attorney for Howard ~/ekerle and others , the undersigned,
Owner(s) Name(s)
do(es) hereby stat(::
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at 600 Koke Dr., $outhold
· which is shown and designated on the Suffolk
County tax map as District 100O, Section 87 , Block 5 , Lot 5
That thc undersigned (has) (have) filed, 'or caused to be filed, an applica-
tion in'th,, Sou[hold Town Llullcling lnsp~uL,....~ o~£~oo £o.. ~h,~ fnl]nwin~:
T~o story frame house ~rlth porch
That the undersigned do(es) hereby give consent to the Building Inspectors
of the Town o~Soufl~oldto 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 or[he laws. ordinances, rules
and regulations or the Town of Sou[hold.
The undersigned, in consenting to such inspections, do(es) so with the
knowledge and understanding that any information obtained In the conduct
such inspections mafbe used as evidence in subsequent prosecutions for vio-
lations o6 the la~vs, ordinances, rules or regulations of the To~vn of Sou[hold.
Dated:
David Worthington Olsen
-- ' (prin~ name)
(signature)
(print name)
.~04 12:25 6317653803 C21 AGAWAM ALBERTSON ~