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Home My WebLink AboutZ-30676 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- 30676 Date: O1 07 OS THIS CERTIPIES that the building DWELLING Location of Property 1769 SMITH RD PECONIC (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473869 Section 098 Block 0004 Lot 020 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 CERTIPICATE OF OCCUPANCY NUMBER Z- 30676 dated JANUARY 7, 2005 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 SEASONAL DWELLING WITH ATTACHED GARAGE* The certificate is issued to CAROL DOEBLER FOEHR (OWNER) of the aforesaid building. SUPPOLIC COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATBD N/A *PLEASE SEE ATTACHED INSPECTION REPORT. ~~~iy ~ Authorized Signature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT IACATION: 1769 SMITH RD PECONIC SUBDIVISION: MAP NO.: I.O'P IS) NAME OF ONNIDt (S): CAROL DOEHLER FOEHR OCCUPANCY: SINGLE FAMILY DWELLING CAROL DOEBLER FOEHR AIk1ITT® BY: TOM UHLINGER ACCOMPANIED BY: SAME RHY AVAILABLE: SUFF. CO. TAX MAP NO.: 9H.-4-20 SOURCB OP REQUEST: THOMAS UHLINGER 1/3/05 DATE: O1 07 OS DWELLING: TYPH OP CONSTRUCTION: WOOD FRAME R STORMS: 1.0 R ®CITS: 2 FOUNDATION: PILINGS CBLLAR: NO CRANL SPACE: TOTAL ROOMS: 1ST PLR.: 6 2ND PLR.: 0 3RD PLR.: 0 BATHROOM(S): 2.0 TOIL4P ROOM(S): 0.0 UTILITY ROOM(S): ONE PORCH TYPE: REAR COVERED DECX TYPE: NO PATIO TYPB: NO HRBBZHNIIY: FIREPLACE: ONE GARAGE: 2 CAR ATTACHED DOMBSTIC HOTNATHR: YES TYPE HEATB&: NONE AIRCONDITIOHING: TYPH HEAT: NONE iD1RM AIR: HOTMATER: ELECTRIC OTHER: ACCESSORY STRUCTURES: GARAGB, TYPE OP CONST.: STORAGE, TYPE COHST.: SMII4IING POOL: GUBST, TYPH CONST.: OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION ~ DESCRIPTION ~ ART. ~ SEC. R@IARRS: INSPECTED BY: DATE ON INSPECTION: OS 06 04 GEORGE GILLEN TIMB START: 11:30 AM END: 11:55 AM r^ ~ I~K' 5 ~ ' Form No. 6 TOWN OF SOUTHOLD ? _ ~ 3 .Z7 , BUILDING DEPARTMENT b I ~o J 7 TOWN HALL Gp~ 2r7 ~ _ ~CR1~ .IAN 3 76s-lsoz v Z gJ 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 Boazd of Fire Underwriters. 4. Swom 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 similaz buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Plazming Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 19s7) 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 Fre-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 D~at/e.~ ~~J~rrt 4 3, 2 dO~ New Construction: p, Old or Pre-existing Building: ? (check on(e~ Location of Property: ~ 7 6 / Sih t rl.lt- ~2~ ?t~ r t~ CG A/ I House No. A~ nn `Street Hamlet Owner or Owners of Property: ~ ~K 0 ~-qt !J . ~oE (T 2 Suffolk County Tax Map No 1000, Section Q / g Block O Lot Q ~ y Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: ~ (check one) m! Fee Submitted: $ ~ . ~ 'I [J3Yte,.~ Applican gnature ~~Co X30 6 76 C/d-+~~ ~~~n Jan 03 2005 10:07RM Rnthony J. Centone, P. C. 914-993-0654 p.2 a<, 6WKYY Y .LOT D MAP OF INDIAN-NECK Pq~tK LgNR6 "fi PECONIC TOWN OF SOUTHOLD SUF~OLK COUNTY. N.Y: 1 SURVE7ED FOR: 'KATHRYN FARRAND jy~ Ff'W11) #w . ~~J 0~1TE~f¢EO Wr 47, 191} KEN8iAN0 ti-.~ O P iNE JWIQK 11RE 840R.wCE EGENCY. 1LZ TY/ 1000-0404-040 BRRK. OF MAENCA NE F unw f`, ! Iowa Wwr wr X 5E'07' 84, 2 .my ~`E .30' h~E ~ y ~y~ F GEYM1:1 K ~ ~ M f R+ (PM1 Of t01 El Cvy ~~yMyMI~Ly~M~ N M YWR V MYM.f MyM: WW~Mi] lItWf+PW y KOPp.:u MU4YtP OMi P y ~ MwLYV~i F~b~ yµ • w IY! ew+s M Jlw[/r• iRYw/L ' II[ W.0 yF(MI MO® F4 YW. _ O W ~ ~f OllfOfOWRI. '4f0 wK O Z + . o~ ( $ ` q + N r l u 6 ~s. ~ I.~' ~ f 5 e' b.t ~ ~ - ~ •~]ME SLOP/ - ` R6vR6xcc ~ ~ rG - , 6 ~ 5. J' a 5' . ' F •:':R:. [ t a ' r } u m b ` A 1 w m 4 q SUNYETEO: JO MVfM9EP 2v.- SCV.E I`~ fo' hRU ~ 30J>6 Sr. OR J ]06 4CPC5 ate uF ~~~~{~tt irf Q `T .,24.E ,v 56 ~~1~`C L'~l SURSE~EDEBYJ. 15ARSc'^:. ~:c. PIJ~. P. D. BOX 29S / ~ NEw SuP~V1-!<. n1_r. I V~~jfc ~ 1 67 R-734 583°. ENSEG d^~EL ?rF E,: .,,.EIg273 ~137a CONSENT TO INSPECTION ~i~-~L ~F Q~ f} it ,the undersigned, do(es) hereby state: Owner(s) Name(s) That the undersigned (is) (are) the owner(s) of the premis gsin the Town of Southold, located at / ~ro 9 SM ~ ~ ~ Q, ~l~ f'J~~ t L , which is shown and designated on the Suffolk County Tax Map as District 1000, Section Q~ ,Block d ~ ,Lot 0.2 0 That the undersigned (has) (have) filed, or cause to be filed,a~ application in they" Southold Town Building Inspector's Office for the following: Y2E-~~i.ST. G.O. 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: I 3 LOSS ~ (Signal ~ 1- ~ - (Print Name) (Signature) (Print Name) b ,~F-gea ~ ~